WorldWideScience

Sample records for health impact scale

  1. 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.

  2. Validation of a French language version of the Early Childhood Oral Health Impact Scale (ECOHIS

    Directory of Open Access Journals (Sweden)

    Veronneau Jacques

    2008-01-01

    Full Text Available Abstract Background An English language oral health-related negative impact scale for 0–5 year old infants (the Early Childhood Oral Health Impact Scale [ECOHIS] has recently been developed and validated. The overall aim of our study was to validate a French version of the ECOHIS. The objectives were to investigate the scale's: i internal consistency; ii test-retest reliability; iii convergent validity; and iv discriminant validity. Methods Data were collected from two separate samples. Firstly, from 398 parents of children aged 12 months, recruited to a community-based intervention study, and secondly from 94 parents of 0–5 year-old children attending a hospital dental clinic. In a sub-sample of 101 of the community-based group, the scale was distributed a second time two weeks after initial evaluation. Internal consistency was evaluated through generation of Cronbach's alpha, test-retest reliability through intra-class-correlation coefficients (ICC, convergent validity through comparing scale total scores with a global evaluation of oral health and discriminant validity through investigation of differences in total scale scores between the community- and clinic-based samples. Results Cronbach's alpha for both the child and family impact sections was 0.79, and for the whole scale was 0.82. The ICC was 0.95. Mean ECOHIS scores for parents rating their child's oral health as "relatively poor", "good" and "very good" were 10.8, 3.4 and 2.7 respectively. In the community- and clinic-based samples, the mean ECOHIS scores were 3.7 and 4.9 respectively. Conclusion These results suggest this French language version of the ECOHIS is valid.

  3. 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.

  4. Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.

    Science.gov (United States)

    Dykes, Patricia C; Hurley, Ann C; Brown, Suzanne; Carr, Robyn; Cashen, Margaret; Collins, Rita; Cook, Robyn; Currie, Leanne; Docherty, Charles; Ensio, Anneli; Foster, Joanne; Hardiker, Nicholas R; Honey, Michelle L L; Killalea, Rosaleen; Murphy, Judy; Saranto, Kaija; Sensmeier, Joyce; Weaver, Charlotte

    2009-01-01

    In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.

  5. Impact of terrorism on health and Hospital Anxiety Depression Scale screening in medical students, Karachi, Pakistan.

    Science.gov (United States)

    Nasim, Sara; Khan, Mahjabeen; Aziz, Sina

    2014-03-01

    To determine the association of terrorism with psychiatric morbidity by Hospital Anxiety Depression scale among medical students in Karachi, Pakistan. The questionnaire based cross-sectional survey was conducted from February to March 2011 and comprised students of the Institute of Physical and Medical Rehabilitation and the Dow Medical College, Dow University of Health Sciences, Karachi. The study tool was a validated Hospital Anxiety Depression scale questionnaire. The data was analysed on SPSS 16. Factor analysis was performed to check which factors had the most influence. Overall there were 1036 respondents. The impact of terrorism on physical, social and mental health was 40 (3.9%), 178 (17.2%) and 818 (79%) respectively. There was an association of terrorism in 980 (84.6%) respondents with psychiatric morbidity. There was an association of terrorism with psychiatric morbidity in majority of respondents. The significant risk factors were age, gender, physical, mental and social health and the desire to live in Pakistan.

  6. Impacts of Scale on Geographic Analysis of Health Data: An Example of Obesity Prevalence

    Directory of Open Access Journals (Sweden)

    Jay Lee

    2014-10-01

    Full Text Available The prevalence of obesity has increased dramatically in recent decades. It is an important public health issue as it causes many other chronic health conditions, such as hypertension, cardiovascular diseases, and type II diabetics. Obesity affects life expectancy and even the quality of lives. Eventually, it increases social costs in many ways due to increasing costs of health care and workplace absenteeism. Using the spatial patterns of obesity prevalence as an example; we show how different geographic units can reveal different degrees of detail in results of analysis. We used both census tracts and census block groups as units of geographic analysis. In addition; to reveal how different geographic scales may impact on the analytic results; we applied geographically weighted regression to model the relationships between obesity rates (dependent variable and three independent variables; including education attainment; unemployment rates; and median family income. Though not including an exhaustive list of explanatory variables; this regression model provides an example for revealing the impacts of geographic scales on analysis of health data. With obesity data based on reported heights and weights on driver’s licenses in Summit County, Ohio, we demonstrated that geographically weighted regression reveals varying spatial trends between dependent and independent variables that conventional regression models such as ordinary least squares regression cannot. Most importantly, analyses carried out with different geographic scales do show very different results. With these findings, we suggest that, while possible, smaller geographic units be used to allow better understanding of the studies phenomena.

  7. Measuring the effects of online health information: Scale validation for the e-Health Impact Questionnaire.

    Science.gov (United States)

    Kelly, Laura; Ziebland, Sue; Jenkinson, Crispin

    2015-11-01

    Health-related websites have developed to be much more than information sites: they are used to exchange experiences and find support as well as information and advice. This paper documents the development of a tool to compare the potential consequences and experiences a person may encounter when using health-related websites. Questionnaire items were developed following a review of relevant literature and qualitative secondary analysis of interviews relating to experiences of health. Item reduction steps were performed on pilot survey data (n=167). Tests of validity and reliability were subsequently performed (n=170) to determine the psychometric properties of the questionnaire. Two independent item pools entered psychometric testing: (1) Items relating to general views of using the internet in relation to health and, (2) Items relating to the consequences of using a specific health-related website. Identified sub-scales were found to have high construct validity, internal consistency and test-retest reliability. Analyses confirmed good psychometric properties in the eHIQ-Part 1 (11 items) and the eHIQ-Part 2 (26 items). This tool will facilitate the measurement of the potential consequences of using websites containing different types of material (scientific facts and figures, blogs, experiences, images) across a range of health conditions. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. A multi-scale health impact assessment of air pollution over the 21st century.

    Science.gov (United States)

    Likhvar, Victoria N; Pascal, Mathilde; Markakis, Konstantinos; Colette, Augustin; Hauglustaine, Didier; Valari, Myrto; Klimont, Zbigniew; Medina, Sylvia; Kinney, Patrick

    2015-05-01

    Ozone and PM₂.₅ are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM₂.₅ under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109,000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM₂.₅ changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios. Multi-scale HIAs can illustrate the difference in direct consequences of costly mitigation policies and provide results that may help decision-makers choose between different policy alternatives at different scales. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Regional and urban down scaling of global climate scenarios for health impact assessments

    Energy Technology Data Exchange (ETDEWEB)

    San Jose, R.; Perez, J. L.; Perez, L.; Gonzalez, R. M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-07-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meteorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed down scaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the no feedback simulation is lower than when we activate the feedback effects. (Author)

  10. The impact of Health Information Technology (I-HIT) Scale: the Australian results.

    Science.gov (United States)

    Cook, Robyn; Foster, Joanne

    2009-01-01

    One of role of the nurse in the clinical setting is that of co-ordinating communication across the healthcare team. On a daily basis nurses interact with the person receiving care, their family members, and multiple care providers thus placing the nurse in the central position with access to a vast array of information on the person. Through this nurses have historically functioned as "information repositories". With the advent of Health Information Technology (HIT) tools there is a potential that HIT could impact interdisciplinary communication, practice efficiency and effectiveness, relationships and workflow in acute care settings [1][3]. In 2005, the HIMSS Nursing Informatics Community developed the I-HIT Scale to measure the impact of HIT on the nursing role and interdisciplinary communication in USA hospitals. In 2007, nursing informatics colleagues from Australia, Finland, Ireland, New Zealand, Scotland and the USA formed a research collaborative to validate the I-HIT in six additional countries. This paper will discuss the background, methodology, results and implications from the Australian I-HIT survey of over 1,100 nurses. The results are currently being analyzed and will be presented at the conference.

  11. The impact of the design of payment scales on the willingness to pay for health gains

    NARCIS (Netherlands)

    L. Soeteman (Lotte); N.J.A. van Exel (Job); A. Bobinac (Ana)

    2016-01-01

    textabstractThe questionnaire format applied in a CV study represents the way in which the WTP estimates are obtained. Payment scales are often used in CV studies as the questionnaire format of choice. The study summarized here analyzes the impact of the design of two payment scales (PS) on the

  12. The Malay version of the Early Childhood Oral Health Impact Scale (Malay-ECOHIS)--assessing validity and reliability.

    Science.gov (United States)

    Hashim, Azlina N; Yusof, Zamros Y M; Esa, Rashidah

    2015-11-25

    The Early Childhood Oral Health Impact Scale (ECOHIS) is used to assess oral impacts on the quality of life of preschool aged children and their families. The objective of this study was to perform a cross-cultural adaptation of the ECOHIS into Malay and assess its psychometric properties. The cross-cultural adaptation of ECOHIS into Malay comprised of translating the ECOHIS into the Malay language (Malay-ECOHIS) by experts followed by face validation of the Malay-ECOHIS by a group of mothers. The Malay-ECOHIS was back translated into English and this was compared with the original ECOHIS. Minor changes were made to the Malay-ECOHIS before it was finalised. The Malay-ECOHIS' psychometric properties were assessed in terms of construct, convergent and discriminant validity as well as internal and test-retest reliability based on two separate studies involving 127 parents of 4-6 year old preschool children followed by oral examinations of 860 preschool children from 25 kindergartens from two districts in Selangor state, Malaysia. Non-parametric statistics were used to assess the relationships between the Malay-ECOHIS and the subjective and clinical outcome measures. The Cronbach's alpha was 0.83 and the weighted Kappa was 0.95 (intraclass correlation = 0.94). The Malay-ECOHIS demonstrated significant associations with different subjective and normative measures, i.e. levels of oral health satisfaction, perceived oral health status, perceived oral health need, toothache experience, pattern of dental attendance, and caries status of preschool children. These significant associations supported its construct, convergent and discriminant validity as well as internal and test-retest reliability. This study showed that the Malay-ECOHIS is a valid and reliable instrument to assess the negative impacts of oral disorders/conditions on the quality of life of 4-6 year old preschool children and their families in Malaysia.

  13. The impact of human immunodeficiency virus (HIV) service scale-up on mechanisms of accountability in Zambian primary health centres: a case-based health systems analysis.

    Science.gov (United States)

    Topp, Stephanie M; Black, Jim; Morrow, Martha; Chipukuma, Julien M; Van Damme, Wim

    2015-02-18

    Questions about the impact of large donor-funded HIV interventions on low- and middle-income countries' health systems have been the subject of a number of expert commentaries, but comparatively few empirical research studies. Aimed at addressing a particular evidence gap vis-à-vis the influence of HIV service scale-up on micro-level health systems, this article examines the impact of HIV scale-up on mechanisms of accountability in Zambian primary health facilities. Guided by the Mechanisms of Effect framework and Brinkerhoff's work on accountability, we conducted an in-depth multi-case study to examine how HIV services influenced mechanisms of administrative and social accountability in four Zambian primary health centres. Sites were selected for established (over 3 yrs) antiretroviral therapy (ART) services and urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (2 wks/centre) and key informant interviews (14). Resource-intensive investment in HIV services contributed to some early gains in administrative answerability within the four ART departments, helping to establish the material capabilities necessary to deliver and monitor service delivery. Simultaneous investment in external supervision and professional development helped to promote transparency around individual and team performance and also strengthened positive work norms in the ART departments. In the wider health centres, however, mechanisms of administrative accountability remained weak, hindered by poor data collection and under capacitated leadership. Substantive gains in social accountability were also elusive as HIV scale-up did little to address deeply rooted information and power asymmetries in the wider facilities. Short terms gains in primary-level service accountability may arise from investment in health system hardware. However, sustained improvements in service quality and

  14. Validations of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS Validação da versão brasileira do Early Childhood Oral Health Impact Scale (ECOHIS

    Directory of Open Access Journals (Sweden)

    Paulo Antônio Martins-Júnior

    2012-02-01

    Full Text Available This study aimed to evaluate the psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS. A total of 247 children aged 2 to 5 years and their parents/guardians participated in this study. A clinical oral examination was performed and the parents/guardians completed the ECOHIS questionnaire. Within a period of four-weeks, 20% of the participants repeated the ECOHIS questionnaire. Construct validity was determined using Spearman's rank correlation. Discriminant validity, internal consistency and test-retest reliability were also evaluated. The children were divided into 2 groups: group 1 (with dental caries and group 2 (caries-free. Children with caries showed higher mean ECOHIS scores than the caries-free children. The child impact section (p O objetivo deste estudo foi avaliar as propriedades psicométricas da versão brasileira do Early Childhood Oral Health Impact Scale (ECOHIS. Duzentas e quarenta e sete crianças de 2 a 5 anos e seus pais/cuidadores foram convidados a participar. Foi realizado exame clínico bucal e os pais completaram o ECOHIS. Após quatro semanas, 20% dos participantes responderam ao ECOHIS pela segunda vez. A validade de construto foi determinada através da correlação de Spearman. A validade discriminante, consistência interna e confiabilidade teste-reteste foram avaliadas. As crianças foram divididas em dois grupos: grupo 1 (com cárie e grupo 2 (sem cárie. As crianças com cárie tinham maiores escores médios do ECOHIS do que as crianças sem cárie. Os domínios impacto na criança (p < 0,01, impacto na família (p < 0,01 e escores totais ECOHIS (p < 0,01 foram significativamente correlacionados com dentes cariados. Coeficientes alfa de Cronbach demonstraram consistência interna satisfatória. A versão brasileira do ECOHIS é apropriada para a avaliação da qualidade de vida relacionada à saúde bucal em crianças pré-escolares de pais cuja língua prim

  15. The health and economic impact of scaling cervical cancer prevention in 50 low- and lower-middle-income countries.

    Science.gov (United States)

    Campos, Nicole G; Sharma, Monisha; Clark, Andrew; Lee, Kyueun; Geng, Fangli; Regan, Catherine; Kim, Jane; Resch, Stephen

    2017-07-01

    To estimate the health impact, financial costs, and cost-effectiveness of scaling-up coverage of human papillomavirus (HPV) vaccination (young girls) and cervical cancer screening (women of screening age) for women in countries that will likely need donor assistance. We used a model-based approach to synthesize population, demographic, and epidemiological data from 50 low- and lower-middle-income countries. Models were used to project the costs (US $), lifetime health impact (cervical cancer cases, deaths averted), and cost-effectiveness (US $ per disability adjusted life year [DALY] averted) of: (1) two-dose HPV-16/18 vaccination of girls aged 10 years; (2) once-in-a-lifetime screening, with treatment when needed, of women aged 35 years with either HPV DNA testing or visual inspection with acetic acid (VIA); and (3) cervical cancer treatment over a 10-year roll-out. We estimated that both HPV vaccination and screening would be very cost-effective, and a comprehensive program could avert 5.2 million cases, 3.7 million deaths, and 22.0 million DALYs over the lifetimes of the intervention cohorts for a total 10-year program cost of US $3.2 billion. Investment in HPV vaccination of young girls and cervical cancer screen-and-treat programs in low- and lower-middle-income countries could avert a substantial burden of disease while providing good value for public health dollars. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  16. Elders Health Empowerment Scale

    Science.gov (United States)

    2014-01-01

    Introduction: Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Objective: Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. Methods: The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. Results: The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. Conclusions: HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs. PMID:25767307

  17. Differences between Magnitudes and Health Impacts of BC Emissions Across the United States using 12 km Scale Seasonal Source Apportionment

    Czech Academy of Sciences Publication Activity Database

    Turner, M.D.; Henze, D.K.; Hakami, A.; Zhao, S.; Resler, Jaroslav; Carmichael, G.; Stanier, C.; Baek, J.; Sandu, A.; Russell, A.G.; Nenes, A.; Jeong, G.; Capps, S.; Percell, P.; Pinder, R.; Napelenok, S.; Bash, J.; Chai, T.

    2015-01-01

    Roč. 49, č. 7 (2015), s. 4362-4371 ISSN 0013-936X Institutional support: RVO:67985807 Keywords : air quality * health impact * source apportionment * adjoint * particulate matter * black carbon Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 5.393, year: 2015

  18. Regionalized life cycle impact assessment of air pollution on the global scale: Damage to human health and vegetation

    Science.gov (United States)

    van Zelm, Rosalie; Preiss, Philipp; van Goethem, Thomas; Van Dingenen, Rita; Huijbregts, Mark

    2016-06-01

    We developed regionalized characterization factors (CFs) for human health damage from particulate matter (PM2.5) and ozone, and for damage to vegetation from ozone, at the global scale. These factors can be used in the impact assessment phase of an environmental life cycle assessment. CFs express the overall damage of a certain pollutant per unit of emission of a precursor, i.e. primary PM2.5, nitrogen oxides (NOx), ammonia (NH3), sulfur dioxide (SO2) and non-methane volatile organic compounds (NMVOCs). The global chemical transport model TM5 was used to calculate intake fractions of PM2.5 and ozone for 56 world regions covering the whole globe. Furthermore, region-specific effect and damage factors were derived, using mortality rates, background concentrations and years of life lost. The emission-weighted world average CF for primary PM2.5 emissions is 629 yr kton-1, varying up to 3 orders of magnitude over the regions. Larger CFs were obtained for emissions in central Asia and Europe, and smaller factors in Australia and South America. The world average CFs for PM2.5 from secondary aerosols, i.e. NOx, NH3, and SO2, is 67.2 to 183.4 yr kton-1. We found that the CFs for ozone human health damage are 2-4 orders of magnitude lower compared to the CFs for damage due to primary PM2.5 and PM2.5 precursor emissions. Human health damage due to the priority air pollutants considered in this study was 1.7·10-2 yr capita-1 worldwide in year 2010, with primary PM2.5 emissions as the main contributor (62%). The emission-weighted world average CF for ecosystem damage due to ozone was 2.5 km2 yr kton-1 for NMVOCs and 8.7 m2 yr kg-1 for NOx emissions, varying 2-3 orders of magnitude over the regions. Ecosystem damage due to the priority air pollutants considered in this study was 1.6·10-4 km2 capita-1 worldwide in 2010, with NOx as the main contributor (72%). The spatial range in CFs stresses the importance of including spatial variation in life cycle impact assessment of

  19. 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....

  20. 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…

  1. Future health impact assessment of air pollution at the global, European and Ile-de-France scales: the Air Pollution Climate Health Impact Assessment (A-C HIA) project

    International Nuclear Information System (INIS)

    Likhvar, Victoria; Hauglustaine, Didier; Kinney, Patrick; Colette, Augustin; Valari, Myrto; Markakis, Konstandinos; Pascal, Mathilde; Medina, Sylvia

    2016-01-01

    Ozone and fine particles are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. The overall objective of the A-C HIA project (2011-2014) was to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of O 3 and PM2.5 under different scenarios of emissions for the period 2030-2050. A-C HIA created an interdisciplinary team to study the impacts of climate change on health through air quality changes, and to establish longer-term collaborations between communities. This question has been explored at three spatial scales: global, regional (Europe), and urban (ile-de-France). We f ind that 1.5 millions of cardio-vascular deaths could be delayed each year in 2030 compared to 2010. In Europe, air-pollution-related mortality should decrease in 2030 compared to 2010. At the finer scale (ile-de-France) we found that the respiratory mortality should increase over the highly populated area of Paris. In the coming years, substantial benefits to public health could be achieved through coordinated strategies to reduce emissions of greenhouse gases and improving air quality. (authors)

  2. A Scale of Mobbing Impacts

    Science.gov (United States)

    Yaman, Erkan

    2012-01-01

    The aim of this research was to develop the Mobbing Impacts Scale and to examine its validity and reliability analyses. The sample of study consisted of 509 teachers from Sakarya. In this study construct validity, internal consistency, test-retest reliabilities and item analysis of the scale were examined. As a result of factor analysis for…

  3. Correlation and comparative analysis of discriminative validity of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Early Childhood Oral Health Impact Scale (ECOHIS) for dental caries.

    Science.gov (United States)

    Fernandes, Izabella Barbosa; Ramos-Jorge, Joana; Ramos-Jorge, Maria Letícia; Bönecker, Marcelo; Abanto, Jenny; Marques, Leandro Silva; Paiva, Saul Martins

    2015-03-10

    The perceptions of parents and children regarding oral health are useful to oral public health and clinical practice in pediatric dentistry. The primary aim of the present study was to evaluate the correlation between the total and item scores of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) (parental version and child's self-reports) and the Early Childhood Oral Health Impact Scale (ECOHIS). Subsequently, the discriminative validity of these assessment tools regarding dental caries was compared. One hundred twenty-one children randomly selected in the city of Diamantina (Brazil) were submitted to oral examinations. Parents answered the ECOHIS and SOHO-5p (parental version) and children answered the SOHO-5c (child's self-reports). Statistical analysis involved the Mann-Whitney test as well as the calculation of Spearman's correlation coefficients. A significant correlation was found between the SOHO-5p and ECOHIS (r = 0.85), whereas no significant correlations were found between the SOHO-5c and SOHO-5p (r = 0.00) or between the SOHO-5c and ECOHIS (r = -0.41). Significant differences in the impact on quality of life were found between children with severe decay and no severe decay (caries free, with initial or established caries) both the ECOHIS and SOHO-5p (p ≤ 0.05), whereas no difference was found in SOHO-5c (p > 0.05). The ECOHIS and SOHO-5p were correlated with each other. The accounts of the children differed from their parents' reports and were not capable of discriminating dental caries in advanced stages of progression.

  4. Mercury exposure and health impacts among individuals in the artisanal and small-scale gold mining community: a comprehensive review.

    Science.gov (United States)

    Gibb, Herman; O'Leary, Keri Grace

    2014-07-01

    Mercury (Hg) is used in gold mining to extract gold from ore by forming "amalgam"-a mixture composed of approximately equal parts mercury and gold. Approximately 15 million people, including approximately 3 million women and children, participate in artisanal small-scale gold mining (ASGM) in developing countries. Thirty-seven percent of global air emissions of Hg are produced by ASGM. The recently adopted Minamata Convention calls for nations to gather health data, train health-care workers, and raise awareness in regard to ASGM activity. The purpose of our review was to evaluate the current literature regarding the health effects of Hg among those working and/or living in or near ASGM communities. We searched PubMed, ScienceDirect, and Google Scholar for studies relating to health effects and biomarkers of Hg exposure in ASGM communities. Articles published from 1990 through December 2012 were evaluated for relevance. Studies reporting health assessments, kidney dysfunction, neurological disorders and symptoms, and immunotoxicity/autoimmune dysfunction in individuals living in or near an ASGM community were identified. More than 60 studies that measured biomarkers of Hg exposure in individuals living in or near ASGM communities were also identified. These studies, conducted in 19 different countries in South America, Asia, and Africa, demonstrated that hair and urine concentrations are well above World Health Organization health guidance values in ASGM communities. ASGM workers and their families are exposed to Hg vapor, and workers, workers' families, and residents of nearby and downstream communities are consuming fish heavily contaminated with methylmercury.

  5. Civil society, political mobilization, and the impact of HIV scale-up on health systems in Brazil.

    Science.gov (United States)

    Parker, Richard G

    2009-11-01

    This article examines the role of civil society in shaping HIV and AIDS policies and programs in Brazil. It focuses on the historical context of the redemocratization of Brazilian society during the 1980s, when the initial response to the epidemic took shape, and emphasizes the role of social movements linked to the progressive Catholic Church, the sanitary reform movement in public health, and the emerging gay rights movement in the early response to the epidemic in Brazil. It highlights the broad-based civil society coalition that took shape over the course of the 1990s and the political alliances that were built up shortly after the 1996 International AIDS Conference in Vancouver, Canada, to pass legislation guaranteeing the right to access to antiretroviral treatment. It emphasizes the continued importance of civil society organizations-in particular, AIDS-related nongovernmental organizations-and leading AIDS activists in exerting continued pressure to guarantee the sustainability of treatment access and the impact that action focused on HIV and AIDS has had on the Brazilian public health system more broadly, particularly through strengthening health infrastructures and providing a model for health-related social mobilization.

  6. The Torino Impact Hazard Scale

    Science.gov (United States)

    Binzel, Richard P.

    2000-04-01

    Newly discovered asteroids and comets have inherent uncertainties in their orbit determinations owing to the natural limits of positional measurement precision and the finite lengths of orbital arcs over which determinations are made. For some objects making predictable future close approaches to the Earth, orbital uncertainties may be such that a collision with the Earth cannot be ruled out. Careful and responsible communication between astronomers and the public is required for reporting these predictions and a 0-10 point hazard scale, reported inseparably with the date of close encounter, is recommended as a simple and efficient tool for this purpose. The goal of this scale, endorsed as the Torino Impact Hazard Scale, is to place into context the level of public concern that is warranted for any close encounter event within the next century. Concomitant reporting of the close encounter date further conveys the sense of urgency that is warranted. The Torino Scale value for a close approach event is based upon both collision probability and the estimated kinetic energy (collision consequence), where the scale value can change as probability and energy estimates are refined by further data. On the scale, Category 1 corresponds to collision probabilities that are comparable to the current annual chance for any given size impactor. Categories 8-10 correspond to certain (probability >99%) collisions having increasingly dire consequences. While close approaches falling Category 0 may be no cause for noteworthy public concern, there remains a professional responsibility to further refine orbital parameters for such objects and a figure of merit is suggested for evaluating such objects. Because impact predictions represent a multi-dimensional problem, there is no unique or perfect translation into a one-dimensional system such as the Torino Scale. These limitations are discussed.

  7. 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.

  8. 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

  9. The impact of stroke aphasia on health and well-being and appropriate nursing interventions: an exploration using the Theory of Human Scale Development.

    Science.gov (United States)

    Thompson, Juliana; McKeever, Margo

    2014-02-01

    This paper considers the impact of aphasia on health and well-being and provides suggestions for appropriate nursing interventions. Background.  Effective communication is essential to holistic care and positive outcomes for individuals affected by aphasia. When verbal communication is absent, nurses fail to adequately use alternative strategies so that the standard of nurse/patient communication is frequently poor. This is a discursive paper which reviews relevant literature and uses the Theory of Human Scale Development as a framework for discussion. The Theory of Human Scale Development is introduced. This theory emphasises that quality of life depends as much upon self-actualisation and relation building as on physical health. The theory is used within the discussion to highlight the significance of communication to quality of life and how its loss has profound psychological and social consequences. Aphasia results in 'loss of self'. The situation is exacerbated by inadequate healthcare communication strategies. Suggestions are offered regarding more appropriate strategies. Efficacy of family input is considered; nursing competence regarding language practice therapies is discussed, and the 'quest approach' is explored. Aphasia has a negative impact on relationships by denying access to support networks, which results in isolation. The individual's predicament is worsened by negative nursing responses. Positive nursing strategies, which alleviate effects of aphasia on individuals' social health, are investigated. Concept analysis and self-awareness exercises as methods of enhancing compassion skills are explored. The social model of disability is discussed to highlight the benefits to individuals of environmental adaptations. The social benefits of aphasia-group affiliation are discussed. The paper concludes by emphasising that fundamental human needs involve social and psychological as well as physical aspects. Nursing interventions must address all needs to

  10. [Economic impact of etanercept and adalimumab biosimilars on hospitals scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products].

    Science.gov (United States)

    Berreur, B; Guerin, F; Christophe, B; Limido, G; Paubel, P

    2018-01-01

    To evaluate the economic impact of future prescriptions of etanercept and adalimumab biosimilars at the territorial scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products. Determination of the number and status of patients (naive or in continuation of treatment) from the National Database "Datamart de Consommation Inter-Régimes" of health insurance, concerned by a dispensation in a pharmacy of etanercept or adalimumab in 2015. Calculation of potential savings in case of biosimilar requirements according to 3 hypotheses: 63% (rate observed in a previous study) of initiations are treated with biosimiliaries and the others by princeps (H 1 ); all initiations under biosimilars and continuation therapy with the princeps (H 2 ) or all patients are treated with biosimilars (H 3 ). The annual savings are estimated at 237,000 € with the H 1 hypothesis. In the case of H 2 , the expected savings would be 376,200 € per year. In the case of H 3 , savings for the community could reach almost 1,282,800 € per year. The arrival of biosimilars allows significant savings for medicines market. According to the French recommendations in 2016, the expected savings are between the H 1 and H 2 hypothesis. The rate of penetration of biosimilars depends on many factors such as the involvement of health professionals, patient adherence, or health authority recommendations. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  11. Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource limited health care environment.

    Science.gov (United States)

    Busari, Jamiu O; Moll, Franka M; Duits, Ashley J

    2017-01-01

    A critical assessment of current health care practices, as well as the training needs of various health care providers, is crucial for improving patient care. Several approaches have been proposed for defining these needs with attention on communication as a key competency for effective collaboration. Taking our cultural context, resource limitations, and small-scale setting into account, we researched the applicability of a mixed focus group approach for analysis of the communication between doctors and nurses, as well as the measures for improvement. Assessment of nurse-physician communication perception in patient care in a Caribbean setting. Focus group sessions consisting of nurses, interns, and medical specialists were conducted using an ethnographic approach, paying attention to existing communication, risk evaluation, and recommendations for improvement. Data derived from the focus group sessions were analyzed by thematic synthesis method with descriptive themes and development of analytic themes. The initial focus group sessions produced an extensive list of key recommendations which could be clustered into three domains (standardization, sustainment, and collaboration). Further discussion of these domains in focus groups showed nurses' and physicians' domain perspectives and effects on patient care to be broadly similar. Risks related to lack of information, knowledge sharing, and professional respect were clearly described by the participants. The described mixed focus group session approach for effectively determining current interprofessional communication and key improvement areas seems suitable for our small-scale, limited resource setting. The impact of the cultural context should be further evaluated by a similar study in a different cultural context.

  12. Scaling up: Assessing social impacts at the macro-scale

    International Nuclear Information System (INIS)

    Schirmer, Jacki

    2011-01-01

    Social impacts occur at various scales, from the micro-scale of the individual to the macro-scale of the community. Identifying the macro-scale social changes that results from an impacting event is a common goal of social impact assessment (SIA), but is challenging as multiple factors simultaneously influence social trends at any given time, and there are usually only a small number of cases available for examination. While some methods have been proposed for establishing the contribution of an impacting event to macro-scale social change, they remain relatively untested. This paper critically reviews methods recommended to assess macro-scale social impacts, and proposes and demonstrates a new approach. The 'scaling up' method involves developing a chain of logic linking change at the individual/site scale to the community scale. It enables a more problematised assessment of the likely contribution of an impacting event to macro-scale social change than previous approaches. The use of this approach in a recent study of change in dairy farming in south east Australia is described.

  13. Northeast Snowfall Impact Scale (NESIS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — While the Fujita and Saffir-Simpson Scales characterize tornadoes and hurricanes respectively, there is no widely used scale to classify snowstorms. The Northeast...

  14. Estimates of occupational safety and health impacts resulting from large-scale production of major photovoltaic technologies

    Energy Technology Data Exchange (ETDEWEB)

    Owens, T.; Ungers, L.; Briggs, T.

    1980-08-01

    The purpose of this study is to estimate both quantitatively and qualitatively, the worker and societal risks attributable to four photovoltaic cell (solar cell) production processes. Quantitative risk values were determined by use of statistics from the California semiconductor industry. The qualitative risk assessment was performed using a variety of both governmental and private sources of data. The occupational health statistics derived from the semiconductor industry were used to predict injury and fatality levels associated with photovoltaic cell manufacturing. The use of these statistics to characterize the two silicon processes described herein is defensible from the standpoint that many of the same process steps and materials are used in both the semiconductor and photovoltaic industries. These health statistics are less applicable to the gallium arsenide and cadmium sulfide manufacturing processes, primarily because of differences in the materials utilized. Although such differences tend to discourage any absolute comparisons among the four photovoltaic cell production processes, certain relative comparisons are warranted. To facilitate a risk comparison of the four processes, the number and severity of process-related chemical hazards were assessed. This qualitative hazard assessment addresses both the relative toxicity and the exposure potential of substances in the workplace. In addition to the worker-related hazards, estimates of process-related emissions and wastes are also provided.

  15. Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource limited health care environment

    Directory of Open Access Journals (Sweden)

    Busari JO

    2017-06-01

    Full Text Available Jamiu O Busari,1,2 Franka M Moll,3 Ashley J Duits3-5 1Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands; 2Department of Pediatrics, Zuyderland Medical Center, Heerlen, the Netherlands; 3Department of Medical Education, St. Elisabeth Hospital, Willemstad, Curaçao; 4Institute for Medical Education, University Medical Center Groningen, Groningen, the Netherlands; 5Red Cross Blood Bank Foundation, Willemstad, Curaçao Background: A critical assessment of current health care practices, as well as the training needs of various health care providers, is crucial for improving patient care. Several approaches have been proposed for defining these needs with attention on communication as a key competency for effective collaboration. Taking our cultural context, resource limitations, and small-scale ­setting into account, we researched the applicability of a mixed focus group approach for analysis of the communication between doctors and nurses, as well as the measures for improvement. Study objective: Assessment of nurse-physician communication perception in patient care in a Caribbean setting. Methods: Focus group sessions consisting of nurses, interns, and medical specialists were conducted using an ethnographic approach, paying attention to existing communication, risk evaluation, and recommendations for improvement. Data derived from the focus group sessions were analyzed by thematic synthesis method with descriptive themes and development of analytic themes. Results: The initial focus group sessions produced an extensive list of key recommendations which could be clustered into three domains (standardization, sustainment, and collaboration. Further discussion of these domains in focus groups showed nurses’ and physicians’ domain perspectives and effects on patient care to be broadly similar. Risks related to lack of information, knowledge

  16. Rasch analysis of the Multiple Sclerosis Impact Scale (MSIS-29)

    OpenAIRE

    Ramp, Melina; Khan, Fary; Misajon, Rose Anne; Pallant, Julie F

    2009-01-01

    Abstract Background Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) im...

  17. 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.

  18. 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...

  19. A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.

    Science.gov (United States)

    Makombe, Simon D; Jahn, Andreas; Tweya, Hannock; Chuka, Stuart; Yu, Joseph Kwong-Leung; Hochgesang, Mindy; Aberle-Grasse, John; Pasulani, Olesi; Schouten, Erik J; Kamoto, Kelita; Harries, Anthony D

    2007-11-01

    To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.

  20. 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.

  1. 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...

  2. 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

  3. 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.

  4. 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

  5. The Impact of Combat Deployment on Health Care Provider Burnout in a Military Emergency Department: A Cross-Sectional Professional Quality of Life Scale V Survey Study.

    Science.gov (United States)

    Cragun, Joshua N; April, Michael D; Thaxton, Robert E

    2016-08-01

    Compassion fatigue is a problem for many health care providers manifesting as physical, mental, and spiritual exhaustion. Our objective was to evaluate the association between prior combat deployment and compassion fatigue among military emergency medicine providers. We conducted a nonexperimental cross-sectional survey of health care providers assigned to the San Antonio Military Medical Center, Department of Emergency Medicine. We used the Professional Quality of Life Scale V survey instrument that evaluates provider burnout, secondary traumatic stress, and compassion satisfaction. Outcomes included burnout, secondary traumatic stress, and compassion satisfaction raw scores. Scores were compared between providers based on previous combat deployments using two-tailed independent sample t tests and multiple regression models. Surveys were completed by 105 respondents: 42 nurses (20 previously deployed), 30 technicians (11 previously deployed), and 33 physicians (16 previously deployed). No statistically significant differences in burnout, secondary traumatic stress, or compassion satisfaction scores were detected between previously deployed providers versus providers not previously deployed. There was no association between previous combat deployment and emergency department provider burnout, secondary traumatic stress, or compassion satisfaction scores. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  6. 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...

  7. 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.

  8. Evaluating the impact of farm scale innovation at catchment scale

    Science.gov (United States)

    van Breda, Phelia; De Clercq, Willem; Vlok, Pieter; Querner, Erik

    2014-05-01

    responsibilities and inadequate procedures of implementing objectives. Planning for development in South Africa needs to take various factors into account. Economic and green economic growth is pursued, while social imbalances are addressed and the environment is protected against unreasonable exploitation. The term Sustainable Development is a neutral concept in the vision of many of the regulating authorities; however, the implementation of sustainability is difficult. This study considers an approach which aligns activities in a specified region to the vision and objectives of the applicable regulatory authorities, as an alternative to achieving objectives strictly through enforcing regulations. It was determined whether objectives of development planning were realistic in terms of water availability. It was established that the position of a farm in the landscape is a determining factor of the impact it has on the catchment area's water supply. For this purpose, hydrological modelling (SWAT and SIMGRO) was done for the Letaba catchment of the Limpopo Province, on two scales to also accommodate small-scale farming communities more accurately. Parallel to the modelling, the National Development Plan (NDP), the National Framework for Sustainable Development (NFSD), the Integrated Sustainable Rural Development Strategy (ISRDS) and the principles of Water Allocation Reform (WAR) were regarded. For regional categorisation, the relevant municipal Integrated Development Plan (IDP), Spatial Development Framework (SDF), Local Economic Development (LED) plan and the applicable Catchment Management Strategy (CMS) were considered. The developed Integrated Evaluation Model combined all the visions and objectives of the mentioned strategic documents to specifically assess the contribution a small-scale farm makes. The evaluation results provided insight into the alignment of activities to the ideals of a region and can be useful when formulating actions to reach a common vision. Small-scale

  9. Rasch analysis of the Multiple Sclerosis Impact Scale (MSIS-29

    Directory of Open Access Journals (Sweden)

    Misajon Rose

    2009-06-01

    Full Text Available Abstract Background Multiple Sclerosis (MS is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29 is a disease-specific health-related quality of life (HRQoL instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS and psychological (MSIS-29-PSYCH impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality. Methods Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29. Results Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score. Conclusion In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings.

  10. Rasch analysis of the Multiple Sclerosis Impact Scale (MSIS-29)

    Science.gov (United States)

    Ramp, Melina; Khan, Fary; Misajon, Rose Anne; Pallant, Julie F

    2009-01-01

    Background Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality. Methods Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29. Results Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score. Conclusion In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings. PMID:19545445

  11. A longitudinal study of the Friedreich Ataxia Impact Scale.

    Science.gov (United States)

    Tai, Geneieve; Yiu, Eppie M; Corben, Louise A; Delatycki, Martin B

    2015-05-15

    Quality of life in Friedreich ataxia (FRDA) has been explored using various generic health status measurement tools, most commonly the Short Form Health Survey Version 2 (SF-36v2). The tool did not address many specific issues related to disease impact in people with FRDA. The Friedreich Ataxia Impact Scale (FAIS) was developed to examine clinically relevant areas in FRDA. The aims of the current study were to assess the relationship between the FAIS and clinical characteristics of FRDA, as well as to determine the responsiveness of the FAIS to change over one and two years. One hundred and four individuals with FRDA, homozygous for the GAA expansion in intron 1 of FXN, completed the FAIS at baseline. Seventy individuals completed the FAIS again 12 months later and 49 completed the FAIS at 24 months. Clinical parameters and neurologic scales (Friedreich Ataxia Rating Scale (FARS)) were also recorded. The total FARS score, onset age and disease duration correlated significantly with FAIS subscales measuring symptoms and physical functioning. The physical and mental summary measures of the SF-36 V2 also correlated well with the FAIS subscales. Speech was the only subscale that demonstrated significant change over one and two years. The FAIS provides valuable insight into the perspective of individuals with FRDA on their health status, and is an important measure of morbidity. It has, however, limited responsiveness to change and its use in intervention studies is questionable. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. 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.

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

    Science.gov (United States)

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

  14. Scaling Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Neilsen, Petter

    2006-01-01

    This article addresses the issues of scaling health information system in the context of developing countries by taking a case study from Ethiopia. Concepts of information infrastructure have been used as an analytical lens to better understand scaling of Health Information systems. More...... specifically, we question the fruitfulness of focusing on not being installed base hostile and suggest focusing on how to be installed base “friendly” by underscoring how the installed base can also be draw upon and shaped by human agents. The paper conceptualizes health information infrastructure (HII......) building as an intertwined process of the evolution of the installed base and the construction activities of human agents. Overall, we argue that it is not only the adverse situation that determines how things develop, but HII builders need to navigate and take into account a wide range of issues related...

  15. Watershed Scale Impacts of Stormwater Green Infrastructure ...

    Science.gov (United States)

    Despite the increasing use of urban stormwater green infrastructure (SGI), including detention ponds and rain gardens, few studies have quantified the cumulative effects of multiple SGI projects on hydrology and water quality at the watershed scale. To assess the effects of SGI, Baltimore County, MD, Montgomery County, MD, and Washington, DC, were selected based on the availability of data on SGI, water quality, and stream flow. The watershed scale impact of SGI was evaluated by assessing how increased spatial density of SGI correlates with stream hydrology and nitrogen exports over space and time. The most common SGI types were detention ponds (58%), followed by marshes (12%), sand filters (9%), wet ponds (7%), infiltration trenches (4%), and rain gardens (2%). When controlling for watersheds size and percent impervious surface cover, watersheds with greater amounts of SGI (>10% SGI) have 44% lower peak runoff, 26% less frequent runoff events, and 26% less variable runoff than watersheds with lower SGI. Watersheds with more SGI also show 44% less NO3− and 48% less total nitrogen exports compared to watersheds with minimal SGI. There was no significant reduction in combined sewer overflows in watersheds with greater SGI. Based on specific SGI types, infiltration trenches (R2 = 0.35) showed the strongest correlation with hydrologic metrics, likely due to their ability to attenuate flow, while bioretention (R2 = 0.19) and wet ponds (R2 = 0.12) showed stronger

  16. Development of the bullying and health experiences scale.

    Science.gov (United States)

    Beran, Tanya; Stanton, Lauren; Hetherington, Ross; Mishna, Faye; Shariff, Shaheen

    2012-11-09

    Until recently, researchers have studied forms of bullying separately. For 40 years, research has looked at the traditional forms of bullying, including physical (eg, hitting), verbal (eg, threats), and social (eg, exclusion). Attention focused on cyberbullying in the early 2000s. Although accumulating research suggests that bullying has multiple negative effects for children who are targeted, these effects excluded cyberbullying from the definition of bullying. This paper responds to the need for a multidimensional measure of the impact of various forms of bullying. We used a comprehensive definition of bullying, which includes all of its forms, to identify children who had been targeted or who had participated in bullying. We then examined various ways in which they were impacted. We used an online method to administer 37 impact items to 377 (277 female, 100 male) children and youth, to develop and test the Bullying and Health Experience Scale. A principal components analysis of the bullying impact items with varimax rotation resulted in 8 factors with eigenvalues greater than one, explaining 68.0% of the variance. These scales include risk, relationships, anger, physical injury, drug use, anxiety, self-esteem, and eating problems, which represent many of the cognitive, psychological, and behavioral consequences of bullying. The Cronbach alpha coefficients for the 8 scales range from .73 to .90, indicating good inter-item consistency. Comparisons between the groups showed that children involved in bullying had significantly higher negative outcomes on all scales than children not involved in bullying. The high Cronbach alpha values indicate that the 8 impact scales provide reliable scores. In addition, comparisons between the groups indicate that the 8 scales provide accurate scores, with more negative outcomes reported by children involved in bullying compared to those who are not involved in bullying. This evidence of reliability and validity indicates that

  17. 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...

  18. The Impacts of Water Quality and Food Availability on Children's Health in West Africa: A Spatial Analysis Using Remotely Sensed Data and Small-Scale Water Quality Data and Country-level Health Data

    Science.gov (United States)

    Frederick, L.; Grace, K.; Lloyd, B.

    2015-12-01

    As the global climate changes and the populations of many African countries grow, ensuring clean drinking water and food has become a pressing concern. Because of their vulnerability to malnutrition and food insecurity, children face the greatest risk for adverse health outcomes related to climate change. Vulnerability, however, is highly variable, with some children in food insecure communities showing healthy growth, while some children in food secure communities show signs of malnutrition. In West Africa, Burkina Faso faces high levels of child malnutrition, loses to farmland and a large share of the population have no access to clean water. Because the overwhelming majority of children rely on locally grown, rainfed agriculture and well/surface water, the combined impact of climate change and population growth decreases water availability and farmland per person. However, there is notable community and individual variation in malnutrition levels suggesting that there are important coping strategies that vulnerable families may use to secure their children's health. No spatially relevant analysis of water and food insecurity and children's health exists for Burkina Faso. The goal of this research is to identify and quantify the combined and inter-related impact of unsafe drinking water and community-level food availability on the physical health outcomes of Burkinabe children under five years of age. To accomplish this goal we rely on a publically available highly detailed, geo-referenced data set (Demographic and Health Survey (DHS)) to provide information on measures of childhood malnutrition and details on parental characteristics related to children's health. Information on water source (covered/uncovered well, piped water, etc.) and water quality (measures of arsenic and pollution) comes from DHS along with a recently collected geo-referenced US Agency for International Development (USAID) data set. Critical information on food production, environmental

  19. 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.

  20. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1987-01-01

    Best estimates of possible additional health effects were projected for the Northern Hemisphere: (1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths from natural or spontaneous causes; (2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and (3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Due to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs., 4 figs., 6 tabs

  1. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1987-01-01

    Best estimates of possible additional health effects were projected for the Northern Hemisphere: (1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths FR-om natural or spontaneous causes; (2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and (3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Due to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs., 4 figs., 6 tabs

  2. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1988-01-01

    Estimates of projected collective dose and average individual dose commitments from Chernobyl releases were made for various regions. Consideration was given to the possible effectiveness of protective actions taken by various countries to reduce projected doses to their populations. Although some preliminary data indicate possible mean reductions of about 25% in total collective doses over the first year, and of about 55% in collective dose to the thyroid, no corrections were made to these dose estimates because of the variable nature of the data. A new combined set of dose-effect models recently published by the United States Nuclear Regulatory Commission was then applied to estimate the ranges of possible future additional health effects due to the Chernobyl accident. In this method possible health effects are estimated on an individual site basis and the results are then summed. Both absolute and relative risk projection models are used. By use of these methods, ''best'' estimates of possible additional health effects were projected for the Northern Hemisphere as follows: 1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths from natural or spontaneous causes; 2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and 3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Owing to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs, 4 figs, 6 tabs

  3. 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

  4. Factor Analysis of the HEW National Strategy for Youth Development Model's Community Program Impact Scales.

    Science.gov (United States)

    Truckenmiller, James L.

    The former HEW (Health, Education, and Welfare) National Strategy for Youth Development Model proposed a community-based program to promote positive youth development and to prevent delinquency through a sequence of youth needs assessments, needs-targeted programs, and program impact evaluation. HEW Community Program Impact Scales data obtained…

  5. Replica scaling studies of hard missile impacts on reinforced concrete

    International Nuclear Information System (INIS)

    Barr, P.; Carter, P.G.; Howe, W.D.; Neilson, A.J.

    1982-01-01

    Missile and target combinations at three different liners scales have been used in an experimental assessment of the applicability of replica scaling to the dynamic behaviour of reinforced concrete structures impacted by rigid missiles. Experimental results are presented for models with relative linear scales of 1, 0.37 and 0.12. (orig.) [de

  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. Environmental impacts of utility-scale solar energy

    Science.gov (United States)

    Hernandez, R.R.; Easter, S.B.; Murphy-Mariscal, M. L.; Maestre, F.T.; Tavassoli, M.; Allen, E.B.; Barrows, C.W.; Belnap, J.; Ochoa-Hueso, R.; Ravi, S.; Allen, M.F.

    2014-01-01

    Renewable energy is a promising alternative to fossil fuel-based energy, but its development can require a complex set of environmental tradeoffs. A recent increase in solar energy systems, especially large, centralized installations, underscores the urgency of understanding their environmental interactions. Synthesizing literature across numerous disciplines, we review direct and indirect environmental impacts – both beneficial and adverse – of utility-scale solar energy (USSE) development, including impacts on biodiversity, land-use and land-cover change, soils, water resources, and human health. Additionally, we review feedbacks between USSE infrastructure and land-atmosphere interactions and the potential for USSE systems to mitigate climate change. Several characteristics and development strategies of USSE systems have low environmental impacts relative to other energy systems, including other renewables. We show opportunities to increase USSE environmental co-benefits, the permitting and regulatory constraints and opportunities of USSE, and highlight future research directions to better understand the nexus between USSE and the environment. Increasing the environmental compatibility of USSE systems will maximize the efficacy of this key renewable energy source in mitigating climatic and global environmental change.

  8. 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

  9. 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...

  10. Nuclear Waste: Increasing Scale and Sociopolitical Impacts

    Science.gov (United States)

    La Porte, Todd R.

    1978-01-01

    Discusses the impact of radioactive waste management system on social and political development. The article also presents (1) types of information necessary to estimate the costs and consequences of radioactive waste management; and (2) an index of radioactive hazards to improve the basis for policy decisions. (HM)

  11. Impact and fracture analysis of fish scales from Arapaima gigas.

    Science.gov (United States)

    Torres, F G; Malásquez, M; Troncoso, O P

    2015-06-01

    Fish scales from the Amazonian fish Arapaima gigas have been characterised to study their impact and fracture behaviour at three different environmental conditions. Scales were cut in two different directions to analyse the influence of the orientation of collagen layers. The energy absorbed during impact tests was measured for each sample and SEM images were taken after each test in order to analyse the failure mechanisms. The results showed that scales tested at cryogenic temperatures display fragile behaviour, while scales tested at room temperature did not fracture. Different failure mechanisms have been identified, analysed and compared with the failure modes that occur in bone. The impact energy obtained for fish scales was two to three times higher than the values reported for bone in the literature. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Analysis of full scale impact into an abutment

    International Nuclear Information System (INIS)

    Fullard, K.; Dowler, H.J.; Soanes, T.P.T.

    1985-01-01

    A 60mph impact into a tunnel abutment, of a flask on a railway flatrol with following vehicles, is shown to be a much less severe event for the flask than a 9 metre drop test to IAEA regulations. This involves the use of mathematical models of the full scale event of the same type as were employed in studying the behaviour of quarter scale models. The latter were subject to actual impact testing as part of the validation process. (author)

  13. Psychometric properties of the Positive Mental Health Scale (PMH-scale)

    NARCIS (Netherlands)

    Lukat, J.; Margraf, J.; Lutz, R.; Veld, W.M. van der; Becker, E.S.

    2016-01-01

    Background: In recent years, it has been increasingly recognized that the absence of mental disorder is not the same as the presence of positive mental health (PMH). With the PMH-scale we propose a short, unidimensional scale for the assessment of positive mental health. The scale consists of 9

  14. 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.

  15. 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.

  16. Resolute large scale mining company contribution to health services of

    African Journals Online (AJOL)

    Resolute large scale mining company contribution to health services of Lusu ... in terms of socio economic, health, education, employment, safe drinking water, ... The data were analyzed using Scientific Package for Social Science (SPSS).

  17. 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.

  18. 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...

  19. 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 ...

  20. SCALING LAW FOR THE IMPACT OF MAGNET FRINGE FIELDS

    International Nuclear Information System (INIS)

    WEI, J.; PAPAPHILIPPOU, Y.; TALMAN, R.

    2000-01-01

    A general scaling law can be derived for the relative momentum deflection produced on a particle beam by fringe fields, to leading order. The formalism is applied to two concrete examples, for magnets having dipole and quadrupole symmetry. During recent years, the impact of magnet fringe fields is becoming increasingly important for rings of relatively small circumference but large acceptance. A few years ago, following some heuristic arguments, a scaling law was proposed [1], for the relative deflection of particles passing through a magnet fringe-field. In fact, after appropriate expansion of the magnetic fields in Cartesian coordinates, which generalizes the expansions of Steffen [2], one can show that this scaling law is true for any multipole magnet, at leading order in the transverse coefficients [3]. This paper intends to provide the scaling law to estimate the impact of fringe fields in the special cases of magnets with dipole and quadrupole symmetry

  1. Place identity and place scale: the impact of place salience.

    OpenAIRE

    Bernardo, Fátima; Palma-Oliveira, José-Manuel

    2013-01-01

    Research about place, place identity and attachment supports the idea that bonds with places may differ depending on the place scale. Based on the view that identity is context-dependent, this paper brings to the table the impact of manipulating the salience of place on the intensity of place identity and place attachment reported. A study was designed to examine place identity and place attachment in two groups of residents (permanent and temporary) at three different scales (nei...

  2. Validation of the Paranormal Health Beliefs Scale for adults.

    Science.gov (United States)

    Donizzetti, Anna Rosa; Petrillo, Giovanna

    2017-01-01

    We present the validation study of the Paranormal Health Beliefs Scale adult version, aimed to measure illusory beliefs about health. The scale was administered to 643 participants (54.3% females), having an average age of 29.7 years (standard deviation = 18.31). The results of the analyses confirmed the dimensions of the Paranormal Health Beliefs Scale as developed in the previous adolescent study (Beliefs: Religious, Superstitious, in Extraordinary Events, Parapsychological, and Pseudo-scientific of a biomedical nature), as well as the convergent and discriminant validity through the correlation with other constructs (locus of control and self-efficacy). The results also showed significant differences between subgroups by gender and age. The Paranormal Health Beliefs Scale shows satisfactory psychometric properties and thus may be used effectively to identify the varied range of illusory beliefs related to health, even within the context of lifelong educational programs aimed at health promotion.

  3. Validation of the Paranormal Health Beliefs Scale for adults

    Directory of Open Access Journals (Sweden)

    Anna Rosa Donizzetti

    2017-12-01

    Full Text Available We present the validation study of the Paranormal Health Beliefs Scale adult version, aimed to measure illusory beliefs about health. The scale was administered to 643 participants (54.3% females, having an average age of 29.7 years (standard deviation = 18.31. The results of the analyses confirmed the dimensions of the Paranormal Health Beliefs Scale as developed in the previous adolescent study (Beliefs: Religious, Superstitious, in Extraordinary Events, Parapsychological, and Pseudo-scientific of a biomedical nature, as well as the convergent and discriminant validity through the correlation with other constructs (locus of control and self-efficacy. The results also showed significant differences between subgroups by gender and age. The Paranormal Health Beliefs Scale shows satisfactory psychometric properties and thus may be used effectively to identify the varied range of illusory beliefs related to health, even within the context of lifelong educational programs aimed at health promotion.

  4. 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” ...

  5. Development of a Customizable Health IT Usability Evaluation Scale

    Science.gov (United States)

    Yen, Po-Yin; Wantland, Dean; Bakken, Suzanne

    2010-01-01

    We developed a customizable questionnaire, the Health Information Technology (IT) Usability Evaluation Scale (Health-ITUES) and conducted an exploratory factor analysis to examine the scale’s psychometric properties. Nurses (n=377) completed Health-ITUES to rate the usability of a web-based communication system for scheduling nursing staff. The analysis revealed a four-factor structure of Health-ITUES. The results provided preliminary evidence for the factorial validity and internal consistency reliability of Health-ITUES. PMID:21347112

  6. 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)

  7. 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.

  8. Development of a foot impact scale for rheumatoid arthritis.

    Science.gov (United States)

    Helliwell, Philip; Reay, Naomi; Gilworth, Gill; Redmond, Anthony; Slade, Anita; Tennant, Alan; Woodburn, James

    2005-06-15

    To develop a new foot impact scale to assess foot status in rheumatoid arthritis (RA) using established qualitative methodology and the latest item response techniques (Rasch analysis). Foot problems in RA were explored by conducting qualitative interviews that were then used to generate items for a new foot impact scale. Further validation was undertaken following postal surveys and Rasch analysis. Analysis of the first postal survey (n = 192 responses) produced a 63-item binary response, 4-subscale instrument. The 4 subscales covered the domains impairment, activities, participation, and footwear. Following test-retest postal surveys and additional analysis, the instrument was reduced to a 2 subscale, 51-item questionnaire covering the domains of impairments/shoes and activities/participation. Initial results of these subscales indicate good psychometric properties, external validity, and test-retest reliability. A foot impact scale to assess the impact of RA and to measure the effect of interventions has been developed. The 2 scales comprising the instrument demonstrate good psychometric properties.

  9. The use of scale models in impact testing

    International Nuclear Information System (INIS)

    Donelan, P.J.; Dowling, A.R.

    1985-01-01

    Theoretical analysis, component testing and model flask testing are employed to investigate the validity of scale models for demonstrating the behaviour of Magnox flasks under impact conditions. Model testing is shown to be a powerful and convenient tool provided adequate care is taken with detail design and manufacture of models and with experimental control. (author)

  10. 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

  11. 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.

  12. 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.

  13. 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...

  14. Wind power impacts and electricity storage - a time scale perspective

    DEFF Research Database (Denmark)

    Hedegaard, Karsten; Meibom, Peter

    2012-01-01

    Integrating large amounts of wind power in energy systems poses balancing challenges due to the variable and only partly predictable nature of wind. The challenges cover different time scales from intra-hour, intra-day/day-ahead to several days and seasonal level. Along with flexible electricity...... demand options, various electricity storage technologies are being discussed as candidates for contributing to large-scale wind power integration and these also differ in terms of the time scales at which they can operate. In this paper, using the case of Western Denmark in 2025 with an expected 57% wind...... power penetration, wind power impacts on different time scales are analysed. Results show consecutive negative and high net load period lengths indicating a significant potential for flexibility measures capable of charging/activating demand and discharging/inactivating demand in periods of 1 h to one...

  15. Large-scale impact cratering on the terrestrial planets

    International Nuclear Information System (INIS)

    Grieve, R.A.F.

    1982-01-01

    The crater densities on the earth and moon form the basis for a standard flux-time curve that can be used in dating unsampled planetary surfaces and constraining the temporal history of endogenic geologic processes. Abundant evidence is seen not only that impact cratering was an important surface process in planetary history but also that large imapact events produced effects that were crucial in scale. By way of example, it is noted that the formation of multiring basins on the early moon was as important in defining the planetary tectonic framework as plate tectonics is on the earth. Evidence from several planets suggests that the effects of very-large-scale impacts go beyond the simple formation of an impact structure and serve to localize increased endogenic activity over an extended period of geologic time. Even though no longer occurring with the frequency and magnitude of early solar system history, it is noted that large scale impact events continue to affect the local geology of the planets. 92 references

  16. Impact of small-scale structures on estuarine circulation

    Science.gov (United States)

    Liu, Zhuo; Zhang, Yinglong J.; Wang, Harry V.; Huang, Hai; Wang, Zhengui; Ye, Fei; Sisson, Mac

    2018-05-01

    We present a novel and challenging application of a 3D estuary-shelf model to the study of the collective impact of many small-scale structures (bridge pilings of 1 m × 2 m in size) on larger-scale circulation in a tributary (James River) of Chesapeake Bay. We first demonstrate that the model is capable of effectively transitioning grid resolution from 400 m down to 1 m near the pilings without introducing undue numerical artifact. We then show that despite their small sizes and collectively small area as compared to the total channel cross-sectional area, the pilings exert a noticeable impact on the large-scale circulation, and also create a rich structure of vortices and wakes around the pilings. As a result, the water quality and local sedimentation patterns near the bridge piling area are likely to be affected as well. However, when evaluating over the entire waterbody of the project area, the near field effects are weighed with the areal percentage which is small compared to that for the larger unaffected area, and therefore the impact on the lower James River as a whole becomes relatively insignificant. The study highlights the importance of the use of high resolution in assessing the near-field impact of structures.

  17. Numerical simulation of small scale soft impact tests

    International Nuclear Information System (INIS)

    Varpasuo, Pentti

    2008-01-01

    This paper describes the small scale soft missile impact tests. The purpose of the test program is to provide data for the calibration of the numerical simulation models for impact simulation. In the experiments, both dry and fluid filled missiles are used. The tests with fluid filled missiles investigate the release speed and the droplet size of the fluid release. This data is important in quantifying the fire hazard of flammable liquid after the release. The spray release velocity and droplet size are also input data for analytical and numerical simulation of the liquid spread in the impact. The behaviour of the impact target is the second investigative goal of the test program. The response of reinforced and pre-stressed concrete walls is studied with the aid of displacement and strain monitoring. (authors)

  18. Impact of the heavy quark matching scales in PDF fits

    Energy Technology Data Exchange (ETDEWEB)

    Bertone, V. [VU Univ., Amsterdam (Netherlands). Dept. of Physics and Astronomy; Nikhef Theory Goup, Amsterdam (Netherlands); Britzger, D. [DESY, Hamburg (Germany); Camarda, S. [CERN, Geneva (Switzerland); Collaboration: The xFitter Developers' Team; and others

    2017-07-15

    We investigate the impact of displaced heavy quark matching scales in a global fit. The heavy quark matching scale μ{sub m} determines at which energy scale μ the QCD theory transitions from N{sub F} to N{sub F}+1 in the Variable Flavor Number Scheme (VFNS) for the evolution of the Parton Distribution Functions (PDFs) and strong coupling α{sub S}(μ). We study the variation of the matching scales, and their impact on a global PDF fit of the combined HERA data. As the choice of the matching scale μ{sub m} effectively is a choice of scheme, this represents a theoretical uncertainty; ideally, we would like to see minimal dependence on this parameter. For the transition across the charm quark (from N{sub F}=3 to 4), we find a large μ{sub m}=μ{sub c} dependence of the global fit χ{sup 2} at NLO, but this is significantly reduced at NNLO. For the transition across the bottom quark (from N{sub F}=4 to 5), we have a reduced μ{sub m}=μ{sub b} dependence of the χ{sup 2} at both NLO and NNLO as compared to the charm. This feature is now implemented in xFitter 2.0.0, an open source QCD fit framework.

  19. 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

  20. Organizational Health and Higher Education: Concept and Measurement Scale Development.

    Science.gov (United States)

    Klingele, William E.; Lyden, Julie A.; Vaughan, Beverly J.

    2001-01-01

    A scale to measure higher education institutions' organizational health was developed and tested using 198 survey responses. Scale dimensions include communication adequacy, participation/involvement, commitment/loyalty, morale, external reputation, ethics, performance recognition, goal alignment, leadership, development, and resource use.…

  1. Impact of Spatial Scales on the Intercomparison of Climate Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Wei; Steptoe, Michael; Chang, Zheng; Link, Robert; Clarke, Leon; Maciejewski, Ross

    2017-01-01

    Scenario analysis has been widely applied in climate science to understand the impact of climate change on the future human environment, but intercomparison and similarity analysis of different climate scenarios based on multiple simulation runs remain challenging. Although spatial heterogeneity plays a key role in modeling climate and human systems, little research has been performed to understand the impact of spatial variations and scales on similarity analysis of climate scenarios. To address this issue, the authors developed a geovisual analytics framework that lets users perform similarity analysis of climate scenarios from the Global Change Assessment Model (GCAM) using a hierarchical clustering approach.

  2. 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...

  3. Health Impacts from Human Interaction with the Environment

    Science.gov (United States)

    Hasan, S. E.

    2008-12-01

    Humans have produced far greater impact on the environment than any other living form. The impact has been so significant-particularly during the past 50 years-that a new word, Anthrposphere has started appearing in recent literature. It is now being used along with the four major components of the system earth to underscore humans' influence on the environment. Human activities have produced a myriad of impacts on the environment that span the scale from local to global. The slow process that brought humanity to the present environmental crisis began with the Industrial Revolution and has greatly accelerated since the World War II. The past 50 years mark a unique period in human history that is characterized by rapid technological advances and unprecedented population growth. While the use of technology has been very effective in meeting the needs of the growing population, it has also produced serious impact on the environment. Large scale exploitation of mineral, fuel, water, forest, and marine resources has led to severe environmental degradation; and the resulting pollution of air, water, and land has caused serious consequences to human and ecological health. The presentation deals with the adverse impact on human health associated with mining, dam and reservoir construction, improper waste management, use of fossil fuels, and climate change. Case studies are included to illustrate health impacts from metal and coal mining; dam and reservoir construction and preponderance of disease vectors; pollution caused by improper waste disposal and the resulting incidence of cancer and other diseases; and emergence of vector-borne diseases at hitherto unknown locations, cardiovascular and respiratory track ailments, and increased morbidity and mortality triggered by elevated temperatures associated with climate change. A brief discussion of possible measures to mitigate the health consequences is also included in the presentation.

  4. Health Service Quality Scale: Brazilian Portuguese translation, reliability and validity.

    Science.gov (United States)

    Rocha, Luiz Roberto Martins; Veiga, Daniela Francescato; e Oliveira, Paulo Rocha; Song, Elaine Horibe; Ferreira, Lydia Masako

    2013-01-17

    The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson's correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach's alpha coefficient; the intraclass (ICC) and Pearson's correlation coefficients were used for test-retest reliability. One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson's correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson's correlation coefficient was 0.89 and ICC was 0.90. The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.

  5. Health service quality scale: Brazilian Portuguese translation, reliability and validity

    Science.gov (United States)

    2013-01-01

    Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC) and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality. PMID:23327598

  6. Non-dimensional scaling of impact fast ignition experiments

    International Nuclear Information System (INIS)

    Farley, D R; Shigemori, K; Murakami, M; Azechi, H

    2008-01-01

    Recent experiments at the Osaka University Institute for Laser Engineering (ILE) showed that 'Impact Fast Ignition' (IFI) could increase the neutron yield of inertial fusion targets by two orders of magnitude [1]. IFI utilizes the thermal and kinetic energy of a laser-accelerated disk to impact an imploded fusion target. ILE researchers estimate a disk velocity of 10 8 cm/sec is needed to ignite the fusion target [2]. To be able to study the IFI concept using lasers different from that at ILE, appropriate non-dimensionalization of the flow should be done. Analysis of the rocket equation gives parameters needed for producing similar IFI results with different lasers. This analysis shows that a variety of laboratory-scale commercial lasers could produce results useful to full-scale ILE experiments

  7. Testing of materials and scale models for impact limiters

    International Nuclear Information System (INIS)

    Maji, A.K.; Satpathi, D.; Schryer, H.L.

    1991-01-01

    Aluminum Honeycomb and Polyurethane foam specimens were tested to obtain experimental data on the material's behavior under different loading conditions. This paper reports the dynamic tests conducted on the materials and on the design and testing of scale models made out of these open-quotes Impact Limiters,close quotes as they are used in the design of transportation casks. Dynamic tests were conducted on a modified Charpy Impact machine with associated instrumentation, and compared with static test results. A scale model testing setup was designed and used for preliminary tests on models being used by current designers of transportation casks. The paper presents preliminary results of the program. Additional information will be available and reported at the time of presentation of the paper

  8. Evidence-based adaptation and scale-up of a mobile phone health information service.

    Science.gov (United States)

    L'Engle, Kelly; Plourde, Kate F; Zan, Trinity

    2017-01-01

    development, research into new business/distribution models, and serving as the foundation for derivative NGO and quasi-governmental mHealth platforms. The m4RH platform provides an excellent case study of how to apply best practices to successfully scale up mobile phone interventions for health improvement. Applying principles of scale can inform the successful scale-up, sustainability, and potential impact of mHealth programs across health topics and settings.

  9. Assessing Impacts of National Scale Droughts on Cereal Production

    Science.gov (United States)

    Udmale, P. D.; Ichikawa, Y.

    2017-12-01

    Till date, several drought indices have been developed and used to monitor local to regional scale droughts on various temporal scales. However, there are no generalized criteria to define a threshold to declare a national level drought using drought indices. EM-DAT (a global database on natural and technological disasters) lists disasters (including drought) from 1900 until the present confirming one of the following criteria: 10 or more people dead; 100 or more people affected; the declaration of a state of emergency; or a call for international assistance. This data is gathered from various organizations like United Nations Institutes, Governments, etc. and do not cover all disasters or have political limitations that could affect the numbers. These criteria are neither objective nor quantitative, and accordingly may cause uncertainties when the data is used for further investigation on disaster impacts. Here we present a methodology to define drought at a national scale and its impacts on national level crop production (mainly cereals). We define drought based on the percentage of cropland area affected by drought in a country during its seasonal rainfall. For this purpose meteorological definition of drought in combination with country's cropland area is proposed to prepare a drought inventory for major cereal producing countries (1902-2012). This drought inventory together with FAO's Crop data is used to identify the impacts of drought on a national level cereal production (and yield) using Superposed Epoch Analysis for the period 1961-2012.

  10. The Validation of the Active Learning in Health Professions Scale

    Science.gov (United States)

    Kammer, Rebecca; Schreiner, Laurie; Kim, Young K.; Denial, Aurora

    2015-01-01

    There is a need for an assessment tool for evaluating the effectiveness of active learning strategies such as problem-based learning in promoting deep learning and clinical reasoning skills within the dual environments of didactic and clinical settings in health professions education. The Active Learning in Health Professions Scale (ALPHS)…

  11. 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

  12. Large-scale Health Information Database and Privacy Protection*1

    OpenAIRE

    YAMAMOTO, Ryuichi

    2016-01-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law...

  13. 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

  14. 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.

  15. The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients.

    Science.gov (United States)

    Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

    2010-07-01

    Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.

  16. 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.

  17. Shrinking cities examined from a shrinking scale – the impact ...

    Science.gov (United States)

    Urban populations continue to increase globally and cities have become the dominant human habitat. However, the growth of cities is not universal. Shrinking cities face decreased income, reduced property values, and decreased tax revenue. Fewer people per unit area creates inefficiencies and higher costs for infrastructure maintenance and the provision of public amenities. However, population losses and economic distress are not equal in all neighborhoods, and in fact are quite heterogeneously distributed across the landscape. Broader statements about the trajectory of a shrinking city may mask underlying differences in economic, cultural, and environmental impacts as well as the ability of some neighborhoods to be resilient and adaptive to economic changes as well as climate change and other environmental stressors. This paper examines the recent impact of population loss in neighborhoods in the Río Piedras watershed in San Juan, Puerto Rico, on the provision of ecosystem services, material and energy flows, and ecological impacts, using public data and data collected previously in two household surveys. Using scenarios, we estimate future population changes and their potential positive and negative impacts on the environment and human well-being in these neighborhoods. This paper expands on prior research on shrinking cities by examining the impacts of population loss on urban social-ecological systems at the household and neighborhood scales. The purpose

  18. The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

    Directory of Open Access Journals (Sweden)

    Bendo Cristiane B

    2012-04-01

    Full Text Available Abstract Background Oral and orofacial problems may cause a profound impact on children’s oral health-related quality of life (OHRQoL because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory™ (PedsQL™ Oral Health Scale in combination with the PedsQL™ 4.0 Generic Core Scales. Methods The PedsQL™ Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL™ Oral Health Scale, PedsQL™ 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ11-14 and CPQ8-10 and Parental-Caregiver Perception Questionnaire (P-CPQ were administered. Statistical analysis included feasibility (missing values, confirmatory factor analysis (CFA, internal consistency reliability, and test-retest intraclass correlation coefficients (ICC of the PedsQL™ Oral Health Scale. Results There were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL™ Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbach's alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test

  19. 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

  20. 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.

  1. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...... with MS with walking impairment. METHODS: ENABLE was a 48-week, open-label, Phase 4 study of PR-fampridine 10 mg twice daily. Patients who showed any improvement in Timed 25-Foot Walk walking speed at weeks 2 and 4 and any improvement in 12-item MS Walking Scale score at week 4 remained on treatment....... The primary endpoint was change from baseline in 36-Item Short-Form Health Survey (SF-36) physical component summary (PCS) score. RESULTS: At week 4, 707/901 (78.5%) patients met the criteria to remain on treatment. Patients on treatment demonstrated significant and clinically meaningful improvements in SF-36...

  2. The Impact of Process Scaling on Scratchpad Memory Energy Savings

    Directory of Open Access Journals (Sweden)

    Bennion Redd

    2014-09-01

    Full Text Available Scratchpad memories have been shown to reduce power consumption, but the different characteristics of nanometer scale processes, such as increased leakage power, motivate an examination of how the benefits of these memories change with process scaling. Process and application characteristics affect the amount of energy saved by a scratchpad memory. Increases in leakage as a percentage of total power particularly impact applications that rarely access memory. This study examines how the benefits of scratchpad memories have changed in newer processes, based on the measured performance of the WIMS (Wireless Integrated MicroSystems microcontroller implemented in 180- and 65-nm processes and upon simulations of this microcontroller implemented in a 32-nm process. The results demonstrate that scratchpad memories will continue to improve the power dissipation of many applications, given the leakage anticipated in the foreseeable future.

  3. Horizontal impact testing of quarter scale flasks using masonry targets

    International Nuclear Information System (INIS)

    Tufton, E.P.S.

    1985-01-01

    The programme leading up to the Train Crash Demonstration included investigation of flask impacts, in horizontal motion, against masonry targets representing abutment structures. An outline is given of a series of eight tests, of which five are described in detail. All the tests used quarter-scale flasks, and the design and construction of the appropriate brick and stone masonry targets is described. A summary of results is given in terms of damage to the model flask compared with the more severe damage seen in regulatory drop tests. (author)

  4. Ready for eHealth. Older Swedes’ Perceptions of eHealth Services: Using the PIADS Scale as a Predictor for Readiness

    Directory of Open Access Journals (Sweden)

    Sarianne Wiklund Axelsson

    2016-09-01

    Full Text Available Introduction: Relevant determinants of adoption of eHealth are needed in order to understand future usage. Aim: To investigate the anticipated psychosocial impact of present and future eHealth services and discuss how psychosocial factors can impact the readiness for eHealth services among older Swedes and reflect upon instruments for measuring eHealth acceptance. Method: The Psychosocial Impact of Assistive Device Scale (PIADS measured the psychosocial impact of eHealth services as illustrated in pictures of a set of events of eHealth services that may reasonably occur in the present and the future. The PIADS scale and the scenarios were administered via a randomly selected sample from the Swedish population aged 55–105. Results and Discussion: Older Swedes have, from a psychosocial perspective, positive expectations regarding eHealth services. The PIADS scale could be a useful supplement to acceptance measurements in the context of eHealth. Using animated illustrations to depict eHealth services, together with the PIADS scale, can generate findings that are generalizable across technologies. The dimensions adaptability, competence and self-esteem could be relevant determinants of adoption of eHealth.

  5. 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.

  6. The impact of pediatric blood and marrow transplant on parents: introduction of the parent impact scale.

    Science.gov (United States)

    Heinze, Katherine E; Rodday, Angie Mae; Nolan, Marie T; Bingen, Kristin; Kupst, Mary Jo; Patel, Sunita K; Syrjala, Karen; Harris, Lynnette; Recklitis, Christopher; Schwartz, Lisa; Davies, Stella; Guinan, Eva C; Noll, Robert; Chang, Grace; Parsons, Susan K

    2015-04-09

    Parents often experience stress-related complications when their child requires blood and marrow transplant (BMT). Previous studies have described the emotional toll BMT places on parents during the acute phase of care and within the context of clinical complications. In this paper we introduce the Parent Impact Scale (PARimpact), designed to capture physical and emotional challenges of the child's health on the parent. The primary aim of this paper is to examine psychometric properties of PARimpact, and the secondary aim is to explore factors associated with PARimpact scores for further hypothesis generation. This analysis used a merged dataset of two longitudinal studies. Accompanying parents (n = 363) of children undergoing BMT were surveyed up to six times from pre-BMT baseline to one year after their child's BMT. For this analysis, pre-BMT baseline responses to PARimpact were used to examine the factor structure with Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA). Construct validity was assessed, and multivariable regression was used to examine relationships between PARimpact and BMT clinical variables. PCA and EFA revealed a one-factor solution with acceptable item loading; Cronbach's α was 0.83 at baseline. Hypothesized differences in known groups were detected for BMT complications with significantly higher PARimpact scores for those with vs. without each complication. In the adjusted multivariable regression models, acute graft versus host disease (b = 5.3; p = 0.03), end organ toxicity (b = 5.9; p < 0.01), and systemic infection (b = 9.1; p < 0.01) were associated with significantly higher mean PARimpact scores in the first 3 months following transplant. After the first 3 months to 1 year post BMT, systemic infection was associated with increased mean PARimpact scores (b = 19.2; p < 0.01). Initial results suggest that the PARimpact is valid and reliable. Our finding that clinical

  7. Scaling of Health Information Systems in Nigeria and Ethiopia

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Shaw, Vincent; Braa, Jørn

    2007-01-01

    Systems Programme in Nigeria and Ethiopia, the interdependencies between three spheres are identified as being important in scaling health information systems. The three spheres that are explored are the volume of data collected, human resource factors and access to technology. We draw on concepts from...... the balance. Three flexible standards are identified as being critical strategies to global health information scaling initiatives, namely an essential data set, a scalable process of information systems collection and collation consisting of gateways between paper based systems and hardware and software...

  8. 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

  9. Modeling of urban atmospheric pollution and impact on health

    International Nuclear Information System (INIS)

    Myrto, Valari

    2009-10-01

    The goal of this dissertation, is to develop a methodology that provides an improved knowledge of the associations between atmospheric contaminant concentrations and health impact. The propagation of uncertainties from input data to the output concentrations through a Chemistry Transport Model was first studied. The influence of the resolutions of meteorological parameters and emissions data were studied separately, and their relative role was compared. It was found that model results do not improve linearly with the resolution of emission input. A critical resolution was found, beyond which model error becomes higher and the model breaks down. Based on this first investigation concerning the direct down scaling, further research focused on sub grid scale modeling. Thus, a statistical down scaling approach was adopted for the modeling of sub grid-scale concentration variability due to heterogeneous surface emissions. Emission fractions released from different types of sources (industry, roads, residential, natural etc.) were calculated from a high-resolution emission inventory. Then emission fluxes were mapped on surfaces emitting source-specific species. Simulations were run independently over the defined micro-environments allowing the modeling of sub grid-scale concentration variability. Sub grid scale concentrations were therefore combined with demographic and human activity data to provide exposure estimates. The spatial distribution of human exposure was parameterized through a Monte-Carlo model. The new information concerning exposure variability was added to an existing epidemiological model to study relative health risks. A log-linear Poisson regression model was used for this purpose. The principal outcome of the investigation was that a new functionality was added to the regression model which allows the dissociation of the health risk associated with each pollutant (e.g. NO 2 and PM 2.5 ). (author)

  10. REVIEW ARTICLE: Fast Foods and their Impact on Health

    Directory of Open Access Journals (Sweden)

    Ashakiran

    2012-07-01

    Full Text Available Eat healthy and live healthy’ is one of the essential requirements for long life. Unfortunately, today’s world has been adapted to a system of consumption of foods which has several adverse effects on health. Lifestyle changes has compelled us so much that one has so little time to really think what we are eating is right Globalisation and urbanisation have greatly affected one’s eating habits and forced many people to consume fancy and high calorie fast foods, popularly known as ‘Junk foods. Research into the possible health hazards on consumption of such high calorie foods has given an insight to avoid them, but unfortunately measures taken are not aseffective as they need to be. Diseases like coronary artery disease and diabetes mellitus have seen a profound rise in developing countries and such unhealthy junk food consumption is one of the notable factors to its contribution. This global problem of consuming junk food on a large scale and its impact on health needs emphasis and health education which can greatly contribute to itslimited consumption and switching over to healthy eating habits for the better living. knowledge highlighting about the eating habits,nutritional aspects, quality of unhealthy foods, their health impact and preventive measures should be given to create awareness and render health education for a change towards good eating practices. Junk food and its impact on health have been reviewed from variousresources and have been systematically presented, so as to emphasize its ill effects and measures to be adapted towards healthy living.

  11. Health education and competency scale: Development and testing.

    Science.gov (United States)

    Hwang, Huei-Lih; Kuo, Mei-Ling; Tu, Chin-Tang

    2018-02-01

    To develop a tool for measuring competency in conducting health education and to evaluate its psychometric properties in a population of entry-level nurses. Until now, no generic instrument has been developed specifically for measuring competency in health education, which is an essential competency for nurses. Existing scales are either insufficient for psychometric evaluation or are designed specifically for senior nurses. To evaluate curricula and courses designed for entry-level nurses, educators require an instrument for measuring improvement in core competency from baseline to determine whether the minimum level of ability has been achieved. Item development for the survey instrument used for data collection in this study was based on the results of a literature review. The self-evaluated Health Education Competency Scale developed in this study was used to survey 457 nursing students at two nursing schools and 165 clinical nurses at a medical centre in south Taiwan in 2016. The participants were randomly divided into two equal groups. One group was analysed by exploratory factor analysis with varimax rotation, and one group was analysed by confirmatory factor analysis. Factor analysis yielded a four-factor (assessment, pedagogy, motivation and empowerment) solution (18 items) that accounted for 75.9% of the variance. The total scale and subscales had good reliabilities and construct validity coefficients. For measuring competency in entry-level nurses, the Health Education Competency Scale had a good data fit and sound psychometric properties. The proposed scale can be used to assess health education competency for college nursing students and practising nurses. Furthermore, it can provide educators with valuable insight into the minimum competencies required for entry-level nurses to deliver quality health care to clients and can guide them in the practice of client-based teaching. © 2017 John Wiley & Sons Ltd.

  12. 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.

  13. 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.

  14. 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)

  15. 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)

  16. Renewable biomass energy: Understanding regional scale environmental impacts

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R.L.; Downing, M.

    1993-12-31

    If biomass energy is to become a significant component of the US energy sector, millions of acres of farmland must be converted to energy crops. The environmental implications of this change in land use must be quantitatively evaluated. The land use changes will be largely driven by economic considerations. Farmers will grow energy crops when it is profitable to do so. Thus, models which purport to predict environmental changes induced by energy crop production must take into account those economic features which will influence land use change. In this paper, we present an approach for projecting the probable environmental impacts of growing energy crops at the regional scale. The approach takes into account both economic and environmental factors. We demonstrate the approach by analyzing, at a county-level the probable impact of switchgrass production on erosion, evapotranspiration, nitrate in runoff, and phosphorous fertilizer use in multi-county subregions within the Tennessee Valley Authority (TVA) region. Our results show that the adoption of switchgrass production will have different impacts in each subregion as a result of differences in the initial land use and soil conditions in the subregions. Erosion, evapotranspiration, and nitrate in runoff are projected to decrease in both subregions as switchgrass displaces the current crops. Phosphorous fertilizer applications are likely to increase in one subregion and decrease in the other due to initial differences in the types of conventional crops grown in each subregion. Overall these changes portend an improvement in water quality in the subregions with the increasing adoption of switchgrass.

  17. Renewable biomass energy: Understanding regional scale environmental impacts

    International Nuclear Information System (INIS)

    Graham, R.L.; Downing, M.

    1993-01-01

    If biomass energy is to become a significant component of the US energy sector, millions of acres of farmland must be converted to energy crops. The environmental implications of this change in land use must be quantitatively evaluated. The land use changes will be largely driven by economic considerations. Farmers will grow energy crops when it is profitable to do so. Thus, models which purport to predict environmental changes induced by energy crop production must take into account those economic features which will influence land use change. In this paper, we present an approach for projecting the probable environmental impacts of growing energy crops at the regional scale. The approach takes into account both economic and environmental factors. We demonstrate the approach by analyzing, at a county-level, the probable impact of switchgrass production on erosion, evapotranspiration, nitrate in runoff, and phosphorous fertilizer use in two multi-county subregions within the Tennessee Valley Authority (TVA) region. Our results show that the adoption of switchgrass production will have different impacts in each subregion as a result of differences in the initial land use and soil conditions in the subregions. Erosion, evapotranspiration, and nitrate in runoff are projected to decrease in both subregions as switchgrass displaces the current crops. Phosphorous fertilizer applications are likely to increase in one subregion and decrease in the other due to initial differences in the types of conventional crops grown in each subregion. Overall these changes portend an improvement in water quality in the subregions with the increasing adoption of switchgrass

  18. Elders Health Empowerment Scale: Spanish adaptation and psychometric analysis.

    Science.gov (United States)

    Serrani Azcurra, Daniel Jorge Luis

    2014-01-01

    Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs.

  19. Measuring the Impact of the Human Rights on Health in Global Health Financing.

    Science.gov (United States)

    Davis, Sara L M

    2015-12-10

    In response to new scientific developments, UNAIDS, WHO, and global health financing institutions have joined together to promote a "fast-track" global scale-up of testing and treatment programs. They have set ambitious targets toward the goal of ending the three diseases by 2030. These numerical indicators, based on infectious disease modeling, can assist in measuring countries' progressive realization of the right to health. However, they only nominally reference the catastrophic impact that human rights abuses have on access to health services; they also do not measure the positive impact provided by law reform, legal aid, and other health-related human rights programs. Drawing on experience at the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has incorporated expanded stakeholder consultation and human rights programming into its grants, the article argues that addressing human rights barriers to access is often an ad hoc activity occurring on the sidelines of a health grantmaking process that has focused on the scale-up of biomedical programs to meet global health indicators. To ensure that these biomedical programs have impact, UN agencies and health financing mechanisms must begin to more systematically and proactively integrate human rights policy and practice into their modeling and measurement tools. Copyright © 2015 Davis. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  20. 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.

  1. Holistic impact assessment and cost savings of rainwater harvesting at the watershed scale

    Directory of Open Access Journals (Sweden)

    Santosh R. Ghimire

    2017-03-01

    Full Text Available We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S. using life cycle assessment (LCA and life cycle cost assessment. Life cycle impact assessment (LCIA categories included energy demand, fossil fuel, metals, ozone depletion, global warming, acidification, smog, blue and green water use, ecotoxicity, eutrophication, and human health effects. Building upon previous LCAs of near-optimal domestic and agricultural RWH systems in the region, we scaled functional unit LCIA scores for adoption rates of 25%, 50%, 75%, and 100% and compared these to conventional municipal water and well water systems. In addition to investigating watershed-scale impacts of RWH adoption, which few studies have addressed, potential life cycle cost savings due to reduced cumulative energy demand were scaled in each watershed for a more comprehensive analysis. The importance of managing the holistic water balance, including blue water (surface/ground water, green water (rainwater use, and annual precipitation and their relationship to RWH are also addressed. RWH contributes to water resource sustainability by offsetting surface and ground water consumption and by reducing environmental and human health impacts compared to conventional sources. A watershed-wide RWH adoption rate of 25% has a number of ecological and human health benefits including blue water use reduction ranging from 2–39 Mm3, cumulative energy savings of 12–210 TJ, and reduced global warming potential of 600–10,100 Mg CO2 eq. Potential maximum lifetime energy cost savings were estimated at $5M and $24M corresponding to domestic RWH in Greens Mill and agricultural RWH in Back Creek watersheds.

  2. Managing environmental and health impacts of uranium mining

    Energy Technology Data Exchange (ETDEWEB)

    Vance, R.E.; Cameron, R., E-mail: robert.vance@oecd.org, E-mail: ron.cameron@oecd.org [OECD Nuclear Energy Agency (France)

    2014-07-01

    As the raw material that fuels nuclear power plants that generate significant amounts of electricity with full life cycle carbon emissions as low as renewable energy sources, uranium is a valuable commodity. Yet uranium mining remains controversial, principally because of environmental and health impacts created when mining was undertaken by governments to meet Cold War strategic requirements. Uranium mining is conducted under significantly different circumstances today. Since the era of military production, societal expectations of environmental protection and the safety of workers and the public have evolved as the outcomes of the early era of mining became apparent, driving changes in regulatory oversight and mining practices. Key aspects of leading practice uranium mining are presented (conventional worker health and safety, worker radiation protection, public health and safety, water quality, tailings and waste rock management) and compared with historic practices to demonstrate the scale of differences. The application of additional aspects of uranium mine life cycle management (public consultation, environmental impact assessment, analysis of socio-economic impacts/benefits, environmental monitoring, financial assurance, product transport, security and safeguards, emergency planning and knowledge transfer), introduced as the industry matured, enhance overall management practices for the long term. Results from several case studies show that improved management of key aspects of uranium mining, combined with the incorporation of new life cycle parameters, have transformed the industry into the most regulated and arguably one of the safest and environmentally responsible types of mining in the world. (author)

  3. Worksite health and safety climate: scale development and effects of a health promotion intervention.

    Science.gov (United States)

    Basen-Engquist, K; Hudmon, K S; Tripp, M; Chamberlain, R

    1998-01-01

    Environmental influences on health and health behavior have an important place in research on worksite health promotion. We tested the validity and internal consistency of a new measure of organizational health and safety climate that was used in a large randomized trial of a worksite cancer prevention program (the Working Well Trial). The resulting scales then were applied to assess intervention effects. This study uses data from a subset of 40 worksites in the Working Well Trial. Employees at 20 natural gas pipeline worksite and 20 rural electrical cooperatives completed a cross-sectional questionnaire at baseline and 3-year follow-up. A factor analysis of this self-report instrument produced a two-factor solution. The resulting health and safety climate scales had good internal consistency (Cronbach's alpha = 0.74 and 0.82, respectively) and concurrent validity. The health climate scale was correlated more highly with organizational measures that were indicative of a supportive health climate than those indicating supportive safety climate, while the reverse was true of the safety climate scale. Changes in health climate were associated with the number of smoking and smokeless tobacco programs offered at the worksites at the time of the 3-year follow-up (r = 0.46 and 0.42, respectively). The scales were not correlated with most employee health behaviors. The health climate scores increased at intervention worksites, compared with scores at control worksites (F[1,36] = 7.57, P = 0.009). The health and safety climate scales developed for this study provide useful instruments for measuring organizational change related to worksite health promotion activities. The Working Well Intervention resulted in a significant improvement in worksite health climate.

  4. 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)

  5. Violent breaking wave impacts. Part 3. Effects of scale and aeration

    DEFF Research Database (Denmark)

    Bredmose, Henrik; Bullock, G. N.; Hogg, A. J.

    2015-01-01

    . The Bagnold-Mitsuyasu scaling law for the compression of an air pocket by a piston of incompressible water is rederived and generalised to 3D air pockets of arbitrary shape. Numerical results for wall pressure, force and impulse are then presented for a flip-through impact, a low-aeration impact and a high......The effects of scale and aeration on violent breaking wave impacts with trapped and entrained air are investigated both analytically and numerically. By dimensional analysis we show that the impact pressures for Froude scaled conditions prior to the impact depend on the scale and aeration level......-aeration impact, for nine scales and five levels of initial aeration. Two of these impact types trap a pocket of air at the wall. Among the findings of the paper is that for fixed initial aeration, impact pressures from the flip-through impact broadly follow Froude scaling. This is also the case for the two...

  6. 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.

  7. EI Scale: an environmental impact assessment scale related to the construction materials used in the reinforced concrete

    Directory of Open Access Journals (Sweden)

    Gilson Morales

    2010-12-01

    Full Text Available This study aimed to create EI Scal, an environmental impact assessment scal, related to construction materials used in the reinforced concrete structure production. The main reason for that was based on the need to classify the environmental impact levels through indicators to assess the damage level process. The scale allowed converting information to estimate the environmental impact caused. Indicators were defined trough the requirements and classification criteria of impact aspects considering the eco-design theory. Moreover, the scale allowed classifying the materials and processes environmental impact through four score categories which resulted in a single final impact score. It was concluded that the EI scale could be cheap, accessible, and relevant tool for environmental impact controlling and reduction, allowing the planning and material specification to minimize the construction negative effects caused in the environment.

  8. Small-scale wind power design, analysis, and environmental impacts

    CERN Document Server

    Abraham, John P

    2014-01-01

    In today's world, clean and robust energy sources are being sought to provide power to residences, commercial operations, and manufacturing enterprises. Among the most appealing energy sources is wind power-with its high reliability and low environmental impact. Wind power's rapid penetration into markets throughout the world has taken many forms, and this book discusses the types of wind power, as well as the appropriate decisions that need to be made regarding wind power design, testing, installation, and analysis. Inside, the authors detail the design of various small-wind systems including horizontal-axis wind turbines (HAWTs) and vertical-axis wind turbines (VAWTs). The design of wind turbines takes advantage of many avenues of investigation, all of which are included in the book. Analytical methods that have been developed over the past few decades are major methods used for design. Alternatively, experimentation (typically using scaled models in wind tunnels) and numerical simulation (using modern comp...

  9. 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

  10. 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.

  11. 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.

  12. Impact of Scattering Model on Disdrometer Derived Attenuation Scaling

    Science.gov (United States)

    Zemba, Michael; Luini, Lorenzo; Nessel, James; Riva, Carlo (Compiler)

    2016-01-01

    NASA Glenn Research Center (GRC), the Air Force Research Laboratory (AFRL), and the Politecnico di Milano (POLIMI) are currently entering the third year of a joint propagation study in Milan, Italy utilizing the 20 and 40 GHz beacons of the Alphasat TDP5 Aldo Paraboni scientific payload. The Ka- and Q-band beacon receivers were installed at the POLIMI campus in June of 2014 and provide direct measurements of signal attenuation at each frequency. Collocated weather instrumentation provides concurrent measurement of atmospheric conditions at the receiver; included among these weather instruments is a Thies Clima Laser Precipitation Monitor (optical disdrometer) which records droplet size distributions (DSD) and droplet velocity distributions (DVD) during precipitation events. This information can be used to derive the specific attenuation at frequencies of interest and thereby scale measured attenuation data from one frequency to another. Given the ability to both predict the 40 GHz attenuation from the disdrometer and the 20 GHz timeseries as well as to directly measure the 40 GHz attenuation with the beacon receiver, the Milan terminal is uniquely able to assess these scaling techniques and refine the methods used to infer attenuation from disdrometer data.In order to derive specific attenuation from the DSD, the forward scattering coefficient must be computed. In previous work, this has been done using the Mie scattering model, however, this assumes a spherical droplet shape. The primary goal of this analysis is to assess the impact of the scattering model and droplet shape on disdrometer derived attenuation predictions by comparing the use of the Mie scattering model to the use of the T-matrix method, which does not assume a spherical droplet. In particular, this paper will investigate the impact of these two scattering approaches on the error of the resulting predictions as well as on the relationship between prediction error and rain rate.

  13. Disturbance to desert soil ecosystems contributes to dust-mediated impacts at regional scales

    Science.gov (United States)

    Pointing, Stephen B.; Belnap, Jayne

    2014-01-01

    This review considers the regional scale of impacts arising from disturbance to desert soil ecosystems. Deserts occupy over one-third of the Earth’s terrestrial surface, and biological soil covers are critical to stabilization of desert soils. Disturbance to these can contribute to massive destabilization and mobilization of dust. This results in dust storms that are transported across inter-continental distances where they have profound negative impacts. Dust deposition at high altitudes causes radiative forcing of snowpack that leads directly to altered hydrological regimes and changes to freshwater biogeochemistry. In marine environments dust deposition impacts phytoplankton diazotrophy, and causes coral reef senescence. Increasingly dust is also recognized as a threat to human health.

  14. Psychometrics of the Laffrey Health Conception Scale for adolescents.

    Science.gov (United States)

    Yarcheski, Adela; Mahon, Noreen E; Yarcheski, Thomas J

    2005-01-01

    The purposes of this methodological study were to factor analyze the Laffrey Health Conception Scale (LHCS) and to assess construct validity of the instrument with early adolescents. The final sample consisted of 230 early adolescents, aged 12 to 14, who responded to instrument packets in classrooms in an urban middle school. Data obtained on the LHCS were subjected to principal components factor analysis with oblique rotation. A two-factor solution was accepted, which is consistent with early adolescents' conceptions of health. Factor I was labeled Wellness and Factor II was labeled Clinical Health. A higher order factor analysis yielded one factor with 26 items, labeled the LHCS for Early Adolescents. The 26-item LHCS had a coefficient alpha of .95. Construct validity was assessed by testing three theoretical propositions, which significantly linked health conception to social support, self-esteem, and positive health practices. The findings indicate that the LHCS is a reliable and valid measure of health conceptions in early adolescents. Results also offer flexibility to researchers interested in testing theory involving the constructs of the definition of health, wellness, and clinical health in early adolescents.

  15. 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

  16. ENSO impacts on flood risk at the global scale

    Science.gov (United States)

    Ward, Philip; Dettinger, Michael; Jongman, Brenden; Kummu, Matti; Winsemius, Hessel

    2014-05-01

    We present the impacts of El Niño Southern Oscillation (ENSO) on society and the economy, via relationships between ENSO and the hydrological cycle. We also discuss ways in which this knowledge can be used in disaster risk management and risk reduction. This contribution provides the most recent results of an ongoing 4-year collaborative research initiative to assess and map the impacts of large scale interannual climate variability on flood hazard and risk at the global scale. We have examined anomalies in flood risk between ENSO phases, whereby flood risk is expressed in terms of indicators such as: annual expected damage; annual expected affected population; annual expected affected Gross Domestic Product (GDP). We show that large anomalies in flood risk occur during El Niño or La Niña years in basins covering large parts of the Earth's surface. These anomalies reach statistical significance river basins covering almost two-thirds of the Earth's surface. Particularly strong anomalies exist in southern Africa, parts of western Africa, Australia, parts of Central Eurasia (especially for El Niño), the western USA (especially La Niña anomalies), and parts of South America. We relate these anomalies to possible causal relationships between ENSO and flood hazard, using both modelled and observed data on flood occurrence and extremity. The implications for flood risk management are many-fold. In those regions where disaster risk is strongly influenced by ENSO, the potential predictably of ENSO could be used to develop probabilistic flood risk projections with lead times up to several seasons. Such data could be used by the insurance industry in managing risk portfolios and by multinational companies for assessing the robustness of their supply chains to potential flood-related interruptions. Seasonal forecasts of ENSO influence of peak flows could also allow for improved flood early warning and regulation by dam operators, which could also reduce overall risks

  17. Stroke Impact Scale 3.0: Reliability and Validity Evaluation of the Korean Version.

    Science.gov (United States)

    Choi, Seong Uk; Lee, Hye Sun; Shin, Joon Ho; Ho, Seung Hee; Koo, Mi Jung; Park, Kyoung Hae; Yoon, Jeong Ah; Kim, Dong Min; Oh, Jung Eun; Yu, Se Hwa; Kim, Dong A

    2017-06-01

    To establish the reliability and validity the Korean version of the Stroke Impact Scale (K-SIS) 3.0. A total of 70 post-stroke patients were enrolled. All subjects were evaluated for general characteristics, Mini-Mental State Examination (MMSE), the National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index, Hospital Anxiety and Depression Scale (HADS). The SF-36 and K-SIS 3.0 assessed their health-related quality of life. Statistical analysis after evaluation, determined the reliability and validity of the K-SIS 3.0. A total of 70 patients (mean age, 54.97 years) participated in this study. Internal consistency of the SIS 3.0 (Cronbach's alpha) was obtained, and all domains had good co-efficiency, with threshold above 0.70. Test-retest reliability of SIS 3.0 required correlation (Spearman's rho) of the same domain scores obtained on the first and second assessments. Results were above 0.5, with the exception of social participation and mobility. Concurrent validity of K-SIS 3.0 was assessed using the SF-36, and other scales with the same or similar domains. Each domain of K-SIS 3.0 had a positive correlation with corresponding similar domain of SF-36 and other scales (HADS, MMSE, and NIHSS). The newly developed K-SIS 3.0 showed high inter-intra reliability and test-retest reliabilities, together with high concurrent validity with the original and various other scales, for patients with stroke. K-SIS 3.0 can therefore be used for stroke patients, to assess their health-related quality of life and treatment efficacy.

  18. Environmental Impacts of Large Scale Biochar Application Through Spatial Modeling

    Science.gov (United States)

    Huber, I.; Archontoulis, S.

    2017-12-01

    In an effort to study the environmental (emissions, soil quality) and production (yield) impacts of biochar application at regional scales we coupled the APSIM-Biochar model with the pSIMS parallel platform. So far the majority of biochar research has been concentrated on lab to field studies to advance scientific knowledge. Regional scale assessments are highly needed to assist decision making. The overall objective of this simulation study was to identify areas in the USA that have the most gain environmentally from biochar's application, as well as areas which our model predicts a notable yield increase due to the addition of biochar. We present the modifications in both APSIM biochar and pSIMS components that were necessary to facilitate these large scale model runs across several regions in the United States at a resolution of 5 arcminutes. This study uses the AgMERRA global climate data set (1980-2010) and the Global Soil Dataset for Earth Systems modeling as a basis for creating its simulations, as well as local management operations for maize and soybean cropping systems and different biochar application rates. The regional scale simulation analysis is in progress. Preliminary results showed that the model predicts that high quality soils (particularly those common to Iowa cropping systems) do not receive much, if any, production benefit from biochar. However, soils with low soil organic matter ( 0.5%) do get a noteworthy yield increase of around 5-10% in the best cases. We also found N2O emissions to be spatial and temporal specific; increase in some areas and decrease in some other areas due to biochar application. In contrast, we found increases in soil organic carbon and plant available water in all soils (top 30 cm) due to biochar application. The magnitude of these increases (% change from the control) were larger in soil with low organic matter (below 1.5%) and smaller in soils with high organic matter (above 3%) and also dependent on biochar

  19. Performance Health Monitoring of Large-Scale Systems

    Energy Technology Data Exchange (ETDEWEB)

    Rajamony, Ram [IBM Research, Austin, TX (United States)

    2014-11-20

    This report details the progress made on the ASCR funded project Performance Health Monitoring for Large Scale Systems. A large-­scale application may not achieve its full performance potential due to degraded performance of even a single subsystem. Detecting performance faults, isolating them, and taking remedial action is critical for the scale of systems on the horizon. PHM aims to develop techniques and tools that can be used to identify and mitigate such performance problems. We accomplish this through two main aspects. The PHM framework encompasses diagnostics, system monitoring, fault isolation, and performance evaluation capabilities that indicates when a performance fault has been detected, either due to an anomaly present in the system itself or due to contention for shared resources between concurrently executing jobs. Software components called the PHM Control system then build upon the capabilities provided by the PHM framework to mitigate degradation caused by performance problems.

  20. Scaling-Up the Impact of Aflatoxin Research in Africa. The Role of Social Sciences

    Directory of Open Access Journals (Sweden)

    Francois Stepman

    2018-03-01

    Full Text Available At the interface between agriculture and nutrition, the aflatoxin contamination of food and feed touches on agriculture, health, and trade. For more than three decades now, the problem of aflatoxin has been researched in Africa. The interest of development cooperation for aflatoxin and the support to aflatoxin mitigation projects has its ups and downs. The academic world and the development world still seem to operate in different spheres and a collaboration is still challenging due to the complexity of the contamination sources at pre-harvest and post-harvest levels. There is a growing call by research funders and development actors for the impact of solutions at a scale. The solutions to mitigate aflatoxin contamination require new ways of working together. A more prominent role is to be played by social scientists. The role of social scientists in scaling-up the impact of aflatoxin research in Africa and the proposed mitigation solutions is to ensure that awareness, advantage, affordability, and access are systematically assessed. Aflatoxin-reduced staple foods and feed would be an agricultural result with a considerable health and food safety impact.

  1. EI Scale: an environmental impact assessment scale related to the construction materials used in the reinforced concrete

    OpenAIRE

    Gilson Morales; Antonio Edésio Jungles; Sheila Elisa Scheidemantel Klein; Juliana Guarda

    2010-01-01

    This study aimed to create EI Scal, an environmental impact assessment scal, related to construction materials used in the reinforced concrete structure production. The main reason for that was based on the need to classify the environmental impact levels through indicators to assess the damage level process. The scale allowed converting information to estimate the environmental impact caused. Indicators were defined trough the requirements and classification criteria of impact aspects consid...

  2. 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.

  3. Watershed scale impacts of bioenergy, landscape changes, and ecosystem response

    Science.gov (United States)

    Chaubey, Indrajeet; Cibin, Raj; Chiang, Li-Chi

    2013-04-01

    loading at watershed outlet were reduced with bioenergy scenarios except for stover removal scenarios with reduction ranging between 2.4% to 30.5%. Based on the simulation results for different bioenergy crop production scenario, we have also developed a multi-level spatial optimization framework (MLSOPT) to optimize production of food and energy crops under various sustainability objective functions. The method works in two levels, first level divides large watershed into small subareas and optimum solutions for individually for these subareas are identified. The second level uses these optimum solutions from the first level to identify watershed scale optimum solutions. The framework is tested with a complex spatial optimization case study designed to maximize crop residue (corn stover) harvest with minimum environmental impacts in a 2000 km2 watershed, located in Indiana, USA. In this presentation, results related to optimize sustainability of bioenergy crops will also be discussed.

  4. Urban land use, air toxics and public health: Assessing hazardous exposures at the neighborhood scale

    International Nuclear Information System (INIS)

    Corburn, Jason

    2007-01-01

    Land use data are increasingly understood as important indicators of potential environmental health risk in urban areas where micro-scale or neighborhood level hazard exposure data are not routinely collected. This paper aims to offer a method for estimating the distribution of air toxics in urban neighborhoods using land use information because actual air monitoring data rarely exist at this scale. Using Geographic Information System spatial modeling tools, we estimate air toxics concentrations across neighborhoods in New York City and statistically compare our model with the US Environmental Protection Agency's National Air Toxic Assessment and air monitoring data across three NYC neighborhoods. We conclude that land use data can act as a good proxy for estimating neighborhood scale air toxics, particularly in the absence of monitoring data. In addition, the paper suggests that land use data can expand the reach of environmental impact assessments that routinely exclude analyses of potential exposures to urban air toxics at the neighborhood scale

  5. 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.

  6. Development of Wagle Health-Specific Religiousness scale.

    Science.gov (United States)

    Wagle, Ann M; Champion, Victoria L; Russell, Kathleen M; Rawl, Susan M

    2009-01-01

    African American women have a lower rate of regular mammography screening, resulting in higher incidence of advanced-stage breast cancer at diagnosis and a lower 5-year survival rate as compared with white women. Researchers have demonstrated that several health beliefs relate to mammography screening in African American women, but little attention has been paid to the importance of religiousness. Although some authors have attempted to determine a link between religiousness and health, we lack a valid and reliable instrument to measure religiousness that can be found in the context of health behaviors. The purpose of this article is to describe the development and psychometric testing of the Wagle Health-Specific Religiousness (WHSR) scale, an instrument used to measure religious beliefs and the influence of those beliefs on mammography screening for African American women. A sample of 344 low-income African American women who were nonadherent to mammography at accrual participating in a randomized trial completed the WHSR. Data from this trial were used to determine the validity and reliability of the WHSR. The 19-item WHSR scale had a Cronbach alpha of. 94. Construct validity was supported via factor analysis and analysis of theoretical relationships. Although further testing is warranted, this analysis indicates that the concept of religiousness is an important component of mammography behavior in African American women.

  7. Scaling Lean in primary care: impacts on system performance.

    Science.gov (United States)

    Hung, Dorothy Y; Harrison, Michael I; Martinez, Meghan C; Luft, Harold S

    2017-03-01

    We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff. We used interrupted time series analysis with generalized linear mixed models to estimate Lean impacts over time. Projected outcomes in the absence of changes (ie, counterfactuals) were compared with observed outcomes after Lean redesigns were implemented, and mean differences were assessed using 95% bias-corrected bootstrap confidence intervals (CIs). We observed systemwide improvements in workflow efficiencies (eg, 95% CI, 5.8-10.4) and physician productivity (95% CI, 3.9-27.2), with no adverse effects on clinical quality. Patient satisfaction increased with respect to access to care (95% CI, 15.2-20.7), handling of personal issues (95% CI, 2.1-6.9), and overall experience of care (95% CI, 11.0-17.0), but decreased with respect to interactions with care providers (95% CI, -13.4 to -5.7). Departmental operating costs decreased, and annual staff and physician satisfaction scores increased particularly among early adopters, with key improvements in employee engagement, connection to purpose, relationships with staff, and physician time spent working. Lean redesigns can benefit primary care patients, physicians, and staff without negatively impacting the quality of clinical care. Study results may lead other delivery system leaders to innovate using Lean techniques and may further enhance support for Lean learning among public and private payers.

  8. Air Pollution and Climate Change Health Impact Assessment. The ACHIA Project

    International Nuclear Information System (INIS)

    Kinney, P.L.

    2013-01-01

    Climate change may affect human health via interactions with air pollutants such as ozone and PM 2.5 . These air pollutants are linked to climate because they can be both affected by and have effects on climate. In coming decades, substantial, cost-effective improvements in public health may be achieved with well-planned strategies to mitigate climate impacts while also reducing health effects of ozone and PM 2.5 . Climate mitigation actions affect greenhouse pollutant emissions, including methane and black carbon, but also may affect other key air pollution precursors such as NOx, CO, and SOx. To better understand the potential of such strategies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. The overall objective of this project is to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of ozone and PM 2.5 under different IPCCs scenario of climate change, focusing specifically on pollution-related health co-benefits which could be achieved under alternative climate mitigation pathways in the period 2030-2050. This question will be explored at three spatial scales: global, regional (Europe), and urban (Paris). ACHIA is comprised of an integrated set of four work packages: WP1. Global Climate and Air Pollution Impacts of Alternative Emissions Pathways; WP2. Climate and Air Quality at Regional and Urban Scales: Results for Europe and Paris; WP3. Health Impact Assessment; WP4. Dissemination, Evaluation, Management. ACHIA is designed to create an interdisciplinary approach to the impacts of climate change on health through air quality changes, and to start longer-term collaborations between communities. We expect the project to advance state of art across all WPs, with important implications for research groups around the world. A particular innovation of the project is the multi-scale aspect, i.e., the

  9. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study

    Directory of Open Access Journals (Sweden)

    Julius T Kamwesiga

    2016-09-01

    Full Text Available Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17% items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75. Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision

  10. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study.

    Science.gov (United States)

    Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

    2016-01-01

    Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda ( in English ) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda ( both in English and Luganda ) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement

  11. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study

    Science.gov (United States)

    Kamwesiga, Julius T; von Koch, Lena; Kottorp, Anders; Guidetti, Susanne

    2016-01-01

    Background: Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point

  12. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

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

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

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

  13. Impact of large scale flows on turbulent transport

    Energy Technology Data Exchange (ETDEWEB)

    Sarazin, Y [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Grandgirard, V [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Dif-Pradalier, G [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Fleurence, E [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Garbet, X [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Ghendrih, Ph [Association Euratom-CEA, CEA/DSM/DRFC centre de Cadarache, 13108 St-Paul-Lez-Durance (France); Bertrand, P [LPMIA-Universite Henri Poincare Nancy I, Boulevard des Aiguillettes BP239, 54506 Vandoe uvre-les-Nancy (France); Besse, N [LPMIA-Universite Henri Poincare Nancy I, Boulevard des Aiguillettes BP239, 54506 Vandoe uvre-les-Nancy (France); Crouseilles, N [IRMA, UMR 7501 CNRS/Universite Louis Pasteur, 7 rue Rene Descartes, 67084 Strasbourg (France); Sonnendruecker, E [IRMA, UMR 7501 CNRS/Universite Louis Pasteur, 7 rue Rene Descartes, 67084 Strasbourg (France); Latu, G [LSIIT, UMR 7005 CNRS/Universite Louis Pasteur, Bd Sebastien Brant BP10413, 67412 Illkirch (France); Violard, E [LSIIT, UMR 7005 CNRS/Universite Louis Pasteur, Bd Sebastien Brant BP10413, 67412 Illkirch (France)

    2006-12-15

    The impact of large scale flows on turbulent transport in magnetized plasmas is explored by means of various kinetic models. Zonal flows are found to lead to a non-linear upshift of turbulent transport in a 3D kinetic model for interchange turbulence. Such a transition is absent from fluid simulations, performed with the same numerical tool, which also predict a much larger transport. The discrepancy cannot be explained by zonal flows only, despite they being overdamped in fluids. Indeed, some difference remains, although reduced, when they are artificially suppressed. Zonal flows are also reported to trigger transport barriers in a 4D drift-kinetic model for slab ion temperature gradient (ITG) turbulence. The density gradient acts as a source drive for zonal flows, while their curvature back stabilizes the turbulence. Finally, 5D simulations of toroidal ITG modes with the global and full-f GYSELA code require the equilibrium density function to depend on the motion invariants only. If not, the generated strong mean flows can completely quench turbulent transport.

  14. Impact of large scale flows on turbulent transport

    International Nuclear Information System (INIS)

    Sarazin, Y; Grandgirard, V; Dif-Pradalier, G; Fleurence, E; Garbet, X; Ghendrih, Ph; Bertrand, P; Besse, N; Crouseilles, N; Sonnendruecker, E; Latu, G; Violard, E

    2006-01-01

    The impact of large scale flows on turbulent transport in magnetized plasmas is explored by means of various kinetic models. Zonal flows are found to lead to a non-linear upshift of turbulent transport in a 3D kinetic model for interchange turbulence. Such a transition is absent from fluid simulations, performed with the same numerical tool, which also predict a much larger transport. The discrepancy cannot be explained by zonal flows only, despite they being overdamped in fluids. Indeed, some difference remains, although reduced, when they are artificially suppressed. Zonal flows are also reported to trigger transport barriers in a 4D drift-kinetic model for slab ion temperature gradient (ITG) turbulence. The density gradient acts as a source drive for zonal flows, while their curvature back stabilizes the turbulence. Finally, 5D simulations of toroidal ITG modes with the global and full-f GYSELA code require the equilibrium density function to depend on the motion invariants only. If not, the generated strong mean flows can completely quench turbulent transport

  15. Impact of trismus on health-related quality of life and mental health.

    Science.gov (United States)

    Johnson, Joakim; Johansson, Mia; Rydén, Anna; Houltz, Erik; Finizia, Caterina

    2015-11-01

    Trismus is a common symptom often related to the treatment for head and neck cancer and to temporomandibular disorders. The purpose of the present study was to measure the impact of trismus on health-related quality of life (HRQOL) and mental health in patients with head and neck cancer and temporomandibular disorder. We used the criteria for trismus of maximum interincisal opening (MIO) ≤35 mm and the study subjects responded to the following instruments: the Gothenburg Trismus Questionnaire (GTQ), the Short-Form 36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). The study also comprised an age-matched and sex-matched control group without trismus. Patients with trismus reported significantly more dysfunction in all GTQ domains and more facial pain compared to the control group. The patients with head and neck cancer and trismus scored significantly lower on all SF-36 domains except general health compared to the control group, and the patients with temporomandibular disorder with trismus scored significantly lower in 3 of the 8 domains in SF-36. According to the HADS, a greater proportion of patients with head and neck cancer with trismus displayed more depression compared to the control group. The results showed that trismus is associated with a significant impact on HRQOL and that patients with trismus should be approached in a holistic way with respect for the underlying cause, treating not only the physical aspects of trismus but also addressing the patients' mental health. © 2014 Wiley Periodicals, Inc.

  16. 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.

  17. Predicting physical health: implicit mental health measures versus self-report scales.

    Science.gov (United States)

    Cousineau, Tara McKee; Shedler, Jonathan

    2006-06-01

    Researchers have traditionally relied on self-report questionnaires to assess psychological well-being, but such measures may be unable to differentiate individuals who are genuinely psychologically healthy from those who maintain a facade or illusion of mental health based on denial and self-deception. Prior research suggests that clinically derived assessment procedures that assess implicit psychological processes may have advantages over self-report mental health measures. This prospective study compared the Early Memory Index, an implicit measure of mental health/distress, with a range of familiar self-report scales as predictors of physical health. The Early Memory Index showed significant prospective associations with health service utilization and clinically verified illness. In contrast, self-report measures of mental health, perceived stress, life events stress, and mood states did not predict health outcomes. The findings highlight the limitations of self-report questionnaires and suggest that implicit measures have an important role to play in mental health research.

  18. 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

  19. 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

  20. Workplace relationships impact self-rated health: A survey of Swedish municipal health care employees.

    Science.gov (United States)

    Persson, Sophie Schön; Lindström, Petra Nilsson; Pettersson, Pär; Andersson, Ingemar

    2018-05-22

    The impact of positive social relationships on the health of municipal employees in the elder care sector in Sweden needs further examination. To explore the association between health and relationships among elderly care employees using a salutogenic perspective. Survey of all employees (n = 997) in special housing, home care and Disabled Support and Services in a Swedish municipality. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, social climate, and health-promoting workplace relationships. The response rate was 69% . Results of a multivariable linear regression model showed four significant predictors of health: general work experiences, colleague belongingness and positive relationships with managers and care recipients. In another model, colleague belongingness was significantly related to satisfaction with care recipients, work, length of employment as well as general work experiences and relationships with managers. Strengthening of positive work relationships, not only between workmates but also with managers and care recipients, seems to be an essential area for employee health promotion. Colleague belongingness may be deepened by development of a positive work climate, including satisfactory work experiences, positive manager relationships and a stable work force.

  1. A regional-scale Ocean Health Index for Brazil.

    Science.gov (United States)

    Elfes, Cristiane T; Longo, Catherine; Halpern, Benjamin S; Hardy, Darren; Scarborough, Courtney; Best, Benjamin D; Pinheiro, Tiago; Dutra, Guilherme F

    2014-01-01

    Brazil has one of the largest and fastest growing economies and one of the largest coastlines in the world, making human use and enjoyment of coastal and marine resources of fundamental importance to the country. Integrated assessments of ocean health are needed to understand the condition of a range of benefits that humans derive from marine systems and to evaluate where attention should be focused to improve the health of these systems. Here we describe the first such assessment for Brazil at both national and state levels. We applied the Ocean Health Index framework, which evaluates ten public goals for healthy oceans. Despite refinements of input data and model formulations, the national score of 60 (out of 100) was highly congruent with the previous global assessment for Brazil of 62. Variability in scores among coastal states was most striking for goals related to mariculture, protected areas, tourism, and clean waters. Extractive goals, including Food Provision, received low scores relative to habitat-related goals, such as Biodiversity. This study demonstrates the applicability of the Ocean Health Index at a regional scale, and its usefulness in highlighting existing data and knowledge gaps and identifying key policy and management recommendations. To improve Brazil's ocean health, this study suggests that future actions should focus on: enhancing fisheries management, expanding marine protected areas, and monitoring coastal habitats.

  2. Fetal health locus of control: Scale properties and applications in preconception health programs.

    Science.gov (United States)

    Soliday, Elizabeth; Strahm, Anna; Mammenga, Stefani

    2016-04-01

    Preconception health programs have resulted in improved health behaviors among participants and have shown promise in reducing adverse birth outcomes. However, the role of health beliefs in preconception health program outcomes has been overlooked but warrants attention due to reported positive associations between women's views of control over fetal health and health behavior in pregnancy. Towards an ultimate aim of improving preconception health program reach and effectiveness, we examined properties of a fetal health locus of control (FHLC; Labs & Wurtele, 1986) measure in nulliparous, childbearing aged university women and men. Students (n=1467) completed an online survey that included the FHLC subscales maternal, powerful others', and chance control over fetal health. Factor analyses and correlations with related scales supported the soundness of FHLC constructs in both women and men. All participants rated maternal control in fetal health nearly twice as highly as powerful others' and chance. We therefore recommend that FHLC be integrated into preconception health program evaluation as personal agency in fetal health likely has an important role in women's and men's preconception health behavior and health behavior change. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Environmental Impacts From the Installation and Operation of Large-scale Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Fthenakis, V.; Turney, Damon

    2011-04-23

    Large-scale solar power plants are being developed at a rapid rate, and are setting up to use thousands or millions of acres of land globally. The environmental issues related to the installation and operation phases of such facilities have not, so far, been addressed comprehensively in the literature. Here we identify and appraise 32 impacts from these phases, under the themes of land use intensity, human health and well-being, plant and animal life, geohydrological resources, and climate change. Our appraisals assume that electricity generated by new solar power facilities will displace electricity from traditional U.S. generation technologies. Altogether we find 22 of the considered 32 impacts to be beneficial. Of the remaining 10 impacts, 4 are neutral, and 6 require further research before they can be appraised. None of the impacts are negative relative to traditional power generation. We rank the impacts in terms of priority, and find all the high-priority impacts to be beneficial. In quantitative terms, large-scale solar power plants occupy the same or less land per kW h than coal power plant life cycles. Removal of forests to make space for solar power causes CO{sub 2} emissions as high as 36 g CO{sub 2} kW h{sup -1}, which is a significant contribution to the life cycle CO{sub 2} emissions of solar power, but is still low compared to CO{sub 2} emissions from coal-based electricity that are about 1100 g CO{sub 2} kW h{sup -1}.

  4. Aging and health: Self-efficacy for Self-direction in Health Scale

    Directory of Open Access Journals (Sweden)

    Albertina L Oliveira

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To validate the Escala de Autoeficácia para a Autodireção na Saúde (EAAS – Self-efficacy for Self-direction in Health Scale. METHODS Non-experimental quantitative study of EAAS validation, by confirmatory factorial analyses, evaluating a sample of 508 older adults from the north and the center of Portugal with mean age of 71.67 (from 51 to 96 years, to whom the Self-efficacy for Self-direction in Health Scale, the Rosenberg Self-esteem Scale, the Positive and Negative Affect Schedule, the Satisfaction with Life Scale, and the Instrumental Activities of Daily Living Scale were applied. The EAAS was developed from the theoretical constructs of self-efficacy and from self-directed learning within the PALADIN European project framework, aiming to develop an instrument able to assess the extent to which older adults take good care of their health. RESULTS The internal consistency was 0.87 (Cronbach’s alpha and confirmatory factorial analyses enabled to find a model near the one theoretically proposed, indicating a structure consisting of four dimensions: physical exercise, healthy diet, engaging in health-related learning, and visits to health professionals. From the psychometric point of view, the model in four factors showed quite satisfactory fit indicators. CONCLUSIONS The Self-efficacy for Self-direction in Health Scale, with 16 items, is adequate to evaluate to what extent older adults have confidence in their ability to take care of their own health, with high degree of autonomy.

  5. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  6. 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.

  7. Climate Change, Air Pollution, and the Economics of Health Impacts

    Science.gov (United States)

    Reilly, J.; Yang, T.; Paltsev, S.; Wang, C.; Prinn, R.; Sarofim, M.

    2003-12-01

    Climate change and air pollution are intricately linked. The distinction between greenhouse substances and other air pollutants is resolved at least for the time being in the context of international negotiations on climate policy through the identification of CO2, CH4, N2O, SF6 and the per- and hydro- fluorocarbons as substances targeted for control. Many of the traditional air pollutant emissions including for example CO, NMVOCs, NOx, SO2, aerosols, and NH3 also directly or indirectly affect the radiative balance of the atmosphere. Among both sets of gases are precursors of and contributors to pollutants such as tropopospheric ozone, itself a strong greenhouse gas, particulate matter, and other pollutants that affect human health. Fossil fuel combustion, production, or transportation is a significant source for many of these substances. Climate policy can thus affect traditional air pollution or air pollution policy can affect climate. Health effects of acute or chronic exposure to air pollution include increased asthma, lung cancer, heart disease and bronchitis among others. These, in turn, redirect resources in the economy toward medical expenditures or result in lost labor or non-labor time with consequent effects on economic activity, itself producing a potential feedback on emissions levels. Study of these effects ultimately requires a fully coupled earth system model. Toward that end we develop an approach for introducing air pollution health impacts into the Emissions Prediction and Policy Analysis (EPPA) model, a component of the MIT Integrated Global Systems Model (IGSM) a coupled economics-chemistry-atmosphere-ocean-terrestrial biosphere model of earth systems including an air pollution model resolving the urban scale. This preliminary examination allows us to consider how climate policy affects air pollution and consequent health effects, and to study the potential impacts of air pollution policy on climate. The novel contribution is the effort to

  8. The Impact of Micro-Finance on the Performance of Small-Scale ...

    African Journals Online (AJOL)

    The Impact of Micro-Finance on the Performance of Small-Scale Enterprises: A Comparison of ... PROMOTING ACCESS TO AFRICAN RESEARCH ... the impact that the study-MFIs are making on their SMEs-client in the Wa Municipality.

  9. 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.

  10. 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

  11. The Short Health Scale: a valid and reliable measure of health related quality of life in English speaking inflammatory bowel disease patients.

    LENUS (Irish Health Repository)

    McDermott, Edel

    2013-09-01

    Health related quality of life in inflammatory bowel disease is influenced both by disease activity as well as by the psychosocial characteristics of the individual patient. The Short Health Scale (SHS) is a four-part visual analogue scale questionnaire using open-ended questions that are designed to assess the impact of inflammatory bowel disease on a health related quality of life. The four dimensions include bowel symptoms, activities of daily life, worry and general wellbeing. It has previously been validated in Swedish and Norwegian speaking patients.

  12. The global financial crisis and health: scaling up our effort.

    Science.gov (United States)

    Labonté, Ronald

    2009-01-01

    Economic events of the past year are beginning to create hardships for tens of thousands of Canadians. There are likely to be health effects as well, to the extent that unemployment and poverty rates rise. Conditions, however, will be much worse for those living in poorer countries. High-income countries are committing trillions of dollars in countercyclical spending and banking bail-outs. Poorer countries need to do the same, but lack the resources to do so. Yet foreign aid and fairer trade are widely expected to be among the first high-income country victims of the recession fallout as nations turn inwards and protectionist. This is neither good for global health nor necessary given the scale of untaxed (or unfairly taxed) wealth that could be harnessed for a truly global rescue package. Policy choices confront us. The Canadian public health community must hold our political leadership accountable for making those choices that will improve health globally and not further imperil the well-being of much of the world's population in efforts to secure our own future economic revival.

  13. Large-scale Health Information Database and Privacy Protection.

    Science.gov (United States)

    Yamamoto, Ryuichi

    2016-09-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients' medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  14. Large-scale Health Information Database and Privacy Protection*1

    Science.gov (United States)

    YAMAMOTO, Ryuichi

    2016-01-01

    Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA*2 projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients’ medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

  15. Bias-correction and Spatial Disaggregation for Climate Change Impact Assessments at a basin scale

    Science.gov (United States)

    Nyunt, Cho; Koike, Toshio; Yamamoto, Akio; Nemoto, Toshihoro; Kitsuregawa, Masaru

    2013-04-01

    Basin-scale climate change impact studies mainly rely on general circulation models (GCMs) comprising the related emission scenarios. Realistic and reliable data from GCM is crucial for national scale or basin scale impact and vulnerability assessments to build safety society under climate change. However, GCM fail to simulate regional climate features due to the imprecise parameterization schemes in atmospheric physics and coarse resolution scale. This study describes how to exclude some unsatisfactory GCMs with respect to focused basin, how to minimize the biases of GCM precipitation through statistical bias correction and how to cover spatial disaggregation scheme, a kind of downscaling, within in a basin. GCMs rejection is based on the regional climate features of seasonal evolution as a bench mark and mainly depends on spatial correlation and root mean square error of precipitation and atmospheric variables over the target region. Global Precipitation Climatology Project (GPCP) and Japanese 25-uear Reanalysis Project (JRA-25) are specified as references in figuring spatial pattern and error of GCM. Statistical bias-correction scheme comprises improvements of three main flaws of GCM precipitation such as low intensity drizzled rain days with no dry day, underestimation of heavy rainfall and inter-annual variability of local climate. Biases of heavy rainfall are conducted by generalized Pareto distribution (GPD) fitting over a peak over threshold series. Frequency of rain day error is fixed by rank order statistics and seasonal variation problem is solved by using a gamma distribution fitting in each month against insi-tu stations vs. corresponding GCM grids. By implementing the proposed bias-correction technique to all insi-tu stations and their respective GCM grid, an easy and effective downscaling process for impact studies at the basin scale is accomplished. The proposed method have been examined its applicability to some of the basins in various climate

  16. Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

    Science.gov (United States)

    Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

    2018-01-05

    Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. ©Rebecca Schnall, Hwayoung Cho, Jianfang Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 05.01.2018.

  17. 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...

  18. An evaluation of Health of the Nation Outcome Scales data to inform psychiatric morbidity following the Canterbury earthquakes.

    Science.gov (United States)

    Beaglehole, Ben; Frampton, Chris M; Boden, Joseph M; Mulder, Roger T; Bell, Caroline J

    2017-11-01

    Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. The Canterbury earthquakes were followed by an increase in Health of the Nation

  19. 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

  20. 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...

  1. Impact of scaling on the nitric-glycolic acid flowsheet

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, D. [Savannah River Site (SRS), Aiken, SC (United States)

    2016-02-01

    Savannah River Remediation (SRR) is considering using glycolic acid as a replacement for formic acid in Sludge Receipt and Adjustment Tank (SRAT) processing in the Defense Waste Processing Facility (DWPF). Catalytic decomposition of formic acid is responsible for the generation of hydrogen, a potentially flammable gas, during processing. To prevent the formation of a flammable mixture in the offgas, an air purge is used to dilute the hydrogen concentration below the 60% of the Composite Lower Flammability Limit (CLFL). The offgas is continuously monitored for hydrogen using Gas Chromatographs (GCs). Since formic acid is much more volatile and toxic than glycolic acid, a formic acid spill would lead to the release of much larger quantities to the environment. Switching from formic acid to glycolic acid is expected to eliminate the hydrogen flammability hazard leading to lower air purges, thus downgrading of Safety Significant GCs to Process Support GCs, and minimizing the consequence of a glycolic acid tank leak in DWPF. Overall this leads to a reduction in process operation costs and an increase in safety margin. Experiments were completed at three different scales to demonstrate that the nitric-glycolic acid flowsheet scales from the 4-L lab scale to the 22-L bench scale and 220-L engineering scale. Ten process demonstrations of the sludge-only flowsheet for SRAT and Slurry Mix Evaporator (SME) cycles were performed using Sludge Batch 8 (SB8)-Tank 40 simulant. No Actinide Removal Process (ARP) product or strip effluent was added during the runs. Six experiments were completed at the 4-L scale, two experiments were completed at the 22-L scale, and two experiments were completed at the 220-L scale. Experiments completed at the 4-L scale (100 and 110% acid stoichiometry) were repeated at the 22-L and 220-L scale for scale comparisons.

  2. Large-scale coastal impact induced by a catastrophic storm

    DEFF Research Database (Denmark)

    Fruergaard, Mikkel; Andersen, Thorbjørn Joest; Johannessen, Peter N

    breaching. Our results demonstrate that violent, millennial-scale storms can trigger significant large-scale and long-term changes on barrier coasts, and that coastal changes assumed to take place over centuries or even millennia may occur in association with a single extreme storm event....

  3. Scaling of neck performance requirements in side impacts

    NARCIS (Netherlands)

    Wismans, J.S.H.M.; Meijer, R.; Rodarius, C.; Been, B.W.

    2008-01-01

    Neck biofidelity performance requirements for different sized crash dummies and human body computer models are usually based on scaling of performance requirements derived for a 50th percentile body size. The objective of this study is to investigate the validity of the currently used scaling laws

  4. 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.

  5. 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.

  6. Impact of small-scale storage systems on the photovoltaic penetration potential at the municipal scale

    Science.gov (United States)

    Ramirez Camargo, Luis; Dorner, Wolfgang

    2016-04-01

    municipality using a series of indicators. These indicators include: a) the total photovoltaic installed capacity, b) the total storage installed capacity, c) the output variability, d) the total unfulfilled demand, e) total excess energy, f) total properly supplied energy, g) the loss of power supply probability, h) the amount of hours of supply higher than the highest demand in a year, i) the number of hours, when supply is 1.5. times higher than the highest demand in a year, and j) the additional storage energy capacity and power required to store all excess energy generated by the photovoltaic installations. The comparison of the proposed indicators serves to quantify the contribution that household-sized small-scale storage systems would make to the energy balance of the studied municipality. Increased installed energy storage capacity allows a higher roof-top photovoltaic share and improves energy utilization, variability and reliability indicators. The proposed methodology serves also to determine the amount of storage capacity with the highest positive impact on the local energy balance.

  7. A multi-scale metrics approach to forest fragmentation for Strategic Environmental Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eunyoung, E-mail: eykim@kei.re.kr [Korea Environment Institute, 215 Jinheungno, Eunpyeong-gu, Seoul 122-706 (Korea, Republic of); Song, Wonkyong, E-mail: wksong79@gmail.com [Suwon Research Institute, 145 Gwanggyo-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do 443-270 (Korea, Republic of); Lee, Dongkun, E-mail: dklee7@snu.ac.kr [Department of Landscape Architecture and Rural System Engineering, Seoul National University, 599 Gwanakro, Gwanak-gu, Seoul 151-921 (Korea, Republic of); Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul 151-921 (Korea, Republic of)

    2013-09-15

    Forests are becoming severely fragmented as a result of land development. South Korea has responded to changing community concerns about environmental issues. The nation has developed and is extending a broad range of tools for use in environmental management. Although legally mandated environmental compliance requirements in South Korea have been implemented to predict and evaluate the impacts of land-development projects, these legal instruments are often insufficient to assess the subsequent impact of development on the surrounding forests. It is especially difficult to examine impacts on multiple (e.g., regional and local) scales in detail. Forest configuration and size, including forest fragmentation by land development, are considered on a regional scale. Moreover, forest structure and composition, including biodiversity, are considered on a local scale in the Environmental Impact Assessment process. Recently, the government amended the Environmental Impact Assessment Act, including the SEA, EIA, and small-scale EIA, to require an integrated approach. Therefore, the purpose of this study was to establish an impact assessment system that minimizes the impacts of land development using an approach that is integrated across multiple scales. This study focused on forest fragmentation due to residential development and road construction sites in selected Congestion Restraint Zones (CRZs) in the Greater Seoul Area of South Korea. Based on a review of multiple-scale impacts, this paper integrates models that assess the impacts of land development on forest ecosystems. The applicability of the integrated model for assessing impacts on forest ecosystems through the SEIA process is considered. On a regional scale, it is possible to evaluate the location and size of a land-development project by considering aspects of forest fragmentation, such as the stability of the forest structure and the degree of fragmentation. On a local scale, land-development projects should

  8. Development of a Work Climate Scale in Emergency Health Services.

    Science.gov (United States)

    Sanduvete-Chaves, Susana; Lozano-Lozano, José A; Chacón-Moscoso, Salvador; Holgado-Tello, Francisco P

    2018-01-01

    An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS) have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability) are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate . Thus, we integrated the results found in (a) a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b) the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work). In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension). Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with four

  9. Development of a Work Climate Scale in Emergency Health Services

    Directory of Open Access Journals (Sweden)

    Susana Sanduvete-Chaves

    2018-01-01

    Full Text Available An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate. Thus, we integrated the results found in (a a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work. In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension. Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with

  10. 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.

  11. 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.

  12. 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...

  13. Differential melt scaling for oblique impacts on terrestrial planets

    Science.gov (United States)

    Abramov, Oleg; Wong, Stephanie M. Wong; Kring, David A. Kring

    2012-01-01

    Analytical estimates of melt volumes produced by a given projectile and contained in a given impact crater are derived as a function of impact velocity, impact angle, planetary gravity, target and projectile densities, and specific internal energy of melting. Applications to impact events and impact craters on the Earth, Moon, and Mars are demonstrated and discussed. The most probable oblique impact (45°) produces ∼1.6 times less melt volume than a vertical impact, and ∼1.6 and 3.7 times more melt volume than impacts with 30° and 15° trajectories, respectively. The melt volume for a particular crater diameter increases with planetary gravity, so a crater on Earth should have more melt than similar-size craters on Mars and the Moon. The melt volume for a particular projectile diameter does not depend on gravity, but has a strong dependence on impact velocity, so the melt generated by a given projectile on the Moon is significantly larger than on Mars. Higher surface temperatures and geothermal gradients increase melt production, as do lower energies of melting. Collectively, the results imply thinner central melt sheets and a smaller proportion of melt particles in impact breccias on the Moon and Mars than on Earth. These effects are illustrated in a comparison of the Chicxulub crater on Earth, linked to the Cretaceous–Tertiary mass extinction, Gusev crater on Mars, where the Mars Exploration Rover Spirit landed, and Tsiolkovsky crater on the Moon. The results are comparable to those obtained from field and spacecraft observations, other analytical expressions, and hydrocode simulations.

  14. Land use change impacts on floods at the catchment scale

    NARCIS (Netherlands)

    Rogger, M.; Agnoletti, M.; Alaoui, A.; Bathurst, J.C.; Bodner, G.; Borga, M.; Chaplot, Vincent; Gallart, F.; Glatzel, G.; Hall, J.; Holden, J.; Holko, L.; Horn, R.; Kiss, A.; Kohnová, S.; Leitinger, G.; Lennartz, B.; Parajka, J.; Perdigão, R.; Peth, S.; Plavcová, L.; Quinton, John N.; Robinson, Matthew R.; Salinas, J.L.; Santoro, A.; Szolgay, J.; Tron, S.; Akker, van den J.J.H.; Viglione, A.; Blöschl, G.

    2017-01-01

    Research gaps in understanding flood changes at the catchment scale caused by changes in forest management, agricultural practices, artificial drainage, and terracing are identified. Potential strategies in addressing these gaps are proposed, such as complex systems approaches to link processes

  15. 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...

  16. Semi-Automated Air-Coupled Impact-Echo Method for Large-Scale Parkade Structure

    Directory of Open Access Journals (Sweden)

    Tyler Epp

    2018-03-01

    Full Text Available Structural Health Monitoring (SHM has moved to data-dense systems, utilizing numerous sensor types to monitor infrastructure, such as bridges and dams, more regularly. One of the issues faced in this endeavour is the scale of the inspected structures and the time it takes to carry out testing. Installing automated systems that can provide measurements in a timely manner is one way of overcoming these obstacles. This study proposes an Artificial Neural Network (ANN application that determines intact and damaged locations from a small training sample of impact-echo data, using air-coupled microphones from a reinforced concrete beam in lab conditions and data collected from a field experiment in a parking garage. The impact-echo testing in the field is carried out in a semi-autonomous manner to expedite the front end of the in situ damage detection testing. The use of an ANN removes the need for a user-defined cutoff value for the classification of intact and damaged locations when a least-square distance approach is used. It is postulated that this may contribute significantly to testing time reduction when monitoring large-scale civil Reinforced Concrete (RC structures.

  17. Modelling future impacts of air pollution using the multi-scale UK Integrated Assessment Model (UKIAM).

    Science.gov (United States)

    Oxley, Tim; Dore, Anthony J; ApSimon, Helen; Hall, Jane; Kryza, Maciej

    2013-11-01

    Integrated assessment modelling has evolved to support policy development in relation to air pollutants and greenhouse gases by providing integrated simulation tools able to produce quick and realistic representations of emission scenarios and their environmental impacts without the need to re-run complex atmospheric dispersion models. The UK Integrated Assessment Model (UKIAM) has been developed to investigate strategies for reducing UK emissions by bringing together information on projected UK emissions of SO2, NOx, NH3, PM10 and PM2.5, atmospheric dispersion, criteria for protection of ecosystems, urban air quality and human health, and data on potential abatement measures to reduce emissions, which may subsequently be linked to associated analyses of costs and benefits. We describe the multi-scale model structure ranging from continental to roadside, UK emission sources, atmospheric dispersion of emissions, implementation of abatement measures, integration with European-scale modelling, and environmental impacts. The model generates outputs from a national perspective which are used to evaluate alternative strategies in relation to emissions, deposition patterns, air quality metrics and ecosystem critical load exceedance. We present a selection of scenarios in relation to the 2020 Business-As-Usual projections and identify potential further reductions beyond those currently being planned. © 2013.

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

    Science.gov (United States)

    Shannak, S.; Jaber, F. H.

    2013-12-01

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

  19. The impact of health system governance and policy processes on health services in Iraqi Kurdistan.

    Science.gov (United States)

    Tawfik-Shukor, Ali; Khoshnaw, Hiro

    2010-06-08

    Relative to the amount of global attention and media coverage since the first and second Gulf Wars, very little has been published in the health services research literature regarding the state of health services in Iraq, and particularly on the semi-autonomous region of Kurdistan. Building on findings from a field visit, this paper describes the state of health services in Kurdistan, analyzes their underlying governance structures and policy processes, and their overall impact on the quality, accessibility and cost of the health system, while stressing the importance of reinvesting in public health and community-based primary care. Very little validated, research-based data exists relating to the state of population health and health services in Kurdistan. What little evidence exists, points to a region experiencing an epidemiological polarization, with different segments of the population experiencing rapidly-diverging rates of morbidity and mortality related to different etiological patterns of communicable, non-communicable, acute and chronic illness and disease. Simply put, the rural poor suffer from malnutrition and cholera, while the urban middle and upper classes deal with issues of obesity and Type 2 diabetes. The inequity is exacerbated by a poorly governed, fragmented, unregulated, specialized and heavily privatized system, that not only leads to poor quality of care and catastrophic health expenditures, but also threatens the economic and political stability of the region. There is an urgent need to revisit and clearly define the core values and goals of a future health system, and to develop an inclusive governance and policy framework for change, towards a more equitable and effective primary care-based health system, with attention to broader social determinants of health and salutogenesis. This paper not only frames the situation in Kurdistan in terms of a human rights or special political issue of a minority population, but provides important

  20. The impact of health system governance and policy processes on health services in Iraqi Kurdistan

    Directory of Open Access Journals (Sweden)

    Khoshnaw Hiro

    2010-06-01

    Full Text Available Abstract Background Relative to the amount of global attention and media coverage since the first and second Gulf Wars, very little has been published in the health services research literature regarding the state of health services in Iraq, and particularly on the semi-autonomous region of Kurdistan. Building on findings from a field visit, this paper describes the state of health services in Kurdistan, analyzes their underlying governance structures and policy processes, and their overall impact on the quality, accessibility and cost of the health system, while stressing the importance of reinvesting in public health and community-based primary care. Discussion Very little validated, research-based data exists relating to the state of population health and health services in Kurdistan. What little evidence exists, points to a region experiencing an epidemiological polarization, with different segments of the population experiencing rapidly-diverging rates of morbidity and mortality related to different etiological patterns of communicable, non-communicable, acute and chronic illness and disease. Simply put, the rural poor suffer from malnutrition and cholera, while the urban middle and upper classes deal with issues of obesity and Type 2 diabetes. The inequity is exacerbated by a poorly governed, fragmented, unregulated, specialized and heavily privatized system, that not only leads to poor quality of care and catastrophic health expenditures, but also threatens the economic and political stability of the region. There is an urgent need to revisit and clearly define the core values and goals of a future health system, and to develop an inclusive governance and policy framework for change, towards a more equitable and effective primary care-based health system, with attention to broader social determinants of health and salutogenesis. Summary This paper not only frames the situation in Kurdistan in terms of a human rights or special political

  1. 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....

  2. Health and environmental impact of depleted uranium

    International Nuclear Information System (INIS)

    Furitsu, Katsumi

    2010-01-01

    conflict in which DU weapon was used on a large military scale (320 t). The weapon was used again during the Iraqi War in 2003 (UNEP reported 'speculative figures from various studies range between 170 and 1,700 metric tones'). DU weapon was also used in Balkans and probably in Afghanistan. The health problems called 'Gulf War or Balkan Syndrome' of veterans who came back from these conflicts areas became one of the social problems in the US as well as Europe since during 1990s. Exposure to DU has been discussed as one of the responsible factors for the syndrome. Medical doctors in the affected areas as Iraq have been pointing out the environmental disruption by the wars, including contamination of DU, may influence the increase of cancer incidence rate among the local population. The reliable cancer registry in Basrah in southern Iraq, where DU weapons were heavily used, has been established for the further epidemiological study.

  3. 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.

  4. Impact of Puberty Health Education on Anxiety of Adolescents

    Directory of Open Access Journals (Sweden)

    Hoda Mokari

    2016-05-01

    Full Text Available Adolescents, as a large group in the world, face many physical changes and psychological evolutions in their puberty period. If enough attention is not paid to such changes, negative effects on their health and knowledge may be induced. Thus, it is very important to hold health education approperiate for their needs using new educational methods and confident sources. The main goal of this study is to explore the impact of puberty health education on the anxiety of girls. Itis a quasi-experimental study using clustered sampling which was done on 159 girls from two high schools in Tehran divided into two experimental (N=86 and control (N=73 groups. Then,using a systematic educational plan revised by the researcher and expert panel from Department of Midwifery, all the students and their parents in the experimental group were instructed. Data were gathered by demographic questionnaire and Spielberger Scale. Questionnaires were completed by students in three phases including before, after, and three months after the end of the educational program. Data analysis was performed by paired t-test, independent t-test, Chi square, and multivariate tests. Mean anxiety scores in the experimental and control groups were 90.45 and 85.36 before the education, 78.79 and 85.49 at the end of the education, and 78.46 as well as 87.33 3 months later, respectively.Anxiety scores were statistically different post-intervention (p<0.001 and three months later(p<0.001. Puberty health education programs could reduce anxiety in female adolescents.

  5. Development of a mobbing short scale in the Gutenberg Health Study.

    Science.gov (United States)

    Garthus-Niegel, Susan; Nübling, Matthias; Letzel, Stephan; Hegewald, Janice; Wagner, Mandy; Wild, Philipp S; Blettner, Maria; Zwiener, Isabella; Latza, Ute; Jankowiak, Sylvia; Liebers, Falk; Seidler, Andreas

    2016-01-01

    Despite its highly detrimental potential, most standard questionnaires assessing psychosocial stress at work do not include mobbing as a risk factor. In the German standard version of COPSOQ, mobbing is assessed with a single item. In the Gutenberg Health Study, this version was used together with a newly developed short scale based on the Leymann Inventory of Psychological Terror. The purpose of the present study was to evaluate the psychometric properties of these two measures, to compare them and to test their differential impact on relevant outcome parameters. This analysis is based on a population-based sample of 1441 employees participating in the Gutenberg Health Study. Exploratory and confirmatory factor analyses and reliability analyses were used to assess the mobbing scale. To determine their predictive validities, multiple linear regression analyses with six outcome parameters and log-binomial regression models for two of the outcome aspects were run. Factor analyses of the five-item scale confirmed a one-factor solution, reliability was α = 0.65. Both the single-item and the five-item scales were associated with all six outcome scales. Effect sizes were similar for both mobbing measures. Mobbing is an important risk factor for health-related outcomes. For the purpose of psychosocial risk assessment in the workplace, both the single-item and the five-item constructs were psychometrically appropriate. Associations with outcomes were about equivalent. However, the single item has the advantage of parsimony, whereas the five-item construct depicts several distinct forms of mobbing.

  6. 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

  7. MEGAPOLI: concept and first results of multi-scale modelling of megacity impacts

    Science.gov (United States)

    Baklanov, A. A.; Lawrence, M.; Pandis, S.

    2009-09-01

    The European FP7 project MEGAPOLI: ‘Megacities: Emissions, urban, regional and Global Atmospheric POLlution and climate effects, and Integrated tools for assessment and mitigation' (http://megapoli.info), started in October 2008, brings together 27 leading European research groups from 11 countries, state-of-the-art scientific tools and key players from countries outside Europe to investigate the interactions among megacities, air quality and climate. MEGAPOLI bridges the spatial and temporal scales that connect local emissions, air quality and weather with global atmospheric chemistry and climate. The main MEGAPOLI objectives are: 1. to assess impacts of megacities and large air-pollution hot-spots on local, regional and global air quality, 2. to quantify feedbacks among megacity air quality, local and regional climate, and global climate change, 3. to develop improved integrated tools for prediction of air pollution in megacities. In order to achieve these objectives the following tasks are realizing: • Develop and evaluate integrated methods to improve megacity emission data, • Investigate physical and chemical processes starting from the megacity street level, continuing to the city, regional and global scales, • Assess regional and global air quality impacts of megacity plumes, • Determine the main mechanisms of regional meteorology/climate forcing due to megacity plumes, • Assess global megacity pollutant forcing on climate, • Examine feedback mechanisms including effects of climate change on megacity air quality, • Develop integrated tools for prediction of megacity air quality, • Evaluate these integrated tools and use them in case studies, • Develop a methodology to estimate the impacts of different scenarios of megacity development on human health and climate change, • Propose and assess mitigation options to reduce the impacts of megacity emissions. We follow a pyramid strategy of undertaking detailed measurements in one European

  8. Large-scale mHealth professional support for health workers in rural Maharashtra, India.

    Science.gov (United States)

    Hegde, Shailendra Kumar B; Saride, Sriranga Prasad; Kuruganty, Sudha; Banker, Niraja; Patil, Chetan; Phanse, Vishal

    2018-04-01

    Expanding mobile telephony in India has prompted interest in the potential of mobile-telephone health (mHealth) in linking health workers in rural areas with specialist medical advice and other professional services. In 2012, a toll-free helpline offering specialist medical advice to community-based health workers throughout Maharashtra was launched. Calls are handled via a 24 h centre in Pune, staffed by health advisory officers and medical specialists. Health advisory officers handle general queries, which include medical advice via validated algorithms; blood on-call services; grievance issues; and mental health support - the latter calls are transferred to a qualified counsellor. Calls requiring more specialist advice are transferred to the appropriate medical specialist. This paper describes the experience of the first 4 years of this helpline, in terms of the services used, callers, nature of calls, types of queries serviced and lessons learnt. In the first 4 years of the helpline, 669 265 calls were serviced. Of these calls, 453 373 (67.74%) needed medical advice and were handled by health advisory officers. Specialist services were required to address 199 226 (29.77%) calls. Blood-bank-related services accounted for 7919 (1.18%) calls, while 2462 (0.37%) were grievance calls. Counselling for mental health issues accounted for 6285 (0.94%) calls. The large-scale mHealth professional support provided by this helpline in Maharashtra has reached many health workers serving rural communities. Future work is required to explore ways to expand the reach of the helpline further and to measure its effectiveness in improving health outcomes.

  9. 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

  10. CO2-impacts of a small-scale consumers levy

    International Nuclear Information System (INIS)

    1995-02-01

    Because of a number of developments (altered budgets of Dutch ministries and implementation of environmental policy plans of energy distribution companies in the Netherlands) the 1993 analyses of the effects of a small-scale consumer levy on the emission of CO 2 are updated. First, attention is paid to the conservation impetus as a result of an increase of the energy price for small-scale consumers. Next, the effects that can occur as a consequence of the presently suggested form of the levy (in particular, the exemption of renewable energy and waste heat) are discussed. Subsequently, the alterations of other policy tools, that are necessary in case a higher effectiveness of conservation measures is realized, are dealt with. The direct effect of a higher energy price on the saving behavior of the small-scale consumers is calculated by means of the CENECA-model. 4 tabs., 1 appendix, 8 refs

  11. Subjective underchallenge at work and its impact on mental health.

    Science.gov (United States)

    Lehmann, Anja; Burkert, Silke; Daig, Isolde; Glaesmer, Heide; Brähler, Elmar

    2011-08-01

    To investigate the relation between subjective underchallenge at work and the degree of depressiveness and life satisfaction. A representative sample of the German general population of N = 1,178 (52.5% men; age: M = 40.4 years, SD = 11.3) was included in this study. Measurements contain Satisfaction with Life Scalè (SWLS) and the Patient Health Questionnairè (PHQ-D). To assess subjective underchallenge at work, a ten-item scale was developed for the purpose of this study. The association between subjective underchallenge at work, life satisfaction and depressiveness was examined by means of path analyses. A significant positive association was found between subjective underchallenge at work and depressiveness, mediated by life satisfaction. This association was not moderated by income but by level of education. Participants with a medium educational level displayed a weaker association than participants with either a high or a low educational level. Not only work overload but also feeling underchallenged at work can have a negative impact on mental health and well-being. This is not an issue for blue-collar workers only and deserves more attention in future research.

  12. Hydrological impacts of urbanization at the catchment scale

    Science.gov (United States)

    Oudin, Ludovic; Salavati, Bahar; Furusho-Percot, Carina; Ribstein, Pierre; Saadi, Mohamed

    2018-04-01

    The impacts of urbanization on floods, droughts and the overall river regime have been largely investigated in the past few decades, but the quantification and the prediction of such impacts still remain a challenge in hydrology. We gathered a sample of 142 catchments that have a documented increase in urban areas over the hydrometeorological record period in the United States. The changes in river flow regimes due to urban spread were differentiated from climate variability using the GR4J conceptual hydrological model. High, low and mean flows were impacted at a threshold of a 10% total impervious area. Moreover, the historical evolution of urban landscape spatial patterns was used to further detail the urbanization process in terms of extent and fragmentation of urban areas throughout the catchment and to help interpret the divergent impacts observed in streamflow behaviors. Regression analysis pointed out the importance of major wastewater treatment facilities that might overpass the effects of imperviousness, and therefore further research should either take them explicitly into account or select a wastewater facility-free catchment sample to clearly evaluate the impacts of urban landscape on low flows.

  13. 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

  14. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Science.gov (United States)

    Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

    2017-01-01

    Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

  15. Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

    Directory of Open Access Journals (Sweden)

    Mauricio Toyama

    2017-09-01

    Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

  16. Scaling up: Expanding the impact of food security and nutrition ...

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

    Corey Piccioni

    Together with partners, IDRC is scaling up proven food security and ... In rural Kenya and Uganda, a pre-mix for preparation of yogurt in community-based kitchens is key to ... Pre-cooked beans for improving food security, nutrition, and income.

  17. The Impact of Emotional Priming on MMPI-2 Scale Scores

    Science.gov (United States)

    Lee, Tayla T. C.; Forbey, Johnathan D.; Ritchey, Kristin A.

    2011-01-01

    The current study investigated potential emotional priming effects on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale scores. Participants included 98 college students who completed a personal narrative intended to induce temporary mood states, the MMPI-2, and a mood rating inventory. Results of the mood manipulation indicated that…

  18. Assessment of climate change impacts on rainfall using large scale ...

    Indian Academy of Sciences (India)

    Many of the applied techniques in water resources management can be directly or indirectly influenced by ... is based on large scale climate signals data around the world. In order ... predictand relationships are often very complex. .... constraints to solve the optimization problem. ..... social, and environmental sustainability.

  19. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, Mirko S., E-mail: mirko.winkler@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); Divall, Mark J., E-mail: mdivall@shapeconsulting.org [SHAPE Consulting Ltd., Pretoria 0062 (South Africa); Krieger, Gary R., E-mail: gkrieger@newfields.com [NewFields, LLC, Denver, CO 80202 (United States); Schmidlin, Sandro, E-mail: sandro.schmidlin@gmail.com [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); Magassouba, Mohamed L., E-mail: laminemagass@yahoo.fr [Clinique Ambroise Pare, P.O. Box, 1042 Conakry (Guinea); Knoblauch, Astrid M., E-mail: astrid.knoblauch@me.com [SHAPE Consulting Ltd., Pretoria 0062 (South Africa); Singer, Burton H., E-mail: bhsinger@epi.ufl.edu [Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610 (United States); Utzinger, Juerg, E-mail: juerg.utzinger@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland)

    2012-02-15

    The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed.

  20. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys

    International Nuclear Information System (INIS)

    Winkler, Mirko S.; Divall, Mark J.; Krieger, Gary R.; Schmidlin, Sandro; Magassouba, Mohamed L.; Knoblauch, Astrid M.; Singer, Burton H.; Utzinger, Jürg

    2012-01-01

    The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed.

  1. 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

  2. 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

  3. Impacts of Large Scale Wind Penetration on Energy Supply Industry

    Directory of Open Access Journals (Sweden)

    John Kabouris

    2009-11-01

    Full Text Available Large penetration of Renewable Energy Sources (RES impacts Energy Supply Industry (ESI in many aspects leading to a fundamental change in electric power systems. It raises a number of technical challenges to the Transmission System Operators (TSOs, Distribution System Operators (DSOs and Wind Turbine Generators (WTG constructors. This paper aims to present in a thorough and coherent way the redrawn picture for Energy Systems under these conditions. Topics related to emergent technical challenges, technical solutions required and finally the impact on ESI due to large wind power penetration, are analyzed. Finally, general conclusions are extracted about the ESI current and future state and general directions are recommended.

  4. 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.

  5. Item reduction and psychometric validation of the Oily Skin Self Assessment Scale (OSSAS) and the Oily Skin Impact Scale (OSIS).

    Science.gov (United States)

    Arbuckle, Robert; Clark, Marci; Harness, Jane; Bonner, Nicola; Scott, Jane; Draelos, Zoe; Rizer, Ronald; Yeh, Yating; Copley-Merriman, Kati

    2009-01-01

    Developed using focus groups, the Oily Skin Self Assessment Scale (OSSAS) and Oily Skin Impact Scale (OSIS) are patient-reported outcome measures of oily facial skin. The aim of this study was to finalize the item-scale structure of the instruments and perform psychometric validation in adults with self-reported oily facial skin. The OSSAS and OSIS were administered to 202 adult subjects with oily facial skin in the United States. A subgroup of 152 subjects returned, 4 to 10 days later, for test–retest reliability evaluation. Of the 202 participants, 72.8% were female; 64.4% had self-reported nonsevere acne. Item reduction resulted in a 14-item OSSAS with Sensation (five items), Tactile (four items) and Visual (four items) domains, a single blotting item, and an overall oiliness item. The OSIS was reduced to two three-item domains assessing Annoyance and Self-Image. Confirmatory factor analysis supported the construct validity of the final item-scale structures. The OSSAS and OSIS scales had acceptable item convergent validity (item-scale correlations >0.40) and floor and ceiling effects (skin severity (P skin (P skin), as assessments of self-reported oily facial skin severity and its emotional impact, respectively.

  6. Translation and psychometric evaluation of Persian versions of Burn Specific Pain Anxiety Scale and Impact of Event Scale.

    Science.gov (United States)

    Ghezeljeh, Tahereh Najafi; Ardebili, Fatimah Mohades; Rafii, Forough; Hagani, Hamid

    2013-09-01

    Burn as a traumatic life incident manifests severe pain and psychological problems. Specific instruments are needed to evaluate burn patients' psychological issues related to the injury. The aim of this study was to translate and evaluate the reliability and validity of the Persian versions of Impact of Burn Specific Pain Anxiety scale (BSPAS) and Impact of Event Scale (IES). In this cross-sectional study, convenience sampling method was utilized to select 55 Iranian hospitalized burn patients. Combined translation was utilized for translating scales. Alpha cronbach, item-total correlation, convergent and discriminative validity were evaluated. The Cronbach's α for both BSPAS- and IES-Persian version was 0.96. Item-total correlation coefficients ranged from 0.70 to 0.90. Convergent construct validity was confirmed by indicating high correlation between the scales designed to measure the same concepts. The mean score of BSPAS- and IES-Persian version was lower for individuals with a lower TBSA burn percentage which assessed discriminative construct validity of scales. BSPAS- and IES-Persian version showed high internal consistency and good validity for the assessment of burn psychological outcome in hospitalized burn patients. Future studies are needed to determine repeatability, factor structure, sensitivity and specificity of the scales. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  7. 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...

  8. Scaling up impact assessment results through statistics and simulation

    NARCIS (Netherlands)

    Noort, M. van; Jonkers, E.; Haak, W.P. van den; Ouboter, T.M.

    2011-01-01

    For a successful introduction of Intelligent Transport Systems (ITS) it is important to determine (socio-economic) impacts and societal costs and benefits of these systems beforehand, and to develop business models. Governments usually make investment decisions based on these aspects. In the field

  9. Assessing local scale impacts of Opuntia stricta (Cactaceae ...

    African Journals Online (AJOL)

    ... assemblages were significantly different from uninvaded control sites. This study suggests that the current density of O. stricta does not significantly affect spider species richness, density or assemblages but that beetle assemblages are significantly affected. Key words: Araneae, arthropods, Coleoptera, invasion impacts, ...

  10. Full-scale Tornado-missile impact tests

    International Nuclear Information System (INIS)

    1976-04-01

    Initial tests with four types of hypothetical tornado-borne missiles impacting reinforced concrete panels have been completed. Panel thicknesses are typical of walls in nuclear power facilities. In the seven tests, the missiles were rocket propelled to velocities currently postulated as being attainable by debris in tornadoes. The objective of the 18-test program is to ascertain the vulnerability of test panels to penetration and backface scabbing. The four missile types being tested are: a 1500-pound 35-foot long utility pole, an 8-pound 1-inch Grade 60 reinforcing bar, a 78-pound 3-inch Schedule 40 pipe, and a 743-pound 12-inch Schedule 40 pipe. The test panels are 12, 18, and 24 inches thick with 15 by 15 foot free spans. They were constructed to current minimum ACI standards: 3000 psi design strength (actual strength about 3600 psi) and 0.2 percent reinforcing steel area each way, each face (actual area is about 0.27 percent with bars on 12-inch centers). The 12-inch pipe has been identified as the critical missile for design of nuclear facility walls under currently specified impact conditions. The utility poles splintered upon impact causing virtually no impact damage, and the 3-inch pipe and 1-inch rebar were comparatively ineffectual because of their light weight

  11. Experimental studies of dynamic impact response with scale models of lead shielded radioactive material shipping containers

    International Nuclear Information System (INIS)

    Robinson, R.A.; Hadden, J.A.; Basham, S.J.

    1978-01-01

    Preliminary experimental studies of dynamic impact response of scale models of lead-shielded radioactive material shipping containers are presented. The objective of these studies is to provide DOE/ECT with a data base to allow the prediction of a rational margin of confidence in overviewing and assessing the adequacy of the safety and environmental control provided by these shipping containers. Replica scale modeling techniques were employed to predict full scale response with 1/8, 1/4, and 1/2 scale models of shipping containers that are used in the shipment of spent nuclear fuel and high level wastes. Free fall impact experiments are described for scale models of plain cylindrical stainless steel shells, stainless steel shells filled with lead, and replica scale models of radioactive material shipping containers. Dynamic induced strain and acceleration measurements were obtained at several critical locations on the models. The models were dropped from various heights, attitudes to the impact surface, with and without impact limiters and at uniform temperatures between -40 and 175 0 C. In addition, thermal expansion and thermal gradient induced strains were measured at -40 and 175 0 C. The frequency content of the strain signals and the effect of different drop pad compositions and stiffness were examined. Appropriate scale modeling laws were developed and scaling techniques were substantiated for predicting full scale response by comparison of dynamic strain data for 1/8, 1/4, and 1/2 scale models with stainless steel shells and lead shielding

  12. Understanding ocean acidification impacts on organismal to ecological scales

    Science.gov (United States)

    Andersson, Andreas J; Kline, David I; Edmunds, Peter J; Archer, Stephen D; Bednaršek, Nina; Carpenter, Robert C; Chadsey, Meg; Goldstein, Philip; Grottoli, Andrea G.; Hurst, Thomas P; King, Andrew L; Kübler, Janet E.; Kuffner, Ilsa B.; Mackey, Katherine R M; Menge, Bruce A.; Paytan, Adina; Riebesell, Ulf; Schnetzer, Astrid; Warner, Mark E; Zimmerman, Richard C

    2015-01-01

    Ocean acidification (OA) research seeks to understand how marine ecosystems and global elemental cycles will respond to changes in seawater carbonate chemistry in combination with other environmental perturbations such as warming, eutrophication, and deoxygenation. Here, we discuss the effectiveness and limitations of current research approaches used to address this goal. A diverse combination of approaches is essential to decipher the consequences of OA to marine organisms, communities, and ecosystems. Consequently, the benefits and limitations of each approach must be considered carefully. Major research challenges involve experimentally addressing the effects of OA in the context of large natural variability in seawater carbonate system parameters and other interactive variables, integrating the results from different research approaches, and scaling results across different temporal and spatial scales.

  13. Impact of small-scale geometric roughness on wetting behavior.

    Science.gov (United States)

    Kumar, Vaibhaw; Errington, Jeffrey R

    2013-09-24

    We examine the extent to which small-scale geometric substrate roughness influences the wetting behavior of fluids at solid surfaces. Molecular simulation is used to construct roughness wetting diagrams wherein the progression of the contact angle is traced from the Cassie to Wenzel to impregnation regime with increasing substrate strength for a collection of systems with rectangularly shaped grooves. We focus on the evolution of these diagrams as the length scale of the substrate features approaches the size of a fluid molecule. When considering a series of wetting diagrams for substrates with fixed shape and variable feature periodicity, we find that the diagrams progressively shift away from a common curve as the substrate features become smaller than approximately 10 fluid diameters. It is at this length scale that the macroscopic models of Cassie and Wenzel become unreliable. Deviations from the macroscopic models are attributed to the manner in which the effective substrate-fluid interaction strength evolves with periodicity and the important role that confinement effects play for substrates with small periodicities.

  14. Managing Environmental and Health Impacts of Uranium Mining

    International Nuclear Information System (INIS)

    Vance, Robert; ); Hinton, Nicole; Huffman, Dale; Harris, Frank; Arnold, Nikolas; Ruokonen, Eeva; Jakubick, Alexander; Tyulyubayev, Zekail; Till, William von; Woods, Peter; ); Hall, Susan; Da Silva, Felipe; Vostarek, Pavel

    2014-01-01

    world. In support of this statement, this report provides an overview of the evolution of mining practices and outlines how health and environmental impacts of leading practice uranium mines are managed and minimised. All aspects of the full life cycle of a mine are covered, from the time that a deposit is considered to be of economic interest for mining to the time that mining is completed, the facility is closed and remediated and control of the leased land is returned to the landowner, usually the government. Case studies are included to further demonstrate the scale of the changes undertaken as well as to outline the outcomes of historic and modern mining practices. This report provides a factual account of leading practices in order to inform public debate on uranium mine development and to provide policy makers with a framework of approaches that should be undertaken to ensure that uranium mining is conducted in a safe and environmentally responsible manner. Key components in achieving this goal include the establishment of an appropriate regulatory framework, planning for closure before the mine begins production, requiring financial assurance from companies to cover the costs of closure and remediation, application of leading practices to minimise radiation exposure of workers and the public, protection of water resources and the safe, long-term disposal of tailings and problematic waste rock. Public consultation and information sharing, environmental impact assessment and environmental monitoring throughout the life cycle of the mine facility are also shown to be crucial components of this framework. (authors)

  15. Contamination of estuaries from failing septic tank systems: difficulties in scaling up from monitored individual systems to cumulative impact.

    Science.gov (United States)

    Geary, Phillip; Lucas, Steven

    2018-02-03

    Aquaculture in many coastal estuaries is threatened by diffuse sources of runoff from different land use activities. The poor performance of septic tank systems (STS), as well as runoff from agriculture, may contribute to the movement of contaminants through ground and surface waters to estuaries resulting in oyster contamination, and following their consumption, impacts to human health. In monitoring individual STS in sensitive locations, it is possible to show that nutrients and faecal contaminants are transported through the subsurface in sandy soils off-site with little attenuation. At the catchment scale however, there are always difficulties in discerning direct linkages between failing STS and water contamination due to processes such as effluent dilution, adsorption, precipitation and vegetative uptake. There is often substantial complexity in detecting and tracing effluent pathways from diffuse sources to water bodies in field studies. While source tracking as well as monitoring using tracers may assist in identifying potential pathways from STS to surface waters and estuaries, there are difficulties in scaling up from monitored individual systems to identify their contribution to the cumulative impact which may be apparent at the catchment scale. The processes which may be obvious through monitoring and dominate at the individual scale may be masked and not readily discernible at the catchment scale due to impacts from other land use activities.

  16. 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...

  17. 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

  18. Full-scale tornado-missile impact tests. Interim report

    International Nuclear Information System (INIS)

    Stephenson, A.E.

    1976-04-01

    Seven completed initial tests are described with 4 types of hypothetical tornado-borne missiles (impacting reinforced concrete panels that are typical of walls in nuclear power facilities). The missiles were rocket propelled to velocities currently postulated as being attainable by debris in tornadoes. (1500-pound 35-foot long utility pole; 8-pound 1-inch Grade 60 reinforcing bar; 78-pound 3-inch Schedule 40 pipe; and 743-pound 12-inch Schedule 40 pipe;) The results show that a minimum thickness of 24 inches is sufficient to prevent backface scabbing from normal impacts of currently postulated tornado missiles and that existing power plant walls are adequate for the most severe conditions currently postulated by regulatory agencies. This report gives selected detailed data on the tests completed thus far, including strain, panel velocity, and reaction histories

  19. Relating quality of life to Glasgow outcome scale health states.

    Science.gov (United States)

    Kosty, Jennifer; Macyszyn, Luke; Lai, Kevin; McCroskery, James; Park, Hae-Ran; Stein, Sherman C

    2012-05-01

    There has recently been a call for the adoption of comparative effectiveness research (CER) and related research approaches for studying traumatic brain injury (TBI). These methods allow researchers to compare the effectiveness of different therapies in producing patient-oriented outcomes of interest. Heretofore, the only measures by which to compare such therapies have been mortality and rate of poor outcome. Better comparisons can be made if parametric, preference-based quality-of-life (QOL) values are available for intermediate outcomes, such as those described by the Glasgow Outcome Scale Extended (GOSE). Our objective was therefore to determine QOL for the health states described by the GOSE. We interviewed community members at least 18 years of age using the standard gamble method to assess QOL for descriptions of GOSE scores of 2-7 derived from the structured interview. Linear regression analysis was also performed to assess the effect of age, gender, and years of education on QOL. One hundred and one participants between the ages of 18 and 83 were interviewed (mean age 40 ± 19 years), including 55 men and 46 women. Functional impairment and QOL showed a strong inverse relationship, as assessed by both linear regression and the Spearman rank order coefficient. No consistent effect or age, gender, or years of education was seen. As expected, QOL decreased with functional outcome as described by the GOSE. The results of this study will provide the groundwork for future groups seeking to apply CER methods to clinical studies of TBI.

  20. Participatory health impact assessment for the development of local government regulation on hazard control

    International Nuclear Information System (INIS)

    Inmuong, Uraiwan; Rithmak, Panee; Srisookwatana, Soomol; Traithin, Nathathai; Maisuporn, Pornpun

    2011-01-01

    The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action research attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.

  1. 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 ...

  2. 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

  3. Large scale food retailing as an intervention for diet and health: quasi-experimental evaluation of a natural experiment.

    Science.gov (United States)

    Cummins, Steven; Petticrew, Mark; Higgins, Cassie; Findlay, Anne; Sparks, Leigh

    2005-12-01

    To assess the effect on fruit and vegetable consumption, self reported, and psychological health of a "natural experiment"-the introduction of large scale food retailing in a deprived Scottish community. Prospective quasi-experimental design comparing baseline and follow up data in an "intervention" community with a matched "comparison" community in Glasgow, UK. 412 men and women aged 16 or over for whom follow up data on fruit and vegetable consumption and GHQ-12 were available. Fruit and vegetable consumption in portions per day, poor self reported health, and poor psychological health (GHQ-12). Adjusting for age, sex, educational attainment, and employment status there was no population impact on daily fruit and vegetable consumption, self reported, and psychological health. There was some evidence for a net reduction in the prevalence of poor psychological health for residents who directly engaged with the intervention. Government policy has advocated using large scale food retailing as a social intervention to improve diet and health in poor communities. In contrast with a previous uncontrolled study this study did not find evidence for a net intervention effect on fruit and vegetable consumption, although there was evidence for an improvement in psychological health for those who directly engaged with the intervention. Although definitive conclusions about the effect of large scale retailing on diet and health in deprived communities cannot be drawn from non-randomised controlled study designs, evaluations of the impacts of natural experiments may offer the best opportunity to generate evidence about the health impacts of retail interventions in poor communities.

  4. 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 ...

  5. Sparse deconvolution for the large-scale ill-posed inverse problem of impact force reconstruction

    Science.gov (United States)

    Qiao, Baijie; Zhang, Xingwu; Gao, Jiawei; Liu, Ruonan; Chen, Xuefeng

    2017-01-01

    Most previous regularization methods for solving the inverse problem of force reconstruction are to minimize the l2-norm of the desired force. However, these traditional regularization methods such as Tikhonov regularization and truncated singular value decomposition, commonly fail to solve the large-scale ill-posed inverse problem in moderate computational cost. In this paper, taking into account the sparse characteristic of impact force, the idea of sparse deconvolution is first introduced to the field of impact force reconstruction and a general sparse deconvolution model of impact force is constructed. Second, a novel impact force reconstruction method based on the primal-dual interior point method (PDIPM) is proposed to solve such a large-scale sparse deconvolution model, where minimizing the l2-norm is replaced by minimizing the l1-norm. Meanwhile, the preconditioned conjugate gradient algorithm is used to compute the search direction of PDIPM with high computational efficiency. Finally, two experiments including the small-scale or medium-scale single impact force reconstruction and the relatively large-scale consecutive impact force reconstruction are conducted on a composite wind turbine blade and a shell structure to illustrate the advantage of PDIPM. Compared with Tikhonov regularization, PDIPM is more efficient, accurate and robust whether in the single impact force reconstruction or in the consecutive impact force reconstruction.

  6. Temporal and spatial scaling impacts on extreme precipitation

    Science.gov (United States)

    Eggert, B.; Berg, P.; Haerter, J. O.; Jacob, D.; Moseley, C.

    2015-01-01

    Both in the current climate and in the light of climate change, understanding of the causes and risk of precipitation extremes is essential for protection of human life and adequate design of infrastructure. Precipitation extreme events depend qualitatively on the temporal and spatial scales at which they are measured, in part due to the distinct types of rain formation processes that dominate extremes at different scales. To capture these differences, we first filter large datasets of high-resolution radar measurements over Germany (5 min temporally and 1 km spatially) using synoptic cloud observations, to distinguish convective and stratiform rain events. In a second step, for each precipitation type, the observed data are aggregated over a sequence of time intervals and spatial areas. The resulting matrix allows a detailed investigation of the resolutions at which convective or stratiform events are expected to contribute most to the extremes. We analyze where the statistics of the two types differ and discuss at which resolutions transitions occur between dominance of either of the two precipitation types. We characterize the scales at which the convective or stratiform events will dominate the statistics. For both types, we further develop a mapping between pairs of spatially and temporally aggregated statistics. The resulting curve is relevant when deciding on data resolutions where statistical information in space and time is balanced. Our study may hence also serve as a practical guide for modelers, and for planning the space-time layout of measurement campaigns. We also describe a mapping between different pairs of resolutions, possibly relevant when working with mismatched model and observational resolutions, such as in statistical bias correction.

  7. Reliability and Validity of Five Mental Health Scales in Older Persons.

    Science.gov (United States)

    Himmelfarb, Samuel; Murrell, Stanley A.

    1983-01-01

    Assessed five scales as mental health measures for older persons (N=318). The internal consistency reliabilities for the anxiety, depression, and well-being scales were moderately high to high, but the reliabilities for the affect balance scale suggest some caution. Cutting points for the well-being and depression scales are suggested. (Author/JAC)

  8. 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.

  9. Full-scale tornado-missile impact tests

    International Nuclear Information System (INIS)

    Stephenson, A.E.; Sliter, G.E.; Burdette, E.G.

    1978-01-01

    Full-scale poles, pipes, and rods, representing postulated tornado-borne missiles, were rocket-propelled into reinforced concrete panels with thicknesses typical of walls and roofs in the auxillary buildings of nuclear power plants. Data from the 18 tests can be used directly for structural design or for validating design and analysis techniques. The test panels, constructed with 3000-psi design strength concrete and minimum allowable reinforcement, were 12, 18 and 24 in. thick with 15 X 15-ft unsupported spans. (Auth.)

  10. 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.

  11. Potential Impact of Large Scale Abstraction on the Quality of Shallow ...

    African Journals Online (AJOL)

    PRO

    Significant increase in crop production would not, however, be ... sounding) using Geonics EM34-3 and Abem SAS300C Terrameter to determine the aquifer (fresh water lens) ..... Final report on environmental impact assessment of large scale.

  12. Cost optimization of biofuel production – The impact of scale, integration, transport and supply chain configurations

    NARCIS (Netherlands)

    de Jong, S.A.|info:eu-repo/dai/nl/41200836X; Hoefnagels, E.T.A.|info:eu-repo/dai/nl/313935998; Wetterlund, Elisabeth; Pettersson, Karin; Faaij, André; Junginger, H.M.|info:eu-repo/dai/nl/202130703

    2017-01-01

    This study uses a geographically-explicit cost optimization model to analyze the impact of and interrelation between four cost reduction strategies for biofuel production: economies of scale, intermodal transport, integration with existing industries, and distributed supply chain configurations

  13. Impact of Pore-Scale Wettability on Rhizosphere Rewetting

    Directory of Open Access Journals (Sweden)

    Pascal Benard

    2018-04-01

    Full Text Available Vast amounts of water flow through a thin layer of soil around the roots, the rhizosphere, where high microbial activity takes place—an important hydrological and biological hotspot. The rhizosphere was shown to turn water repellent upon drying, which has been interpreted as the effect of mucilage secreted by roots. The effects of such rhizosphere water dynamics on plant and microbial activity are unclear. Furthermore, our understanding of the biophysical mechanisms controlling the rhizosphere water repellency remains largely speculative. Our hypothesis is that the key to describe the emergence of water repellency lies within the microscopic distribution of wettability on the pore-scale. At a critical mucilage content, a sufficient fraction of pores is blocked and the rhizosphere turns water repellent. Here we tested whether a percolation approach is capable to predict the flow behavior near the critical mucilage content. The wettability of glass beads and sand mixed with chia seed mucilage was quantified by measuring the infiltration rate of water drops. Drop infiltration was simulated using a simple pore-network model in which mucilage was distributed heterogeneously throughout the pore space with a preference for small pores. The model approach proved capable to capture the percolation nature of the process, the sudden transition from wettable to water repellent and the high variability in infiltration rates near the percolation threshold. Our study highlights the importance of pore-scale distribution of mucilage in the emergent flow behavior across the rhizosphere.

  14. 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

  15. 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.

  16. 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.

  17. Aging and health: Self-efficacy for Self-direction in Health Scale.

    Science.gov (United States)

    Oliveira, Albertina L; Silva, José T; Lima, Margarida P

    2016-07-04

    To validate the Escala de Autoeficácia para a Autodireção na Saúde (EAAS - Self-efficacy for Self-direction in Health Scale). Non-experimental quantitative study of EAAS validation, by confirmatory factorial analyses, evaluating a sample of 508 older adults from the north and the center of Portugal with mean age of 71.67 (from 51 to 96 years), to whom the Self-efficacy for Self-direction in Health Scale, the Rosenberg Self-esteem Scale, the Positive and Negative Affect Schedule, the Satisfaction with Life Scale, and the Instrumental Activities of Daily Living Scale were applied. The EAAS was developed from the theoretical constructs of self-efficacy and from self-directed learning within the PALADIN European project framework, aiming to develop an instrument able to assess the extent to which older adults take good care of their health. The internal consistency was 0.87 (Cronbach's alpha) and confirmatory factorial analyses enabled to find a model near the one theoretically proposed, indicating a structure consisting of four dimensions: physical exercise, healthy diet, engaging in health-related learning, and visits to health professionals. From the psychometric point of view, the model in four factors showed quite satisfactory fit indicators. The Self-efficacy for Self-direction in Health Scale, with 16 items, is adequate to evaluate to what extent older adults have confidence in their ability to take care of their own health, with high degree of autonomy. Validar a Escala de Autoeficácia para a Autodireção no domínio da Saúde (EAAS). Estudo quantitativo não experimental de validação da EAAS, por meio de análises fatoriais confirmatórias, avaliando amostra de 508 seniores e idosos provenientes das regiões Norte e Centro de Portugal com média etária de 71.67 (51 a 96 anos), a quem foram aplicadas a Escala de Autoeficácia para a Autodireção na Saúde, a Escala de Autoestima de Rosenberg, a Escala de Afeto Positivo e Afeto Negativo, a Escala de

  18. 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.

  19. 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.

  20. 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 ...

  1. 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

  2. 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 ...

  3. 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 ...

  4. 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.

  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. 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.

  10. 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

  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. [Actual conditions of occupational health activities in small-scale enterprises in Japan: system for occupational health, health management and demands by small-scale enterprises].

    Science.gov (United States)

    Hirata, M; Kumagai, S; Tabuchi, T; Tainaka, H; Andoh, K; Oda, H

    1999-11-01

    In order to clarify the real conditions of occupational health services (OHS) in small-scale enterprises (SSEs) in Japan, we analyzed questionnaires recovered from 765 SSEs in the area of a city neighboring Osaka City (recovery rate, 69.3%). The SSEs included 358 SSEs with 1 to 4 workers (46.8% of total SSEs), 203 with 5 to 9 (26.5%), 163 with 10 to 29 (21.3%) and 41 with 30 to 49 (5.4%). The main types of businesses were manufacturing (374, 48.9% of total SSEs), wholesale/retail trade/restaurants (153, 20.0%), community, social and personal services (132, 17.3%) and construction (72, 9.4%). Health examinations were performed in 47.7% of SSEs. The reason for the lack of examinations were "shortage of time" (33.3% of SSEs lacking health examination) and "employees do not want to be examined" (28.1%). Some health promotion measures were conducted in 29.2% of SSEs. Health examination (59.0% of SSEs), health promotion (36.5%), measure of mental health (25.9%) and information service for employers and employees (25.5%) were demanded by SSEs as OHS. Financial subsidies and economical incentives were demanded by 46.4% and 28.8% of SSEs, respectively. Regional occupational health center in this area was poorly known among SSEs (8.2%), but health examination (48.4%), information service (37.5%), assessment of work method and advice to improve (19.8%) and environment measurement (12.4%) are demanded of the center by SSEs.

  14. 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.

  15. 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.

  16. How Does Scale of Implementation Impact the Environmental Sustainability of Wastewater Treatment Integrated with Resource Recovery?

    Science.gov (United States)

    Cornejo, Pablo K; Zhang, Qiong; Mihelcic, James R

    2016-07-05

    Energy and resource consumptions required to treat and transport wastewater have led to efforts to improve the environmental sustainability of wastewater treatment plants (WWTPs). Resource recovery can reduce the environmental impact of these systems; however, limited research has considered how the scale of implementation impacts the sustainability of WWTPs integrated with resource recovery. Accordingly, this research uses life cycle assessment (LCA) to evaluate how the scale of implementation impacts the environmental sustainability of wastewater treatment integrated with water reuse, energy recovery, and nutrient recycling. Three systems were selected: a septic tank with aerobic treatment at the household scale, an advanced water reclamation facility at the community scale, and an advanced water reclamation facility at the city scale. Three sustainability indicators were considered: embodied energy, carbon footprint, and eutrophication potential. This study determined that as with economies of scale, there are benefits to centralization of WWTPs with resource recovery in terms of embodied energy and carbon footprint; however, the community scale was shown to have the lowest eutrophication potential. Additionally, technology selection, nutrient control practices, system layout, and topographical conditions may have a larger impact on environmental sustainability than the implementation scale in some cases.

  17. Development of the Community Impact Scale Measuring Community Organization Perceptions of Partnership Benefits and Costs

    Science.gov (United States)

    Srinivas, Tejaswinhi; Meenan, Chelsea E.; Drogin, Elizabeth; DePrince, Anne P.

    2015-01-01

    This article describes the development and psychometric properties of the Community Impact Scale (CIS), a measure of benefits and costs of community-university partnerships across a range of outcomes as perceived by community partners. Scale development was carried out in two phases: (a) item generation, through which the research team, in close…

  18. Small Reservoir Impact on Simulated Watershed-Scale Nutrient Yield

    Directory of Open Access Journals (Sweden)

    Shane J. Prochnow

    2007-01-01

    Full Text Available The soil and water assessment tool (SWAT is used to assess the influence of small upland reservoirs (PL566 on watershed nutrient yield. SWAT simulates the impact of collectively increasing and decreasing PL566 magnitudes (size parameters on the watershed. Totally removing PL566 reservoirs results in a 100% increase in total phosphorus and an 82% increase in total nitrogen, while a total maximum daily load (TMDL calling for a 50% reduction in total phosphorus can be achieved with a 500% increase in the magnitude of PL566s in the watershed. PL566 reservoirs capture agriculture pollution in surface flow, providing long-term storage of these constituents when they settle to the reservoir beds. A potential strategy to reduce future downstream nutrient loading is to enhance or construct new PL566 reservoirs in the upper basin to better capture agricultural runoff.

  19. Acoustic fluidization and the scale dependence of impact crater morphology

    Science.gov (United States)

    Melosh, H. J.; Gaffney, E. S.

    1983-01-01

    A phenomenological Bingham plastic model has previously been shown to provide an adequate description of the collapse of impact craters. This paper demonstrates that the Bingham parameters may be derived from a model in which acoustic energy generated during excavation fluidizes the rock debris surrounding the crater. Experimental support for the theoretical flow law is presented. Although the Bingham yield stress cannot be computed without detailed knowledge of the initial acoustic field, the Bingham viscosity is derived from a simple argument which shows that it increases as the 3/2 power of crater diameter, consistent with observation. Crater collapse may occur in material with internal dissipation Q as low as 100, comparable to laboratory observations of dissipation in granular materials. Crater collapse thus does not require that the acoustic field be regenerated during flow.

  20. The impacts of large-scale assessment on school curriculum

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Silva Godoi Menegão

    2016-09-01

    Full Text Available This work results from a doctoral research which analyzed the curriculum at the interface with the external evaluation in order to identify, describe and analyze how the subjects are positioning themselves in this context of tests, and map the changes made in the school curriculum driven by Prova Brasil and IDEB. The approach is descriptive and analytical, using documentary analysis, questionnaire and oral interviews in a sample of 55 teachers, subjects. The investigation was based on Freitas and colleagues (2012, Gimeno Sacristán (2000, Apple (2005, Sousa (2004 among others. The external evaluation has impacted the setting of the school curriculum and induced to over training for tests, thus compromising the quality of education.

  1. Validation of a 10-item care-related regret intensity scale (RIS-10) for health care professionals.

    Science.gov (United States)

    Courvoisier, Delphine S; Cullati, Stéphane; Haller, Chiara S; Schmidt, Ralph E; Haller, Guy; Agoritsas, Thomas; Perneger, Thomas V

    2013-03-01

    Regret after one of the many decisions and interventions that health care professionals make every day can have an impact on their own health and quality of life, and on their patient care practices. To validate a new care-related regret intensity scale (RIS) for health care professionals. Retrospective cross-sectional cohort study with a 1-month follow-up (test-retest) in a French-speaking University Hospital. A total of 469 nurses and physicians responded to the survey, and 175 answered the retest. RIS, self-report questions on the context of the regret-inducing event, its consequences for the patient, involvement of the health care professionals, and changes in patient care practices after the event. We measured the impact of regret intensity on health care professionals with the satisfaction with life scale, the SF-36 first question (self-reported health), and a question on self-esteem. On the basis of factor analysis and item response analysis, the initial 19-item scale was shortened to 10 items. The resulting scale (RIS-10) was unidimensional and had high internal consistency (α=0.87) and acceptable test-retest reliability (0.70). Higher regret intensity was associated with (a) more consequences for the patient; (b) lower life satisfaction and poorer self-reported health in health care professionals; and (c) changes in patient care practices. Nurses reported analyzing the event and apologizing, whereas physicians reported talking preferentially to colleagues, rather than to their supervisor, about changing practices. The RIS is a valid and reliable measure of care-related regret intensity for hospital-based physicians and nurses.

  2. 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...

  3. 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...

  4. Family Impact Scale (FIS): Cross-cultural Adaptation and Psychometric Properties for the Peruvian Spanish Language.

    Science.gov (United States)

    Abanto, Jenny; Albites, Ursula; Bönecker, Marcelo; Paiva, Saul M; Castillo, Jorge L; Aguilar-Gálvez, Denisse

    2015-12-01

    The lack of a Family Impact Scale (FIS) in Spanish language limits its use as an indicator in Spanish-speaking countries and precludes comparisons with data from other cultural and ethnic groups. The purpose of this study was therefore to adapt the FIS cross-culturally to the Peruvian Spanish language and assess its reliability and validity. In order to translate and adapt the FIS cross-culturally, it was answered by 60 parents in two pilot tests, after which it was tested on 200 parents of children aged 11 to 14 years who were clinically examined for dental caries experience and malocclusions. Internal consistency was assessed by Cronbach's alpha coefficient while repeat administration of the FIS on the same 200 parents enabled the test-retest reliability to be assessed via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the FIS with global ratings of oral health and clinical groups, respectively. Mean (standard deviation) FIS total score was 5.20 (5.86). Internal consistency was confirmed by Cronbach's alpha 0.84. Test-retest reliability revealed excellent reproducibility (ICC = 0.96). Construct validity was good, demonstrating statistically significant associations between total FIS score and global ratings of oral health (p=0.007) and overall wellbeing (p=0.002), as well as for the subscale scores (pfamily caused by children's oral conditions. Sociedad Argentina de Investigación Odontológica.

  5. 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

  6. 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...

  7. 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...

  8. 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.

  9. 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...

  10. 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.

  11. The Impacts of Pine Tree Die-Off on Snow Accumulation and Distribution at Plot to Catchment Scales

    Science.gov (United States)

    Biederman, J. A.; Harpold, A. A.; Gutmann, E. D.; Reed, D. E.; Gochis, D. J.; Brooks, P. D.

    2011-12-01

    Seasonal snow cover is a primary water source throughout much of Western North America, where insect-induced tree die-off is changing the montane landscape. Widespread mortality from insects or drought differs from well-studied cases of fire and logging in that tree mortality is not accompanied by other immediate biophysical changes. Much of the impacted landscape is a mosaic of stands of varying species, structure, management history and health overlain on complex terrain. To address the challenge of predicting the effects of forest die-off on snow water input, we quantified snow accumulation and ablation at scales ranging from individual trees, through forest stands, to nested small catchments. Our study sites in Northern Colorado and Southern Wyoming are dominated by lodgepole pine, but they include forest stands that are naturally developed, managed and clear-cut with varying mortality from Mountain Pine Beetle (MPB). Our record for winters 2010 and 2011 includes continuous meteorological data and snow depth in plots with varying MPB impact as well as stand- to catchment-scale snow surveys mid-winter and near maximal accumulation. At the plot scale, snow depth sensors in healthy stands recorded greater inputs during storms (21-42% of depth) and greater seasonal accumulation (15-40%) in canopy gaps than under trees, whereas no spatial effects of canopy geometry were observed in stands with heavy mortality. Similar patterns were observed in snow surveys near peak accumulation. At both impacted and thinned sites, spatial variability in snow depth was more closely associated with larger scale topography and changes in stand structure than with canopy cover. The role of aspect in ablation was observed to increase in impacted stands as both shading and wind attenuation decreased. Evidence of wind-controlled snow distribution was found 80-100 meters from exposed stand edges in impacted forest as compared to 10-15 meters in healthy forest. Integrating from the scale of

  12. 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

  13. 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.

  14. 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.

  15. Incorporating consideration of health impacts into land use development approval processes: Development of a Health Background Study Framework.

    Science.gov (United States)

    Moloughney, Brent W; Bursey, Gayle E; Neumann, Jana; Leeming, Daniel H; Gutmann, Christine E; Sivanand, Bhavna; Mowat, David L

    2014-09-12

    This project involved development of a Health Background Study (HBS) Framework to support consideration of health impacts within municipalities' approval process for land use development. Peel Public Health and Toronto Public Health led the project with the participation of planners, urban designers, engineers, public health staff and development industry representatives. Historical growth in the Region of Peel and suburban Toronto has resulted in extensive low-density development, creating car-dependent communities with disconnected streets and segregated land uses. The inclusion of an HBS in developers' applications to municipalities is one approach by which health-related expectations for the built environment can be established within the approval process. Development of the HBS Framework used the six core elements of the built environment with the strongest evidence for impact on health and was informed by analysis of the provincial and local policy contexts, practices of other municipalities and stakeholder interviews. The Framework's contents were refined according to feedback from multidisciplinary stakeholder workshops. The HBS Framework identifies minimum standards for built environment core elements that developers need to address in their applications. The Framework was created to be simple and instructive with applicability to a range of development locations and scales, and to various stages of the development approval process. Peel Public Health is leading several initiatives to support the use of the HBS as a part of the development application process. The HBS Framework is a tool that public health and planning can use to support the consideration of health impacts within municipalities' land use development processes.

  16. The stroke impact scale: performance as a quality of life measure in a community-based stroke rehabilitation setting.

    Science.gov (United States)

    Richardson, Marina; Campbell, Nerissa; Allen, Laura; Meyer, Matthew; Teasell, Robert

    2016-07-01

    The objective of this study was to assess the psychometric properties of the Stroke Impact Scale (SIS). Data was derived from a study assessing a community-based stroke rehabilitation program. Patients were administered the SIS and Euroqol-5D (EQ-5D-5L) on admission to the study, and at six month and 12 month follow-up. The psychometric performance of each domain of the SIS was assessed at each time point. A total of 164 patients completed outcome measures at baseline, 108 patients at six months and 37 patients at 12 months. Correlation of the SIS domains with the EQ-5D-5L suggested that the dimensions of health contributing to a patient's perception of health-related quality of life changes over time. The SIS performed well in a sample of patients undergoing stroke rehabilitation in the community. Our findings suggest that the multidimensionality of the SIS may allow health professionals to track patient progress and tailor rehabilitation interventions to target the dimensions of health that are most important to a patient's overall health and perceived quality of life over time. Implications for Rehabilitation There is an increased need for valid and reliable measures to evaluate the outcomes of patients recovering from stroke in the community. The Stroke Impact Scale (SIS) measures multiple domains of health and is well-suited for use in patients recovering from stroke in the community. There is a high level of internal consistency in the eight SIS domains with no evidence of floor effects; ceiling effects were noted for several domains. Correlation of the SIS with the Euroqol-5D suggested that the dimensions of health contributing to a patient's perception of health related quality of life changes over time.

  17. Impact of post-traumatic stress disorder on oral health.

    Science.gov (United States)

    de Oliveira Solis, Ana Cristina; Araújo, Álvaro Cabral; Corchs, Felipe; Bernik, Marcio; Duran, Érica Panzani; Silva, Cláudio; Lotufo-Neto, Francisco

    2017-09-01

    The stress experienced as an intense and traumatic event can increase the odds of orofacial pain, affect the biomechanics of masticatory system and compromise the periodontal health. This study was conducted to investigate the impact of post-traumatic stress disorder (PTSD) on oral health. A case-control study with a convenience sample was designed. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing, and plaque were recorded at 6 sites per tooth. A visual analog scale (VAS) was used to evaluate the pain after probing. The Research Diagnostic Criteria for Temporomandibular Disorders Axis II (RDC/TMD Axis II) and Structured Clinical Interview (DSM-IV) were also applied. The final sample comprised 38 PTSD patients and 38 controls. Patients with PTSD had a higher degree of chronic pain, more depression and nonspecific physical symptoms (including and excluding pain) compared with the control group (Fisher exact test p PTSD also had more pain after periodontal probing compared with controls (Mann-Whitney, p = 0.037). The prevalence of sites with CAL or PPD ≥ 4, ≥ 5, ≥ 6 were not different between the groups. Age was associated with moderate periodontitis (multivariable logistic regression model, OR = 3.33, 95% CI = 1.03-10.75, p = 0.04). The severity of PTSD precluded an ample sample size. Patients with PTSD presented a worse RDC/TMD Axis II profile, more pain after periodontal probing, and no difference related to periodontal clinical parameters. More studies are needed to confirm these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Multifaceted health impacts of Particulate Matter (PM and its management: An overview

    Directory of Open Access Journals (Sweden)

    Prabhat Kumar Rai

    2015-03-01

    Full Text Available Urban air quality is becoming a serious public health concern at global scale. Particulate matter (PM pollution is intimately linked with human health. Present review describes the different human health implications associated with PM pollution. PM may derive its origin from natural and anthropogenic sources. Vehicle derived pollutants as well as industrial emissions simultaneously release deleterious fine-grained PM into the atmosphere. Fine PM especially PM2.5 and PM10 are particularly deleterious to human health. Air pollution PM is an important environmental health risk factor for several respiratory and cardiovascular morbidity and mortality. Further, PM is inextricably linked with genotoxicity and mutations. Literature review of the cellular and molecular basis of adverse effects associated with PM is presented in this paper. Finally, management, existing technologies and policy options to reduce or mitigate the adverse health impacts of PM pollution is discussed as an eco-sustainable approach.

  19. Development and psychometric validation of social cognitive theory scales in an oral health context.

    Science.gov (United States)

    Jones, Kelly; Parker, Eleanor J; Steffens, Margaret A; Logan, Richard M; Brennan, David; Jamieson, Lisa M

    2016-04-01

    This study aimed to develop and evaluate scales reflecting potentially modifiable social cognitive theory-based risk indicators associated with homeless populations' oral health. The scales are referred to as the social cognitive theory risk scales in an oral health context (SCTOH) and are referred to as SCTOH(SE), SCTOH(K) and SCTOH(F), respectively. The three SCTOH scales assess the key constructs of social cognitive theory: self-efficacy, knowledge and fatalism. The reliability and validity of the three scales were evaluated in a convenience sample of 248 homeless participants (age range 17-78 years, 79% male) located in a metropolitan setting in Australia. The scales were supported by exploratory factor analysis and established three distinct and internally consistent domains of social cognition: oral health-related self-efficacy, oral health-related knowledge and oral health-related fatalism, with Cronbach's alphas of 0.95, 0.85 and Spearman's-Brown ρ of 0.69. Concurrent ability was confirmed by each SCTOH scale's association with oral health status in the expected directions. The three SCTOH scales appear to be internally valid and reliable. If confirmed by further research, these scales could potentially be used for tailored educational and cognitive-behavioural interventions to reduce oral health inequalities among homeless and other vulnerable populations. © 2015 Public Health Association of Australia.

  20. [Work in mental health: a job satisfaction and work impact study].

    Science.gov (United States)

    Rebouças, Denise; Abelha, Lúcia; Legay, Letícia Fortes; Lovisi, Giovanni Marcos

    2008-03-01

    Knowledge of job satisfaction and work impact among psychiatric staff is highly useful for policymakers and mental health professionals. Since there are few studies on this issue in Brazil, a cross-sectional study was carried out among mental health professionals. Data were collected for 133 professionals from 4 mental health services in Rio de Janeiro, using SATIS-BR and IMPACTO-BR scales and a socio-demographic questionnaire. Statistical associations were analyzed using the Mann-Whitney, Kruskal-Wallis, and chi-square tests and multiple linear regression. SPSS 10.1 for Windows was used for statistical analyses. Mean satisfaction was 3.30 and mean work impact was 2.08 (on a scale from 1 to 5). 62.4% of subjects reported moderate satisfaction. Mental health workers with less schooling showed higher satisfaction. Work impact was not associated with any explanatory variable. The results for job satisfaction were similar to those of other studies. Work impact was very low. Unlike studies from the United States and Europe, there were no differences between the community-based and in-hospital staff.

  1. Recent Trends in Local-Scale Marine Biodiversity Reflect Community Structure and Human Impacts.

    Science.gov (United States)

    Elahi, Robin; O'Connor, Mary I; Byrnes, Jarrett E K; Dunic, Jillian; Eriksson, Britas Klemens; Hensel, Marc J S; Kearns, Patrick J

    2015-07-20

    The modern biodiversity crisis reflects global extinctions and local introductions. Human activities have dramatically altered rates and scales of processes that regulate biodiversity at local scales. Reconciling the threat of global biodiversity loss with recent evidence of stability at fine spatial scales is a major challenge and requires a nuanced approach to biodiversity change that integrates ecological understanding. With a new dataset of 471 diversity time series spanning from 1962 to 2015 from marine coastal ecosystems, we tested (1) whether biodiversity changed at local scales in recent decades, and (2) whether we can ignore ecological context (e.g., proximate human impacts, trophic level, spatial scale) and still make informative inferences regarding local change. We detected a predominant signal of increasing species richness in coastal systems since 1962 in our dataset, though net species loss was associated with localized effects of anthropogenic impacts. Our geographically extensive dataset is unlikely to be a random sample of marine coastal habitats; impacted sites (3% of our time series) were underrepresented relative to their global presence. These local-scale patterns do not contradict the prospect of accelerating global extinctions but are consistent with local species loss in areas with direct human impacts and increases in diversity due to invasions and range expansions in lower impact areas. Attempts to detect and understand local biodiversity trends are incomplete without information on local human activities and ecological context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Mental Health Services in South Africa: Scaling up and future ...

    African Journals Online (AJOL)

    “No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world. It is timely to consider the implications of this call for South Africa. We review key evidence regarding the burden ...

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. Statistical Determination of Impact of Property Attributes for Weak Measurement Scales

    Directory of Open Access Journals (Sweden)

    Doszyń Mariusz

    2017-12-01

    Full Text Available Many of the property attributes are measured on weak scales (nominal and ordinal scale. For example, land allocation in the development plan is measured on a nominal scale and such categories as proximity, equipment, access to means of communication, location, and soil and water conditions, are measured on an ordinal scale. The use of statistical measures appropriate for interval or quotient scales is wrong in such cases. Therefore, the article presents statistical measures that allow specifying the impact of the attributes on real estate prices, which can be used for the weaker scales, mainly for the ordinal scale. In the empirical illustration the proposed measures will be calculated by using the actual database of transaction prices.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. [ETAP: A smoking scale for Primary Health Care].

    Science.gov (United States)

    González Romero, Pilar María; Cuevas Fernández, Francisco Javier; Marcelino Rodríguez, Itahisa; Rodríguez Pérez, María Del Cristo; Cabrera de León, Antonio; Aguirre-Jaime, Armando

    2016-05-01

    To obtain a scale of tobacco exposure to address smoking cessation. Follow-up of a cohort. Scale validation. Primary Care Research Unit. Tenerife. A total of 6729 participants from the "CDC de Canarias" cohort. A scale was constructed under the assumption that the time of exposure to tobacco is the key factor to express accumulated risk. Discriminant validity was tested on prevalent cases of acute myocardial infarction (AMI; n=171), and its best cut-off for preventive screening was obtained. Its predictive validity was tested with incident cases of AMI (n=46), comparing the predictive power with markers (age, sex) and classic risk factors of AMI (hypertension, diabetes, dyslipidaemia), including the pack-years index (PYI). The scale obtained was the sum of three times the years that they had smoked plus years exposed to smoking at home and at work. The frequency of AMI increased with the values of the scale, with the value 20 years of exposure being the most appropriate cut-off for preventive action, as it provided adequate predictive values for incident AMI. The scale surpassed PYI in predicting AMI, and competed with the known markers and risk factors. The proposed scale allows a valid measurement of exposure to smoking and provides a useful and simple approach that can help promote a willingness to change, as well as prevention. It still needs to demonstrate its validity, taking as reference other problems associated with smoking. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.

    Science.gov (United States)

    Pettigrew, Luisa M; Kumpunen, Stephanie; Mays, Nicholas; Rosen, Rebecca; Posaner, Rachel

    2018-03-01

    Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England. Systematic review. Embase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England. A total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care. Good-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why. © British Journal of General Practice 2018.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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 West however, may be problematic in non-Western, and particularly, non-Christian cultures, for many of the assumptions that underlie the approach to suffering and death in the West are culturally based in the values and beliefs of western European society. Therefore this paper provides a means to explore how such translation across cultures might occur by: (1) providing a definition of culture so that the context for the subsequent discussion is framed, (2) describing how culture impacts the cancer experience, (3) how culture affects communication to relieve suffering and improve quality of life for patients and families. The paper closes with 8 recommended steps to improve communication cross-culturally to provide effective quality palliative care for patients and families from diverse backgrounds.

  4. Health impacts of climate change and health and social inequalities in the UK.

    Science.gov (United States)

    Paavola, Jouni

    2017-12-05

    This article examines how social and health inequalities shape the health impacts of climate change in the UK, and what the implications are for climate change adaptation and health care provision. The evidence generated by the other articles of the special issue were interpreted using social justice reasoning in light of additional literature, to draw out the key implications of health and social inequalities for health outcomes of climate change. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes. Age, pre-existing medical conditions and social deprivation are found to be the key (but not only) factors that make people vulnerable and to experience more adverse health outcomes related to climate change impacts. In the future, climate change, aging population and decreasing public spending on health and social care may aggravate inequality of health outcomes related to climate change. Health education and public preparedness measures that take into account differential exposure, sensitivity and adaptive capacity of different groups help address health and social inequalities to do with climate change. Adaptation strategies based on individual preparedness, action and behaviour change may aggravate health and social inequalities due to their selective uptake, unless they are coupled with broad public information campaigns and financial support for undertaking adaptive measures.

  5. The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.

    Science.gov (United States)

    Wang, Wenjuan; Temsah, Gheda; Mallick, Lindsay

    2017-04-01

    While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  6. Household-scale environmental health in the Ezulwini Valley ...

    African Journals Online (AJOL)

    cinthia

    class, and were only somewhat comparable to previous national-scale assessments. ..... iPads and Fulcrum app offered a number of advantages, including .... Solid waste disposal method (percent households surveyed) by community.

  7. 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.

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

    Science.gov (United States)

    Guzzone, F.; Setegn, S.

    2013-12-01

    Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

  9. Dust storms and their impact on ocean and human health: dust in Earth's atmosphere

    Science.gov (United States)

    Griffin, Dale W.; Kellog, Christina A.

    2004-01-01

    Satellite imagery has greatly influenced our understanding of dust activity on a global scale. A number of different satellites such as NASA's Earth-Probe Total Ozone Mapping Spectrometer (TOMS) and Se-viewing Field-of-view Sensor (SeaWiFS) acquire daily global-scale data used to produce imagery for monitoring dust storm formation and movement. This global-scale imagery has documented the frequent transmission of dust storm-derived soils through Earth's atmosphere and the magnitude of many of these events. While various research projects have been undertaken to understand this normal planetary process, little has been done to address its impact on ocean and human health. This review will address the ability of dust storms to influence marine microbial population densities and transport of soil-associated toxins and pathogenic microorganisms to marine environments. The implications of dust on ocean and human health in this emerging scientific field will be discussed.

  10. Arms trade and its impact on global health.

    Science.gov (United States)

    Mahmudi-Azer, Salahaddin

    2006-01-01

    The most obvious adverse impact of the arms trade on health is loss of life and maiming from the use of weapons in conflicts. Wealthy countries suffer damage to their health and human services when considerable resources are diverted to military expenditure. However, the relative impact of military expenditures and conflict on third world countries is much greater, and often devastating, by depriving a significant portion of the population of essential food, medicine, shelter, education, and economic opportunities. Further, the physical and psychological damage inflicted specifically on children is debilitating - through loss of (or separation from) families, loss of education, destruction of homes, exposure to murder and other violence, sexual abuse, abduction, torture, slavery, and forcible conscription as soldiers. This article outlines the socio-economic impact of the global arms trade in general and the damage done to human health and the environment, specifically.

  11. Health impact assessment of climate change in Bangladesh

    International Nuclear Information System (INIS)

    Nelson, Deborah Imel

    2003-01-01

    Global climate change (GCC) may have serious and irreversible impacts. Improved methods are needed to predict and quantify health impacts, so that appropriate risk management strategies can be focused on vulnerable areas. The disability-adjusted life year (DALY) is proposed as an effective tool in environmental health impact assessment (HIA). The DALY accounts for years of life lost to premature death and/or morbidity. Both the DALY and the determinants-of-health approach are applied to HIA of GCC in Bangladesh. Based on historical data, a major storm event may result in approximately 290 DALY per 1000 population, including both deaths and injuries, compared to a current all-cause rate of about 280 per 1000 in the region. A more precise result would require a large input of data; however, this level of analysis may be sufficient to rank risks, and to motivate and target risk management efforts

  12. Health impact assessment of the Atlanta BeltLine.

    Science.gov (United States)

    Ross, Catherine L; Leone de Nie, Karen; Dannenberg, Andrew L; Beck, Laurie F; Marcus, Michelle J; Barringer, Jason

    2012-03-01

    Although a health impact assessment (HIA) is a tool that can provide decision makers with recommendations to promote positive health impacts and mitigate adverse health impacts of proposed projects and policies, it is not routinely conducted on most major projects or policies. To make health a decision criterion for the Atlanta BeltLine, a multibillion-dollar transit, trails, parks, and redevelopment project. An HIA was conducted in 2005-2007 to anticipate and influence the BeltLine's effect on health determinants. Changes in access and equity, environmental quality, safety, social capital, and physical activity were forecast, and steps to maximize health benefits and reduce negative effects were recommended. Key recommendations included giving priority to the construction of trails and greenspace rather than residential and retail construction, making health an explicit goal in project priority setting, adding a public health professional to decision-making boards, increasing the connectivity between the BeltLine and civic spaces, and ensuring that affordable housing is built. BeltLine project decision makers have incorporated most of the HIA recommendations into the planning process. The HIA was cited in the awarding of additional funds of $7,000,000 for brownfield clean-up and greenspace development. The project is expected to promote the health of local residents more than in the absence of the HIA. This report is one of the first HIAs to tie specific assessment findings to specific recommendations and to identifiable impacts from those recommendations. The lessons learned from this project may help others engaged in similar efforts. Copyright © 2012. Published by Elsevier Inc.

  13. Nutrition economics - characterising the economic and health impact of nutrition.

    Science.gov (United States)

    Lenoir-Wijnkoop, I; Dapoigny, M; Dubois, D; van Ganse, E; Gutiérrez-Ibarluzea, I; Hutton, J; Jones, P; Mittendorf, T; Poley, M J; Salminen, S; Nuijten, M J C

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner.

  14. A New Functional Health Literacy Scale for Japanese Young Adults Based on Item Response Theory.

    Science.gov (United States)

    Tsubakita, Takashi; Kawazoe, Nobuo; Kasano, Eri

    2017-03-01

    Health literacy predicts health outcomes. Despite concerns surrounding the health of Japanese young adults, to date there has been no objective assessment of health literacy in this population. This study aimed to develop a Functional Health Literacy Scale for Young Adults (funHLS-YA) based on item response theory. Each item in the scale requires participants to choose the most relevant term from 3 choices in relation to a target item, thus assessing objective rather than perceived health literacy. The 20-item scale was administered to 1816 university students and 1751 responded. Cronbach's α coefficient was .73. Difficulty and discrimination parameters of each item were estimated, resulting in the exclusion of 1 item. Some items showed different difficulty parameters for male and female participants, reflecting that some aspects of health literacy may differ by gender. The current 19-item version of funHLS-YA can reliably assess the objective health literacy of Japanese young adults.

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

    Science.gov (United States)

    Cheng, June J; Berry, Peter

    2013-10-01

    This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. 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 developed. Total scores for each indicator were calculated based on the rating scale. A total of 77 health indicators were identified from the literature. After evaluation using the chosen criteria, 8 indicators were identified as the best for use. They include excess daily all-cause mortality due to heat, premature deaths due to air pollution (ozone and particulate matter 2.5), preventable deaths from climate change, disability-adjusted life years lost from climate change, daily all-cause mortality, daily non-accidental mortality, West Nile Disease incidence, and Lyme borreliosis incidence. There is need for further data and research related to health effect quantification in the area of climate change.

  16. The impact of educational interventions on the empathic concern of health professional students: A literature review.

    Science.gov (United States)

    Everson, Naleya; Levett-Jones, Tracy; Pitt, Victoria

    2018-05-24

    This review aimed to identify programs that promote health professional students' empathic concern. Empathic concern is a key mediator of important outcomes for both patients and health professionals. However the empathic concern of health professional students tends to decline over the course of their studies. To date studies that have evaluated the impact of educational programs on empathic concern have not been reviewed. The databases ProQuest, CINAHL and Ovid were searched for studies that had evaluated educational programs for health professional students using a validated psychometric measure of empathic concern. Studies were graded using The Quality Assessment Tool for Quantitative Studies. Of 2977 identified studies, fifteen met inclusion criteria. Seven studies separately reported empathic concern scores. Four of the fifteen studies reported increased empathy scale scores after students took part in a program. Two studies received a strong quality rating, six a moderate rating and seven a weak rating. This review did not identify any studies that clearly demonstrated an increase in students' empathic concern after taking part in an educational program. Mindfulness based stress reduction, providing empathy content at each stage of a degree, programs that incorporate the film Wit, and Balint groups, may promote empathic concern. In light of the significant impact of health professionals' levels of empathic concern on outcomes for patients and health professionals, further robustly designed research using appropriate psychometric scales is needed to inform the development of education programs in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Measuring workplace trauma response in Australian paramedics: an investigation into the psychometric properties of the Impact of Event Scale

    Directory of Open Access Journals (Sweden)

    Hogan N

    2015-12-01

    Full Text Available Nicola Hogan,1 Shane Costello,1 Malcolm Boyle,2 Brett Williams2 1Faculty of Education, Monash University, Clayton, VIC, Australia; 2Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia Introduction: Investigation into the psychological effects of violence toward health care workers and its associated trauma is increasing. The Impact of Event Scale (IES provides a measure of current, subjective, emotional distress symptomatic of a specific traumatic event. However, its validity among paramedics is largely unknown. Problem: The purpose of this study was to investigate the psychometric properties and factor structure of the IES with a sample of Australian paramedics. Methods: The study aimed to investigate the psychometric properties and factor structure of the 15-item IES with a sample of Australian paramedics using Exploratory Factor Analysis with model fit statistics as found in confirmatory analysis. Results: Maximum Likelihood Factor Analysis with Varimax rotation supported the hypothesis that a two-factor solution would provide the best fit of the data. Procrustes rotation provided further support for this hypothesis indicating that the factors, labeled “Intrusion” and “Avoidance”, as well as the individual items of the 12-item final model, were a good fit to an ideal solution. Conclusion: The revision of the scale has improved its validity for use in the general population of paramedics, improving the potential for its use in trauma-related research. Keywords: impact of event scale, psychometrics, paramedics, occupational violence, PTSD

  18. Current and future impact of osteoarthritis on health care

    DEFF Research Database (Denmark)

    Turkiewicz, A; Petersson, I F; Björk, J

    2014-01-01

    OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary and specia......OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary...

  19. Oral health impact of periodontal diseases in adolescents.

    Science.gov (United States)

    López, R; Baelum, V

    2007-11-01

    The need for treatment of destructive periodontal diseases is based on observations made by oral health professionals, who, prompted by clinical findings, recommend treatment. We hypothesized that clinical signs of periodontal destruction have an impact on the oral-health-related quality of life of adolescents. We conducted a cross-sectional study among 9203 Chilean high school students sampled by a multistage random cluster procedure. We recorded clinical attachment levels and the presence of necrotizing ulcerative gingivitis. The students answered the Spanish version of the Oral Health Impact Profile and provided information on several socio-economic indicators. The results of multivariable logistic regression analyses (adjusted for age, gender, and tooth loss) showed that both attachment loss [OR = 2.0] and necrotizing ulcerative gingivitis [OR = 1.6] were significantly associated with higher impact on the Oral Health Related Quality of Life of adolescents. Individuals in lower socioeconomic positions systematically reported a higher impact on their oral-health-related quality of life.

  20. Impact of ACA Health Reforms for People With Mental Health Conditions.

    Science.gov (United States)

    Thomas, Kathleen C; Shartzer, Adele; Kurth, Noelle K; Hall, Jean P

    2018-02-01

    This brief report explores the impact of health reform for people with mental illness. The Health Reform Monitoring Survey was used to examine health insurance, access to care, and employment for 1,550 people with mental health conditions pre- and postimplementation of the Affordable Care Act (ACA) and by state Medicaid expansion status. Multivariate logistic regressions with predictive margins were used. Post-ACA reforms, people with mental health conditions were less likely to be uninsured (5% versus 13%; t=-6.89, df=50, peffects were experienced in both Medicaid expansion and nonexpansion states. Findings underscore the importance of ACA improvements in the quality of health insurance coverage.

  1. Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

    Energy Technology Data Exchange (ETDEWEB)

    Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T., E-mail: markku.kuitunen@jyu.fi

    2014-11-15

    Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state.

  2. Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

    International Nuclear Information System (INIS)

    Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T.

    2014-01-01

    Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state

  3. Building-related health impacts in European and Chinese cities: a scalable assessment method.

    Science.gov (United States)

    Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki; Asikainen, Arja; Perez, Laura; Trüeb, Stephan; Jantunen, Matti; Künzli, Nino; Sabel, Clive E

    2015-12-14

    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 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 should follow the building stock in time, make comparisons between scenarios, propagate uncertainties, and scale to different levels of detail. We tested The functionalities of the model in two case cities, namely Kuopio and Basel. We estimated the health and climate impacts of two actual policies planned or implemented in the cities. The assessed policies were replacement of peat with wood chips in co-generation of district heat and power, and improved energy efficiency of buildings achieved by renovations. Health impacts were not large in the two cities, but also clear differences in implementation and predictability between the two tested policies were seen. Renovation policies can improve the energy efficiency of buildings and reduce greenhouse gas emissions significantly, but this requires systematic policy sustained for decades. In contrast, fuel changes in large district heating facilities may have rapid and large impacts on emissions. However, the life cycle impacts of different fuels is somewhat an open question. In conclusion, we were able to develop a practical model for city

  4. Impacts of large-scale introduction of hydrogen in the road transport sector on urban air pollution and human exposure in Copenhagen

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, S.S.; Ketzel, M.; Brandt, J.; Frohn, L.M.; Winther, M.; Nielsen, O.K. (Aarhus Univ.. National Environmental Research Institute, Roskilde (Denmark)); Joergensen, K.; Karlsson, K. (Technical Univ. of Denmark, Risoe National Lab. for Sustainable Energy. Dept. of System Analysis, Roskilde (Denmark))

    2011-07-15

    The aim of the project 'Environmental and Health Impact Assessment of Scenarios for Renewable Energy Systems with Hydrogen' (HYSCENE) is to improve modelling of the environmental impacts and related socio-cultural and welfare economic impacts of a proposed hydrogen/renewable energy system with focus on large-scale introduction of hydrogen as energy carrier in the road transport sector (http://hyscene.dmu.dk). This extended abstract will focus on the impacts on urban air pollution and human exposure. (Author)

  5. Impacts of different characterizations of large-scale background on simulated regional-scale ozone over the continental United States

    Science.gov (United States)

    Hogrefe, Christian; Liu, Peng; Pouliot, George; Mathur, Rohit; Roselle, Shawn; Flemming, Johannes; Lin, Meiyun; Park, Rokjin J.

    2018-03-01

    This study analyzes simulated regional-scale ozone burdens both near the surface and aloft, estimates process contributions to these burdens, and calculates the sensitivity of the simulated regional-scale ozone burden to several key model inputs with a particular emphasis on boundary conditions derived from hemispheric or global-scale models. The Community Multiscale Air Quality (CMAQ) model simulations supporting this analysis were performed over the continental US for the year 2010 within the context of the Air Quality Model Evaluation International Initiative (AQMEII) and Task Force on Hemispheric Transport of Air Pollution (TF-HTAP) activities. CMAQ process analysis (PA) results highlight the dominant role of horizontal and vertical advection on the ozone burden in the mid-to-upper troposphere and lower stratosphere. Vertical mixing, including mixing by convective clouds, couples fluctuations in free-tropospheric ozone to ozone in lower layers. Hypothetical bounding scenarios were performed to quantify the effects of emissions, boundary conditions, and ozone dry deposition on the simulated ozone burden. Analysis of these simulations confirms that the characterization of ozone outside the regional-scale modeling domain can have a profound impact on simulated regional-scale ozone. This was further investigated by using data from four hemispheric or global modeling systems (Chemistry - Integrated Forecasting Model (C-IFS), CMAQ extended for hemispheric applications (H-CMAQ), the Goddard Earth Observing System model coupled to chemistry (GEOS-Chem), and AM3) to derive alternate boundary conditions for the regional-scale CMAQ simulations. The regional-scale CMAQ simulations using these four different boundary conditions showed that the largest ozone abundance in the upper layers was simulated when using boundary conditions from GEOS-Chem, followed by the simulations using C-IFS, AM3, and H-CMAQ boundary conditions, consistent with the analysis of the ozone fields

  6. Assessments of Drought Impacts on Vegetation in China with the Optimal Time Scales of the Climatic Drought Index

    Directory of Open Access Journals (Sweden)

    Zheng Li

    2015-07-01

    Full Text Available Drought is expected to increase in frequency and severity due to global warming, and its impacts on vegetation are typically extensively evaluated with climatic drought indices, such as multi-scalar Standardized Precipitation Evapotranspiration Index (SPEI. We analyzed the covariation between the SPEIs of various time scales and the anomalies of the normalized difference vegetation index (NDVI, from which the vegetation type-related optimal time scales were retrieved. The results indicated that the optimal time scales of needle-leaved forest, broadleaf forest and shrubland were between 10 and 12 months, which were considerably longer than the grassland, meadow and cultivated vegetation ones (2 to 4 months. When the optimal vegetation type-related time scales were used, the SPEI could better reflect the vegetation’s responses to water conditions, with the correlation coefficients between SPEIs and NDVI anomalies increased by 5.88% to 28.4%. We investigated the spatio-temporal characteristics of drought and quantified the different responses of vegetation growth to drought during the growing season (April–October. The results revealed that the frequency of drought has increased in the 21st century with the drying trend occurring in most of China. These results are useful for ecological assessments and adapting management steps to mitigate the impact of drought on vegetation. They are helpful to employ water resources more efficiently and reduce potential damage to human health caused by water shortages.

  7. Mercury use in small scale gold mining in Ghana: an assessment of its impact on miners

    International Nuclear Information System (INIS)

    Biagya, Robert Yakubu

    2002-12-01

    Small scale gold mining is responsible for about 5% of Ghana’s annual gold production. It is estimated that between 80,000 and 100,000 people are engaged in small scale gold mining either on part-time or permanent basis. Amalgamation is the preferred method used by small scale gold miners for extracting free gold from its ores. The rate at which mercury, an important input in this method, is discharged into the atmosphere and water bodies is alarming. This research describes the various mining and processing methods in small scale gold mining and the extent of mercury use and releases to the environment. It discusses mercury and its human and environmental effects. It defines the various forms of mercury, routes of exposure, toxic effects. The levels of exposure to mercury by all groups of small scale gold miners are determined, and the impacts on the miners and the environment are assessed. It concludes that: • Mercury is mainly released into the environment as a result of small scale gold mining through spillage of elemental mercury and evaporation of mercury from the amalgam and sponge gold when they are heated on open fire. • Mercury in environmental samples from small scale gold mining areas is well above standard limit values. • Mercury released into the environment through small scale gold mining impacts negatively on the miners themselves and the general environment. Finally, it recommends the need for the adoption of mercury emission reduction strategies for dealing with the mercury problem. (au)

  8. Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo

    Directory of Open Access Journals (Sweden)

    Gaurang S Krishna

    2013-01-01

    Full Text Available Background : Vitiligo is a disease that significantly impairs quality of life. Previous studies have shown that vitiligo has an impact that may not correlate with the size and extent of depigmentation, indicating a need for an independent measure of the psychosocial burden. Aims : To develop a rating scale to assess the psychosocial impact of vitiligo. Methods : The study was undertaken in three broad phases: item generation, pre- and pilot testing, and test administration. Items were generated largely from a qualitative study using semi-structured interviews of patients. Face and content validity were assessed through pre- and pilot testing in 80 patients and the final version was administered to 100 patients who also received the Dermatology Life Quality Index (DLQI and the Skindex-16. Each patient also underwent a physician global assessment (PGA of the impact of vitiligo. Test-retest reliability was assessed in 20 patients. Results: Of 72 items initially generated for the scale, 27 were retained in the final version. Subjects were able to comprehend the items and took about 5-7 min to complete the instrument. The scale was internally consistent (Cronbach′s α = 0.85. Scores on the scale correlated moderately well with the DLQI and the Skindex (Spearman rank correlation: 0.51 and 0.65, respectively. The scale was able to discriminate between patients having mild and those having moderate and severe impact as assessed by PGA. The test-retest reliability coefficient (Spearman rank correlation was 0.80. Conclusion: The Vitiligo Impact Scale appears to be a valid measure of the psychosocial impact of vitiligo and this instrument may be useful both in the clinic and in clinical trials.

  9. Individual and Community Socioeconomic Status: Impact on Mental Health in Individuals with Arthritis

    Directory of Open Access Journals (Sweden)

    Chivon A. Mingo

    2014-01-01

    Full Text Available To examine the impact of individual and community socioeconomic status (SES measures on mental health outcomes in individuals with arthritis, participants with self-reported arthritis completed a telephone survey assessing health status, health attitudes and beliefs, and sociodemographic variables. Regression analyses adjusting for race, gender, BMI, comorbidities, and age were performed to determine the impact of individual and community level SES on mental health outcomes (i.e., Medical Outcomes Study SF-12v2 mental health component, the Centers for Disease Control and Prevention Health-Related Quality of Life Healthy Days Measure, Center for Epidemiological Studies Depression [CES-D] scale. When entered singly, lower education and income, nonmanagerial occupation, non-homeownership, and medium and high community poverty were all significantly associated with poorer mental health outcomes. Income, however, was more strongly associated with the outcomes in comparison to the other SES variables. In a model including all SES measures simultaneously, income was significantly associated with each outcome variable. Lower levels of individual and community SES showed most consistent statistical significance in association with CES-D scores. Results suggest that both individual and community level SES are associated with mental health status in people with arthritis. It is imperative to consider how interventions focused on multilevel SES factors may influence existing disparities.

  10. Integrated Approach for Improving Small Scale Market Oriented Dairy Systems in Pakistan: Economic Impact of Interventions

    Directory of Open Access Journals (Sweden)

    A. Ghaffar

    2010-02-01

    Full Text Available The International Atomic Energy Agency (IAEA launched a Coordinated Research Program in 10 developing countries including Pakistan involving small scale market oriented dairy farmers to identify and prioritize the constraints and opportunities in the selected dairy farms, develop intervention strategies and assess the economic impact of the intervention. The interventions in animal health (control of mastitis at sub-clinical stage and reduction in calf mortality, nutrition (balanced feed reproduction (mineral supplementation, and general management (training of farmers were identified and implemented in a participatory approach at the selected dairy farms. The calf mortality was reduced from 35 to 13 percent up to the age of 3 months. Use of Alfa Deval post milking teat dips reduced the incidence of sub-clinical mastitis from 34 to 5% showing economical benefits of the interventions. Partial budget technique was used to analyze its impact in the registered herds. The farmers recorded monthly quantities of different feed ingredients and seasonal green fodder offered to the animals. From this data set total metabolizeable energy requirements and availability from feed were computed which revealed that animals were deficient in metabolizeable energy in all locations. This was also confirmed by seasonal variation in body condition scoring. At some selected farms the mineral mixture supplement was introduced which exhibited increased milk yield by 5 % in addition to shorten service period by 30 days. Three sessions of training were arranged to train the farmers to care new born calves, daily farm management and detect the animals in heat efficiently to enhance the over all income of the farmers. The overall income of the farm was increased by 40%.

  11. The need for health impact assessment in China: Potential benefits for public health and steps forward

    Energy Technology Data Exchange (ETDEWEB)

    Wu Liming, E-mail: lmwu@scdc.sh.c [Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336 (China); Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia); Rutherford, Shannon; Chu, Cordia [Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia)

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  12. The need for health impact assessment in China: Potential benefits for public health and steps forward

    International Nuclear Information System (INIS)

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-01-01

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  13. Bioeffects on an In Vitro Model by Small-Scale Explosives and Shock Wave Overpressure Impacts

    Science.gov (United States)

    2017-11-01

    Many TBIs are associated with blast from improvised explosive devices.2–4 Explosions are physical, chemical , or nuclear reactions involving a rapid...ARL-TR-8210 ● NOV 2017 US Army Research Laboratory Bioeffects on an In Vitro Model by Small-Scale Explosives and Shock Wave...Research Laboratory Bioeffects on an In Vitro Model by Small-Scale Explosives and Shock Wave Overpressure Impacts by Nicole E Zander, Thuvan

  14. Spatial connectivity, scaling, and temporal trajectories as emergent urban stormwater impacts

    Science.gov (United States)

    Jovanovic, T.; Gironas, J. A.; Hale, R. L.; Mejia, A.

    2016-12-01

    Urban watersheds are structurally complex systems comprised of multiple components (e.g., streets, pipes, ponds, vegetated swales, wetlands, riparian corridors, etc.). These multiple engineered components interact in unanticipated and nontrivial ways with topographic conditions, climate variability, land use/land cover changes, and the underlying eco-hydrogeomorphic dynamics. Such interactions can result in emergent urban stormwater impacts with cascading effects that can negatively influence the overall functioning of the urban watershed. For example, the interaction among many detention ponds has been shown, in some situations, to synchronize flow volumes and ultimately lead to downstream flow amplifications and increased pollutant mobilization. Additionally, interactions occur at multiple temporal and spatial scales requiring that urban stormwater dynamics be represented at the long-term temporal (decadal) and across spatial scales (from the single lot to the watershed scale). In this study, we develop and implement an event-based, high-resolution, network hydro-engineering model (NHEM), and demonstrate an approach to reconstruct the long-term regional infrastructure and land use/land cover conditions of an urban watershed. As the study area, we select an urban watershed in the metropolitan area of Scottsdale, Arizona. Using the reconstructed landscapes to drive the NHEM, we find that distinct surficial, hydrologic connectivity patterns result from the intersection of hydrologic processes, infrastructure, and land use/land cover arrangements. These spatial patters, in turn, exhibit scaling characteristics. For example, the scaling of urban watershed dispersion mechanisms shows altered scaling exponents with respect to pre-urban conditions. For example, the scaling exponent associated with geomorphic dispersion tends to increase for urban conditions, reflecting increased surficial path heterogeneity. Both the connectivity and scaling results can be used to

  15. Defining migration and its health impact in China.

    Science.gov (United States)

    Mou, J; Griffiths, S M; Fong, H F; Dawes, M G

    2015-10-01

    The scale and rapid expansion of urbanization resulting from socio-economic transformation in China at the beginning of the 21st century has accelerated rural-urban migration. Public health concerns from this increasing internal population mobility are now receiving attention from researchers. The health problems from internal migration pose particular demands on healthcare systems and relate to its demographic characteristics, with many younger and older people being left behind in the rural countryside. A review of literature, census, policy reports, government documents and media was undertaken to look at the classification system and health characteristics of China's internal migrants. It suggests that public health bears the consequences of political and economic decisions made elsewhere in society. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  16. Analysis of environmental impact assessment for large-scale X-ray medical equipments

    International Nuclear Information System (INIS)

    Fu Jin; Pei Chengkai

    2011-01-01

    Based on an Environmental Impact Assessment (EIA) project, this paper elaborates the basic analysis essentials of EIA for the sales project of large-scale X-ray medical equipment, and provides the analysis procedure of environmental impact and dose estimation method under normal and accident conditions. The key points of EIA for the sales project of large-scale X-ray medical equipment include the determination of pollution factor and management limit value according to the project's actual situation, the utilization of various methods of assessment and prediction such as analogy, actual measurement and calculation to analyze, monitor, calculate and predict the pollution during normal and accident condition. (authors)

  17. Measuring Narcissism within Add Health: The Development and Validation of a New Scale

    Science.gov (United States)

    Davis, Mark S.; Brunell, Amy B.

    2012-01-01

    This study reports the development of a measure of narcissism within the National Longitudinal Study of Adolescent Health (Add Health) data set. In Study 1, items were selected from Wave III to form the Add Health Narcissism Scale (AHNS). These were factor analyzed, yielding a single factor comprised of five subscales. We correlated the AHNS and…

  18. Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?

    Science.gov (United States)

    Tobi, Patrick; George, Gavin; Schmidt, Elena; Renton, Adrian

    2008-12-01

    To investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. Exploratory interviews with health managers and senior clinical staff were used to identify locally relevant work environment indicators. A self-reported Likert scale questionnaire was administered to a randomly selected cohort of 269 health professionals at health facilities in KwaZulu Natal and Western Cape provinces of South Africa that included ART delivery sites. The cohort was disaggregated into ART and non-ART groups and differences between the two compared with Fisher's exact test and the non-parametric Mann-Whitney U-test. The ART sub-cohort reported: (i) a lighter workload (P = 0.013), (ii) higher level of staffing (P = 0.010), (iii) lower sickness absence (P = 0.032), (iv) higher overall job satisfaction (P = 0.010), (v) poorer physical state of their work premises (P = 0.003), and (vi) higher staff turnover (P = 0.036). Conclusion Scale-up affects the work environment in ways that influence workers' motivation both positively and negatively. A net negative balance is likely to drive staff out-migration, undermine the quality of care and compromise the capacity of the programme to achieve significant scale. As health workers are the most important element of the health system, a comprehensive and systematic understanding of scale-up impacts on their working conditions and motivation needs to be an integral part of any delivery strategy.

  19. Campus Sexual Violence: The Impact of Disclosure on Mental Health

    Science.gov (United States)

    Double, Katelin B.

    2018-01-01

    A mixed methodological approach was used to examine the impact of disclosure characteristics on mental health among individuals who have experienced campus sexual violence occurring at Christian and non-religiously affiliated universities. After completing an online survey, a sample of 97 participants qualified for the study. No disclosure and…

  20. 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

  1. 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 ...

  2. The impact of a modified World Health Organization surgical safety ...

    African Journals Online (AJOL)

    The impact of a modified World Health Organization surgical safety checklist on maternal ... have shown an alarming increase in deaths during or after caesarean delivery. ... Methods. The study was a stratified cluster-randomised controlled trial ... Training of healthcare personnel took place over 1 month, after which the ...

  3. Disrupted seasonal biology impacts health, food security and ecosystems

    NARCIS (Netherlands)

    Stevenson, T. J.; Visser, M. E.; Arnold, W.; Barrett, P.; Biello, S.; Dawson, A.; Denlinger, D. L.; Dominoni, D.; Ebling, F. J.; Elton, S.; Evans, N.; Ferguson, H. M.; Foster, R. G.; Hau, M.; Haydon, D. T.; Hazlerigg, D. G.; Heideman, P.; Hopcraft, J. G. C.; Jonsson, N. N.; Kronfeld-Schor, N.; Kumar, V.; Lincoln, G. A.; MacLeod, R.; Martin, S. A. M.; Martinez-Bakker, M.; Nelson, R. J.; Reed, T.; Robinson, J. E.; Rock, D.; Schwartz, W. J.; Steffan-Dewenter, I.; Tauber, E.; Thackeray, S. J.; Umstatter, C.; Yoshimura, T.; Helm, B.

    2015-01-01

    The rhythm of life on earth is shaped by seasonal changes in the environment. Plants and animals show profound annual cycles in physiology, health, morphology, behaviour and demography in response to environmental cues. Seasonal biology impacts ecosystems and agriculture, with consequences for

  4. Distribution-based estimates of minimal important difference for hospital anxiety and depression scale and impact of event scale-revised in survivors of acute respiratory failure.

    Science.gov (United States)

    Chan, Kitty S; Aronson Friedman, Lisa; Bienvenu, O Joseph; Dinglas, Victor D; Cuthbertson, Brian H; Porter, Richard; Jones, Christina; Hopkins, Ramona O; Needham, Dale M

    2016-01-01

    This study will estimate distribution-based minimal important difference (MID) for the Hospital Anxiety and Depression Scale anxiety (HADS-A) and depression (HADS-D) subscales, and the Impact of Event Scale-Revised (IES-R) in survivors of acute respiratory failure (ARF). Secondary analyses of data from two US and three UK studies of ARF survivors (total N=1223). HADS-D and HADS-A were used to assess depression and anxiety symptoms. IES-R assessed post-traumatic stress disorder symptoms. Standard error of measurement, minimal detectable change90, 0.5 standard deviation (S.D.), and 0.2 S.D. were used to estimate MID for the combined sample, by studies, 6- and 12-month follow-ups, country and mental health condition. Overall, MID estimates converged to 2.0-2.5 for the HADS-A, 1.9-2.3 for the HADS-D and 0.17-0.18 for the IES-R. MID estimates were comparable across studies, follow-up, country and mental health condition. Among ARF survivors, 2.0-2.5 is a reasonable range for the MID for both HADS subscales, and 0.2 is reasonable for IES-R. Until anchor-based MIDs for these instruments are available, these distribution-based estimates can help researchers plan future studies and interpret the clinical importance of findings in ARF patient populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. International trade of health services: global trends and local impact.

    Science.gov (United States)

    Lautier, Marc

    2014-10-01

    Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. A Review of the impact of the health literacy status of patients on ...

    African Journals Online (AJOL)

    Alasia Datonye

    health, economic and social impacts; it will also discuss the implications for ... Key words: Low health literacy, healthcare impact, health outcomes. .... mouth every 6 hours as needed”. To test ... media and many more need to collaborate to take.

  7. Modeling the impact of large-scale energy conversion systems on global climate

    International Nuclear Information System (INIS)

    Williams, J.

    There are three energy options which could satisfy a projected energy requirement of about 30 TW and these are the solar, nuclear and (to a lesser extent) coal options. Climate models can be used to assess the impact of large scale deployment of these options. The impact of waste heat has been assessed using energy balance models and general circulation models (GCMs). Results suggest that the impacts are significant when the heat imput is very high and studies of more realistic scenarios are required. Energy balance models, radiative-convective models and a GCM have been used to study the impact of doubling the atmospheric CO 2 concentration. State-of-the-art models estimate a surface temperature increase of 1.5-3.0 0 C with large amplification near the poles, but much uncertainty remains. Very few model studies have been made of the impact of particles on global climate, more information on the characteristics of particle input are required. The impact of large-scale deployment of solar energy conversion systems has received little attention but model studies suggest that large scale changes in surface characteristics associated with such systems (surface heat balance, roughness and hydrological characteristics and ocean surface temperature) could have significant global climatic effects. (Auth.)

  8. Implementation of health impact assessment in Danish municipal context

    DEFF Research Database (Denmark)

    Kraemer, Stella R. J.; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-01-01

    . Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.......Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health...... policy. Methods: Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used...

  9. [Mental health impact of stalking in men and women].

    Science.gov (United States)

    Kuehner, Christine; Gass, Peter; Dressing, Harald

    2006-08-01

    Using data from the Mannheim stalking study, the present report analyses gender differences with regard to various mental health indicators and potential mediator effects of stalking victimization. Furthermore, we were interested in whether the impact of stalking on mental health was comparable for men and women. The study included a postal survey of 675 community residents on the experience of intruding harassment and on mental health indicators. In the Patient Health Questionnaire (PHQ-D, Lowe et al. 2001), women scored higher on most of the subscales (depression, anxiety, somatic complaints, stress, psychosocial impairment) than men. Furthermore, more women fulfilled criteria for at least one threshold or subthreshold mental disorder syndrome according to DSM-IV, and more women were under psychotropic medication. However, the identified associations were completely mediated by the higher prevalence of stalking victims in women. In contrast, the associations of stalking victimization with poor mental health, psychosocial functioning, and use of medication were largely comparable across gender.

  10. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

  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. Differing forms, differing purposes: A typology of health impact assessment

    International Nuclear Information System (INIS)

    Harris-Roxas, Ben; Harris, Elizabeth

    2011-01-01

    There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between different forms of HIAs. This paper describes the three historical and disciplinary fields from which HIA has emerged - environmental health, a social view of health, and health equity. It also puts forward a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-led HIAs. This paper argues that these different forms of HIA serve different purposes and are not necessarily in competition; rather they allow HIA to be responsive to a range of population health concerns and purposes.

  13. Impact of organisational change on mental health: a systematic review.

    Science.gov (United States)

    Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2012-08-01

    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 Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.

  14. 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

  15. ABORTION IN BRAZIL: IMPACTS OF ILLEGALITY IN PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Vanessa Cruz Santos

    2013-12-01

    Full Text Available Abortion in Brazil provides public health impacts, mainly due to the high rate of maternal morbidity and mortality, because it most often occurs in an illegal practice and / or unsafe, because of the illegality of abortion in certain situations in the country. Therefore, it is an issue that refers to the various reflections, such as legal, moral, cultural, socio-economic and bioethical. Given the above, the study aims to address about abortion in Brazil and the impacts of illegality in public health. Study of literature review, descriptive and discursive, held in the database SciELO sites and governmental and non-governmental organizations. It was evident that the illegality of abortion in Brazil is harmful to the health of women who resort to unsafe practices and / or illegal, a violation of human rights, the women’s autonomy, as well as providing public health impacts, and sometimes this actually happens because the deficit in quality of care, specifically to sexual and reproductive health, as the actions of Family Planning. It is considered that the way of abortion in Brazil requires modifications, especially with regard to legislative and bioethics conflicts.

  16. 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.

  17. Full scale aircraft impact test for evaluation of impact forces-Part 1

    International Nuclear Information System (INIS)

    Von Riesemann, W.A.; Parrish, R.L.; Bickel, D.C.; Heffelfinger, S.R.; Muto, K.; Sugano, T.; Tsubota, H.; Koshika, N.; Suzuki, M.; Ohrui, S.

    1989-01-01

    This paper describes a test conducted at an existing rocket sled facility in which an actual F-4 Phantom aircraft was impacted at a nominal velocity of 215 m/s into an essentially rigid block of concrete. This was accomplished by supporting the F-4 on four struts that were attached to the sled track by carriage shoes to direct the path of the aircraft. Propulsion was accomplished by two stages of rockets. The concrete target was floated on a set of air bearings. Data acquisition consisted of measurements of the acceleration of the fuselage and engines of the F-4, and measurements of the displacement, velocity and acceleration of the concrete target. High-speed photograph recorded the impact process and also permitted the determination of the impact velocity. This paper describes the test plan, method and results

  18. Microbial Indicators, Pathogens, and Antibiotic Resistance in Groundwater Impacted by Animal Farming: Field Scale to Basin Scale

    Science.gov (United States)

    Harter, T.; Li, X.; Atwill, E. R.; Packman, A. I.

    2015-12-01

    Several surveys of microbial indicators and pathogens were conducted to determine the impact of confined animal farming operations (CAFOs) on shallow, local, and regional groundwater quality in the Central Valley aquifer system, California. The aquifer system consists of highly heterogeneous, alluvial, unconsolidated coarse- to fine-grained sediments and is among the largest aquifers in the U.S.. Overlying landuse includes 3 million ha of irrigated agriculture and 1.7 million mature dairy cows in nearly 1,500 CAFOs. A multi-scale survey of water-borne indicator pathogens (Enterococcus spp. and generic E. coli) and of three water-borne pathogens (Campylobacter, Salmonella, and E. coli O157:H7) was conducted at five different spatial scales, increasing with distance from animal sources of these enteric microbial organisms: moist surfaces within individual CAFO sub-systems (calf-hutches, heifer corrals, mature cow stalls, hospital barn etc.), first encountered (shallow) groundwater immediately below these sub-systems, production aquifer below CAFOs, production aquifer near CAFOs, and production aquifer away from CAFOs. Where found, indicator pathogens were tested for antibiotic resistance. Hundreds of samples were collected at each scale: continuously during irrigation events and seasonally over a multi-year period at the three smaller site-scales; and in a one-time survey at the two larger, regional scales. All three pathogens were frequently detected in moist surface samples across CAFO sub-systems, albeit at concentrations several orders of magnitude lower than enteric indicators. Two of the three pathogens (but not Campylobacter) were also detected in first encountered groundwater, at 3-9 m below ground surface, in 1% of samples. No pathogens were found at the production aquifer scales. Generic E. coli was detected in ¼ of first encountered groundwater samples, and in 4% of production aquifer samples, while Enterococcus spp. was ubiquitously present across the

  19. Development and Validation of a Scale to Measure Adolescent Sexual and Reproductive Health Stigma: Results From Young Women in Ghana

    Science.gov (United States)

    Hall, Kelli Stidham; Manu, Abubakar; Morhe, Emmanuel; Harris, Lisa H.; Loll, Dana; Ela, Elizabeth; Kolenic, Giselle; Dozier, Jessica L.; Challa, Sneha; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Dalton, Vanessa K.

    2018-01-01

    Young women’s experiences with sexual and reproductive health (SRH) stigma may contribute to unintended pregnancy. Thus, stigma interventions and rigorous measures to assess their impact are needed. Based on formative work, we generated a pool of 51 items on perceived stigma around different dimensions of adolescent SRH and family planning (sex, contraception, pregnancy, child-bearing, abortion). We tested items in a survey study of 1,080 women ages 15 to 24 recruited from schools, health facilities, and universities in Ghana. Confirmatory factor analysis (CFA) identified the most conceptually and statistically relevant scale, and multivariable regression established construct validity via associations between stigma and contraceptive use. CFA provided strong support for our hypothesized Adolescent SRH Stigma Scale (chi-square p value stigma (six items), enacted stigma (seven items), and stigmatizing lay attitudes (seven items). The scale demonstrated good internal consistency (α = 0.74) and strong subscale correlations (α = 0.82 to 0.93). Higher SRH stigma scores were inversely associated with ever having used modern contraception (adjusted odds ratio [AOR] = 0.96, confidence interval [CI] = 0.94 to 0.99, p value = 0.006). A valid, reliable instrument for assessing SRH stigma and its impact on family planning, the Adolescent SRH Stigma Scale can inform and evaluate interventions to reduce/manage stigma and foster resilience among young women in Africa and beyond. PMID:28266874

  20. 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.

  1. 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.

  2. Examination of an eHealth literacy scale and a health literacy scale in a population with moderate to high cardiovascular risk: Rasch analyses.

    Directory of Open Access Journals (Sweden)

    Sarah S Richtering

    Full Text Available Electronic health (eHealth strategies are evolving making it important to have valid scales to assess eHealth and health literacy. Item response theory methods, such as the Rasch measurement model, are increasingly used for the psychometric evaluation of scales. This paper aims to examine the internal construct validity of an eHealth and health literacy scale using Rasch analysis in a population with moderate to high cardiovascular disease risk.The first 397 participants of the CONNECT study completed the electronic health Literacy Scale (eHEALS and the Health Literacy Questionnaire (HLQ. Overall Rasch model fit as well as five key psychometric properties were analysed: unidimensionality, response thresholds, targeting, differential item functioning and internal consistency.The eHEALS had good overall model fit (χ2 = 54.8, p = 0.06, ordered response thresholds, reasonable targeting and good internal consistency (person separation index (PSI 0.90. It did, however, appear to measure two constructs of eHealth literacy. The HLQ subscales (except subscale 5 did not fit the Rasch model (χ2: 18.18-60.60, p: 0.00-0.58 and had suboptimal targeting for most subscales. Subscales 6 to 9 displayed disordered thresholds indicating participants had difficulty distinguishing between response options. All subscales did, nonetheless, demonstrate moderate to good internal consistency (PSI: 0.62-0.82.Rasch analyses demonstrated that the eHEALS has good measures of internal construct validity although it appears to capture different aspects of eHealth literacy (e.g. using eHealth and understanding eHealth. Whilst further studies are required to confirm this finding, it may be necessary for these constructs of the eHEALS to be scored separately. The nine HLQ subscales were shown to measure a single construct of health literacy. However, participants' scores may not represent their actual level of ability, as distinction between response categories was unclear for

  3. Place shaping to create health and wellbeing using health impact assessment: health geography applied to develop evidence-based practice.

    Science.gov (United States)

    Learmonth, Alyson; Curtis, Sarah

    2013-11-01

    In a political milieu where there is pressure towards localised and participative decisionmaking, and an environment of global recession and environmental degradation, it is crucial that population health considerations inform strategic decisions. The paper puts forward 'place shaping to create health and wellbeing' as a strategic tool, drawing on ideas that are fundamental in health geography, and argues that this is an important emerging application of Health Impact Assessment (HIA), as part of evidence-based practice. These views developed primarily from case study work in the North East of England aiming to enhance health and wellbeing in a population with significant health disadvantages. © 2013 Elsevier Ltd. All rights reserved.

  4. A summary of LED lighting impacts on health

    Directory of Open Access Journals (Sweden)

    Cosmin Ticleanu

    2017-06-01

    Full Text Available Lighting can affect the health of people in buildings. This goes beyond the safety aspects of providing enough illumination to see by; lighting affects mood and human circadian rhythms, while poor lighting can cause glare, headaches, eyestrain, aches and pains associated with poor body posture or, in extreme cases, skin conditions and various types of sight loss. These aspects ought to be considered by designers and building owners and occupiers in order to improve the lit environment and use adequate lighting and lighting controls that meet the recommendations of codes and standards. Various types of lighting can have different impacts depending on their spectral, optical and electrical characteristics. This paper discusses potential impacts of LED lighting on human health, and is based on a recent BRE review of research investigating the most typical effects of lighting on human health.

  5. Perceived and calculated health risks: do the impacts differ

    International Nuclear Information System (INIS)

    Payne, B.A.; Williams, R.G.

    1986-01-01

    In many cases of radioactive and hazardous waste management, some members of the general public perceive that human health risks associated with the wastes are higher than the calculated risks. Calculated risks are projections that have been derived from models, and it is these risks that are usually used as the basis for waste management. However, for various reasons, the calculated risks are often considered by the public as too low or inappropriate. The reasons that calculated risks are not perceived as accurate and the factors that affect these perceptions are explored in this paper. Also discussed are the impacts related to the perceived and calculated health risks: what they are, and if and how they differ. The kinds of potential impacts examined are health effects, land value changes, and social, transportation, and economic effects. The paper concludes with a discussion of the implications of incorporating these different risk perspectives in decisions on waste management

  6. Metabolomics in Sepsis and Its Impact on Public Health.

    Science.gov (United States)

    Evangelatos, Nikolaos; Bauer, Pia; Reumann, Matthias; Satyamoorthy, Kapaettu; Lehrach, Hans; Brand, Angela

    2017-01-01

    Sepsis, with its often devastating consequences for patients and their families, remains a major public health concern that poses an increasing financial burden. Early resuscitation together with the elucidation of the biological pathways and pathophysiological mechanisms with the use of "-omics" technologies have started changing the clinical and research landscape in sepsis. Metabolomics (i.e., the study of the metabolome), an "-omics" technology further down in the "-omics" cascade between the genome and the phenome, could be particularly fruitful in sepsis research with the potential to alter the clinical practice. Apart from its benefit for the individual patient, metabolomics has an impact on public health that extends beyond its applications in medicine. In this review, we present recent developments in metabolomics research in sepsis, with a focus on pneumonia, and we discuss the impact of metabolomics on public health, with a focus on free/libre open source software. © 2018 S. Karger AG, Basel.

  7. Health and safety impacts of renewable, geothermal, and rusion energy

    International Nuclear Information System (INIS)

    Holdren, J.P.; Anderson, K.B.; Deibler, P.M.; Gleick, P.H.; Mintzer, I.M.; Morris, G.P.

    1983-01-01

    The public may view many renewable energy sources as having no direct public impacts because they produce no pollutants during normal operation. However, these energy technologies produce health impacts during their fabricatin and construction, and also through the materials-supply sectors required to support them. This survey of the health risks associated with renewable energy technologies concludes that some of the renewable options have particular promise for reducing health and environmental costs per unit of energy delivered to well below levels associated with the use of oil and coal; Holdren and his co-authors feel that few, if any, pose the indirect threats of fossil fuels and nuclear fission. 46 references, 7 tables

  8. MEGAPOLI: concept of multi-scale modelling of megacity impact on air quality and climate

    Science.gov (United States)

    Baklanov, A.; Lawrence, M.; Pandis, S.; Mahura, A.; Finardi, S.; Moussiopoulos, N.; Beekmann, M.; Laj, P.; Gomes, L.; Jaffrezo, J.-L.; Borbon, A.; Coll, I.; Gros, V.; Sciare, J.; Kukkonen, J.; Galmarini, S.; Giorgi, F.; Grimmond, S.; Esau, I.; Stohl, A.; Denby, B.; Wagner, T.; Butler, T.; Baltensperger, U.; Builtjes, P.; van den Hout, D.; van der Gon, H. D.; Collins, B.; Schluenzen, H.; Kulmala, M.; Zilitinkevich, S.; Sokhi, R.; Friedrich, R.; Theloke, J.; Kummer, U.; Jalkinen, L.; Halenka, T.; Wiedensholer, A.; Pyle, J.; Rossow, W. B.

    2010-11-01

    The EU FP7 Project MEGAPOLI: "Megacities: Emissions, urban, regional and Global Atmospheric POLlution and climate effects, and Integrated tools for assessment and mitigation" (http://megapoli.info) brings together leading European research groups, state-of-the-art scientific tools and key players from non-European countries to investigate the interactions among megacities, air quality and climate. MEGAPOLI bridges the spatial and temporal scales that connect local emissions, air quality and weather with global atmospheric chemistry and climate. The suggested concept of multi-scale integrated modelling of megacity impact on air quality and climate and vice versa is discussed in the paper. It requires considering different spatial and temporal dimensions: time scales from seconds and hours (to understand the interaction mechanisms) up to years and decades (to consider the climate effects); spatial resolutions: with model down- and up-scaling from street- to global-scale; and two-way interactions between meteorological and chemical processes.

  9. The impacts of household retrofit and domestic energy efficiency schemes: A large scale, ex post evaluation

    International Nuclear Information System (INIS)

    Webber, Phil; Gouldson, Andy; Kerr, Niall

    2015-01-01

    There is widespread interest in the ability of retrofit schemes to shape domestic energy use in order to tackle fuel poverty and reduce carbon emissions. Although much has been written on the topic, there have been few large-scale ex post evaluations of the actual impacts of such schemes. We address this by assessing domestic energy use before and after the Kirklees Warm Zone (KWZ) scheme, which by fitting insulation in 51,000 homes in the 2007–2010 period is one of the largest retrofit schemes completed in the UK to date. To do this, we develop and apply a new methodology that isolates the impacts of retrofit activity from broader background trends in energy use. The results suggest that the actual impacts of the KWZ scheme have been higher than predicted, and that the scale of any performance gaps or rebound effects have been lower than has often been assumed. They also suggest that impacts on energy use in lower income areas are consistent with predictions, but that impacts in middle and higher income areas are higher than predicted. These findings support the case for the wider and/or accelerated adoption of domestic retrofit schemes in other contexts. -- Highlights: •A large scale, ex post evaluation of the impacts of a household retrofit scheme. •A new methodology to separate retrofit impacts from background trends. •Shows impacts of retrofit have been 1.2–1.7 times higher than predicted. •Impacts as predicted in lower income areas, higher in middle and upper income areas. •Findings support the case for the wider and faster adoption of domestic retrofit

  10. Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

    Directory of Open Access Journals (Sweden)

    Leon Natalie

    2012-11-01

    Full Text Available Abstract Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT, the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains

  11. Health at the Sub-catchment Scale: Typhoid and Its Environmental Determinants in Central Division, Fiji.

    Science.gov (United States)

    Jenkins, Aaron Peter; Jupiter, Stacy; Mueller, Ute; Jenney, Adam; Vosaki, Gandercillar; Rosa, Varanisese; Naucukidi, Alanieta; Mulholland, Kim; Strugnell, Richard; Kama, Mike; Horwitz, Pierre

    2016-12-01

    The impact of environmental change on transmission patterns of waterborne enteric diseases is a major public health concern. This study concerns the burden and spatial nature of enteric fever, attributable to Salmonella Typhi infection in the Central Division, Republic of Fiji at a sub-catchment scale over 30-months (2013-2015). Quantitative spatial analysis suggested relationships between environmental conditions of sub-catchments and incidence and recurrence of typhoid fever. Average incidence per inhabited sub-catchment for the Central Division was high at 205.9/100,000, with cases recurring in each calendar year in 26% of sub-catchments. Although the numbers of cases were highest within dense, urban coastal sub-catchments, the incidence was highest in low-density mountainous rural areas. Significant environmental determinants at this scale suggest increased risk of exposure where sediment yields increase following runoff. The study suggests that populations living on large systems that broaden into meandering mid-reaches and floodplains with alluvial deposition are at a greater risk compared to small populations living near small, erosional, high-energy headwaters and small streams unconnected to large hydrological networks. This study suggests that anthropogenic alteration of land cover and hydrology (particularly via fragmentation of riparian forest and connectivity between road and river networks) facilitates increased transmission of typhoid fever and that environmental transmission of typhoid fever is important in Fiji.

  12. Multi-scales modeling of reactive transport mechanisms. Impact on petrophysical properties during CO2 storage

    International Nuclear Information System (INIS)

    Varloteaux, C.

    2012-01-01

    The geo-sequestration of carbon dioxide (CO 2 ) is an attractive option to reduce the emission of greenhouse gases. Within carbonate reservoirs, acidification of brine in place can occur during CO 2 injection. This acidification leads to mineral dissolution which can modify the transport properties of a solute in porous media. The aim of this study is to quantify the impact of reactive transport on a solute distribution and on the structural modification induced by the reaction from the pore to the reservoir scale. This study is focused on reactive transport problem in the case of single phase flow in the limit of long time. To do so, we used a multi-scale up-scaling method that takes into account (i) the local scale, where flow, reaction and transport are known; (ii) the pore scale, where the reactive transport is addressed by using averaged formulation of the local equations; (iii) the Darcy scale (also called core scale), where the structure of the rock is taken into account by using a three-dimensions network of pore-bodies connected by pore-throats; and (iv) the reservoir scale, where physical phenomenon, within each cell of the reservoir model, are taken into account by introducing macroscopic coefficients deduced from the study of these phenomenon at the Darcy scale, such as the permeability, the apparent reaction rate, the solute apparent velocity and dispersion. (author)

  13. Impact of large-scale tides on cosmological distortions via redshift-space power spectrum

    Science.gov (United States)

    Akitsu, Kazuyuki; Takada, Masahiro

    2018-03-01

    Although large-scale perturbations beyond a finite-volume survey region are not direct observables, these affect measurements of clustering statistics of small-scale (subsurvey) perturbations in large-scale structure, compared with the ensemble average, via the mode-coupling effect. In this paper we show that a large-scale tide induced by scalar perturbations causes apparent anisotropic distortions in the redshift-space power spectrum of galaxies in a way depending on an alignment between the tide, wave vector of small-scale modes and line-of-sight direction. Using the perturbation theory of structure formation, we derive a response function of the redshift-space power spectrum to large-scale tide. We then investigate the impact of large-scale tide on estimation of cosmological distances and the redshift-space distortion parameter via the measured redshift-space power spectrum for a hypothetical large-volume survey, based on the Fisher matrix formalism. To do this, we treat the large-scale tide as a signal, rather than an additional source of the statistical errors, and show that a degradation in the parameter is restored if we can employ the prior on the rms amplitude expected for the standard cold dark matter (CDM) model. We also discuss whether the large-scale tide can be constrained at an accuracy better than the CDM prediction, if the effects up to a larger wave number in the nonlinear regime can be included.

  14. Climate change and food security: health impacts in developed countries.

    Science.gov (United States)

    Lake, Iain R; Hooper, Lee; Abdelhamid, Asmaa; Bentham, Graham; Boxall, Alistair B A; Draper, Alizon; Fairweather-Tait, Susan; Hulme, Mike; Hunter, Paul R; Nichols, Gordon; Waldron, Keith W

    2012-11-01

    Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries. We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries. Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes. Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain. Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate food production, monitor food quality and safety, and

  15. The impact of biomedical innovation on longevity and health

    Directory of Open Access Journals (Sweden)

    Frank R Lichtenberg

    2015-03-01

    Full Text Available Many authors have expressed the view that a substantial portion of recent gains in longevity and health is due to biomedical research and innovation. This article describes the methodologies and findings of a number of studies based on observational data that have sought to measure the impact of biomedical innovation on the longevity and health of Americans and other populations during recent decades. Most of these studies have examined the impact of innovation in pharmaceuticals, the most research-intensive medical good or service. Two measures of medical innovation that have been used are the mean vintage of the medical goods or procedures used by an individual or population, and the number of distinct products (e.g. drugs available for treating a condition. Longevity (e.g. time till death is the health outcome that has been analyzed the most, but several studies have studied the impact of medical (i.e. pharmaceutical innovation on the ability of people to work or engage in activities of daily living. Some studies have been based on cross-sectional patient-level data. Others have been based on longitudinal, region-level data; they have investigated whether regions (e.g. states undergoing more rapid medical innovation have exhibited larger improvements in health. And some studies have been based on longitudinal, disease-level data; they have investigated whether the medical conditions undergoing more rapid innovation have exhibited larger gains in health outcomes. Innovation related to some specific major diseases (e.g. cardiovascular disease and cancer has been investigated, but the overall impact of innovation related to other major diseases (e.g. diabetes has not.These studies provide considerable support for the hypothesis that a substantial portion of recent gains in longevity and health is due to biomedical research and innovation. It would be desirable to apply these methods to data from developing countries.

  16. Measuring Youths’ Perceptions of Counseling Impact: Description, Psychometric Evaluation, and Longitudinal Examination of the Youth Counseling Impact Scale v.2

    OpenAIRE

    Kearns, Marcia A.; Athay, M. Michele; Riemer, Manuel

    2012-01-01

    The Youth Counseling Impact Scale (YCIS) is an empirically validated treatment progress measure that assesses youths’ perceptions of the short term effectiveness of therapy. Since its initial publication, the original 10-item measure has been shortened to ease measurement burden and revised to include a question about a youth’s insight into his or her strengths. The current study describes the development of the revised YCIS (v.2) and evaluates its psychometric properties. A...

  17. Multidimensional health locus of control scales: applicability among ...

    African Journals Online (AJOL)

    Exploratory factor analysis gave two sub-factors of the MHLC corresponding to internal and provider control over health and having internal consistency reliability of 0.72 and 0.76, respectively. Conclusion: The results lend support to the cultural correspondence of the MHLC instrument, several aspects of its validity and ...

  18. [Job satisfaction and work impact among providers of a mental health service].

    Science.gov (United States)

    Rebouças, Denise; Legay, Letícia Fortes; Abelha, Lúcia

    2007-04-01

    To assess job satisfaction and work impact among providers of a mental health service and their potential association with sociodemographic and job-related variables. A cross-sectional study was carried out in 321 employees of a long-stay mental health service in Rio de Janeiro, Southeastern Brazil, in 2005. The following instruments were applied: the WHO Mental Health Services Satisfaction and Work Impact scales, and a questionnaire on sociodemographic and job features. Variable associations were analysed using the Mann-Whitney, Kruskal-Wallis, Chi-square tests and multiple linear regression. The mean score of satisfaction was 3.29 (SD=0.64) and the mean score for work impact was 1.77 (SD=0.62). Of all respondents, 61.8% reported a moderate level of satisfaction. Job satisfaction was positively associated with increasing age, lower schooling, being a non-governmental organization employee, developing non-patient-related activities, being involved in an innovative project. The highest levels of work impact were observed among civil servants, young people and females. Most features associated to the lowest levels of job satisfaction were associated to the highest levels of work impact. Despite the moderate level of satisfaction among providers, there is an evident need for policy changes, mainly those related to increasing availability of supplies and human resources and building restoration.

  19. Health impact assessment in planning: Development of the design for health HIA tools

    International Nuclear Information System (INIS)

    Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

    2010-01-01

    How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

  20. Combined Use of Self-Efficacy Scale for Oral Health Behaviour and Oral Health Questionnaire: A Pilot Study

    Science.gov (United States)

    Soutome, Sakiko; Kajiwara, Kazumi; Oho, Takahiko

    2012-01-01

    Objective: To examine whether the combined use of a task-specific self-efficacy scale for oral health behaviour (SEOH) and an oral health questionnaire (OHQ) would be useful for evaluating subjects' behaviours and cognitions. Design: Questionnaires. Methods: One hundred and eighty-five students completed the SEOH and OHQ. The 30-item OHQ uses a…

  1. The health cost of energy. The health impacts of the different energy sources

    International Nuclear Information System (INIS)

    Masse, Roland

    2017-01-01

    This publication proposes an assessment of impacts of the different energy sources on public health. After a discussion of general aspects regarding this issue, the author addresses the identification and assessment of risks. While referring to different statistical data, he discusses the impacts of accidents in terms of dead, injured or evacuated people. He also addresses health impacts during a normal operation of power plants, i.e. in the case of nuclear plants (issue of exposure to various levels of radiation at the different steps of fuel cycle), of carbon-based plants (health risks and impacts during coal extraction, due to CO 2 emissions and to other toxic emissions, due to atmospheric pollution, identified risks, modelling attempts, assessment of a loss in life expectancy), and of other energies. While acknowledging that there are still many unknowns to assess these health impacts, the author compares these assessments. A summarized version of this article is proposed, in which the author briefly comments data regarding severe accidents related to energy production, discusses health consequences of electric power production and use, and makes a distinction between the most and less hazardous energies as far as public health is concerned

  2. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  3. The Ecological Impacts of Large-Scale Agrofuel Monoculture Production Systems in the Americas

    Science.gov (United States)

    Altieri, Miguel A.

    2009-01-01

    This article examines the expansion of agrofuels in the Americas and the ecological impacts associated with the technologies used in the production of large-scale monocultures of corn and soybeans. In addition to deforestation and displacement of lands devoted to food crops due to expansion of agrofuels, the massive use of transgenic crops and…

  4. The Impact of Overreporting on MMPI-2-RF Substantive Scale Score Validity

    Science.gov (United States)

    Burchett, Danielle L.; Ben-Porath, Yossef S.

    2010-01-01

    This study examined the impact of overreporting on the validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scale scores by comparing correlations with relevant external criteria (i.e., validity coefficients) of individuals who completed the instrument under instructions to (a) feign psychopathology…

  5. Delinquency Level Classification Via the HEW Community Program Youth Impact Scales.

    Science.gov (United States)

    Truckenmiller, James L.

    The former HEW National Strategy for Youth Development (NSYD) model was created as a community-based planning and procedural tool to promote youth development and prevent delinquency. To assess the predictive power of NSYD Impact Scales in classifying youths into low, medium, and high delinquency levels, male and female students aged 10-19 years…

  6. Small scale agriculture, marginal conditions and market access: impacts on natural resources and farmers' welfare

    NARCIS (Netherlands)

    Cavatassi, R.

    2010-01-01

    Keywords: small-scale farmers, food security, impact evaluation, Ecuador, Ethiopia, crop choice, social capital, crop genetic diversity, pesticides.

    Numerous are the obstacles and difficulties smallholder farmers from developing countries have to face to achieve food security or improve

  7. Transportation Matters: A Health Impact Assessment in Rural New Mexico.

    Science.gov (United States)

    Del Rio, Michelle; Hargrove, William L; Tomaka, Joe; Korc, Marcelo

    2017-06-13

    This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  8. Transportation Matters: A Health Impact Assessment in Rural New Mexico

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-06-01

    Full Text Available This Health Impact Assessment (HIA informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1 84% for health services; (2 83% for formal and informal education opportunities; and (3 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1 health services, and fresh foods, especially for older adults; (2 education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3 economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1 long distances to travel; (2 difficulties in scheduling to meet all needs; and (3 poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  9. Universal scaling and nonlinearity of aggregate price impact in financial markets

    Science.gov (United States)

    Patzelt, Felix; Bouchaud, Jean-Philippe

    2018-01-01

    How and why stock prices move is a centuries-old question still not answered conclusively. More recently, attention shifted to higher frequencies, where trades are processed piecewise across different time scales. Here we reveal that price impact has a universal nonlinear shape for trades aggregated on any intraday scale. Its shape varies little across instruments, but drastically different master curves are obtained for order-volume and -sign impact. The scaling is largely determined by the relevant Hurst exponents. We further show that extreme order-flow imbalance is not associated with large returns. To the contrary, it is observed when the price is pinned to a particular level. Prices move only when there is sufficient balance in the local order flow. In fact, the probability that a trade changes the midprice falls to zero with increasing (absolute) order-sign bias along an arc-shaped curve for all intraday scales. Our findings challenge the widespread assumption of linear aggregate impact. They imply that market dynamics on all intraday time scales are shaped by correlations and bilateral adaptation in the flows of liquidity provision and taking.

  10. Transforming Global Health by Improving the Science of Scale-Up

    OpenAIRE

    Kruk, Margaret E.; Yamey, Gavin; Angell, Sonia Y.; Beith, Alix; Cotlear, Daniel; Guanais, Frederico; Jacobs, Lisa; Saxenian, Helen; Victora, Cesar; Goosby, Eric

    2016-01-01

    In its report Global Health 2035, the Commission on Investing in Health proposed that health investments can reduce mortality in nearly all low- and middle-income countries to very low levels, thereby averting 10 million deaths per year from 2035 onward. Many of these gains could be achieved through scale-up of existing technologies and health services. A key instrument to close this gap is policy and implementation research (PIR) that aims to produce generalizable evidence on what works to i...

  11. Do nurses' personal health behaviours impact on their health promotion practice? A systematic review.

    Science.gov (United States)

    Kelly, Muireann; Wills, Jane; Sykes, Susie

    2017-11-01

    There is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses' personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services. An integrated systematic review was conducted to determine if nurses' personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted. 31 studies were included in the review. No consistent associations were noted between nurses' weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours. Although it is assumed that nurses' personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence. Copyright

  12. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Directory of Open Access Journals (Sweden)

    Ying Zhou

    Full Text Available Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary, and three-component (ternary combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs. We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although

  13. Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

    Science.gov (United States)

    Zhou, Ying; Li, Chaoyang; Huijbregts, Mark A J; Mumtaz, M Moiz

    2015-01-01

    Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs) combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA) by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary), and three-component (ternary) combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs). We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although there are many

  14. Scales

    Science.gov (United States)

    Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum ... Scales may be caused by dry skin, certain inflammatory skin conditions, or infections. Examples of disorders that ...

  15. Crisis in the health sector: Impact on nurses' working conditions.

    Science.gov (United States)

    Granero-Lázaro, Alberto; Blanch-Ribas, Josep M; Roldán-Merino, Juan Francisco; Torralbas-Ortega, Jordi; Escayola-Maranges, Ana María

    In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. To assess the perceived impact on nurses' work conditions of measures to contain health spending. The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Health Impacts of Climate Change-Induced Subzero Temperature Fires.

    Science.gov (United States)

    Metallinou, Maria-Monika; Log, Torgrim

    2017-07-20

    General fire risk and the special risk related to cold climate cellulosic drying processes are outlined. Four recent subzero temperatures fires are studied with respect to health impacts: a wooden village fire, a single wood structure fire, a wildland urban interface (WUI) fire and a huge wildland fire. The health impacts range from stress related to loss of jobs, psychological effects of lost possessions, exposure to smoke and heat as well as immediate, or delayed, loss of lives. These four fires resulted in 32 fatalities, 385 persons hospitalized for shorter or longer periods, 104 structures lost and 1015 km² of wildland burned north of, and just south of, the Arctic Circle. It is shown that the combination of subzero temperature dry weather, strong winds, changing agricultural activities and declining snowpack may lead to previously anticipated threats to people and the environment. There are reasons to believe that these fires are a result of the ongoing climate changes. Risk impacts are discussed. Rural districts and/or vulnerable populations seem to be most affected. Training methods to identify and better monitor critical fire risk parameters are suggested to mitigate the health impacts of a possibly increasing number of such fires.

  17. Health impact assessment: where does the law come in?

    International Nuclear Information System (INIS)

    Hart, David Q.C.

    2004-01-01

    The European Convention on Human Rights has profound implications for HIA. Public authorities have a positive obligation to stop others from infringing citizens' rights to life and to respect for private and family life. These rights are qualified and have now been interpreted in many thousands of cases. Authorities must, as best they reasonably can, secure the safety of citizens and inform the citizens about the safety or otherwise of any development. Authorities have to strike a balance between the individuals rights and the public benefit. Any public authority before approving a scheme or reaching a regulatory decision which may impact on human rights must consider the nature of that impact, its seriousness and whether it can be justified on public interest grounds. A number of court judgements in cases concerning these issues are discussed. This article is not about how certain of the ideas underlying Health Impact Assessment, in certain circumstances, are or can be incorporated in existing legally recognised instruments such as Environmental Impact Assessments. Nor is it about the statutory powers which authorities--local and national--could, if so inclined, exercise, to further the health and well-being of their constituents. It is about something rather more general, important and yet rather formless, namely the duties identified by the European Court of Human Rights as resting upon public authorities to take steps to safeguard the public health rights of their citizens

  18. Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

    Directory of Open Access Journals (Sweden)

    Patrick Harris

    2015-01-01

    Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

  19. Comparing the health impacts of different energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1982-01-01

    Assessing health impacts of different energy sources requires synthesis of research results from many different disciplines into a rational framework. Information is often scanty; qualitatively different risks, or energy systems with substantially different end uses, must be put on a common footing. Historically institutional constraints have inhibited agencies from making incisive intercomparisons necessary for formulating energy policy; this has exacerbated public controversy over appropriate energy sources. Risk assessment methods reviewed include examples drawn from work of the Biomedical and Environmental Assessment Division at Brookhaven National Laboratory and elsewhere. Uncertainty over the mechanism and size of air pollution health damage is addressed through a probabilistic health-damage function, using sulphate-particle exposure as an indicator. This facilitates intercomparison through analysis of each step in the whole fuel cycle between a typical coal and nuclear power plant. Occupational health impacts, a significant fraction of overall damage, are illustrated by accident trends in coal-mining. In broadening comparisons to include new technologies, one must include the impact of manufacturing the energy-producing device as part of an expanded fuel cycle, via input/output methods. Throughout the analysis, uncertainties must be made explicit in the results, including uncertainty of data and uncertainty in choice of appropriate models and methods. No single method of comparative risk assessment is fully satisfactory; each has its limitations. Several methods must be compared if decision-making is to be realistic. (author)

  20. Health impacts of rapid economic changes in Thailand.

    Science.gov (United States)

    Tangcharoensathien, V; Harnvoravongchai, P; Pitayarangsarit, S; Kasemsup, V

    2000-09-01

    The economic crisis in Thailand in July 1997 had major social implications for unemployment, under employment, household income contraction, changing expenditure patterns, and child abandonment. The crisis increased poverty incidence by 1 million, of whom 54% were the ultra-poor. This paper explores and explains the short-term health impact of the crisis, using existing data and some special surveys and interviews for 2 years during 1998-99. The health impacts of the crisis are mixed, some being negative and some being positive. Household health expenditure reduced by 24% in real terms; among the poorer households, institutional care was replaced by self-medication. The pre-crisis rising trend in expenditure on alcohol and tobacco consumption was reversed. Immunization spending and coverage were sustained at a very high level after the crisis, but reports of increases in diphtheria and pertussis indicate declining programme quality. An increase in malaria, despite budget increases, had many causes but was mainly due to reduced programme effectiveness. STD incidence continued the pre-crisis downward trend. Rates of HIV risky sexual behaviour were higher among conscripts than other male workers, but in both groups there was lower condom use with casual partners. HIV serosurveillance showed a continuation of the pre-crisis downward trend among commercial sex workers (CSW, both brothel and non-brothel based), pregnant women and donated blood; this trend was slightly reversed among male STD patients and more among intravenous drug users. Condom coverage among brothel based CSW continued to increase to 97.5%, despite a 72% budget cut in free condom distribution. Poverty and lack of insurance coverage are two major determinants of absence of or inadequate antenatal care, and low birthweight. The Low Income Scheme could not adequately cover the poor but the voluntary Health Card Scheme played a health safety net role for maternal and child health. Low birthweight and

  1. Climate Change-Related Water Disasters' Impact on Population Health.

    Science.gov (United States)

    Veenema, Tener Goodwin; Thornton, Clifton P; Lavin, Roberta Proffitt; Bender, Annah K; Seal, Stella; Corley, Andrew

    2017-11-01

    Rising global temperatures have resulted in an increased frequency and severity of cyclones, hurricanes, and flooding in many parts of the world. These climate change-related water disasters (CCRWDs) have a devastating impact on communities and the health of residents. Clinicians and policymakers require a substantive body of evidence on which to base planning, prevention, and disaster response to these events. The purpose of this study was to conduct a systematic review of the literature concerning the impact of CCRWDs on public health in order to identify factors in these events that are amenable to preparedness and mitigation. Ultimately, this evidence could be used by nurses to advocate for greater preparedness initiatives and inform national and international disaster policy. A systematic literature review of publications identified through a comprehensive search of five relevant databases (PubMed, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, Scopus, and Web of Science) was conducted using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach in January 2017 to describe major themes and associated factors of the impact of CCRWDs on population health. Three major themes emerged: environmental disruption resulting in exposure to toxins, population susceptibility, and health systems infrastructure (failure to plan-prepare-mitigate, inadequate response, and lack of infrastructure). Direct health impact was characterized by four major categories: weather-related morbidity and mortality, waterborne diseases/water-related illness, vector-borne and zoonotic diseases, and psychiatric/mental health effects. Scope and duration of the event are factors that exacerbate the impact of CCRWDs. Discussion of specific factors amenable to mitigation was limited. Flooding as an event was overrepresented in this analysis (60%), and the majority of the research reviewed was conducted in high-income or upper

  2. Environment, Health and Climate: Impact of African aerosols

    Science.gov (United States)

    Liousse, C.; Doumbia, T.; Assamoi, E.; Galy-Lacaux, C.; Baeza, A.; Penner, J. E.; Val, S.; Cachier, H.; Xu, L.; Criqui, P.

    2012-12-01

    Fossil fuel and biofuel emissions of particles in Africa are expected to significantly increase in the near future, particularly due to rapid growth of African cities. In addition to biomass burning emissions prevailing in these areas, air quality degradation is then expected with important consequences on population health and climatic/radiative impact. In our group, we are constructing a new integrated methodology to study the relations between emissions, air quality and their impacts. This approach includes: (1) African combustion emission characterizations; (2) joint experimental determination of aerosol chemistry from ultrafine to coarse fractions and health issues (toxicology and epidemiology). (3) integrated environmental, health and radiative modeling. In this work, we show some results illustrating our first estimates of African anthropogenic emission impacts: - a new African anthropogenic emission inventory adapted to regional specificities on traffic, biofuel and industrial emissions has been constructed for the years 2005 and 2030. Biomass burning inventories were also improved in the frame of AMMA (African Monsoon) program. - carbonaceous aerosol radiative impact in Africa has been modeled with TM5 model and Penner et al. (2011) radiative code for these inventories for 2005 and 2030 and for two scenarios of emissions : a reference scenario, with no further emission controls beyond those achieved in 2003 and a ccc* scenario including planned policies in Kyoto protocol and regulations as applied to African emission specificities. In this study we will show that enhanced heating is expected with the ccc* scenarios emissions in which the OC fraction is relatively lower than in the reference scenario. - results of short term POLCA intensive campaigns in Bamako and Dakar in terms of aerosol chemical characterization linked to specific emissions sources and their inflammatory impacts on the respiratory tract through in vitro studies. In this study, organic

  3. Chemical concentrations, exposures, health risks by census tract from National Scale Air Toxics Assessment (NATA)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Chemical concentrations, exposures, health risks by census tract for the United States from National Scale Air Toxics Assessment (NATA). This dataset is associated...

  4. Impact of scaling on the performance and reliability degradation of metal-contacts in NEMS devices

    KAUST Repository

    Dadgour, Hamed F.

    2011-04-01

    Nano-electro-mechanical switches (NEMS) offer new possibilities for the design of ultra energy-efficient systems; however, thus far, all the fabricated NEMS devices require high supply voltages that limit their applicability for logic designs. Therefore, research is being conducted to lower the operating voltages by scaling down the physical dimensions of these devices. However, the impact of device scaling on the electrical and mechanical properties of metal contacts in NEMS devices has not been thoroughly investigated in the literature. Such a study is essential because metal contacts play a critical role in determining the overall performance and reliability of NEMS. Therefore, the comprehensive analytical study presented in this paper highlights the performance and reliability degradations of such metal contacts caused by scaling. The proposed modeling environment accurately takes into account the impact of roughness of contact surfaces, elastic/plastic deformation of contacting asperities, and various inter-molecular forces between mating surfaces (such as Van der Waals and capillary forces). The modeling results are validated and calibrated using available measurement data. This scaling analysis indicates that the key contact properties of gold contacts (resistance, stiction and wear-out) deteriorate "exponentially" with scaling. Simulation results demonstrate that reliable (stiction-free) operation of very small contact areas (≈ 6nm x 6nm) will be a daunting task due to the existence of strong surface forces. Hence, contact degradation is identified as a major problem to the scaling of NEMS transistors. © 2011 IEEE.

  5. Longitudinal Impact of Hurricane Sandy Exposure on Mental Health Symptoms.

    Science.gov (United States)

    Schwartz, Rebecca M; Gillezeau, Christina N; Liu, Bian; Lieberman-Cribbin, Wil; Taioli, Emanuela

    2017-08-24

    Hurricane Sandy hit the eastern coast of the United States in October 2012, causing billions of dollars in damage and acute physical and mental health problems. The long-term mental health consequences of the storm and their predictors have not been studied. New York City and Long Island residents completed questionnaires regarding their initial Hurricane Sandy exposure and mental health symptoms at baseline and 1 year later (N = 130). There were statistically significant decreases in anxiety scores (mean difference = -0.33, p Hurricane Sandy has an impact on PTSD symptoms that persists over time. Given the likelihood of more frequent and intense hurricanes due to climate change, future hurricane recovery efforts must consider the long-term effects of hurricane exposure on mental health, especially on PTSD, when providing appropriate assistance and treatment.

  6. The impact of Chernobyl on health and labour market performance.

    Science.gov (United States)

    Lehmann, Hartmut; Wadsworth, Jonathan

    2011-09-01

    Using longitudinal data from Ukraine we examine the extent of any long-lasting effects of exposure to the Chernobyl disaster on the health and labour market performance of the adult workforce. Variation in the local area level of radiation fallout from the Chernobyl accident is considered as a random exogenous shock with which to try to establish its causal impact on poor health, labour force participation, hours worked and wages. There appears to be a significant positive association between local area-level radiation dosage and perception of poor health, though much weaker associations between local area-level dosage and other specific self-reported health conditions. There is also some evidence to suggest that those who lived in areas more exposed to Chernobyl-induced radiation have significantly lower levels of labour market performance 20 years on. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Waterpipe tobacco smoking impact on public health: implications for policy

    Directory of Open Access Journals (Sweden)

    Martinasek MP

    2015-08-01

    Full Text Available Mary P Martinasek,1 Linda M Gibson-Young,2 Janiece N Davis,3 Robert J McDermott41Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, 2College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, 3Department of Health – Palm Beach County, West Palm beach, FL, 4Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USABackground: Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods: Identification of Clean Indoor Air Acts (CIAAs from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results: States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion: Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.Keywords: health policy, waterpipe tobacco, hookah smoking, tobacco regulation

  8. Monetary burden of health impacts of air pollution in Mumbai, India: implications for public health policy.

    Science.gov (United States)

    Patankar, A M; Trivedi, P L

    2011-03-01

    Mumbai, a mega city with a population of more than 12 million, is experiencing acute air pollution due to commercial activity, a boom in construction and vehicular traffic. This study was undertaken to investigate the link between air pollution and health impacts for Mumbai, and estimate the monetary burden of these impacts. Cross-sectional data were subjected to logistic regression to analyse the link between air pollution and health impacts, and the cost of illness approach was used to measure the monetary burden of these impacts. Data collected by the Environmental Pollution Research Centre at King Edward Memorial Hospital in Mumbai were analysed using logistic regression to investigate the link between air pollution and morbidity impacts. The monetary burden of morbidity was estimated through the cost of illness approach. For this purpose, information on treatment costs and foregone earnings due to illness was obtained through the household survey and interviews with medical practitioners. Particulate matter (PM(10)) and nitrogen dioxide (NO(2)) emerged as the critical pollutants for a range of health impacts, including symptoms such as cough, breathlessness, wheezing and cold, and illnesses such as allergic rhinitis and chronic obstructive pulmonary disease (COPD). This study developed the concentration-response coefficients for these health impacts. The total monetary burden of these impacts, including personal burden, government expenditure and societal cost, is estimated at 4522.96 million Indian Rupees (INR) or US$ 113.08 million for a 50-μg/m(3) increase in PM(10), and INR 8723.59 million or US$ 218.10 million for a similar increase in NO(2). The estimated monetary burden of health impacts associated with air pollution in Mumbai mainly comprises out-of-pocket expenses of city residents. These expenses form a sizable proportion of the annual income of individuals, particularly those belonging to poor households. These findings have implications for public

  9. 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.

  10. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    Science.gov (United States)

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Impacts of Extreme Events on Human Health. Chapter 4

    Science.gov (United States)

    Bell, Jesse E.; Herring, Stephanie C.; Jantarasami, Lesley; Adrianopoli, Carl; Benedict, Kaitlin; Conlon, Kathryn; Escobar, Vanessa; Hess, Jeremy; Luvall, Jeffrey; Garcia-Pando, Carlos Perez; hide

    2016-01-01

    Increased Exposure to Extreme Events Key Finding 1: Health impacts associated with climate-related changes in exposure to extreme events include death, injury, or illness; exacerbation of underlying medical conditions; and adverse effects on mental health[High Confidence]. Climate change will increase exposure risk in some regions of the United States due to projected increases in the frequency and/or intensity of drought, wildfires, and flooding related to extreme precipitation and hurricanes [Medium Confidence].Disruption of Essential Infrastructure Key Finding 2: Many types of extreme events related to climate change cause disruption of infrastructure, including power, water, transportation, and communication systems, that are essential to maintaining access to health care and emergency response services and safeguarding human health [High Confidence].Vulnerability to Coastal Flooding Key Finding 3: Coastal populations with greater vulnerability to health impacts from coastal flooding include persons with disabilities or other access and functional needs, certain populations of color, older adults, pregnant women and children, low-income populations, and some occupational groups [High Confidence].Climate change will increase exposure risk to coastal flooding due to increases in extreme precipitation and in hurricane intensity and rainfall rates, as well as sea level rise and the resulting increases in storm surge.

  12. Global health and economic impacts of future ozone pollution

    International Nuclear Information System (INIS)

    Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S

    2009-01-01

    We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.

  13. Participation in health impact assessment: objectives, methods and core values.

    Science.gov (United States)

    Wright, John; Parry, Jayne; Mathers, Jonathan

    2005-01-01

    Health impact assessment (HIA) is a multidisciplinary aid to decision-making that assesses the impact of policy on public health and on health inequalities. Its purpose is to assist decision-makers to maximize health gains and to reduce inequalities. The 1999 Gothenburg Consensus Paper (GCP) provides researchers with a rationale for establishing community participation as a core value of HIA. According to the GCP, participation in HIA empowers people within the decision-making process and redresses the democratic deficit between government and society. Participation in HIA generates a sense that health and decision-making is community-owned, and the personal experiences of citizens become integral to the formulation of policy. However, the participatory and empowering dimensions of HIA may prove difficult to operationalize. In this review of the participation strategies adopted in key applications of HIA in the United Kingdom, we found that HIA's aim of influencing decision-making creates tension between its participatory and knowledge-gathering dimensions. Accordingly, researchers have decreased the participatory dimension of HIA by reducing the importance attached to the community's experience of empowerment, ownership and democracy, while enlarging its knowledge-gathering dimension by giving pre-eminence to "expert" and "research-generated" evidence. Recent applications of HIA offer a serviceable rationale for participation as a means of information gathering and it is no longer tenable to uphold HIA as a means of empowering communities and advancing the aims of participatory democracy. PMID:15682250

  14. Full-scale impact test data for tornado-missile design of nuclear plants

    International Nuclear Information System (INIS)

    Stephenson, A.E.; Sliter, G.E.

    1977-01-01

    It is standard practice to consider the effects of low-probability impacts of tornado-borne debris (''tornado missiles'' such as utility poles and steel pipes) in the structural design of nuclear power plants in the United States. To provide data that can be used directly in the design procedure, a series of full-scale tornado-missile impact tests was performed. This paper is a brief summary of the results and conclusions from these tests. The tests consisted of reinforced concrete panels impacted by poles, pipes, and rods propelled by a rocket sled. The panels were constructed to current minimum standards and had thicknesses typical of auxiliary buildings of nuclear power plants. A specific objective was the determination of the impact velocities below which the panels do not experience backface scabbing. Another objective was to assess the adequacy of (1) conventional design formulae for penetration and scabbing and (2) conventional design methods for overall structural response. Test missiles and velocities represented those in current design standards. Missiles included utility poles, steel pipes, and steel bars. It is important to interpret the data in this paper in recognition that the test conditions represent conservative assumptions regarding maximum wind speeds, injection of the missile into the wind stream, aerodynamic trajectory, and orientation of missile at impact. Even with the severe assumptions made, the full-scale tests described demonstrate the ability of prototypical nuclear plant walls and roofs to provide adequate protection against postulated tornado-missile impact

  15. 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.

  16. Development of Saudi e-health literacy scale for chronic diseases in Saudi Arabia: using integrated health literacy dimensions.

    Science.gov (United States)

    Zakaria, Nasriah; AlFakhry, Ohoud; Matbuli, Abeer; Alzahrani, Asma; Arab, Noha Samir Sadiq; Madani, Alaa; Alshehri, Noura; Albarrak, Ahmed I

    2018-05-01

    Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD). Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL. Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia. As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension.

  17. Evidence-Based Mental Health Practices with Children Self-Efficacy Scale: Development and Preliminary Findings

    Science.gov (United States)

    McMeel, Lorri S.; Leathers, Sonya J.; Strand, Tonya C.

    2017-01-01

    This article reviews existing measures related to evidence-based practices with children and self-efficacy and describes the development and psychometric properties of the Evidence-Based Mental Health Practices With Children Efficacy Scale. This scale was developed to assess students' and clinicians' self-efficacy in their abilities to use…

  18. Implementation of the Agitated Behavior Scale in the Electronic Health Record.

    Science.gov (United States)

    Wilson, Helen John; Dasgupta, Kritis; Michael, Kathleen

    The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.

  19. Attitudes toward Mental Illness: The Construction of the Libertarian Mental Health Ideology Scale.

    Science.gov (United States)

    Nevid, Jeffrey S.; Morrison, James

    1980-01-01

    The study was an attempt to construct an attitude scale to measure the radical psychosocial or libertarian position about "mental illness" and mental health practices. The factor analysis defined four scale factors: mental illness mythology, antimedical model, social deviance control, and anti-coercive treatment. (Author)

  20. Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods.

    Science.gov (United States)

    Galiatsatos, Panagis; Sundar, Siddhi; Qureshi, Adil; Ooi, Gavyn; Teague, Paula; Daniel Hale, W

    2016-06-01

    Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital's accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014-2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.

  1. 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

  2. Impact of caffeine and coffee on our health.

    Science.gov (United States)

    Gonzalez de Mejia, Elvira; Ramirez-Mares, Marco Vinicio

    2014-10-01

    Coffee is the most frequently consumed caffeine-containing beverage. The caffeine in coffee is a bioactive compound with stimulatory effects on the central nervous system and a positive effect on long-term memory. Although coffee consumption has been historically linked to adverse health effects, new research indicates that coffee consumption may be beneficial. Here we discuss the impact of coffee and caffeine on health and bring attention to the changing caffeine landscape that includes new caffeine-containing energy drinks and supplements, often targeting children and adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A partnership development process assessment scale for public health nurses in Japan.

    Science.gov (United States)

    Shigematsu, Yukako; Hatano, Yoko; Kimura, Hitoe

    2015-01-01

    The objective of this study was to develop and test a Partnership Development Process Assessment (PDPA) scale for content and construct validity and internal consistency reliability. This is needed to document and evaluate community health partnership development processes between public health nurses and community-based organizations in Japan. The study was conducted in three phases. Ten semi-structured interviews were conducted to generate items for a new scale. Thirty items were generated and reviewed by an expert panel for content validity and item refinement. A national postal survey of public health nurses was conducted to determine the scale's internal structure, evaluate its reliability, and explore its construct and criterion validity. Validity and reliability testing of the PDPA scale using a content validity index and analysis of correlations with an existing scale were performed. Twenty-six items were selected and grouped into four factors: activities to share roles to manage community health issues, platform activities to support partnerships, activities to evaluate partnership practices, and activities to share information regarding community health issues. After factor analysis, 23 items were retained. The PDPA scale is a valid and reliable instrument for public health nurses to assess partnership development activities. © 2015 Wiley Periodicals, Inc.

  4. Development and validation of an Eating Disorders Symptom Impact Scale (EDSIS for carers of people with eating disorders

    Directory of Open Access Journals (Sweden)

    Hankins Matthew

    2008-04-01

    Full Text Available Abstract Background Family members of relatives with eating disorders experience high levels of distress due to the difficulties in their care giving role. However no measures have been developed to measure the specific impact that an individual with an eating disorder has on family life. The aim of this study was to develop a measure to assess the specific caregiving burden of both anorexia nervosa and bulimia nervosa. A secondary aim was to examine whether this measure was sensitive to change. Methods A new scale, the Eating Disorders Symptom Impact Scale (EDSIS, was generated by a panel of clinicians and researchers based upon quantitative and qualitative work with carers and reviewed by a panel of "expert carers". A cross-sectional study was conducted among carers of relatives with an eating disorder to examine the properties of the new scale. In addition, participants from an ongoing pre-and-post design study completed several self-report questionnaires to assess the sensitivity of the EDSIS to change. Results A sample of 196 carers of relatives with an eating disorder aged 25–68 compted the scale. A 24-item EDSIS scale was derived with four factors: nutrition, guilt, dysregulated behaviour and social isolation. These explained 58.4% of the variance in carer distress. Reliability was acceptable (Cronbach's alpha ranged from 0.84 to 0.90. The convergent validity of the EDSIS subscales was moderately supported by correlations with a general caregiving measure (Experience of Caregiving Inventory (ECI, r = 0.42 to 0.60, psychological distress (General Health Questionnaire (GHQ-12, r = 0.33 and perceived functioning of the relative (Children Global Assessment Scale (CGAS, r = -30. A sample of 57 primary caregivers completed pre-post intervention assessments and the overall scale (t = 2.3, p Conclusion The EDSIS instrument has good psychometric properties and may be of value to assess the impact of eating disorder symptoms on family members. It

  5. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    International Nuclear Information System (INIS)

    Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-01-01

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA

  6. Growth and Efficiency of Small Scale Industry and its Impact on Economic Development of Sindh

    Directory of Open Access Journals (Sweden)

    Mumtaz Ali Junejo

    2008-09-01

    Full Text Available The purpose of this study is to analyze the growth, efficiency, causes of sickness of small scale industry, emergence of entrepreneur and competencies of entrepreneurs at Larkana estate area of Sindh Province. The study examines the educational background of the entrepreneurs of small scale industry who are the helm of affairs and its impact on the growth of sales of the every year. Strong evidence emerges that owners of small industrial units are family concern and having a low educational background, lack of managerial knowledge and conservation-oriented attitude results in under utilization of capacity and low growth of units established every year. This research paper provides a survey of the theoretical and empirical literature relating to promote the small scale industry in the Larkana region. This study indicates effective policy measures to promote the small scale industry particularly in Larkana region and generally in Pakistan.

  7. Prioritizing child health interventions in Ethiopia: modeling impact on child mortality, life expectancy and inequality in age at death.

    Directory of Open Access Journals (Sweden)

    Kristine Husøy Onarheim

    Full Text Available BACKGROUND: The fourth Millennium Development Goal calls for a two-thirds reduction in under-5 mortality between 1990 and 2015. Under-5 mortality rate is declining, but many countries are still far from achieving the goal. Effective child health interventions that could reduce child mortality exist, but national decision-makers lack contextual information for priority setting in their respective resource-constrained settings. We estimate the potential health impact of increasing coverage of 14 selected health interventions on child mortality in Ethiopia (2011-2015. We also explore the impact on life expectancy and inequality in the age of death (Gini(health. METHODS AND FINDINGS: We used the Lives Saved Tool to estimate potential impact of scaling-up 14 health interventions in Ethiopia (2011-2015. Interventions are scaled-up to 1 government target levels, 2 90% coverage and 3 90% coverage of the five interventions with the highest impact. Under-5 mortality rate, neonatal mortality rate and deaths averted are primary outcome measures. We used modified life tables to estimate impact on life expectancy at birth and inequality in the age of death (Gini(health. Under-5 mortality rate declines from 101.0 in 2011 to 68.8, 42.1 and 56.7 per 1000 live births under these three scenarios. Prioritizing child health would also increase life expectancy at birth from expected 60.5 years in 2015 to 62.5, 64.2 and 63.4 years and reduce inequality in age of death (Gini(health substantially from 0.24 to 0.21, 0.18 and 0.19. CONCLUSIONS: The Millennium Development Goal for child health is reachable in Ethiopia. Prioritizing child health would also increase total life expectancy at birth and reduce inequality in age of death substantially (Gini(health.

  8. Impact of a mental health teaching programme on adolescents.

    Science.gov (United States)

    Naylor, Paul B; Cowie, Helen A; Walters, Stephen J; Talamelli, Lorenzo; Dawkins, Judith

    2009-04-01

    Child and adolescent mental health disorders are present in around 10% of the population. Research indicates that many young people possess negative attitudes towards mental health difficulties among peers. To assess the impact of a mental health teaching programme on adolescent pupils' understanding. Two-group pre-test-post-test control group study in two English secondary schools. Experimental classes (School E) received a six-lesson teaching intervention on mental health; control classes (School C) did not. Participants were 14- and 15-year-old pupils. The intervention consisted of six lessons on mental health issues common to young people: stress; depression; suicide/self-harm; eating disorders; being bullied; and intellectual disability. School C was given access to these lesson plans and materials on completion of the study. Understanding was measured at two time points, Time 1 (T(1)) and Time 2 (T(2)), 8 months apart, by a Mental Health Questionnaire. Behavioural, emotional and relationship strengths and difficulties were measured by the self-rated Strengths and Difficulties Questionnaire (SDQ) with five subscales: hyperactivity, emotional symptoms, conduct problems, peer problems and prosocial behaviour. At T(2), pupils in School E compared with those in School C showed significantly more sensitivity and empathy towards people with mental health difficulties. They also used significantly fewer pejorative expressions to describe mental health difficulties. There was a significant reduction in SDQ scores on conduct problems and a significant increase on prosocial behaviour among School E pupils compared with controls. Pupils valued the intervention highly, in particular the lessons on suicide/self-harm. Teaching 14- and 15-year-olds about mental health difficulties helps to reduce stigma by increasing knowledge and promoting positive attitudes. The intervention also reduced self-reported conduct problems and increased prosocial behaviour. Generally

  9. Socioeconomic impacts of large-scale developments: implications for high-level nuclear waste repositories

    International Nuclear Information System (INIS)

    Murdock, S.H.; Leistritz, F.L.; Hamm, R.R.

    1983-01-01

    High-level nuclear waste repositories will likely be located in sparsely settled rural areas in the US. These projects will significantly affect the economic, demographic, public service, fiscal, and social (the socioeconomic) dimensions of those rural areas. The impacts and means of mitigating them thus require careful analysis. This paper examines some of the potential socioeconomic impacts likely to occur in rural areas as a result of repository siting and development, and it describes some of the characteristics of mitigation programs that are likely to be necessary, if the impacts are to be addressed. Both (1) standard impacts, those resulting from the fact that, like many other large-scale developments, repositories will involve a substantial number of new workers and residents (relative to the size of existing communities), and (2) special impacts, those resulting from the fact that repositories store radioactive materials, are examined. The discussion indicates that economic, demographic, public service, fiscal, and social impacts (standard and special) of these repositories will be substantial and problematic in many cases. Unless the impacts are effectively addressed with carefully planned and well financed mitigation efforts that insure that high-quality planning information is provided to local residents, and that local residents are involved in impact planning and management throughout the siting and development process, repository siting is unlikely to be effectively and equitably achieved. 44 references

  10. A system approach for reducing the environmental impact of manufacturing and sustainability improvement of nano-scale manufacturing

    Science.gov (United States)

    Yuan, Yingchun

    This dissertation develops an effective and economical system approach to reduce the environmental impact of manufacturing. The system approach is developed by using a process-based holistic method for upstream analysis and source reduction of the environmental impact of manufacturing. The system approach developed consists of three components of a manufacturing system: technology, energy and material, and is useful for sustainable manufacturing as it establishes a clear link between manufacturing system components and its overall sustainability performance, and provides a framework for environmental impact reductions. In this dissertation, the system approach developed is applied for environmental impact reduction of a semiconductor nano-scale manufacturing system, with three case scenarios analyzed in depth on manufacturing process improvement, clean energy supply, and toxic chemical material selection. The analysis on manufacturing process improvement is conducted on Atomic Layer Deposition of Al2O3 dielectric gate on semiconductor microelectronics devices. Sustainability performance and scale-up impact of the ALD technology in terms of environmental emissions, energy consumption, nano-waste generation and manufacturing productivity are systematically investigated and the ways to improve the sustainability of the ALD technology are successfully developed. The clean energy supply is studied using solar photovoltaic, wind, and fuel cells systems for electricity generation. Environmental savings from each clean energy supply over grid power are quantitatively analyzed, and costs for greenhouse gas reductions on each clean energy supply are comparatively studied. For toxic chemical material selection, a