WorldWideScience

Sample records for including operational health

  1. Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

    International Nuclear Information System (INIS)

    Adams, S.R.

    1985-10-01

    A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences

  2. Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

    Energy Technology Data Exchange (ETDEWEB)

    Adams, S.R.

    1985-10-01

    A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences.

  3. Operational health physics training

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1992-06-01

    The initial four sections treat basic information concerning atomic structure and other useful physical quantities, natural radioactivity, the properties of {alpha}, {beta}, {gamma}, x rays and neutrons, and the concepts and units of radiation dosimetry (including SI units). Section 5 deals with biological effects and the risks associated with radiation exposure. Background radiation and man-made sources are discussed next. The basic recommendations of the ICRP concerning dose limitations: justification, optimization (ALARA concepts and applications) and dose limits are covered in Section seven. Section eight is an expanded version of shielding, and the internal dosimetry discussion has been extensively revised to reflect the concepts contained in the MIRD methodology and ICRP 30. The remaining sections discuss the operational health physics approach to monitoring radiation. Individual sections include radiation detection principles, instrument operation and counting statistics, health physics instruments and personnel monitoring devices. The last five sections deal with the nature of, operation principles of, health physics aspects of, and monitoring approaches to air sampling, reactors, nuclear safety, gloveboxes and hot cells, accelerators and x ray sources. Decontamination, waste disposal and transportation of radionuclides are added topics. Several appendices containing constants, symbols, selected mathematical topics, and the Chart of the Nuclides, and an index have been included.

  4. Operational health physics training

    International Nuclear Information System (INIS)

    1988-09-01

    The initial four sections treat basic information concerning atomic structure and other useful physical quantities, natural radioactivity, the properties of α, β, γ, x rays and neutrons, and the concepts and units of radiation dosimetry (including SI units). Section 5 deals with biological effects and the risks associated with radiation exposure. Background radiation and man-made sources are discussed next. The basic recommendations of the ICRP concerning dose limitations: justification, optimization (ALARA concepts and applications) and dose limits are covered in Section seven. Section eight is an expanded version of shielding, and the internal dosimetry discussion has been extensively revised to reflect the concepts contained in the MIRD methodology and ICRP 30. The remaining sections discuss the operational health physics approach to monitoring radiation. Individual sections include radiation detection principles, instrument operation and counting statistics, health physics instruments and personnel monitoring devices. The last five sections deal with the nature of, operation principles of, health physics aspects of, and monitoring approaches to air sampling, reactors, nuclear safety, gloveboxes and hot cells, accelerators and x ray sources. Decontamination, waste disposal and transportation of radionuclides are added topics. Several appendices containing constants, symbols, selected mathematical topics, and the Chart of the Nuclides, and an index have been included

  5. W-026, health physics instrumentation operational test report

    International Nuclear Information System (INIS)

    Hackworth, M.F.

    1998-01-01

    This report documents the testing of the Health Physics Instrumentation associated with phase 2 and 3 start-up of Project W-026, WRAP. The Health Physics Instrumentation includes: Alpha and Beta Continuous Air Monitors (CAMS), Personnel Contamination Monitors (PCMs), Gamma Area Radiation Monitors (ARMs), Criticality Monitors, Alpha and Beta Smear Sample Counters, Portable Friskers, and Operator Breathing Zone Air Samplers. This OTR will cover only the Health Physics Instrumentation that was tested under the Operational test Plan for Health Physics Instrumentation (Phase 2 and 3). That instrumentation included: Alpha CAMS, Beta CAMs and ARMs located in rooms 107 and 113 of 2336-W. The remaining Health Physics Instrumentation that will be used for phase 2 and 3 start-up is tested during calibrations. These calibrations are outside the scope of the Operational Test Plan

  6. Upgraded safety analysis document including operations policies, operational safety limits and policy changes. Revision 2

    International Nuclear Information System (INIS)

    Batchelor, K.

    1996-03-01

    The National Synchrotron Light Source Safety Analysis Reports (1), (2), (3), BNL reports number-sign 51584, number-sign 52205 and number-sign 52205 (addendum) describe the basic Environmental Safety and Health issues associated with the department's operations. They include the operating envelope for the Storage Rings and also the rest of the facility. These documents contain the operational limits as perceived prior or during construction of the facility, much of which still are appropriate for current operations. However, as the machine has matured, the experimental program has grown in size, requiring more supervision in that area. Also, machine studies have either verified or modified knowledge of beam loss modes and/or radiation loss patterns around the facility. This document is written to allow for these changes in procedure or standards resulting from their current mode of operation and shall be used in conjunction with the above reports. These changes have been reviewed by NSLS and BNL ES and H committee and approved by BNL management

  7. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  8. Operating manual for the Health Physics Research Reactor

    International Nuclear Information System (INIS)

    1985-11-01

    This manual is intended to serve as a guide in the operation and maintenance of the Health Physics Researh Reactor (HPRR) of the Health Physics Dosimetry Applications Research (DOSAR) Facility. It includes descriptions of the HPRR and of associated equipment such as the reactor positioning devises and the derrick. Procedures for routine operation of the HPRR are given in detail, and checklists for the various steps are provided where applicable. Emergency procedures are similarly covered, and maintenance schedules are outlined. Also, a bibliography of references giving more detailed information on the DOSAR Facility is included. Changes to this manual will be approved by at least two of the following senior staff members: (1) the Operations Division Director, (2) the Reactor Operations Department Head, (3) the Supervisor of Reactor Operations TSF-HPRR Areas. The master copy and the copy of the manual issued to the HPRR Operations Supervisor will always reflect the latest revision. 22 figs

  9. 29 CFR 780.616 - Operations included in raising livestock.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Operations included in raising livestock. 780.616 Section... Employment in Agriculture and Livestock Auction Operations Under the Section 13(b)(13) Exemption Requirements for Exemption § 780.616 Operations included in raising livestock. Raising livestock includes such...

  10. Operations management in health care.

    Science.gov (United States)

    Henderson, M D

    1995-01-01

    Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.

  11. Ground Operations Autonomous Control and Integrated Health Management

    Science.gov (United States)

    Daniels, James

    2014-01-01

    The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

  12. Work organization, health, and obesity in urban transit operators: A qualitative study.

    Science.gov (United States)

    Dobson, Marnie; Choi, BongKyoo; Schnall, Peter L

    2017-11-01

    Urban transit operators have high rates of obesity, hypertension, and other cardiovascular risk-factors compared to other occupations. There have been few qualitative studies exploring the interrelationships between the organization of transit work, stress, and health including obesity, from the perspective of operators. Five focus groups were conducted at five Divisions in a transit authority in Southern California and included 65 bus and rail operators. Operators reported a great deal of stress related to their work, including 1) time pressures and lack of recovery time; 2) long work shifts and overtime; 3) feeling unsafe when dealing with the public; 4) lack of respect from supervisors and management. Operators believed stressful working conditions negatively impacted their health and weight. This qualitative study yielded new as well as confirmatory data about stress and transit work organization, health, and weight in operators. This study will add to future survey research and interventions in this population. © 2017 Wiley Periodicals, Inc.

  13. Comprehensive adolescent health programs that include sexual and reproductive health services: a systematic review.

    Science.gov (United States)

    Kågesten, Anna; Parekh, Jenita; Tunçalp, Ozge; Turke, Shani; Blum, Robert William

    2014-12-01

    We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998-2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects.

  14. A Kantorovich Type of Szasz Operators Including Brenke-Type Polynomials

    Directory of Open Access Journals (Sweden)

    Fatma Taşdelen

    2012-01-01

    convergence properties of these operators by using Korovkin's theorem. We also present the order of convergence with the help of a classical approach, the second modulus of continuity, and Peetre's -functional. Furthermore, an example of Kantorovich type of the operators including Gould-Hopper polynomials is presented and Voronovskaya-type result is given for these operators including Gould-Hopper polynomials.

  15. Operational Health Physics-Science or Philosophy?

    International Nuclear Information System (INIS)

    Carter, M. W.

    2004-01-01

    Operational health physics is concerned with protecting workers and the public from harm due to ionizing radiation. This requires the application of philosophy (ethics) as well as science. Operational health physics philosophy has been dominated by the ICRP. A particular aspect of ICRP's philosophy that is often misunderstood is (As low as reasonably achievable, economic and social factors being taken into account). (ALARA) Although the ALARA philosophy has been interpreted as a cost-benefit approach it is in fact a risk-benefit approach including social considerations as the ICRP has emphasised from time to time. A recent report has accused the ICRP of using a discarded philosophical approach, namely Utilitarianism, as a result of which its recommendations are unethical. The report suggests that a (rights) based philosophy such as Rawls' Theory of Justice would be a more appropriate basis. This paper discusses this accusation, considers some relevant philosophies and concludes that the accusation is not valid and that ICRP's recommendations are ethical but are frequently misinterpreted. (Author)

  16. Development of a health and safety manual for emergency response operations

    International Nuclear Information System (INIS)

    Riland, C.A.; Junio, S.S.

    2000-01-01

    The Federal Radiological Monitoring and Assessment Center (FRMAC) Health and Safety Manual, which has been under development by a multi-agency group, is nearing completion and publication. The manual applies to offsite monitoring during a radiological accident or incident. Though written for multi-agency offsite monitoring activities (FRMAC), the manual is generic in nature and should be readily adaptable for other emergency response operations. Health and safety issues for emergency response situations often differ from those of normal operations. Examples of these differences and methodologies to address these issues are discussed. Challenges in manual development, including lack of regulatory and guidance documentation, are also discussed. One overriding principle in the Health and Safety Manual development is the overall reduction of risk, not just dose. The manual is broken into several chapters, which include Overview of Responsibities, Health Physics, Industrial Hygiene and Safey, Medical, and Environmental Compliance and Records. Included is a series of appendices, which presents additional information on forms and plans for default scenarios

  17. Operational Health Physics-Science or Philosophy?

    Energy Technology Data Exchange (ETDEWEB)

    Carter, M. W.

    2004-07-01

    Operational health physics is concerned with protecting workers and the public from harm due to ionizing radiation. This requires the application of philosophy (ethics) as well as science. Operational health physics philosophy has been dominated by the ICRP. A particular aspect of ICRP's philosophy that is often misunderstood is (As low as reasonably achievable, economic and social factors being taken into account). (ALARA) Although the ALARA philosophy has been interpreted as a cost-benefit approach it is in fact a risk-benefit approach including social considerations as the ICRP has emphasised from time to time. A recent report has accused the ICRP of using a discarded philosophical approach, namely Utilitarianism, as a result of which its recommendations are unethical. The report suggests that a (rights) based philosophy such as Rawls' Theory of Justice would be a more appropriate basis. This paper discusses this accusation, considers some relevant philosophies and concludes that the accusation is not valid and that ICRP's recommendations are ethical but are frequently misinterpreted. (Author)

  18. [Philanthropic hospitals and the operation of provider-owned health plans in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Barbosa, Pedro Ribeiro; Gerschman, Silvia; Vasconcellos, Miguel Murat

    2007-02-01

    To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.

  19. Sustainable Model for Public Health Emergency Operations Centers for Global Settings.

    Science.gov (United States)

    Balajee, S Arunmozhi; Pasi, Omer G; Etoundi, Alain Georges M; Rzeszotarski, Peter; Do, Trang T; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A; Phu, Tran Dac; Mounts, Anthony W

    2017-10-01

    Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidemiology, surveillance, or equivalent department rather than exist as a stand-alone space and serve as operational hubs during nonoutbreak times but in emergencies can scale up according to the traditional Incident Command System structure.

  20. Sustainable Model for Public Health Emergency Operations Centers for Global Settings

    OpenAIRE

    Balajee, S. Arunmozhi; Pasi, Omer G.; Etoundi, Alain Georges M.; Rzeszotarski, Peter; Do, Trang T.; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A.; Phu, Tran Dac; Mounts, Anthony W.

    2017-01-01

    Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidem...

  1. Operational power reactor health physics

    International Nuclear Information System (INIS)

    Watson, B.A.

    1987-01-01

    Operational Health Physics can be comprised of a multitude of organizations, both corporate and at the plant sites. The following discussion centers around Baltimore Gas and Electric's (BG and E) Calvert Cliffs Nuclear Power Plant, located in Lusby, Maryland. Calvert Cliffs is a twin Combustion Engineering 825 MWe pressurized water reactor site with Unit I having a General electric turbine-generator and Unit II having a Westinghouse turbine-generator. Having just completed each Unit's ten-year Inservice Inspection and Refueling Outge, a total of 20 reactor years operating health physics experience have been accumulated at Calvert Cliffs. Because BG and E has only one nuclear site most health physics functions are performed at the plant site. This is also true for the other BG and E nuclear related organizations, such as Engineering and Quality Assurance. Utilities with multiple plant sites have corporate health physics entity usually providing oversight to the various plant programs

  2. Health requirements for nuclear reactor operators

    International Nuclear Information System (INIS)

    1980-05-01

    The health prerequisites established for the qualification of nuclear reactor operators according to CNEN-NE-1.01 Guidelines Licensing of nuclear reactor operators, CNEN-12/79 Resolution, are described. (M.A.) [pt

  3. On Some Extensions of Szasz Operators Including Boas-Buck-Type Polynomials

    Directory of Open Access Journals (Sweden)

    Sezgin Sucu

    2012-01-01

    Full Text Available This paper is concerned with a new sequence of linear positive operators which generalize Szasz operators including Boas-Buck-type polynomials. We establish a convergence theorem for these operators and give the quantitative estimation of the approximation process by using a classical approach and the second modulus of continuity. Some explicit examples of our operators involving Laguerre polynomials, Charlier polynomials, and Gould-Hopper polynomials are given. Moreover, a Voronovskaya-type result is obtained for the operators containing Gould-Hopper polynomials.

  4. Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis.

    Science.gov (United States)

    Golding, Sarah E; Horsfield, Claire; Davies, Annette; Egan, Bernadette; Jones, Martyn; Raleigh, Mary; Schofield, Patricia; Squires, Allison; Start, Kath; Quinn, Tom; Cropley, Mark

    2017-01-01

    The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: 'Organisational and Operational Factors' and 'Interactions with Others'. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. CRD42014010806.

  5. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. © The Author(s) 2015.

  6. Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis

    Directory of Open Access Journals (Sweden)

    Sarah E. Golding

    2017-10-01

    Full Text Available Background The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC operatives, and to identify key stressors experienced by EDC operatives. Methods Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. Results A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: ‘Organisational and Operational Factors’ and ‘Interactions with Others’. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. Discussion EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. PROSPERO Registration Number CRD42014010806.

  7. A framework for including family health spillovers in economic evaluation

    NARCIS (Netherlands)

    H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)

    2016-01-01

    textabstractHealth care interventions may affect the health of patients' family networks. It has been suggested that these health spillovers? should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health

  8. [Structure of Relationships Formed by Occupational Health Nurses for Co-operating with Managers to Support Workers with Mental Health Concerns].

    Science.gov (United States)

    Hatanaka, Junko; Takasaki, Masako; Hatanaka, Michiyo

    2018-05-31

    Occupational health staff and managers play important roles in supporting workers with mental health concerns and mutual co-operation among them is a necessary element. However, when co-operating with other professionals, several problems arise that often make such co-operation a challenge. Effective mutual actions are needed to promote such co-operation, and relationships must be formed for this purpose. Therefore, in this study, we aimed to clarify how occupational health nurses form relationships for facilitating co-operation with managers to provide support to workers with mental health concerns. Data were collected using semi-structured interviews with 11 occupational health nurses who provide individualized mental health support and who have at least 5 years of experience as occupational health nurses. Analysis of the recorded interviews was performed using a qualitative statistical method (KJ method). Six elements that constitute the formation of relationships were identified. When occupational health nurses form relationships for facilitating co-operation with a manager to provide support to workers, they "form relationships through strategic communication" with them and when co-operation is required, they form a relationship by "acting in a manner that suits the manager," such as his/her character and the situation. To support this relationship, occupational health nurses "provide mental support to the manager" by listening to his/her anxiety or real intention about supporting the subordinate with mental health concerns and provide relief while understanding their burdens during the co-operation. Occupational health nurses even "provide support to the manager in their activities," which assessed the situation at the workplace as the specialist and advised the manager to understand how to concern to the subordinate specifically. In addition, they "indirectly support the manager" which included coordinating with the concerned persons so as to not excessively

  9. [Origin of sennosides in health teas including Malva leaves].

    Science.gov (United States)

    Kojima, T; Kishi, M; Sekita, S; Satake, M

    2001-06-01

    The aim of this study is to clarify whether sennosides are contained in the leaf of Malva verticillata L., and then to clarify the source of sennosides in health teas including malva leaves. The identification and determination of sennosides were performed with thin layer chromatography and high performance liquid chromatography. The leaf of Malva verticillata L. did not contain sennosides A or B and could be easily distinguished from senna leaf. Our previous report showed that sennosides are contained in weight-reducing herbal teas including malva leaves, and that senna leaf is a herbal component in some teas. Furthermore, in 10 samples of health tea including malva leaves that were bought last year, the smallest amount of sennosides was 6.1 mg/bag, and all health teas including malva leaves contained the leaf and midrib of senna. We suggest that sennosides A and B are not contained in the leaf of Malva verticillata L., and that the sennosides in health teas including malva leaves are not derived from malva leaf but from senna leaf.

  10. A Kantorovich-Stancu Type Generalization of Szasz Operators including Brenke Type Polynomials

    Directory of Open Access Journals (Sweden)

    Rabia Aktaş

    2013-01-01

    Full Text Available We introduce a Kantorovich-Stancu type modification of a generalization of Szasz operators defined by means of the Brenke type polynomials and obtain approximation properties of these operators. Also, we give a Voronovskaya type theorem for Kantorovich-Stancu type operators including Gould-Hopper polynomials.

  11. Using virtual reality technology to include field operators in simulation and training

    International Nuclear Information System (INIS)

    Nystad, E.; Strand, S.

    2006-01-01

    By using virtual reality technology, field operators can be included in simulator training. A study has been performed where field operators could perform their activities in a virtual plant and communicate with a control room operator who was placed in a physical control room simulator. This paper describes the use of VR technology in the study and how the operators experienced interacting with the virtual plant. (author)

  12. Meeting global health challenges through operational research and management science.

    Science.gov (United States)

    Royston, Geoff

    2011-09-01

    This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.

  13. Barriers and benefits to using mobile health technology after operation: A qualitative study.

    Science.gov (United States)

    Abelson, Jonathan S; Kaufman, Elinore; Symer, Matthew; Peters, Alexander; Charlson, Mary; Yeo, Heather

    2017-09-01

    Recently, mobile health technology has emerged as a promising avenue for improving physician-patient communication and patient outcomes. The objective of our study was to determine the public's perception of barriers and benefits to using mobile health technology technologies to enhance recovery after operation. We used the Empire State Poll to ask 2 open-ended questions to 800 participants assessing their perceptions of benefits and barriers to use mobile health technology after operation. All responses were coded independently, and any discrepancies were resolved by consensus. We used grounded theory to allow themes to arise from the codes. Interrater reliability was calculated using Cohen's Kappa. Participants identified a range of possible barriers to using mobile health technology apps after operation including: protecting personal health information, technology effectiveness and failure, preference for face-to-face interaction with their surgeon, level of effort required, and ability of the older adults to navigate mobile health technology. Participants identified multiple possible benefits including: better monitoring, improved communication with their surgeon, minimizing follow-up visits, improved convenience, and increased patient knowledge. In the study, 15% of all respondents stated there were no barriers whereas 6% stated there were no benefits. Participants were receptive to the many potential benefits of this technology to enhance not only their relationships with providers and the convenience of access, but also their health outcomes. We must address participants concerns about data security and their fears of losing a personal relationship with their doctor. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. A Study on the Operation Strategy for Combined Accident including TLOFW accident

    International Nuclear Information System (INIS)

    Kim, Bo Gyung; Kang, Gook Young; Yoon, Ho Joon

    2014-01-01

    It is difficult for operators to recognize the necessity of a feed-and-bleed (F-B) operation when the loss of coolant accident and failure of secondary side occur. An F-B operation directly cools down the reactor coolant system (RCS) using the primary cooling system when residual heat removal by the secondary cooling system is not available. The plant is not always necessary the F-B operation when the secondary side is failed. It is not necessary to initiate an F-B operation in the case of a medium or large break because these cases correspond to low RCS pressure sequences when the secondary side is failed. If the break size is too small to sufficiently decrease the RCS pressure, the F-B operation is necessary. Therefore, in the case of a combined accident including a secondary cooling system failure, the provision of clear information will play a critical role in the operators' decision to initiate an F-B operation. This study focuses on the how we establish the operation strategy for combined accident including the failure of secondary side in consideration of plant and operating conditions. Previous studies have usually focused on accidents involving a TLOFW accident. The plant conditions to make the operators confused seriously are usually the combined accident because the ORP only focuses on a single accident and FRP is less familiar with operators. The relationship between CET and PCT under various plant conditions is important to decide the limitation of initiating the F-B operation to prevent core damage

  15. What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review.

    Science.gov (United States)

    Rotter, Thomas; Plishka, Christopher; Lawal, Adegboyega; Harrison, Liz; Sari, Nazmi; Goodridge, Donna; Flynn, Rachel; Chan, James; Fiander, Michelle; Poksinska, Bonnie; Willoughby, Keith; Kinsman, Leigh

    2018-01-01

    Industrial improvement approaches such as Lean management are increasingly being adopted in health care. Synthesis is necessary to ensure these approaches are evidence based and requires operationalization of concepts to ensure all relevant studies are included. This article outlines the process utilized to develop an operational definition of Lean in health care. The literature search, screening, data extraction, and data synthesis processes followed the recommendations outlined by the Cochrane Collaboration. Development of the operational definition utilized the methods prescribed by Kinsman et al. and Wieland et al. This involved extracting characteristics of Lean, synthesizing similar components to establish an operational definition, applying this definition, and updating the definition to address shortcomings. We identified two defining characteristics of Lean health-care management: (1) Lean philosophy, consisting of Lean principles and continuous improvement, and (2) Lean activities, which include Lean assessment activities and Lean improvement activities. The resulting operational definition requires that an organization or subunit of an organization had integrated Lean philosophy into the organization's mandate, guidelines, or policies and utilized at least one Lean assessment activity or Lean improvement activity. This operational definition of Lean management in health care will act as an objective screening criterion for our systematic review. To our knowledge, this is the first evidence-based operational definition of Lean management in health care.

  16. Space Toxicology: Human Health during Space Operations

    Science.gov (United States)

    Khan-Mayberry, Noreen; James, John T.; Tyl, ROchelle; Lam, Chiu-Wing

    2010-01-01

    Space Toxicology is a unique and targeted discipline for spaceflight, space habitation and occupation of celestial bodies including planets, moons and asteroids. Astronaut explorers face distinctive health challenges and limited resources for rescue and medical care during space operation. A central goal of space toxicology is to protect the health of the astronaut by assessing potential chemical exposures during spaceflight and setting safe limits that will protect the astronaut against chemical exposures, in a physiologically altered state. In order to maintain sustained occupation in space on the International Space Station (ISS), toxicological risks must be assessed and managed within the context of isolation continuous exposures, reuse of air and water, limited rescue options, and the need to use highly toxic compounds for propulsion. As we begin to explore other celestial bodies in situ toxicological risks, such as inhalation of reactive mineral dusts, must also be managed.

  17. 29 CFR 784.108 - Operations not included in named operations on forms of aquatic “life.”

    Science.gov (United States)

    2010-07-01

    ... subject matter of the exemptions is concerned with “aquatic forms of animal and vegetable life,” the..., novelties, liquid glue, isinglass, pearl essence, and fortified or refined fish oil is not within these... 29 Labor 3 2010-07-01 2010-07-01 false Operations not included in named operations on forms of...

  18. Use of technology to support information needs for continuity of operations planning in public health: a systematic review.

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne; Demiris, George

    2010-01-01

    Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems. To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review. A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems. There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.

  19. Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

    Science.gov (United States)

    Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

    2017-03-01

    The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

  20. A preliminary study on related factors of mental health in nuclear power plant operators

    International Nuclear Information System (INIS)

    Dai Tingting; Liu Yulong; Li Yuan; Liao Haihong; Qiu Mengyue; Bian Huahui; Chen Weibo; Liu Chunfeng

    2012-01-01

    Objective: To explore the status of nuclear power plant operators in mental health and its correlation with emotional stability, liveliness, anxiety and urgency. Methods: 255 male operators were randomly selected from three nuclear power bases, meanwhile 61 undergraduates were used as control group. The mental health and neurobehavioral evaluation system of Chinese nuclear power plant operators was developed by Second Affiliated Hospital of Soochow University, which was used to assess mental health of the subjects. The scores of mental health personality factors were recorded, together with four main personality factors including emotional stability, liveliness, anxiety and urgency. Results: The score of lie was lower than 8 which showed all inspected groups were normal. 1.57% (4/255) operators had psychological disorders, 3.92% (10/255) had poor mental health, 27.84% (71/255) had general mental health, 66.7% (170/255) had excellent mental health, whereas 9.84% (6/61) for control group had psychological disorders. Obvious difference was observed in the final scores between the nuclear power plant operators and control group. The former gained higher scores on mental health,emotional stability,and lower scores on anxiety and urgency (t=3.437, 4.423, -2.493, -2.093, P<0.05). Both groups aged over 27 years and with length of service over 5 years were awarded higher scores on mental health, emotional stability (t=2.585, 2.349; t=2.606, 2.947, P<0.05), lower scores on anxiety and urgency (t=-3.407, -2.138; t=- 2.941, -2.256, P<0.05). The mental health was positively correlated with emotional stability and liveliness (r=0.721, 0.650, P<0.05), but negatively correlated with anxiety and urgency (r=-0.809, -0.693, P<0.05). Conclusions: The majority of nuclear power plant operators had excellent psychological quality, but some factors should be paid more attention, such as different ages and length of service time. (authors)

  1. Health effects of technologies for power generation: Contributions from normal operation, severe accidents and terrorist threat

    International Nuclear Information System (INIS)

    Hirschberg, Stefan; Bauer, Christian; Burgherr, Peter; Cazzoli, Eric; Heck, Thomas; Spada, Matteo; Treyer, Karin

    2016-01-01

    As a part of comprehensive analysis of current and future energy systems we carried out numerous analyses of health effects of a wide spectrum of electricity supply technologies including advanced ones, operating in various countries under different conditions. The scope of the analysis covers full energy chains, i.e. fossil, nuclear and renewable power plants and the various stages of fuel cycles. State-of-the-art methods are used for the estimation of health effects. This paper addresses health effects in terms of reduced life expectancy in the context of normal operation as well as fatalities resulting from severe accidents and potential terrorist attacks. Based on the numerical results and identified patterns a comparative perspective on health effects associated with various electricity generation technologies and fuel cycles is provided. In particular the estimates of health risks from normal operation can be compared with those resulting from severe accidents and hypothetical terrorist attacks. A novel approach to the analysis of terrorist threat against energy infrastructure was developed, implemented and applied to selected energy facilities in various locations. Finally, major limitations of the current approach are identified and recommendations for further work are given. - Highlights: • We provide state-of-the-art comparative assessment of energy health risks. • The scope of the analysis should to the extent possible cover full energy chains. • Health impacts from normal operation dominate the risks. • We present novel approach to analysis of terrorist threat. • Limitations include technology choices, geographical coverage and terrorist issues.

  2. Psychological health of operators in NPPs and accident prevention

    International Nuclear Information System (INIS)

    Zhou Huayun

    2004-01-01

    Mental and physical health of operators of nuclear power plants (NPPs) is directly related to normal and safe operation of NPPs. The cognitive process, volitional character, attention, emotion, feeling and personality are important factors that affect operators' safe behavior. Alcohol, medical drugs and operators' biological rhythm are can also make great effects on their psychological health. By means of job-fitness psychological test, better candidates for operators could be primarily selected from point of psychological view. Psychological follow-up of post skill training, simulator training and practical work of operators can make NPPs prevent from operational accidents due to human errors to the greatest extent. It is helpful for NPPs to find and solve some psychological problems by means of psychological counseling, regulation or psychotherapy. (author)

  3. General Purpose Data-Driven Online System Health Monitoring with Applications to Space Operations

    Science.gov (United States)

    Iverson, David L.; Spirkovska, Lilly; Schwabacher, Mark

    2010-01-01

    Modern space transportation and ground support system designs are becoming increasingly sophisticated and complex. Determining the health state of these systems using traditional parameter limit checking, or model-based or rule-based methods is becoming more difficult as the number of sensors and component interactions grows. Data-driven monitoring techniques have been developed to address these issues by analyzing system operations data to automatically characterize normal system behavior. System health can be monitored by comparing real-time operating data with these nominal characterizations, providing detection of anomalous data signatures indicative of system faults, failures, or precursors of significant failures. The Inductive Monitoring System (IMS) is a general purpose, data-driven system health monitoring software tool that has been successfully applied to several aerospace applications and is under evaluation for anomaly detection in vehicle and ground equipment for next generation launch systems. After an introduction to IMS application development, we discuss these NASA online monitoring applications, including the integration of IMS with complementary model-based and rule-based methods. Although the examples presented in this paper are from space operations applications, IMS is a general-purpose health-monitoring tool that is also applicable to power generation and transmission system monitoring.

  4. Risks and health effects in operating room personnel

    NARCIS (Netherlands)

    van den Berg-Dijkmeijer, Marleen L.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2011-01-01

    The objective was to find the factors that pose a possible health risk to OR personnel. Work-related health problems of operating room (OR) personnel were signalled by an occupational physician and preparations for the development of new Worker's Health Surveillance (WHS) were started with a

  5. Operating Room Delays: Meaningful Use in Electronic Health Record.

    Science.gov (United States)

    Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

    2016-06-01

    Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives.

  6. Twenty years of health physics research reactor operation

    International Nuclear Information System (INIS)

    Sims, C.S.; Gilley, L.W.

    1983-01-01

    The Health Physics Research Reactor at the Oak Ridge National Laboratory has been in regular use for more than two decades. Safe operation of this fast reactor over this extended period indicates that (1) fundamental design, (2) operational procedures, (3) operator training and performance, (4) maintenance activites, and (5) management have all been eminently satisfactory. The reactor and its uses are described, the operational history and significant events are reviewed, and operational improvements and maintenance are discussed

  7. Holistic Health: Does It Really Include Mental Health?

    OpenAIRE

    McClanahan, Kimberly K.; Huff, Marlene B.; Omar, Hatim A.

    2006-01-01

    Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate publi...

  8. Holistic Health: Does It Really Include Mental Health?

    Directory of Open Access Journals (Sweden)

    Kimberly K. McClanahan

    2006-01-01

    Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

  9. Holistic health: does it really include mental health?

    Science.gov (United States)

    McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

    2006-03-14

    Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

  10. Exposure Based Health Issues Project Report: Phase I of High Level Tank Operations, Retrieval, Pretreatment, and Vitrification Exposure Based Health Issues Analysis

    International Nuclear Information System (INIS)

    Stenner, Robert D.; Bowers, Harold N.; Kenoyer, Judson L.; Strenge, Dennis L.; Brady, William H.; Ladue, Buffi; Samuels, Joseph K.

    2001-01-01

    The Department of Energy (DOE) has the responsibility to understand the ''big picture'' of worker health and safety which includes fully recognizing the vulnerabilities and associated programs necessary to protect workers at the various DOE sites across the complex. Exposure analysis and medical surveillance are key aspects for understanding this big picture, as is understanding current health and safety practices and how they may need to change to relate to future health and safety management needs. The exposure-based health issues project was initiated to assemble the components necessary to understand potential exposure situations and their medical surveillance and clinical aspects. Phase I focused only on current Hanford tank farm operations and serves as a starting point for the overall project. It is also anticipated that once the pilot is fully developed for Hanford HLW (i.e., current operations, retrieval, pretreatment, vitrification, and disposal), the process and analysis methods developed will be available and applicable for other DOE operations and sites. The purpose of this Phase I project report is to present the health impact information collected regarding ongoing tank waste maintenance operations, show the various aspects of health and safety involved in protecting workers, introduce the reader to the kinds of information that will need to be analyzed in order to effectively manage worker safety

  11. Including oral health training in a health system strengthening program in Rwanda

    Directory of Open Access Journals (Sweden)

    Brittany Seymour

    2013-03-01

    Full Text Available Objective: Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design: In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results: The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions: Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

  12. Including oral health training in a health system strengthening program in Rwanda

    Science.gov (United States)

    Seymour, Brittany; Muhumuza, Ibra; Mumena, Chris; Isyagi, Moses; Barrow, Jane; Meeks, Valli

    2013-01-01

    Objective Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH) Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come. PMID:23473054

  13. Integrated model of port oil piping transportation system safety including operating environment threats

    Directory of Open Access Journals (Sweden)

    Kołowrocki Krzysztof

    2017-06-01

    Full Text Available The paper presents an integrated general model of complex technical system, linking its multistate safety model and the model of its operation process including operating environment threats and considering variable at different operation states its safety structures and its components safety parameters. Under the assumption that the system has exponential safety function, the safety characteristics of the port oil piping transportation system are determined.

  14. Integrated model of port oil piping transportation system safety including operating environment threats

    OpenAIRE

    Kołowrocki, Krzysztof; Kuligowska, Ewa; Soszyńska-Budny, Joanna

    2017-01-01

    The paper presents an integrated general model of complex technical system, linking its multistate safety model and the model of its operation process including operating environment threats and considering variable at different operation states its safety structures and its components safety parameters. Under the assumption that the system has exponential safety function, the safety characteristics of the port oil piping transportation system are determined.

  15. Mental health care use by soldiers conducting counterinsurgency operations.

    Science.gov (United States)

    Applewhite, Larry; Keller, Nathan; Borah, Adam

    2012-05-01

    Counterinsurgency (COIN) has become the cornerstone of the military's strategy to combat terrorist threats. COIN operations are complex and often expose soldiers to unfamiliar stressors as they fight the enemy while developing and maintaining rapport with the local populace. Utilizing a retrospective record review protocol, we examined 282 mental health files of soldiers assigned to a brigade combat team that operated from a large forward operating base in Iraq during the counterinsurgency campaign. Most reported sleep disturbance, depression, anxiety, irritability, and conflict with supervisors related to either operational stress, exposure to direct combat, or home front concerns. Most received brief individual supportive therapy or attended solution-focused group counseling emphasizing life skills training, post-traumatic stress treatment, women's support, or relationship skills. Psychopharmacologic treatment was an essential adjunct to the counseling program. Results indicate that supporting a COIN deployment requires a comprehensive mental health program that can respond to a wide range of mental health problems.

  16. 78 FR 12358 - UBS Financial Services, Inc., Wealth Management Americas Operations, Including On-Site Leased...

    Science.gov (United States)

    2013-02-22

    ..., Inc., Wealth Management Americas Operations, Including On-Site Leased Workers From Leafstone... Services, Inc., Wealth Management Americas Operations (UBS), Weehawken, New Jersey. The workers are engaged... to include all leased workers on-site at UBS Financial Services, Inc., Wealth Management Americas...

  17. Oswer integrated health and safety standard operating practices. Directive

    International Nuclear Information System (INIS)

    1993-02-01

    The directive implements the OSWER (Office of Solid Waste and Emergency Response) Integrated Health and Safety Standards Operating Practices in conjunction with the OSHA (Occupational Safety and Health Act) Worker Protection Standards, replacing the OSWER Integrated Health and Safety Policy

  18. Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

    Science.gov (United States)

    Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

    2015-04-02

    Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an

  19. High volume hydraulic fracturing operations: potential impacts on surface water and human health.

    Science.gov (United States)

    Mrdjen, Igor; Lee, Jiyoung

    2016-08-01

    High volume, hydraulic fracturing (HVHF) processes, used to extract natural gas and oil from underground shale deposits, pose many potential hazards to the environment and human health. HVHF can negatively affect the environment by contaminating soil, water, and air matrices with potential pollutants. Due to the relatively novel nature of the process, hazards to surface waters and human health are not well known. The purpose of this article is to link the impacts of HVHF operations on surface water integrity, with human health consequences. Surface water contamination risks include: increased structural failure rates of unconventional wells, issues with wastewater treatment, and accidental discharge of contaminated fluids. Human health risks associated with exposure to surface water contaminated with HVHF chemicals include increased cancer risk and turbidity of water, leading to increased pathogen survival time. Future research should focus on modeling contamination spread throughout the environment, and minimizing occupational exposure to harmful chemicals.

  20. Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

    Science.gov (United States)

    Korenman, Sanders D; Remler, Dahlia K

    2016-12-01

    We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Co-Operative Advances in Behavioral Health and Performance Research and Operations

    Science.gov (United States)

    VanderArk, Stephen T.; Leveton, Lauren B.

    2011-01-01

    In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework

  2. Potential and Actual Health Hazards in the Dense Urban Operational Environment: Critical Gaps and Solutions for Military Occupational Health.

    Science.gov (United States)

    Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D

    2017-11-01

    : This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.

  3. Health complaints among subjects involved in oil cleanup operations during oil spillage from a Greek tanker "Tasman Spirit".

    Science.gov (United States)

    Meo, Sultan Ayoub; Al-Drees, Abdul Majeed; Rasheed, Shahzad; Meo, Imran Mu; Al-Saadi, Muslim M; Ghani, Hamza A; Alkandari, Jasem Ramadan

    2009-01-01

    Oil spillage in the sea water is a disaster for marine life and humans in the vicinity. The study aimed at investigating health complaints among subjects involved in oil cleanup operations during a spillage from a Greek oil tanker "Tasman Spirit". The project was conducted under the supervision of the Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. The study concerned the respiratory and general health complaints in 50 apparently healthy, non-smoking male workers exposed to crude oil during oil cleanup operations. The exposed group was matched with a similar number of male, non-smoking controls. The health complaints were evaluated based on a comprehensive interview. The subjects involved in oil cleanup operations had significantly higher rates of health complaints including cough (38%), runny nose (36%), eye irritation/redness (32%), sore throat (28%), headache (28%), nausea (24%) and general illness (18%), compared to their matched controls. Air pollution due to crude oil spillage into sea water may cause respiratory and general health complaints in workers involved in oil cleanup operations.

  4. An operational health physics quality assurance program

    International Nuclear Information System (INIS)

    Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.

    1996-01-01

    DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records

  5. Joint operating agreements - health and safety and employment issues

    International Nuclear Information System (INIS)

    Molnar, L.F.

    1999-01-01

    The extent of non-operator exposure to health and safety and other employment liability is considered. Under the terms of the Canadian Association of Petroleum Landman agreements, the designated operator is the sole employer for joint operations. By these terms, the placement of responsibility for employees involved in a joint operation appears clear. It is to rest with the operator alone. As such, one would expect that the non-operator would be free from liabilities arising out of the employment relations of a project. It has been held, in cases of interrelated companies, that an individual can be an employee of more than one company at the same time. Alberta's Occupational Health and Safety Act, as well as the similar Acts in other provinces, impose a hierarchy of duties and obligations not only on employers but also upon contractors, suppliers and workers to ensure that safety is secured. Relevant definitions in the Act state this. An employer of an employee is vicariously liable for torts committed by the employee in the course of his employment. The questions are asked of what happens if a non-operator lends an employee to the operator and the employee tortiously injures a third party, and if the temporary employer, the operator, becomes the employer in the event of vicarious liability. 20 refs

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

    Science.gov (United States)

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

    2013-03-01

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

  7. A Co-operative Inquiry Into Generating, Describing, and Transforming Knowledge About De-escalation Practices in Mental Health Settings

    DEFF Research Database (Denmark)

    Berring, Lene Lauge; Hummelvoll, J. K.; Pedersen, Liselotte

    2016-01-01

    De-escalation is concerned with managing violent behaviour without resorting to coercive measures. Co-operative Inquiry provided the conceptual basis for generating knowledge regarding de-escalation practices in acute mental health care settings. The research included service users and staff memb...... transforming violence management. Neighbouring mental health communities’ involvement strengthened the transformation process and assisted in validating the research results. © 2016, Taylor & Francis Group, LLC.......De-escalation is concerned with managing violent behaviour without resorting to coercive measures. Co-operative Inquiry provided the conceptual basis for generating knowledge regarding de-escalation practices in acute mental health care settings. The research included service users and staff...... members as co-researchers and knowledge was generated in dynamic research cycles around an extended epistemology of knowing: experiential, presentational, propositional, and practical. Through this process, co-researchers became de-escalation learners, implementing de-escalation practices while...

  8. Determining the Adequacy of Operation of DMUs in Health Care

    Directory of Open Access Journals (Sweden)

    Jože Benčina

    2014-05-01

    operational efficiency of Slovenian hospitals. The introduction defines efficiency within the concept of adequacy and its dimensions of efficiency, accessibility and quality. The empirical part of the article presents the use of the DEA method for determining the adequacy of operation of hospitals on the basis of data on Slovenian hospitals. It is apparent that the model for the evaluation of adequacy of operation of hospitals is suitable within limitations. The interpretation of results is hampered by inadequately structured data and non-transparent prices of hospital services. Therefore, the results of the research indicate the direction in which thedatabase should be developed to ensure greater comparability in a rather heterogeneous population of hospitals. Furthermore, the authors point out that new indicators, reflecting the condition of the dimensions of adequacy, should be included in the model for the purposes of the evaluation of adequacy. On the basis of the results of the research, the question of implementing suitable methods of planning and controlling the adequacy of the functioning of health care into practice arises.

  9. 78 FR 61389 - Sanyo Solar of Oregon, LLC, Wafer Slicing and Quality Control Operations, Including On-Site...

    Science.gov (United States)

    2013-10-03

    ..., LLC, Wafer Slicing and Quality Control Operations, Including On-Site Leased Workers From Brown and... Quality Control Operations, Salem, Oregon, including on-site leased workers from Brown and Dunton, Inc... and included workers who supplied quality control and support functions. The company reports that...

  10. structured operational research and training in the public health

    African Journals Online (AJOL)

    2016-10-01

    Oct 1, 2016 ... PUBLIC HEALTH SECTOR: THE KENYAN EXPERIENCE. Operational research is becoming an increasingly valuable tool to health programmes seeking to ... Odense, Denmark) or EpiInfo (4), and the third and last workshop focuses on manuscript writing and submission to an open access peer reviewed.

  11. Universal health coverage in 'One ASEAN': are migrants included?

    Science.gov (United States)

    Guinto, Ramon Lorenzo Luis R; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S

    2015-01-01

    As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of

  12. NLO QCD corrections to Higgs pair production including dimension-6 operators

    Energy Technology Data Exchange (ETDEWEB)

    Groeber, Ramona [INFN, Sezione di Roma Tre, Roma (Italy); Muehlleitner, Margarete; Streicher, Juraj [Karlsruher Institut fuer Technologie (KIT), Karlsruhe (Germany). Institut fuer Theoretische Physik; Spira, Michael [Paul Scherrer Institut, Villigen (Switzerland)

    2016-07-01

    The role of the Higgs boson has developed from the long-sought particle into a tool for exploring beyond Standard Model (BSM) physics. While the Higgs boson signal strengths are close to the values predicted in the Standard Model (SM), the trilinear Higgs-selfcoupling can still deviate significantly from the SM expectations in some BSM scenarios. The Effective Field Theory (EFT) framework provides a way to describe these deviations in a rather model independent way, by including higher-dimensional operators which modify the Higgs boson couplings and induce novel couplings not present in the SM. The trilinear Higgs-selfcoupling is accessible in Higgs pair production, for which the gluon fusion is the dominant production channel. The next-to-leading (NLO) QCD corrections to this process are important for a proper prediction of the cross section and are known in the limit of heavy top quark masses. In our work, we provide the NLO QCD corrections in the large top quark mass limit to Higgs pair production including dimension-6 operators. The various higher-dimensional contributions are affected differently by the QCD corrections, leading to deviations in the relative NLO QCD corrections of several per-cent, while modifying the cross section by up to an order of magnitude.

  13. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all.

  14. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    International Nuclear Information System (INIS)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all

  15. A qualitative content analysis of global health engagements in Peacekeeping and Stability Operations Institute's stability operations lessons learned and information management system.

    Science.gov (United States)

    Nang, Roberto N; Monahan, Felicia; Diehl, Glendon B; French, Daniel

    2015-04-01

    Many institutions collect reports in databases to make important lessons-learned available to their members. The Uniformed Services University of the Health Sciences collaborated with the Peacekeeping and Stability Operations Institute to conduct a descriptive and qualitative analysis of global health engagements (GHEs) contained in the Stability Operations Lessons Learned and Information Management System (SOLLIMS). This study used a summative qualitative content analysis approach involving six steps: (1) a comprehensive search; (2) two-stage reading and screening process to identify first-hand, health-related records; (3) qualitative and quantitative data analysis using MAXQDA, a software program; (4) a word cloud to illustrate word frequencies and interrelationships; (5) coding of individual themes and validation of the coding scheme; and (6) identification of relationships in the data and overarching lessons-learned. The individual codes with the most number of text segments coded included: planning, personnel, interorganizational coordination, communication/information sharing, and resources/supplies. When compared to the Department of Defense's (DoD's) evolving GHE principles and capabilities, the SOLLIMS coding scheme appeared to align well with the list of GHE capabilities developed by the Department of Defense Global Health Working Group. The results of this study will inform practitioners of global health and encourage additional qualitative analysis of other lessons-learned databases. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  16. Radiation and nuclear safety included in the environmental health programme

    International Nuclear Information System (INIS)

    Salomaa, S.

    1996-01-01

    Finland is currently preparing a national environmental health programme, the objective of which is to chart the main environmental health problems in Finland, to identify means for securing a healthy environment, and to draw up a practical action programme for preventing and rectifying problems pertaining to environmental health. Radiation and nuclear safety form an essential part of preventive health care. The action programme is based on decisions and programmes approved at the WHO Conference on the Environment and Health, held in Helsinki in June 1994. In addition to the state of the Finnish environment and the health of the Finnish population, the programme addresses the relevant international issues, in particular in areas adjacent to Finland. The Committee on Environmental Health is expected to complete its work by the end of the year. A wide range of representatives from various branches of administration have contributed to the preparation of the programme. Besides physical, biological and chemical factors, the environmental factors affecting health also include the physical environment and the psychological, social and aesthetic features of the environment. Similarly, environmental factors that have an impact on the health of present or future generations, on the essential preconditions of life and on the quality of life are investigated. The serious risk to nature caused by human actions is also considered as a potential risk to human health. (orig.)

  17. Nursing operations automation and health care technology innovations: 2025 and beyond.

    Science.gov (United States)

    Suby, ChrysMarie

    2013-01-01

    This article reviews why nursing operations automation is important, reviews the impact of computer technology on nursing from a historical perspective, and considers the future of nursing operations automation and health care technology innovations in 2025 and beyond. The increasing automation in health care organizations will benefit patient care, staffing and scheduling systems and central staffing offices, census control, and measurement of patient acuity.

  18. Integrated System Health Management: Pilot Operational Implementation in a Rocket Engine Test Stand

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John L.; Morris, Jonathan A.; Turowski, Mark P.; Franzl, Richard

    2010-01-01

    This paper describes a credible implementation of integrated system health management (ISHM) capability, as a pilot operational system. Important core elements that make possible fielding and evolution of ISHM capability have been validated in a rocket engine test stand, encompassing all phases of operation: stand-by, pre-test, test, and post-test. The core elements include an architecture (hardware/software) for ISHM, gateways for streaming real-time data from the data acquisition system into the ISHM system, automated configuration management employing transducer electronic data sheets (TEDS?s) adhering to the IEEE 1451.4 Standard for Smart Sensors and Actuators, broadcasting and capture of sensor measurements and health information adhering to the IEEE 1451.1 Standard for Smart Sensors and Actuators, user interfaces for management of redlines/bluelines, and establishment of a health assessment database system (HADS) and browser for extensive post-test analysis. The ISHM system was installed in the Test Control Room, where test operators were exposed to the capability. All functionalities of the pilot implementation were validated during testing and in post-test data streaming through the ISHM system. The implementation enabled significant improvements in awareness about the status of the test stand, and events and their causes/consequences. The architecture and software elements embody a systems engineering, knowledge-based approach; in conjunction with object-oriented environments. These qualities are permitting systematic augmentation of the capability and scaling to encompass other subsystems.

  19. The need to include Health Impact Assessment at the International Monetary Fund.

    Science.gov (United States)

    Cave, Ben; Birley, Martin

    2010-01-01

    The lending and technical support provided by the International Monetary Fund affect the determinants of health and healthy equity. Most health determinants lie outside the control of the health sector, and thus non-health-sector policies have profound positive and negative effects on population health. Health Impact Assessment (HIA) is an instrument for identifying the effect of policies, plans, programs, and projects on population health and health equity. It is a feasible, cost-effective, and transparent process that has been adopted by several financial institutions, including members of the World Bank Group. Adopting HIA would assist the IMF in ensuring that the potential health consequences of its policies are identified and addressed.

  20. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    Science.gov (United States)

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

  1. FFTF operating experience with sodium natural circulation: slides included

    Energy Technology Data Exchange (ETDEWEB)

    Burke, T.M.; Additon, S.L.; Beaver, T.R.; Midgett, J.C.

    1981-01-01

    The Fast Flux Test Facility (FFTF) has been designed for passive, back-up, safety grade decay heat removal utilizing natural circulation of the sodium coolant. This paper discusses the process by which operator preparation for this emergency operating mode has been assured, in paralled with the design verification during the FFTF startup and acceptance testing program. Over the course of the test program, additional insights were gained through the testing program, through on-going plant analyses and through general safety evaluations performed throughout the nuclear industry. These insights led to development of improved operator training material for control of decay heat removal during both forced and natural circulation as well as improvements in the related plant operating procedures.

  2. FFTF operating experience with sodium natural circulation: slides included

    International Nuclear Information System (INIS)

    Burke, T.M.; Additon, S.L.; Beaver, T.R.; Midgett, J.C.

    1981-01-01

    The Fast Flux Test Facility (FFTF) has been designed for passive, back-up, safety grade decay heat removal utilizing natural circulation of the sodium coolant. This paper discusses the process by which operator preparation for this emergency operating mode has been assured, in paralled with the design verification during the FFTF startup and acceptance testing program. Over the course of the test program, additional insights were gained through the testing program, through on-going plant analyses and through general safety evaluations performed throughout the nuclear industry. These insights led to development of improved operator training material for control of decay heat removal during both forced and natural circulation as well as improvements in the related plant operating procedures

  3. Self-assessment and woman’s health control location after gynaecological operations

    Directory of Open Access Journals (Sweden)

    Angelina Rogala

    2016-07-01

    Full Text Available Introduction: Surgical treatment in gynaecology has a specific influence on a woman’s life and has a psychological effect because of the organs involved. Self-assessment and women’s health control location after gynaecological operation determine the treatment and rehabilitation process. Aim of the research : Self-assessment and women’s health control location after gynaecological operation evaluation was the aim of this study. Material and methods : There were 167 women after gynaecological treatment evaluated. Patients were registered in the Obstetrics and Gynaecology department and the Gynaecology outpatient Clinic in Chełm Public Specialist Hospital. MHCL version B scale with polish adaptation (Z. Juszyński and sociodemographic, self-evaluation, and health control questionnaires created by the authors were used. This analysis used Kołmogorow-Smirnow, U Mann-Whitney and Kruskal-Wallis tests. Confidence intervals of p < 0.05 and p < 0.01 were established. IBM SPSS Statistics software was used. Results and conclusions : Most of the women after their gynaecological operations (61.1% revealed their health perception as good and only one (0.6% as poor. Over half of the patients self-assessed themselves as a valuable person (56.3% and womanlike (55.1%, whilst a small number of patients stated as not attractive, impoverished, worse than others, useless, or worthless. The highest self-assessment scores were from women in early stages after their operation, e.g. from one month to one year after treatment (M = 14.95. MHLC scale analysis showed that most of the patients overbalanced internal health self-control (M = 25.33, indicating that life control is dependent on the patient. Respondents who stated their health status as poor in every health control scale had higher results. Age and education had a significant influence on the MHCL and self-assessment scales (p < 0.001.

  4. Improving perioperative performance: the use of operations management and the electronic health record.

    Science.gov (United States)

    Foglia, Robert P; Alder, Adam C; Ruiz, Gardito

    2013-01-01

    Perioperative services require the orchestration of multiple staff, space and equipment. Our aim was to identify whether the implementation of operations management and an electronic health record (EHR) improved perioperative performance. We compared 2006, pre operations management and EHR implementation, to 2010, post implementation. Operations management consisted of: communication to staff of perioperative vision and metrics, obtaining credible data and analysis, and the implementation of performance improvement processes. The EHR allows: identification of delays and the accountable service or person, collection and collation of data for analysis in multiple venues, including operational, financial, and quality. Metrics assessed included: operative cases, first case on time starts; reason for delay, and operating revenue. In 2006, 19,148 operations were performed (13,545 in the Main Operating Room (OR) area, and 5603, at satellite locations); first case on time starts were 12%; reasons for first case delay were not identifiable; and operating revenue was $115.8M overall, with $78.1M in the Main OR area. In 2010, cases increased to 25,856 (+35%); Main OR area increased to 13,986 (+3%); first case on time starts improved to 46%; operations outside the Main OR area increased to 11,870 (112%); case delays were ascribed to nurses 7%, anesthesiologists 22%, surgeons 33%, and other (patient, hospital) 38%. Five surgeons (7%) accounted for 29% of surgical delays and 4 anesthesiologists (8%) for 45% of anesthesiology delays; operating revenue increased to $177.3M (+53%) overall, and in the Main OR area rose to $101.5M (+30%). The use of operations management and EHR resulted in improved processes, credible data, promptly sharing the metrics, and pinpointing individual provider performance. Implementation of these strategies allowed us to shift cases between facilities, reallocate OR blocks, increase first case on time starts four fold and operative cases by 35%, and

  5. Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project.

    Science.gov (United States)

    Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha

    2018-01-01

    Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be

  6. Including customers in health service design.

    Science.gov (United States)

    Perrott, Bruce E

    2013-01-01

    This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

  7. Regional Disparities in Romania. Contribution of the Regional Operational Program to Health Infrastructure

    Directory of Open Access Journals (Sweden)

    VICTOR PLATON

    2013-01-01

    Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.

  8. Universal health coverage in ‘One ASEAN’: are migrants included?

    Science.gov (United States)

    Guinto, Ramon Lorenzo Luis R.; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S.

    2015-01-01

    Background As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC

  9. Universal health coverage in ‘One ASEAN’: are migrants included?

    Directory of Open Access Journals (Sweden)

    Ramon Lorenzo Luis R. Guinto

    2015-01-01

    Full Text Available Background: As the Association of South East Asian Nations (ASEAN gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design: A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results: In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as

  10. Why do health and social care providers co-operate?

    Science.gov (United States)

    van Raak, Arno; Paulus, Aggie; Mur-Veeman, Ingrid

    2005-09-28

    Within Europe, although there are numerous examples of poor co-ordination in the delivery of integrated care, many providers do co-operate. We wanted to know why providers are moved to co-operate. In terms of systematic research, this is a new field; researchers have only begun to theorise about the rationales for co-operation. Practically, the issue of achieving co-operation attracts much attention from policymakers. Understanding the reasons for co-operation is a prerequisite for developing effective policy in support of integrated care. Our aim is to explore the comparative validity of different theoretical perspectives on the reasons for co-operation, to indicate directions for further study and for policy making. We used data from three successive studies to perform pattern matching with six established theoretical perspectives: transaction costs economics, strategic choice theory, resource dependence theory, learning theory, stakeholder theory and institutional theory. Insights from the studies were compared for validating purposes (triangulation). The first study concerned the evaluation of the Dutch 'National Home Health Care Programme' according to the case study methodology. The second and third studies were surveys among project directors: questionnaires were based on the concepts derived from the first study. Researchers should combine normative institutional theory, resource dependence theory and stakeholder theory into one perspective, in order to study relationship formation in health and social care. The concept of institutions (rules) is the linchpin between the theories. Policy makers must map the institutions of stakeholders and enable integrated care policy to correspond with these institutions as much as possible.

  11. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

    Science.gov (United States)

    Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

    2018-05-10

    Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

  12. Operational health physics at the Los Alamos meson physics proton accelerator

    International Nuclear Information System (INIS)

    Engelke, M.J.

    1975-01-01

    The operational health physics practices and procedures at the Clinton P. Anderson Los Alamos Meson Physics Facility (LAMPF), a medium energy, high intensity proton accelerator are reviewed. The operational philosophy used for the control of personnel exposures and radioactive materials is discussed. A particular operation involving the removal of a radioactive beam stop reading in excess of 1000 R/h is described

  13. The value of including spirometry in health checks - a randomized controlled study in primary health care

    DEFF Research Database (Denmark)

    Ørts, Lene Maria; Ottesen, Anders Løkke; Bjerregaard, Anne-Louise

    Background Lung diseases are among the most frequent and most serious ailments in Denmark. Preventive health checks including spirometry can be used to detect lung diseases earlier. Over time the attendance at preventive health checks has decreased and at present the response rate is approximately...... 50%. Little is known about initiatives that can influence the attendance rate. Objectives To examine whether focused information on spirometry in the invitation material will influence the attendance in preventive health checks. Materiel/Methods Design: A randomized controlled study on information...... on spirometry embedded in “Check your health Prevention Program, CHPP” from 2015-16. CHPP is a house-hold cluster randomized controlled trial offering a preventive health check to 30-49 year olds in a Danish municipality during the years 2012 through to 2017 (n= 26,216), carried out in collaboration between...

  14. Operating health analysis of electric power systems

    Science.gov (United States)

    Fotuhi-Firuzabad, Mahmud

    The required level of operating reserve to be maintained by an electric power system can be determined using both deterministic and probabilistic techniques. Despite the obvious disadvantages of deterministic approaches there is still considerable reluctance to apply probabilistic techniques due to the difficulty of interpreting a single numerical risk index and the lack of sufficient information provided by a single index. A practical way to overcome difficulties is to embed deterministic considerations in the probabilistic indices in order to monitor the system well-being. The system well-being can be designated as healthy, marginal and at risk. The concept of system well-being is examined and extended in this thesis to cover the overall area of operating reserve assessment. Operating reserve evaluation involves the two distinctly different aspects of unit commitment and the dispatch of the committed units. Unit commitment health analysis involves the determination of which unit should be committed to satisfy the operating criteria. The concepts developed for unit commitment health, margin and risk are extended in this thesis to evaluate the response well-being of a generating system. A procedure is presented to determine the optimum dispatch of the committed units to satisfy the response criteria. The impact on the response wellbeing being of variations in the margin time, required regulating margin and load forecast uncertainty are illustrated. The effects on the response well-being of rapid start units, interruptible loads and postponable outages are also illustrated. System well-being is, in general, greatly improved by interconnection with other power systems. The well-being concepts are extended to evaluate the spinning reserve requirements in interconnected systems. The interconnected system unit commitment problem is decomposed into two subproblems in which unit scheduling is performed in each isolated system followed by interconnected system evaluation

  15. Bechtel Hanford, Inc./ERC team health and safety plan Environmental Restoration Disposal Facility operations

    International Nuclear Information System (INIS)

    Turney, S.R.

    1996-02-01

    A comprehensive safety and health program is essential for reducing work-related injuries and illnesses while maintaining a safe and health work environment. This document establishes Bechtel Hanford, Inc. (BHI)/Environmental Restoration Contractor (ERC) team requirements, policies, and procedures and provides preliminary guidance to the Environmental Restoration Disposal Facility (ERDF) subcontractor for use in preparing essential safety and health documents. This health and safety plan (HASP) defines potential safety and health issues associated with operating and maintaining the ERDF. A site-specific HASP shall be developed by the ERDF subcontractor and shall be implemented before operations and maintenance work can proceed. An activity hazard analysis (AHA) shall also be developed to provide procedures to identify, assess, and control hazards or potential incidents associated with specific operations and maintenance activities

  16. International military operations and mental health--A review.

    Science.gov (United States)

    Kaikkonen, Noora M; Laukkala, Tanja

    2016-01-01

    Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. A systematic literature search was carried out using relevant search terms to identify the articles for this review. The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.

  17. 75 FR 49528 - Thomson Reuters Legal, Legal Editorial Operations Cleveland Office Including Workers Whose...

    Science.gov (United States)

    2010-08-13

    ... Philippines and India. The amended notice applicable to TA-W-73,370 is hereby issued as follows: ``All workers..., Legal Editorial Operations Cleveland Office Including Workers Whose Unemployment Insurance (UI) Wages... Certification Regarding Eligibility To Apply for Worker Adjustment Assistance In accordance with Section 223 of...

  18. Including a Client Sexual Health Pathway in a National Youth Mental Health Early Intervention Service--Project Rationale and Implementation Strategy

    Science.gov (United States)

    Edwards, C. A.; Britton, M. L.; Jenkins, L.; Rickwood, D. J.; Gillham, K. E.

    2014-01-01

    Young people have higher rates of sexually transmissible infections (STIs) than the general population. Research has shown that there is a clear link between emotional distress, depression, substance abuse and sexual risk taking behaviours in young people. "headspace" is a youth mental health early intervention service operating in more…

  19. Learning strategies of public health nursing students: conquering operational space.

    Science.gov (United States)

    Hjälmhult, Esther

    2009-11-01

    To develop understanding of how public health nursing students learn in clinical practice and explore the main concern for the students and how they acted to resolve this main concern. How professionals perform their work directly affects individuals, but knowledge is lacking in understanding how learning is connected to clinical practice in public health nursing and in other professions. Grounded theory. Grounded theory was used in gathering and analysing data from 55 interviews and 108 weekly reports. The participants were 21 registered nurses who were public health nursing students. The grounded theory of conquering operational space explains how the students work to resolve their main concern. A social process with three identified phases, positioning, involving and integrating, was generated from analysing the data. Their subcategories and dimensions are related to the student role, relations with a supervisor, student activity and the consequences of each phase. Public health nursing students had to work towards gaining independence, often working against 'the system' and managing the tension by taking a risk. Many of them lost, changed and expanded their professional identity during practical placements. Public health nursing students' learning processes in clinical training are complex and dynamic and the theory of 'Conquering operational space' can assist supervisors in further developing their role in relation to guiding students in practice. Relationships are one key to opening or closing access to situations of learning and directly affect the students' achievement of mastering. The findings are pertinent to supervisors and educators as they prepare students for practice. Good relationships are elementary and supervisors can support students in conquering the field by letting students obtain operational space and gain independence. This may create a dialectical process that drives learning forward.

  20. Behavioral Health and Performance Operations During the Space Shuttle Program

    Science.gov (United States)

    Beven, G.; Holland, A.; Moomaw, R.; Sipes, W.; Vander Ark, S.

    2011-01-01

    Prior to the Columbia STS 107 disaster in 2003, the Johnson Space Center s Behavioral Health and Performance Group (BHP) became involved in Space Shuttle Operations on an as needed basis, occasionally acting as a consultant and primarily addressing crew-crew personality conflicts. The BHP group also assisted with astronaut selection at every selection cycle beginning in 1991. Following STS 107, an event that spawned an increased need of behavioral health support to STS crew members and their dependents, BHP services to the Space Shuttle Program were enhanced beginning with the STS 114 Return to Flight mission in 2005. These services included the presence of BHP personnel at STS launches and landings for contingency support, a BHP briefing to the entire STS crew at L-11 months, a private preflight meeting with the STS Commander at L-9 months, and the presence of a BHP consultant at the L-1.5 month Family Support Office briefing to crew and family members. The later development of an annual behavioral health assessment of all active astronauts also augmented BHP s Space Shuttle Program specific services, allowing for private meetings with all STS crew members before and after each mission. The components of each facet of these BHP Space Shuttle Program support services will be presented, along with valuable lessons learned, and with recommendations for BHP involvement in future short duration space missions

  1. 75 FR 47632 - Thomson Reuters Legal, Legal Editorial Operations, Cleveland Office, Including Workers Whose...

    Science.gov (United States)

    2010-08-06

    ... Philippines and India. The amended notice applicable to TA-W-73,370 is hereby issued as follows: All workers..., Legal Editorial Operations, Cleveland Office, Including Workers Whose Unemployment Insurance (UI) Wages... To Apply for Worker Adjustment Assistance In accordance with Section 223 of the Trade Act of 1974, as...

  2. [The operational role of the occupational health physician in the assessment and management of health risks related to night risks].

    Science.gov (United States)

    Mucci, Nicola; Giorgi, Gabriele; Gonnelli, Irene Margherita; Garbarino, Sergio; Cupelli, Vincenzo; Arcangelil, Giulio

    2016-01-01

    The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers).

  3. Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors

    Science.gov (United States)

    Matthews, Derrick D.; Blosnich, John R.; Farmer, Grant W.; Adams, Brian J.

    2014-01-01

    Purpose Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. Methods Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. Results Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as “not sure” also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. Conclusion Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations. PMID:25110718

  4. Spine surgeon's kinematics during discectomy, part II: operating table height and visualization methods, including microscope.

    Science.gov (United States)

    Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2014-05-01

    Surgeon spine angle during surgery was studied ergonomically and the kinematics of the surgeon's spine was related with musculoskeletal fatigue and pain. Spine angles varied depending on operation table height and visualization method, and in a previous paper we showed that the use of a loupe and a table height at the midpoint between the umbilicus and the sternum are optimal for reducing musculoskeletal loading. However, no studies have previously included a microscope as a possible visualization method. The objective of this study is to assess differences in surgeon spine angles depending on operating table height and visualization method, including microscope. We enrolled 18 experienced spine surgeons for this study, who each performed a discectomy using a spine surgery simulator. Three different methods were used to visualize the surgical field (naked eye, loupe, microscope) and three different operating table heights (anterior superior iliac spine, umbilicus, the midpoint between the umbilicus and the sternum) were studied. Whole spine angles were compared for three different views during the discectomy simulation: midline, ipsilateral, and contralateral. A 16-camera optoelectronic motion analysis system was used, and 16 markers were placed from the head to the pelvis. Lumbar lordosis, thoracic kyphosis, cervical lordosis, and occipital angle were compared between the different operating table heights and visualization methods as well as a natural standing position. Whole spine angles differed significantly depending on visualization method. All parameters were closer to natural standing values when discectomy was performed with a microscope, and there were no differences between the naked eye and the loupe. Whole spine angles were also found to differ from the natural standing position depending on operating table height, and became closer to natural standing position values as the operating table height increased, independent of the visualization method

  5. Conducting Accessible Research: Including People With Disabilities in Public Health, Epidemiological, and Outcomes Studies.

    Science.gov (United States)

    Rios, Dianne; Magasi, Susan; Novak, Catherine; Harniss, Mark

    2016-12-01

    People with disabilities are largely absent from mainstream health research. Exclusion of people with disabilities may be explicit, attributable to poorly justified exclusion criteria, or implicit, attributable to inaccessible study documents, interventions, or research measures. Meanwhile, people with disabilities experience poorer health, greater incidence of chronic conditions, and higher health care expenditure than people without disabilities. We outline our approach to "accessible research design"-research accessible to and inclusive of people with disabilities. We describe a model that includes 3 tiers: universal design, accommodations, and modifications. Through our work on several large-scale research studies, we provide pragmatic examples of accessible research design. Making efforts to include people with disabilities in public health, epidemiological, and outcomes studies will enhance the interpretability of findings for a significant patient population.

  6. Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

    Science.gov (United States)

    Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

    2017-10-01

    This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

  7. 78 FR 42805 - HarperCollins Publishers Distribution Operations Including On-Site Leased Workers From Action...

    Science.gov (United States)

    2013-07-17

    ... Distribution Operations Including On- Site Leased Workers From Action Personnel, CGA Staffing Services, Dynamic... from Action Personnel, CGA Staffing Services, Dynamic Staffing, Kelly Services, and Manpower, Scranton... (Volume 78 FR Pages 28628-28630). At the request of the State Workforce Office, the Department reviewed...

  8. Long-term impacts of unconventional drilling operations on human and animal health.

    Science.gov (United States)

    Bamberger, Michelle; Oswald, Robert E

    2015-01-01

    Public health concerns related to the expansion of unconventional oil and gas drilling have sparked intense debate. In 2012, we published case reports of animals and humans affected by nearby drilling operations. Because of the potential for long-term effects of even low doses of environmental toxicants and the cumulative impact of exposures of multiple chemicals by multiple routes of exposure, a longitudinal study of these cases is necessary. Twenty-one cases from five states were followed longitudinally; the follow-up period averaged 25 months. In addition to humans, cases involved food animals, companion animals and wildlife. More than half of all exposures were related to drilling and hydraulic fracturing operations; these decreased slightly over time. More than a third of all exposures were associated with wastewater, processing and production operations; these exposures increased slightly over time. Health impacts decreased for families and animals moving from intensively drilled areas or remaining in areas where drilling activity decreased. In cases of families remaining in the same area and for which drilling activity either remained the same or increased, no change in health impacts was observed. Over the course of the study, the distribution of symptoms was unchanged for humans and companion animals, but in food animals, reproductive problems decreased and both respiratory and growth problems increased. This longitudinal case study illustrates the importance of obtaining detailed epidemiological data on the long-term health effects of multiple chemical exposures and multiple routes of exposure that are characteristic of the environmental impacts of unconventional drilling operations.

  9. Fort Calhoun Station, Unit 1. Annual operation report: January-December 1977 (including environmental report)

    International Nuclear Information System (INIS)

    1978-02-01

    Net electrical energy generated in 1977 was 2,922,683.7 MWH with the generator on line 6,959.8 hours. Information is presented concerning operations, power generation, shutdowns, maintenance, changes, tests, experiments, occupational personnel radiation exposures, and primary coolant chemistry. Data on radioactive effluent releases, meteorology, environmental monitoring, and potential radiation doses to individuals for July 7, 1977 to December 31, 1977 are also included

  10. 78 FR 8587 - Thomson Reuters, Finance Operations & Technology Division, Including On-Site Leased Workers From...

    Science.gov (United States)

    2013-02-06

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,755] Thomson Reuters, Finance Operations & Technology Division, Including On-Site Leased Workers From Adecco; Eagan, MN; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance In accordance with Section 223 of the Trade Act of 1974, as amended (`...

  11. [Experience with games in operative groups as part of health education for diabetics].

    Science.gov (United States)

    Torres, Heloisa de Carvalho; Hortale, Virginia Alonso; Schall, Virginia

    2003-01-01

    This paper presents and discusses an educational strategy implemented in a specialized hospital clinic. The goal was to stimulate individuals to reflect on their everyday lifestyles as related to their disease, specifically diabetes mellitus. The strategy can be characterized as an educational tool from the perspective of health promotion and disease prevention and control. The experience was implemented on an interactive basis (health professionals and individual patients) with educational games in operative groups. Pedagogical techniques were used: orientation concerning diabetes mellitus, individual consultation, the operative group, and educational games (communications and learning). The techniques enabled participants to improve knowledge and exchange experiences. In addition, the health professionals gained a better understanding of the participants' experience with their illness.

  12. Vibration analysis of the sulky accessory for a commercial walk-behind lawn mower to determine operator comfort and health.

    Science.gov (United States)

    Thrailkill, Elizabeth A; Lowndes, Bethany R; Hallbeck, M Susan

    2013-01-01

    A sulky is a single-wheeled platform attachment on which the operator of a commercial walk-behind lawn mower rides while standing. The effects of sulky vibration on operator comfort and health have not been investigated. In this study, tri-axial accelerometers measured sulky vibration during mower use by two commercial mowers on varied terrain and 12 volunteer mowers over a controlled course. The accelerometer data were processed according to methods established in ISO 2631. Results indicate the mean frequency-weighted root mean square (RMS) acceleration sums fall into the 'very uncomfortable' range for vibration of standing persons (1.9 ± 0.48 m s⁻²). Additionally, vibration dose values indicated that the mean vibration dosages exceeded the daily exposure limit values established in Directive 2002 /44/EC (z-axis A(8) value of 1.30 ± 34 m s⁻²; VDV(exp) value of 28.1 ± 6.25 m s⁻¹·⁷⁵). This information suggests that modifications including vibration damping should be added to the sulky to reduce rider discomfort and health risks. This study investigated the effects of vibration during use of a commercial lawn mowing sulky. Findings from accelerometer data suggest that the vibration experienced by sulky operators is significant enough to cause discomfort and health risks which may lead to personnel turnover or long-term effects for the operator.

  13. [Protection of working mothers: operational guide document. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) ].

    Science.gov (United States)

    Alessandroni, Morena; Balzani, Barbara; Cancellieri, Francesca; Colao, Annamaria; Comai, M; Elezi, Lindita; Mengucci, Rosella; Montesi, Simona; Olivi, Cinzia; Perticaroli, Patrizia; Pettinari, A; Ruschioni, Angela

    2013-01-01

    Protection of working mothers: operational guide document. The aim of this operational guide document is to protect the health of working mothers and their babies during pregnancy, puerperium and breastfeeding. The project was developed by a technical working group which included professionals in the pertinent fields from the Workplace Prevention and Safety Services of the local Vasta-2 Area of the Marche Regional Health Service:physicians, health assistants, and nurses. It is considered to be a useful tool for risk assessment at the workplace aimed at professionals who are involved, with various duties and responsibilities, in the health care of the working mother. This paper consists of two functionally related sections, "Table of risks" and "Technical specifications". In the "Table of Risks" section, the occupational hazards for women during pregnancy or postpartum were analyzed with the highest possible degree of care. To this end the technical group provided, for each occupational hazard, its own operational suggestions, in relation to legislation, current scientific knowledge and Guidelines of other Italian Regions. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) participated in the final draft of the entire document. The second section, "Technical Specifications", illustrates the main tasks and any risks involved in the 34 manufacturing sectors most prevalent in this area. This operational guide document is intended to be the beginning of a common strategy in public health to achieve a wider field of action in promotion and information aimed at protecting the reproductive health of working mothers.

  14. [Intersectoral experience to bridge the gap between human resources in public health and the technical-operational level for Peruvian Voluntary Military Service members].

    Science.gov (United States)

    Romaní-Romaní, Franco; Curisinche-Rojas, Maricela; Arteaga, Norka Rojas; Lopez, Pedro Riega; Cabezas, César

    2016-01-01

    There is a gap between human resources and technical-operational education that limits the Peruvian health system's ability to implement public health interventions. The Peruvian Ministry of Health, through the National Health Institute and the Ministry of Defense, implemented a Public Health Training Program addressed to young full-time military servicemen, on the basis of the competency profile of a public health technician. The program consists of seven thematic units given in 390 hours, 200 of which correspond to classroom and field practices. Between July 2014 and December 2015, the program has been carried out in 10 venues of the three armed forces, training and certifying 405 young servicemen. The intervention provides the military service with an additional educational benefit, making it more appealing as a chance for development and opens up a line of work in the public health sector for young people in more remote areas. This experience seeks to increase public health-trained human resources to a technical-operational level. In collaboration with regional governments, graduates are expected to be welcomed and included in the public health system.

  15. Space Toxicology: Environmental Health Considerations during Spaceflight Operations and Potential Paths for Research

    Science.gov (United States)

    Khan-Mayberry, Noreen N.; Sundaresan, Alemalu

    2009-01-01

    Space Toxicology is a specialized discipline for spaceflight, space habitation and occupation of celestial bodies including planets, moons and asteroids [1]. Astronaut explorers face unique challenges to their health while working and living with limited resources for rescue and medical care during space operation. At its core the practice of space toxicology to identify, assess and predict potential chemical contaminants and limit the astronaut s exposure to these environmental factors in order to protect crew health. Space toxicologists are also charged with setting safe exposure limits that will protect the astronaut against a multitude of chemical exposures, in a physiologically altered state. In order to maintain sustained occupation in space, toxicological risks are gauged and managed within the context of isolation, continual exposures, reuse of air and water, limited rescue options, and the necessary use of highly toxic compounds required for propulsion. As the space program move towards human presence and exploration other celestial bodies in situ toxicological risks, such as inhalation of unusual and/or reactive mineral dusts must also be analyzed and controlled. Placing humans for long-term presence in space creates several problems and challenges to the long-term health of the crew, such as bone-loss and immunological challenges and has spurred research into acute, chronic and episodic exposure of the pulmonary system to mineral dusts [2]. NASA has demonstrated that lunar soil contains several types of reactive dusts, including an extremely fine respirable component. In order to protect astronaut health, NASA is now investigating the toxicity of this unique class of dusts. Understanding how these reactive components behave "biochemically" in a moisture-rich pulmonary environment will aid in determining how toxic these particles are to humans. The data obtained from toxicological examination of lunar dusts will determine the human risk criteria for lunar

  16. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  17. Operation Iraqi Freedom 06-08

    Science.gov (United States)

    2008-02-14

    Managemen 15.6.6 Results Related t 15.6.7 NCOs and Multiple-Deployments 15.6.8 Validated Trainin 15.6.9 Theater Suicide Prevention Program and Suicide...include mental health providers who have deployed to the IT0 and are experienced using AHLTA- T . As noted above, as the operational theater matures in...Mental Health Advisory Team (MHAT) V Operation Iraqi Freedom 06-08 14 February 2008 Office of the Surgeon Multi-National Force-Iraq and Office

  18. Containment of Ebola and Polio in Low-Resource Settings Using Principles and Practices of Emergency Operations Centers in Public Health.

    Science.gov (United States)

    Shuaib, Faisal M; Musa, Philip F; Muhammad, Ado; Musa, Emmanuel; Nyanti, Sara; Mkanda, Pascal; Mahoney, Frank; Corkum, Melissa; Durojaiye, Modupeoluwa; Nganda, Gatei Wa; Sani, Samuel Usman; Dieng, Boubacar; Banda, Richard; Ali Pate, Muhammad

    Emergency Operations Centers (EOCs) have been credited with driving the recent successes achieved in the Nigeria polio eradication program. EOC concept was also applied to the Ebola virus disease outbreak and is applicable to a range of other public health emergencies. This article outlines the structure and functionality of a typical EOC in addressing public health emergencies in low-resource settings. It ascribes the successful polio and Ebola responses in Nigeria to several factors including political commitment, population willingness to engage, accountability, and operational and strategic changes made by the effective use of an EOC and Incident Management System. In countries such as Nigeria where the central or federal government does not directly hold states accountable, the EOC provides a means to improve performance and use data to hold health workers accountable by using innovative technologies such as geographic position systems, dashboards, and scorecards.

  19. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

    International Nuclear Information System (INIS)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

  20. Health physics operations in hospitals

    International Nuclear Information System (INIS)

    Anderson, W.; Trott, N.G.

    1984-01-01

    The special problems of applying the basic principles of radiological protection in the environment of a hospital are outlined, the hospital being not only a workplace but also the temporary home of the patients. In these circumstances, close co-operation is needed between all groups of hospital staff. Many technical innovations have been made over the past 50 years in the applications of both ionizing and non-ionizing radiation for diagnosis and therapy and, at the present time, an intensive development of these applications is in progress. Within that context, the role of health physics has become a major one. There is the need to provide high standards in radiological protection of the staff, of members of the public, and increasingly, of the patient. At the same time, there is the need to provide sound perspective on hazards arising from exposure to various forms of radiation, whether ionizing or non-ionizing, for that perspective will influence future developments in this field. (author)

  1. Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Pallab K. Maulik

    2018-04-01

    Full Text Available Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that

  2. Lay Worker Health Literacy: A Concept Analysis and Operational Definition.

    Science.gov (United States)

    Cadman, Kathleen Paco

    2017-10-01

    The concept of lay worker health literacy is created by concurrently analyzing and synthesizing two intersecting concepts, lay workers and health literacy. Articulation of this unique intersection is the result of implementing a simplified Wilson's Concept Analysis Procedure. This process incorporates the following components: a) selecting a concept, b) determining the aims/purposes of analysis, c) identifying all uses of the concept, d) determining defining attributes, e) identifying a model case, f) identifying borderline, related, contrary, and illegitimate cases, g) identifying antecedents and consequences, and h) defining empirical referents. Furthermore, as current literature provides no operational definition for lay worker health literacy, one is created to contribute cohesion to the concept. © 2017 Wiley Periodicals, Inc.

  3. A practical algorithm for optimal operation management of distribution network including fuel cell power plants

    Energy Technology Data Exchange (ETDEWEB)

    Niknam, Taher; Meymand, Hamed Zeinoddini; Nayeripour, Majid [Electrical and Electronic Engineering Department, Shiraz University of Technology, Shiraz (Iran)

    2010-08-15

    Fuel cell power plants (FCPPs) have been taken into a great deal of consideration in recent years. The continuing growth of the power demand together with environmental constraints is increasing interest to use FCPPs in power system. Since FCPPs are usually connected to distribution network, the effect of FCPPs on distribution network is more than other sections of power system. One of the most important issues in distribution networks is optimal operation management (OOM) which can be affected by FCPPs. This paper proposes a new approach for optimal operation management of distribution networks including FCCPs. In the article, we consider the total electrical energy losses, the total electrical energy cost and the total emission as the objective functions which should be minimized. Whereas the optimal operation in distribution networks has a nonlinear mixed integer optimization problem, the optimal solution could be obtained through an evolutionary method. We use a new evolutionary algorithm based on Fuzzy Adaptive Particle Swarm Optimization (FAPSO) to solve the optimal operation problem and compare this method with Genetic Algorithm (GA), Particle Swarm Optimization (PSO), Differential Evolution (DE), Ant Colony Optimization (ACO) and Tabu Search (TS) over two distribution test feeders. (author)

  4. Interactions between the Design and Operation of Shale Gas Networks, Including CO2 Sequestration

    Directory of Open Access Journals (Sweden)

    Sharifzadeh Mahdi

    2017-04-01

    Full Text Available As the demand for energy continues to increase, shale gas, as an unconventional source of methane (CH4, shows great potential for commercialization. However, due to the ultra-low permeability of shale gas reservoirs, special procedures such as horizontal drilling, hydraulic fracturing, periodic well shut-in, and carbon dioxide (CO2 injection may be required in order to boost gas production, maximize economic benefits, and ensure safe and environmentally sound operation. Although intensive research is devoted to this emerging technology, many researchers have studied shale gas design and operational decisions only in isolation. In fact, these decisions are highly interactive and should be considered simultaneously. Therefore, the research question addressed in this study includes interactions between design and operational decisions. In this paper, we first establish a full-physics model for a shale gas reservoir. Next, we conduct a sensitivity analysis of important design and operational decisions such as well length, well arrangement, number of fractures, fracture distance, CO2 injection rate, and shut-in scheduling in order to gain in-depth insights into the complex behavior of shale gas networks. The results suggest that the case with the highest shale gas production may not necessarily be the most profitable design; and that drilling, fracturing, and CO2 injection have great impacts on the economic viability of this technology. In particular, due to the high costs, enhanced gas recovery (EGR using CO2 does not appear to be commercially competitive, unless tax abatements or subsidies are available for CO2 sequestration. It was also found that the interactions between design and operational decisions are significant and that these decisions should be optimized simultaneously.

  5. Occupational Therapy embraces the National #Littlethings mental health and wellbeing campaign in Offaly via an Operation Transformation Programme

    Directory of Open Access Journals (Sweden)

    Deirdre Deegan

    2017-10-01

    Full Text Available Purpose - In early 2015, an Occupational Therapy led Operation Transformation healthy eating and exercise programme produced results suggestive of the value and need to promote and integrate physical activity interventions into mental health services. Design/methodology/approach - In all, 41 clients with various mental illness diagnoses participated in the eight-week Operation Transformation programme. The outcome measures involved weekly weigh-ins and an end of programme evaluation form. Findings - The quantifiable benefits – a total weight loss of nine stone ten and a half pounds – were mirrored in equally impressive qualitative impacts. Participants’ feedback via anonymous evaluation forms, echoed the findings of the articles appraised in the literature, including improvements in mood and energy levels, better sleep and increased motivation. Practical implications - The organisers will benefit from lessons learned in this first experience, including overcoming logistical and organisational difficulties experienced in enabling clients’ full participation. Originality/value - The evidence base points to the successful benefits of physical activity in promoting positive mental health. Occupational Therapists have a unique opportunity to drive forward the message of promoting physical activity via meaningful occupations.

  6. 29 CFR 780.110 - Operations included in “cultivation and tillage of the soil.”

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Operations included in âcultivation and tillage of the soil.â 780.110 Section 780.110 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS EXEMPTIONS APPLICABLE TO AGRICULTURE, PROCESSIN...

  7. Occupational health and safety policy in the operations of the wood ...

    African Journals Online (AJOL)

    Occupational health and safety policy in the operations of the wood ... 14 randomly selected WPIs located at Ahensan, Asokwa and Kaasi industrial area in Kumasi. ... accidents as a result of inadequate engineering and administrative controls, ...

  8. How do strategic decisions and operative practices affect operating room productivity?

    Science.gov (United States)

    Peltokorpi, Antti

    2011-12-01

    Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

  9. Coal Mine Health and Safety Regulation 2006 under the Coal Mine Health and Safety Act 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-12-22

    The aim of the Act is to secure the health, safety and welfare of people in connection with coal operations (which include all places of work where coal is mined and certain other places). The Regulation contains provisions about the following matters: (a) places of work to which the Act does not apply, (b) duties relating to health, welfare and safety at coal operations, including the following: (i) the nomination of the operator of a coal operation and the provision of health and safety information for incoming operators, (ii) the contents of health and safety management systems for coal operations, (iii) major hazards and the contents of major hazard management plans for coal operations, (iv) duties relating to contractors, (v) the contents of management structures and emergency management systems for coal operations, escape and rescue plans and fire fighting plans and high risk activities, (c) notifications, including (i) notification of incidents, (ii) inquiries, (iii) notification of other matters to the Chief Inspector), (d) aspects of safety at coal operations, including the following: (i) controlled materials, plants and practices, (ii) coal dust explosion prevention and suppression, (iii) ventilation at coal operations, (iv) escape from coal operations, (v) the operation of transport at coal operations, (vi) surveys and certified plans, (vii) employment at coal operations, (e) the licensing of certain activities, (f) competence standards, (g) the Coal Competence Board, (h) check inspectors, (i) exemptions from provisions of this Regulation, (j) the following miscellaneous matters concerning coal mine health and safety: (i) the keeping of records and reporting, (ii) penalties, the review of decisions by the Administrative Decisions Tribunal, fees and charges, consultation, information and other miscellaneous matters, (k) savings and transitional provisions.

  10. First-Case Operating Room Delays: Patterns Across Urban Hospitals of a Single Health Care System

    Directory of Open Access Journals (Sweden)

    Callie M. Cox Bauer

    2016-08-01

    Full Text Available Purpose: Operating room delays decrease health care system efficiency and increase costs. To improve operating room efficiency in our system, we retrospectively investigated delay frequencies, causes and costs. Methods: We studied all first-of-the-day nonemergent surgical cases performed at three high-volume urban hospitals of a large health system from July 2012 to November 2013. Times for patient flow from arrival to procedure start and documented reasons for delay were obtained from electronic medical records. Delay was defined as patient placement in the operating room later than scheduled surgery time. Effects of patient characteristics, late patient arrival to the hospital, number of planned procedures, years of surgeon experience, service department and hospital facility on odds of delay were examined using logistic regression. Results: Of 5,598 cases examined, 88% were delayed. Patients arrived late to the hospital (surgery in 65% of first cases. Mean time from arrival to scheduled surgery and in-room placement was 104.6 and 127.4 minutes, respectively. Mean delay time was 28.2 minutes. Nearly 60% of delayed cases had no documented reason for delay. For cases with documentation, causes included the physician (52%, anesthesia (15%, patient (13%, staff (9%, other sources (6% and facility (5%. Regression analysis revealed age, late arrival, department and facility as significant predictors of delay. Estimated delay costs, based on published figures and representing lost revenue, were $519,388. Conclusions: To improve operating room efficiency, multidisciplinary strategies are needed for increasing patient adherence to recommended arrival times, documentation of delay by medical staff and consistency in workflow patterns among facilities and departments.

  11. Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

    OpenAIRE

    Waller, Michael; Treloar, Susan A; Sim, Malcolm R; McFarlane, Alexander C; McGuire, Annabel C L; Bleier, Jonathan; Dobson, Annette J

    2012-01-01

    Abstract Background The association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments. Methods Two cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704) and those reported by a group deployed on operations which included warl...

  12. 40 CFR 142.307 - What terms and conditions must be included in a small system variance?

    Science.gov (United States)

    2010-07-01

    ... that may affect proper and effective operation and maintenance of the technology; (2) Monitoring... effective installation, operation and maintenance of the applicable small system variance technology in... health, which may include: (i) Public education requirements; and (ii) Source water protection...

  13. Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj.

    Science.gov (United States)

    Alotaibi, Badriah M; Yezli, Saber; Bin Saeed, Abdul-Aziz A; Turkestani, Abdulhafeez; Alawam, Amnah H; Bieh, Kingsley L

    2017-05-01

    Hajj is one of the largest and the most ethnically and culturally diverse mass gatherings worldwide. The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. The literature describes infectious diseases prevention and control strategies for Hajj but with limited information on the operations and characteristics of the existing Hajj infectious diseases surveillance systems. We reviewed documents, including guidelines and reports from the Saudi Ministry of Health's database, to describe the characteristics of the infectious diseases surveillance systems that were operational during the 2015 Hajj, highlighting best practices and gaps and proposing strategies for strengthening and improvement. Using Pubmed and Embase online search engines and a combination of search terms including, 'mass gatherings' 'Olympics' 'surveillance' 'Hajj' 'health security', we explored the existing literature and highlighted some lessons learnt from other international mass gatherings. A regular indicator-based infectious disease surveillance system generates routine reports from health facilities within the Kingdom to the regional and central public health directorates all year round. During Hajj, enhanced indicator-based notifiable diseases surveillance systems complement the existing surveillance tool to ensure timely reporting of event information for appropriate action by public health officials. There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security. © International Society of Travel Medicine, 2017. Published by Oxford University

  14. Operational integration in primary health care: patient encounters and workflows.

    Science.gov (United States)

    Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Markaki, Adelais; Kritikos, Kyriakos; Petelos, Elena; Lionis, Christos

    2017-11-29

    Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review. Overall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows. Existing patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web

  15. Operational Stress Control and Readiness (OSCAR): The United States Marine Corps Initiative to Deliver Mental Health Services to Operating Forces

    National Research Council Canada - National Science Library

    Nash, William P

    2006-01-01

    .... The role of military mental health professionals in combat/operational stress control is to adapt scientific tools for prevention, identification, and treatment for use by military leaders at all levels...

  16. Operational Programme Health 2007-2013

    International Nuclear Information System (INIS)

    Anon

    2007-08-01

    The Operational Programme Health (OPH) is a programming document of the Slovak Republic (SR) for drawing assistance from funds of the European Union (EU) for the healthcare sector for the 2007 - 2013 period. It contains the strategy, aims and also defines years-long measures to attain them, which are to be carried out with the help of national funds and of the European Regional Development Fund (ERDF). On the basis of Government Resolution of the SR No. 832/2006 of 8 October 2006, the Managing Authority for the OPH is the Ministry of Health of the Slovak Republic. The OPH has been elaborated on the basis of Council Regulation (EC) No 1083/2006 laying down general provisions on the European Regional Development Fund (ERDF), the European Social Fund (ESF) and the Cohesion Fund (CF) and repealing Regulation (EC) No 1260/1999, and of Regulation (EC) No 1080/2006 of the European Parliament and of the Council on the ERDF and repealing Regulation (EC) No 1783/1999. Under the 'Convergence' objective, supported can be on the level NUTS II, i. e. their 2000 - 2002 gross domestic product (hereinafter referred to as 'GDP') per capita measured by purchasing power parity is less than 75% of the Community average. All regions of NUTS II of the Slovak Republic (Western, Central and Eastern Slovakia) except for the Bratislava region fulfil this condition. The West Slovak region consists of the following self-governing regions (NUTS III): Trnava region (TT), Trencin region (TN), Nitra region (NR); The Central Slovak Region consists of the following self-governing regions (NUTS III): Banska Bystrica region and Zilina region; The East Slovak Region consists of the following self-governing regions (NUTS III): Presov region and Kosice region. The OPH strategy creates conditions for the convergence of the SR towards the EU level in the area of healthcare. Concurrently, it helps considerably to keep the overall SR economy convergence to the EU-15 average in line with sustainable

  17. 30 CFR 785.19 - Surface coal mining and reclamation operations on areas or adjacent to areas including alluvial...

    Science.gov (United States)

    2010-07-01

    ... alluvial valley floor exists if it finds that— (i) Unconsolidated streamlaid deposits holding streams are... on areas or adjacent to areas including alluvial valley floors in the arid and semiarid areas west of....19 Surface coal mining and reclamation operations on areas or adjacent to areas including alluvial...

  18. Demand and supply-based operating modes--a framework for analyzing health care service production.

    Science.gov (United States)

    Lillrank, Paul; Groop, P Johan; Malmström, Tomi J

    2010-12-01

    The structure of organizations that provide services should reflect the possibilities of and constraints on production that arise from the market segments they serve. Organizational segmentation in health care is based on urgency and severity as well as disease type, bodily function, principal method, or population subgroup. The result is conflicting priorities, goals, and performance metrics. A managerial perspective is needed to identify activities with similar requirements for integration, coordination, and control. The arguments in this article apply new reasoning to the previous literature. The method used in this article to classify health care provision distinguishes different types of health problems that share generic constraints of production. The analysis leads to seven different demand-supply combinations, each with its own operational logic. These are labeled demand and supply-based operating modes (DSO modes), and constitute the managerial building blocks of health care organizations. The modes are Prevention, Emergency, One visit, Project, Elective, Cure, and Care. As analytical categories the DSO modes can be used to understand current problems. Several operating modes in one unit create managerial problems of conflicting priorities, goals, and performance metrics. The DSO modes are constructed as managerially homogeneous categories or care platforms responding to general types of demand, and supply constraints. The DSO modes bring methods of industrial management to bear on efforts to improve health care. © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

  19. Condition Monitoring for Roller Bearings of Wind Turbines Based on Health Evaluation under Variable Operating States

    Directory of Open Access Journals (Sweden)

    Lei Fu

    2017-10-01

    Full Text Available Condition monitoring (CM is used to assess the health status of wind turbines (WT by detecting turbine failure and predicting maintenance needs. However, fluctuating operating conditions cause variations in monitored features, therefore increasing the difficulty of CM, for example, the frequency-domain analysis may lead to an inaccurate or even incorrect prediction when evaluating the health of the WT components. In light of this challenge, this paper proposed a method for the health evaluation of WT components based on vibration signals. The proposed approach aimed to reduce the evaluation error caused by the impact of the variable operating condition. First, the vibration signal was decomposed into a set of sub-signals using variational mode decomposition (VMD. Next, the sub-signal energy and the probability distribution were obtained and normalized. Finally, the concept of entropy was introduced to evaluate the health condition of a monitored object to provide an effective guide for maintenance. In particular, the health evaluation for CM was based on a performance review over a range of operating conditions, rather than at a certain single operating condition. Experimental investigations were performed which verified the efficiency of the evaluation method, as well as a comparison with the previous method.

  20. [Effects of electromagnetic radiation on health and immune function of operators].

    Science.gov (United States)

    Li, Yan-zhong; Chen, Shao-hua; Zhao, Ke-fu; Gui, Yun; Fang, Si-xin; Xu, Ying; Ma, Zi-jian

    2013-08-01

    To investigate the effects of electromagnetic radiation on the physiological indices and immune function of operators. The general conditions and electromagnetic radiation awareness rate of 205 operators under electromagnetic radiation were evaluated using a self-designed questionnaire. Physical examination, electrocardiography, and routine urine test were performed in these operators. Peripheral blood was collected from the operators under electromagnetic radiation for blood cell counting and biochemical testing, and their peripheral blood lymphocytes were cultured for determination of chromosomal aberrant frequency and micronucleus frequency. The data from these operators (exposure group) were compared with those of 95 ordinary individuals (control group). The chief complaint of giddiness, tiredness, dizziness, and amnesia showed significant differences between the exposure group and control group (P electromagnetic radiation damage was significantly higher in the exposure group than in the control group. The difference in bradycardia was significant between the two groups (P Electromagnetic radiation may lead to the changes in physiological indices, genetic effects, and immune function and affect the health and immune function in operators. The adverse effects are increased as the working years increase. So it is important to strengthen occupational protection of operators under electromagnetic radiation.

  1. Structural Health Monitoring under Nonlinear Environmental or Operational Influences

    Directory of Open Access Journals (Sweden)

    Jyrki Kullaa

    2014-01-01

    Full Text Available Vibration-based structural health monitoring is based on detecting changes in the dynamic characteristics of the structure. It is well known that environmental or operational variations can also have an influence on the vibration properties. If these effects are not taken into account, they can result in false indications of damage. If the environmental or operational variations cause nonlinear effects, they can be compensated using a Gaussian mixture model (GMM without the measurement of the underlying variables. The number of Gaussian components can also be estimated. For the local linear components, minimum mean square error (MMSE estimation is applied to eliminate the environmental or operational influences. Damage is detected from the residuals after applying principal component analysis (PCA. Control charts are used for novelty detection. The proposed approach is validated using simulated data and the identified lowest natural frequencies of the Z24 Bridge under temperature variation. Nonlinear models are most effective if the data dimensionality is low. On the other hand, linear models often outperform nonlinear models for high-dimensional data.

  2. Risk assessment in international operations

    International Nuclear Information System (INIS)

    Stricklin, Daniela L.

    2008-01-01

    During international peace-keeping missions, a diverse number of non-battle hazards may be encountered, which range from heavily polluted areas, endemic disease, toxic industrial materials, local violence, traffic, and even psychological factors. Hence, elevated risk levels from a variety of sources are encountered during deployments. With the emphasis within the Swedish military moving from national defense towards prioritization of international missions in atypical environments, the risk of health consequences, including long term health effects, has received greater consideration. The Swedish military is interested in designing an optimal approach for assessment of health threats during deployments. The Medical Intelligence group at FOI CBRN Security and Defence in Umea has, on request from and in collaboration with the Swedish Armed Forces, reviewed a variety of international health threat and risk assessment models for military operations. Application of risk assessment methods used in different phases of military operations will be reviewed. An overview of different international approaches used in operational risk management (ORM) will be presented as well as a discussion of the specific needs and constraints for health risk assessment in military operations. This work highlights the specific challenges of risk assessment that are unique to the deployment setting such as the assessment of exposures to a variety of diverse hazards concurrently

  3. Scenario-based design: a method for connecting information system design with public health operations and emergency management.

    Science.gov (United States)

    Reeder, Blaine; Turner, Anne M

    2011-12-01

    Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Interview analysis identified 25 information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create 25 scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. 42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... printed materials that meet the requirements of § 417.124(b). (ii) Access may not be more restrictive or... benefits plan. 417.155 Section 417.155 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Organizations in Employee Health Benefits Plans § 417.155 How the HMO option must be included in the health...

  5. Operation and maintenance of thermal power stations best practices and health monitoring

    CERN Document Server

    Chanda, Pradip

    2016-01-01

    This book illustrates operation and maintenance practices/guidelines for economic generation and managing health of a thermal power generator beyond its regulatory life. The book provides knowledge for professionals managing power station operations, through its unique approach to chemical analysis of water, steam, oil etc. to identify malfunctioning/defects in equipment/systems much before the physical manifestation of the problem. The book also contains a detailed procedure for conducting performance evaluation tests on different equipment, and for analyzing test results for predicting maintenance requirements, which has lent a new dimension to power systems operation and maintenance practices. A number of real life case studies also enrich the book. This book will prove particularly useful to power systems operations professionals in the developing economies, and also to researchers and students involved in studying power systems operations and control. .

  6. Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

    Science.gov (United States)

    Leveton, L. B.; VanderArk, S. T.

    2014-01-01

    The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day-to-day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

  7. Persistent pain and comorbidity among Operation Enduring Freedom/Operation Iraqi Freedom/operation New Dawn veterans.

    Science.gov (United States)

    Higgins, Diana M; Kerns, Robert D; Brandt, Cynthia A; Haskell, Sally G; Bathulapalli, Harini; Gilliam, Wesley; Goulet, Joseph L

    2014-05-01

    Chronic pain is a significant concern for the Veterans Health Administration (VHA), with chronic pain conditions among those most frequently reported by Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans. The current study examined VHA electronic medical record data to examine variation in demographics and high prevalence and high impact medical and mental health conditions in order to characterize the differences between patients with persistent pain and no pain. A conservative operational definition of chronic or "persistent pain" based on multiple indicators of pain (i.e., pain intensity ratings, prescription opioids, pain clinic visits, International Classification of Diseases, Ninth Revision codes) was employed. Analyses included the entire roster of longitudinal clinical data on OEF/OIF/OND veterans who used VHA care to compare those with persistent pain with those with no clinical evidence of pain. Results of logistic regression models suggest that sex, race, education, military variables, body mass index (BMI), traumatic brain injury (TBI), and mental health conditions, but not age, reliably discriminate the two groups. Those with persistent pain were more likely to be Black, female, on active duty, enlisted, Army service members, have a high school education or less, and have diagnoses of mood disorders, post-traumatic stress disorder, substance use disorders, anxiety disorders, TBI, and have a BMI consistent with overweight and obesity. The operational definition of chronic pain used in this study may have research implications for examining predictors of incident and chronic pain. These data have important clinical implications in that addressing comorbid conditions of persistent pain may improve adaptive coping and functioning in these patients. Wiley Periodicals, Inc.

  8. To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Belrhiti, Zakaria; Booth, Andrew; Marchal, Bruno; Verstraeten, Roosmarijn

    2016-04-27

    District health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research (or action research) on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms. We will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database (DARE), Cochrane Effective Practice and Organisation of Care (EPOC) group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed (hand-searching journals and citation and reference tracking). Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators. Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration's tools for randomized

  9. Operational Linescan System (OLS) - Derived Products (including posters and slides)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Visible and infrared imagery from DMSP Operational Linescan System (OLS) instruments are used to monitor the global distribution of clouds and cloud top temperatures...

  10. Biogas production and distribution. Operators' health and safety. Extended abstract

    International Nuclear Information System (INIS)

    Gardeur-Algros, E.; Chesnot, T.; Charissou, A.M.; Paris, T.; Bronner, C.

    2013-06-01

    Production and recovery of biogas from different substrates of agricultural, urban and industrial issues are at the heart of sustainable development for the production of renewable energy, reducing greenhouse gases and waste treatment. In 2011, in France, about 200 biogas plants were operational. Moreover, about 300 ISDND (nonhazardous waste storage or landfill sites) also produce biogas, about 90 that of them valorize it. Because of regulatory contexts and favorable measures to bolster the economy, the number of sites is growing and anaerobic pathways are diversifying in terms of substrate / treated waste, anaerobic digestion processes and ways of valorization. So it seems appropriate to focus on the health and safety of workers potentially exposed to various hazards during operations of monitoring, maintenance or malfunction of facilities. First, through a literature search and a query of experts, data such as substrate, digestate and biogas composition, information feedback on reported incidents / accidents or accidents at work and illnesses of operators have been sought. Then, critical points concerning the health and safety of operators in these sectors were identified by implementing some steps of HACCP (Hazard Analysis - Critical Control Points). Five sectors (agricultural methanization in farms and in centralized plants - methanization of urban sewage sludge - methanization of household garbage - industrial methanization in sectors like food industry, stationery and chemistry - biogas production from landfill sites) have been studied and led to dedicated syntheses. They summarize the collected information and present an operating diagram indicating the different stages of biogas production and recovery. On this diagram, critical points are identified, assessed according to their importance and are associated with phases of maintenance operation, or malfunction. The results are intended to educate the actors to potential risks and attention they need to

  11. Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

    Science.gov (United States)

    Sareen, Jitender; Cox, Brian J; Afifi, Tracie O; Stein, Murray B; Belik, Shay-Lee; Meadows, Graham; Asmundson, Gordon J G

    2007-07-01

    Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use. To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality. Cross-sectional, population-based survey. Canadian military. A total of 8441 currently active military personnel (aged 16-54 years). The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed. The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders. This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides

  12. Achieving shift work excellence: maximizing health, safety and operating efficiency in round-the-clock operations

    Energy Technology Data Exchange (ETDEWEB)

    Sirois, W. G. (circadian Technologies Ltd., Cambridge, MA (United States))

    1999-01-01

    Alertness Assurance techniques, Lifestyle Training and Shift Scheduling practices are described as weapons in the fight against the consequences of sleep deprivation and fatigue, higher operating risks , the adverse health, safety and quality of life effects on workers. Fatigue is a fundamental problem for all round-the-clock industries. The central message of this paper is that by making appropriate interventions and taking counter-measures to fatigue, the risks and liabilities of human error can be dramatically minimized through increased employee alertness, vigilance and cognitive reasoning skills around-the-clock. 12 refs., 1 fig.

  13. NASA Earth Observation Systems and Applications for Health: Moving from Research to Operational End Users

    Science.gov (United States)

    Haynes, J.; Estes, S. M.

    2017-12-01

    Health providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate NASA's applied science programs efforts to transition from research to operations to benefit society. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the health research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Health Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in health research and the transition to operational end users.

  14. Medical Logistics Lessons Observed During Operations Enduring Freedom and Iraqi Freedom.

    Science.gov (United States)

    Dole, Mark J; Kissane, Jonathan M

    2016-01-01

    Medical Logistics (MEDLOG) is a function of the Army's integrated System for Health that provides the medical products and specialized logistics services required to deliver health protection and care under all operational conditions. In unified land operations, MEDLOG is an inherent function of Health Service Support (HSS), which also includes casualty care and medical evacuation. This paper focuses on a few key lessons observed during Operations Enduring Freedom and Iraqi Freedom with direct implications for the support of HSS in future operations as envisioned in the Army Operating Concept and the Joint Concept for Health Services. It also examines a few key enablers that helped mitigate these challenges that are not yet fully acknowledged in Army Medical Department doctrine, policy, and planning.

  15. Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.

    Science.gov (United States)

    Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C

    2017-07-21

    Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and

  16. 76 FR 66328 - Callaway Golf Ball Operations, Inc., Including On-Site Leased Workers From Reliable Temp Services...

    Science.gov (United States)

    2011-10-26

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,110] Callaway Golf Ball... Golf Ball Operations, Inc., including on-site leased workers from Reliable Temp Services, Inc., and... production of golf balls. The notice was published in the Federal Register on July 8, 2011 (76 FR 40401). At...

  17. Public Health System in Brazil nowadays: challenges for its operation and funding

    Directory of Open Access Journals (Sweden)

    Alethele de Oliveira Santos

    2016-09-01

    Full Text Available This paper has the aim to revisit the theme of the brazilian public health system from the perspective of its operation and funding of its actions and services, analyzing some of the main obstacles to its effectiveness. Endowed with its own logic of organization, planning and funding of its actions and services, the Brazilian Unified Health System (SUS finds barriers to its sustainability when it comes to funding and the judicialization of health. Historical under-funding worsened by the economic and political crisis the country currently faces plus the increase in casuistic judicial decisions that prioritize the individual logic over the collective right have produced serious shocks in the system. These are just some of the challenges to an effective public health system. This is why the work of public bodies must be responsible and always take into consideration the collective dimension of the right to health under penalty of causing the collapse of the public health system altogether.

  18. Health risks associated with ingesting venison from a uranium enrichment facility with multiple operable units

    International Nuclear Information System (INIS)

    Duncan, J.; Welsh, C.

    1995-01-01

    Ingestion of game, including venison, may be a significant exposure pathway in human health risk assessments at hazardous waste sites. The difficulty associated with modeling contaminant tissue concentrations in a wide-ranging herbivorous mammal is compounded when the home range of the mammal extends over multiple operable units (OUs) of varying size and media contaminant concentration. Using biotransfer factors extracted from the literature and species-specific parameter information (e.g., home range size, diet, forage and water ingestion rates) the authors estimate contaminant concentrations in venison based on soil and surface water contaminant concentrations and determine the contribution of individual OUs to modeled venison tissue concentrations. Estimated tissue concentrations are calculated through the use of site foraging factors (SFFS) that adjust exposure contributions from individual OUs to account for the size of the OU in relation to the animals home range. The authors then use the venison tissue concentrations to estimate human health risk associated with ingesting venison under both a current and future exposure scenario

  19. Family stress and posttraumatic stress: the impact of military operations on military health care providers.

    Science.gov (United States)

    Gibbons, Susanne W; Barnett, Scott D; Hickling, Edward J

    2012-08-01

    This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed. Published by Elsevier Inc.

  20. Design of the system of maintenance operations occupational safety and health database application of nuclear power station

    International Nuclear Information System (INIS)

    Wang Xuehong; Li Xiangyang; Ye Yongjun

    2011-01-01

    Based on the KKS code of building equipment in nuclear power station, this paper introduces the method of establishing the system of maintenance operation occupational safety and health database application. Through the application system of maintenance occupational safety and health database, it can summarize systematically all kinds of maintenance operation dangerous factor of nuclear power station, and make a convenience for staff to learn the maintenance operation dangerous factors and the prevention measures, so that it can achieve the management concept of 'precaution crucial, continuous improvement' that advocated by OSHMS. (authors)

  1. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  2. The effects of Medicare Health Management Organizations on hospital operating profit in Florida.

    Science.gov (United States)

    Large, John T; Sear, Alan M

    2005-02-01

    Between 1992 and 1997, the number of members enrolled in Medicare Health Management Organizations (HMOs) nationwide in the USA more than doubled. During this period, managed care organizations wielded considerable influence over the health care of a large segment of the Medicare population in Florida. This study examined the impact on operational profit of 148 short-term, acute-care Florida hospitals in this period from Medicare HMO patients, as part of a hospital's payer mix. Three measures of hospital profitability were used: operating profit per actual bed, total operating profit with no adjustment for bed size, and operating margins. The multivariate statistical model employed in this study was a linear mixed model with an autoregressive order one (AR[1]) parametric structure on the covariance matrix. The results of the study indicate that Florida hospitals experienced greater profit pressures from Medicare HMO inpatients than from traditional Medicare inpatients. Further, these hospitals could have experienced positive profit effects with greater traditional Medicare participation and negative financial effects with greater Medicare HMO participation. Additionally, Medicare HMO patients appear to have been admitted to hospitals in worse health condition than those in traditional Medicare. Medicare HMO patients were more likely to have used emergency rooms as the source of admission than traditional Medicare patients. Also, Medicare HMO patients were more likely to have been admitted as emergent cases than traditional Medicare patients. Other research has shown that Medicare HMO patients, at the time of enrolment, are probably healthier than traditional Medicare enrollees, but here they appear to have been admitted to hospitals with higher levels of severity of illness. Explanations are offered for these findings.

  3. Toward an operational model of decision making, emotional regulation, and mental health impact.

    Science.gov (United States)

    Collura, Thomas Francis; Zalaquett, Ronald P; Bonnstetter, Carlos Joyce; Chatters, Seria J

    2014-01-01

    Current brain research increasingly reveals the underlying mechanisms and processes of human behavior, cognition, and emotion. In addition to being of interest to a wide range of scientists, educators, and professionals, as well as laypeople, brain-based models are of particular value in a clinical setting. Psychiatrists, psychologists, counselors, and other mental health professionals are in need of operational models that integrate recent findings in the physical, cognitive, and emotional domains, and offer a common language for interdisciplinary understanding and communication. Based on individual traits, predispositions, and responses to stimuli, we can begin to identify emotional and behavioral pathways and mental processing patterns. The purpose of this article is to present a brain-path activation model to understand individual differences in decision making and psychopathology. The first section discusses the role of frontal lobe electroencephalography (EEG) asymmetry, summarizes state- and trait-based models of decision making, and provides a more complex analysis that supplements the traditional simple left-right brain model. Key components of the new model are the introduction of right hemisphere parallel and left hemisphere serial scanning in rendering decisions, and the proposition of pathways that incorporate both past experiences as well as future implications into the decision process. Main attributes of each decision-making mechanism are provided. The second section applies the model within the realm of clinical mental health as a tool to understand specific human behavior and pathology. Applications include general and chronic anxiety, depression, paranoia, risk taking, and the pathways employed when well-functioning operational integration is observed. Finally, specific applications such as meditation and mindfulness are offered to facilitate positive functioning.

  4. Toward the way forward: the national children's disaster mental health concept of operations.

    Science.gov (United States)

    Schreiber, Merritt; Pfefferbaum, Betty; Sayegh, Lisa

    2012-06-01

    Although increasing evidence suggests that children are at particular risk from disasters and evidence-based practices have been developed to triage and treat them effectively, no strategy or concept of operations linking best practices for disaster response is currently in place. To our knowledge, this report describes the first effort to address this critical gap and outlines a triage-driven children's disaster mental health incident response strategy for seamless preparedness, response, and recovery elements that can be used now. The national children's disaster mental health concept of operations (NCDMH CONOPS) details the essential elements needed for an interoperable, coordinated response for the mental health needs of children by local communities, counties, regions, and states to better meet the needs of children affected by disasters and terrorism incidents. This CONOPS for children proposes the use of an evidence-based, rapid triage system to provide a common data metric to incident response and recovery action and to rationally align limited resources to those at greater need in a population-based approach.

  5. Post-Polio Health International including International Ventilator Users Network

    Science.gov (United States)

    ... PHI Annual Reports Contact Us Copyright EDUCATION Post-Polio Health newsletter Health Care Considerations Handbook on the Late Effects ... Late Effects of Polio Post-Polio Syndrome (PPS) About Acute Polio Major ...

  6. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Liability Surgeons as Advocates Surgeons and Bundled Payment Models Surgeons as Institutional Employees Our Changing Health Care ... Lung Operation After Your Operation Your Discharge and Recovery Complete Video After Your Operation Guidance for after ...

  7. Operative Links

    DEFF Research Database (Denmark)

    Wistoft, Karen; Højlund, Holger

    2012-01-01

    educational goals, learning content, or value clarification. Health pedagogy is often a matter of retrospective rationalization rather than the starting point of planning. Health and risk behaviour approaches override health educational approaches. Conclusions: Operational links between health education......, health professionalism, and management strategies pose the foremost challenge. Operational links indicates cooperative levels that facilitate a creative and innovative effort across traditional professional boundaries. It is proposed that such links are supported by network structures, shared semantics...

  8. 76 FR 72243 - Proposed Information Collection (Operation Enduring Freedom/Operation Iraqi Freedom Veterans...

    Science.gov (United States)

    2011-11-22

    ... (Operation Enduring Freedom/ Operation Iraqi Freedom Veterans Health Needs Assessment) Activity; Comment... Operation Enduring Freedom/ Operation Iraqi Freedom veterans and their families. DATES: Written comments and...: Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment, VA Form 10-21091. OMB...

  9. Health state of population in the locality of the Mochovce nuclear power plant after four years of operation

    International Nuclear Information System (INIS)

    Letkovicova, M.; Letkovicova, H.; Letkovic, M.

    2002-01-01

    The Mochovce NPP was put into the operation in 1998. Authors monitor the health state of the population in its vicinity since 1993. The authors recorded this health state also in before-operational safety report of Mochovce NPP. The authors show in the presentation the evaluation of nine years, five before putting of Mochovce NPP into the operation and four during its operation. The aim of the authors is to evaluate the state of chosen health indicators in individual villages in whole monitored region and to try to found out the differences between of their size before and after putting the Mochovce NPP into the operation. Authors used the methods of so-called population epidemiology, where they evaluate the health risks by the system of multidimensional mathematical-statistical methods, by using of the theory of fuzzy sets. The Mochovce region belongs for the long period to the regions with very unfavourable health state. Its very general comparison with one year all Slovak values of the relevant indicators in 2000 are following: more newborn on thousand inhabitants (in 12 per cent) (consequence of wholly older population), higher general mortality of population (in 11 per cent), higher premature mortality of population (in 17 per cent), higher mortality from selected causes, thus malignant tumours of digestive tract (in 20 per cent), higher mortality from malignant tumours of lungs (in 25 per cent), higher mortality from malignant tumours of leukaemia (in 25 per cent). However the authors found out very positive findings in the evaluation of the trends: in the case of fifteen most serious health indicators in the vicinity of Mochovce NPP authors state also mathematically visible influence on the surroundings, which is registerable only in positive meaning. There are created the demonstrable clusters of the villages with low general, also premature women mortality. This locality was far off the industrial and cultural centres, there were always historically higher

  10. 20 CFR 638.510 - Health care and services.

    Science.gov (United States)

    2010-04-01

    ... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and mental...

  11. Integrated simulations of H-mode operation in ITER including core fuelling, divertor detachment and ELM control

    Science.gov (United States)

    Polevoi, A. R.; Loarte, A.; Dux, R.; Eich, T.; Fable, E.; Coster, D.; Maruyama, S.; Medvedev, S. Yu.; Köchl, F.; Zhogolev, V. E.

    2018-05-01

    ELM mitigation to avoid melting of the tungsten (W) divertor is one of the main factors affecting plasma fuelling and detachment control at full current for high Q operation in ITER. Here we derive the ITER operational space, where ELM mitigation to avoid melting of the W divertor monoblocks top surface is not required and appropriate control of W sources and radiation in the main plasma can be ensured through ELM control by pellet pacing. We apply the experimental scaling that relates the maximum ELM energy density deposited at the divertor with the pedestal parameters and this eliminates the uncertainty related with the ELM wetted area for energy deposition at the divertor and enables the definition of the ITER operating space through global plasma parameters. Our evaluation is thus based on this empirical scaling for ELM power loads together with the scaling for the pedestal pressure limit based on predictions from stability codes. In particular, our analysis has revealed that for the pedestal pressure predicted by the EPED1  +  SOLPS scaling, ELM mitigation to avoid melting of the W divertor monoblocks top surface may not be required for 2.65 T H-modes with normalized pedestal densities (to the Greenwald limit) larger than 0.5 to a level of current of 6.5–7.5 MA, which depends on assumptions on the divertor power flux during ELMs and between ELMs that expand the range of experimental uncertainties. The pellet and gas fuelling requirements compatible with control of plasma detachment, core plasma tungsten accumulation and H-mode operation (including post-ELM W transient radiation) have been assessed by 1.5D transport simulations for a range of assumptions regarding W re-deposition at the divertor including the most conservative assumption of zero prompt re-deposition. With such conservative assumptions, the post-ELM W transient radiation imposes a very stringent limit on ELM energy losses and the associated minimum required ELM frequency. Depending on

  12. [Effectiveness of mental health training including active listening for managers].

    Science.gov (United States)

    Ikegami, Kazunori; Tagawa, Yoshimasa; Mafune, Kosuke; Hiro, Hisanori; Nagata, Shoji

    2008-07-01

    significant increases post-training in "Job demands", "Worksite support by supervisor" and "Worksite support by co-worker", subscales of the BJSQ 12 items version. Particularly, the "Worksite support by supervisor" subscale increased significantly in 8 of the 47 sections in a comparison among sections. In this present study, we investigated the effectiveness of mental health training including Active Listening for managers, and suggest that to train Active Listening and use it at the worksite possibly strengthens "Worksite support by supervisor".

  13. Including the Effect of Shielding in Prediction of Weather Window for Offshore Lifting Operations

    OpenAIRE

    Olsen, Camilla Waldum

    2015-01-01

    The offshore industry is constantly seeking to operate in more extreme conditions. DeepOcean is a subsea service company, where offshore lifts is a part of every day operations. To remain competitive, it is important to reduce operational downtime, where time spent waiting on weather is one of the main contributors. The main goal of this thesis is to investigate how shielding effects influence the operational limit for offshore lifting operations at different heading angles. Common practice i...

  14. 78 FR 12358 - Cardinal Health, Financial Shared Services West, Including On-Site Leased Workers From Aerotek...

    Science.gov (United States)

    2013-02-22

    ... office financial services from India and the Philippines. Based on these findings, the Department is..., Financial Shared Services West, Including On- Site Leased Workers From Aerotek, eXcel Staffing, Experis..., applicable to workers of Cardinal Health, Financial Shared Services West, including on-site leased workers...

  15. 1997 Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One year ago, the Office of International Health Programs provided you with our 1996 Operating Plan, which defined our ideas and ideals for conducting business in 1996. We have again this year undertaken an intensive planning effort, first reviewing our accomplishments and shortcomings during 1996, and then developing plans and priorities for the upcoming year, taking into account input from customers and outside review panels, and ensuring that the demands on the office have been balanced with anticipated human, financial, and material resources.

  16. [Tour operator liability in health protection for not informing travellers about health risks they could be exposed].

    Science.gov (United States)

    Macrì, P G

    2009-01-01

    Consumer-tourist is considered the weaker bargaining party in an "all included" travel contract, compared with tour organizer and tour vendor. That's why Statute Act protecting consumer's rights provides a specific discipline concerning this particular sector In front of widening of warrants for travellers, obligations for organizer and seller of the travel have been increased, and include now specific duty to inform travellers as well. According to the law such duties of information are consistent with travel contract performance itself. In such way, failing to inform client constitutes a breach of contract liable not only in the field of civil responsibility; the subject liable with such an omission may face criminal prosecution as well. More specifically we are in front of a breach of contract by the tour organizer who will respond of all damages concerned with such a breach. Damages will concern not only the price of the travel package, but also other damages connected with the illness suffered by traveller: compensation for spoiled holidays, biological damages, patrimonial damages (these last ones could include for instance expenses for medical treatments, just to quote the more likely one). In other words, tour organizer has to grant general organization of the tour which has to take place as specified on travel brochure, but traveller have to be provided also with any information, concerning documents necessary for the travel, whether passport or visa are needed or not, vaccinations peremptory or optional. It will be very difficult for tour operator be exempted from liability for damages if traveller hasn't been informed of health risks; the only possibility consists in managing to demonstrate that the obligation hasn't been compelled due to reason for which the operator couldn't be held responsible. Besides as we have already mentioned before, criminal relevance of such omission of information couldn't be excluded. In fact, it's true that such omission

  17. Evaluation of the nervous-psychic working ability of the operators of the Kozloduj NPP concerning their health conditions

    International Nuclear Information System (INIS)

    Jonkova, A.

    1988-01-01

    By means of psychological methods the neuroticism and work tiredness in 170 operators from the Kozloduj NPP have been investigated. The distribution of the individuals with work overtiredness according to health conditions and the operative service duration was considered. In 73 operators, who had sufficiently informative complaints of overtiredness, a high incidence of cardiocascular and gastrointestinal diseases, of neuroses and increased neuroticism was established. The relative part of the individuals with overtiredness augmented substantially after 5-year duration service. Since overtiredness is an inadmissible functional condition for operators, its observation in 42,9% of the examined contingent is estimated as a real danger for decrease of the reliability and for worsening of the health conditions

  18. Estimating Implementation and Operational Costs of an Integrated Tiered CD4 Service including Laboratory and Point of Care Testing in a Remote Health District in South Africa

    Science.gov (United States)

    Cassim, Naseem; Coetzee, Lindi M.; Schnippel, Kathryn; Glencross, Deborah K.

    2014-01-01

    Background An integrated tiered service delivery model (ITSDM) has been proposed to provide ‘full-coverage’ of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing 600 samples/day and serving >100 or >200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Methods Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. Results The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of >24–48 hours. Full service coverage with TAT cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured ‘full service coverage’ and Implementing a single Tier-3/community laboratory to extend and improve delivery of services in Pixley-ka-Seme, with an estimated local ∼12–24-hour LTR-TAT, is ∼$2 more than existing referred services per-test, but 2–4 fold cheaper than implementing eight Tier-2/POC-hubs or providing twenty-seven Tier-1/POCT CD4 services. PMID:25517412

  19. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. 77 FR 7243 - Proposed Information Collection (Operation Enduring Freedom/Operation Iraqi Freedom Veterans...

    Science.gov (United States)

    2012-02-10

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0728] Proposed Information Collection (Operation Enduring Freedom/ Operation Iraqi Freedom Veterans Health Needs Assessment) Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs...

  1. Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments

    Directory of Open Access Journals (Sweden)

    Waller Michael

    2012-07-01

    Full Text Available Abstract Background The association between stressful events on warlike deployments and subsequent mental health problems has been established. Less is known about the effects of stressful events on peacekeeping deployments. Methods Two cross sectional studies of the Australian Defence Force were used to contrast the prevalence of exposures reported by a group deployed on a peacekeeping operation (Bougainville, n = 1704 and those reported by a group deployed on operations which included warlike and non-warlike exposures (East Timor, n = 1333. A principal components analysis was used to identify groupings of non-traumatic exposures on deployment. Multiple regression models were used to assess the association between self-reported objective and subjective exposures, stressors on deployment and subsequent physical and mental health outcomes. Results The principal components analysis produced four groups of non-traumatic stressors which were consistent between the peacekeeping and more warlike deployments. These were labelled ‘separation’, ‘different culture’, ‘other people’ and ‘work frustration’. Higher levels of traumatic and non-traumatic exposures were reported by veterans of East Timor compared to Bougainville. Higher levels of subjective traumatic exposures were associated with increased rates of PTSD in East Timor veterans and more physical and psychological health symptoms in both deployed groups. In Bougainville and East Timor veterans some non-traumatic deployment stressors were also associated with worse health outcomes. Conclusion Strategies to best prepare, identify and treat those exposed to traumatic events and other stressors on deployment should be considered for Defence personnel deployed on both warlike and peacekeeping operations.

  2. Professional adaptability of nuclear power plant operators

    International Nuclear Information System (INIS)

    He Xuhong; Huang Xiangrui

    2006-01-01

    The paper concerns in the results of analysis for nuclear power plant (NPP) operator job and analysis for human errors related NPP accidents. Based on the principle of ergonomics a full psychological selection system of the professional adaptability of NPP operators including cognitive ability, personality and psychological health was established. The application way and importance of the professional adaptability research are discussed. (authors)

  3. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

    Science.gov (United States)

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-09-05

    In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among

  4. Design and operation of the National Survey of Children with Special Health Care Needs, 2009-2010.

    Science.gov (United States)

    Bramlett, Matthew D; Blumberg, Stephen J; Ormson, A Elizabeth; George, Jacquelyn M; Williams, Kim L; Frasier, Alicia M; Skalland, Benjamin J; Santos, Kathleen B; Vsetecka, Danielle M; Morrison, Heather M; Pedlow, Steven; Wang, Fang

    2014-11-01

    This report presents the development, plan, and operation of the 2009-2010 National Survey of Children with Special Health Care Needs, a module of the State and Local Area Integrated Telephone Survey. The survey is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. This survey was designed to produce national and state-specific prevalence estimates of children with special health care needs (CSHCN), to describe the types of services that they need and use, and to assess aspects of the system of care for CSHCN. A random-digit-dial sample of households with children under age 18 years was constructed for each of the 50 states and the District of Columbia. The sampling frame consisted of landline phone numbers and cellular(cell) phone numbers of households that reported a cell-phone-only or cell-phone-mainly status. Children in identified households were screened for special health care needs. If CSHCN were identified in the household, a detailed interview was conducted for one randomly selected child with special health care needs. Respondents were parents or guardians who knew about the children's health and health care. A total of 196,159 household screening interviews were completed from July 2009 through March 2011, resulting in 40,242 completed special-needs interviews, including 2,991 from cell-phone interviews. The weighted overall response rate was 43.7% for the landline sample, 15.2% for the cell-phone sample, and 25.5% overall. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  5. Safety in nuclear power plant operation, including commissioning and decommissioning. A code of practice

    International Nuclear Information System (INIS)

    1978-01-01

    Safe operation of a nuclear power plant postulates satisfactory siting, design, construction and commissioning, together with proper management and operation of the plant. This Code of Practice deals with the safety aspects of management, commissioning, operation and decommissioning of the plant. It forms part of the Agency's programme, referred to as the NUSS programme, for establishing Codes of Practice and Safety Guides relating to land-based stationary thermal neutron power plants. It has been prepared for the use of those responsible for the operation of stationary nuclear power plants, the main function of which is the generation of electrical and/or thermal power, and for the use of those responsible for regulating the operation of such plants. It is not intended for application to reactors used solely for experimental or research purposes. The provisions in the Code are designed to provide assurance that operational activities are carried out without undue radiological hazard to the general public and to persons on the site. It should be understood that the provisions in the Code set forth minimum requirements which shall be met in order to achieve safe operation of a nuclear power plant

  6. Mental health status of Sri Lanka Navy personnel three years after end of combat operations: a follow up study.

    Directory of Open Access Journals (Sweden)

    Raveen Hanwella

    Full Text Available The main aim of this study was to assess the mental health status of the Navy Special Forces and regular forces three and a half years after the end of combat operations in mid 2009, and compare it with the findings in 2009. This cross sectional study was carried out in the Sri Lanka Navy (SLN, three and a half years after the end of combat operations. Representative samples of SLN Special Forces and regular forces deployed in combat areas were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to the end of combat operations were included in the study. The sample consisted of 220 Special Forces and 275 regular forces personnel. Compared to regular forces a significantly higher number of Special Forces personnel had experienced potentially traumatic events. Compared to the period immediately after end of combat operations, in the Special Forces, prevalence of psychological distress and fatigue showed a marginal increase while hazardous drinking and multiple physical symptoms showed a marginal decrease. In the regular forces, the prevalence of psychological distress, fatigue and multiple somatic symptoms declined and prevalence of hazardous drinking increased from 16.5% to 25.7%. During the same period prevalence of smoking doubled in both Special Forces and regular forces. Prevalence of PTSD reduced from 1.9% in Special Forces to 0.9% and in the regular forces from 2.07% to 1.1%. Three and a half years after the end of combat operations mental health problems have declined among SLN regular forces while there was no significant change among Special Forces. Hazardous drinking among regular forces and smoking among both Special Forces and regular forces have increased.

  7. Mental health status of Sri Lanka Navy personnel three years after end of combat operations: a follow up study.

    Science.gov (United States)

    Hanwella, Raveen; Jayasekera, Nicholas E L W; de Silva, Varuni A

    2014-01-01

    The main aim of this study was to assess the mental health status of the Navy Special Forces and regular forces three and a half years after the end of combat operations in mid 2009, and compare it with the findings in 2009. This cross sectional study was carried out in the Sri Lanka Navy (SLN), three and a half years after the end of combat operations. Representative samples of SLN Special Forces and regular forces deployed in combat areas were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to the end of combat operations were included in the study. The sample consisted of 220 Special Forces and 275 regular forces personnel. Compared to regular forces a significantly higher number of Special Forces personnel had experienced potentially traumatic events. Compared to the period immediately after end of combat operations, in the Special Forces, prevalence of psychological distress and fatigue showed a marginal increase while hazardous drinking and multiple physical symptoms showed a marginal decrease. In the regular forces, the prevalence of psychological distress, fatigue and multiple somatic symptoms declined and prevalence of hazardous drinking increased from 16.5% to 25.7%. During the same period prevalence of smoking doubled in both Special Forces and regular forces. Prevalence of PTSD reduced from 1.9% in Special Forces to 0.9% and in the regular forces from 2.07% to 1.1%. Three and a half years after the end of combat operations mental health problems have declined among SLN regular forces while there was no significant change among Special Forces. Hazardous drinking among regular forces and smoking among both Special Forces and regular forces have increased.

  8. A BEFORE AND AFTER TRIAL OF THE EFFECTIVENESS OF NETWORK ANALYSIS IN HEALTH OPERATIONS MANAGEMENT.

    Science.gov (United States)

    Bhalwar, R; Srivastava, M; Verma, S S; Vaze, M; Tilak, V W

    1996-10-01

    An intervention trial using "before-and-after" approach was undertaken to address the question whether network analysis as a health managerial tool of control can favourably affect the delays that occur in planning and executing the antimalaria operations of a Station Health Organization in a large military station. Exposure variable of interest was intervention with a network diagram, by which the potential causes of delay along the various activities were assessed and remedial measures were introduced during the second year. Sample size was calculated using conventional alpha and beta error levels. The study indicated that there was a definite beneficial outcome in that the operations could be started as well as completed in time during the intervention year. There was reduction in time requirement in 5 out of the 9 activities, the exact 'p' value being 0.08, by both parametric and non-parametric tests. The use of network analysis in health care management has been recommended.

  9. Occurrence reporting and processing of operations information

    International Nuclear Information System (INIS)

    1997-01-01

    DOE O 232.1A, Occurrence Reporting and Processing of Operations Information, and 10 CFR 830.350, Occurrence Reporting and Processing of Operations Information (when it becomes effective), along with this manual, set forth occurrence reporting requirements for Department of Energy (DOE) Departmental Elements and contractors responsible for the management and operation of DOE-owned and -leased facilities. These requirements include categorization of occurrences related to safety, security, environment, health, or operations (''Reportable Occurrences''); DOE notification of these occurrences; and the development and submission of documented follow-up reports. This Manual provides detailed information for categorizing and reporting occurrences at DOE facilities. Information gathered by the Occurrence Reporting and processing System is used for analysis of the Department's performance in environmental protection, safeguards and security, and safety and health of its workers and the public. This information is also used to develop lessons learned and document events that significantly impact DOE operations

  10. Occurrence reporting and processing of operations information

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-21

    DOE O 232.1A, Occurrence Reporting and Processing of Operations Information, and 10 CFR 830.350, Occurrence Reporting and Processing of Operations Information (when it becomes effective), along with this manual, set forth occurrence reporting requirements for Department of Energy (DOE) Departmental Elements and contractors responsible for the management and operation of DOE-owned and -leased facilities. These requirements include categorization of occurrences related to safety, security, environment, health, or operations (``Reportable Occurrences``); DOE notification of these occurrences; and the development and submission of documented follow-up reports. This Manual provides detailed information for categorizing and reporting occurrences at DOE facilities. Information gathered by the Occurrence Reporting and processing System is used for analysis of the Department`s performance in environmental protection, safeguards and security, and safety and health of its workers and the public. This information is also used to develop lessons learned and document events that significantly impact DOE operations.

  11. Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

    Science.gov (United States)

    Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

    2016-01-01

    Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

  12. Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment.

    Science.gov (United States)

    Calain, Philippe

    2008-10-21

    In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomized by oil extraction in sub-Saharan Africa. Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalized and instrumentalized toward economic and corporate interests in resource curse settings. From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.

  13. Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment

    Directory of Open Access Journals (Sweden)

    Calain Philippe

    2008-10-01

    Full Text Available Abstract Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan, I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components and more open perspectives on causal mechanisms.

  14. Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review.

    Science.gov (United States)

    Watterson, Andrew; Dinan, William

    2018-04-04

    Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally.

  15. Main competences and skills to perform Essential Public Health Operations, offered by Schools of Public Health in four European countries

    DEFF Research Database (Denmark)

    Otok, Robert; Foldspang, Anders

    2016-01-01

    ) in each of the four countries, France, Poland, Portugal and the UK, reported the strength of intellectual and practical competences as well as skills to perform essential public health operations (EPHOs), offered by their education and training programmes. RESULTS: The self-reports indicated substantial...... education and training....

  16. Do Undergraduate Engineering Faculty Include Occupational and Public Health and Safety in the Engineering Curriculum?

    Science.gov (United States)

    Farwell, Dianna; And Others

    1995-01-01

    The purpose of this study was to determine whether and, if so, why engineering faculty include occupational and public health and safety in their undergraduate engineering courses. Data were collected from 157 undergraduate engineering faculty from 65 colleges of engineering in the United States. (LZ)

  17. Implementing primary health care-based PMTCT interventions: operational perspectives from Muhima cohort analysis (Rwanda)

    Science.gov (United States)

    Bucagu, Maurice; Muganda, John

    2014-01-01

    Introduction In countries with high burden of HIV, major programmatic challenges have been identified to preventing new infections among children and scaling up of treatment for pregnant mothers. We initiated this study to examine operational approaches that were used to enhance implementation of PMTCT interventions in Muhima health Centre (Kigali/Rwanda) from 2007 to 2010. Methods The prospective cohort study was conducted at Muhima health centre. A sample size of 656 was the minimum number required for the study. The main outcome was cumulative incidence of mother - to - child transmission of HIV-1 measured at 6 weeks of life among live born children. Results Among the 679 live born babies and followed up in this study, the overall cumulative rate of HIV-1 mother - to - child transmission observed was 3.2% at 6 weeks of age after birth. Disclosure of HIV status to partner was significantly associated with HIV-1 status of infants at 6 weeks of age (non-disclosure of HIV status adjusted odds ratio [AOR] 4.68, CI 1.39 to 15.77, p. Conclusion The Muhima type of decentralized health facility offered an appropriate platform for implementation of PMTCT interventions, with the following operational features: family - centered approach; integrated service delivery for PMTCT/MCH interventions, task shifting; subsidized membership fees for people living with HIV, allowing for access to the community-based health insurance benefits. PMID:26113893

  18. Changes in dental care access upon health care benefit expansion to include scaling.

    Science.gov (United States)

    Park, Hee-Jung; Lee, Jun Hyup; Park, Sujin; Kim, Tae-Il

    2016-12-01

    This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

  19. Richland Operations (DOE-RL) Environmental Safety Health (ES and H) FY 2000 and FY 2001 Execution Commitment Summary

    Energy Technology Data Exchange (ETDEWEB)

    REEP, I.E.

    2000-12-01

    All sites in the U.S. Department of Energy (DOE) Complex prepare this report annually for the DOE Office of Environment, Safety and Health (EH). The purpose of this report is to provide a summary of the previous and current year's Environment, Safety and Health (ES&H) execution commitments and the Safety and Health (S&H) resources that support these activities. The fiscal year (FY) 2000 and 2001 information and data contained in the Richland Operations Environment, Safefy and Health Fiscal Year 2002 Budget-Risk Management Summary (RL 2000a) were the basis for preparing this report. Fiscal year 2001 activities are based on the President's Amended Congressional Budget Request of $689.6 million for funding Ofice of Environmental Management (EM) $44.0 million for Fast Flux Test Facility standby less $7.0 million in anticipated DOE, Headquarters holdbacks for Office of Nuclear Energy, Science and Technology (NE); and $55.3 million for Safeguards and Security (SAS). Any funding changes as a result of the Congressional appropriation process will be reflected in the Fiscal Year 2003 ES&H Budget-Risk Management Summary to be issued in May 2001. This report provides the end-of-year status of FY 2000 ES&H execution commitments, including actual S&H expenditures, and describes planned FY 2001 ES&H execution commitments and the S&H resources needed to support those activities. This requirement is included in the ES&H guidance contained in the FY 2002 Field Budget Call (DOE 2000).

  20. [A preliminary evaluation of mental status and an investigation of occupational health knowledge demand in operating and maintenance personnel in wind power plants].

    Science.gov (United States)

    Hu, S Q; Zhang, Q; Zhu, X H; Sun, K; Chen, S Z; Liu, A G; Luo, G L; Huang, W

    2016-10-20

    Objective: To investigate the mental status, level of occupational health knowledge, health behaviors, and occupational health knowledge demand in operating and maintenance personnel in wind power plants, and to provide a basis for formulating protective measures of occupational health for operating and maintenance personnel in wind power plants. Methods: A cluster sampling was performed in regionally representative wind power plants in the wind power industry from May 2014 to June 2015, and the Symptom Checklist-90 (SCL-90) and a self-made evaluation questionnaire were used to investigate the general status, mental health, and occupational health knowledge demand in 160 operating and maintenance workers. Results: Of all respondents, 26.9% had mental health issues. The awareness rate of infectious disease knowledge and preventive measures was 11.9%. Of all workers, 96.5% wanted to know the occupational hazard factors in the workplace, and 96.3% wanted to get the knowledge of the prevention of related diseases. Conclusion: Mental health issues in operating and maintenance personnel in wind power plants cannot be neglected and there is a high demand for occupational health services and related knowledge. Comprehensive intervention measures for health promotion in the workplace should be adopted to improve working environment, enhance individual mental health education, increase the level of occupational health management, and protect the health of workers.

  1. Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations.

    Science.gov (United States)

    Jones, Norman; Fear, Nicola T; Jones, Margaret; Wessely, Simon; Greenberg, Neil

    2010-01-01

    little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of "Forward Psychiatry," aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. to examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. FMHT clinical records were linked to occupational records with 825 resulting matches. 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. the results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

  2. Future health physics prospects in high-level nuclear waste management

    International Nuclear Information System (INIS)

    Waite, D.A.; Mayberry, J.J.

    1986-01-01

    The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

  3. Optimizing winter/snow removal operations in MoDOT St. Louis district : includes outcome based evaluation of operations.

    Science.gov (United States)

    2011-10-01

    The objective of this project was to develop fleet location, route decision, material selection, and treatment procedures for winter snow removal operations to improve MoDOTs services and lower costs. This work uses a systematic, heuristic-based o...

  4. Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review

    Directory of Open Access Journals (Sweden)

    Andrew Watterson

    2018-04-01

    Full Text Available Unconventional oil and gas extraction (UOGE including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally.

  5. Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review

    Science.gov (United States)

    Watterson, Andrew

    2018-01-01

    Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally. PMID:29617318

  6. Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

    Science.gov (United States)

    Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

    2016-12-01

    School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

  7. Operational Research(ers in development: Growing a new generation of operational researchers

    Directory of Open Access Journals (Sweden)

    I Durbach

    2013-06-01

    Full Text Available This paper explores the theme of training operational research (OR practitioners in South Africa by critically evaluating a Masters program in Operational Research in Development (ORD, launched in 2005 at the University of Cape Town. This program was specifically focused on applying OR to the problems of the developing world in general and Africa in particular. We describe the program and review the practical work undertaken by students participating in the program. Topics range widely across domains including health (antimalarial drug resistance; poverty (food banking; governance (NGO management structures and monitoring of local government performance and sustainable livelihoods (spaza shop operations. We use the review to highlight strengths and weaknesses of the program, as well as challenges faced in the OR education in South Africa at a postgraduate level.

  8. Collection and analysis of Health Physics Research Reactor operational and use data

    International Nuclear Information System (INIS)

    Sims, C.S.

    1985-04-01

    The Health Physics Research Reactor (HPRR) is the primary research tool at the Dosimetry Applications Research (DOSAR) Facility. In addition to use by the DOSAR staff, the HPRR is used by a wide segment of the scientific community for a variety of experimental purposes. This report is a compilation and analysis of data concerning HPRR uses, users, and operations through the end of FY 1984. 17 refs., 12 tabs.,

  9. Health Promotion Behavior of Chinese International Students in Korea Including Acculturation Factors: A Structural Equation Model.

    Science.gov (United States)

    Kim, Sun Jung; Yoo, Il Young

    2016-03-01

    The purpose of this study was to explain the health promotion behavior of Chinese international students in Korea using a structural equation model including acculturation factors. A survey using self-administered questionnaires was employed. Data were collected from 272 Chinese students who have resided in Korea for longer than 6 months. The data were analyzed using structural equation modeling. The p value of final model is .31. The fitness parameters of the final model such as goodness of fit index, adjusted goodness of fit index, normed fit index, non-normed fit index, and comparative fit index were more than .95. Root mean square of residual and root mean square error of approximation also met the criteria. Self-esteem, perceived health status, acculturative stress and acculturation level had direct effects on health promotion behavior of the participants and the model explained 30.0% of variance. The Chinese students in Korea with higher self-esteem, perceived health status, acculturation level, and lower acculturative stress reported higher health promotion behavior. The findings can be applied to develop health promotion strategies for this population. Copyright © 2016. Published by Elsevier B.V.

  10. Operational health and physics service during the maintenance of the Australian National Medical Cyclotron

    International Nuclear Information System (INIS)

    Mukherjee, B.

    1994-01-01

    Modern Medical Cyclotrons use intense beams of high energy protons or deuterons to produce large activities of short and medium lived radionuclides. After continuous operation for prolonged periods the Cyclotron components become activated through various nuclear interactions therefore, the risk of personal radiation hazard while handling such activated cyclotron components is high. This paper describes all operational aspects of the Health Physics service evolved during the first preventative maintenance program of the Australian National Medical Cyclotron, which took place in June 1993. 5 refs., 3 tabs., 2 figs

  11. [Materiality Analysis of Health Plans Based on Stakeholder Engagement and the Issues Included at ISO 26000:2010].

    Science.gov (United States)

    Moyano Santiago, Miguel Angel; Rivera Lirio, Juana María

    2017-01-18

    Health plans of the Spanish autonomous communities can incorporate sustainable development criteria in its development. There have been no analysis or proposals about development and indicators. The goal is to add a contribution to help build better health plans aimed at sustainable development and help to manage economic, social and environmental impacts of health systems criteria. We used a variation of the RAND/UCLA or modified Delphi technique method. The process consisted of a bibliographical and context matters and issues related to health and social responsibility analysis based on ISO 26000: 2010. A survey by deliberately to a selection of 70 expert members of the identified stakeholders was carried out and a discussion group was held to determine the consensus on the issues addressed in the survey sample. The research was conducted in 2015. From the literature review 33 health issues included in ISO 26000:2010 were obtained. 7 survey proved relevant high consensus, 8 relevance and average consensus and 18 with less relevance and high level of dissent. The expert group excluded 4 of the 18 subjects with less consensus. 29 issues included 33 at work, divided into 7 subjects contained in the guide ISO 26000 of social responsibility, were relevant stakeholders regarding possible inclusion in health plans. Considering the direct relationship published by ISO (International Organization for Standardization) among the issues ISO 26000 and the economic, social and environmental indicators in GRI (Global Reporting Initiative) in its G4 version, a panel with monitoring indicators related to relevant issues were elaborated.

  12. The need to include obstetric nurses in prenatal care visits in the public health system

    Directory of Open Access Journals (Sweden)

    Selma Aparecida Lagrosa Garcia

    2010-06-01

    Full Text Available Objective: To investigate, with a qualitative approach, the role of Obstetric Nurses at the primary level of care given to women’s health as a vital component of the multidisciplinary team, which today is fundamental for providing care, prevention as well as health education and promotion, especially in programs whose activities are geared towards primary care of pregnant, parturient, and puerpera women. Methods: Brazilian laws and the determinations of Nursing Councils in reference to the activities of the obstetric nurse were researched, including the nurse’s responsibilities and limits. The bibliographic search was conducted in health-related journals, lay publications, and the Internet. Results: The conflicts between professional physicians and nurses were discussed. Conclusions: It was concluded that the activities of the nurse, conducting low-risk prenatal clinical visits in the basic healthcare network, has legal and ethical support and provides true benefit to the clients.

  13. Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

    Science.gov (United States)

    Hadi, Tamer A; Fleshler, Keren

    2016-10-01

    Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

  14. A conceptual framework for automating the operational and strategic decision-making process in the health care delivery system.

    Science.gov (United States)

    Ruohonen, Toni; Ennejmy, Mohammed

    2013-01-01

    Making reliable and justified operational and strategic decisions is a really challenging task in the health care domain. So far, the decisions have been made based on the experience of managers and staff, or they are evaluated with traditional methods, using inadequate data. As a result of this kind of decision-making process, attempts to improve operations usually have failed or led to only local improvements. Health care organizations have a lot of operational data, in addition to clinical data, which is the key element for making reliable and justified decisions. However, it is progressively problematic to access it and make usage of it. In this paper we discuss about the possibilities how to exploit operational data in the most efficient way in the decision-making process. We'll share our future visions and propose a conceptual framework for automating the decision-making process.

  15. The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems.

    Science.gov (United States)

    MacNeill, Andrea J; Lillywhite, Robert; Brown, Carl J

    2017-12-01

    Climate change is a major global public health priority. The delivery of health-care services generates considerable greenhouse gas emissions. Operating theatres are a resource-intensive subsector of health care, with high energy demands, consumable throughput, and waste volumes. The environmental impacts of these activities are generally accepted as necessary for the provision of quality care, but have not been examined in detail. In this study, we estimate the carbon footprint of operating theatres in hospitals in three health systems. Surgical suites at three academic quaternary-care hospitals were studied over a 1-year period in Canada (Vancouver General Hospital, VGH), the USA (University of Minnesota Medical Center, UMMC), and the UK (John Radcliffe Hospital, JRH). Greenhouse gas emissions were estimated using primary activity data and applicable emissions factors, and reported according to the Greenhouse Gas Protocol. Site greenhouse gas evaluations were done between Jan 1 and Dec 31, 2011. The surgical suites studied were found to have annual carbon footprints of 5 187 936 kg of CO 2 equivalents (CO 2 e) at JRH, 4 181 864 kg of CO 2 e at UMMC, and 3 218 907 kg of CO 2 e at VGH. On a per unit area basis, JRH had the lowest carbon intensity at 1702 kg CO 2 e/m 2 , compared with 1951 kg CO 2 e/m 2 at VGH and 2284 kg CO 2 e/m 2 at UMMC. Based on case volumes at all three sites, VGH had the lowest carbon intensity per operation at 146 kg CO 2 e per case compared with 173 kg CO 2 e per case at JRH and 232 kg CO 2 e per case at UMMC. Anaesthetic gases and energy consumption were the largest sources of greenhouse gas emissions. Preferential use of desflurane resulted in a ten-fold difference in anaesthetic gas emissions between hospitals. Theatres were found to be three to six times more energy-intense than the hospital as a whole, primarily due to heating, ventilation, and air conditioning requirements. Overall, the carbon footprint of surgery in the

  16. Financial health and customer satisfaction in private health care providers in Brazil.

    Science.gov (United States)

    Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard

    2011-11-01

    This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.

  17. Conceptualising the public health role of actors operating outside of formal health systems: The case of social enterprise.

    Science.gov (United States)

    Roy, Michael J; Baker, Rachel; Kerr, Susan

    2017-01-01

    This paper focuses on the role of actors that operate outside formal health systems, but nevertheless have a vital, if often under-recognised, role in supporting public health. The specific example used is the 'social enterprise', an organisation that seeks, through trading, to maximise social returns, rather than the distribution of profits to shareholders or owners. In this paper we advance empirical and theoretical understanding of the causal pathways at work in social enterprises, by considering them as a particularly complex form of public health 'intervention'. Data were generated through qualitative, in depth, semi-structured interviews and a focus group discussion, with a purposive, maximum variation sample of social enterprise practitioners (n = 13) in an urban setting in the west of Scotland. A method of analysis inspired by critical realism - Causation Coding - enabled the identification of a range of explanatory mechanisms and potential pathways of causation between engagement in social enterprise-led activity and various outcomes, which have been grouped into physical health, mental health and social determinants. The findings then informed the construction of an empirically-informed conceptual model to act as a platform upon which to develop a future research agenda. The results of this work are considered to not only encourage a broader and more imaginative consideration of what actually constitutes a public health intervention, but also reinforces arguments that actors within the Third Sector have an important role to play in addressing contemporary and future public health challenges. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. [The health system of Ecuador].

    Science.gov (United States)

    Lucio, Ruth; Villacrés, Nilhda; Henríquez, Rodrigo

    2011-01-01

    This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

  19. Improving the production of applied health research findings: insights from a qualitative study of operational research.

    Science.gov (United States)

    Crowe, Sonya; Turner, Simon; Utley, Martin; Fulop, Naomi J

    2017-09-08

    Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings. A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy. Semi-structured interviews (n = 20) were conducted with all members of the project's research team and advisory group (patient and health professional representatives and academics). These were augmented by participant (> 150 h) and non-participant (> 15 h) observations focusing on the process and experience of attempting to support knowledge production. Data were analysed thematically using QSR NVivo software. Operational research performed a knowledge mediation role shaped by a problem-focused approach and an intent to perform those tasks necessary to producing readily implementable knowledge but outwith the remit of other disciplinary strands of the project. Three characteristics of the role were found to support this: engaging and incorporating different perspectives to improve services by capturing a range of health professional and patient views alongside quantitative and qualitative research evidence; rendering data meaningful by creating and presenting evidence in forms that are accessible to and engage different audiences, enabling them to make sense of it for practical use; and maintaining perceived objectivity and rigour by establishing credibility, perceived neutrality and confidence in the robustness of the research in order to unite diverse professionals in thinking creatively about system-wide service improvement. Our study

  20. Should CAM and CAM Training Programs Be Included in the Curriculum of Schools That Provide Health Education?

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available Objectives: This study aimed to determine the knowledge levels and attitudes of School of Health and Vocational School of Health students toward complementary and alternative medicine (CAM. Methods: Three hundred thirty-three (333 students studying at the Mehmet Akif Ersoy University School of Health and the Golhisar Vocational School of Health in Burdur, Turkey, were included in the study. Research data were collected by using a survey method based on the expressed opinions of the participants. Results: Of the participants, 69.7% were female and 97% were single (unmarried. Of cigarette users and those with chronic illnesses, 46.8% and 47.8%, respectively, used CAM. Those using CAM were statistically more likely to be female (P < 0.021, to have higher grades (P < 0.007, to be single (P < 0.005, to be vocational school of health graduates (P < 0.008, and to have fathers at work (P < 0.021. While 9.6% of the students thought CAM to be nonsense, 10.8% thought that the methods of CAM should be tried before consulting a doctor. Conclusion: A majority of the students in the study population were found to use complementary and alternative medicine, but that they lacked information about its methods. As a way to address this, CAM should be included in the curriculum of schools that provide health education, and CAM training programs should be given to healthcare professionals to improve their knowledge of CAM. In Turkey, many more studies should be performed to determine nurses’ and doctors’ knowledge of and attitudes about CAM methods so that they can give correct guidance to society and take more active responsibility in improving patient safety.

  1. Cost-Utility Analysis of Extending Public Health Insurance Coverage to Include Diabetic Retinopathy Screening by Optometrists.

    Science.gov (United States)

    van Katwyk, Sasha; Jin, Ya-Ping; Trope, Graham E; Buys, Yvonne; Masucci, Lisa; Wedge, Richard; Flanagan, John; Brent, Michael H; El-Defrawy, Sherif; Tu, Hong Anh; Thavorn, Kednapa

    2017-09-01

    Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system. We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed. Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%. Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Honey bee (Apis mellifera) colony health and pathogen composition in migratory beekeeping operations involved in California almond pollination.

    Science.gov (United States)

    Glenny, William; Cavigli, Ian; Daughenbaugh, Katie F; Radford, Rosemarie; Kegley, Susan E; Flenniken, Michelle L

    2017-01-01

    Honey bees are important pollinators of agricultural crops. Pathogens and other factors have been implicated in high annual losses of honey bee colonies in North America and some European countries. To further investigate the relationship between multiple factors, including pathogen prevalence and abundance and colony health, we monitored commercially managed migratory honey bee colonies involved in California almond pollination in 2014. At each sampling event, honey bee colony health was assessed, using colony population size as a proxy for health, and the prevalence and abundance of seven honey bee pathogens was evaluated using PCR and quantitative PCR, respectively. In this sample cohort, pathogen prevalence and abundance did not correlate with colony health, but did correlate with the date of sampling. In general, pathogen prevalence (i.e., the number of specific pathogens harbored within a colony) was lower early in the year (January-March) and was greater in the summer, with peak prevalence occurring in June. Pathogen abundance in individual honey bee colonies varied throughout the year and was strongly associated with the sampling date, and was influenced by beekeeping operation, colony health, and mite infestation level. Together, data from this and other observational cohort studies that monitor individual honey bee colonies and precisely account for sampling date (i.e., day of year) will lead to a better understanding of the influence of pathogens on colony mortality and the effects of other factors on these associations.

  3. Honey bee (Apis mellifera colony health and pathogen composition in migratory beekeeping operations involved in California almond pollination.

    Directory of Open Access Journals (Sweden)

    William Glenny

    Full Text Available Honey bees are important pollinators of agricultural crops. Pathogens and other factors have been implicated in high annual losses of honey bee colonies in North America and some European countries. To further investigate the relationship between multiple factors, including pathogen prevalence and abundance and colony health, we monitored commercially managed migratory honey bee colonies involved in California almond pollination in 2014. At each sampling event, honey bee colony health was assessed, using colony population size as a proxy for health, and the prevalence and abundance of seven honey bee pathogens was evaluated using PCR and quantitative PCR, respectively. In this sample cohort, pathogen prevalence and abundance did not correlate with colony health, but did correlate with the date of sampling. In general, pathogen prevalence (i.e., the number of specific pathogens harbored within a colony was lower early in the year (January-March and was greater in the summer, with peak prevalence occurring in June. Pathogen abundance in individual honey bee colonies varied throughout the year and was strongly associated with the sampling date, and was influenced by beekeeping operation, colony health, and mite infestation level. Together, data from this and other observational cohort studies that monitor individual honey bee colonies and precisely account for sampling date (i.e., day of year will lead to a better understanding of the influence of pathogens on colony mortality and the effects of other factors on these associations.

  4. Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research.

    Science.gov (United States)

    Wallis, Selina; Cole, Donald C; Gaye, Oumar; Mmbaga, Blandina T; Mwapasa, Victor; Tagbor, Harry; Bates, Imelda

    2017-09-05

    Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. Four African universities. 83 university staff and students from 11 cadres. A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be

  5. Expanding Health Technology Assessments to Include Effects on the Environment

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    2016-01-01

    decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing......There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case...... and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some...

  6. Physician communication in the operating room: expanding application of face-negotiation theory to the health communication context.

    Science.gov (United States)

    Kirschbaum, Kristin

    2012-01-01

    Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians.

  7. The District Health Information System (DHIS2): A literature review and meta-synthesis of its strengths and operational challenges based on the experiences of 11 countries.

    Science.gov (United States)

    Dehnavieh, Reza; Haghdoost, AliAkbar; Khosravi, Ardeshir; Hoseinabadi, Fahime; Rahimi, Hamed; Poursheikhali, Atousa; Khajehpour, Nahid; Khajeh, Zahra; Mirshekari, Nadia; Hasani, Marziyeh; Radmerikhi, Samera; Haghighi, Hajar; Mehrolhassani, Mohammad Hossain; Kazemi, Elaheh; Aghamohamadi, Saeide

    2018-01-01

    Health information systems offer many potential benefits for healthcare, including financial benefits and for improving the quality of patient care. The purpose of District Health Information Systems (DHIS) is to document data that are routinely collected in all public health facilities in a country using the system. The aim of this study was to examine the strengths and operational challenges of DHIS2, with a goal to enable decision makers in different counties to more accurately evaluate the outcomes of introducing DHIS2 into their particular country. A review of the literature combined with the method of meta-synthesis was used to source information and interpret results relating to the strengths and operational challenges of DHIS2. Databases (Embase, PubMed, Scopus and Google Scholar) were searched for documents related to strengths and operational challenges of DHIS2, with no time limit up to 8 April 2017. The review and evaluation of selected studies was conducted in three stages: title, abstract and full text. Each of the selected studies was reviewed carefully and key concepts extracted. These key concepts were divided into two categories of strengths and operational challenges of DHIS2. Then, each category was grouped based on conceptual similarity to achieve the main themes and sub-themes. Content analysis was used to analyse extracted data. Of 766 identified citations, 20 studies from 11 countries were included and analysed in this study. Identified strengths in the DHIS were represented in seven themes (with 21 categories): technical features of software, proper management of data, application flexibility, networking and increasing the satisfaction of stakeholders, development of data management, increasing access to information and economic benefits. Operational challenges were identified and captured in 11 themes (with 18 categories): funds; appropriate communication infrastructure; the need for the existence of appropriate data; political, cultural

  8. A Concept of Operations for an Integrated Vehicle Health Assurance System

    Science.gov (United States)

    Hunter, Gary W.; Ross, Richard W.; Berger, David E.; Lekki, John D.; Mah, Robert W.; Perey, Danie F.; Schuet, Stefan R.; Simon, Donald L.; Smith, Stephen W.

    2013-01-01

    This document describes a Concept of Operations (ConOps) for an Integrated Vehicle Health Assurance System (IVHAS). This ConOps is associated with the Maintain Vehicle Safety (MVS) between Major Inspections Technical Challenge in the Vehicle Systems Safety Technologies (VSST) Project within NASA s Aviation Safety Program. In particular, this document seeks to describe an integrated system concept for vehicle health assurance that integrates ground-based inspection and repair information with in-flight measurement data for airframe, propulsion, and avionics subsystems. The MVS Technical Challenge intends to maintain vehicle safety between major inspections by developing and demonstrating new integrated health management and failure prevention technologies to assure the integrity of vehicle systems between major inspection intervals and maintain vehicle state awareness during flight. The approach provided by this ConOps is intended to help optimize technology selection and development, as well as allow the initial integration and demonstration of these subsystem technologies over the 5 year span of the VSST program, and serve as a guideline for developing IVHAS technologies under the Aviation Safety Program within the next 5 to 15 years. A long-term vision of IVHAS is provided to describe a basic roadmap for more intelligent and autonomous vehicle systems.

  9. 33 CFR 150.15 - What must the operations manual include?

    Science.gov (United States)

    2010-07-01

    ... containment; (iii) Connecting and disconnecting transfer equipment, including a floating hose string for a...) Connecting and disconnecting of transfer equipment, including to a floating hose string for a SPM; (iv) Line..., bolted flanges, and quick-disconnect coupling. (10) A description of the method used to water and de...

  10. Operation management system evaluation in the central Finland health care district - end users' view of system implementation.

    Science.gov (United States)

    Lemmetty, Kaisa; Häyrinen, Eija

    2005-01-01

    In this paper we evaluate the implementation of the operation management system in the Central Finland Health Care District. The implementation of the operation management system changed the practice of operation management for the surgical clinic and concerned 500 personnel in total. A survey was carried out to investigate the end users' views on the system's usefulness, usability and the training and user support provided. The users' possibilities to accomplish their tasks and the kind of obstacles they face in operation management were explored. The assessment revealed that more end support is needed after the system implementation, even though a generally positive attitude towards the system was manifested among the staff.

  11. Health-related quality of life after transforaminal percutaneous endoscopic discectomy: An analysis according to the level of operation.

    Science.gov (United States)

    Kapetanakis, Stylianos; Charitoudis, Georgios; Thomaidis, Tryfon; Theodosiadis, Panagiotis; Papathanasiou, Jannis; Giatroudakis, Konstantinos

    2017-01-01

    Many patients suffer from radiculopathy and low back pain due to lumbar disc hernia. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive method that accesses the disc pathology through the intervertebral foramen. Health-related quality of life (HRQoL) has been previously assessed for this method. However, a possible effect of the level of operation on the postoperative progress of HRQoL remains undefined. The purpose of this study was to evaluate the impact of the level of operation on HRQoL, following TPED. A total of 76 patients diagnosed with lumbar disc hernia were enrolled in the study. According to the level of operation, they were divided into three groups: Group A (21 patients) for L3-L4, Group B (40 patients) for L4-L5, and Group C (15 patients) for L5-S1 intervertebral level. All patients underwent TPED. Their HRQoL was evaluated by the short-form-36 (SF-36) health survey questionnaire before the operation and at 6 weeks, 3, 6, and 12 months postsurgery. The progress of SF-36 was analyzed in relation to the operated level. All aspects of SF-36 showed statistical significant improvement, at every given time interval ( P ≤ 0.05) in the total of patients and in each group separately. Group A had a significantly higher increase in physical functioning (PF) score at 3 and 12 months postsurgery ( P = 0.046 and P = 0.056, respectively). On the other hand, Group B had a significant lower increase in mental health (MH) score at 6 months ( P = 0.009) postoperatively. Our study concludes that the level of operation in patients who undergo TPED for lumbar disc herniation affects the HRQoL 1 year after surgery, with Group A having a significantly greater improvement of PF in comparison with Groups B and C.

  12. Operating a Microwave Radiation Detection Monitor. Module 10. Vocational Education Training in Environmental Health Sciences.

    Science.gov (United States)

    Consumer Dynamics Inc., Rockville, MD.

    This module, one of 25 on vocational education training for careers in environmental health occupations, contains self-instructional materials on operating a microwave radiation detection monitor. Following guidelines for students and instructors and an introduction that explains what the student will learn are three lessons: (1) testing the…

  13. Radiation safety and operational health physics of hospital based medical cyclotrons

    International Nuclear Information System (INIS)

    Mukherjee, B.

    2002-01-01

    Full text: Compact, low energy, high current Medical Cyclotrons are now primarily used to produce large activities of short lived, neutron deficient, positron- emitting radioisotopes. These isotopes constitute the key ingredients of important PET (Positron Emission Tomography) radiopharmaceuticals used in diagnostic nuclear medicine. The PET-radioisotope producing Medical Cyclotrons are now increasingly installed in modern urban hospitals in many countries of the world. Modern Medical Cyclotrons run at a very high beam current (∼100-200 micro Amp) level and thereby produce intense fields of parasitic gamma rays and neutrons, causing the activation of cyclotron components, ambient air and radiation exposure to patients and members of the public. This report highlights the important operational aspects and the characteristics of the radiation fields produced by Medical Cyclotrons. The pathways of personnel radiation exposure are also analyzed. The above information constitutes the scientific basis of a sound operational health physics service, which is manifested in an effective dose reduction and an enhanced radiological safety of the Medical Cyclotron facility within the framework of ALARA

  14. Modifying effects of perceived adaptation to shift work on health, wellbeing, and alertness on the job among nuclear power plant operators.

    Science.gov (United States)

    Takahashi, Masaya; Tanigawa, Takeshi; Tachibana, Naoko; Mutou, Keiko; Kage, Yoshiko; Smith, Lawrence; Iso, Hiroyasu

    2005-01-01

    This study examined the relationship between perceived adaptation to shift work and shift-related problems. A total of 608 male operators at nuclear power plants completed a set of validated questionnaires including a modified version of the Standard Shiftwork Index, which covered adaptation to shift work, fit to job content, chronotypes, chronic fatigue, sleep, naps, shift work locus of control (SHLOC), psychological health, social/family life, daytime sleepiness, workload, alertness on the job, and lifestyle factors. Participants were divided into two groups according to their perceived level of adaptation to shift work. The good adaptation group showed better outcomes than the poor adaptation group in terms of fit to job content, chronic fatigue, daytime sleep before night shifts, social and family disruption, SHLOC, psychological health, and alertness during night shifts (pseffects of working shifts may be modified by perceptions of shift work adaptation.

  15. Everyday discrimination and physical health: Exploring mental health processes.

    Science.gov (United States)

    Earnshaw, Valerie A; Rosenthal, Lisa; Carroll-Scott, Amy; Santilli, Alycia; Gilstad-Hayden, Kathryn; Ickovics, Jeannette R

    2016-10-01

    Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress. © The Author(s) 2015.

  16. Public health emergencies and the public health/managed care challenge.

    Science.gov (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  17. Innovations in occupational health nursing education, including a distance learning approach.

    Science.gov (United States)

    Lowis, A; Ellington, H

    1991-07-01

    The results of a survey in the United Kingdom in the late 1980s indicated that many occupational health nurses were not being sent for formal training because of the length of time nurses needed to be away from their employment and the difficulty employers had in finding nurse replacements during training. To meet the needs of occupational health nurses and their employers, the Robert Gordon Institute of Technology (RGIT) instituted a modular training course that offers full time attendance or distance learning options. RGIT's course consists of six modules over a 1 to 3 year period, which students can take in any order after completing a short Return to Study course. Using the innovative distance learning option, occupational health nurses can earn a Diploma in Occupational Health Nursing while completing most of their courses at the workplace, thus avoiding conflicts between training and work schedules.

  18. Changes in quality of life and perceptions of general health before and after operation of wind turbines.

    Science.gov (United States)

    Jalali, Leila; Bigelow, Philip; McColl, Stephen; Majowicz, Shannon; Gohari, Mahmood; Waterhouse, Ryan

    2016-09-01

    Ontario is Canada's provincial leader in wind energy, with over 4000 MW of installed capacity supplying approximately five percent of the province's electricity demand. Wind energy is now one of the fastest-growing sources of renewable power in Canada and many other countries. However, its possible negative impact on population health, as a new source of environmental noise, has raised concerns for people living in proximity to wind turbines (WTs). The aims of this study were to assess the effect of individual differences and annoyance on the self-reported general health and health-related quality of life (QOL) of nearby residents, using a pre- and post-exposure design. Prospective cohort data were collected before and after WT operations, from the individuals (n = 43) in Ontario, Canada. General health and QOL metrics were measured using standard scales, such as SF12, life satisfaction scales developed by Diener (SWLS) and the Canadian Community Health Survey (CCHS-SWL). The mean values for the Mental Component Score of SF12 (p = 0.002), SWLS (p < 0.001), and CCHS-SWL (p = 0.044) significantly worsened after WT operation for those participants who had a negative attitude to WTs, who voiced concerns about property devaluation, and/or who reported being visually or noise annoyed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Health surveillance in milling, baking and other food manufacturing operations--five years' experience.

    Science.gov (United States)

    Smith, T A; Patton, J

    1999-04-01

    The objective of this study was to describe the incidence of allergic respiratory disease and its outcome in terms of symptoms and jobs, across different flour-using industries. It uses the findings of a health surveillance programme in a large food organization over a five-year period. The population under surveillance consisted of 3,450 employees with exposure to ingredient dusts, of whom 400 were in flour milling, 1,650 in bread baking, 550 in cake baking and 850 in other flour-using operations. A total of 66 employees with either asthma or rhinitis symptoms attributable to sensitization to allergens in the workplace were identified. The majority of these (48/66) had become symptomatic prior to the commencement of the health surveillance programme in 1993. The incidence rates (per million employees per year) for those who developed symptoms between 1993 and 1997 were 550 for flour milling, 1,940 for bread baking, 0 for cake baking and 235 for other flour-using operations. The agent believed to be responsible for symptoms was most commonly grain dust in flour millers and fungal amylase in bread bakers. Wheat flour appeared to have a weaker sensitizing potential than these other two substances. In terms of outcome, at follow-up 18% of symptomatically sensitized employees had left the company. Two of the ex-employees retired through ill health due to occupational asthma. Of those still in employment, 63% described an improvement in symptoms, 32% were unchanged and 4% were worse than when first diagnosed. Over half the cases still in employment were continuing to work in the same job as at the time of diagnosis.

  20. Application of OMA to an Operating Wind Turbine: now including Vibration Data from the Blades

    DEFF Research Database (Denmark)

    Tcherniak, Dmitri; Larsen, Gunner Chr.

    2013-01-01

    due to the rotor rotation) as well as the considerable aerodynamic damping make OMA of operating wind turbines a difficult task. While in the previous works OMA was based on data provided by sensors mounted on the wind turbine tower and nacelle, we here attempt to improve the results by instrumenting......The presented study continues the work on application of Output Only Modal Analysis (OMA) to operating wind turbines. It is known from previous studies that issues like the time-varying nature of the equations of motion of an operating wind turbine (in particular the significant harmonic components...... discusses the technical challenges regarding blade instrumentation and data acquisition, data processing applied to eliminate the time-varying nature of an operating wind turbine in the resulting eigenvalue problem and, finally, it presents and discusses the initial results....

  1. Talisman Energy Inc : corporate social responsibility report 2001 : Sudan operations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    Talisman Energy Inc. is a large independent Canadian oil and gas producer with operations worldwide, including operations in Sudan, Malaysia, Trinidad and Colombia. This report includes a discussion on seismic exploration in the Acevedo block in Colombia, but most of the report focuses on operations in Sudan because that is the primary concern of many stakeholders, particularly the impact of the long-running civil war in that country and the way in which oil revenues will be used. The report describes Talisman Energy's compliance with the International Code of Ethics for Canadian Business which Talisman adopted in December 1999. The report evaluates Talisman's progress towards achieving objectives in the areas of human rights, community participation, employee rights, ethical business conduct, health, safety and the environment. Talisman will continue to advocate peace and the fair distribution of oil revenues. It was noted that the funding provided by the Sudan oil project consortium Greater Nile Petroleum Operating Company (GNPOC) for community development was increased for 2002. Talisman and GNPOC funding helps in community development initiatives such as the provision of water wells, health clinics and schools in Sudan. PricewaterhouseCoopers (PwC) was asked by Talisman to gather comments on the company's operations in Sudan from a range of stakeholder groups. This report presents audit statements by PwC regarding Talisman's social responsibility. The report also included an independent opinion regarding the challenge of facing ethical dilemmas in business. tabs., figs.

  2. Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation

    OpenAIRE

    Bucki, Marek; Lobos, Claudio; Payan, Yohan

    2007-01-01

    In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we desc...

  3. Human factors design of nuclear power plant control rooms including computer-based operator aids

    International Nuclear Information System (INIS)

    Bastl, W.; Felkel, L.; Becker, G.; Bohr, E.

    1983-01-01

    The scientific handling of human factors problems in control rooms began around 1970 on the basis of safety considerations. Some recent research work deals with the development of computerized systems like plant balance calculation, safety parameter display, alarm reduction and disturbance analysis. For disturbance analysis purposes it is necessary to homogenize the information presented to the operator according to the actual plant situation in order to supply the operator with the information he most urgently needs at the time. Different approaches for solving this problem are discussed, and an overview is given on what is being done. Other research projects concentrate on the detailed analysis of operators' diagnosis strategies in unexpected situations, in order to obtain a better understanding of their mental processes and the influences upon them when such situations occur. This project involves the use of a simulator and sophisticated recording and analysis methods. Control rooms are currently designed with the aid of mock-ups. They enable operators to contribute their experience to the optimization of the arrangement of displays and controls. Modern control rooms are characterized by increasing use of process computers and CRT (Cathode Ray Tube) displays. A general concept for the integration of the new computerized system and the conventional control panels is needed. The technical changes modify operators' tasks, and future ergonomic work in nuclear plants will need to consider the re-allocation of function between man and machine, the incorporation of task changes in training programmes, and the optimal design of information presentation using CRTs. Aspects of developments in control room design are detailed, typical research results are dealt with, and a brief forecast of the ergonomic contribution to be made in the Federal Republic of Germany is given

  4. Nuclear health and safety. Status of GAO's environmental, safety, and health recommendations to DOE

    International Nuclear Information System (INIS)

    England-Joseph, Judy; Bannerman, Carl J.; Fenzel, William F.; Brack, David L.; Harter, Frederick A.

    1990-04-01

    DOE's operations are carried out at many contractor-operated sites around the country, including major sites within the nuclear weapons complex that are involved in the production of nuclear material for weapons and naval fuel. At these sites DOE contractors routinely use and generate large quantities of a wide range of hazardous and radioactive materials. Because these materials require special handling by workers. Also pursuant to Mar. 15, 1989, request, we provided you a report entitled Nuclear Health and Safety: Need for Improved Responsiveness to Problems at DOE Sites (GAO/RCED-90-101, Mar. 28, 1990). to prevent exposure to themselves or releases into the environment, DOE's weapons complex, considered in its entirety, is among the potentially more dangerous industrial operations in the world. Over the last decade, at the request of the Congress, we have carried out a series of assessments and evaluations of various aspects of the complex. In over 60 reports and testimonies published since 1990, we have called attention to the mounting problems facing DOE's nuclear weapons complex. This body of work includes (1) identifying serious, costly, and widespread environmental, safety, and health problems at DOE facilities, (2) calling for outside independent oversight of DOE's nuclear operations, and (3) making recommendations to DOE to strengthen its oversight, providing more detailed information and plans to the Congress, and improving its management and accounting practices. In total, our reports and testimonies have included 54 recommendations to DOE, in addition to recommendations to the Congress, concerning environmental, safety, and health matters at the complex. We consider 23 of the 54 recommendations to be still open. The open recommendations call for improvements such as tighter program controls and clearer standards and policies related to environmental, safety, and health matters

  5. Advanced Modeling of Ramp Operations including Departure Status at Secondary Airports, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This project addresses three modeling elements relevant to NASA's IADS research and ATD-2 project, two related to ramp operations at primary airports and one related...

  6. Minimizing the health and climate impacts of emissions from heavy-duty public transportation bus fleets through operational optimization.

    Science.gov (United States)

    Gouge, Brian; Dowlatabadi, Hadi; Ries, Francis J

    2013-04-16

    In contrast to capital control strategies (i.e., investments in new technology), the potential of operational control strategies (e.g., vehicle scheduling optimization) to reduce the health and climate impacts of the emissions from public transportation bus fleets has not been widely considered. This case study demonstrates that heterogeneity in the emission levels of different bus technologies and the exposure potential of bus routes can be exploited though optimization (e.g., how vehicles are assigned to routes) to minimize these impacts as well as operating costs. The magnitude of the benefits of the optimization depend on the specific transit system and region. Health impacts were found to be particularly sensitive to different vehicle assignments and ranged from worst to best case assignment by more than a factor of 2, suggesting there is significant potential to reduce health impacts. Trade-offs between climate, health, and cost objectives were also found. Transit agencies that do not consider these objectives in an integrated framework and, for example, optimize for costs and/or climate impacts alone, risk inadvertently increasing health impacts by as much as 49%. Cost-benefit analysis was used to evaluate trade-offs between objectives, but large uncertainties make identifying an optimal solution challenging.

  7. Including public-health benefits of trees in urban-forestry decision making

    Science.gov (United States)

    Geoffrey H. Donovan

    2017-01-01

    Research demonstrating the biophysical benefits of urban trees are often used to justify investments in urban forestry. Far less emphasis, however, is placed on the non-bio-physical benefits such as improvements in public health. Indeed, the public-health benefits of trees may be significantly larger than the biophysical benefits, and, therefore, failure to account for...

  8. Operations of the Biblioteca Regional de Medicina (BIREME).

    Science.gov (United States)

    Neghme, A

    1975-04-01

    The operations and accomplishments of the Biblioteca Regional de Medicina (BIREME), the regional medical library of the Pan American Health Organization, are summarized. Aspects of BIREME's program which are described include: strengthening biomedical collections in Latin America, network organization, international cooperation, document and information delivery, bibliographic services, and educational efforts.

  9. The Impact of Including Immigrants without Permanent Residence Status in the Public Health Insurance System in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Tepperová Jana

    2016-03-01

    Full Text Available Whether an individual can or cannot participate in the Czech public health insurance system depends on several characteristics, one of which is whether he/she has permanent residence status in the Czech Republic, and a second whether he/she is employed. This means that those without permanent residence status, including self-employed migrants from third countries, their dependent relatives, and the dependent relatives of third country employees in the Czech Republic, cannot participate in the public health insurance system. Some argue that such migrants should be included in the system, since commercial health insurance is disadvantageous and the contributions they would pay into the public health insurance system would increase the public health insurance agencies’ income. We estimate the value of the contributions to public health insurance that would be paid by third country self-employed and non-working immigrants, if they were insured based on data from 2011 to 2013, and compare this to the assumed costs of their medical care. To calculate the contributions for self-employed migrants we use data on the distribution of the tax base for self-employed persons from personal income tax returns. Our estimation results in an overall negative balance of 22 million CZK on the data for 2012 and 2013. In the current system this deficit would be covered by the state, which would pay contributions to the system for certain (state insured persons amounting to 97 million CZK; overall therefore the inclusion of these immigrants would result in a positive balance of 75 million CZK.

  10. Safety and health in forest harvesting operations. Diagnosis and preventive actions. A review.

    OpenAIRE

    P. Albizu-Urionabarrenetxea; E. Tolosana-Esteban; E. Roman-Jordan

    2013-01-01

    Aim of study: to review the present state of the art in relation to the main labour risks and the most relevant results of recent studies evaluating the safety and health conditions of the forest harvesting work and better ways to reduce accidents.Area of study: It focuses mainly on developed Countries, where the general concern about work risks prevention, together with the complex idiosyncrasy of forest work in forest harvesting operations, has led to a growing interest from the forest scie...

  11. Stress and Fatigue in Operators Under Radiofrequency Electromagnetic Radiation and Shift Work

    Directory of Open Access Journals (Sweden)

    Vangelova K.

    2014-12-01

    Full Text Available The aim was to study the effect of radiofrequency electromagnetic radiation (EMR on stress indices, health complaints and fatigue of operators working fast-rotating extended shifts. Working conditions, job content, job control, social support, health complaints and fatigue were followed in 220 operators, 110 exposed to EMR and 110 control operators, matched by age and sex. The EMR was measured and time-weighted average (TWA was calculated. The excretion rates of stress hormones cortisol, adrenaline and noradrenaline were followed during the extended shifts in 36 operators, working at different levels of exposure and 24-hour exposure was calculated. The exposed group pointed more problems with the working conditions, including EMR, noise, currents and risk of accidents, more health complaints and higher level of fatigue. The most common health complaints were mental and physical exhaustion after work, pains in the chest, musculoskeletal complaints, headache, and apathy. High level EMR exposure (TWAmean = 3.10 μW/cm2, TWAmax = 137.00 μW/cm2 significantly increased the 24-hour excretion of cortisol and noradrenaline, whereas the increase of adrenaline excretion did not reach significance, as well as hormone excretion rates under low level exposure (TWAmean = 1.89 μW/cm2, TWAmax = 5.24 μW/cm2. In conclusion, higher number of health complaints, higher stress hormone excretion rates and fatigue were found in operators under EMR.

  12. The changing emphases in health physics

    International Nuclear Information System (INIS)

    Denham, D.H.; Kathren, R.L.

    1987-11-01

    This paper explores the changing emphases in health physics as evidenced by the subject matter of published papers in four primary English language journals of interest to health physicists. Articles from each journal were first grouped by subject and date of publication and were then compiled according to the list of professional domains practiced by health physicists. Five domains of practice were examined, measurements including dosimetry and environmental monitoring; regulations and standards; facilities and equipment including shielding, ventilation, and instrumentation; operations and procedures; and education and training. 2 tabs

  13. Claims of operators, non-operators and third parties arising from oil and gas operations

    International Nuclear Information System (INIS)

    Block, R.W.; Semadeni, T.

    1999-01-01

    There has come a resurgence in the number of companies involved in the oil and gas industry seeking protection from their creditors because of the recent weakness in commodity prices. Because most operations in this industry are conducted jointly, a single insolvency can lead to a toppling of other participants in the joint venture and beyond. The problem is to minimize one's losses if other members of the joint venture become insolvent. An examination is included of some remedies which may be available to operators, non-operators and third parties when faced with an insolvent oil and gas participant. The remedies which may be available to the non-operator that is owed moneys by its operator are discussed. The remedies that the operator has against its non-operators, with an emphasis on the nature of the operator's lien and the right of set-off, are described. A brief review is included of some of the remedies that might be available to a third party as against the operators and non-operators. Some s uggestions are included for directors, bankers, third parties, non-operators and operators

  14. Co-operation Between Different Authorities on Radiation and Health Protection Related to the Measures in Andreeva Bay

    International Nuclear Information System (INIS)

    Sneve, Malgorzata K.

    2003-01-01

    The Norwegian Radiation Protection Authority (NRPA) has been involved in the implementation of the Norwegian Plan of Action run by the Norwegian Government to ensure appropriate environmental protection and nuclear safety in the decommissioning of nuclear installations in the Northwest Russia. One objective is to ensure that the procedures used for the decommissioning of nuclear installations and radioactive waste management are appropriate and consistent with relevant policies and guidelines adopted by Russian regulatory bodies and international agencies. NRPA is an advisor for the Norwegian Ministry of Foreign Affairs on radiation protection and nuclear safety issues and ensures good co-operation with Russian authorities on the common goals. The Russian Federation state regulatory process imposes strict requirements on operators to demonstrate adequate safety, environmental and human health protection. Practically, however, there is little experience in Russia of how to assess coherently and combine all different issues within an overall process that leads to informed decision making. Regulatory requirements and related assessments tend to focus either on safety (prevention of accidents), protection of human health (in normal operations and in the event of accidents) or protection of the environment as distinct from human health, not on the whole problem. The Regulatory Support Project has been carried out by NRPA and different Russian regulatory bodies like Gosatomnadzor, Medbioextreme and others with support also from regulatory bodies in other countries. The major goal of the Regulatory Support Project is to support Russian regulatory bodies when developing guidelines and requirements for the planning, licensing and implementation of the industry projects. Another goal is that related industrial projects in Northwest Russia are managed in such a way as to efficiently secure an acceptable level of protection of human health and the environment, consistent with

  15. 30 CFR 77.408 - Welding operations.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Welding operations. 77.408 Section 77.408 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... for Mechanical Equipment § 77.408 Welding operations. Welding operations shall be shielded and the...

  16. The Case to Include Brand of Moist Snuff in Health Surveys.

    Science.gov (United States)

    Timberlake, David S

    2016-08-01

    Brand of smokeless tobacco was added to the most recent Tobacco Use Supplement to the Current Population Survey (TUS-CPS), but deleted from the Centers for Disease Control's National Adult Tobacco Survey. The objective of this study was to assess the utility of brand in distinguishing users of moist snuff. The sample consisted of participants from the 2010-2011 TUS-CPS who reported having used one of 14 brands of moist snuff in the past month (n = 2334). The brands were categorized into one of three types: snus, discount snuff, premium snuff. Multinomial logistic regression was employed for testing for associations between brand type and a series of demographic and tobacco use measures. Females, metropolitan residents, current smokers, and moderate users of snuff had significantly greater odds of using snus relative to premium snuff in the adjusted model (P discount versus premium snuff. Separate analyses among current smokers (n = 470) and former smokers (n = 70) revealed positive associations between smoking cessation attempts and smokers' switch to discount snuff. Differences among the three categories of snuff users are likely attributed to variations in marketing campaigns. The differences are sufficient to warrant inclusion of snuff brand in health surveys because brand type could serve as a proxy measure for snuff use and dependence. Inclusion of brand of moist snuff in health surveys will enable researchers to categorize snuff users by brand type. Findings from this study indicate that brand type, defined according to cost (ie, discount vs. premium brands) and type of preferred snuff (ie, snus vs. other moist snuff), can distinguish snuff users by various demographic and tobacco use measures. Consequently, categorization by brand type could be used as a proxy measure for studies whose surveys do not include detailed information on snuff use and behavior. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on

  17. Identifying interprofessional global health competencies for 21st-century health professionals.

    Science.gov (United States)

    Jogerst, Kristen; Callender, Brian; Adams, Virginia; Evert, Jessica; Fields, Elise; Hall, Thomas; Olsen, Jody; Rowthorn, Virginia; Rudy, Sharon; Shen, Jiabin; Simon, Lisa; Torres, Herica; Velji, Anvar; Wilson, Lynda L

    2015-01-01

    At the 2008 inaugural meeting of the Consortium of Universities for Global Health (CUGH), participants discussed the rapid expansion of global health programs and the lack of standardized competencies and curricula to guide these programs. In 2013, CUGH appointed a Global Health Competency Subcommittee and charged this subcommittee with identifying broad global health core competencies applicable across disciplines. The purpose of this paper is to describe the Subcommittee's work and proposed list of interprofessional global health competencies. After agreeing on a definition of global health to guide the Subcommittee's work, members conducted an extensive literature review to identify existing competencies in all fields relevant to global health. Subcommittee members initially identified 82 competencies in 12 separate domains, and proposed four different competency levels. The proposed competencies and domains were discussed during multiple conference calls, and subcommittee members voted to determine the final competencies to be included in two of the four proposed competency levels (global citizen and basic operational level - program oriented). The final proposed list included a total of 13 competencies across 8 domains for the Global Citizen Level and 39 competencies across 11 domains for the Basic Operational Program-Oriented Level. There is a need for continued debate and dialog to validate the proposed set of competencies, and a need for further research to identify best strategies for incorporating these competencies into global health educational programs. Future research should focus on implementation and evaluation of these competencies across a range of educational programs, and further delineating the competencies needed across all four proposed competency levels. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Comprehensive Performance Nutrition for Special Operations Forces.

    Science.gov (United States)

    Daigle, Karen A; Logan, Christi M; Kotwal, Russ S

    2015-01-01

    Special Operations Forces (SOF) training, combat, and contingency operations are unique and demanding. Performance nutrition within the Department of Defense has emphasized that nutrition is relative to factors related to the desired outcome, which includes successful performance of mentally and physically demanding operations and missions of tactical and strategic importance, as well as nonoperational assignments. Discussed are operational, nonoperational, and patient categories that require different nutrition strategies to facilitate category-specific performance outcomes. Also presented are 10 major guidelines for a SOF comprehensive performance nutrition program, practical nutrition recommendations for Special Operators and medical providers, as well as resources for dietary supplement evaluation. Foundational health concepts, medical treatment, and task-specific performance factors should be considered when developing and systematically implementing a comprehensive SOF performance nutrition program. When tailored to organizational requirements, SOF unit- and culture-specific nutrition education and services can optimize individual Special Operator performance, overall unit readiness, and ultimately, mission success. 2015.

  19. Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

    Directory of Open Access Journals (Sweden)

    Jahagirdar Deepa

    2012-11-01

    Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.

  20. Strategies to include sexual orientation and gender identity in health ...

    African Journals Online (AJOL)

    2015-05-04

    May 4, 2015 ... Social justice and equity are important principles in African health sciences ... Courses that endeavour to develop students' skills in patient-provider .... (sexual and emotional attraction) and gender identity (one's sense of.

  1. On the Value of Structural Health Monitoring Information for the Operation of Wind Parks

    DEFF Research Database (Denmark)

    Thöns, Sebastian; Faber, Michael H.; Val, Dimitri V.

    2017-01-01

    wind turbine systems and its components is developed accounting for the wind park functionality, i.e. power production, its operation and its cascading damage and failure scenarios. This system model facilitates to quantify the expected benefits and risks throughout the service life accounting......In the present paper, an approach for the quantification of the Value of Structural Health Monitoring (SHM) Information building upon a framework for infrastructure system utility and decision analysis is developed and applied to the operation of wind parks. The quantification of the value of SHM...... facilitates a benefit and risk informed assessment and optimization of SHM strategies and encompasses models for the infrastructure functionality, the structural constituent and system risks and its management as well as the performance of SHM strategies. A wind park system model incorporating the structural...

  2. Guidelines for developing effective health education service in a national health agency.

    Science.gov (United States)

    Ochor, J O

    1983-01-01

    The constraints facing health education include: the fragmentation and dispersal of health-educational services among different agencies and personnel; lack of policy guidelines; ineffectively organized and inefficiently managed health education systems; poor hierarchical status and inadequacy of resources. To resolve these constraints, national health education systems in health agencies should be developed on the basis of stipulated guidelines that could ensure their viability, efficiency and effectiveness. A study at the African Regional Health Education Centre, Ibadan, Nigeria, has yielded thirty synthesized guidelines. The "guidelines" were empirically tested as an evaluation tool by assessing the operational and organizational status of Oyo State Health Education Unit, Ibadan, Nigeria. These guidelines are adaptable to local conditions to enhance the re-organization, re-orientation and consolidation of health education in national health agencies.

  3. Creation of operation algorithms for combined operation of anti-lock braking system (ABS) and electric machine included in the combined power plant

    Science.gov (United States)

    Bakhmutov, S. V.; Ivanov, V. G.; Karpukhin, K. E.; Umnitsyn, A. A.

    2018-02-01

    The paper considers the Anti-lock Braking System (ABS) operation algorithm, which enables the implementation of hybrid braking, i.e. the braking process combining friction brake mechanisms and e-machine (electric machine), which operates in the energy recovery mode. The provided materials focus only on the rectilinear motion of the vehicle. That the ABS task consists in the maintenance of the target wheel slip ratio, which depends on the tyre-road adhesion coefficient. The tyre-road adhesion coefficient was defined based on the vehicle deceleration. In the course of calculated studies, the following operation algorithm of hybrid braking was determined. At adhesion coefficient ≤0.1, driving axle braking occurs only due to the e-machine operating in the energy recovery mode. In other cases, depending on adhesion coefficient, the e-machine provides the brake torque, which changes from 35 to 100% of the maximum available brake torque. Virtual tests showed that values of the wheel slip ratio are close to the required ones. Thus, this algorithm makes it possible to implement hybrid braking by means of the two sources creating the brake torque.

  4. Protecting the Force - Occupational Medicine's Expanded Role in Future Theaters of Operation

    National Research Council Canada - National Science Library

    Stover, William

    1998-01-01

    .... Other aspects of health service support that are not so closely tied to the hospital like medical intelligence and preventive medicine must also be considered and included for in the operational planning process...

  5. Development of a quantitative safety assessment method for nuclear I and C systems including human operators

    International Nuclear Information System (INIS)

    Kim, Man Cheol

    2004-02-01

    Conventional PSA (probabilistic safety analysis) is performed in the framework of event tree analysis and fault tree analysis. In conventional PSA, I and C systems and human operators are assumed to be independent for simplicity. But, the dependency of human operators on I and C systems and the dependency of I and C systems on human operators are gradually recognized to be significant. I believe that it is time to consider the interdependency between I and C systems and human operators in the framework of PSA. But, unfortunately it seems that we do not have appropriate methods for incorporating the interdependency between I and C systems and human operators in the framework of Pasa. Conventional human reliability analysis (HRA) methods are not developed to consider the interdependecy, and the modeling of the interdependency using conventional event tree analysis and fault tree analysis seem to be, event though is does not seem to be impossible, quite complex. To incorporate the interdependency between I and C systems and human operators, we need a new method for HRA and a new method for modeling the I and C systems, man-machine interface (MMI), and human operators for quantitative safety assessment. As a new method for modeling the I and C systems, MMI and human operators, I develop a new system reliability analysis method, reliability graph with general gates (RGGG), which can substitute conventional fault tree analysis. RGGG is an intuitive and easy-to-use method for system reliability analysis, while as powerful as conventional fault tree analysis. To demonstrate the usefulness of the RGGG method, it is applied to the reliability analysis of Digital Plant Protection System (DPPS), which is the actual plant protection system of Ulchin 5 and 6 nuclear power plants located in Republic of Korea. The latest version of the fault tree for DPPS, which is developed by the Integrated Safety Assessment team in Korea Atomic Energy Research Institute (KAERI), consists of 64

  6. [Evaluation auditing of the quality of health care in accreditation of health facilities].

    Science.gov (United States)

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

    This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

  7. [The operation of the health program SICALIDAD: the role of managers in primary care and hospitals].

    Science.gov (United States)

    Granados-Cosme, José Arturo; Tetelboin-Henrion, Carolina; Torres-Cruz, César; Pineda-Pérez, Dayana; Villa-Contreras, Blanca Margarita

    2011-01-01

    To characterize the role of quality managers in health care units and health districts, identifying the constraints they experience in their performance. An interview guide and a questionnaire were carried out and were applied to quality managers in nine states as well as in Mexico City´s Health Services, in a Reference Federal Hospital and in a National Institute of Health. These instruments were analyzed using SPSS and Atlas.ti software. The activities done by the managers depend on the organizational level of services, which can be a care unit or the health jurisdiction. For each of these, we identified different order constraints that affect the performance of the role of management in the strategies to improve the quality of the services for population without social insurance, which together make up the government program called Integrated Quality Health System. Jurisdictional managers are the link between care units and state authorities in the management of information, while the medical units' managers drive operational strategies to improve the quality. Although the health program is implemented with the personal and infrastructure of the health system, it requires a greater institutionalization and strengthening of its structure and integration, as well as greater human and material resources.

  8. Crew-Centered Operations: What HAL 9000 Should Have Been

    Science.gov (United States)

    Korsmeyer, David J.; Clancy, Daniel J.; Crawford, James M.; Drummond, Mark E.

    2005-01-01

    To date, manned space flight has maintained the locus of control for the mission on the ground. Mission control performs tasks such as activity planning, system health management, resource allocation, and astronaut health monitoring. Future exploration missions require the locus of control to shift to on-board due light speed constraints and potential loss of communication. The lunar campaign must begin to utilize a shared control approach to validate and understand the limitations of the technology allowing astronauts to oversee and direct aspects of operation that require timely decision making. Crew-centered Operations require a system-level approach that integrates multiple technologies together to allow a crew-prime concept of operations. This paper will provide an overview of the driving mission requirements, highlighting the limitations of existing approaches to mission operations and identifying the critical technologies necessary to enable a crew-centered mode of operations. The paper will focus on the requirements, trade spaces, and concepts for fulfillment of this capability. The paper will provide a broad overview of relevant technologies including: Activity Planning and Scheduling; System Monitoring; Repair and Recovery; Crew Work Practices.

  9. Eielson Air Force Base Operable Unit 2 baseline risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, R.E.; Jarvis, T.T.; Jarvis, M.R.; Whelan, G.

    1994-10-01

    Operable Unit 2 at Eielson Air Force Base (AFB) near Fairbanks, is one of several operable units characterized by petroleum, oil, and lubricant contamination, and by the presence of organic products floating at the water table, as a result of Air Force operations since the 1940s. The base is approximately 19,270 acres in size, and comprises the areas for military operations and a residential neighborhood for military dependents. Within Operable Unit 2, there are seven source areas. These source areas were grouped together primarily because of the contaminants released and hence are not necessarily in geographical proximity. Source area ST10 includes a surface water body (Hardfill Lake) next to a fuel spill area. The primary constituents of concern for human health include benzene, toluene, ethylbenzene, and xylenes (BTEX). Monitored data showed these volatile constituents to be present in groundwater wells. The data also showed an elevated level of trace metals in groundwater.

  10. Review of health issues of workers engaged in operations related to the accident at the Fukushima Daiichi Nuclear Power Plant.

    Science.gov (United States)

    Hiraoka, Koh; Tateishi, Seiichiro; Mori, Koji

    2015-01-01

    The aim of this review was to summarize the lessons learned from the experience in protecting the health of workers engaged in operations following the accident at the Fukushima Daiichi Nuclear Power Plant (NPP). We reviewed all types of scientific papers examining workers' health found in Medline and Web of Sciences as well as some official reports published by the Ministry of Health, Labour and Welfare of Japan and other governmental institutes. The papers and reports were classified into those investigating workers at the Fukushima Daiichi and Daini NPPs, workers engaged in decontamination operations in designated areas, and other workers. Regarding workers at the NPPs, many efforts were made to establish an emergency-care and occupational health system. Risk management efforts were undertaken for radiation exposure, heat stress, psychological stress, outbreak of infectious diseases, and fitness for work. Only a few reports dealt with decontamination workers and others; however, the health management of these workers was clearly weaker than that for workers at the NPPs. Many lessons can be learned from what occurred. That knowledge can be applied to ongoing decommissioning work and to future disasters. In addition, it is necessary to study the long-term health effects of radiation exposure and to accumulate data about the health of workers engaged in decontamination work and other areas.

  11. Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation.

    Science.gov (United States)

    Bucki, M; Lobos, C; Payan, Y

    2007-01-01

    In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we describe a procedure to generate patient specific finite element meshes of the brain and propose a biomechanical model which can take into account tissue deformations and surgical procedures that modify the brain structure, like tumour or tissue resection.

  12. Liquid Crystal Membrane Dust Mitigation System for Lunar or Martian Operations, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Lunar dust creates a number of hazards to lunar operations including, effect on human health, degradation of life support systems, wear to mechanical systems and...

  13. [Nursing professionals and health care assistants' perception of patient safety culture in the operating room].

    Science.gov (United States)

    Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto

    2015-01-01

    To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  14. Towards a Location-based Service for Early Mental Health Interventions in Disaster Response Using Minimalistic Tele-operated Android Robots Technology

    Science.gov (United States)

    Vahidi, H.; Mobasheri, A.; Alimardani, M.; Guan, Q.; Bakillah, M.

    2014-04-01

    Providing early mental health services during disaster is a great challenge in the disaster response phase. Lack of access to adequate mental-health professionals in the early stages of large-scale disasters dramatically influences the trend of a successful mental health aid. In this paper, a conceptual framework has been suggested for adopting cellphone-type tele-operated android robots in the early stages of disasters for providing the early mental health services for disaster survivors by developing a locationbased and participatory approach. The techniques of enabling GI-services in a Peer-to-Peer (P2P) environment were studied to overcome the limitations of current centralized services. Therefore, the aim of this research study is to add more flexibility and autonomy to GI web services (WMS, WFS, WPS, etc.) and alleviate to some degree the inherent limitations of these centralized systems. A P2P system Architecture is presented for the location-based service using minimalistic tele-operated android robots, and some key techniques of implementing this service using BestPeer were studied for developing this framework.

  15. Strategies to include sexual orientation and gender identity in health ...

    African Journals Online (AJOL)

    Various disciplines can teach sexual orientation and gender identity issues in their context by challenging heteronormativity and highlighting specific LGBTI health concerns, and can do so more successfully with interactive teaching approaches that hold more potential than formalised lectures. Rights-based teaching ...

  16. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  17. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  18. Automation of Hubble Space Telescope Mission Operations

    Science.gov (United States)

    Burley, Richard; Goulet, Gregory; Slater, Mark; Huey, William; Bassford, Lynn; Dunham, Larry

    2012-01-01

    On June 13, 2011, after more than 21 years, 115 thousand orbits, and nearly 1 million exposures taken, the operation of the Hubble Space Telescope successfully transitioned from 24x7x365 staffing to 815 staffing. This required the automation of routine mission operations including telemetry and forward link acquisition, data dumping and solid-state recorder management, stored command loading, and health and safety monitoring of both the observatory and the HST Ground System. These changes were driven by budget reductions, and required ground system and onboard spacecraft enhancements across the entire operations spectrum, from planning and scheduling systems to payload flight software. Changes in personnel and staffing were required in order to adapt to the new roles and responsibilities required in the new automated operations era. This paper will provide a high level overview of the obstacles to automating nominal HST mission operations, both technical and cultural, and how those obstacles were overcome.

  19. Towards a public health profession

    DEFF Research Database (Denmark)

    Foldspang, Anders

    2015-01-01

    in the theoretical as well as the practical potential of the public health professional. Thus, he and she must be able to perform, what WHO Europe has developed as Essential Public Health Operations (EPHOs).3 This, in turn, implies that the public health professional possesses the set of intellectual (knowledge...... endorsed by WHO Europe’s member states as the basis for the public health education in Europe.5 The sections of the lists include: Public health methods; Population health and: Its social and economic determinants, and: Its material environmental determinants; Man-made interventions and systems, namely...... Health policy, health economics, organizational theory, health legislation, and public health leadership and management; Health promotion—health education, health protection, disease prevention; public health ethics. This should form the central part of the basis for all public health professionals...

  20. Operator decision support system for integrated wastewater management including wastewater treatment plants and receiving water bodies.

    Science.gov (United States)

    Kim, Minsoo; Kim, Yejin; Kim, Hyosoo; Piao, Wenhua; Kim, Changwon

    2016-06-01

    An operator decision support system (ODSS) is proposed to support operators of wastewater treatment plants (WWTPs) in making appropriate decisions. This system accounts for water quality (WQ) variations in WWTP influent and effluent and in the receiving water body (RWB). The proposed system is comprised of two diagnosis modules, three prediction modules, and a scenario-based supporting module (SSM). In the diagnosis modules, the WQs of the influent and effluent WWTP and of the RWB are assessed via multivariate analysis. Three prediction modules based on the k-nearest neighbors (k-NN) method, activated sludge model no. 2d (ASM2d) model, and QUAL2E model are used to forecast WQs for 3 days in advance. To compare various operating alternatives, SSM is applied to test various predetermined operating conditions in terms of overall oxygen transfer coefficient (Kla), waste sludge flow rate (Qw), return sludge flow rate (Qr), and internal recycle flow rate (Qir). In the case of unacceptable total phosphorus (TP), SSM provides appropriate information for the chemical treatment. The constructed ODSS was tested using data collected from Geumho River, which was the RWB, and S WWTP in Daegu City, South Korea. The results demonstrate the capability of the proposed ODSS to provide WWTP operators with more objective qualitative and quantitative assessments of WWTP and RWB WQs. Moreover, the current study shows that ODSS, using data collected from the study area, can be used to identify operational alternatives through SSM at an integrated urban wastewater management level.

  1. Prevalence of dental fluorosis in children taking part in an oral health programme including fluoride tablet supplements from the age of 2 years

    DEFF Research Database (Denmark)

    Eckersten, Charlotte; Pylvänen, Lena; Schröder, Ulla

    2010-01-01

    To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years.......To investigate the prevalence of dental fluorosis in children who had participated in an oral health programme between the ages 2-5 years, including fluoride tablets from the age of 2 years....

  2. Communication, control, and co-operation: (Latin) American interchanges in the history of international health.

    Science.gov (United States)

    Birn, Anne-Emanuelle; Hochman, Gilberto

    2008-01-01

    This article discusses the development of historical studies of international health since the 1980s, showing that the field has gained considerable density and complexity. The authors touch on various current research trends in the history of international health, including reconsideration of so-called centre-periphery and imperial-colonial relations. They emphasize the important, if often forgotten, role of Latin America in the history of international health and bring attention to the relevance of Canada to the international health field, especially in the last 30 years. The article concludes by introducing the articles that make up this special issue of CBMH, pointing out their most significant findings and cross-cutting themes.

  3. Co-operation of the CMEA member countries in the development of different reactor types, including certain aspects of their nuclear fuel cycle

    International Nuclear Information System (INIS)

    Panasenkov, A.; Barbur, I.; Barchenkov, A.; Molnar, L.; Tolpygo, V.; Khake, V.; Shcherbinin, B.

    1977-01-01

    The report gives an account of the problems of the projected development of atomic power and evaluates its role in the fuel and power complex and long-range development of interconnected power systems of the CMEA member countries. The report emphasizes the importance of scientific and technical co-operation in the creation of thermal and fast-neutron power reactors with 1000-1500MW(e) units, and in the elaboration of nuclear plants for heating services. The positive experience of the international scientific and research group of scientists of the CMEA member countries carrying out reactor-physics studies on critical assemblies is mentioned. The report contains basic conclusions from the forecasts for nuclear power in the CMEA member countries up to 1990, including forecasting methodology; the role of nuclear power plants in saving natural and enriched uranium for a projected period; and the impact of nuclear power development rates on its structure (thermal and fast reactor ratio). It lists the impacts of scientific and technical co-operation of the CMEA member countries on the fuel cycle, including the transport of spent nuclear fuel, its recovery, reprocessing and radioactive waste disposal. Particular effects of co-operation of the CMEA member countries on the radiation safety of nuclear power plants and environmental protection are analysed. The report notes the role of the international economic associations Interatomenergo and Interatominstrument in the accelerated development of nuclear power. (author)

  4. Health care in the United States: organization, management, and policy

    National Research Council Canada - National Science Library

    Greenwald, Howard P

    2010-01-01

    "Health Care in the United States discusses the basic structures and operations of the U.S. health system. This resource includes examples, tables, and a glossary with key terms and acronyms to help understand important concepts...

  5. Mental health among young adult survivors of childhood cancer and their siblings including posttraumatic growth.

    Science.gov (United States)

    Kamibeppu, Kiyoko; Sato, Iori; Honda, Misato; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Okamura, Jun; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Horibe, Keizo; Ishida, Yasushi

    2010-12-01

    Few studies have addressed the mental health status of young adult childhood cancer survivors (CCSs) and their siblings (SIBs). This paper focuses on depression, anxiety, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG) among Japanese CCSs and their SIBs. Adolescent and young adult CCSs (n=185), in remission for more than 1 year, their SIBs (n=72), and general controls (CONTs) (n=1,000) completed anonymous self-report questionnaires for depression, anxiety, PTSS, and PTG. The physicians in charge also completed an anonymous disease/treatment data sheet. CCSs were approximately 8 years old at diagnosis and approximately 23 years old at the time of the survey. Their diagnoses included leukemia (57%), lymphoma (12%), and solid tumors (30%). Thirty-eight percent underwent surgery and 25% received stem cell transplantation. No significant differences were found between CCSs and CONTs in terms of depression and anxiety. CCSs had significantly more PTSS and had remarkably greater PTG compared to CONTs. Although no significant differences were found between SIBs and CONTs regarding depression, anxiety, or PTSS, female SIBs exhibited greater PTG compared to female CONTs. To empower CCSs, they should be evaluated periodically regarding PTSS and PTG and should be provided appropriate care and feedback. The fact that the mental health status of young adult SIBs was similar to CONTs at 15 years after their siblings' diagnoses may help reassure parents who worry about mental health among the siblings of an affected child during and after his/her treatment.

  6. The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

    Science.gov (United States)

    Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

    2009-06-01

    The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

  7. Disparities in operative outcomes in patients with comorbid mental illness.

    Science.gov (United States)

    Bailey, Elizabeth A; Wirtalla, Christopher; Sharoky, Catherine E; Kelz, Rachel R

    2018-04-01

    Patients with mental health disorders have worse medical outcomes and experience excess mortality compared with those without a mental health comorbidity. This study aimed to evaluate the relationship between mental health comorbidities and surgical outcomes. This retrospective cohort study used the National Inpatient Sample (2009-2011) to select patients who underwent one of the 4 most common general surgery procedures (cholecystectomy and common duct exploration, colorectal resection, excision and lysis of peritoneal adhesions, and appendectomy). Patients with a concurrent mental health diagnosis were identified. Multivariable logistic regression examined outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications. Of the 579,851 patients included, 38,702 patients (6.7%) had a mental health diagnosis. Mood disorders were most prevalent (58.7%), followed by substance abuse (23.8%). After adjustment for confounders, including sex, race, number of comorbidities, admission status, open operations, insurance, and income quartile, we found that having a mental health diagnosis conferred a 40% greater odds of including prolonged length of stay (OR 1.41, P mental health diagnosis cohort. General surgery patients with comorbid mental disease experience a greater incidence of postoperative complications and longer hospitalizations. Recognizing these disparate outcomes is the first step in understanding how to optimize care for this frequently marginalized population. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Cost and benefit including value of life, health and environmental damage measured in time units

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager; Friis-Hansen, Peter

    2009-01-01

    Key elements of the authors' work on money equivalent time allocation to costs and benefits in risk analysis are put together as an entity. This includes the data supported dimensionless analysis of an equilibrium relation between total population work time and gross domestic product leading...... of this societal value over the actual costs, used by the owner for economically optimizing an activity, motivates a simple risk accept criterion suited to be imposed on the owner by the public. An illustration is given concerning allocation of economical means for mitigation of loss of life and health on a ferry...

  9. Federal Health Care Center: VA and DOD Need to Develop Better Information to Monitor Operations and Improve Efficiency

    Science.gov (United States)

    2017-01-01

    Defense (DOD) responsibility for contracting support Quality assurance Accreditation and oversight from external entities and credentialing and...MTF designation would introduce additional operational requirements and challenges to the FHCC, including financial management and quality assurance...departments—including DOD’s operational readiness mission—by integrating services previously provided by the former North Chicago VA Medical Center

  10. Operational calculus

    CERN Document Server

    Boehme, Thomas K

    1987-01-01

    Operational Calculus, Volume II is a methodical presentation of operational calculus. An outline of the general theory of linear differential equations with constant coefficients is presented. Integral operational calculus and advanced topics in operational calculus, including locally integrable functions and convergence in the space of operators, are also discussed. Formulas and tables are included.Comprised of four sections, this volume begins with a discussion on the general theory of linear differential equations with constant coefficients, focusing on such topics as homogeneous and non-ho

  11. Mortality after cardiac or vascular operations by preexisting serious mental illness status in the Veterans Health Administration.

    Science.gov (United States)

    Copeland, Laurel A; Sako, Edward Y; Zeber, John E; Pugh, Mary Jo; Wang, Chen-Pin; MacCarthy, Andrea A; Restrepo, Marcos I; Mortensen, Eric M; Lawrence, Valerie A

    2014-01-01

    To estimate 1-year mortality risk associated with preoperative serious mental illness (SMI) as defined by the Veterans Health Administration (schizophrenia, bipolar disorder, posttraumatic stress disorder [PTSD], major depression) following nonambulatory cardiac or vascular surgical procedures compared to patients without SMI. Cardiac/vascular operations were selected because patients with SMI are known to be at elevated risk of cardiovascular disease. Retrospective analysis of system-wide data from electronic medical records of patients undergoing nonambulatory surgery (inpatient or day-of-surgery admission) October 2005-September 2009 with 1-year follow-up (N=55,864; 99% male; operations (64%; 23% died), coronary artery bypass graft (26%; 10% died) or other cardiac operations (11%; 15%-18% died). Fourteen percent of patients with PTSD died, 20% without SMI and 24% with schizophrenia, with other groups intermediate. In multivariable stratified models, SMI was associated with increased mortality only for patients with bipolar disorder following cardiac operations. Bipolar disorder and PTSD were negatively associated with death following vascular operations. SMI is not consistently associated with postoperative mortality in covariate-adjusted analyses. Published by Elsevier Inc.

  12. The early indicators of financial failure: a study of bankrupt and solvent health systems.

    Science.gov (United States)

    Coyne, Joseph S; Singh, Sher G

    2008-01-01

    This article presents a series of pertinent predictors of financial failure based on analysis of solvent and bankrupt health systems to identify which financial measures show the clearest distinction between success and failure. Early warning signals are evident from the longitudinal analysis as early as five years before bankruptcy. The data source includes seven years of annual statements filed with the Securities and Exchange Commission by 13 health systems before they filed bankruptcy. Comparative data were compiled from five solvent health systems for the same seven-year period. Seven financial solvency ratios are included in this study, including four cash liquidity measures, two leverage measures, and one efficiency measure. The results show distinct financial trends between solvent and bankrupt health systems, in particular for the operating-cash-flow-related measures, namely Ratio 1: Operating Cash Flow Percentage Change, from prior to current period; Ratio 2: Operating Cash Flow to Net Revenues; and Ratio 4: Cash Flow to Total Liabilities, indicating sensitivity in the hospital industry to cash flow management. The high dependence on credit from third-party payers is cited as a reason for this; thus, there is a great need for cash to fund operations. Five managerial policy implications are provided to help health system managers avoid financial solvency problems in the future.

  13. SPACE MEDICINE and Medical Operations Overview

    Science.gov (United States)

    Dervay, Joe

    2009-01-01

    This presentation is an overview of the function of the work of the Space Medicine & Health Care Systems Office. The objective of the medical operations is to ensure the health, safety and well being of the astronaut corps and ground support team during all phases of space flight. There are many issues that impact the health of the astronauts. Some of them are physiological, and others relate to behavior, psychological issues and issues of the environment of space itself. Reviews of the medical events that have affected both Russian, and Americans while in space are included. Some views of shuttle liftoff, and ascent, the medical training aboard NASA's KC-135 and training in weightlessness, the Shuttle Orbiter Medical system (SOMS), and some of the medical equipment are included. Also included are a graphs showing Fluid loading countermeasures, and vertical pursuit tracking with head and eye. The final views are representations of the future crew exploration vehicle (CEV) approaching the International Space Station, and the moon, and a series of perspective representations of the earth in comparison to the other planets and the Sun, the Sun in relation to other stars, and a view of where in the galaxy the Sun is.

  14. Achieving excellence in community health centers: implications for health reform.

    Science.gov (United States)

    Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

    2012-02-01

    Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

  15. 48 CFR 352.223-70 - Safety and health.

    Science.gov (United States)

    2010-10-01

    ... laboratories; and other applicable occupational health and safety standards issued by OSHA and included in 29... Commission Standards and Regulations, pursuant to the Energy Reorganization Act of 1974 (42 U.S.C. 5801 et... health and safety operating procedures and practices for both personnel and facilities: (i) Biosafety in...

  16. Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations.

    Science.gov (United States)

    Sareen, Jitender; Belik, Shay-Lee; Afifi, Tracie O; Asmundson, Gordon J G; Cox, Brian J; Stein, Murray B

    2008-12-01

    We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5). A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.

  17. [Research on social determinants of health and health inequalities: evidence for health in all policies].

    Science.gov (United States)

    Borrell, Carme; Malmusi, Davide

    2010-12-01

    This article aims to review conceptual frameworks and some principles to be considered in research on social determinants of health and health inequalities. Some indicators of research on these issues in Spain are described. General expenditure on research and development in Spain is far from the Organisation for Economic Co-operation and Development mean. In addition, both globally and within Spain, the scientific production on health inequalities is very low, especially compared with other research areas. The budget for research on health inequalities is also reduced. A striking example is provided by analysis of the projects funded by the Marató de TV3, which seems to have little interest in funding research on health inequalities. However, both the scientific production and project financing on health inequalities have increased in the last decade. Finally, to advance research on health inequalities and its contribution to the incorporation of health in all policies, recommendations are made, which include redefining priorities, ensuring resources and promoting knowledge translation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Environmental impact of nuclear fuel cycle operations

    International Nuclear Information System (INIS)

    Wilkinson, W.L.

    1989-09-01

    This paper considers the environmental impact of nuclear fuel cycle operations, particularly those operated by British Nuclear Fuels plc, which include uranium conversion, fuel fabrication, uranium enrichment, irradiated fuel transport and storage, reprocessing, uranium recycle and waste treatment and disposal. Quantitative assessments have been made of the impact of the liquid and gaseous discharges to the environment from all stages in the fuel cycle. An upper limit to the possible health effects is readily obtained using the codified recommendations of the International Commission on Radiological Protection. This contrasts with the lack of knowledge concerning the health effects of many other pollutants, including those resulting from the burning of fossil fuels. Most of the liquid and gaseous discharges result at the reprocessing stage and although their impact on the environment and on human health is small, they have given rise to much public concern. Reductions in discharges at Sellafield over the last few years have been quite dramatic, which shows what can be done provided the necessary very large investment is undertaken. The cost-effectiveness of this investment must be considered. Some of it has gone beyond the point of justification in terms of health benefit, having been undertaken in response to public and political pressure, some of it on an international scale. The potential for significant off-site impact from accidents in the fuel cycle has been quantitatively assessed and shown to be very limited. Waste disposal will also have an insignificant impact in terms of risk. It is also shown that it is insignificant in relation to terrestrial radioactivity and therefore in relation to the human environment. 14 refs, 5 figs, 2 tabs

  19. Real-Time Rocket/Vehicle System Integrated Health Management Laboratory For Development and Testing of Health Monitoring/Management Systems

    Science.gov (United States)

    Aguilar, R.

    2006-01-01

    Pratt & Whitney Rocketdyne has developed a real-time engine/vehicle system integrated health management laboratory, or testbed, for developing and testing health management system concepts. This laboratory simulates components of an integrated system such as the rocket engine, rocket engine controller, vehicle or test controller, as well as a health management computer on separate general purpose computers. These general purpose computers can be replaced with more realistic components such as actual electronic controllers and valve actuators for hardware-in-the-loop simulation. Various engine configurations and propellant combinations are available. Fault or failure insertion capability on-the-fly using direct memory insertion from a user console is used to test system detection and response. The laboratory is currently capable of simulating the flow-path of a single rocket engine but work is underway to include structural and multiengine simulation capability as well as a dedicated data acquisition system. The ultimate goal is to simulate as accurately and realistically as possible the environment in which the health management system will operate including noise, dynamic response of the engine/engine controller, sensor time delays, and asynchronous operation of the various components. The rationale for the laboratory is also discussed including limited alternatives for demonstrating the effectiveness and safety of a flight system.

  20. African-American and Latina Women Seeking Public Health Services: Cultural Beliefs regarding Pregnancy, including Medication-taking Behavior

    Directory of Open Access Journals (Sweden)

    Luz Dalia Sanchez, MD, MCP, MHA, PhD

    2011-01-01

    Full Text Available Objective: to describe cultural beliefs and medication-taking-behavior about pregnancy in African-American and Latina women. Design: qualitative study using phenomenological methodology; face-to-face, semi structured interviews and focus group. Thematic analysis was done to obtain themes consistent with the research objective. Setting: Maricopa County, Arizona, Department of Public-health Programs, November 2008 through April 2009.Participants: women seeking public-health services in the greater Phoenix, Arizona.Results: fifteen adult women representing two ethnic groups (seven African-Americans and eight Latinas participated. Themes derived from the interview data included: “The Dilemma: To Become or Not to Become Pregnant;” “The Ideal Stress-free World: Support System;” “Changing Worlds: Wanting Dependency;” and “The Health care System: Disconnection from Pregnancy to Postpartum.”Conclusions: based on the cultural themes: 1. pregnancies were not planned; 2. healthy life-style changes were not likely to occur during pregnancy; 3. basic facts about the biology of sexual intercourse and pregnancy were not understood, and there was no usage of any preconceptional or prenatal medications; and 4. professional health care was not desired or considered necessary (except during delivery. These cultural beliefs can contribute to negative birth outcomes, and need to be considered by pharmacists and other health-care providers. The information gained from this study can guide the implementation of educational programs developed by pharmacists that are more sensitive to the cultural beliefs and points of view of these particular women. Such programs would thus be more likely to be favorably received and utilized.

  1. 30 CFR 75.1729 - Welding operations.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Welding operations. 75.1729 Section 75.1729 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Miscellaneous § 75.1729 Welding operations. Welding...

  2. Emergency Operations Center ribbon cutting

    Science.gov (United States)

    2009-01-01

    Center Director Gene Goldman and special guests celebrate the opening of the site's new Emergency Operations Center on June 2. Participants included (l t r): Steven Cooper, deputy director of the National Weather Service Southern Region; Tom Luedtke, NASA associate administrator for institutions and management; Charles Scales, NASA associate deputy administrator; Mississippi Gov. Haley Barbour; Gene Goldman, director of Stennis Space Center; Jack Forsythe, NASA assistant administrator for the Office of Security and Program Protection; Dr. Richard Williams, NASA chief health and medical officer; and Weldon Starks, president of Starks Contracting Company Inc. of Biloxi.

  3. Climate Services to Improve Public Health

    Science.gov (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-01-01

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

  4. Pandemic planning : oilsands operators and the regional municipality constantly refine strategy

    Energy Technology Data Exchange (ETDEWEB)

    Ball, C.G.

    2008-06-15

    The Alberta government anticipates that between 17 to 43 per cent of the province's population will be affected during a potential influenza pandemic. It is expected that between 3 and 12,000 Albertans will be hospitalized and up to 3000 will die. This article discussed emergency plans made by the oil and gas industry for future pandemics. Oil sands operators in the Wood Buffalo municipality prepared plans based on guidelines made by the World Health Organization (WHO) and various government bodies. The transient nature of the region's population and its limited health resources may increase the level of risk associated with a pandemic. The planning process adopted by the region has been designed to provide staff with the ability to deal with increased numbers of people visiting the hospital. The planning process includes training exercises that range from desktop drills to the setting up of triage areas. Other plans include the identification of operations and processes that would be at risk in the event of a pandemic, as well the identification of key operations and roles. Plans are constantly being refined in order to identify new areas of risk. 1 fig.

  5. Using Smartphones for Research Outside Clinical Settings: How Operating Systems, App Developers, and Users Determine Geolocation Data Quality in mHealth Studies.

    Science.gov (United States)

    Beukenhorst, A L; Schultz, D M; McBeth, J; Lakshminarayana, R; Sergeant, J C; Dixon, W G

    2017-01-01

    Smartphones that collect user geolocation provid opportunities for mobile Health (mHealth). Although granularity of geolocation data may be high, data completeness depends on the device's operating system, application developer decisions, and user actions. We investigate completeness of geolocation data collected via smartphones of 5601 people that self-reported daily chronic pain symptoms on 349,293 days. On 17% of these days, hourly geolocation data is reported, but days with 0 (16%), 1 (14%) and 2 (13%) geolocations are common. Android phones collect geolocation more often than iPhones (median 17 versus 2 times a day). Factors on operating system level and individual user level influence completeness of geolocation data collected with smartphones. mHealth researchers should be aware of these factors when designing their studies. The mHealth research community should devise standards for reporting geolocation data quality, analysing systematic differences in data quality between participant groups, and methods for data imputation.

  6. Civil society participation in the health system: the case of Brazil's Health Councils.

    Science.gov (United States)

    Martinez, Martha Gabriela; Kohler, Jillian Clare

    2016-10-26

    Brazil created Health Councils to bring together civil society groups, heath professionals, and government officials in the discussion of health policies and health system resource allocation. However, several studies have concluded that Health Councils are not very influential on healthcare policy. This study probes this issue further by providing a descriptive account of some of the challenges civil society face within Brazil's Health Councils. Forty semi-structured interviews with Health Council Members at the municipal, state and national levels were conducted in June and July of 2013 and May of 2014. The geographical location of the interviewees covered all five regions of Brazil (North, Northeast, Midwest, Southeast, South) for a total of 5 different municipal Health Councils, 8 different state Health Councils, and the national Health Council in Brasilia. Interview data was analyzed using a thematic approach. Health Councils are limited by a lack of legal authority, which limits their ability to hold the government accountable for its health service performance, and thus hinders their ability to fulfill their mandate. Equally important, their membership guidelines create a limited level of inclusivity that seems to benefit only well-organized civil society groups. There is a reported lack of support and recognition from the relevant government that negatively affects the degree to which Health Council deliberations are implemented. Other deficiencies include an insufficient amount of resources for Health Council operations, and a lack of training for Health Council members. Lastly, strong individual interests among Health Council members tend to influence how members participate in Health Council discussions. Brazil's Health Councils fall short in providing an effective forum through which civil society can actively participate in health policy and resource allocation decision-making processes. Restrictive membership guidelines, a lack of autonomy from the

  7. 40 CFR 300.435 - Remedial design/remedial action, operation and maintenance.

    Science.gov (United States)

    2010-07-01

    ... features of the selected remedy with respect to scope, performance, or cost. To amend the ROD, the lead...) Include appropriate language in the solicitation requiring potential prime contractors to submit... protection of human health and the environment, the operation of such treatment or other measures for a...

  8. Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

    Directory of Open Access Journals (Sweden)

    Chervoni Julia

    2006-12-01

    Full Text Available Abstract Background Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. Methods The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Results Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p Conclusion Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective.

  9. Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

    Science.gov (United States)

    Hadjichristodoulou, Christos; Mouchtouri, Varvara; Vaitsi, Vasiliki; Kapoula, Christina; Vousoureli, Anastasia; Kalivitis, Isidiros; Chervoni, Julia; Papastergiou, Panagiotis; Vasilogiannakopoulos, Antonios; Daniilidis, Vasilis D; Kremastinou, Jenny

    2006-12-18

    Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc) of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p quality tests (r = 0.39, p restaurant which accommodated athletes during a test event. Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective.

  10. Health physics experience in commissioning and operation of radiation and air activity monitoring system at FBTR

    International Nuclear Information System (INIS)

    Raghunath, V.M.; Meenakshisundaram, V.; Viswanathan, S.; Bala Sundar, S.; Jose, M.T.; Suriyamurthy, N.; Ravi, T.; Subramanian, V.

    2001-01-01

    The Radiation and Air Activity Monitoring System (RAAMS) at Fast Breeder Test Reactor (FBTR) is meant to monitor and record the radiation and air activity levels at various potentially active areas in FBTR complex. Health Physics Group, FBTR was associated during commissioning of RAAMS in fixing the alarm settings for the monitors, their relocation and in formulating the surveillance procedures. The areas were surveyed to check for any release of activity for confirming the observed readings during operation of the reactor. In such cases, augmentation of shielding was recommended and was promptly implemented by the station management. The details of the long and fruitful experience gained by the Health Physics Group, FBTR are described in this paper. (author)

  11. In situ health monitoring of piezoelectric sensors

    Science.gov (United States)

    Jensen, Scott L. (Inventor); Drouant, George J. (Inventor)

    2013-01-01

    An in situ health monitoring apparatus may include an exciter circuit that applies a pulse to a piezoelectric transducer and a data processing system that determines the piezoelectric transducer's dynamic response to the first pulse. The dynamic response can be used to evaluate the operating range, health, and as-mounted resonance frequency of the transducer, as well as the strength of a coupling between the transducer and a structure and the health of the structure.

  12. Issues on E-health Adoption in Nigeria

    OpenAIRE

    Kolawole J. Adebayo; Edward O. Ofoegbu

    2014-01-01

    E-health is the application of information technology for health care management. It includes all applications of information communication technologies to promote healthcare services support, delivery and education for improving efficiency in health care delivery to the citizens. Many factors contribute to the poor state of the medical sector of Nigeria, and in fact many developing countries, two of the most important being record keeping and accessibility. Nigeria still operates a paper bas...

  13. Ergonomic risk factor identification for sewing machine operators through supervised occupational therapy fieldwork in Bangladesh: A case study.

    Science.gov (United States)

    Habib, Md Monjurul

    2015-01-01

    Many sewing machine operators are working with high risk factors for musculoskeletal health in the garments industries in Bangladesh. To identify the physical risk factors among sewing machine operators in a Bangladeshi garments factory. Sewing machine operators (327, 83% female), were evaluated. The mean age of the participants was 25.25 years. Six ergonomic risk factors were determined using the Musculoskeletal Disorders risk assessment. Data collection included measurements of sewing machine table and chair heights; this data was combined with information from informal interviews. Significant ergonomic risk factors found included the combination of awkward postures of the neck and back, repetitive hand and arm movements, poor ergonomic workstations and prolonged working hours without adequate breaks; these risk factors resulted in musculoskeletal complaints, sick leave, and switching jobs. One aspect of improving worker health in garment factories includes addressing musculoskeletal risk factors through ergonomic interventions.

  14. The role of health system governance in strengthening the rural health insurance system in China.

    Science.gov (United States)

    Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

    2017-05-23

    Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding

  15. Quality of narrative operative reports in pancreatic surgery.

    Science.gov (United States)

    Wiebe, Meagan E; Sandhu, Lakhbir; Takata, Julie L; Kennedy, Erin D; Baxter, Nancy N; Gagliardi, Anna R; Urbach, David R; Wei, Alice C

    2013-10-01

    Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13-54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care.

  16. Environmental aspects based on operation performance of nuclear fuel fabrication facilities

    International Nuclear Information System (INIS)

    2001-07-01

    This publication was prepared within the framework of the IAEA Project entitled Development and Upgrading of Guidelines, Databases and Tools for Integrating Comparative Assessment into Energy System Analysis and Policy Making, which included the collection, review and input of data into a database on health and environmental impacts related to operation of nuclear fuel cycle facilities. The objectives of the report included assembling environmental data on operational performance of nuclear fabrication facilities in each country; compiling and arranging the data in a database, which will be easily available to experts and the public; and presenting data that may be of value for future environmental assessment of nuclear fabrication facilities

  17. Optimizing Clinical Operations as part of a Global Emergency Medicine Initiative in Kumasi, Ghana: Application of Lean Manufacturing Principals to Low Resource Health Systems

    Science.gov (United States)

    Carter, Patrick M.; Desmond, Jeffery S.; Akanbobnaab, Christopher; Oteng, Rockefeller A.; Rominski, Sarah; Barsan, William G.; Cunningham, Rebecca

    2012-01-01

    Background Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems; but use of Lean in low to middle income countries with developing emergency medicine systems has not been well characterized. Objectives To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital in Ghana and to identify key lessons learned to aid future global EM initiatives. Methods A three-week Lean improvement program focused on the hospital admissions process at Komfo Anokye Teaching Hospital was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. Results The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem solving techniques worked well in a low resource system without modification; 7) using Lean highlighted that

  18. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: application of Lean manufacturing principals to low-resource health systems.

    Science.gov (United States)

    Carter, Patrick M; Desmond, Jeffery S; Akanbobnaab, Christopher; Oteng, Rockefeller A; Rominski, Sarah D; Barsan, William G; Cunningham, Rebecca M

    2012-03-01

    Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems, but use of Lean in low to middle income countries with developing emergency medicine (EM) systems has not been well characterized. To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital (KATH) in Ghana and to identify key lessons learned to aid future global EM initiatives. A 3-week Lean improvement program focused on the hospital admissions process at KATH was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem-solving techniques worked well in a low-resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; and

  19. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Use Patient Opioid Use Position Statements and Task Force Patient Education Initiatives Advocacy and Health Policy Updates Selected Research ... at ACS ACS and Veterans Diversity at ACS ... and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Your Lung Operation ...

  20. Spacecraft operations

    CERN Document Server

    Sellmaier, Florian; Schmidhuber, Michael

    2015-01-01

    The book describes the basic concepts of spaceflight operations, for both, human and unmanned missions. The basic subsystems of a space vehicle are explained in dedicated chapters, the relationship of spacecraft design and the very unique space environment are laid out. Flight dynamics are taught as well as ground segment requirements. Mission operations are divided into preparation including management aspects, execution and planning. Deep space missions and space robotic operations are included as special cases. The book is based on a course held at the German Space Operation Center (GSOC).

  1. Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.

    Science.gov (United States)

    Wan, Eric L; Xie, Li; Barrett, Miceile; Baltodano, Pablo A; Rivadeneira, Andres F; Noboa, Jonathan; Silver, Maya; Zhou, Richard; Cho, Suzy; Tam, Tammie; Yurter, Alp; Gentry, Carol; Palacios, Jorge; Rosson, Gedge D; Redett, Richard J

    2015-01-01

    In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. We established a recovery and donation program to collect clean and unused supplies for healthcare institutions in developing nations. We analyzed items donated over a 3-year period (September 2010-November 2013) by quantity and weight, and estimated the projected value of the program under potential nationwide participation. To capture the health benefits attributable to the donated supplies at recipient institutions, we partnered with two tertiary-care centers in Guayaquil, Ecuador and conducted a pilot study on the utility of the donated supplies at the recipient institutions (October 2013). We determined the disability-adjusted life years (DALY) averted for all patients undergoing procedures involving donated items and estimated the annual attributable DALY as well as the cost per DALY averted both by supply and by procedure. Approximately, 2 million lbs (907,185 kg) per year of medical supplies are recoverable from large non-rural US academic medical centers. Of these supplies, 19 common categories represent a potential for donation worth US $15 million per year, at a cost-utility of US $2.14 per DALY averted. Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.

  2. Implementation of ORT: some problems encountered in training of health workers during an operational research programme.

    Science.gov (United States)

    Gupta, D N; SenGupta, P G; Sircar, B K; Mondal, S; Sarkar, S; Deb, B C

    1994-01-01

    During an operational research study on implementation of oral rehydration therapy in a block of West Bengal, India, amongst a population of 2, 16,805, a total of 171 Community Health Guides and 152 Anganwadi Workers were initially trained for one working day by lectures and slides about diarrhoea case management at the community level. The training was evaluated after two months and found to be inadequate. The workers were then retrained with modern approach using a module (prepared in local language) as suggested by World Health Organisation. The level of retention of the imparted knowledge of Health Workers for different items 2-3 months after training with lectures and slides ranged between 5-25% except preparation of ORS which was 80%. With the use of modules, 47-98% of health workers could retain the same knowledge 3 months after the training. The knowledge thus acquired were sustained even after 12 months of training to a level which was still much better than that retained 2 months after training with slides and lectures. However some of the items like indication of use of Home Available Fluids, dosage of ORS and when to refer a diarrhoea case to health facility were more difficult to recall after one year. This possibly indicates need for in-service training of grassroot level health workers at suiTable interval.

  3. A Semantically-enabled Community Health Portal for Cancer Prevention and Control

    Science.gov (United States)

    2011-06-01

    original team identified relevant datasets including data from the National Health Interview Survey ( NHIS 1) and the Health Information National Trends...Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302

  4. Cost-effectiveness of Crohn’s disease post-operative care

    Science.gov (United States)

    Wright, Emily K; Kamm, Michael A; Dr Cruz, Peter; Hamilton, Amy L; Ritchie, Kathryn J; Bell, Sally J; Brown, Steven J; Connell, William R; Desmond, Paul V; Liew, Danny

    2016-01-01

    AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection. METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo. RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated. PMID:27076772

  5. Improving health, safety, and profits in extended hours operations (shiftwork).

    Science.gov (United States)

    Kerin, Alex; Aguirre, Acacia

    2005-01-01

    Circadian Technologies, Inc. (CIRCADIAN) is an international consulting firm that for over 20 yr has helped employees better cope with shiftwork, while ensuring their employers reduce costs and maximize profits. This paper describes two of the methods employed to reduce accidents, absenteeism, and turnover, while improving morale and productivity in extended hour operations (shiftwork). Shiftworkers rarely receive on-the-job training to help them cope better with the rigors of working nights, evenings, and early mornings. A pre- and post-training study by CIRCADIAN demonstrated improvements in health and fatigue indices, and an increase in daytime sleep length. Companies who provide shiftwork lifestyle training also have lower rates of absenteeism and turnover compared to companies that do not provide training. The second intervention described in this paper is a novel method of shift scheduling. There are thousands of potential schedules, so how does a company choose the best schedule for their facility? The answer lies in allowing employees to be involved in the process of selection. This results in a workforce that experiences less fatigue, turnover and absenteeism, and higher morale.

  6. Minimally Processed Functional Foods: Technological and Operational Pathways.

    Science.gov (United States)

    Rodgers, Svetlana

    2016-10-01

    This paper offers a concise review of technical and operational concepts underpinning commercialization of minimally processed functional foods (FFs), foods with fresh-like qualities commanding premium prices. The growing number of permitted nutritional content/health claims, many of which relate to well-being, coupled with emerging extraction and food processing technologies offers new exciting opportunities for small and medium size enterprises (SMEs) specializing in fresh produce to play an active role in the health market. Supporting SMEs, governments could benefit from savings in healthcare costs and value creation in the economy. Consumers could benefit from novel FF formats such as refrigerated RTE (ready-to-eat) meals, a variety of fresh-like meat-, fish-, and egg-based products, fresh-cut fruits and vegetables, cereal-based fermented foods and beverages. To preserve these valuable commodities, mild biological (enzymatic treatment, fermentation and, bio-preservation) and engineering solutions are needed. The latter include nonthermal techniques such as high-pressure treatment, cook-chill, sous-vide, mirco-encapsulation, vacuum impregnation and others. "De-constructive" culinary techniques such as 3D food printing and molecular gastronomy as well as developments in nutrigenomics and digital technologies facilitate novel product formats, personalization and access to niche markets. In the operational sense, moving from nourishment to health improvement demands a shift from defensive market-oriented to offensive market-developing strategies including collaborative networks with research organizations. © 2016 Institute of Food Technologists®.

  7. Site Environmental Report for Calendar Year 1999. DOE Operations at The Boeing Company, Rocketdyne

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-09-01

    OAK A271 Site Environmental Report for Calendar Year 1999. DOE Operations at The Boeing Company, Rocketdyne. This Annual Site Environmental Report (ASER) for 1999 describes the environmental conditions related to work performed for the Department of Energy (DOE) at Area IV of the Rocketdyne Santa Susana Field Laboratory (SSFL). In the past, these operations included development, fabrication, and disassembly of nuclear reactors, reactor fuel, and other radioactive materials under the former Atomics International Division. Other activities included the operation of large-scale liquid metal facilities for testing of liquid metal fast breeder components at the Energy Technology Engineering Center (ETEC), a government-owned, company-operated test facility within Area IV. All nuclear work was terminated in 1988, and subsequently, all radiological work has been directed toward decontamination and decommissioning (D&D) of the previously used nuclear facilities and associated site areas. Large-scale D&D activities of the sodium test facilities began in 1996. This Annual Site Environmental Report provides information showing that there are no indications of any potential impact on public health and safety due to the operations conducted at the SSFL. All measures and calculations of off-site conditions demonstrate compliance with applicable regulations, which provide for protection of human health and the environment.

  8. Site Environmental Report for Calendar Year 1999. DOE Operations at The Boeing Company, Rocketdyne

    International Nuclear Information System (INIS)

    None

    2000-01-01

    OAK A271 Site Environmental Report for Calendar Year 1999. DOE Operations at The Boeing Company, Rocketdyne. This Annual Site Environmental Report (ASER) for 1999 describes the environmental conditions related to work performed for the Department of Energy (DOE) at Area IV of the Rocketdyne Santa Susana Field Laboratory (SSFL). In the past, these operations included development, fabrication, and disassembly of nuclear reactors, reactor fuel, and other radioactive materials under the former Atomics International Division. Other activities included the operation of large-scale liquid metal facilities for testing of liquid metal fast breeder components at the Energy Technology Engineering Center (ETEC), a government-owned, company-operated test facility within Area IV. All nuclear work was terminated in 1988, and subsequently, all radiological work has been directed toward decontamination and decommissioning (D and D) of the previously used nuclear facilities and associated site areas. Large-scale D and D activities of the sodium test facilities began in 1996. This Annual Site Environmental Report provides information showing that there are no indications of any potential impact on public health and safety due to the operations conducted at the SSFL. All measures and calculations of off-site conditions demonstrate compliance with applicable regulations, which provide for protection of human health and the environment

  9. Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001-2014.

    Science.gov (United States)

    Ramsey, Christine; Dziura, James; Justice, Amy C; Altalib, Hamada Hamid; Bathulapalli, Harini; Burg, Matthew; Decker, Suzanne; Driscoll, Mary; Goulet, Joseph; Haskell, Sally; Kulas, Joseph; Wang, Karen H; Mattocks, Kristen; Brandt, Cynthia

    2017-02-01

    To evaluate gender, age, and race/ethnicity as predictors of incident mental health diagnoses among Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans. We used US Veterans Health Administration (VHA) electronic health records from 2001 to 2014 to examine incidence rates and sociodemographic risk factors for mental health diagnoses among 888 142 veterans. Posttraumatic stress disorder (PTSD) was the most frequently diagnosed mental health condition across gender and age groups. Incidence rates for all mental health diagnoses were highest at ages 18 to 29 years and declined thereafter, with the exceptions of major depressive disorder (MDD) in both genders, and PTSD among women. Risk of incident bipolar disorder and MDD diagnoses were greater among women; risk of incident schizophrenia, and alcohol- and drug-use disorders diagnoses were greater in men. Compared with Whites, risk incident PTSD, MDD, and alcohol-use disorder diagnoses were lower at ages 18 to 29 years and higher at ages 45 to 64 years for both Hispanics and African Americans. Differentiating high-risk demographic and gender groups can lead to improved diagnosis and treatment of mental health diagnoses among veterans and other high-risk groups.

  10. Implementation and Operational Analysis of an Interactive Intensive Care Unit within a Smart Health Context.

    Science.gov (United States)

    Lopez-Iturri, Peio; Aguirre, Erik; Trigo, Jesús Daniel; Astrain, José Javier; Azpilicueta, Leyre; Serrano, Luis; Villadangos, Jesús; Falcone, Francisco

    2018-01-29

    In the context of hospital management and operation, Intensive Care Units (ICU) are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework.

  11. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  12. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  13. Transportation System Concept of Operations

    Energy Technology Data Exchange (ETDEWEB)

    N. Slater-Thompson

    2006-08-16

    The Nuclear Waste Policy Act of 1982 (NWPA), as amended, authorized the DOE to develop and manage a Federal system for the disposal of SNF and HLW. OCRWM was created to manage acceptance and disposal of SNF and HLW in a manner that protects public health, safety, and the environment; enhances national and energy security; and merits public confidence. This responsibility includes managing the transportation of SNF and HLW from origin sites to the Repository for disposal. The Transportation System Concept of Operations is the core high-level OCRWM document written to describe the Transportation System integrated design and present the vision, mission, and goals for Transportation System operations. By defining the functions, processes, and critical interfaces of this system early in the system development phase, programmatic risks are minimized, system costs are contained, and system operations are better managed, safer, and more secure. This document also facilitates discussions and understanding among parties responsible for the design, development, and operation of the Transportation System. Such understanding is important for the timely development of system requirements and identification of system interfaces. Information provided in the Transportation System Concept of Operations includes: the functions and key components of the Transportation System; system component interactions; flows of information within the system; the general operating sequences; and the internal and external factors affecting transportation operations. The Transportation System Concept of Operations reflects OCRWM's overall waste management system policies and mission objectives, and as such provides a description of the preferred state of system operation. The description of general Transportation System operating functions in the Transportation System Concept of Operations is the first step in the OCRWM systems engineering process, establishing the starting point for the lower

  14. Development of an operational manual for a consultation-liaison psychiatry service.

    Science.gov (United States)

    Wand, Anne Pf; Sharma, Swapnil; Carpenter, Lindsay J; Gatsi, Mike

    2018-02-01

    Consultation-liaison psychiatry (CLP) services sit between mental health and the general hospital, and risk being poorly understood by both systems. The aim of this study was to develop an operational manual for a CLP service, which defined functions and governance. The CLP literature was reviewed with a focus on descriptions of CLP roles, organisational processes, quality measures and service development. The CLP team held service planning meetings and met with members of the mental health and hospital executives. Site visits and collaboration with other CLP services occurred in defining the roles of the CLP service and organisational governance. A CLP operational document was developed, including a description of the service, its functions, staff roles and governance. Procedural information such as the CLP timetable, referral process, triage and assessment, documentation, activity recording, quality assurance and relevant policies were outlined. The development of a dedicated operational manual for CLP clarified the roles, functions and governance of CLP within the general hospital and mental health systems. The development process facilitated the engagement of key clinicians and administrators of these systems, the determination of quality improvement targets and greater transparency and accountability.

  15. Oil well fires of Operation Desert Storm--defining troop exposures and determining health risks.

    Science.gov (United States)

    Heller, Jack M

    2011-07-01

    During Operation Desert Storm, in February 1991, Iraqi troops began burning Kuwaiti oil wells. Almost immediately there was concern about possible adverse health effects in U.S. personnel exposed to crude oil combustion products. Combustions products were predicted from the known composition of Kuwaiti crude oil. Monitoring sites were established in Saudi Arabia and Kuwait; about 5,000 environmental samples were studied. Data collected were used to develop health risk assessments for the geographic areas sampled. This initial approach to assessing risk had to be greatly expanded when Congress passed Public Law 102-190, requiring development of means to calculate environmental exposures for individual U.S. service members. To estimate daily exposure levels for the entire area over 10 months for all U.S. troops, air dispersion modeling was used in conjunction with satellite imagery and geographic information system technology. This methodology made it possible to separate the risk caused by oil fire smoke from the total risk from all sources for each service member. The U.S. military responses to health concerns related to the oil well fires and to Public Law 102-190 were reviewed. Consideration was given to changes in technology, practices, and policies over the last two decades that might impact a similar contemporary response.

  16. 77 FR 67399 - Trim Systems Operating Corp., a Subsidiary of Commercial Vehicle Group, Inc., Including On-Site...

    Science.gov (United States)

    2012-11-09

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,393] Trim Systems Operating..., applicable to workers and former workers of Trim Systems Operating Corp., a subsidiary of Commercial Vehicle.... The amended notice applicable to TA-W-81,393 is hereby issued as follows: All workers of Trim Systems...

  17. World Health Organization's Innovative Direct Disbursement Mechanism for Payment of Grassroots Immunization Personnel and Operations in Nigeria: 2004-2015.

    Science.gov (United States)

    Yehualashet, Yared G; Wadda, Alieu; Agblewonu, Koffi B; Zhema, Theophilus; Ibrahim, Al-Asi A; Corr, Alhagie; Linkins, Jennifer; Mkanda, Pascal; Vaz, Rui G; Nsubuga, Peter; Ashogbon, Daniel

    2016-05-01

    Following the 1988 World Health Assembly resolution to eradicate polio, the government of Nigeria, with support from partners, has been implementing several rounds of supplementary immunization activities (SIAs) each year. In addition to the technical requirements, the success of the polio eradication initiative depends on timely provision of adequate financial resources. Disbursement of funds for SIAs and payment of allowances to numerous vaccination personnel at the grassroots level are enormous operational challenges in a country the size of Nigeria. Upon donors' request for a transparent and effective payment mechanism, the World Health Organization (WHO), in consultation with national counterparts, created the innovative direct disbursement mechanism (DDM) in 2004. The objective of the DDM was to timely deploy operational funds at the field level and directly pay vaccination personnel allowances at the grassroots level. A detailed operational guideline for funds disbursement was developed in close consultation with central and field stakeholders. Multiyear financial resource requirements and operational budgets for every campaign were produced by an interagency-coordinated finance subcommittee. The WHO engaged a bank and an accounting firm as DDM partners to support disbursement of and accounting for the SIA funds, respectively. The 37 WHO field offices were equipped with electronic financial systems to support the DDM process, and temporary payment sites were set up to facilitate payment to vaccination personnel at the grassroots level. Coordination meetings among DDM partners were held regularly to reconcile financial records and address operational challenges. Between 2004 and 2014, DDM supported 99 polio and nonpolio vaccination campaigns, disbursing more than $370 million to about 16 million beneficiaries across 280 temporary payment sites. To mitigate security risks and reduce operational costs, the WHO and DDM partners introduced mobile payment to

  18. Including Youth with Intellectual Disabilities in Health Promotion Research: Development and Reliability of a Structured Interview to Assess the Correlates of Physical Activity among Youth

    Science.gov (United States)

    Curtin, Carol; Bandini, Linda G.; Must, Aviva; Phillips, Sarah; Maslin, Melissa C. T.; Lo, Charmaine; Gleason, James M.; Fleming, Richard K.; Stanish, Heidi I.

    2016-01-01

    Background: The input of youth with intellectual disabilities in health promotion and health disparities research is essential for understanding their needs and preferences. Regular physical activity (PA) is vital for health and well-being, but levels are low in youth generally, including those with intellectual disabilities. Understanding the…

  19. Advanced Autonomous Systems for Space Operations

    Science.gov (United States)

    Gross, A. R.; Smith, B. D.; Muscettola, N.; Barrett, A.; Mjolssness, E.; Clancy, D. J.

    2002-01-01

    New missions of exploration and space operations will require unprecedented levels of autonomy to successfully accomplish their objectives. Inherently high levels of complexity, cost, and communication distances will preclude the degree of human involvement common to current and previous space flight missions. With exponentially increasing capabilities of computer hardware and software, including networks and communication systems, a new balance of work is being developed between humans and machines. This new balance holds the promise of not only meeting the greatly increased space exploration requirements, but simultaneously dramatically reducing the design, development, test, and operating costs. New information technologies, which take advantage of knowledge-based software, model-based reasoning, and high performance computer systems, will enable the development of a new generation of design and development tools, schedulers, and vehicle and system health management capabilities. Such tools will provide a degree of machine intelligence and associated autonomy that has previously been unavailable. These capabilities are critical to the future of advanced space operations, since the science and operational requirements specified by such missions, as well as the budgetary constraints will limit the current practice of monitoring and controlling missions by a standing army of ground-based controllers. System autonomy capabilities have made great strides in recent years, for both ground and space flight applications. Autonomous systems have flown on advanced spacecraft, providing new levels of spacecraft capability and mission safety. Such on-board systems operate by utilizing model-based reasoning that provides the capability to work from high-level mission goals, while deriving the detailed system commands internally, rather than having to have such commands transmitted from Earth. This enables missions of such complexity and communication` distances as are not

  20. Assessment of risks of accidents and normal operation at nuclear power plants

    International Nuclear Information System (INIS)

    Savolainen, Ilkka; Vuori, Seppo.

    1977-01-01

    A probabilistic assessment model for the analysis of risks involved in the operation of nuclear power plants is described. With the computer code ARANO it is possible to estimate the health and economic consequences of reactor accidents both in probabilistic and deterministic sense. In addition the code is applicable to the calculation of individual and collective doses caused by the releases during normal operation. The estimation of release probabilities and magnitudes is not included in the model. (author)

  1. Solution to selected occupational health problems in the operation of large machinery in potash mines

    Energy Technology Data Exchange (ETDEWEB)

    Stuhrmann, D.

    1979-01-01

    This paper discusses health hazards, such as noise, vibrations and air pollution caused by the operation of large machines and their effect on the human body. Means of reducing the influence of these factors are: improved ear protection against noise, special gymnastics at the end of each shift, warm water swimming and a weekly sauna treatment for the effects of vibrations. Air pollution caused by diesel engines is monitored. Engine exhaust standards are examined in detail and methods are proposed to further reduce air pollution.

  2. Pre-operative assessment and post-operative care in elective shoulder surgery.

    Science.gov (United States)

    Akhtar, Ahsan; Macfarlane, Robert J; Waseem, Mohammad

    2013-01-01

    Pre-operative assessment is required prior to the majority of elective surgical procedures, primarily to ensure that the patient is fit to undergo surgery, whilst identifying issues that may need to be dealt with by the surgical or anaesthetic teams. The post-operative management of elective surgical patients begins during the peri-operative period and involves several health professionals. Appropriate monitoring and repeated clinical assessments are required in order for the signs of surgical complications to be recognised swiftly and adequately. This article examines the literature regarding pre-operative assessment in elective orthopaedic surgery and shoulder surgery, whilst also reviewing the essentials of peri- and post-operative care. The need to recognise common post-operative complications early and promptly is also evaluated, along with discussing thromboprophylaxis and post-operative analgesia following shoulder surgery.

  3. The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

    Science.gov (United States)

    Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

    2011-06-01

    In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

  4. Nuclear safety requirements for operation licensing of Egyptian research reactors

    International Nuclear Information System (INIS)

    Ahmed, E.E.M.; Rahman, F.A.

    2000-01-01

    From the view of responsibility for health and nuclear safety, this work creates a framework for the application of nuclear regulatory rules to ensure safe operation for the sake of obtaining or maintaining operation licensing for nuclear research reactors. It has been performed according to the recommendations of the IAEA for research reactor safety regulations which clearly states that the scope of the application should include all research reactors being designed, constructed, commissioned, operated, modified or decommissioned. From that concept, the present work establishes a model structure and a computer logic program for a regulatory licensing system (RLS code). It applies both the regulatory inspection and enforcement regulatory rules on the different licensing process stages. The present established RLS code is then applied to the Egyptian Research Reactors, namely; the first ET-RR-1, which was constructed and still operating since 1961, and the second MPR research reactor (ET-RR-2) which is now in the preliminary operation stage. The results showed that for the ET-RR-1 reactor, all operational activities, including maintenance, in-service inspection, renewal, modification and experiments should meet the appropriate regulatory compliance action program. Also, the results showed that for the new MPR research reactor (ET-RR-2), all commissioning and operational stages should also meet the regulatory inspection and enforcement action program of the operational licensing safety requirements. (author)

  5. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    Science.gov (United States)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  6. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  7. International observatory on mental health systems: structure and operation

    Directory of Open Access Journals (Sweden)

    Minas Harry

    2009-04-01

    Full Text Available Abstract Introduction Sustained cooperative action is required to improve the mental health of populations, particularly in low and middle-income countries where meagre mental health investment and insufficient human and other resources result in poorly performing mental health systems. The Observatory The International Observatory on Mental Health Systems is a mental health systems research, education and development network that will contribute to the development of high quality mental health systems in low and middle-income countries. The work of the Observatory will be done by mental health systems research, education and development groups that are located in and managed by collaborating organisations. These groups will be supported by the IOMHS Secretariat, the International IOMHS Steering Group and a Technical Reference Group. Summary The International Observatory on Mental Health Systems is: 1 the mental health systems research, education and development groups; 2 the IOMHS Steering Group; 3 the IOMHS Technical Reference Group; and 4 the IOMHS Secretariat. The work of the Observatory will depend on free and open collaboration, sharing of knowledge and skills, and governance arrangements that are inclusive and that put the needs and interests of people with mental illness and their families at the centre of decision-making. We welcome contact from individuals and institutions that wish to contribute to achieving the goals of the Observatory. Now is the time to make it happen where it matters, by turning scientific knowledge into effective action for people's health. (J.W. Lee, in his acceptance speech on his appointment as the Director-General of the World Health Organization 1.

  8. Electric shovels meet the demands for mining operations

    Energy Technology Data Exchange (ETDEWEB)

    Fiscor, S.

    2008-03-15

    Rugged, intelligent shovels offer better productivity and help mine operators avoid costly downtime in a very tight market. In 2007 P & H Mining Equipment began to produce a new breed of electric mining shovels designed to help reduce operating cost in coal and other mining operations. These were designated the P & H C-Series. All have an advanced communication, command and control system called the Centurion system. Coal mining applications for this series include 4100XPCs in Australia, China and Wyoming, USA. The Centurion system provides information on shovel performance and systems health which is communicated via graphic user interface terminals to the operators cab. Bucyrus International is developing a hydraulic crowd mechanism for its electric shovels and is now field testing one for its 495 series shovel. The company has also added greater capability in the primary software in the drive system for troubleshooting and fault identification to quickly diagnose problems onboard or remotely. 4 photos.

  9. Preliminary study on psychosomatic status of nuclear power plant operators

    International Nuclear Information System (INIS)

    Bi Jinling; Liu Yulong; Li Yuan; Bian Huahui; Sun Yiling; Qiu Mengyue; Liu Chunfeng

    2011-01-01

    Objective: To understand the operators' psychosomatic health status in nuclear power plant; and provide the scientific basis of measures for preventing and reducing mental disorders in operators. Methods: The Psychosomatic Health Battery (PSHB) was used to assess the psychosomatic health status in 109 operators who were random selected from Qinshan nuclear power plant, etc. They were tested from lie, emotional stability, liveliness, tension, apprehension, mental health, such as psychopathic deviatesuch 7 personality traits. Results: Lie < 8, all inspected groups were normal. Psychopathic deviate: 98.2% for normal group 0.9% for both of groups occurred possible mental health problems and confirmed mental health problems; Mental health: 80.7% (88/109) for fine mental health ones, 29.4% (32/109) for those with excellent mental health, 51.4% (56/109) for good mental health ones, 13.8% (15/109) for general mental health ones, 5.5% (6/109) for poor mental health ones. Age factor could influence the mean values of the factors of apprehension, tension, mental health and psychopathic deviate. Correlation analysis showed that there was a correlation between tension and psychopathic deviate (r=0.664, P<0.01), and the other correlation coefficient was between apprehension and mental health (r=-0.789, P<0.01). Conclusions: There is an excellent condition of psychosomatic health in most of the operators, however, there are still a very small percentage of psychosomatic disorders among these operators, to improve the quality of their psychosomatic health, psychological counseling should be particularly strengthened to those with problems of psychosomatic health. (authors)

  10. Implementation and Operational Analysis of an Interactive Intensive Care Unit within a Smart Health Context

    Science.gov (United States)

    Aguirre, Erik

    2018-01-01

    In the context of hospital management and operation, Intensive Care Units (ICU) are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework. PMID:29382148

  11. Implementation and Operational Analysis of an Interactive Intensive Care Unit within a Smart Health Context

    Directory of Open Access Journals (Sweden)

    Peio Lopez-Iturri

    2018-01-01

    Full Text Available In the context of hospital management and operation, Intensive Care Units (ICU are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework.

  12. Care Management In The Family Health Support Core: Technologies Operated In The Professional Dimension

    Directory of Open Access Journals (Sweden)

    José Maria Ximenes Guimarães

    2017-03-01

    Full Text Available Introduction: The Centre for Health Support Family - NASF has a innovative character with potential to concretize change in the organization of services and in care practices, supporting and expanding the solvability of the actions of the teams of the Family Health Strategy - FHS. To this end, it must operationalize technologies, arrangements and care management devices. Objective: To describe the care management technologies, particularly in the professional dimension, operated by the teams of the Support Centre for Family Health, in its dialogue with the Health Strategy. Methods: case study with a qualitative approach, with the 12 professionals from a NASF team of Maracanaú, Ceará, Brazil. Focal group was performed. The empirical material was analysed based on the content analysis. Results: there is evidence of a proposal for production of integral care based on the use of technologies as host, bond, autonomy and accountability. The user approach is based on the principles of the extended clinic. However, there are difficulties related to the regulation of access, the construction of bonds, the construction of therapeutic projects and intersectional articulation. Final thoughts: it appears necessary to overcome the challenges, strengthen mechanisms for coordination and for negotiation of labour, as well as rethinking the NASF linking logic to a seemingly high number of FHS teams complicates the organization of work processes, building of agendas, weakens the bonds with the users and even the solvency.

  13. Discourse versus practice: are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system?

    Science.gov (United States)

    Gallegos, Carlos Andres; Waters, William F; Kuhlmann, Anne Sebert

    2017-03-01

    Traditional beliefs, knowledge and practices are formally integrated into the Ecuadorian health system. We sought to understand whether they are integrated in practice. Qualitative data were collected in two rural parishes in the central highlands of Ecuador through four focus group discussions (30 participants), eight key informant interviews, three participatory exercises (24 participants), structured observations of health facilities and analysis of official documents. We found different levels of integration, coexistence, tolerance, and intolerance of traditional health beliefs and practices in health facilities. One parish has undergone dramatic social and cultural transformation, and the role of traditional birth attendants is limited. In the other parish, traditional indigenous norms and values persist, and traditional birth attendants are sought during pregnancy and childbirth. The degree to which traditional birth attendants, indigenous women and their families are included or excluded from public health services depends largely on decisions taken by local health professionals. Formal policies in Ecuador stipulate that health care should be intercultural, but the role of traditional birth attendants is not necessarily incorporated in practice. The integration of culturally-informed beliefs and practices is critical for providing appropriate health services to members of vulnerable populations. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Popular epidemiology and "fracking": citizens' concerns regarding the economic, environmental, health and social impacts of unconventional natural gas drilling operations.

    Science.gov (United States)

    Powers, Martha; Saberi, Poune; Pepino, Richard; Strupp, Emily; Bugos, Eva; Cannuscio, Carolyn C

    2015-06-01

    Pennsylvania sits atop the Marcellus Shale, a reservoir of natural gas that was untapped until the 2004 introduction of unconventional natural gas drilling operations (UNGDO) in the state. Colloquially known as fracking, UNGDO is a controversial process that employs large volumes of water to fracture the shale and capture gas; it has become a multi-billion dollar industry in Pennsylvania. We analyzed letters to the editor of the most widely circulated local newspaper in the most heavily drilled county in Pennsylvania (Bradford County) in order to characterize residents' concerns and their involvement in popular epidemiology--the process by which citizens investigate risks associated with a perceived environmental threat. We reviewed 215 letters to the editor that referenced natural gas operations and were published by The Daily Review between January 1, 2008 and June 8, 2013. We used NVivo 10 to code and analyze letters and identify major themes. Nvivo is qualitative data analysis software (http://www.qsrinternational.com/products_nvivo.aspx) that allows researchers to code and analyze "unstructured" data, including text files of any type (e.g., interview transcripts, news articles, letters, archival materials) as well as photographs and videos. Nvivo can be used to classify, sort, query, comment on, and share data across a research group. Letters demonstrated citizen engagement in beginning and intermediate stages of lay epidemiology, as well as discord and stress regarding four main issues: socio-economic impacts, perceived threats to water, population growth and implications, and changes to the rural landscape. Residents called for stronger scientific evidence and a balance of economic development and health and environmental protections. Citizens' distress regarding UNGDO appeared to be exacerbated by a dearth of information to guide economic growth and health, environmental, and social concerns. This analysis proposes locally informed questions to guide future

  15. Autonomous Operations System: Development and Application

    Science.gov (United States)

    Toro Medina, Jaime A.; Wilkins, Kim N.; Walker, Mark; Stahl, Gerald M.

    2016-01-01

    Autonomous control systems provides the ability of self-governance beyond the conventional control system. As the complexity of mechanical and electrical systems increases, there develops a natural drive for developing robust control systems to manage complicated operations. By closing the bridge between conventional automated systems to knowledge based self-awareness systems, nominal control of operations can evolve into relying on safe critical mitigation processes to support any off-nominal behavior. Current research and development efforts lead by the Autonomous Propellant Loading (APL) group at NASA Kennedy Space Center aims to improve cryogenic propellant transfer operations by developing an automated control and health monitoring system. As an integrated systems, the center aims to produce an Autonomous Operations System (AOS) capable of integrating health management operations with automated control to produce a fully autonomous system.

  16. Environmental, safety, and health plan for the remedial investigation of Waste Area Grouping 10, Operable Unit 3, at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1993-10-01

    This document outlines the environmental, safety, and health (ES ampersand H) approach to be followed for the remedial investigation of Waste Area Grouping (WAG) 10 at Oak at Ridge National Laboratory. This ES ampersand H Plan addresses hazards associated with upcoming Operable Unit 3 field work activities and provides the program elements required to maintain minimal personnel exposures and to reduce the potential for environmental impacts during field operations. The hazards evaluation for WAG 10 is presented in Sect. 3. This section includes the potential radiological, chemical, and physical hazards that may be encountered. Previous sampling results suggest that the primary contaminants of concern will be radiological (cobalt-60, europium-154, americium-241, strontium-90, plutonium-238, plutonium-239, cesium-134, cesium-137, and curium-244). External and internal exposures to radioactive materials will be minimized through engineering controls (e.g., ventilation, containment, isolation) and administrative controls (e.g., procedures, training, postings, protective clothing)

  17. Operator interface programs for KSTAR operation

    International Nuclear Information System (INIS)

    Lee, Sangil; Park, Mikyung; Park, Jinseop; Na, Hoonkyun; Kwon, M.

    2013-01-01

    Beginning the first plasma discharging experiment of KSTAR since 2008, KSTAR performed the third plasma discharging experiment by 2010. During the experiment of three times, KSTAR OPerator Interface (OPI) programs have been developed for KSTAR operation by itself. OPI programs used in KSTAR were implemented by KSTAR widget plug-in Toolkit (KWT). The KWT means the plug-in library implemented by Qt-based user interface development software. The main purpose of developing the KWT library is to implement full automation libraries having interface with the automated EPICS channel access (CA) guaranteeing the flexibility for requirements of operators. In addition, it has advantages in minimizing human code error and maximizing utilization of the limited human resource. According to the increasing of control systems, a number of OPI servers connected to one EPICS gateway server caused the connection problem and increased the amount of the network data packets. To solve these problems, an algorithm of “CachedChannelAccess” for shared memory base was implemented into an inner logic of the KWT library. KSTAR control system monitoring (CSM) program is one of applications developed by using KWT library. The function of CSM program is to notify alarm to operators by checking health status of every server's network health status and resource (cpu, memory, network packets, disk usage rate and system/user defined process) usage state. Another application is a post-shot sequencing program which is activated after every shot is completed. This application is to display major plasma parameters and diagnostic data in chart form, to save this data to database, and to transfer a chart image file to a web server. This paper describes the technical details how to develop OPI applications which have high productivity using Qt on the EPICS-based control system

  18. Operator interface programs for KSTAR operation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sangil, E-mail: leesi@nfri.re.kr; Park, Mikyung, E-mail: mkpark@nfri.re.kr; Park, Jinseop, E-mail: linupark@nfri.re.kr; Na, Hoonkyun, E-mail: hkna@nfri.re.kr; Kwon, M., E-mail: kwonm@nfri.re.kr

    2013-11-15

    Beginning the first plasma discharging experiment of KSTAR since 2008, KSTAR performed the third plasma discharging experiment by 2010. During the experiment of three times, KSTAR OPerator Interface (OPI) programs have been developed for KSTAR operation by itself. OPI programs used in KSTAR were implemented by KSTAR widget plug-in Toolkit (KWT). The KWT means the plug-in library implemented by Qt-based user interface development software. The main purpose of developing the KWT library is to implement full automation libraries having interface with the automated EPICS channel access (CA) guaranteeing the flexibility for requirements of operators. In addition, it has advantages in minimizing human code error and maximizing utilization of the limited human resource. According to the increasing of control systems, a number of OPI servers connected to one EPICS gateway server caused the connection problem and increased the amount of the network data packets. To solve these problems, an algorithm of “CachedChannelAccess” for shared memory base was implemented into an inner logic of the KWT library. KSTAR control system monitoring (CSM) program is one of applications developed by using KWT library. The function of CSM program is to notify alarm to operators by checking health status of every server's network health status and resource (cpu, memory, network packets, disk usage rate and system/user defined process) usage state. Another application is a post-shot sequencing program which is activated after every shot is completed. This application is to display major plasma parameters and diagnostic data in chart form, to save this data to database, and to transfer a chart image file to a web server. This paper describes the technical details how to develop OPI applications which have high productivity using Qt on the EPICS-based control system.

  19. Occupational health experience with a contractor uranium refinery

    International Nuclear Information System (INIS)

    Heatherton, R.C.

    1975-01-01

    This paper presents information related to the occupational exposure of workers in uranium refinery operations at the Feed Materials Production Center since 1958. Included are: a brief history of the FMPC; a description of the operations and the principal sources of exposure; airborne uranium, urinary excretion, in vivo monitoring and tissue analysis data; and some observations regarding the exposure and health status of employees

  20. Radiological safety aspects of the operation of neutron generators

    International Nuclear Information System (INIS)

    Boggs, R.F.

    1976-01-01

    The purpose of the manual is to provide some basic guidelines to persons with a minimum of training in radiological health or health physics, on some safety aspects of the operation of sealed-tube and Cockcroft-Walton type neutron generators. The manual does not state rules or regulations but presents a description of the most likely hazards. It is relevant to those relatively compact neutron generators which usually operate at less than 150-200 kV for the purpose of producing 14-MeV neutrons. The scope is limited to basic discussions of hazards and measurement techniques. Separate chapters are devoted to the characteristics and use of neutron generators; radiation hazards and safety considerations; radiation monitoring and interpretation of measurements; and requirements for an effective safety programme. Two appendices deal with non-radiation hazards and safety considerations, and with a neutron generator laboratory, respectively. An extensive list of bibliographic references is included

  1. Operational experience in the United Kingdom

    International Nuclear Information System (INIS)

    Gronow, W.S.

    1977-01-01

    In the UK there are 26 Magnox reactors and 4 AGRs operating on 11 licensed sites; a further 6 AGRs are under construction on 2 additional and one of the existing sites. The arrangements by which the Nuclear Installations Inspectorate, on behalf of the Health and Safety Executive, carries out its regulatory functions at operating nuclear power plants are described. The range of activities undertaken is described with special reference being made to the biennial shutdowns for approved maintenance and inspections which are required by conditions attached to the site licence. The other means by which the continuing safety of these power reactors is assured are explained and include the relationship with the licensee's own Nuclear Safety Committee, approved arrangements for modifications to plant systems or components which have importance for safety and long term reviews of safety aspects. (author)

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

    Science.gov (United States)

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

    2016-12-01

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

  3. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    Science.gov (United States)

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  4. Using online analytical processing to manage emergency department operations.

    Science.gov (United States)

    Gordon, Bradley D; Asplin, Brent R

    2004-11-01

    The emergency department (ED) is a unique setting in which to explore and evaluate the utility of information technology to improve health care operations. A potentially useful software tool in managing this complex environment is online analytical processing (OLAP). An OLAP system has the ability to provide managers, providers, and researchers with the necessary information to make decisions quickly and effectively by allowing them to examine patterns and trends in operations and patient flow. OLAP software quickly summarizes and processes data acquired from a variety of data sources, including computerized ED tracking systems. It allows the user to form a comprehensive picture of the ED from both system-wide and patient-specific perspectives and to interactively view the data using an approach that meets his or her needs. This article describes OLAP software tools and provides examples of potential OLAP applications for care improvement projects, primarily from the perspective of the ED. While OLAP is clearly a helpful tool in the ED, it is far more useful when integrated into the larger continuum of health information systems across a hospital or health care delivery system.

  5. Equipment performance monitoring in NPP Krsko (Summarized system health report)

    International Nuclear Information System (INIS)

    Djetelic, N.; Cicvaric, D.

    2004-01-01

    Management common goal is safe, reliable, effective, acceptable to public and conservative/cautious operation of NPP Krsko. A set of programs, including Corrective Action Program, Performance Indicators, Operating Experience, Self Assessment and System Health Report, is developed to assist NPP Krsko management in fulfilling those goals. System Health Report is a tool that management can use to quickly assess how selected systems are performing, to determine where additional management attention is required and to determine if appropriate corrective actions have been established. Summarized System Health Report is developed for management's quick overview of systems status, important system malfunctions and problems as well as major changes from previous assessment period. Summarized Report contains nine sections: status difference including brief explanation, selected performance indicators, new equipment problems, functional failures, important problem analyses, action plan for systems with Potential Danger (RED) status, maintenance rule status overview and systems availability (planned and unplanned).(author)

  6. Photovoltaic energy technologies: Health and environmental effects document

    Science.gov (United States)

    Moskowitz, P. D.; Hamilton, L. D.; Morris, S. C.; Rowe, M. D.

    1980-09-01

    The potential health and environmental consequences of producing electricity by photovoltaic energy systems was analyzed. Potential health and environmental risks are identified in representative fuel and material supply cycles including extraction, processing, refining, fabrication, installation, operation, and isposal for four photovoltaic energy systems (silicon N/P single crystal, silicon metal/insulator/semiconductor (MIS) cell, cadmium sulfide/copper sulfide backwall cell, and gallium arsenide heterojunction cell) delivering equal amounts of useful energy. Each step of the fuel and material supply cycles, materials demands, byproducts, public health, occupational health, and environmental hazards is identified.

  7. Operational research as implementation science: definitions, challenges and research priorities.

    Science.gov (United States)

    Monks, Thomas

    2016-06-06

    Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature. To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users. Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR

  8. Directory of personnel responsible for radiological health programs

    International Nuclear Information System (INIS)

    1977-01-01

    This is a directory of professional personnel who administer the radiological health program activities in state and local governmental agencies. Included in the directory is a listing of each state health officer or the head of the agency responsible for the radiological health program. The name, address, and telephone number of the radiological health personnel are listed, followed by the alternate contact who, in many instances, may be chief of a larger administrative unit of which the radiological health program is a subunit. The address for the program is also included if it differs from the official health department or agency. Generally, the titles of the personnel listed will indicate the administrative status of the radiological health program. The directory also includes a list of key professional personnel in the Bureau of Radiological Health, Radiation Operations Staff, Regional Radiological Health Representatives, Winchester Engineering and Analytical Center, Food and Drug Administration; Office of Radiation Programs, Regional Radiation Representatives, National Environmental Research Center, and Eastern Environmental Radiation Laboratory, Environmental Protection Agency; selected personnel in the U.S. Nuclear Regulatory Commission; and selected personnel in the National Bureau of Standards

  9. Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria.

    Science.gov (United States)

    Chukwu, Emeka; Garg, Lalit; Eze, Godson

    2016-05-17

    Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (Phealth care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations

  10. User-driven health care: answering multidimensional information needs in individual patients utilizing post-EBM approaches: an operational model.

    Science.gov (United States)

    Biswas, Rakesh; Maniam, Jayanthy; Lee, Edwin Wen Huo; Gopal, Premalatha; Umakanth, Shashikiran; Dahiya, Sumit; Ahmed, Sayeed

    2008-10-01

    The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.

  11. Restoring Environmental Flows by Modifying Dam Operations

    Directory of Open Access Journals (Sweden)

    Brian D. Richter

    2007-06-01

    Full Text Available The construction of new dams has become one of the most controversial issues in global efforts to alleviate poverty, improve human health, and strengthen regional economies. Unfortunately, this controversy has overshadowed the tremendous opportunity that exists for modifying the operations of existing dams to recover many of the environmental and social benefits of healthy ecosystems that have been compromised by present modes of dam operation. The potential benefits of dam "re-operation" include recovery of fish, shellfish, and other wildlife populations valued both commercially and recreationally, including estuarine species; reactivation of the flood storage and water purification benefits that occur when floods are allowed to flow into floodplain forests and wetlands; regaining some semblance of the naturally dynamic balance between river erosion and sedimentation that shapes physical habitat complexity, and arresting problems associated with geomorphic imbalances; cultural and spiritual uses of rivers; and many other socially valued products and services. This paper describes an assessment framework that can be used to evaluate the benefits that might be restored through dam re-operation. Assessing the potential benefits of dam re-operation begins by characterizing the dam's effects on the river flow regime, and formulating hypotheses about the ecological and social benefits that might be restored by releasing water from the dam in a manner that more closely resembles natural flow patterns. These hypotheses can be tested by implementing a re-operation plan, tracking the response of the ecosystem, and continually refining dam operations through adaptive management. The paper highlights a number of land and water management strategies useful in implementing a dam re-operation plan, with reference to a variety of management contexts ranging from individual dams to cascades of dams along a river to regional energy grids. Because many of the

  12. Towards an effective co-operation between companies and occupational safety and health services.

    Science.gov (United States)

    van der Drift, Dorine Willy

    2002-01-01

    In the Dutch Working Conditions Act, every employer is required to organize preventive occupational safety and health services (OSH-Services). The OSH-Services need to have a certification that can be compared with ISO-9000. This article is focused on the question: How can companies and OSH-Services co-operate more effectively to obtain a better OSH management system inside the companies? To answer this question, TNO has developed an approach to support organisations in the health care branch to obtain a better service from their OSH-Service. TNO has chosen to focus on supporting the companies, because of the recognition that the effectiveness of OSH-Services has been found in effects on their customers, the companies. As a result of the research project a stepwise approach with several tools was developed. After the development phase, parts of the approach and the tools were used in several other consultancy projects. Evaluative studies have not been performed yet. However, from the development activities and several consultancy projects some remarkable evaluative findings can be given. The approach can be useful for companies and OSH-Services to make their goals and expectations more explicit. The approach also helps to make the management of companies clear that their own behaviour is relevant to the achievement of their goals in occupational health and safety policy, in addition to the services provided by the OSH-Service and their professionals. The approach cannot fulfil the possible need for qualification of OSH professionals. However, the approach can make the OSH professionals clear in what way they have qualification needs.

  13. Improving operating room safety

    Directory of Open Access Journals (Sweden)

    Garrett Jill

    2009-11-01

    Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

  14. Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel.

    Science.gov (United States)

    Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L

    2015-12-01

    Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. Copyright © 2015 International Society for Traumatic Stress Studies.

  15. Design and operation of the national home health aide survey: 2007-2008.

    Science.gov (United States)

    Bercovitz, Anita; Moss, Abigail J; Sengupta, Manisha; Harris-Kojetin, Lauren D; Squillace, Marie R; Emily, Rosenoff; Branden, Laura

    2010-03-01

    This report provides an overview of the National Home Health Aide Survey (NHHAS), the first national probability survey of home health aides. NHHAS was designed to provide national estimates of home health aides who provided assistance in activities of daily living (ADLs) and were directly employed by agencies that provide home health and/or hospice care. This report discusses the need for and objectives of the survey, the design process, the survey methods, and data availability. METHODS NHHAS, a multistage probability sample survey, was conducted as a supplement to the 2007 National Home and Hospice Care Survey (NHHCS). Agencies providing home health and/or hospice care were sampled, and then aides employed by these agencies were sampled and interviewed by telephone. Survey topics included recruitment, training, job history, family life, client relations, work-related injuries, and demographics. NHHAS was virtually identical to the 2004 National Nursing Assistant Survey of certified nursing assistants employed in sampled nursing homes with minor changes to account for differences in workplace environment and responsibilities. RESULTS From September 2007 to April 2008, interviews were completed with 3,416 aides. A public-use data file that contains the interview responses, sampling weights, and design variables is available. The NHHAS overall response rate weighted by the inverse of the probability of selection was 41 percent. This rate is the product of the weighted first-stage agency response rate of 57 percent (i.e., weighted response rate of 59 percent for agency participation in NHHCS times the weighted response rate of 97 percent for agencies participating in NHHCS that also participated in NHHAS) and the weighted second-stage aide response rate of 72 percent to NHHAS.

  16. Births and deaths including fetal deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  17. Optimization of the weekly operation of a multipurpose hydroelectric development, including a pumped storage plant

    International Nuclear Information System (INIS)

    Popa, R; Popa, B; Popa, F; Zachia-Zlatea, D

    2010-01-01

    It is presented an optimization model based on genetic algorithms for the operation of a multipurpose hydroelectric power development consisting in a pumped storage plant (PSP) with weekly operation cycle. The lower reservoir of the PSP is supplied upstream from a peak hydropower plant (HPP) with a large reservoir and supplies the own HPP which provides the required discharges towards downstream. Under these conditions, the optimum operation of the assembly consisting in 3 reservoirs and hydropower plants becomes a difficult problem if there are considered the restrictions as regards: the gradients allowed for the reservoirs filling/emptying, compliance with of a long-term policy of the upper reservoir from the hydroelectric development and of the weekly cycle for the PSP upper reservoir, correspondence between the power output/consumption in the weekly load schedule, turning to account of the water resource at maximum overall efficiencies, etc. Maximization of the net energy value (generated minus consumed) was selected as performance function of the model, considering the differentiated price of the electric energy over the week (working or weekend days, peak, half-peak or base hours). The analysis time step was required to be of 3 hours, resulting a weekly horizon of 56 steps and 168 decision variables, respectively, for the 3 HPPs of the system. These were allowed to be the flows turbined at the HPP and the number of working hydrounits at PSP, on each time step. The numerical application has considered the guiding data of Fantanele-Tarnita-Lapustesti hydroelectric development. Results of various simulations carried out proved the qualities of the proposed optimization model, which will allow its use within a decisional support program for such a development.

  18. Optimization of the weekly operation of a multipurpose hydroelectric development, including a pumped storage plant

    Energy Technology Data Exchange (ETDEWEB)

    Popa, R; Popa, B [Faculty of Power Engineering, University Politehnica of Bucharest, 313 Spl. Independentei, sect. 6, Bucharest, 060042 (Romania); Popa, F [Institute for Hydropower Studies and Design, 5-7 Vasile Lascar, sect. 2, Bucharest, 020491 (Romania); Zachia-Zlatea, D, E-mail: bogdan.popa@rosha.r [Hidroelectrica S.A., 3 Constantin Nacu, sect. 2, Bucharest, 020995 (Romania)

    2010-08-15

    It is presented an optimization model based on genetic algorithms for the operation of a multipurpose hydroelectric power development consisting in a pumped storage plant (PSP) with weekly operation cycle. The lower reservoir of the PSP is supplied upstream from a peak hydropower plant (HPP) with a large reservoir and supplies the own HPP which provides the required discharges towards downstream. Under these conditions, the optimum operation of the assembly consisting in 3 reservoirs and hydropower plants becomes a difficult problem if there are considered the restrictions as regards: the gradients allowed for the reservoirs filling/emptying, compliance with of a long-term policy of the upper reservoir from the hydroelectric development and of the weekly cycle for the PSP upper reservoir, correspondence between the power output/consumption in the weekly load schedule, turning to account of the water resource at maximum overall efficiencies, etc. Maximization of the net energy value (generated minus consumed) was selected as performance function of the model, considering the differentiated price of the electric energy over the week (working or weekend days, peak, half-peak or base hours). The analysis time step was required to be of 3 hours, resulting a weekly horizon of 56 steps and 168 decision variables, respectively, for the 3 HPPs of the system. These were allowed to be the flows turbined at the HPP and the number of working hydrounits at PSP, on each time step. The numerical application has considered the guiding data of Fantanele-Tarnita-Lapustesti hydroelectric development. Results of various simulations carried out proved the qualities of the proposed optimization model, which will allow its use within a decisional support program for such a development.

  19. The Nigerian experience in health, safety, and environmental matters during oil and gas exploration and production operations

    International Nuclear Information System (INIS)

    Oyekan, A.J.

    1991-01-01

    Since crude oil was first discovered in commercial quantities in the Country, in 1956, Nigerian oil and gas exploration and production activities have steadily increased as petroleum assumed strategic importance in the nation's economy. However, just as occurs in many parts of the world, crude oil and gas are found and produced in Nigeria sometimes in very hostile and unfavorable environments. The search for oil and gas takes explorers to the hot regions of the Northern parts of the country, the swamp jungle location of the Niger Delta, as well as offshore locations in the Atlantic Ocean. Each terrain, whether land, swamp or offshore, in deep or shallow waters, present unique health, safety and environmental implications and challenges to the operators, as well as, to the Government regulators. From a background of existing Nigerian Laws and operational experience, this paper details the programmes that have been put in place to guarantee a healthy workforce, ensure the safety of personnel and equipment, and protect the Nigerian environment during oil and gas exploration and production operations, as well as their documented effectiveness. The paper discusses the performance of the Petroleum Industry by analyzing the health, safety and environmental records available from 1956 - 1990. The records of major incidents related to safety and environment over the period are discussed and evaluated. The paper notes that relatively speaking, in spite of the Bomu 2 and Funiwa V oil well blow-outs in 1970 and 1980 respectively which caused extensive environmental damages and the Anieze, Oniku and KC 1 gas well blow-out of 1972, 1975 and 1989 respectively, which resulted in the loss of the rigs drilling the locations concerned, the safety performance records in the Nigerian oil and gas exploration and production activities in the past thirty-five years have been satisfactory compared with the records of similar operations in most other parts of the world

  20. Widening the Aim of Health Promotion to Include the Most Disadvantaged: Vulnerable Adolescents and the Social Determinants of Health

    Science.gov (United States)

    Mohajer, Nicole; Earnest, Jaya

    2010-01-01

    Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health…

  1. Neonatal health including congenital malformation risk of 1072 children born after vitrified embryo transfer.

    Science.gov (United States)

    Belva, F; Bonduelle, M; Roelants, M; Verheyen, G; Van Landuyt, L

    2016-07-01

    Does vitrification of Day 3 and Day 5 embryos adversely affect birth outcomes of singletons and twins in comparison with peers born after fresh embryo transfer? Neonatal health parameters, including the prevalence of congenital malformations, in singletons and twins born after embryo vitrification are similar to or slightly better than after fresh embryo transfer. Although vitrification, rather than slow-freezing, of embryos is routine practice nowadays, convincing evidence regarding the safety for the offspring is sparse. Literature data comprise results from mostly small-sized studies or studies including only Day 3 or only Day 5 vitrified embryo transfers. Overall, better or comparable perinatal outcomes, in terms of higher birthweight and lower risk for small-for-gestational age or for low birthweight, have been reported for singletons born after vitrified embryo transfer compared with fresh embryo transfer. According to the single available study with sufficient sample size, the congenital malformation rate was found to be comparable after vitrified and fresh embryo transfers. Data were collected from 960 cycles after transfer of embryos vitrified on Day 3 (n = 457) or Day 5 (n = 503) and from 1644 cycles after fresh embryo transfer on Day 3 (n = 853) or Day 5 (n = 791), performed between 2008 and 2013 at the Centre for Reproductive Medicine of the university hospital UZ Brussel. Outcome measures were neonatal health in terms of birthweight, small-for-gestational age, prematurity rate, perinatal death and major/minor/total malformation rate. Perinatal health parameters of 11 stillborns and 1061 live borns (827 singletons and 234 twins) in the vitrified group and of 28 stillborns and 1838 live borns (1374 singletons and 464 twins) in the fresh embryo group are reported. Within 3 months after birth, children in the two study groups were assessed clinically with special attention to congenital malformations by a paediatrician blinded to the type of embryo

  2. Environmental health organisations against tobacco.

    LENUS (Irish Health Repository)

    Mulcahy, Maurice

    2009-04-01

    Implementing the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) relies heavily on enforcement. Little is known of the way different enforcement agencies operate, prioritise or network. A questionnaire was sent to representatives of the International Federation of Environmental Health (IFEH) in 36 countries. Tobacco control was given low priority. Almost two thirds did not have any tobacco control policy. A third reported their organisation had worked with other agencies on tobacco control. Obstacles to addressing tobacco control included a lack of resources (61%) and absence of a coherent strategy (39%).

  3. Co-operation of the CMEA member countries in the developing power reactors of various types, including some aspects of their nuclear fuel cycles

    International Nuclear Information System (INIS)

    Barbur, I.; Barchenkov, A.; Molnar, L; Panasenkov, A.; Tolpygo, V.; Hake, V.; Shcherbinin, B.

    1977-01-01

    The report gives an account of the problems of projected development of atomic power and evaluates its role in the fuel and power complex and long-range development of interconnected power systems of the CMEA member countries. The report emphasizes the importance of scientific and technical co-operation in the creation of power reactors on thermal and fast neutrons with 1000-1500 MW unit electric capacity as well as in the elaboration of nuclear plants for heating services. It notes the positive experience of the International scientific and research group of scientists of the CMEA member countries carrying out reactor-physical studies on the critical assembly and its contribution to the elaboration of power reactors. The report contains basic conclusions from the development forecast for nuclear power of the CMEA member countries up to 1990 including forecasting methodology; role of nuclear power plants in saving natural and enriched uranium for a projected period; impact of nuclear power development rates on its structure (thermal and fast reactor ratio); relation between the beginning of mass commissioning of nuclear power plants with fast reactors and the integral demand for nuclear fuel; scale of required capacities of fuel cycle services; time dependence of fuel cycle on nuclear fuel requirements. It examines the problems and lists the results of scientific and technical co-operation of the CMEA member countries in the field of fuel cycle, including the transport of spent nuclear fuel, its recovery, reprocessing and radioactive waste disposal. Particular questions of co-operation of the CMEA member countries to secure radiation safety of nuclear power plants and environmental protection are analyzed. The report notes the role of international economic associations - ''Interatomenergo'' and ''Interatominstrument'' - in the accelerated development of nuclear power on the basis of cooperation and specialization in the manufacture of equipment for nuclear power

  4. Changes in Health-Related Quality of Life During Rehabilitation in Patients With Operable Lung Cancer

    DEFF Research Database (Denmark)

    Sommer, Maja S.; Trier, Karen; Vibe-Petersen, Jette

    2017-01-01

    . RESULTS: Forty patients were included, 73% of whom completed rehabilitation. Results on emotional well-being (P mental health component score (P = .0004) showed an overall statistically significant improvement during the study. CONCLUSION: This feasibility...... study demonstrated that global quality of life, mental health, and emotional well-being improved significantly during the study, from time of diagnosis until 1 year after resection, in patients with NSCLC participating in rehabilitation.......INTRODUCTION: Surgical resection in patients with non-small cell lung cancer (NSCLC) may be associated with significant morbidity, functional limitations, and decreased quality of life. OBJECTIVES: The objective is to present health-related quality of life (HRQoL) changes over time before and 1...

  5. State Token Petri Net modeling method for formal verification of computerized procedure including operator's interruptions of procedure execution flow

    International Nuclear Information System (INIS)

    Kim, Yun Goo; Seong, Poong Hyun

    2012-01-01

    The Computerized Procedure System (CPS) is one of the primary operating support systems in the digital Main Control Room. The CPS displays procedure on the computer screen in the form of a flow chart, and displays plant operating information along with procedure instructions. It also supports operator decision making by providing a system decision. A procedure flow should be correct and reliable, as an error would lead to operator misjudgement and inadequate control. In this paper we present a modeling for the CPS that enables formal verification based on Petri nets. The proposed State Token Petri Nets (STPN) also support modeling of a procedure flow that has various interruptions by the operator, according to the plant condition. STPN modeling is compared with Coloured Petri net when they are applied to Emergency Operating Computerized Procedure. A converting program for Computerized Procedure (CP) to STPN has been also developed. The formal verification and validation methods of CP with STPN increase the safety of a nuclear power plant and provide digital quality assurance means that are needed when the role and function of the CPS is increasing.

  6. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana

    OpenAIRE

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-01-01

    Background In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universa...

  7. Using operational research modelling to improve the provision of health services: the case of DNA technology.

    Science.gov (United States)

    Beech, R

    1995-01-01

    Operational research (OR) analysis provides information and systems to support decision making. In health care there are examples of OR being used to support decisions surrounding both the organization of health services and the treatment of individual patients. However, its uptake is currently low in spite of the increase in potential areas of application. In practice there is a lack of awareness amongst health service staff about what OR is and how it can help. This paper addresses this issue by exposing the contribution that OR made to a programme of research relating to DNA technology. Examples are given of the way it was used to provide information on the costs and outcomes of services and the ways these evolve over time. These examples demonstrate the way OR methods increase the understanding of both analysts and service providers about a problem area. This helps ensure that appropriate and valid approaches to tackling problem areas are developed. When developing these approaches, the problem orientated philosophy of OR means analysts are willing to use a range of methodologies, some originating in OR and some in other disciplines. The broad focus of OR also means that its findings enhance those provided by other disciplines which might seem to be competitors. The conclusion of the paper is that OR has a crucial role to play in the improvement of health services.

  8. Operating systems

    CERN Document Server

    Tsichritzis, Dionysios C; Rheinboldt, Werner

    1974-01-01

    Operating Systems deals with the fundamental concepts and principles that govern the behavior of operating systems. Many issues regarding the structure of operating systems, including the problems of managing processes, processors, and memory, are examined. Various aspects of operating systems are also discussed, from input-output and files to security, protection, reliability, design methods, performance evaluation, and implementation methods.Comprised of 10 chapters, this volume begins with an overview of what constitutes an operating system, followed by a discussion on the definition and pr

  9. Feasibility and quality of cardiovascular disease prevention within a community-based health insurance program in rural Nigeria: an operational cohort study

    NARCIS (Netherlands)

    Hendriks, Marleen E.; Bolarinwa, Oladimeji A.; Wit, Ferdinand W. N. W.; Brewster, Lizzy M.; Odusola, Aina O.; Rosendaal, Nicole T. A.; Bindraban, Navin R.; Adenusi, Peju; Agbede, Kayode; Lange, Joep M. A.; Akande, Tanimola M.; Schultsz, Constance

    2015-01-01

    To assess the feasibility of providing guideline-based cardiovascular disease (CVD) prevention care within the context of a community-based health insurance program (CBHI) in rural Nigeria. A prospective operational cohort study was conducted in a primary healthcare clinic in rural Nigeria,

  10. Treatability test plan for the 200-ZP-1 operable unit

    International Nuclear Information System (INIS)

    1994-07-01

    This document presents the treatability test plan for pilot-scale pump and treat testing at the 200-ZP-1 Operable Unit. The approach discussed in this treatability test plan is to conduct a pilot-scale pump and treat test for the contaminant plume associated with the 200-ZP-1 Operable Unit. The primary contaminants of concern are carbon tetrachloride, chloroform, and trichloroethylene (TCE). The pilot-scale treatability testing has as its primary purpose to assess the performance of aboveground treatment systems with respect to the ability to remove the primary contaminants present in groundwater withdrawn from the contaminant plume. The overall scope of this test plan includes: description of the pump and treat system to be tested, as well as the test performance objectives and data quality objectives (DQOs) that will be used to evaluate the effectiveness of the pilot-scale treatment system; discussion of the treatment technology to be tested and supporting development activities, including process flow and conceptual design descriptions and equipment, fabrication, utility, and system startup needs; description of pilot-scale treatment system performance, operating procedures, and operational controls, as well as anticipated monitoring activities, analytes, parameters, analytical procedures, and quality assurance protocols; summaries of other related treatability testing elements, including personnel and environmental health and safety controls, process and secondary waste management and disposition, schedule, and program organization

  11. Including pathogen risk in life cycle assessment of wastewater management. 2. Quantitative comparison of pathogen risk to other impacts on human health.

    Science.gov (United States)

    Heimersson, Sara; Harder, Robin; Peters, Gregory M; Svanström, Magdalena

    2014-08-19

    Resource recovery from sewage sludge has the potential to save natural resources, but the potential risks connected to human exposure to heavy metals, organic micropollutants, and pathogenic microorganisms attract stakeholder concern. The purpose of the presented study was to include pathogen risks to human health in life cycle assessment (LCA) of wastewater and sludge management systems, as this is commonly omitted from LCAs due to methodological limitations. Part 1 of this article series estimated the overall pathogen risk for such a system with agricultural use of the sludge, in a way that enables the results to be integrated in LCA. This article (part 2) presents a full LCA for two model systems (with agricultural utilization or incineration of sludge) to reveal the relative importance of pathogen risk in relation to other potential impacts on human health. The study showed that, for both model systems, pathogen risk can constitute an important part (in this study up to 20%) of the total life cycle impacts on human health (expressed in disability adjusted life years) which include other important impacts such as human toxicity potential, global warming potential, and photochemical oxidant formation potential.

  12. The association between proximity to animal feeding operations and community health: a systematic review.

    Directory of Open Access Journals (Sweden)

    Annette M O'Connor

    2010-03-01

    Full Text Available A systematic review was conducted for the association between animal feeding operations (AFOs and the health of individuals living near AFOs.The review was restricted to studies reporting respiratory, gastrointestinal and mental health outcomes in individuals living near AFOs in North America, European Union, United Kingdom, and Scandinavia. From June to September 2008 searches were conducted in PUBMED, CAB, Web-of-Science, and Agricola with no restrictions. Hand searching of narrative reviews was also used. Two reviewers independently evaluated the role of chance, confounding, information, selection and analytic bias on the study outcome. Nine relevant studies were identified. The studies were heterogeneous with respect to outcomes and exposures assessed. Few studies reported an association between surrogate clinical outcomes and AFO proximity. A negative association was reported when odor was the measure of exposure to AFOs and self-reported disease, the measure of outcome. There was evidence of an association between self-reported disease and proximity to AFO in individuals annoyed by AFO odor.There was inconsistent evidence of a weak association between self-reported disease in people with allergies or familial history of allergies. No consistent dose response relationship between exposure and disease was observable.

  13. Health and safety annual report 1988

    International Nuclear Information System (INIS)

    1989-01-01

    This report on health and safety provides a review of the impact of the Comapny's activities on its workforce, the public and the environment. New sections include safety auditing, emergency planning and health and safety research. BNFL operates five sites in north west England and southern Scotland. The head office and Engineering Design Centre is at Risley, near Warrington. Fuel is manufactured at Springfields near Preston, uranium is enriched for modern nuclear power stations at Capenhurst near Chester and spent fuel is reprocessed at Sellafield. BNFL also operate Calder Hall (Sellafield) and Chapelcross (Scotland) power stations and a disposal site for low-level radioactive wastes at Drigg near Sellafield. Radiation sources and BNFL's radioactive discharge are first explained generally and then specifically for each BNFL site. Industrial and radiological safety within BNFL are described. (UK)

  14. Statistical assessment of the learning curves of health technologies.

    Science.gov (United States)

    Ramsay, C R; Grant, A M; Wallace, S A; Garthwaite, P H; Monk, A F; Russell, I T

    2001-01-01

    (1) To describe systematically studies that directly assessed the learning curve effect of health technologies. (2) Systematically to identify 'novel' statistical techniques applied to learning curve data in other fields, such as psychology and manufacturing. (3) To test these statistical techniques in data sets from studies of varying designs to assess health technologies in which learning curve effects are known to exist. METHODS - STUDY SELECTION (HEALTH TECHNOLOGY ASSESSMENT LITERATURE REVIEW): For a study to be included, it had to include a formal analysis of the learning curve of a health technology using a graphical, tabular or statistical technique. METHODS - STUDY SELECTION (NON-HEALTH TECHNOLOGY ASSESSMENT LITERATURE SEARCH): For a study to be included, it had to include a formal assessment of a learning curve using a statistical technique that had not been identified in the previous search. METHODS - DATA SOURCES: Six clinical and 16 non-clinical biomedical databases were searched. A limited amount of handsearching and scanning of reference lists was also undertaken. METHODS - DATA EXTRACTION (HEALTH TECHNOLOGY ASSESSMENT LITERATURE REVIEW): A number of study characteristics were abstracted from the papers such as study design, study size, number of operators and the statistical method used. METHODS - DATA EXTRACTION (NON-HEALTH TECHNOLOGY ASSESSMENT LITERATURE SEARCH): The new statistical techniques identified were categorised into four subgroups of increasing complexity: exploratory data analysis; simple series data analysis; complex data structure analysis, generic techniques. METHODS - TESTING OF STATISTICAL METHODS: Some of the statistical methods identified in the systematic searches for single (simple) operator series data and for multiple (complex) operator series data were illustrated and explored using three data sets. The first was a case series of 190 consecutive laparoscopic fundoplication procedures performed by a single surgeon; the second

  15. Safety and health in forest harvesting operations. Diagnosis and preventive actions. A review

    Energy Technology Data Exchange (ETDEWEB)

    Albizu-Urionabarrenetxea, P. M.; Tolosana-Esteban, E.; Roman-Jordan, E.

    2013-07-01

    Aim of study: to review the present state of the art in relation to the main labour risks and the most relevant results of recent studies evaluating the safety and health conditions of the forest harvesting work and better ways to reduce accidents. Area of study: It focuses mainly on developed Countries, where the general concern about work risks prevention, together with the complex idiosyncrasy of forest work in forest harvesting operations, has led to a growing interest from the forest scientific and technical community. Material and Methods: The main bibliographic and Internet references have been identified using common reference analysis tools. Their conclusions and recommendations have been comprehensively summarized. Main results: Collection of the principal references and their most important conclusions relating to the main accident risk factors, their causes and consequences, the means used towards their prevention, both instrumental as well as in the aspects of training and business management, besides the influence of the growing mechanization of logging operations on those risks. Research highlights: Accident risk is higher in forest harvesting than in most other work sectors, and the main risk factors such as experience, age, seasonality, training, protective equipment, mechanization degree, etc. have been identified and studied. The paper summarizes some relevant results, one of the principal being that the proper entrepreneurial risk management is a key factor leading to the success in minimizing labour risks. (Author)

  16. Defense Health Care: DOD Is Meeting Most Mental Health Care Access Standards, but It Needs a Standard for Follow-up Appointments

    Science.gov (United States)

    2016-04-01

    against an enemy of the United States or against an opposing military force. It also includes any military operations that result in the retention of...active duty for that day, precluding them from doing anything else, including working their civilian jobs . While access problems were identified in...certified psychiatric nurse specialists, clinical psychologists, certified marriage and family therapists, pastoral counselors, and mental health

  17. Health infrastructural challenges to health management information ...

    African Journals Online (AJOL)

    Aim: This study aims to assess health management information systems at the ... workers' ability to practice and use the health data generated at their Primary Health ... Only 2 (5.7%) of the health centres surveyed were capable of operating the ... The government at all levels should ensure collective effort and political will to ...

  18. Application of TQM to mental health: lessons from ten mental health centers.

    Science.gov (United States)

    Sluyter, G V

    1996-01-01

    The principles and techniques of total quality management (TQM) have only recently been applied to the field of mental health. This article reviews issues and offers some preliminary observations, based on the author's consultation and training work with ten state-operated mental health organizations in Missouri (Jul 1, 1994-Jun 30, 1995). Since many mental health organizations have operated in the public sector as part of large, hierarchical state agencies, the legacy of bureaucratic structures and a command and control leadership style may pose additional challenges. Two types of training have proven helpful in the Missouri project: general overview or awareness training for all staff and specialized training for team leaders and facilitators. To be successful with TQM, mental health organizations should clearly delineate their governing ideas, continuously reinforce them with all staff, and use the ideas as a measuring stick for progress. Some of the organizations in the Missouri project link their governing ideas and strategic planning efforts with critical success factors and the measurement methodology to track them. This dimension, which may include a quality council, a quality department, and quality improvement (QI) teams, also extends to the way in which facilities are organized and function. The structure evolving from a team-oriented, time-limited, data-based, and problem-solving approach can facilitate the functioning of the entire organization. The philosophy and techniques of TQM are as applicable to mental health as to health care in general--the question is one more of motivation than of fit.

  19. NASA Earth Observation Systems and Applications for Health and Air Quality

    Science.gov (United States)

    Omar, Ali H.

    2015-01-01

    There is a growing body of evidence that the environment can affect human health in ways that are both complex and global in scope. To address some of these complexities, NASA maintains a diverse constellation of Earth observing research satellites, and sponsors research in developing satellite data applications across a wide spectrum of areas. These include environmental health; infectious disease; air quality standards, policies, and regulations; and the impact of climate change on health and air quality in a number of interrelated efforts. The Health and Air Quality Applications fosters the use of observations, modeling systems, forecast development, application integration, and the research to operations transition process to address environmental health effects. NASA has been a primary partner with Federal operational agencies over the past nine years in these areas. This talk presents the background of the Health and Air Quality Applications program, recent accomplishments, and a plan for the future.

  20. THE LEGITIMACY OF INCLUDING THE SOCIAL PARAMETERS IN EVALUATING THE HEALTH STATUS IN THE SOCIAL ASSURANCE SYSTEM

    Directory of Open Access Journals (Sweden)

    MIHAI NEDELCU

    2011-04-01

    Full Text Available The social state crisis encouraged a reductionist tendency which had recently developed in the evaluations of the health status in the social assurance system. A holistic, psycho-medical approach, which took in consideration the implications of the social factors regarding disability, was confronted with a strictly medical model, in which the illness is exclusively considered a person’s problem; therefore, the references towards the „social” are irrelevant. In this context, the present paper states the question of the legitimacy of using some sociological concepts, in medical expertise, considered relevant in this area, such as: „occupational access” or the „social functioning of the person”. The present study doesn’t stop at offering as arguments of legitimacy the authority of some recommendations regarding the use of the social-medical model, including the evaluation of the health status, recommendations received from the behalf of OMS and the European Council (see CIF. The paper presents the construction of specific evaluation instruments and tries to identify the sense in which using the references regarding the „social” could influence the pressures in the social assurance system.

  1. Health physics, safety and medical services report for 1989

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1990-09-01

    The Health Physics, Safety and Medical Services Report for Harwell Laboratory for 1989 includes data on the monitoring of the working environment, personnel monitoring, radiological incidents, disposal of radioactive waste and protection of the public. Work on emergency planning, non-radiological health and safety, occupational hygiene, operations support is also discussed. Finally the medical services available and the medical examinations performed are described. (UK)

  2. A designated centre for people with disabilities operated by Health Service Executive, Cavan

    LENUS (Irish Health Repository)

    Neill, Shane C O

    2012-07-16

    AbstractIntroductionNail patella syndrome is a rare autosomal dominant hereditary condition, with an incidence of 22 per million in the United Kingdom. The syndrome’s most common features include iliac horns, hypoplastic patella and nail dysplasia.Case presentationWe report the case of a 26-year-old Caucasian man with nail patella syndrome who sustained a fracture of his right hypoplastic patella after a fall. His right knee became swollen and he was unable to extend against gravity immediately post fall. Radiographs revealed a fracture of the lower pole of his right patella with associated complete disruption of the extensor mechanism of the knee. He underwent operative fixation and his post operative course was uneventful. He was further treated post operatively with a full knee cast and graded immobilization. At six months he had regained the full range of motion at the knee joint.ConclusionsTo the best of our knowledge, this is the only case report in the literature describing a patella fracture in an individual with nail patella syndrome. We hypothesize that given the extent of pre-existing knee joint impairment in these individuals, functional outcome may be inferior, suggesting the need for more frequent follow-up.

  3. Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)

    2015-05-15

    The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined

  4. Prescription for natural cures: a self-care guide for treating health problems with natural remedies including diet, nutrition, supplements, and other holistic methods

    National Research Council Canada - National Science Library

    Balch, James F; Stengler, Mark; Young-Balch, Robin

    2011-01-01

    .... You'll find easy-to-understand discussions of the symptoms and root causes of each health problem along with a proven, natural, customized prescription that may include supplements, herbal medicine...

  5. Neoclassical transport including collisional nonlinearity.

    Science.gov (United States)

    Candy, J; Belli, E A

    2011-06-10

    In the standard δf theory of neoclassical transport, the zeroth-order (Maxwellian) solution is obtained analytically via the solution of a nonlinear equation. The first-order correction δf is subsequently computed as the solution of a linear, inhomogeneous equation that includes the linearized Fokker-Planck collision operator. This equation admits analytic solutions only in extreme asymptotic limits (banana, plateau, Pfirsch-Schlüter), and so must be solved numerically for realistic plasma parameters. Recently, numerical codes have appeared which attempt to compute the total distribution f more accurately than in the standard ordering by retaining some nonlinear terms related to finite-orbit width, while simultaneously reusing some form of the linearized collision operator. In this work we show that higher-order corrections to the distribution function may be unphysical if collisional nonlinearities are ignored.

  6. The Effects of Projected Future Demand Including Very Light Jet Air-Taxi Operations on U.S. National Airspace System Delays as a Function of Next Generation Air Transportation System Airspace Capacity

    Science.gov (United States)

    Smith, Jerry; Viken, Jeff; Dollyhigh, Samuel; Trani, Antonio; Baik, Hojong; Hinze, Nicholas; Ashiabor, Senanu

    2007-01-01

    This paper presents the results from a study which investigates the potential effects of the growth in air traffic demand including projected Very Light Jet (VLJ) air-taxi operations adding to delays experienced by commercial passenger air transportation in the year 2025. The geographic region studied is the contiguous United States (U.S.) of America, although international air traffic to and from the U.S. is included. The main focus of this paper is to determine how much air traffic growth, including VLJ air-taxi operations will add to enroute airspace congestion and determine what additional airspace capacity will be needed to accommodate the expected demand. Terminal airspace is not modeled and increased airport capacity is assumed.

  7. The physical and mental health of a large military cohort: baseline functional health status of the Millennium Cohort

    Directory of Open Access Journals (Sweden)

    Engel Charles C

    2007-11-01

    Full Text Available Abstract Background: The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations. Methods: Baseline data were collected from 77,047 US service members during 2001–2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study. The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS and mental component summary (MCS scores over a variety of demographic and military characteristics at baseline. Results: The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3–53.4 and 52.8 (95% confidence interval: 52.7–52.9. Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status. Conclusion: The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998–2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.

  8. Can modeling of HIV treatment processes improve outcomes? Capitalizing on an operations research approach to the global pandemic

    Directory of Open Access Journals (Sweden)

    Hollingsworth Eric B

    2008-08-01

    Full Text Available Abstract Background Mathematical modeling has been applied to a range of policy-level decisions on resource allocation for HIV care and treatment. We describe the application of classic operations research (OR techniques to address logistical and resource management challenges in HIV treatment scale-up activities in resource-limited countries. Methods We review and categorize several of the major logistical and operational problems encountered over the last decade in the global scale-up of HIV care and antiretroviral treatment for people with AIDS. While there are unique features of HIV care and treatment that pose significant challenges to effective modeling and service improvement, we identify several analogous OR-based solutions that have been developed in the service, industrial, and health sectors. Results HIV treatment scale-up includes many processes that are amenable to mathematical and simulation modeling, including forecasting future demand for services; locating and sizing facilities for maximal efficiency; and determining optimal staffing levels at clinical centers. Optimization of clinical and logistical processes through modeling may improve outcomes, but successful OR-based interventions will require contextualization of response strategies, including appreciation of both existing health care systems and limitations in local health workforces. Conclusion The modeling techniques developed in the engineering field of operations research have wide potential application to the variety of logistical problems encountered in HIV treatment scale-up in resource-limited settings. Increasing the number of cross-disciplinary collaborations between engineering and public health will help speed the appropriate development and application of these tools.

  9. Should catastrophic risks be included in a regulated competitive health insurance market?

    NARCIS (Netherlands)

    W.P.M.M. van de Ven (Wynand); F.T. Schut (Erik)

    1994-01-01

    textabstractIn 1988 the Dutch government launched a proposal for a national health insurance based on regulated competition. The mandatory benefits package should be offered by competing insurers and should cover both non-catastrophic risks (like hospital care, physician services and drugs) and

  10. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    Science.gov (United States)

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

  11. A call to action on women's health: putting corporate CSR standards for workplace health on the global health agenda.

    Science.gov (United States)

    Wofford, David; MacDonald, Shawn; Rodehau, Carolyn

    2016-11-04

    Business operates within a Corporate Social Responsibility (CSR) system that the global health community should harness to advance women's health and related sustainable development goals for workers and communities in low- and middle-income countries. Corporations and their vast networks of supplier companies, particularly in manufacturing and agribusiness, employ millions of workers, increasingly comprised of young women, who lack access to health information, products and services. However, occupational safety and health practices focus primarily on safety issues and fail to address the health needs, including reproductive health, of women workers. CSR policy has focused on shaping corporate policies and practices related to the environment, labor, and human rights, but has also ignored the health needs of women workers. The authors present a new way for global health to understand CSR - as a set of regulatory processes governed by civil society, international institutions, business, and government that set, monitor, and enforce emerging standards related to the role of business in society. They call this the CSR system. They argue that the global health community needs to think differently about the role of corporations in public health, which has been as "partners," and that the global health practitioners should play the same advocacy role in the CSR system for corporate health policies as it does for government and international health policies.

  12. Operating the plant, quality assurance, and the job of the operating staff, Volume Twelve

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    Subject matter includes operating the plant (the role of the operator, the control room, plant technical specifications, plant operating procedures, initial startup program, BWR/PWR plant startup, BWR/PWR steady state power operation, BWR/PWR transient operation, emergency operation), quality assurance (what is quality, what is quality control, quality assurance includes quality control, government regulation and quality assurance, administrative controls for nuclear power plants, the necessity of reviews and audits, practical quality assurance), and the job of the operating staff (the plant operating staff, plant safety, first aid and resuscitation, general plant hazards, personnel protective equipment, handling chemicals, handling compressed gas, equipment repair and maintenance, communicating with others

  13. [Health management system in outpatient follow-up of kidney transplantation patients].

    Science.gov (United States)

    Zhang, Hong; Xie, Jinliang; Yao, Hui; Liu, Ling; Tan, Jianwen; Geng, Chunmi

    2014-07-01

    To develop a health management system for outpatient follow-up of kidney transplant patients. Access 2010 database software was used to establish the health management system for kidney transplantation patients in Windows XP operating system. Database management and post-operation follow-up of the kidney transplantation patients were realized through 6 function modules including data input, data query, data printing, questionnaire survey, data export, and follow-up management. The system worked stably and reliably, and the data input was easy and fast. The query, the counting and printing were convenient. Health management system for patients after kidney transplantation not only reduces the work pressure of the follow-up staff, but also improves the efficiency of outpatient follow-up.

  14. Expanding Canadian Medicare to include a national pharmaceutical benefit while controlling expenditures: possible lessons from Israel.

    Science.gov (United States)

    Rosen, Bruce

    2018-02-05

    In Canada, there is an ongoing debate about whether to expand Medicare to include a national pharmaceutical benefit on a universal basis. The potential health benefits are understood to be significant, but there are ongoing concerns about affordability. In Israel, the National Health Insurance benefits package includes a comprehensive pharmaceutical benefit. Nonetheless, per capita pharmaceutical spending is well below that of Canada and the Organization for Economic Co-operation and Development average. This paper highlights seven strategies that Israel has employed to constrain pharmaceutical spending: (1) prioritizing new technologies, subject to a global budget constraint; (2) using regulations and market power to secure fair and reasonable prices; (3) establishing an efficient pharmaceutical distribution system; (4) promoting effective prescribing behavior; (5) avoiding artificial inflation of consumer demand; (6) striking an appropriate balance between respect for IP rights, access and cost containment; and (7) developing a shared societal understanding about the value and limits of pharmaceutical spending. Some of these strategies are already in place in some parts of Canada. Others could be introduced into Canada, and might contribute to the affordability of a national pharmaceutical benefit, but substantial adaptation would be needed. For example, in Israel the health maintenance organizations (HMOs) play a central role in promoting effective prescribing behavior, whereas in HMO-free Canada other mechanisms are needed to advance this important goal.

  15. Accelerator operations

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Operations of the SuperHILAC, the Bevatron/Bevalac, and the 184-inch Synchrocyclotron during the period from October 1977 to September 1978 are discussed. These include ion source development, accelerator facilities, the Heavy Ion Spectrometer System, and Bevelac biomedical operations

  16. Effect of Resident Involvement on Operative Time and Operating Room Staffing Costs.

    Science.gov (United States)

    Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M

    The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of

  17. Nuclear units operating improvement by using operating experience

    International Nuclear Information System (INIS)

    Rotaru, I.; Bilegan, I.C.

    1997-01-01

    The paper presents how the information experience can be used to improve the operation of nuclear units. This areas include the following items: conservative decision making; supervisory oversight; teamwork; control room distraction; communications; expectations and standards; operator training and fundamental knowledge, procedure quality and adherence; plant status awareness. For each of these topics, the information illustrate which are the principles, the lessons learned from operating experience and the most appropriate exemplifying documents. (authors)

  18. Forest management practices and the occupational safety and health administration logging standard

    Science.gov (United States)

    John R. Myers; David Elton Fosbroke

    1995-01-01

    The Occupational Safety and Health Administration (OSHA) has established safety and health regulations for the logging industry. These new regulations move beyond the prior OSHA pulpwood harvesting standard by including sawtimber harvesting operations. Because logging is a major tool used by forest managers to meet silvicultural goals, managers must be aware of what...

  19. Tutorials on emerging methodologies and applications in operations research

    CERN Document Server

    2005-01-01

    Operations Research emerged as a quantitative approach to problem-solving in World War II. Its founders, who were physicists, mathematicians, and engineers, quickly found peace-time uses for this new field. Moreover, we can say that Operations Research (OR) was born in the same incubator as computer science, and through the years, it has spawned many new disciplines, including systems engineering, health care management, and transportation science. Fundamentally, Operations Research crosses discipline domains to seek solutions on a range of problems and benefits diverse disciplines from finance to bioengineering. Many disciplines routinely use OR methods. Many scientific researchers, engineers, and others will find the methodological presentations in this book useful and helpful in their problem-solving efforts. OR’s strengths are modeling, analysis, and algorithm design. It provides a quantitative foundation for a broad spectrum of problems, from economics to medicine, from environmental control to sports,...

  20. Nuclear power: Health implications of transuranium elements

    International Nuclear Information System (INIS)

    1982-01-01

    This report provides general guidelines for national public health and environmental authorities. It does not provide detailed technical data, but instead broadly surveys the whole field, indicating the present position as assessed by members of the Working Group. The Working Group considered three major facets: physiological, toxicological and dosimetric aspects of the transuranium elements; the application of occupational health control, including health physics; and environmental behaviour together with public health implications associated with the transuranium elements. The intention was to cover all aspects relevant to health, with respect both to those who are occupationally engaged in work with such elements and to the general public who might be affected as the result of such operations. Consideration was also given to routine and emergency situations

  1. Can eHealth tools enable health organizations to reach their target audience?

    Science.gov (United States)

    Zbib, Ahmad; Hodgson, Corinne; Calderwood, Sarah

    2011-01-01

    Data from the health risk assessment operated by the Heart and Stroke Foundation found users were more likely to be female; married; have completed post secondary education; and report hypertension, stroke, or being overweight or obese. In developing and operating eHealth tools for health promotion, organizations should compare users to their target population(s). eHealth tools may not be optimal for reaching some higher-risk sub-groups, and a range of social marketing approaches may be required.

  2. European military mental health research: benefits of collaboration.

    Science.gov (United States)

    Himmerich, Hubertus; Willmund, G D; Wesemann, U; Jones, N; Fear, N T

    2017-06-01

    Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel. This could include the study of resilience factors, the prevention of mental disorder, mental health awareness, stigma reduction and the treatment of mental disorder. Military mental health research topics, interests and the studies that have been conducted to date in the UK and Germany have considerable overlap and commonality of purpose. To undertake the investigation of the long-term consequences of operational deployment, the specific burdens placed on military families and to further the understanding of the role of factors such as biomarkers for use in military mental health research, it seems advisable to forge international research alliances across European nations, which would allow for researchers to draw transcultural and generalisable conclusions from their work. Such an enterprise is probably worthwhile given the shared research interests of Germany and the UK and the common perspectives on military mental health in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Guidance for implementing an environmental, safety, and health assurance program. Volume 10. Model guidlines for line organization environmental, safety and health audits and appraisals

    International Nuclear Information System (INIS)

    Ellingson, A.C.

    1981-10-01

    This is 1 of 15 documents designed to illustrate how an Environmental, Safety and Health (ES and H) Assurance Program may be implemented. The generic definition of ES and H Assurance Programs is given in a companion document entitled An Environmental, Safety and Health Assurance Program Standard. The Standard specifies that the operational level of an institution must have an internal assurance function, and this document provides guidance for the audit/appraisal portion of the operational level's ES and H program. The appendixes include an ES and H audit checklist, a sample element rating guide, and a sample audit plan for working level line organization internal audits

  4. Theoretical Models and Operational Frameworks in Public Health Ethics

    Science.gov (United States)

    Petrini, Carlo

    2010-01-01

    The article is divided into three sections: (i) an overview of the main ethical models in public health (theoretical foundations); (ii) a summary of several published frameworks for public health ethics (practical frameworks); and (iii) a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided. PMID:20195441

  5. Health Promotion Behavior of Chinese International Students in Korea Including Acculturation Factors: A Structural Equation Model

    Directory of Open Access Journals (Sweden)

    Sun Jung Kim, RN, PhD

    2016-03-01

    Conlcusions: The Chinese students in Korea with higher self-esteem, perceived health status, acculturation level, and lower acculturative stress reported higher health promotion behavior. The findings can be applied to develop health promotion strategies for this population.

  6. Recent Enhancements in NOAA's JPSS Land Product Suite and Key Operational Applications

    Science.gov (United States)

    Csiszar, I. A.; Yu, Y.; Zhan, X.; Vargas, M.; Ek, M. B.; Zheng, W.; Wu, Y.; Smirnova, T. G.; Benjamin, S.; Ahmadov, R.; James, E.; Grell, G. A.

    2017-12-01

    A suite of operational land products has been produced as part of NOAA's Joint Polar Satellite System (JPSS) program to support a wide range of operational applications in environmental monitoring, prediction, disaster management and mitigation, and decision support. The Visible Infrared Imaging Radiometer Suite (VIIRS) on the Suomi National Polar-orbiting Partnership (NPP) and the operational JPSS satellite series forms the basis of six fundamental and multiple additional added-value environmental data records (EDRs). A major recent improvement in the land-based VIIRS EDRs has been the development of global gridded products, providing a format and science content suitable for ingest into NOAA's operational land surface and coupled numerical weather prediction models. VIIRS near-real-time Green Vegetation Fraction is now in the process of testing for full operational use, while land surface temperature and albedo are under testing and evaluation. The operational 750m VIIRS active fire product, including fire radiative power, is used to support emission modeling and air quality applications. Testing the evaluation for operational NOAA implementation of the improved 375m VIIRS active fire product is also underway. Added-value and emerging VIIRS land products include vegetation health, phenology, near-real-time surface type and surface condition change, and other biogeophysical variables. As part of the JPSS program, a global soil moisture data product has also been generated from the Advanced Microwave Scanning Radiometer 2 (AMSR2) sensor on the GCOM-W1 (Global Change Observation Mission - Water 1) satellite since July 2012. This product is included in the blended NESDIS Soil Moisture Operational Products System, providing soil moisture data as a critical input for land surface modeling.

  7. Rear Operations Group medicine: a pilot study of psychological decompression in a Rear Operations Group during Operation HERRICK 14.

    Science.gov (United States)

    Nimenko, Wasyl; Simpson, R G

    2014-12-01

    To investigate group activity psychological decompression (GAPD) in a Rear Operations Group. Provision of military archaeological exercises for a Rear Operations Group's medical centre patients during Op HERRICK 14 with analysis of before and after Patient Health Questionnaires (PHQ), Work and Social Adjustment Scales, generalised anxiety disorder (GAD) 7 Anxiety, Audit Questionnaire and Impact of Events Scale Revised and analysis of interviews with supervisors and soldiers. Soldiers reported a mean of 13%-38% improvement across the self-reported domains. The civilian archaeologists reported improvements in self-esteem, morale and team-working. 10 out of 24 soldiers have expressed an interest to pursue archaeology further; eight soldiers disclosed mental health issues for the first time, four of whom required mental health referral. GAPD can help early-returned soldiers in reducing symptoms of anxiety, depression, isolation and psychological traumatic symptoms. It also helps to increase perception of their ability to work and socialise as a team and help them to an early return to work. It can provide soldiers with the opportunity to approach their supervisors in an informal manner and help in early detection of mental health problems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Site operations

    International Nuclear Information System (INIS)

    House, W.B.; Ebenhack, D.G.

    1989-01-01

    This chapter is a discussion of the management and operations practices used at the Barnwell Waste Management Facility in Barnwell, SC. The following topics are discussed: (1) Waste receiving and inspection, including manifest and certificates of compliance, radiological surveys, disposition of nonconforming items, and decontamination and disposition of secondary waste streams; (2) Waste disposal, including Title 10 CFR 61 requirements, disposal area evaluations, shipment offloading, container emplacement, and radiation protection; (3) Trench closure, including trench backfilling, trench capping, and permanent markers; (4) Site maintenance and stabilization, including trench maintenance, surface water management, and site closure activities; (5) Site monitoring programs, including operational monitoring, and environmental monitoring program; (6) Personnel training and qualifications, including basic training program, safety training program, special skills training, and physical qualifications; (7) Records management, including waste records, personnel training records, personnel dosimetry records, site monitoring records, trench qualification and construction records, and site drawings and stabilization records; (8) Site security; (9) Emergency response plans; and (10) Quality assurance

  9. Benefits to blood banks of a sales and operations planning process.

    Science.gov (United States)

    Keal, Donald A; Hebert, Phil

    2010-12-01

    A formal sales and operations planning (S&OP) process is a decision making and communication process that balances supply and demand while integrating all business operational components with customer-focused business plans that links high level strategic plans to day-to-day operations. Furthermore, S&OP can assist in managing change across the organization as it provides the opportunity to be proactive in the face of problems and opportunities while establishing a plan for everyone to follow. Some of the key outcomes from a robust S&OP process in blood banking would include: higher customer satisfaction (donors and health care providers), balanced inventory across product lines and customers, more stable production rates and higher productivity, more cooperation across the entire operation, and timely updates to the business plan resulting in better forecasting and fewer surprises that negatively impact the bottom line. © 2010 American Association of Blood Banks.

  10. A Study on the Operator Decision Support for Feed-and-Bleed Operation

    International Nuclear Information System (INIS)

    Kim, Bo Gyung; Kim, Sang Ho; Kang, Hyun Gook; Yoon, Ho Joon

    2014-01-01

    In the case of a combined accident that includes a failure of the secondary cooling system, it is difficult for operators to recognize the necessity of an feed and bleed (F and B) operation because a lot of parameters and alarms should be checked before a decision, and operators may spend a considerable amount of time arriving at the entry for a proper emergency operating procedure that contains the procedure for an F and B operation. Therefore, a clear identification of the success boundary of an F and B operation would help operators in their decision-making when a combined accident that includes a secondary cooling system failure occurs. This study will provide a useful guideline for the initiation of an F and B operation for operators. Cooling the RCS after a scram is one of the most important safety functions for preventing core damage. To support the operator in decision making whether to initiate the F and B operation, plant conditions requiring the initiation of an F and B operation were identified. Plant conditions are affected by the steam generator inventory, RCS inventory, core inventory, and safety injection availability. The combination of accident types, component availabilities, and the initiation time of an F and B operation affect the success of the F and B operation. Operators need clear information about the RCS condition when the steam generators, the RCS's main residual heat removal mechanism, become unavailable. When this happens, the initiation of an F and B operation becomes necessary. As the number of the state increases, the necessity of an F and B operation increases. Especially, the operator should initiate an F and B operation when the RCS condition enters State 3 for Type 1 incidents or State 3-2 for Type 2 incidents. The results of this study may be useful in providing information regarding the necessity and effects of an F and B operation in a quantitative manner. In particular, in the case of a combined accident including a

  11. 2nd International Conference on Health Care Systems Engineering

    CERN Document Server

    Sahin, Evren; Li, Jingshan; Guinet, Alain; Vandaele, Nico

    2016-01-01

    In this volume, scientists and practitioners write about new methods and technologies for improving the operation of health care organizations. Statistical analyses play an important role in these methods with the implications of simulation and modeling applied to the future of health care. Papers are based on work presented at the Second International Conference on Health Care Systems Engineering (HCSE2015) in Lyon, France. The conference was a rare opportunity for scientists and practitioners to share work directly with each other. Each resulting paper received a double blind review. Paper topics include: hospital drug logistics, emergency care, simulation in patient care, and models for home care services. Discusses statistical analysis and operations management for health care delivery systems based on real case studies Papers in this volume received a double blind review Brings together the work of scientists, practitioners, and clinicians to unite research and practice in the future of these systems Top...

  12. Improving a Dental School's Clinic Operations Using Lean Process Improvement.

    Science.gov (United States)

    Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

    2016-10-01

    The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.

  13. Operative delay to laparoscopic cholecystectomy: Racking up the cost of health care.

    Science.gov (United States)

    Schwartz, Diane A; Shah, Adil A; Zogg, Cheryl K; Nicholas, Lauren H; Velopulos, Catherine G; Efron, David T; Schneider, Eric B; Haider, Adil H

    2015-07-01

    Health care providers are increasingly focused on cost containment. One potential target for cost containment is in-hospital management of acute cholecystitis. Ensuring cholecystectomy within 24 hours for cholecystitis could mitigate costs associated with longer hospitalizations. We sought to determine the cost consequences of delaying operative management. The Nationwide Inpatient Sample (2003-2011) was queried for adult patients (≥16 years) who underwent laparoscopic cholecystectomy for a primary diagnosis of acute cholecystitis. Patients who underwent open procedures or endoscopic retrograde cholangiopancreatography were excluded. Generalized linear models (GLMs) were used to analyze costs for each day's delay in surgery. Multivariable analyses adjusted for patient demographics, hospital descriptors, Charlson comorbidity index, mortality, and length of stay. We analyzed 191,032 records. Approximately 65% of the patients underwent surgery within 24 hours of admission. The average cost of care for surgery on the admission day was $11,087. Costs disproportionately increased by 22% on the second hospital day ($13,526), by 37% on the third day ($15,243), by 52% on the fourth day ($16,822), by 64% on the fifth day ($18,196), by 81% on the sixth day ($20,125), and by 100% on the seventh day ($22,250) when compared with the cost of care for procedures performed within 24 hours of admission. Subset analysis of patients discharged 24 hours or earlier from the time of surgery demonstrated similar trends. After controlling for patient- and hospital-related factors, we noted significant costs associated with each day's delay in operative management. Cost containment practices for acute cholecystitis justify consideration of same-day or next-day surgery where the diagnosis is straightforward. Economic and value-based analysis, level III.

  14. Shuttle Flight Operations Contract Generator Maintenance Facility Land Use Control Implementation Plan (LUCIP)

    Science.gov (United States)

    Applegate, Joseph L.

    2014-01-01

    This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of the Kennedy Space Center (KSC) Shuttle Flight Operations Contract Generator Maintenance Facility (SFOC; SWMU 081; "the Site") of institutional controls that have been implemented at the Site1. Although there are no current unacceptable risks to human health or the environment associated with the SFOC, an institutional land use control (LUC) is necessary to prevent human health exposure to antimony-affected groundwater at the Site. Controls will include periodic inspection, condition certification, and agency notification.

  15. Mobile Operating Systems

    OpenAIRE

    Vipin Kamboj; Hitesh Gupta

    2012-01-01

    Mobile phones are used by every people in today’s life. We use mobile phones without knowing the different factors that a mobile used including its technology, operating system, CPU ,RAM etc. Many types of operating system are used by different mobile. Every operating system has their advantage

  16. Arrangement between the International Atomic Energy Agency and the World Health Organization concerning the establishment and operation of a network of Secondary Standard Dosimetry Laboratories

    International Nuclear Information System (INIS)

    1986-01-01

    The International Atomic Energy Agency (IAEA) and the World Health Organization (WHO), recognizing that they have been co-operating in the operation of a network of Secondary Standard Dosimetry Laboratories (the Network), established pursuant to a Working Arrangement, dated 5 April 1976; and desiring to continue this co-operation in accordance with Article V of the relationship agreement concluded by IAEA and WHO in 1959; hereby enter a new arrangement to guide their work in operating the Network and providing assistance, when needed, to individual Secondary Standard Dosimetry Laboratories (SSDLs). The purpose of this Arrangement is to set forth responsibilities of IAEA and WHO in the operation and support of the Network and to establish criteria for SSDLs

  17. Theoretical Models and Operational Frameworks in Public Health Ethics

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2010-01-01

    Full Text Available The article is divided into three sections: (i an overview of the main ethical models in public health (theoretical foundations; (ii a summary of several published frameworks for public health ethics (practical frameworks; and (iii a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided.

  18. Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts.

    Science.gov (United States)

    Bouchelle, Zoe; Rawlins, Yasmin; Hill, Caterina; Bennet, Jennifer; Perez, Leonor Xochitl; Oriol, Nancy

    2017-11-03

    There are approximately 2000 mobile health clinics operating in the United States. While researchers have established that mobile health clinics can be cost effective and improve outcomes, there is scant research examining the healthcare experience on a mobile health clinic from patients' perspectives. Data were gathered from interviews with 25 clients receiving care on a Boston-based mobile health clinic and analyzed using grounded theory methodology. Emerging patterns in the data revealed three relational and three structural factors most significant to participants' experience of care on The Family Van. Relational factors include providers who 1) Communicate understandably, 2) Create a culture of respect and inclusivity, and 3) Are diverse with knowledge of the community. Structural factors include 1) A focus on preventative health and managing chronic disease, 2) Expeditious, free, and multiple services, and 3) Location. The participant accounts in this report serve to expand on prior research exploring mobile health clinics' role in patients' healthcare, to more clearly define the most salient aspects of the mobile health clinic model for the patients they serve, and to give voice to patients too seldom heard in the academic literature.

  19. Accreditation and quality approach in operating theatre departments: the French approach.

    Science.gov (United States)

    Soudée, M

    2005-01-01

    Since 1996, French health establishments are subjected to a process of evaluating the quality of care, called "accreditation". This process was controlled by ANAES, which, after January 1st, 2005 became the Haute Autorité de Santé (HAS). The accreditation is characterized by a dual process of self-assessment and external audit, leading to four levels of accreditation. In spite of requiring a time-consuming methodology, this approach provides an important means of consolidating the development of the quality approach and re-stimulating the compliance of establishments with standards of safety and vigilance. The professional teams of many French operating theatre departments have been able to use the regulatory and restricting framework of accreditation to organize quality approaches specific to the operative system, supported by the organizational structures of the department such as the operating suite committee, departmental boards and the steering group. Based on quality guidelines including a commitment from the manager and operating suite committee, as well as a quality flow chart and a quality system, these teams describe the main procedures for running the operating theatre. They also organize the follow-up of incidents and undesirable events, along with the risks and points to watch. Audits of the operative system are planned on a regular basis. The second version of the accreditation process considerably reinforces the assessment of professional practices by evaluating the relevance, the risks and the methods of managing care for pathologies. It will make it possible to implement assessments of the health care provided by operating theatre departments and will reinforce the importance of search for quality.

  20. Federalism and health policy: the intergovernmental committees in Brazil

    Directory of Open Access Journals (Sweden)

    Cristiani Vieira Machado

    2014-08-01

    Full Text Available OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i level of institutionality, classified as advanced, intermediate, or incipient; (ii agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii political processes, considering the character and scope of intergovernmental relations; and (iv capacity of operation, assessed as high, moderate, or low. RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes

  1. Federalism and health policy: the intergovernmental committees in Brazil.

    Science.gov (United States)

    Machado, Cristiani Vieira; Lima, Luciana Dias de; Viana, Ana Luiza d'Ávila; Oliveira, Roberta Gondim de; Iozzi, Fabíola Lana; Albuquerque, Mariana Vercesi de; Scatena, João Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana

    2014-08-01

    To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low. Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees' ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation of federal investments, varied by

  2. The state of physical and mental health of children from the anti-terrorist operation zone

    Directory of Open Access Journals (Sweden)

    N.M. Korenev

    2017-02-01

    Full Text Available The aim of the study was the assessment of physical and mental health of school-age children from the war zone in the Eastern Ukraine. Materials and methods. Clinical and instrumental examination was performed in 286 children aged 7–18 years, of which 209 were from the zone of the antiterrorist operation, and 77 — children of migrants from the Donetsk and Luhansk regions. The comparison group consisted of 672 children of the same age of the Kharkiv region and Kharkiv. To determine the characteristics of violations of children’s mental health, there was conducted a clinical and psychological examination by fil­ling a special form. Results. It was found that most of the children from the war zone in the Eastern Ukraine and migrants had somatic and psychosomatic complaints. The data were obtained on polymorphism of clinical symptoms regarding psychopathological disorders in this cohort, with predominance in the clinical structure of fatigue, emotional instability, stress, and increased physical fatigue, recurrent headaches, dizziness. Conclusions. It was found that in terms of the incidence of most clinical entities with respect to somatic and psychiatric pathologies, the differences between the study group and population controls are absent. One of the priorities of maintaining and strengthening the health of children during the military conflict in the East of Ukraine is the need to develop and put into practice active psychoprophylactic activities regarding adaptation disorders.

  3. Effects of payment method on work control, work risk and work-related musculoskeletal health among sewing machine operators

    Directory of Open Access Journals (Sweden)

    R. Nawawi

    2015-12-01

    Full Text Available Effects of payment method on work control, work risk and work-related musculoskeletal health among sewing machine operators R. Nawawi1, B.M. Deros1*, D.D.I. Daruis2, A. Ramli3, R.M. Zein4 and L.H. Joseph3 1Dept. of Mechanical and Materials Engineering Faculty of Engineering & Built Environment Universiti Kebangsaan Malaysia, Malaysia *Email: hjbaba@ukm.edu.my 2Faculty of Engineering, Universiti Pertahanan Nasional Malaysia, Malaysia 3Department of Physiotherapy Faculty of Science, Lincoln University College, Malaysia 4Department of Consultation, Research & Development, National Institute of Occupational Safety and Health (NIOSH, Malaysia ABSTRACT This study aimed to identify payment method and its effects on work control, work risk and work-related musculoskeletal health among Malaysian sewing machine operators. The study sample comprised 337 sewing machine operators (male, n=122, female, n=215; aged between 18-54 years old; mean 30.74±8.44 from four different garment-making companies in Malaysia. They were being paid via time rate wages (n=246 and piece rate wages (n=91. Data was collected through Nordic Musculoskeletal Questionnaire and pen-and-paper assessment via Rapid Upper Limb Assessment (RULA. From the study, the piece rate wage group was found to take fewer breaks, had high work production demands, worked at a faster pace and experienced more exhaustion and pressure due to increasing work demands as compared to the time rate group. They were also observed working with higher physical exposure such as repetitive tasks, awkward static postures, awkward grips and hand movements, pulling, lifting and pushing as compared to those in the time rate wage group. The final RULA scores was also higher from the piece rate wage group (72.53% RULA score 7 which indicated higher work risks among them. The study found that the type of wage payment was significantly associated with work risks (p=0.036, df=1 and WRMSD at the shoulder, lower back

  4. Health, safety, and environmental management system operation in contracting companies: A case study.

    Science.gov (United States)

    Nassiri, Parvin; Yarahmadi, Rasoul; Gholami, Pari Shafaei; Hamidi, Abdolamir; Mirkazemi, Roksana

    2016-05-03

    Systematic and cooperative interactions among parent industry and contractors are necessary for a successful health, safety, and environmental management system (HSE-MS). This study was conducted to evaluate the HSE-MS performance in contracting companies in one of the petrochemical industries in Iran during 2013. Managers of parent and contracting companies participated in this study. The data collection forms included 7 elements of an integrated HSE-MS (leadership and commitment; policy and strategic objectives; organization, resources, and documentation; evaluation and risk management; planning; implementation and monitoring; auditing and reviewing). The results showed that mean percentage of the total scores in seven elements of HSE-MS was 85.7% and 87.0% based on self-report and report of parent company, respectively. In conclusion, this study showed that HSE-MS was desirably functioning; however, improvement to ensure health and safety of workers is still required.

  5. Behavioral health leadership: new directions in occupational mental health.

    Science.gov (United States)

    Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L

    2014-10-01

    The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

  6. New directions in health physics

    International Nuclear Information System (INIS)

    Vaughan, B.E.

    1975-04-01

    Present statutory and other requirements placed on health physics groups include many areas besides that of radiological monitoring. It is not unusual for health physics groups to also monitor metal contamination and accidental release of certain toxic chemicals. The general approach in terms of medical surveillance, monitoring, sampling, and measurement technology will be applicable outside the nuclear area. With the creation of the U.S. Energy Research and Development Administration, and with abolition of the former U.S. Atomic Energy Commission, it is clear that technologies beyond strictly nuclear technology will be implemented to meet energy needs of the next decade. The impact of some of these technologies for electric power production on the environment are discussed with emphasis on coal. It is pointed out that coal consumption can be expected to increase, and the scale of operation for individual plants can be unbelievably large. The contributions of nuclear power plants and fossil fuels to meet energy demands by the year 2000 are estimated. Both health and environmental implications of such operations are discussed in relation to anticipated research and monitoring programs. (U.S.)

  7. 30 CFR 250.414 - What must my drilling prognosis include?

    Science.gov (United States)

    2010-07-01

    ...) Projected plans for logging; (c) Planned safe drilling margin between proposed drilling fluid weights and... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must my drilling prognosis include? 250... OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations...

  8. Stages of change for physical activity and dietary habits in persons with type 2 diabetes included in a mobile health intervention: the Norwegian study in RENEWING HEALTH.

    Science.gov (United States)

    Holmen, Heidi; Wahl, Astrid; Torbjørnsen, Astrid; Jenum, Anne Karen; Småstuen, Milada Cvancarova; Ribu, Lis

    2016-01-01

    The aim of this study was to investigate stages of change for physical activity and dietary habits using baseline data from persons with type 2 diabetes included in a mobile health intervention. We examined the associations between stages of change for physical activity change and dietary change, and between stages of change for each behavior and individual characteristics, health-related quality of life, self-management, depressive symptoms, and lifestyle. We examined 151 persons with type 2 diabetes with an glycated hemoglobin (HbA1c) level ≥7.1%, aged ≥18 years at baseline of a randomized controlled trial, before testing a mobile app with or without health counseling. Stages of change were dichotomized into 'pre-action' and 'action'. Self-management was measured using the Health Education Impact Questionnaire (heiQ) where a higher score reflects increased self-management, and health-related quality of life was measured with the Short-Form-36 (SF-36). Logistic regression modeling was performed. The median HbA1c level was 7.9% (7.1-12.4), 90% were overweight or obese, and 20% had ≥3 comorbidities. 58% were in the preaction stage for physical activity change and 79% in the preaction stage for dietary change. Higher scores of self-management were associated with an increased chance of being in the action stage for both dietary change and physical activity change. Higher body mass index was associated with an 8% reduced chance of being in the action stage for physical activity change (OR 0.92, 95% CI 0.86 to 0.99). Being in the action stage was associated with higher scores of self-management, crucial for type 2 diabetes. Over half of the participants were in the preaction stage for physical activity and dietary change, and many had a high disease burden with comorbidities and overweight. NCT01315756.

  9. Authorization procedure for the construction and operation of nuclear installations within the EC Member States, including supervision and control

    International Nuclear Information System (INIS)

    Amaducci, Sandro; Didier, J.M.

    1978-01-01

    This report is an updating of the report EUR 5284, Authorization procedure for the construction and operation of nuclear installations within the EEC Member States, prepared in 1974 by J.M. Didier and Associates. Recent developments regarding the authorization procedure for the construction and operation of nuclear installations have taken place in Italy (introduction of a site approval procedure) and in Denmark (adoption of an overall legislation on the subject, however not yet in force). With respect to supervision and control of nuclear installations during construction and operation, competences of, as well as their exercise by, supervisory authorities in all EC Member States, with the exception of Ireland, are also analysed in the current study

  10. INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE.

    Science.gov (United States)

    Heidari, Leila; Younger, Margalit; Chandler, George; Gooch, James; Schramm, Paul

    2016-01-01

    The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building's health impacts reveals that there are multiple co-benefits of a "healthy building," including those related to the economy, environment, society, transportation, planning, and energy efficiency.

  11. Barriers to the use of Veterans Affairs health care services among female veterans who served in Iraq and Afghanistan.

    Science.gov (United States)

    Newins, Amie R; Wilson, Sarah M; Hopkins, Tiffany A; Straits-Troster, Kristy; Kudler, Harold; Calhoun, Patrick S

    2018-02-08

    The study investigated barriers to the utilization of Veterans Affairs (VA) health care services among female veterans who served in served in Iraq and Afghanistan, including reasons for not choosing VA health care, reasons for not seeking mental health treatment, and types of desired VA services. Female respondents to a survey assessing Operation Enduring Freedom/Operation Iraqi Freedom veterans' needs and health (N = 186) completed measures of military history, posttraumatic stress disorder, depression, barriers to VA health care, and preferences for services. Barriers to use of VA health care endorsed by female veterans included receiving care elsewhere and logistical issues. Barriers to utilization of mental health services among female veterans who screened positive for depression or posttraumatic stress disorder included negative treatment biases and concerns about stigma, privacy, and cost. Female veterans endorsed preferences for services related to eligibility education, nonprimary care physical health services, vocational assistance, and a few behavioral/mental health services. Findings highlight the need for ongoing outreach and education regarding eligibility and types of resources for physical and mental health problems experienced by female veterans who served in Iraq and Afghanistan, as well as inform types of VA programming and services desired by female veterans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

    Science.gov (United States)

    Damari, Behzad; Ehsani Chimeh, Elham

    2017-01-01

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

  13. Investments and costs of oral health care for Family Health Care

    Directory of Open Access Journals (Sweden)

    Márcia Stefânia Ribeiro Macêdo

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To estimate the investments to implement and operational costs of a type I Oral Health Care Team in the Family Health Care Strategy. METHODS This is an economic assessment study, for analyzing the investments and operational costs of an oral health care team in the city of Salvador, BA, Northeastern Brazil. The amount worth of investments for its implementation was obtained by summing up the investments in civil projects and shared facilities, in equipments, furniture, and instruments. Regarding the operational costs, the 2009-2012 time series was analyzed and the month of December 2012 was adopted for assessing the monetary values in effect. The costs were classified as direct variable costs (consumables and direct fixed costs (salaries, maintenance, equipment depreciation, instruments, furniture, and facilities, besides the indirect fixed costs (cleaning, security, energy, and water. The Ministry of Health’s share in funding was also calculated, and the factors that influence cost behavior were described. RESULTS The investment to implement a type I Oral Health Care Team was R$29,864.00 (US$15,236.76. The operational costs of a type I Oral Health Care Team were around R$95,434.00 (US$48,690.82 a year. The Ministry of Health’s financial incentives for investments accounted for 41.8% of the implementation investments, whereas the municipality contributed with a 59.2% share of the total. Regarding operational costs, the Ministry of Health contributed with 33.1% of the total, whereas the municipality, with 66.9%. Concerning the operational costs, the element of heaviest weight was salaries, which accounted for 84.7%. CONCLUSIONS Problems with the regularity in the supply of inputs and maintenance of equipment greatly influence the composition of costs, besides reducing the supply of services to the target population, which results in the service probably being inefficient. States are suggested to partake in funding

  14. Investments and costs of oral health care for Family Health Care

    Science.gov (United States)

    Macêdo, Márcia Stefânia Ribeiro; Chaves, Sônia Cristina Lima; Fernandes, Antônio Luis de Carvalho

    2016-01-01

    ABSTRACT OBJECTIVE To estimate the investments to implement and operational costs of a type I Oral Health Care Team in the Family Health Care Strategy. METHODS This is an economic assessment study, for analyzing the investments and operational costs of an oral health care team in the city of Salvador, BA, Northeastern Brazil. The amount worth of investments for its implementation was obtained by summing up the investments in civil projects and shared facilities, in equipments, furniture, and instruments. Regarding the operational costs, the 2009-2012 time series was analyzed and the month of December 2012 was adopted for assessing the monetary values in effect. The costs were classified as direct variable costs (consumables) and direct fixed costs (salaries, maintenance, equipment depreciation, instruments, furniture, and facilities), besides the indirect fixed costs (cleaning, security, energy, and water). The Ministry of Health’s share in funding was also calculated, and the factors that influence cost behavior were described. RESULTS The investment to implement a type I Oral Health Care Team was R$29,864.00 (US$15,236.76). The operational costs of a type I Oral Health Care Team were around R$95,434.00 (US$48,690.82) a year. The Ministry of Health’s financial incentives for investments accounted for 41.8% of the implementation investments, whereas the municipality contributed with a 59.2% share of the total. Regarding operational costs, the Ministry of Health contributed with 33.1% of the total, whereas the municipality, with 66.9%. Concerning the operational costs, the element of heaviest weight was salaries, which accounted for 84.7%. CONCLUSIONS Problems with the regularity in the supply of inputs and maintenance of equipment greatly influence the composition of costs, besides reducing the supply of services to the target population, which results in the service probably being inefficient. States are suggested to partake in funding, especially to cover the

  15. Health physics and operational experience gained from slurry transfer of wastes containing 780 curies of radium-226

    International Nuclear Information System (INIS)

    Borden, W.C.; Land, R.R.

    1986-01-01

    During remedial action at the DOE Niagara Falls Storage Site 3.5 million kilogram (3891 ton) of uranium ore residues (code named K-65 during the Manhattan Project) were slurry transferred about one mile from a concrete water tower to an engineered waste containment facility. This operation presented a number of unusual health physics problems, mandating special handling, measurement, and exposure control methodologies. Principles among these were: (1) a specific activity of 220,000 pCi/gm; (2) open air concentrations of radon-222 of up to 60,000 pCi/1; (3) radon concentrations inside the tower of 1,700,000 pCi/1; (4) exposure rates of up to 350 mR/hr; (5) widely varying climatic conditions; and (6) working atop a 165 foot tall, 40 foot diameter, structure in these conditions. This paper will describe the transfer operation, its problems, problem solutions, and successes. Detailed attention is given to personnel and environmental monitoring, as well as contamination and exposure control methodologies. Operations concluded with the K-65 residues stored in an environmentally stable condition, less than 10 man-rem of worker exposure, and average off-site radon-222 concentrations of less than 0.3 pCi/1 above background

  16. Quality of life and sexual function of women operated on reproductive system organs

    Directory of Open Access Journals (Sweden)

    О. S. Lashkul

    2018-02-01

    Full Text Available Aim – to study the effect of planned gynecological operations on the integral characteristics of physical, psychological, emotional, social and sexual functioning of women. Materials and methods. Quality of life and sexual function were studied in 165 patients who underwent planned gynecological operations. Depending on the type of surgical treatment patients were divided into 6 groups: the 1st group – 20 patients (vaginal hysterectomy without FTS, the 2nd group – 23 patients (abdominal hysterectomy without FTS, the 3rd group – 54 patients (laparoscopic operations on the uterine appendages without FTS, the 4th group – 21 patients (vaginal hysterectomy with FTS, the 5th group – 20 patients (abdominal hysterectomy with FTS, the 6th group – 27 patients (laparoscopic operations on the uterine appendages with FTS. To assess the quality of life a short version of the SF-36 questionnaire was used. The questionnaire was developed at the US Institute of Health, author J. E. Ware, and contains 36 items. They are grouped so that they reflect 8 different aspects related to health. The results for each scale are presented in a point scale (from 1 to 100, where a higher score corresponds to a better quality of life. To assess the sexual function a questionnaire was conducted using the female sexual function index (FSFI. The questionnaire includes 19 items that provide of characteristics of desire, excitement, lubrication, orgasm, getting sexual satisfaction and dyspareunia presence assessment. The minimum score is 2, the maximum is 36. Stages of the questionnaire: before the operation and three months after the operation. Results. In patients before and after laparoscopic surgery on uterine appendages without FTS and with FTS, the mean values of the female sexual function index were significantly higher after surgery and reached the maximum value of 36. So, by questionnaire before and after 3 months it has been found that the indicators

  17. Current Conditions Risk Assessment for the 300-FF-5 Groundwater Operable Unit

    Energy Technology Data Exchange (ETDEWEB)

    Miley, Terri B.; Bunn, Amoret L.; Napier, Bruce A.; Peterson, Robert E.; Becker, James M.

    2007-11-01

    This report updates a baseline risk assessment for the 300 Area prepared in 1994. The update includes consideration of changes in contaminants of interest and in the environment that have occurred during the period of interim remedial action, i.e., 1996 to the present, as well as the sub-regions, for which no initial risk assessments have been conducted. In 1996, a record of decision (ROD) stipulated interim remedial action for groundwater affected by releases from 300 Area sources, as follows: (a) continued monitoring of groundwater that is contaminated above health-based levels to ensure that concentrations continue to decrease, and (b) institutional controls to ensure that groundwater use is restricted to prevent unacceptable exposure to groundwater contamination. In 2000, the groundwater beneath the two outlying sub-regions was added to the operable unit. In 2001, the first 5-year review of the ROD found that the interim remedy and remedial action objectives were still appropriate, although the review called for additional characterization activities. This report includes a current conditions baseline ecological and human health risk assessment using maximum concentrations in the environmental media of the 300-FF-5 Operable Unit and downstream conditions at the City of Richland, Washington. The scope for this assessment includes only current measured environmental concentrations and current use scenarios. Future environmental concentrations and future land uses are not considered in this assessment.

  18. [Terrorism, public health and health services].

    Science.gov (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  19. Operating limit study for the proposed solid waste landfill at Paducah Gaseous Diffusion Plant

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D.W.; Wang, J.C.; Kocher, D.C.

    1995-06-01

    A proposed solid waste landfill at Paducah Gaseous Diffusion Plant (PGDP) would accept wastes generated during normal operations that are identified as non-radioactive. These wastes may include small amounts of radioactive material from incidental contamination during plant operations. A site-specific analysis of the new solid waste landfill is presented to determine a proposed operating limit that will allow for waste disposal operations to occur such that protection of public health and the environment from the presence of incidentally contaminated waste materials can be assured. Performance objectives for disposal were defined from existing regulatory guidance to establish reasonable dose limits for protection of public health and the environment. Waste concentration limits were determined consistent with these performance objectives for the protection of off-site individuals and inadvertent intruders who might be directly exposed to disposed wastes. Exposures of off-site individuals were estimated using a conservative, site-specific model of the groundwater transport of contamination from the wastes. Direct intrusion was analyzed using an agricultural homesteader scenario. The most limiting concentrations from direct intrusion or groundwater transport were used to establish the concentration limits for radionuclides likely to be present in PGDP wastes.

  20. Operating limit study for the proposed solid waste landfill at Paducah Gaseous Diffusion Plant

    International Nuclear Information System (INIS)

    Lee, D.W.; Wang, J.C.; Kocher, D.C.

    1995-06-01

    A proposed solid waste landfill at Paducah Gaseous Diffusion Plant (PGDP) would accept wastes generated during normal operations that are identified as non-radioactive. These wastes may include small amounts of radioactive material from incidental contamination during plant operations. A site-specific analysis of the new solid waste landfill is presented to determine a proposed operating limit that will allow for waste disposal operations to occur such that protection of public health and the environment from the presence of incidentally contaminated waste materials can be assured. Performance objectives for disposal were defined from existing regulatory guidance to establish reasonable dose limits for protection of public health and the environment. Waste concentration limits were determined consistent with these performance objectives for the protection of off-site individuals and inadvertent intruders who might be directly exposed to disposed wastes. Exposures of off-site individuals were estimated using a conservative, site-specific model of the groundwater transport of contamination from the wastes. Direct intrusion was analyzed using an agricultural homesteader scenario. The most limiting concentrations from direct intrusion or groundwater transport were used to establish the concentration limits for radionuclides likely to be present in PGDP wastes

  1. Operating program for an automatic alpha-beta counting system-FAG

    Energy Technology Data Exchange (ETDEWEB)

    German, U; Levinson, L; Shemesh, Y; Peled, O; Weistein, M [Israel Atomic Energy Commission, Beersheba (Israel). Nuclear Research Center-Negev

    1996-12-01

    An alpha and beta counting system - FAG, for planchette samples is operated at the Health Physics department`s laboratory of the NRCN. The system consists of a proportional detector of 8`` diameter operated in coincidence with a guard detector, an automatic sample changer (FAG-FHT770E) and electronics (FAG- FHT1100 digital counter and controller). The original operation mode of the system was based on manual tasks handled by the FHT1100 electronics. Pin option for a basic computer keyboard operation was available too. A computer with appropriate 110 card was connected to the system and a new operating program was developed which enables full automatic control of the various components. The program includes activity calculations and statistical checks as well as data management. The program which was developed enables computer control of all components of the system, based on bi-directional communication. The computer software controls the FHT1100 electronics using the R5232 protocol and the sample changer by an additional 110 card Contec Inodel PIO-48W(PC). The computer controls the whole operation of the system: change of samples, high voltage change, start, stop etc. It handles in the appropriate order the different commands and operates the electronic and mechanic components accordingly (authors).

  2. Operating program for an automatic alpha-beta counting system-FAG

    International Nuclear Information System (INIS)

    German, U.; Levinson, L.; Shemesh, Y.; Peled, O.; Weistein, M.

    1996-01-01

    An alpha and beta counting system - FAG, for planchette samples is operated at the Health Physics department's laboratory of the NRCN. The system consists of a proportional detector of 8'' diameter operated in coincidence with a guard detector, an automatic sample changer (FAG-FHT770E) and electronics (FAG- FHT1100 digital counter and controller). The original operation mode of the system was based on manual tasks handled by the FHT1100 electronics. Pin option for a basic computer keyboard operation was available too. A computer with appropriate 110 card was connected to the system and a new operating program was developed which enables full automatic control of the various components. The program includes activity calculations and statistical checks as well as data management. The program which was developed enables computer control of all components of the system, based on bi-directional communication. The computer software controls the FHT1100 electronics using the R5232 protocol and the sample changer by an additional 110 card Contec Inodel PIO-48W(PC). The computer controls the whole operation of the system: change of samples, high voltage change, start, stop etc. It handles in the appropriate order the different commands and operates the electronic and mechanic components accordingly (authors)

  3. Firewood boiler operators and heat exposure

    Directory of Open Access Journals (Sweden)

    Vilson Bernardo Stollmeier

    2017-12-01

    Full Text Available This article presents an analysis of heat exposure work in boiler industry wood from a company in the industrial sector, focusing on the analysis of the environmental burden of the activity. Therefore, the methodological procedures consisted of document analysis, interviews, filming, evaluation problems of the effects of the hot environment and its prevention. The results show that the fuel to the boiler operators are exposed to heat and need guidance on their daily activities with prevention of diseases affected by excessive heat. Are also suggested training in technical and health to improve working conditions and the operator's health.

  4. A guide to safe field operations

    Science.gov (United States)

    Yobbi, D.K.; Yorke, T.H.; Mycyk, R.T.

    1996-01-01

    Most functions of the U.S. Geological Survey (USGS), Water Resources Division (WRD) require employees to participate in numerous field activities ranging from routine meetings with cooperators, other federal and public officials, and private citizens to potentially hazardous assignments, such as making flood measurements and scuba diving to service underwater instruments. It is paramount that each employee be aware of safety procedures and operational policies of the WRD to ensure that (1) their activities avoid or minimize personal injury to the employee, coworkers, or anyone in the vicinity of the field activity, and (2) their conduct does not infringe on the personal or property rights of any individual or organization. The purpose of the guide is to familiarize employees with the operational and safety procedures expected to be followed by each employee as a representative of the WRD. It is also intended as a training tool for all new employees and a document to be reviewed by each employee before undertaking a field assignment. It includes general procedures that are standard and applicable to all field operations, such as communication, vehicle operation, and adequate preparation for anticipated weather conditions. It also includes a discussion of specific procedures and safety considerations for most of the routine field assignments undertaken by hydrologists and hydrologic technicians of the WRD. The guide is not intended to be a technical handbook outlining step-by-step procedures for performing specific tasks or a comprehensive discussion of every possible activity that may be undertaken by a USGS employee. Employees are referred to the Techniques for Water-Resources Investigations (TWRI) series for specific technical procedures and to the U.S. Geological Survey Safety and Environmental Health Handbook 445-1-H (USGS, August 1989), USGS Occupational Hazards and Safety Procedures Handbook 445-2-H (December 1993), the WRD notebook on Safety Policy and

  5. Ecological and human health sediment risk assessment for a hydrocarbon-impacted site in Lake Athabasca

    International Nuclear Information System (INIS)

    Mcdonald, B.; Wagenaar, A.; LaPorte, J.; Misfeldt, G.; Chatwell, I.

    2009-01-01

    The operation of a public port facility near Uranium City, Saskatchewan has resulted in elevated levels of hydrocarbons in soil, groundwater and sediment. Remedial action in the uplands portion of the site was successful and a risk management approach was initiated for the aquatic portion of the site in order to resolve human health and ecological issues. Ecological risks were assessed using a sediment weight-of-evidence approach involving chemistry, toxicity, bioaccumulation and benthic community structure. Human health risks were assessed via fish consumption, water ingestion and direct contact according to Health Canada guidance. This presentation included an overview of the general risk assessment approach as well as site-specific data and findings. The primary focus was on the challenges confronted during the risk assessment process, such as the need to include alkylated PAHs as a COPC in the human health risk assessment and to evaluate ongoing propeller wash and sediment resuspension for sediment risk management, even though the facility is no longer operational.

  6. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approved sampling devices; operation; air... LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.205 Approved sampling devices; operation; air flowrate...

  7. 30 CFR 90.209 - Respirable dust samples; transmission by operator.

    Science.gov (United States)

    2010-07-01

    ... LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.209 Respirable dust samples; transmission by operator. (a) The operator shall transmit within 24 hours after the end of the sampling shift all samples...

  8. Addressing Stillbirth in India Must Include Men.

    Science.gov (United States)

    Roberts, Lisa; Montgomery, Susanne; Ganesh, Gayatri; Kaur, Harinder Pal; Singh, Ratan

    2017-07-01

    Millennium Development Goal 4, to reduce child mortality, can only be achieved by reducing stillbirths globally. A confluence of medical and sociocultural factors contribute to the high stillbirth rates in India. The psychosocial aftermath of stillbirth is a well-documented public health problem, though less is known of the experience for men, particularly outside of the Western context. Therefore, men's perceptions and knowledge regarding reproductive health, as well as maternal-child health are important. Key informant interviews (n = 5) were analyzed and 28 structured interviews were conducted using a survey based on qualitative themes. Qualitative themes included men's dual burden and right to medical and reproductive decision making power. Wives were discouraged from expressing grief and pushed to conceive again. If not successful, particularly if a son was not conceived, a second wife was considered a solution. Quantitative data revealed that men with a history of stillbirths had greater anxiety and depression, perceived less social support, but had more egalitarian views towards women than men without stillbirth experience. At the same time fathers of stillbirths were more likely to be emotionally or physically abusive. Predictors of mental health, attitudes towards women, and perceived support are discussed. Patriarchal societal values, son preference, deficient women's autonomy, and sex-selective abortion perpetuate the risk for future poor infant outcomes, including stillbirth, and compounds the already higher risk of stillbirth for males. Grief interventions should explore and take into account men's perceptions, attitudes, and behaviors towards reproductive decision making.

  9. eHealth and mHealth initiatives in Bangladesh: A scoping study

    Science.gov (United States)

    2014-01-01

    Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth

  10. eHealth and mHealth initiatives in Bangladesh: a scoping study.

    Science.gov (United States)

    Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

    2014-06-16

    The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully

  11. Building a safety culture in global health: lessons from Guatemala.

    Science.gov (United States)

    Rice, Henry E; Lou-Meda, Randall; Saxton, Anthony T; Johnston, Bria E; Ramirez, Carla C; Mendez, Sindy; Rice, Eli N; Aidar, Bernardo; Taicher, Brad; Baumgartner, Joy Noel; Milne, Judy; Frankel, Allan S; Sexton, J Bryan

    2018-01-01

    Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work-life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes.

  12. Enhancing the role of faith-based organizations to improve health: a commentary.

    Science.gov (United States)

    Schoenberg, Nancy E

    2017-09-01

    Researchers, policymakers, and community members increasingly recognize the potential to leverage faith-based organizations (FBOs) to improve health. This commentary complements Leyva and colleagues' article on whether and how members of FBOs view such a role. The commentary draws on our 13+ years operating a faith-based and community-based research organization, Faith Moves Mountains, in the Appalachian context. Issues to be addressed in the further development of faith-based health promotion include sustainability; adherence to the evidence-based operations of interventions, training, and privacy and protection protocols; and understanding the changing landscape of American public life.

  13. Management, operational, animal health, and economic characteristics of large dairy herds in 4 states in the Upper Midwest of the United States.

    Science.gov (United States)

    Evink, T L; Endres, M I

    2017-11-01

    Recent trends in dairy farm structure in the United States have included a decreasing number of farms, although farm size has increased, especially the share of milk production from very large herds (>2,500 cows). The objectives of this observational study were to describe common management practices; to characterize labor and operational structure; to measure some aspects of animal health, including lameness, hock lesions, mortality, and mastitis incidence; and to summarize cost of production on farms with more than 2,500 cows in 4 states in the Upper Midwest of the United States. The study included 15 dairy farms in Minnesota, Wisconsin, Iowa, and South Dakota. Farms were visited twice, once each year, and on-farm herd records were collected for those 2 yr. On-farm herd records were used to investigate mortality, culling, pregnancy rate, and clinical mastitis incidence. At least 1 high-producing pen of mature cows and 1 pen of fresh cows were scored for locomotion. Likewise, at least 1 pen of high-producing mature cows was scored for cleanliness and hock lesions. Median herd size was 3,975 cows (range = 2,606-13,266). Milk sold per employee was 1,120,745 kg and the number of cows per employee was 105. Eighty percent of the farms had Holstein cows, 13% had Jersey, and 7% had Jersey-Holstein crosses. All farms used artificial insemination as the sole form of breeding and 100% of the farms used hormonal synchronization or timed artificial insemination programs in their reproductive protocols; 21-d pregnancy rate was 21.7%. Median lameness prevalence was 18.3% and median severe lameness prevalence was 5.1%. Median hock lesion prevalence was 17.4% and median severe hock lesion prevalence was 1.9%; mortality rate was 7.4%. Clinical mastitis incidence was 62.5 cases per 100 cow-years. Feed costs accounted for approximately 53% of the total cost of producing milk, followed by labor at 11%, interest and depreciation expenses at 10%, and replacement costs at 9.5%. Herds in

  14. mHealth in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Thomas J. Betjeman

    2013-01-01

    Full Text Available Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS, wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care. This systematic review analyzes and summarizes key articles from the current body of peer-reviewed literature on PubMed on the topic of mHealth in SSA. Studies included in the review demonstrate that mHealth can improve and reduce the cost of patient monitoring, medication adherence, and healthcare worker communication, especially in rural areas. mHealth has also shown initial promise in emergency and disaster response, helping standardize, store, analyze, and share patient information. Challenges for mHealth implementation in SSA include operating costs, knowledge, infrastructure, and policy among many others. Further studies of the effectiveness of mHealth interventions are being hindered by similar factors as well as a lack of standardization in study design. Overall, the current evidence is not strong enough to warrant large-scale implementation of existing mHealth interventions in SSA, but rapid progress of both infrastructure and mHealth-related research in the region could justify scale-up of the most promising programs in the near future.

  15. The Microbiome and Metabolome of Preterm Infant Stool Are Personalized and Not Driven by Health Outcomes, Including Necrotizing Enterocolitis and Late-Onset Sepsis.

    Science.gov (United States)

    Wandro, Stephen; Osborne, Stephanie; Enriquez, Claudia; Bixby, Christine; Arrieta, Antonio; Whiteson, Katrine

    2018-06-27

    The assembly and development of the gut microbiome in infants have important consequences for immediate and long-term health. Preterm infants represent an abnormal case for bacterial colonization because of early exposure to bacteria and frequent use of antibiotics. To better understand the assembly of the gut microbiota in preterm infants, fecal samples were collected from 32 very low birth weight preterm infants over the first 6 weeks of life. Infant health outcomes included health, late-onset sepsis, and necrotizing enterocolitis (NEC). We characterized bacterial compositions by 16S rRNA gene sequencing and metabolomes by untargeted gas chromatography-mass spectrometry. Preterm infant fecal samples lacked beneficial Bifidobacterium spp. and were dominated by Enterobacteriaceae , Enterococcus , and Staphylococcus organisms due to nearly uniform antibiotic administration. Most of the variance between the microbial community compositions could be attributed to the baby from which the sample derived (permutational multivariate analysis of variance [PERMANOVA] R 2 = 0.48, P PERMANOVA R 2 = 0.43, P < 0.001) and weakly associated with bacterial composition (Mantel statistic r = 0.23 ± 0.05, P < 0.05). No measured metabolites were found to be associated with necrotizing enterocolitis, late-onset sepsis, or a healthy outcome. Overall, preterm infant gut microbial communities were personalized and reflected antibiotic usage. IMPORTANCE Preterm infants face health problems likely related to microbial exposures, including sepsis and necrotizing enterocolitis. However, the role of the gut microbiome in preterm infant health is poorly understood. Microbial colonization differs from that of healthy term babies because it occurs in the NICU and is often perturbed by antibiotics. We measured bacterial compositions and metabolomic profiles of 77 fecal samples from 32 preterm infants to investigate the differences between microbiomes in health and disease. Rather than finding

  16. Development of structural health monitoring techniques using dynamics testing