WorldWideScience

Sample records for rapidly changing health

  1. Public health in a rapidly changing world

    Directory of Open Access Journals (Sweden)

    Tatiana I. Andreeva

    2014-06-01

    Full Text Available Several months in 2013 and 2014 have been a hardly predictable time in Ukraine, and the situation is still far from being stable. This made the editorial team of TCPHEE based in Ukraine postpone publishing consecutive issues. However, while the situation still requires practical steps, many aspects including those related to public health require analysis and debate. Thus we invite opinion pieces and studies addressing all different spheres of how public health should function under changing social circumstances. There might be a wide range of such related topics. The most obvious ones are those linked to changing living conditions. Many studies have been undertaken and published with regard to health threats to refugees, people involved in natural or technical disasters (Noji, 2005. Along with environmental health threats, there might be mental health disturbances (World Health Organization, 1992 resulting from long-term strain, losses et cetera. Another important focus is related to changes in health services provision. Crimea, which is a former Ukrainian territory now occupied by the Russian Federation, was among those in Ukraine highly affected with HIV (Dehne, Khodakevich, Hamers, & Schwartlander, 1999. This was responded by several NGOs actively providing harm reduction services to high-risk groups along with methadone substitution therapy to opiate users and antiretroviral medicines to those HIV-infected (Curtis, 2010. However, there are news reports that Russia is going to stop provision of methadone (kommersant.ru, 2014. As opiate substitution programs have been shown an effective approach towards preventing HIV transmission among people who inject drugs (MacArthur et al., 2012, such change in public health policies might affect not only most at risk populations but their partners and population as a whole as well resulting in a rapid spread of HIV. Yet another related topic is that of how health services can be organized at times of

  2. Planetary health: protecting human health on a rapidly changing planet.

    Science.gov (United States)

    Myers, Samuel S

    2018-12-23

    The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health. I highlight several overarching themes that emerge from planetary health and suggest advances in the way we train, reward, promote, and fund the generation of health scientists who will be tasked with breaking out of their disciplinary silos to address this urgent constellation of health threats. I propose that protecting the health of future generations requires taking better care of Earth's natural systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Managing health care organizations in an age of rapid change.

    Science.gov (United States)

    Benjamin, S; al-Alaiwat, S

    1998-03-01

    Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.

  4. Innovation in regulation of rapidly changing health markets.

    Science.gov (United States)

    Bloom, Gerald; Henson, Spencer; Peters, David H

    2014-06-24

    The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. The paper proposes a health market systems conceptual framework, using the value chain for the production, distribution and retail of health goods and services, to examine regulation of health markets in the LMIC context. We conclude by exploring the changing context going forwards, laying out implications for future heath market regulation. We argue that the case for new approaches to the regulation of markets for health products and services in LMICs is compelling. Although traditional "command and control" approaches will have a place in the toolkit of regulators, a broader bundle of approaches is needed that is adapted to the national and market-level context of particular LMICs. The implication is that it is not possible to apply standard or single interventions across countries, as approaches proven to work well in one context will not necessarily work well elsewhere.

  5. Rapid socio-cultural change and health in the Arctic

    DEFF Research Database (Denmark)

    Bjerregaard, P

    2001-01-01

    The colonization of the circumpolar peoples has had a profound influence on their health. History tells about devastating epidemics and the introduction of alcohol. The last 50 years have witnessed an unprecedented societal development in Greenland and a rapid epidemiological transition. Physical...... health and survival have improved but at the expense of mental health. The incidence of tuberculosis and the infant mortality rate have decreased because of improved socioeconomic conditions and health care. Mental health has deteriorated parallel to the rapid modernization of Greenlandic society...

  6. Health impacts of rapid economic changes in Thailand.

    Science.gov (United States)

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

    2000-09-01

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

  7. Smartphone Technology and Apps: Rapidly Changing Health Promotion

    Science.gov (United States)

    Kratzke, Cynthia; Cox, Carolyn

    2012-01-01

    Despite the increased availability of smartphones and health applications (apps), little is known about smartphone technology and apps for implementation in health promotion practice. Smartphones are mobile devices with capabilities for e-mail, text messaging, video viewing, and wireless Internet access. It is essential for health promotion…

  8. Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale.

    Science.gov (United States)

    MacGregor, Hayley; Bloom, Gerald

    2016-12-01

    This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where 'country ownership' of HSR is relatively well established and where there is significant involvement of local researchers and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

  9. Wildlife health in a rapidly changing North: focus on avian disease

    Science.gov (United States)

    Van Hemert, Caroline R.; Pearce, John M.; Handel, Colleen M.

    2014-01-01

    Climate-related environmental changes have increasingly been linked to emerging infectious diseases in wildlife. The Arctic is facing a major ecological transition that is expected to substantially affect animal and human health. Changes in phenology or environmental conditions that result from climate warming may promote novel species assemblages as host and pathogen ranges expand to previously unoccupied areas. Recent evidence from the Arctic and subarctic suggests an increase in the spread and prevalence of some wildlife diseases, but baseline data necessary to detect and verify such changes are still lacking. Wild birds are undergoing rapid shifts in distribution and have been implicated in the spread of wildlife and zoonotic diseases. Here, we review evidence of current and projected changes in the abundance and distribution of avian diseases and outline strategies for future research. We discuss relevant climatic and environmental factors, emerging host–pathogen contact zones, the relationship between host condition and immune function, and potential wildlife and human health outcomes in northern regions.

  10. Tracking and unpacking rapid Arctic change: Indicators of community health and sustainability in northern Alaska and links to cryospheric change

    Science.gov (United States)

    Eicken, H.; Sam, J. M.; Mueller-stoffels, M.; Lovecraft, A. L.; Fresco, N. L.

    2017-12-01

    Tracking and responding to rapid Arctic change benefits from time series of indicator variables that describe the state of the system and can inform anticipatory action. A key challenge is to identify and monitor sets of indicators that capture relevant variability, trends, and transitions in social-environmental systems. We present findings from participatory scenarios focused on community health and sustainability in northern Alaska. In a series of workshops in 2015 and 2016 (Kotzebue workshop photo shown below), over 50 experts, mostly local, identified determinants of community health and sustainability by 2040 in the Northwest Arctic and North Slope Boroughs, Alaska. Drawing on further research, an initial set of factors and uncertainties was refined and prioritized into a total of 20 key drivers, ranging from governance issues to socio-economic and environmental factors. The research team then developed sets of future projections that describe plausible outcomes by mid-century for each of these drivers. A plausibility and consistency analysis of all pairwise combinations of these projections (following Mueller-Stoffels and Eicken, In: North by 2020 - Perspectives on Alaska's Changing Social-Ecological Systems, University of Alaska Press, 2011) resulted in the identification of robust scenarios. The latter were further reviewed by workshop participants, and a set of indicator variables, including indicators of relevant cryospheric change, was identified to help track trajectories towards plausible future states. Publically accessible recorded data only exist for a subset of the more than 70 indicators, reaching back a few years to several decades. For several indicators, the sampling rate or time series length are insufficient for tracking of and response to change. A core set of variables has been identified that meets indicator requirements and can serve as a tool for Alaska Arctic communities in adapting to or mitigating rapid change affecting community

  11. Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training.

    Science.gov (United States)

    Gee, Melanie; Bhanbhro, Sadiq; Cook, Sarah; Killaspy, Helen

    2017-08-01

    The aim of this study was to identify the factors contributing to lasting change in practice following a recovery-based training intervention for inpatient mental health rehabilitation staff. Staff training may help nurses and other staff groups in inpatient mental health rehabilitative settings to increase their recovery-oriented practice. There are no published reviews on the effectiveness of such training and few long-term evaluations. This review informed a realist evaluation of a specific intervention (GetREAL). Rapid realist review methodology was used to generate and prioritize programme theories. ASSIA, CINAHL, Cochrane Library, Medline, PsycINFO, Scopus, Web of Science and grey literature searches were performed in September 2014-March 2015 with no date restrictions. Stakeholders suggested further documents. GetREAL project documentation was consulted. Programme theory development took place iteratively with literature identification. Stakeholders validated and prioritized emerging programme theories and the prioritized theories were refined using literature case studies. Fifty-one relevant documents fed into 49 programme theories articulating seven mechanisms for lasting change. Prioritized mechanisms were: staff receptiveness to change; and staff feeling encouraged, motivated and supported by colleagues and management to change. Seven programme theories were prioritized and refined using data from four case studies. Lasting change can be facilitated by collaborative action planning, regular collaborative meetings, appointing a change agent, explicit management endorsement and prioritization and modifying organizational structures. Conversely, a challenging organizational climate, or a prevalence of 'change fatigue', may block change. Pre-intervention exploration may help identify any potential barriers to embedding recovery in the organizational culture. © 2016 John Wiley & Sons Ltd.

  12. Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements.

    Science.gov (United States)

    Moyad, Mark A

    2011-08-01

    Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Home Health Aides' Perceptions of Quality Care: Goals, Challenges, and Implications for a Rapidly Changing Industry.

    Science.gov (United States)

    Franzosa, Emily; Tsui, Emma K; Baron, Sherry

    2018-02-01

    Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile. Since much of this care was invisible outside the worker-client relationship, aides received little supervisory support and felt excluded from the formal care team. Aligning payment models with quality requires understanding the full scope of services aides provide and a quality work environment that offers support and supervision, engages aides in patient care, and gives them a voice in policy decisions.

  14. The role of employee assistance programs in the era of rapid change in the health care delivery system.

    Science.gov (United States)

    Sumerall, S W; Israel, A R; Brewer, R; Prew, R E

    1999-01-01

    With the rapid changes occurring in the American healthcare system, questions regarding various aspects of care have arisen. These changes have led to the need for individuals working within an Employee Assistance Program (EAP) to respond quickly and effectively to crisis situations. This article summarizes the different roles and responsibilities of EAP workers in the healthcare marketplace.

  15. Medical rehabilitation in low and middle income countries for adult acquired disability: challenges posed by rapidity of health system change and position on the individualistic-collectivist axis

    Directory of Open Access Journals (Sweden)

    Karl Sandin

    2015-01-01

    Full Text Available Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions. While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid. As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values. While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism. The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.

  16. Complex systems thinking in emergency medicine: A novel paradigm for a rapidly changing and interconnected health care landscape.

    Science.gov (United States)

    Widmer, Matthew A; Swanson, R Chad; Zink, Brian J; Pines, Jesse M

    2017-12-27

    The specialty of emergency medicine is experiencing the convergence of a number of transformational forces in the United States, including health care reform, technological advancements, and societal shifts. These bring both opportunity and uncertainty. 21ST CENTURY CHALLENGES: Persistent challenges such as the opioid epidemic, rising health care costs, misaligned incentives, patients with multiple chronic diseases, and emergency department crowding continue to plague the acute, unscheduled care system. The traditional approach to health care practice and improvement-reductionism-is not adequate for the complexity of the twenty-first century. Reductionist thinking will likely continue to produce unintended consequences and suboptimal outcomes. Complex systems thinking provides a perspective and set of tools better suited for the challenges and opportunities facing public health in general, and emergency medicine more specifically. This article introduces complex systems thinking and argues for its application in the context of emergency medicine by drawing on the history of the circumstances surrounding the formation of the specialty and by providing examples of its application to several practice challenges. © 2017 John Wiley & Sons, Ltd.

  17. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    Science.gov (United States)

    Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

    2016-01-01

    Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

  18. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

    Directory of Open Access Journals (Sweden)

    John Odaga

    2016-05-01

    Full Text Available Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs. The Community and District Empowerment for Scale-up (CODES project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying

  19. Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

    Science.gov (United States)

    Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

    2016-01-01

    Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

  20. The Relation of Rapid Changes in Obesity Measures to Lipid Profile - Insights from a Nationwide Metabolic Health Survey in 444 Polish Cities

    Science.gov (United States)

    Kaess, Bernhard M.; Jóźwiak, Jacek; Nelson, Christopher P.; Lukas, Witold; Mastej, Mirosław; Windak, Adam; Tomasik, Tomasz; Grzeszczak, Władysław; Tykarski, Andrzej; Gąsowski, Jerzy; Ślęzak-Prochazka, Izabella; Ślęzak, Andrzej; Charchar, Fadi J.; Sattar, Naveed; Thompson, John R.; Samani, Nilesh J.; Tomaszewski, Maciej

    2014-01-01

    Objective The impact of fast changes in obesity indices on other measures of metabolic health is poorly defined in the general population. Using the Polish accession to the European Union as a model of political and social transformation we examined how an expected rapid increase in body mass index (BMI) and waist circumference relates to changes in lipid profile, both at the population and personal level. Methods Through primary care centres in 444 Polish cities, two cross-sectional nationwide population-based surveys (LIPIDOGRAM 2004 and LIPIDOGRAM 2006) examined 15,404 and 15,453 adult individuals in 2004 and 2006, respectively. A separate prospective sample of 1,840 individuals recruited in 2004 had a follow-up in 2006 (LIPIDOGRAM PLUS). Results Two years after Polish accession to European Union, mean population BMI and waist circumference increased by 0.6% and 0.9%, respectively. This tracked with a 7.6% drop in HDL-cholesterol and a 2.1% increase in triglycerides (all p<0.001) nationwide. The direction and magnitude of the population changes were replicated at the personal level in LIPIDOGRAM PLUS (0.7%, 0.3%, 8.6% and 1.8%, respectively). However, increases in BMI and waist circumference were both only weakly associated with HDL-cholesterol and triglycerides changes prospectively. The relation of BMI to the magnitude of change in both lipid fractions was comparable to that of waist circumference. Conclusions Moderate changes in obesity measures tracked with a significant deterioration in measures of pro-atherogenic dyslipidaemia at both personal and population level. These associations were predominantly driven by factors not measureable directly through either BMI or waist circumference. PMID:24497983

  1. The Health Penalty of China's Rapid Urbanization

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)

    2009-01-01

    textabstractRapid urbanization could have positive and negative health effects, such that the net impact on population health is not obvious. It is, however, highly pertinent to the human welfare consequences of development. This paper uses community and individual level longitudinal data from the

  2. The Rapid Ice Sheet Change Observatory (RISCO)

    Science.gov (United States)

    Morin, P.; Howat, I. M.; Ahn, Y.; Porter, C.; McFadden, E. M.

    2010-12-01

    The recent expansion of observational capacity from space has revealed dramatic, rapid changes in the Earth’s ice cover. These discoveries have fundamentally altered how scientists view ice-sheet change. Instead of just slow changes in snow accumulation and melting over centuries or millennia, important changes can occur in sudden events lasting only months, weeks, or even a single day. Our understanding of these short time- and space-scale processes, which hold important implications for future global sea level rise, has been impeded by the low temporal and spatial resolution, delayed sensor tasking, incomplete coverage, inaccessibility and/or high cost of data available to investigators. New cross-agency partnerships and data access policies provide the opportunity to dramatically improve the resolution of ice sheet observations by an order of magnitude, from timescales of months and distances of 10’s of meters, to days and meters or less. Advances in image processing technology also enable application of currently under-utilized datasets. The infrastructure for systematically gathering, processing, analyzing and distributing these data does not currently exist. Here we present the development of a multi-institutional, multi-platform observatory for rapid ice change with the ultimate objective of helping to elucidate the relevant timescales and processes of ice sheet dynamics and response to climate change. The Rapid Ice Sheet Observatory (RISCO) gathers observations of short time- and space-scale Cryosphere events and makes them easily accessible to investigators, media and general public. As opposed to existing data centers, which are structured to archive and distribute diverse types of raw data to end users with the specialized software and skills to analyze them, RISCO focuses on three types of geo-referenced raster (image) data products in a format immediately viewable with commonly available software. These three products are (1) sequences of images

  3. Indigenous people's detection of rapid ecological change.

    Science.gov (United States)

    Aswani, Shankar; Lauer, Matthew

    2014-06-01

    When sudden catastrophic events occur, it becomes critical for coastal communities to detect and respond to environmental transformations because failure to do so may undermine overall ecosystem resilience and threaten people's livelihoods. We therefore asked how capable of detecting rapid ecological change following massive environmental disruptions local, indigenous people are. We assessed the direction and periodicity of experimental learning of people in the Western Solomon Islands after a tsunami in 2007. We compared the results of marine science surveys with local ecological knowledge of the benthos across 3 affected villages and 3 periods before and after the tsunami. We sought to determine how people recognize biophysical changes in the environment before and after catastrophic events such as earthquakes and tsunamis and whether people have the ability to detect ecological changes over short time scales or need longer time scales to recognize changes. Indigenous people were able to detect changes in the benthos over time. Detection levels differed between marine science surveys and local ecological knowledge sources over time, but overall patterns of statistically significant detection of change were evident for various habitats. Our findings have implications for marine conservation, coastal management policies, and disaster-relief efforts because when people are able to detect ecological changes, this, in turn, affects how they exploit and manage their marine resources. © 2014 Society for Conservation Biology.

  4. Climate Change and Health

    Science.gov (United States)

    ... Home / News / Fact sheets / Detail WHO /A. Craggs Climate change and health 1 February 2018 ","datePublished":"2018-02- ... in improved health, particularly through reduced air pollution. Climate change Over the last 50 years, human activities – particularly ...

  5. Rapid Change Detection Algorithm for Disaster Management

    Science.gov (United States)

    Michel, U.; Thunig, H.; Ehlers, M.; Reinartz, P.

    2012-07-01

    This paper focuses on change detection applications in areas where catastrophic events took place which resulted in rapid destruction especially of manmade objects. Standard methods for automated change detection prove not to be sufficient; therefore a new method was developed and tested. The presented method allows a fast detection and visualization of change in areas of crisis or catastrophes. While often new methods of remote sensing are developed without user oriented aspects, organizations and authorities are not able to use these methods because of absence of remote sensing know how. Therefore a semi-automated procedure was developed. Within a transferable framework, the developed algorithm can be implemented for a set of remote sensing data among different investigation areas. Several case studies are the base for the retrieved results. Within a coarse dividing into statistical parts and the segmentation in meaningful objects, the framework is able to deal with different types of change. By means of an elaborated Temporal Change Index (TCI) only panchromatic datasets are used to extract areas which are destroyed, areas which were not affected and in addition areas where rebuilding has already started.

  6. Observations on the health of infants at a time of rapid societal change: a longitudinal study from birth to fifteen months in Abu Dhabi.

    Science.gov (United States)

    Gardner, Hazel; Green, Katherine; Gardner, Andrew S; Geddes, Donna

    2018-02-07

    Rapid economic and cultural transition in the United Arab Emirates has been accompanied by a rise in chronic disease. Early childhood is known to affect health outcomes in adulthood. This prospective longitudinal study examined the general health of Emirati infants born in a government maternity hospital in the Emirate of Abu Dhabi in October 2002. One hundred twenty-five women, who had recently given birth, were interviewed as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health. They were then re-interviewed at three (n = 94), six (n = 59) and 15 months postpartum (n = 52). Data are presented using univariate statistics. In this study seven infants (6%) were born prematurely and four infants (3%) were classified as small for gestational age, while 11 (9%) of the infants weighed less than 2500 g. Low birth weight infants (LBW) were significantly more likely to require treatment in the neonatal intensive care unit (OR = 30.83, p = 0.00). Iron supplementation during pregnancy was associated with fewer underweight infants (OR = 3.92, p = 0.042). No associations were found between infant birth weight and maternal age, age at marriage, consanguinity, education level, current maternal employment, parity, pre-existing anaemia or anaemia in pregnancy, diabetes, folic acid intake, multivitamin intake or infant gender. Maternally-reported infant health issues, vaccination, medication, breast-feeding and infant nutrition, and use of secure car seats are also reported. The health of infants at birth in this UAE sample showed improvements compared to previous studies. The proportion of LBW infants is decreasing and continuing improvements in health care in the UAE are having a positive impact on infant health.

  7. Investigation of Health Risks and Their Prevention in the Rapid Climate Changes and the Rise of Pollution of the Atmosphere in the Mountain Region of the North Caucasus

    Science.gov (United States)

    Babyakin, Alexander; Polozkov, Igor; Golitsyn, Georgy; Efimenko, Natalia; Zherlitsina, Liubov; Povolotskaya, Nina; Senik, Irina; Chalaya, Elena; Artamonova, Maria; Pogarski, Fedor

    2010-05-01

    The current global climate change is determined by changes in the structure of weather conditions, whose impact on the health of various regions of the planet has not been studied sufficiently. To study this effect on the low-altitude mountains resort of Kislovodsk (southern Russia) multi-factor assessment of the impact of the environment on human health is carried out. There were taking in account atmosphere condition, atmospheric aerosol pollution relationship with atmospheric circulation, the level of pollution matching with different types of weather, and, on the base of analysis of meteopathic reactions (MPR), the extent of their biotropism was revealed. Two sides of weather-climatic influences - specific and nonspecific - are interconnected. They manifest themselves differently in humans with different levels of regulation of vital activity and the adaptive capacity of the organism to the complex environmental effects. This complicates the precise physiological basis of quantitative criteria for the prediction of "biotropic" (adverse) weathers. Nevertheless, clinical observations have shown the existence of the "limiting" physiological bound on the size of medical-meteorological modules (MMM). The reactions of the organism to unfavorable weather factors on the results of a questionnaire monitoring surveillance of patients treated in clinics of Federal State Institution "Pyatigorsk State Research Institute of Curortology, FMBA of Russia" (PSRIC), in comparison with clinical data, have identified various MPR of the organism, the clinical manifestation of which depends on age, sex of the patient, the availability of principal and attendant pathology, reactivity, etc. Analysis of the results of clinical observation, cases of medical aid appealability to the station an ambulance at the sudden ill health, as well as the uptake of advice of sick people among immigrants during their short stay at the resort, and the local population, allowed the first approximation

  8. Millennium Ecosystem Assessment: MA Rapid Land Cover Change

    Data.gov (United States)

    National Aeronautics and Space Administration — The Millennium Ecosystem Assessment: MA Rapid Land Cover Change provides data and information on global and regional land cover change in raster format for...

  9. Are rapid changes in brain elasticity possible?

    Science.gov (United States)

    Parker, K. J.

    2017-09-01

    Elastography of the brain is a topic of clinical and preclinical research, motivated by the potential for viscoelastic measures of the brain to provide sensitive indicators of pathological processes, and to assist in early diagnosis. To date, studies of the normal brain and of those with confirmed neurological disorders have reported a wide range of shear stiffness and shear wave speeds, even within similar categories. A range of factors including the shear wave frequency, and the age of the individual are thought to have a possible influence. However, it may be that short term dynamics within the brain may have an influence on the measured stiffness. This hypothesis is addressed quantitatively using the framework of the microchannel flow model, which derives the tissue stiffness, complex modulus, and shear wave speed as a function of the vascular and fluid network in combination with the elastic matrix that comprise the brain. Transformation rules are applied so that any changes in the fluid channels or the elastic matrix can be mapped to changes in observed elastic properties on a macroscopic scale. The results are preliminary but demonstrate that measureable, time varying changes in brain stiffness are possible simply by accounting for vasodynamic or electrochemical changes in the state of any region of the brain. The value of this preliminary exploration is to identify possible mechanisms and order-of-magnitude changes that may be testable in vivo by specialized protocols.

  10. Social psychiatry in a rapidly changing world

    Directory of Open Access Journals (Sweden)

    Thomas K. J. Craig

    2016-01-01

    Full Text Available Many societies around the world are experiencing a period of unprecedented change in traditional social roles and customs. Globalisation has contributed to materialism and a me-first individualism that heightens awareness of income inequality that itself is one of the most robust markers of unhappiness in society. Ever increasing urbanisation has driven an erosion of large ‘joint’ family arrangements to be replaced by smaller and relatively isolated nuclear families and single parent living. Mass migration has unmasked deep seated fear and prejudice towards the outsider in society. These global changes are fertile ground for the social conditions that have long been known to be risks for mental illness – poverty, poor quality child care, social isolation and the active discrimination and exclusion of the alien, the physically disabled and mentally ill. While there is little we can do to reverse global change, there is much a social psychiatrist can do to mitigate the effect, ensuring his/her voice is added to other calls for reducing discriminatory practice, promoting evidence-based social interventions such as parenting advice and peer support and ensuring that the success of a treatment is measured not just in terms of symptomatic improvement but in whether it results in an outcome that is valued by the patient.

  11. Rapidly changing flows in the Earth's core

    DEFF Research Database (Denmark)

    Olsen, Nils; Mandea, M.

    2008-01-01

    A large part of the Earth's magnetic field is generated by fluid motion in the molten outer core(1). As a result of continuous satellite measurements since 1999, the core magnetic field and its recent variations can now be described with a high resolution in space and time(2). These data have...... field occurring over only a few months, indicative of fluid flow at the top of the core, can in fact be resolved. Using nine years of magnetic field data obtained by satellites as well as Earth-based observatories, we determine the temporal changes in the core magnetic field and flow in the core. We...

  12. Rapid tranquilization: An audit of Irish mental health nursing practice.

    Science.gov (United States)

    Nash, Michael; McDonagh, Caitriona; Culhane, Aisling; Noone, Imelda; Higgins, Agnes

    2018-02-12

    Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self-report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring. The results demonstrate that rapid tranquillization is an intervention used in the management of acute behavioural disturbance in various mental health settings in Ireland. Respondents showed a basic understanding of rapid tranquillization as an intervention; however, some areas reported not having a specific rapid tranquillization policy. There was some evidence of a variation in postrapid tranquillization monitoring of psychiatric/mental health and physical health. Service user debriefing following rapid tranquillization was reported to be common; however, the content of this was not elaborated on. In the light of variations in practice, specific training and the development of rapid tranquillization policies are recommended. © 2018 Australian College of Mental Health Nurses Inc.

  13. Rapid Communication: seniority changing transitions in yrast states ...

    Indian Academy of Sciences (India)

    Bhoomika Maheshwari

    2017-10-26

    Oct 26, 2017 ... Rapid Communication: v = 2 seniority changing ... has been extensively used to understand various system- .... states. This understanding supports the previous inter- ..... Financial support from the Ministry of Human Resource.

  14. Ecosystem stewardship: sustainability strategies for a rapidly changing planet

    Science.gov (United States)

    F. Stuart Chapin; Stephen R. Carpenter; Gary P. Kofinas; Carl Folke; Nick Abel; William C. Clark; Per Olsson; D. Mark Stafford Smith; Brian Walker; Oran R. Young; Fikret Berkes; Reinette Biggs; J. Morgan Grove; Rosamond L. Naylor; Evelyn Pinkerton; Will Steffen; Frederick J. Swanson

    2010-01-01

    Ecosystem stewardship is an action-oriented framework intended to foster the social-ecological sustainability of a rapidly changing planet. Recent developments identify three strategies that make optimal use of current understanding in an environment of inevitable uncertainty and abrupt change: reducing the magnitude of, and exposure and sensitivity to, known stresses...

  15. Regeneration and health: a structured, rapid literature review.

    Science.gov (United States)

    McCartney, G; Hearty, W; Taulbut, M; Mitchell, R; Dryden, R; Collins, C

    2017-07-01

    To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants. Rapid, structured literature review. A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews. The identified citations were screened, critically appraised according to the research design and narratively synthesised. Of the 1382 identified citations, 46 were screened as relevant to the review and included in the synthesis. Fifteen citations were reviews but most of the evidence identified or included within the reviews was of medium or low quality due to a lack of longitudinal follow-up, low response rates or attrition. The evidence base on the impacts of regeneration is generally not of high quality and is prone to bias. However, it is theorised as being an important means of addressing the socio-economic determinants of health. Housing refurbishment (generally, and for specific improvements) seems likely to lead to small improvements in health, whereas rehousing and mixed-tenure approaches have less clear impacts on health and carry risks of disruption to social networks and higher rents. Changes in the social composition of communities (gentrification) is a common outcome of regeneration and some 'partnership' approaches to regeneration have been shown to have caused difficulties within communities. The evidence base for regeneration activities is limited but they have substantial potential to contribute to improving population health. Better quality evidence is available for there being positive health impacts from housing-led regeneration programmes involving refurbishment and specific housing improvements. There is also some evidence of the potential harms of regeneration activities, including social stratification

  16. Rethinking species’ ability to cope with rapid climate change

    DEFF Research Database (Denmark)

    Hof, Christian; Levinsky, Irina; Bastos Araujo, Miguel

    2011-01-01

    Ongoing climate change is assumed to be exceptional because of its unprecedented velocity. However, new geophysical research suggests that dramatic climatic changes during the Late Pleistocene occurred extremely rapid, over just a few years. These abrupt climatic changes may have been even faster...... than contemporary ones, but relatively few continent-wide extinctions of species have been documented for these periods. This raises questions about the ability of extant species to adapt to ongoing climate change. We propose that the advances in geophysical research challenge current views about...... species' ability to cope with climate change, and that lessons must be learned for modelling future impacts of climate change on species....

  17. Method for producing rapid pH changes

    Science.gov (United States)

    Clark, J.H.; Campillo, A.J.; Shapiro, S.L.; Winn, K.R.

    A method of initiating a rapid pH change in a solution comprises irradiating the solution with an intense flux of electromagnetic radiation of a frequency which produces a substantial pK change to a compound in solution. To optimize the resulting pH change, the compound being irradiated in solution should have an excited state lifetime substantially longer than the time required to establish an excited state acid-base equilibrium in the solution. Desired pH changes can be accomplished in nanoseconds or less by means of picosecond pulses of laser radiation.

  18. Rapid Communication: v= 2 seniority changing transitions in yrast 3 ...

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics; Volume 89; Issue 5. Rapid Communication: Δ υ = 2 seniority changing transitions in yrast 3 − states and B ( E 3 ) systematics of Sn isotopes. BHOOMIKA MAHESHWARI SWATI GARG ASHOK KUMAR JAIN. Research Article Volume 89 Issue 5 November 2017 Article ID 75 ...

  19. Major rapid weight loss induces changes in cardiac repolarization

    DEFF Research Database (Denmark)

    Vedel-Larsen, Esben; Iepsen, Eva Winning; Lundgren, Julie

    2016-01-01

    INTRODUCTION: Obesity is associated with increased all-cause mortality, but weight loss may not decrease cardiovascular events. In fact, very low calorie diets have been linked to arrhythmias and sudden death. The QT interval is the standard marker for cardiac repolarization, but T-wave morphology...... analysis has been suggested as a more sensitive method to identify changes in cardiac repolarization. We examined the effect of a major and rapid weight loss on T-wave morphology. METHODS AND RESULTS: Twenty-six individuals had electrocardiograms (ECG) taken before and after eight weeks of weight loss......A1c (pweight loss induces changes in cardiac repolarization. Monitoring of MCS during calorie restriction makes it possible to detect repolarization changes with higher discriminative power than the QT-interval during major rapid weight...

  20. Rapid Health and Needs assessments after disasters: a systematic review

    Directory of Open Access Journals (Sweden)

    Yzermans CJ

    2010-06-01

    Full Text Available Abstract Background Publichealth care providers, stakeholders and policy makers request a rapid insight into health status and needs of the affected population after disasters. To our knowledge, there is no standardized rapid assessment tool for European countries. The aim of this article is to describe existing tools used internationally and analyze them for the development of a workable rapid assessment. Methods A review was conducted, including original studies concerning a rapid health and/or needs assessment. The studies used were published between 1980 and 2009. The electronic databasesof Medline, Embase, SciSearch and Psychinfo were used. Results Thirty-three studies were included for this review. The majority of the studies was of US origin and in most cases related to natural disasters, especially concerning the weather. In eighteen studies an assessment was conducted using a structured questionnaire, eleven studies used registries and four used both methods. Questionnaires were primarily used to asses the health needs, while data records were used to assess the health status of disaster victims. Conclusions Methods most commonly used were face to face interviews and data extracted from existing registries. Ideally, a rapid assessment tool is needed which does not add to the burden of disaster victims. In this perspective, the use of existing medical registries in combination with a brief questionnaire in the aftermath of disasters is the most promising. Since there is an increasing need for such a tool this approach needs further examination.

  1. Perceptual classification in a rapidly-changing environment

    OpenAIRE

    Summerfield, Christopher; Behrens, Timothy E.; Koechlin, Etienne

    2011-01-01

    Humans and monkeys can learn to classify perceptual information in a statistically optimal fashion if the functional groupings remain stable over many hundreds of trials, but little is known about categorisation when the environment changes rapidly. Here, we used a combination of computational modelling and functional neuroimaging to understand how humans classify visual stimuli drawn from categories whose mean and variance jumped unpredictably. Models based on optimal learning (Bayesian mode...

  2. The Chinese experience of rapid modernization: sociocultural changes, psychological consequences?

    Directory of Open Access Journals (Sweden)

    Jiahong eSun

    2016-04-01

    Full Text Available Mainland China has undergone profound changes dating back to the nineteenth century, including a contemporary period of rapid modernization that began in the 1980s. The result has been dramatic social, cultural, and economic shifts impacting the daily lives of Chinese people. In this paper, we explore the psychological implications of sociocultural transformation in China, emphasizing two central themes. First, rising individualism: findings from social and developmental psychology suggest that China’s rapid development has been accompanied by ever-increasing adherence to individualistic values. Second, rising rates of depression: findings from psychiatric epidemiology point to increasing prevalence of depression over this same time period, particularly in rural settings. We argue that links between sociocultural and psychological shifts in China can be usefully studied through a cultural psychology lens, emphasizing the mutual constitution of culture, mind, and brain. In particular, we note that the link between social change, individualism, and rising mental illness deserves careful attention. Our review suggests that shifting values and socialization practices shape emotion norms of concealment and display, with implications for depressive symptom presentation. The challenge comes with interpretation. Increasing prevalence rates of depression may indeed be a general response to the rapidity of sociocultural change, or a specific consequence of rising individualism—but may also result from increasingly ‘Western’ patterns of symptom presentation, or improvements in diagnostic practice. We conclude by considering the challenges posed to standard universal models of psychological phenomena.

  3. The Chinese Experience of Rapid Modernization: Sociocultural Changes, Psychological Consequences?

    Science.gov (United States)

    Sun, Jiahong; Ryder, Andrew G.

    2016-01-01

    Mainland China has undergone profound changes dating back to the nineteenth century, including a contemporary period of rapid modernization that began in the 1980s. The result has been dramatic social, cultural, and economic shifts impacting the daily lives of Chinese people. In this paper, we explore the psychological implications of sociocultural transformation in China, emphasizing two central themes. First, rising individualism: findings from social and developmental psychology suggest that China’s rapid development has been accompanied by ever-increasing adherence to individualistic values. Second, rising rates of depression: findings from psychiatric epidemiology point to increasing prevalence of depression over this same time period, particularly in rural settings. We argue that links between sociocultural and psychological shifts in China can be usefully studied through a cultural psychology lens, emphasizing the mutual constitution of culture, mind, and brain. In particular, we note that the link between social change, individualism, and rising mental illness deserves careful attention. Our review suggests that shifting values and socialization practices shape emotion norms of concealment and display, with implications for depressive symptom presentation. The challenge comes with interpretation. Increasing prevalence rates of depression may indeed be a general response to the rapidity of sociocultural change, or a specific consequence of rising individualism—but may also result from increasingly ‘Western’ patterns of symptom presentation, or improvements in diagnostic practice. We conclude by considering the challenges posed to standard universal models of psychological phenomena. PMID:27092093

  4. Climate Change and Health

    Science.gov (United States)

    ... Iraq Nigeria Somalia South Sudan Syrian Arab Republic Yemen All emergencies » Latest » By country By disease Disease ... billion/year by 2030. Areas with weak health infrastructure – mostly in developing countries – will be the least ...

  5. Middle Holocene rapid environmental changes and human adaptation in Greece

    Science.gov (United States)

    Lespez, Laurent; Glais, Arthur; Lopez-Saez, José-Antonio; Le Drezen, Yann; Tsirtsoni, Zoï; Davidson, Robert; Biree, Laetitia; Malamidou, Dimitra

    2016-03-01

    Numerous researchers discuss of the collapse of civilizations in response to abrupt climate change in the Mediterranean region. The period between 6500 and 5000 cal yr BP is one of the least studied episodes of rapid climate change at the end of the Late Neolithic. This period is characterized by a dramatic decline in settlement and a cultural break in the Balkans. High-resolution paleoenvironmental proxy data obtained in the Lower Angitis Valley enables an examination of the societal responses to rapid climatic change in Greece. Development of a lasting fluvio-lacustrine environment followed by enhanced fluvial activity is evident from 6000 cal yr BP. Paleoecological data show a succession of dry events at 5800-5700, 5450 and 5000-4900 cal yr BP. These events correspond to incursion of cold air masses to the eastern Mediterranean, confirming the climatic instability of the middle Holocene climate transition. Two periods with farming and pastural activities (6300-5600 and 5100-4700 cal BP) are evident. The intervening period is marked by environmental changes, but the continuous occurrence of anthropogenic taxa suggests the persistence of human activities despite the absence of archaeological evidence. The environmental factors alone were not sufficient to trigger the observed societal changes.

  6. Cultural change and mental health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine; Greenland, Population Study

    2002-01-01

    In Greenland, the rapid sociocultural change of the last 50 years has been paralleled by an epidemiological transition characterized by a reduction in infectious diseases, an increase in cancer and cardiovascular diseases, and an increased prevalence of mental health problems. During 1993......-94 and 1997-98, two health interview surveys were conducted among Inuit in Greenland and Inuit migrants in Denmark. The response rates were 71 and 55%. Information on mental health was obtained from 1388 and 1769 adults. As indicators of mental health, the prevalence of potential psychiatric cases according...... of poor mental health: as a result of successful integration into the modern Greenlandic society, some population groups have better mental health compared to other groups....

  7. On being a scientist in a rapidly changing world.

    Science.gov (United States)

    Mandel, I D

    1996-02-01

    The practice of biological science has changed dramatically since mid-century, reshaped not only by a rapid series of landmark discoveries, but also by governmental directives, institutional policies, and public attitudes. Until 1964, the major influences were the mentor, who provided direction and indoctrination into the culture of science, and in dentistry, the newly established NIDR, which fueled the research engine with an expanding research and training program. The 1965-74 period witnessed the advent of the Institutional Review Board, an increased social involvement of biological scientists, and a recognition of the need for biological and physical safeguards in the conduct of research. The most turbulent years were 1975-89, when there was a confluence of animal rights activism and regulation, growing concerns with scientific fraud and publication malpractice, and the stresses and strains (and opportunities) resulting from the rapid expansion of the academic-industrial complex. The current period is characterized by rapid pace, high volume, and an increased depth and breadth of knowledge-a major change in scale in the conduct of science. It is an exciting time but one in which ethical issues are multiplying. Attention must be paid.

  8. Managing change in health care organizations.

    Science.gov (United States)

    Margulies, N

    1977-08-01

    The forces for change seem more potent today than ever before; increased technological advancement and rapid "societal upheavals" create a more critical need for change and a more significant need for skills to manage and channel change toward meaningful ends. The area of health care delivery is probably one of the fields most impinged upon and most affected by these turbulent times. Organizational development is presented herein as an approach to assist people in health care organizations with the problems of adaptation and change. A specific change strategy, action research, is discussed and a concrete case example is presented to illustrate the ways in which the action research model can be applied. Advantages and pitfalls are discussed in the concluding section.

  9. Climate Change and Health

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

    David Gikungu

    ... and river blindness; 4 of the big 7 are zoonoses (Benniston, 2002). ... global burden of disease and premature deaths. ... illnesses a year and more than 150,000 extra deaths. • By 2030, however, the number of climate-related diseases is likely .... What additional public health interventions are likely to reduce the projected.

  10. Rapid Structural Design Change Evaluation with AN Experiment Based FEM

    Science.gov (United States)

    Chu, C.-H.; Trethewey, M. W.

    1998-04-01

    The work in this paper proposes a dynamic structural design model that can be developed in a rapid fashion. The approach endeavours to produce a simplified FEM developed in conjunction with an experimental modal database. The FEM is formulated directly from the geometry and connectivity used in an experimental modal test using beam/frame elements. The model sacrifices fine detail for a rapid development time. The FEM is updated at the element level so the dynamic response replicates the experimental results closely. The physical attributes of the model are retained, making it well suited to evaluate the effect of potential design changes. The capabilities are evaluated in a series of computational and laboratory tests. First, a study is performed with a simulated cantilever beam with a variable mass and stiffness distribution. The modal characteristics serve as the updating target with random noise added to simulate experimental uncertainty. A uniformly distributed FEM is developed and updated. The results show excellent results, all natural frequencies are within 0·001% with MAC values above 0·99. Next, the method is applied to predict the dynamic changes of a hardware portal frame structure for a radical design change. Natural frequency predictions from the original FEM differ by as much as almost 18% with reasonable MAC values. The results predicted from the updated model produce excellent results when compared to the actual hardware changes, the first five modal natural frequency difference is around 5% and the corresponding mode shapes producing MAC values above 0·98.

  11. How Rapid Change Affects Deltas in the Arctic Region

    Science.gov (United States)

    Overeem, I.; Bendixen, M.

    2017-12-01

    Deltas form where the river drains into the ocean. Consequently, delta depositional processes are impacted by either changes in the respective river drainage basin or by changes in the regional marine environment. In a warming Arctic region rapid change has occurred over the last few decades in both the terrestrial domain as well as in the marine domain. Important terrestrial controls include 1) change in permafrost possibly destabilizing river banks, 2) strong seasonality of river discharge due to a short melting season, 3) high sediment supply if basins are extensively glaciated, 4) lake outbursts and ice jams favoring river flooding. Whereas in the Arctic marine domain sea ice loss promotes wave and storm surge impact, and increased longshore transport. We here ask which of these factors dominate any morphological change in Arctic deltas. First, we analyze hydrological data to assess change in Arctic-wide river discharge characteristics and timing, and sea ice concentration data to map changes in sea ice regime. Based on this observational analysis we set up a number of scenarios of change. We then model hypothetical small-scale delta formation considering change in these primary controls by setting up a numerical delta model, and combining it dynamically with a permafrost model. We find that for typical Greenlandic deltas changes in river forcing due to ice sheet melt dominate the morphological change, which is corroborated by mapping of delta progradation from aerial photos and satellite imagery. Whereas in other areas, along the North Slope and the Canadian Arctic small deltas are more stable or experienced retreat. Our preliminary coupled model allows us to further disentangle the impact of major forcing factors on delta evolution in high-latitude systems.

  12. Climate change, conflict and health.

    Science.gov (United States)

    Bowles, Devin C; Butler, Colin D; Morisetti, Neil

    2015-10-01

    Future climate change is predicted to diminish essential natural resource availability in many regions and perhaps globally. The resulting scarcity of water, food and livelihoods could lead to increasingly desperate populations that challenge governments, enhancing the risk of intra- and interstate conflict. Defence establishments and some political scientists view climate change as a potential threat to peace. While the medical literature increasingly recognises climate change as a fundamental health risk, the dimension of climate change-associated conflict has so far received little attention, despite its profound health implications. Many analysts link climate change with a heightened risk of conflict via causal pathways which involve diminishing or changing resource availability. Plausible consequences include: increased frequency of civil conflict in developing countries; terrorism, asymmetric warfare, state failure; and major regional conflicts. The medical understanding of these threats is inadequate, given the scale of health implications. The medical and public health communities have often been reluctant to interpret conflict as a health issue. However, at times, medical workers have proven powerful and effective peace advocates, most notably with regard to nuclear disarmament. The public is more motivated to mitigate climate change when it is framed as a health issue. Improved medical understanding of the association between climate change and conflict could strengthen mitigation efforts and increase cooperation to cope with the climate change that is now inevitable. © The Royal Society of Medicine.

  13. Cosmic rays linked to rapid mid-latitude cloud changes

    Directory of Open Access Journals (Sweden)

    B. A. Laken

    2010-11-01

    Full Text Available The effect of the Galactic Cosmic Ray (GCR flux on Earth's climate is highly uncertain. Using a novel sampling approach based around observing periods of significant cloud changes, a statistically robust relationship is identified between short-term GCR flux changes and the most rapid mid-latitude (60°–30° N/S cloud decreases operating over daily timescales; this signal is verified in surface level air temperature (SLAT reanalysis data. A General Circulation Model (GCM experiment is used to test the causal relationship of the observed cloud changes to the detected SLAT anomalies. Results indicate that the anomalous cloud changes were responsible for producing the observed SLAT changes, implying that if there is a causal relationship between significant decreases in the rate of GCR flux (~0.79 GU, where GU denotes a change of 1% of the 11-year solar cycle amplitude in four days and decreases in cloud cover (~1.9 CU, where CU denotes a change of 1% cloud cover in four days, an increase in SLAT (~0.05 KU, where KU denotes a temperature change of 1 K in four days can be expected. The influence of GCRs is clearly distinguishable from changes in solar irradiance and the interplanetary magnetic field. However, the results of the GCM experiment are found to be somewhat limited by the ability of the model to successfully reproduce observed cloud cover. These results provide perhaps the most compelling evidence presented thus far of a GCR-climate relationship. From this analysis we conclude that a GCR-climate relationship is governed by both short-term GCR changes and internal atmospheric precursor conditions.

  14. Climate engineering and the risk of rapid climate change

    International Nuclear Information System (INIS)

    Ross, Andrew; Damon Matthews, H

    2009-01-01

    Recent research has highlighted risks associated with the use of climate engineering as a method of stabilizing global temperatures, including the possibility of rapid climate warming in the case of abrupt removal of engineered radiative forcing. In this study, we have used a simple climate model to estimate the likely range of temperature changes associated with implementation and removal of climate engineering. In the absence of climate engineering, maximum annual rates of warming ranged from 0.015 to 0.07 deg. C/year, depending on the model's climate sensitivity. Climate engineering resulted in much higher rates of warming, with the temperature change in the year following the removal of climate engineering ranging from 0.13 to 0.76 deg. C. High rates of temperature change were sustained for two decades following the removal of climate engineering; rates of change of 0.5 (0.3,0.1) deg. C/decade were exceeded over a 20 year period with 15% (75%, 100%) likelihood. Many ecosystems could be negatively affected by these rates of temperature change; our results suggest that climate engineering in the absence of deep emissions cuts could arguably constitute increased risk of dangerous anthropogenic interference in the climate system under the criteria laid out in the United Nations Framework Convention on Climate Change.

  15. Climate Change and Public Health.

    Science.gov (United States)

    Ciesielski, Timothy

    2017-05-01

    It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

  16. Modulators of mercury risk to wildlife and humans in the context of rapid global change

    Science.gov (United States)

    Eagles-Smith, Collin A.; Silbergeld, Ellen K.; Basu, Niladri; Bustamante, Paco; Diaz-Barriga, Fernando; Hopkins, William A.; Kidd, Karen A.; Nyland, Jennifer F.

    2018-01-01

    Environmental mercury (Hg) contamination is an urgent global health threat. The complexity of Hg in the environment can hinder accurate determination of ecological and human health risks, particularly within the context of the rapid global changes that are altering many ecological processes, socioeconomic patterns, and other factors like infectious disease incidence, which can affect Hg exposures and health outcomes. However, the success of global Hg-reduction efforts depends on accurate assessments of their effectiveness in reducing health risks. In this paper, we examine the role that key extrinsic and intrinsic drivers play on several aspects of Hg risk to humans and organisms in the environment. We do so within three key domains of ecological and human health risk. First, we examine how extrinsic global change drivers influence pathways of Hg bioaccumulation and biomagnification through food webs. Next, we describe how extrinsic socioeconomic drivers at a global scale, and intrinsic individual-level drivers, influence human Hg exposure. Finally, we address how the adverse health effects of Hg in humans and wildlife are modulated by a range of extrinsic and intrinsic drivers within the context of rapid global change. Incorporating components of these three domains into research and monitoring will facilitate a more holistic understanding of how ecological and societal drivers interact to influence Hg health risks.

  17. Smart health and innovation: facilitating health-related behaviour change.

    Science.gov (United States)

    Redfern, J

    2017-08-01

    Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

  18. Using Ant Communities For Rapid Assessment Of Terrestrial Ecosystem Health

    Energy Technology Data Exchange (ETDEWEB)

    Wike, L

    2005-06-01

    relative health of the ecosystem. The IBI, though originally for Midwestern streams, has been successfully adapted to other ecoregions and taxa (macroinvertebrates, Lombard and Goldstein, 2004) and has become an important tool for scientists and regulatory agencies alike in determining health of stream ecosystems. The IBI is a specific type of a larger group of methods and procedures referred to as Rapid Bioassessment (RBA). These protocols have the advantage of directly measuring the organisms affected by system perturbations, thus providing an integrated evaluation of system health because the organisms themselves integrate all aspects of their environment and its condition. In addition to the IBI, the RBA concept has also been applied to seep wetlands (Paller et al. 2005) and terrestrial systems (O'Connell et al. 1998, Kremen et al. 1993, Rodriguez et al. 1998, Rosenberg et al. 1986). Terrestrial RBA methods have lagged somewhat behind those for aquatic systems because terrestrial systems are less distinctly defined and seem to have a less universal distribution of an all-inclusive taxon, such as fish in the IBI, upon which to base an RBA. In the last decade, primarily in Australia, extensive development of an RBA using ant communities has shown great promise. Ants have the same advantage for terrestrial RBAs that fish do for aquatic systems in that they are an essential and ubiquitous component of virtually all terrestrial ecosystems. They occupy a broad range of niches, functional groups, and trophic levels and they possess one very important characteristic that makes them ideal for RBA because, similar to the fishes, there is a wide range of tolerance to conditions within the larger taxa. Within ant communities there are certain groups, genera, or species that may be very robust and abundant under even the harshest impacts. There are also taxa that are very sensitive to disturbance and change and their presence or absence is also indicative of the local

  19. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  20. Climate change and One Health.

    Science.gov (United States)

    Zinsstag, Jakob; Crump, Lisa; Schelling, Esther; Hattendorf, Jan; Maidane, Yahya Osman; Ali, Kadra Osman; Muhummed, Abdifatah; Umer, Abdurezak Adem; Aliyi, Ferzua; Nooh, Faisal; Abdikadir, Mohammed Ibrahim; Ali, Seid Mohammed; Hartinger, Stella; Mäusezahl, Daniel; de White, Monica Berger Gonzalez; Cordon-Rosales, Celia; Castillo, Danilo Alvarez; McCracken, John; Abakar, Fayiz; Cercamondi, Colin; Emmenegger, Sandro; Maier, Edith; Karanja, Simon; Bolon, Isabelle; de Castañeda, Rafael Ruiz; Bonfoh, Bassirou; Tschopp, Rea; Probst-Hensch, Nicole; Cissé, Guéladio

    2018-06-01

    The journal The Lancet recently published a countdown on health and climate change. Attention was focused solely on humans. However, animals, including wildlife, livestock and pets, may also be impacted by climate change. Complementary to the high relevance of awareness rising for protecting humans against climate change, here we present a One Health approach, which aims at the simultaneous protection of humans, animals and the environment from climate change impacts (climate change adaptation). We postulate that integrated approaches save human and animal lives and reduce costs when compared to public and animal health sectors working separately. A One Health approach to climate change adaptation may significantly contribute to food security with emphasis on animal source foods, extensive livestock systems, particularly ruminant livestock, environmental sanitation, and steps towards regional and global integrated syndromic surveillance and response systems. The cost of outbreaks of emerging vector-borne zoonotic pathogens may be much lower if they are detected early in the vector or in livestock rather than later in humans. Therefore, integrated community-based surveillance of zoonoses is a promising avenue to reduce health effects of climate change.

  1. Rapid treatment-induced brain changes in pediatric CRPS.

    Science.gov (United States)

    Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David

    2016-03-01

    To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation.

  2. Mobile work: Ergonomics in a rapidly changing work environment.

    Science.gov (United States)

    Honan, Meg

    2015-01-01

    Places of work have been completely transformed by innovations in mobile work tools and ever-present access to internet data. This article characterizes use patterns and provides preliminary considerations for productive and comfortable use of common mobile devices. Two surveys described trends in mobile work. In the first, ergonomics professionals who oversee programs reported common mobile devices, their users and what data is accessed. The second, an end user survey, explored common activities performed on mobile devices, duration of use and locations where mobile work is common. The survey results provide a baseline data point for the status of mobile work in early 2014. Research indicates that additional risks have been introduced to the neck, thumbs and hands when using mobile devices. Possible trends regarding device use and work locations emerge. Intervention studies provide some direction for the practitioner. Practical strategies are outlined to reduce exposure intensity and duration. Contemporary mobile work presents tremendous change and opportunity for ergonomists and researchers to keep pace with fitting the changing models of work to the person. Continued research is needed on current mobile device use patterns to better understand ergonomic risk exposure in this rapidly changing realm.

  3. Climate change and respiratory health.

    Science.gov (United States)

    Gerardi, Daniel A; Kellerman, Roy A

    2014-10-01

    To discuss the nature of climate change and both its immediate and long-term effects on human respiratory health. This review is based on information from a presentation of the American College of Chest Physicians course on Occupational and Environmental Lung Disease held in Toronto, Canada, June 2013. It is supplemented by a PubMed search for climate change, global warming, respiratory tract diseases, and respiratory health. It is also supplemented by a search of Web sites including the Environmental Protection Agency, National Oceanic and Atmospheric Administration, World Meteorological Association, National Snow and Ice Data Center, Carbon Dioxide Information Analysis Center, Inter-Governmental Panel on Climate Change, and the World Health Organization. Health effects of climate change include an increase in the prevalence of certain respiratory diseases, exacerbations of chronic lung disease, premature mortality, allergic responses, and declines in lung function. Climate change, mediated by greenhouse gases, causes adverse health effects to the most vulnerable patient populations-the elderly, children, and those in distressed socioeconomic strata.

  4. Climate change and human health

    DEFF Research Database (Denmark)

    Warren, John A; Berner, James E; Curtis, Tine

    2005-01-01

    In northern regions, climate change can include changes in precipitation magnitude and frequency, reductions in sea ice extent and thickness, and climate warming and cooling. These changes can increase the frequency and severity of storms, flooding, or erosion; other changes may include drought...... or degradation of permafrost. Climate change can result in damage to sanitation infrastructure resulting in the spread of disease or threatening a community's ability to maintain its economy, geographic location and cultural tradition, leading to mental stress. Through monitoring of some basic indicators...... communities can begin to develop a response to climate change. With this information, planners, engineers, health care professionals and governments can begin to develop approaches to address the challenges related to climate change....

  5. Social change and women's health.

    Science.gov (United States)

    McDonough, Peggy; Worts, Diana; McMunn, Anne; Sacker, Amanda

    2013-01-01

    Over the past five decades, the organization of women's lives has changed dramatically. Throughout the industrialized world, paid work and family biographies have been altered as the once-dominant role of homemaker has given way to the role of secondary, dual, or even primary wage-earner. The attendant changes represent a mix of gains and losses for women, in which not all women have benefited (or suffered) equally. But little is known about the health consequences. This article addresses that gap. It develops a "situated biographies" model to conceptualize how life course change may influence women's health. The model stresses the role of time, both as individual aging and as the anchoring of lives in particular historical periods. "Situating" biographies in this way highlights two key features of social change in women's lives: the ambiguous implications for the health of women as a group, and the probable connections to growing social and economic disparities in health among them. This approach lays the groundwork for more integrated and productive population-based research about how historical transformations may affect women's health.

  6. [Health behavior change: motivational interviewing].

    Science.gov (United States)

    Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz

    2017-08-01

    Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.

  7. Altering plasma sodium concentration rapidly changes blood pressure during haemodialysis.

    Science.gov (United States)

    Suckling, Rebecca J; Swift, Pauline A; He, Feng J; Markandu, Nirmala D; MacGregor, Graham A

    2013-08-01

    Plasma sodium is increased following each meal containing salt. There is an increasing interest in the effects of plasma sodium concentration, and it has been suggested that it may have direct effects on blood pressure (BP) and possibly influences endothelial function. Experimental increases of plasma sodium concentration rapidly raise BP even when extracellular volume falls. Ten patients with end-stage renal failure established on haemodialysis were studied during the first 2 h of dialysis without fluid removal during this period. They were randomized to receive haemodialysis with (i) dialysate sodium concentration prescribed to 135 mmol/L and (ii) 145 mmol/L in random order in a prospective, single-blinded crossover study. BP measurements and blood samples were taken every 30 min. Pre-dialysis sitting BP was 137/76 ± 7/3 mmHg. Lower dialysate sodium concentration (135 mmol/L) reduced plasma sodium concentration [139.49 ± 0.67 to 135.94 ± 0.52 mmol/L (P area under the curve (AUC) 15823.50 ± 777.15 (mmHg)min] compared with 145 mmol/L [AUC 17018.20 ± 1102.17 (mmHg)min], mean difference 1194.70 ± 488.41 (mmHg)min, P < 0.05. There was a significant positive relationship between change in plasma sodium concentration and change in systolic BP. This direct relationship suggests that a fall of 1 mmol/L in plasma sodium concentration would be associated with a 1.7 mmHg reduction in systolic BP (P < 0.05). The potential mechanism for the increase in BP seen with salt intake may be through small but significant changes in plasma sodium concentration.

  8. Climate change and human health

    International Nuclear Information System (INIS)

    Sanderson, G.

    1991-01-01

    Changes in the earth's climate, stemming from the greenhouse effect, are highly likely to damage human health. As well as the disruptions to food and fresh water supplies, there is the prospect of major diseases flourishing in warmer conditions, in addition the decrease in the ozone layer is causing an increased incidence of skin cancer

  9. Czechoslovakia's changing health care system.

    Science.gov (United States)

    Raffel, M W; Raffel, N K

    1992-01-01

    Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.

  10. Planetary Habitability and Rapid Environmental Change: The Biological Perspective

    Science.gov (United States)

    Schulze-Makuch, D.; Fairen, A.; Irwin, L.

    2012-12-01

    Environmental conditions can change drastically and rapidly during the natural history of a planetary body. We have detailed evidence of these dramatic events from Venus, Earth, Mars, and Titan. Most of these occurrences seem to be triggered by astronomical events such as asteroid impacts or supernova explosions; others are triggered by the planet or moon itself (e.g., supervolcano eruptions). The associated question is always how these events affect the habitability of a planet, particularly the origin and presence of life. Under what conditions would such a drastic event be so catastrophic that it would prohibit the origin of life or be so devastating to existing organisms, that life would not be able to recover and be all but extinguished from a planet? Under what conditions would such an event be positive for the evolution of life, for example spurring life via mass extinctions and associated vacant habitats to the invention of new body plans and higher complexity? Here, we provide insights of what we can learn from the natural history of our own planet, which experienced many environmental disasters and abrupt climate changes, from the impact event that created the Moon to the extinction of the dinosaurs. We apply these insights to other planetary bodies and the question about the presence of life. One example is Mars, which underwent drastic environmental changes at the end of the Noachian period. Assuming that microbial life became established on Mars, could it have survived, perhaps by retreating to environmental niches? Life just starting out would have certainly been more vulnerable to extinction. But how far would it have to have evolved to be more resistant to potential extinction events? Would it have to be global in distribution to survive? Another example is Venus. Should Venus be seen as an example where life, which possibly arose in the first few hundred million years when the planet was still in the habitable zone, would have had no chance to

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

    Science.gov (United States)

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

  12. The health and wellbeing needs of veterans: a rapid review.

    Science.gov (United States)

    Oster, Candice; Morello, Andrea; Venning, Anthony; Redpath, Paula; Lawn, Sharon

    2017-12-29

    For the majority of serving members, life in the military has a positive effect on wellbeing. However, the type, intensity and duration of service, along with the transition from fulltime military to civilian life, may have a negative effect on veterans' wellbeing. Such negative consequences, alongside the growing veteran population, indicate the need for greater exploration of veterans' physical, mental and social wellbeing. The current paper reports on the findings of a rapid review of the literature on the health and wellbeing needs of veterans, commissioned by the Australian Department of Veterans' Affairs to inform future programs and services. The databases Embase, Medline, Cinahl, PubMed, Web of Science and Cochrane Database were searched for systematic reviews reporting on veterans' physical, mental and social wellbeing published in English in peer-reviewed journals. A total of 21 systematic reviews were included. The reviews reported on a range of mental, physical and social health problems affecting veterans. While there was limited information on prevalence rates of physical, mental and social health problems in veterans compared to civilian populations, the reviews demonstrated the interconnection between these domains and the effect of demographic and military service factors. A key finding of the review is the interconnection of the mental, physical, and social health of veterans, highlighting the importance that an integrated approach to veterans' wellbeing is adopted. It is suggested that understanding key factors, such as demographic factors and factors relating to military service, can support improved service provision for veterans.

  13. Climate Change and Human Health

    OpenAIRE

    Semenza, Jan C.

    2014-01-01

    Climate change science points to an increase in sea surface temperature, increases in the severity of extreme weather events, declining air quality, and destabilizing natural systems due to increases in greenhouse gas emissions. The direct and indirect health results of such a global imbalance include excessive heat-related illnesses, vector- and waterborne diseases, increased exposure to environmental toxins, exacerbation of cardiovascular and respiratory diseases due to declining air qualit...

  14. A rapid review of consumer health information needs and preferences.

    Science.gov (United States)

    Ramsey, Imogen; Corsini, Nadia; Peters, Micah D J; Eckert, Marion

    2017-09-01

    This rapid review summarizes best available evidence on consumers' needs and preferences for information about healthcare, with a focus on the Australian context. Three questions are addressed: 1) Where do consumers find and what platform do they use to access information about healthcare? 2) How do consumers use the healthcare information that they find? 3) About which topics or subjects do consumers need healthcare information? A hierarchical approach was adopted with evidence first sought from reviews then high quality studies using Medline (via PubMed), CINAHL, Embase, the JBI Database of Systematic Reviews and Implementation Reports, the Campbell Collaboration Library of Systematic Reviews, EPPI-Centre, and Epistemonikos. Twenty-eight articles were included; four systematic reviews, three literature reviews, thirteen quantitative studies, six qualitative studies, and two mixed methods studies. Consumers seek health information at varying times along the healthcare journey and through various modes of delivery. Complacency with historical health information modes is no longer appropriate and flexibility is essential to suit growing consumer demands. Health information should be readily available in different formats and not exclusive to any single medium. Copyright © 2017. Published by Elsevier B.V.

  15. Climate change, human health, and epidemiological transition.

    Science.gov (United States)

    Barrett, Bruce; Charles, Joel W; Temte, Jonathan L

    2015-01-01

    The health of populations depends on the availability of clean air, water, food, and sanitation, exposure to pathogens, toxins and environmental hazards, and numerous genetic, behavioral and social factors. For many thousands of years, human life expectancy was low, and population growth was slow. The development of technology-based civilizations facilitated what Abdel Omran called "epidemiological transition," with increasing life expectancy and rapid population growth. To a large extent, the spectacular growth of human populations during the past two centuries was made possible by the energy extracted from fossil fuels. We have now learned, however, that greenhouse gases from fossil fuel combustion are warming the planet's surface, causing changes in oceanic and atmospheric systems, and disrupting weather and hydrological patterns. Climate change poses unprecedented threats to human health by impacts on food and water security, heat waves and droughts, violent storms, infectious disease, and rising sea levels. Whether or not humanity can reduce greenhouse gas emissions quickly enough to slow climate change to a rate that will allow societies to successfully adapt is not yet known. This essay reviews the current state of relevant knowledge, and points in a few directions that those interested in human health may wish to consider. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Mental health in the island nations of the Western Pacific: a rapid review of the literature.

    Science.gov (United States)

    Hunter, Ernest; Thusanth, Sneha; McCalman, Janya; Gopalkrishnan, Narayan

    2015-12-01

    The aim of the study was to identify mental-health-relevant literature accessible to policy makers and healthcare workers in the island nations of the Western Pacific. Material collated to support the inaugural Leadership in Mental Health: Island Nations course held in Cairns in May 2015 was used as the basis of a "rapid review". The rapid review considered 303 documents identified by a search carried out using James Cook University's OneSearch, Google Scholar, and the authors' knowledge. Search terms included mental health and the like, and terms with Pacific and current Pacific island country names. Findings were classified by region/country, year of release/publication, mental health issue addressed, peer-reviewed or grey literature, and type of study. Almost half of the findings had been released in the previous five years. However, only 36% were peer-reviewed publications and only 3.6% of the findings were intervention studies. There is limited easily accessible documentation to confidently direct practice or policies regarding which strategies are likely to be effective in responding to the high rates of mental ill-health experienced in the Pacific island nations, or to plan for increases as a consequence of rapid social and demographic changes that are transforming Pacific island societies. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  17. Women in Physics in a Rapidly Changing China

    Science.gov (United States)

    Wu, Ling-An

    2008-03-01

    Despite the upheavals of the 20th century, physics managed to survive quite well in China, where the first woman president of the American Physical Society was born and bred. During the 1950s as a result of policies that emphasized science and engineering, declared equal rights and equal pay for men and women, and assigned jobs to college graduates irrespective of sex, the number of women in physics increased rapidly, many of whom made notable achievements. Since China's opening up over the last thirty years tremendous changes have taken place, and women now face new opportunities as well as challenges in all aspects of society. Whereas physics used to be regarded as the most elite of the sciences, new fields such as computer science, biotechnology and business are now competing for the best students. Compared with other countries the statistics are not bad; in schools and many physics departments the ratio of women teachers may be 30% or higher, but the numbers drop drastically with rank. Moreover, in some research institutions the ratio of female physicists is actually declining, due to retirement of the older generation and fewer successors. Compulsory retirement for women at an earlier age than for men is also a new factor. Conversely, in recent years the ratio of female graduate students enrolling in physics has increased, even reaching 40% in some universities. However, the reasons for this do not bode well: men are not performing so well as women in entrance exams, while the latter are facing increasing discrimination in employment so they have to seek higher degree qualifications. With the further development of China's economy there will be abundant demand for qualified personnel including women with a physics background. It is imperative to actively support the upcoming generation of women physicists and not lose them in the leaky pipeline. The Chinese Physical Society has taken certain positive steps, such as the recent establishment of the Xie Xi

  18. Social Change and its Potential Impacts on Chinese Population Health

    Directory of Open Access Journals (Sweden)

    Wang, Hong

    2004-12-01

    Full Text Available Within the past 25 years, China has experienced transformation of its economic system from a highly centralized planned economy toward a market oriented economic system. This process has led to massive and rapid changes in all aspects of society with profound effects on the population’s health in the large parts of the country. Along with the material prosperity, the living conditions of Chinese people, such as food, shelter, and sanitation status, have been improving steadily. People have more capability to purchase health related merchandise as well as health services. Overall the health status of most Chinese has improved but there are significant exceptions to this overall conclusion. These exceptions arise from increasing inequity of income, increases in unemployment rates, the decline of health insurance coverage, changes in demography, changes in social value, culture, health related behaviors, and the changes of health care systems.

  19. Forest health in a changing world.

    Science.gov (United States)

    Pautasso, Marco; Schlegel, Markus; Holdenrieder, Ottmar

    2015-05-01

    Forest pathology, the science of forest health and tree diseases, is operating in a rapidly developing environment. Most importantly, global trade and climate change are increasing the threat to forest ecosystems posed by new diseases. Various studies relevant to forest pathology in a changing world are accumulating, thus making it necessary to provide an update of recent literature. In this contribution, we summarize research at the interface between forest pathology and landscape ecology, biogeography, global change science and research on tree endophytes. Regional outbreaks of tree diseases are requiring interdisciplinary collaboration, e.g. between forest pathologists and landscape ecologists. When tree pathogens are widely distributed, the factors determining their broad-scale distribution can be studied using a biogeographic approach. Global change, the combination of climate and land use change, increased pollution, trade and urbanization, as well as invasive species, will influence the effects of forest disturbances such as wildfires, droughts, storms, diseases and insect outbreaks, thus affecting the health and resilience of forest ecosystems worldwide. Tree endophytes can contribute to biological control of infectious diseases, enhance tolerance to environmental stress or behave as opportunistic weak pathogens potentially competing with more harmful ones. New molecular techniques are available for studying the complete tree endobiome under the influence of global change stressors from the landscape to the intercontinental level. Given that exotic tree diseases have both ecologic and economic consequences, we call for increased interdisciplinary collaboration in the coming decades between forest pathologists and researchers studying endophytes with tree geneticists, evolutionary and landscape ecologists, biogeographers, conservation biologists and global change scientists and outline interdisciplinary research gaps.

  20. A big data management platform for rapidly changing environments

    NARCIS (Netherlands)

    Zahedi, P.

    2014-01-01

    Big data is now a reality. Storing, managing, and analyzing very large amount of data is a common challenge in the world of technology where digital content is rapidly growing. In recent years, FEI advanced electron microscopes, with their unsurpassed magnification and resolving power brought an

  1. Climate change and ecological public health.

    Science.gov (United States)

    Goodman, Benny

    2015-02-17

    Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.

  2. Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

    Science.gov (United States)

    Guha-Sapir, D

    1991-01-01

    The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the

  3. eHealth Applications Promising Strategies for Behavior Change

    CERN Document Server

    Noar, Seth M

    2012-01-01

    eHealth Applications: Promising Strategies for Behavior Change provides an overview of technological applications in contemporary health communication research, exploring the history and current uses of eHealth applications in disease prevention and management. This volume focuses on the use of these technology-based interventions for public health promotion and explores the rapid growth of an innovative interdisciplinary field. The chapters in this work discuss key eHealth applications by presenting research examining a variety of technology-based applications. Authors Seth M. Noar and Nancy

  4. HealthLines: Seasons Change, Moods Change

    Science.gov (United States)

    ... the onset of a form of depression called seasonal affective disorder (SAD). Most commonly, SAD usually occurs ... time. Others include: medicines, changes in diet, and stress management. If you ... Water Well? If your water comes from a private ...

  5. Rapid deuterium exchange-in time for probing conformational change

    International Nuclear Information System (INIS)

    Dharmasiri, K.; Smith, D.L.

    1995-01-01

    Isotopic exchange of protein backbone amide hydrogens has been used extensively as a sensitive probe of protein structure. One of the salient features of hydrogen exchange is the vast range of exchange rates in one protein. Isotopic exchange methods have been used to study the structural features including protein folding and unfolding (1), functionally different forms of proteins (2), protein-protein complexation (3), and protein stability parameter. Many backbone amide protons that are surface accessible and are not involved in hydrogen bonding undergo rapid deuterium exchange. In order to study, fast exchanging amide protons, fast exchange-in times are necessary

  6. Policy options to respond to rapid climate change

    NARCIS (Netherlands)

    Swart, R.J.; Marinova, N.A.; Bakker, S.; Tilburg, van X.

    2009-01-01

    Ongoing research on climate change indicates that we cannot rule out the possibility of extreme climatic changes, beyond current IPCC scenarios. The thinking about policy responses to address these risks is still in its infancy. This study explores the possibilities for responding to extreme

  7. Health in China and India: a cross-country comparison in a context of rapid globalisation.

    Science.gov (United States)

    Dummer, Trevor J B; Cook, Ian G

    2008-08-01

    China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed.

  8. Climate Change Indicators: Health and Society

    Science.gov (United States)

    ... chapter looks at some of the ways that climate change is affecting human health and society, including changes in Lyme disease, West ... health effects. Why does it matter? Changes in climate affect the ... to human health and welfare. Warmer average temperatures will likely lead ...

  9. San Francisco Bay Area Rapid Transit District (BART) climate change adaptation assessment pilot.

    Science.gov (United States)

    2013-12-01

    The objective of this pilot study was to evaluate the impacts of climate change on the San Francisco Bay Area Rapid Transit District : (BART) infrastructure and to develop and implement adaptation strategies against those impacts. Climate change haza...

  10. Rapid gene expression changes in peripheral blood lymphocytes upon practice of a comprehensive yoga program.

    Directory of Open Access Journals (Sweden)

    Su Qu

    Full Text Available One of the most common integrative medicine (IM modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices--SK&P compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.

  11. Evidence-based medicine in rapidly changing technologies

    DEFF Research Database (Denmark)

    Schroeder, Torben Veith

    2008-01-01

    Evidence-based medicine (EBM) is not a randomised controlled trial (RCT), but EBM seeks to apply evidence gained from scientific methods - which could be RCT - to daily medical practice. Any surgical treatment reflects a certain development technically as well as skills based. The procedure may....... Special considerations should be given in rapidly developing fields. If started too early the resulting comparison will likely turn out to be irrelevant because the new technology is not fully developed, not mastered or the device may have undergone major modifications rendering the results obsolete....... On the other hand, if started too late there is a chance that data may be lost because the technology has already been introduced into the daily clinics and physicians may be unwilling to recruit patients. Or the opposite, that the technique may have been rejected without a proper trial. In this situation...

  12. USING ANT COMMUNITIES FOR RAPID ASSESSMENT OF TERRESTRIAL ECOSYSTEM HEALTH

    Energy Technology Data Exchange (ETDEWEB)

    Wike, L; Doug Martin, D; Michael Paller, M; Eric Nelson, E

    2007-01-12

    Ecosystem health with its near infinite number of variables is difficult to measure, and there are many opinions as to which variables are most important, most easily measured, and most robust, Bioassessment avoids the controversy of choosing which physical and chemical parameters to measure because it uses responses of a community of organisms that integrate all aspects of the system in question. A variety of bioassessment methods have been successfully applied to aquatic ecosystems using fish and macroinvertebrate communities. Terrestrial biotic index methods are less developed than those for aquatic systems and we are seeking to address this problem here. This study had as its objective to examine the baseline differences in ant communities at different seral stages from clear cut back to mature pine plantation as a precursor to developing a bioassessment protocol. Comparative sampling was conducted at four seral stages; clearcut, 5 year, 15 year and mature pine plantation stands. Soil and vegetation data were collected at each site. All ants collected were preserved in 70% ethyl alcohol and identified to genus. Analysis of the ant data indicates that ants respond strongly to the habitat changes that accompany ecological succession in managed pine forests and that individual genera as well as ant community structure can be used as an indicator of successional change. Ants exhibited relatively high diversity in both early and mature seral stages. High ant diversity in the mature seral stages was likely related to conditions on the forest floor which favored litter dwelling and cool climate specialists.

  13. Managing in the rapidly changing context of higher education: a ...

    African Journals Online (AJOL)

    Besides the rate of change in the sector there are also, as seen from the continuous media coverage, a number of universities and technikons in some form of financial or leadership crisis. Over the past years one of the main reasons given for these crises was outstanding student fees. However, the reasons now alluded to ...

  14. Alveolar bone changes after asymmetric rapid maxillary expansion.

    Science.gov (United States)

    Akin, Mehmet; Baka, Zeliha Muge; Ileri, Zehra; Basciftci, Faruk Ayhan

    2015-09-01

    To quantitatively evaluate the effects of asymmetric rapid maxillary expansion (ARME) on cortical bone thickness and buccal alveolar bone height (BABH), and to determine the formation of dehiscence and fenestration in the alveolar bone surrounding the posterior teeth, using cone-beam computed tomography (CBCT). The CBCT records of 23 patients with true unilateral posterior skeletal crossbite (10 boys, 14.06 ± 1.08 years old, and 13 girls, 13.64 ± 1.32 years old) who had undergone ARME were selected from our clinic archives. The bonded acrylic ARME appliance, including an occlusal stopper, was used on all patients. CBCT records had been taken before ARME (T1) and after the 3-month retention period (T2). Axial slices of the CBCT images at 3 vertical levels were used to evaluate the buccal and palatal aspects of the canines, first and second premolars, and first molars. Paired samples and independent sample t-tests were used for statistical comparison. The results suggest that buccal cortical bone thickness of the affected side was significantly more affected by the expansion than was the unaffected side (P ARME significantly reduced the BABH of the canines (P ARME also increased the incidence of dehiscence and fenestration on the affected side. ARME may quantitatively decrease buccal cortical bone thickness and height on the affected side.

  15. Rapid Business Transformations in Health Care: A Systems Approach

    Science.gov (United States)

    Shulaiba, Refaat A.

    2011-01-01

    The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The Health Care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities. …

  16. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  17. Adaptation to climate change in the Ontario public health sector

    Science.gov (United States)

    2012-01-01

    Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

  18. Climate Change, Health, and Communication: A Primer.

    Science.gov (United States)

    Chadwick, Amy E

    2016-01-01

    Climate change is one of the most serious and pervasive challenges facing us today. Our changing climate has implications not only for the ecosystems upon which we depend, but also for human health. Health communication scholars are well-positioned to aid in the mitigation of and response to climate change and its health effects. To help theorists, researchers, and practitioners engage in these efforts, this primer explains relevant issues and vocabulary associated with climate change and its impacts on health. First, this primer provides an overview of climate change, its causes and consequences, and its impacts on health. Then, the primer describes ways to decrease impacts and identifies roles for health communication scholars in efforts to address climate change and its health effects.

  19. Rapid changes in gene expression direct rapid shifts in intestinal form and function in the Burmese python after feeding.

    Science.gov (United States)

    Andrew, Audra L; Card, Daren C; Ruggiero, Robert P; Schield, Drew R; Adams, Richard H; Pollock, David D; Secor, Stephen M; Castoe, Todd A

    2015-05-01

    Snakes provide a unique and valuable model system for studying the extremes of physiological remodeling because of the ability of some species to rapidly upregulate organ form and function upon feeding. The predominant model species used to study such extreme responses has been the Burmese python because of the extreme nature of postfeeding response in this species. We analyzed the Burmese python intestine across a time series, before, during, and after feeding to understand the patterns and timing of changes in gene expression and their relationship to changes in intestinal form and function upon feeding. Our results indicate that >2,000 genes show significant changes in expression in the small intestine following feeding, including genes involved in intestinal morphology and function (e.g., hydrolases, microvillus proteins, trafficking and transport proteins), as well as genes involved in cell division and apoptosis. Extensive changes in gene expression occur surprisingly rapidly, within the first 6 h of feeding, coincide with changes in intestinal morphology, and effectively return to prefeeding levels within 10 days. Collectively, our results provide an unprecedented portrait of parallel changes in gene expression and intestinal morphology and physiology on a scale that is extreme both in the magnitude of changes, as well as in the incredibly short time frame of these changes, with up- and downregulation of expression and function occurring in the span of 10 days. Our results also identify conserved vertebrate signaling pathways that modulate these responses, which may suggest pathways for therapeutic modulation of intestinal function in humans. Copyright © 2015 the American Physiological Society.

  20. Russian science trapped in web of rapid change

    International Nuclear Information System (INIS)

    Josephson, P.R.

    1995-01-01

    During the Cold War, Soviet physicists were revered for their contribution to the country's prestige, economic growth, and national security, says Paul Josephson, a professor in the Department of Science, Technology, and Society at Sarah Lawrence College in Bronxville, New York. But the lavish support the Russian physics establishment once received is gone. In fact, the dissolution of the Soviet regime and deepening economic and political crisis have left scientists struggling to maintain their programs and keep institutes open. Internal crisis and the internationalization of science and technology have led to a drain of top Russian scientists in many fields, particularly in mathematics and theoretical physics. The West has responded to these concerns by giving financial aid and sponsoring initiatives designed to keep former Soviet scientists employed either at home or in the United States or Europe. However, the ultimate health of Russian science will depend on internal government reforms and public support, concludes Josephson

  1. Focus on climate change and mental health

    Science.gov (United States)

    2018-04-01

    The health impacts of climate change are being increasingly recognized, but mental health is often excluded from this discussion. In this issue we feature a collection of articles on climate change and mental health that highlight important directions for future research.

  2. Climate Change and Public Health Policy.

    Science.gov (United States)

    Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

    2017-03-01

    Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

  3. Climate Change: Science, Health and the Environment

    Centers for Disease Control (CDC) Podcasts

    Climate Change: Science, Health and the Environment Howard Frumkin, MD, DrPH, Director of CDC's National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, discusses the science of climate change, the potential for shifts in the natural world to affect our wellbeing, and the challenges of emerging issues in environmental health.

  4. Rapid adaptive responses to climate change in corals

    KAUST Repository

    Torda, Gergely; Donelson, Jennifer M.; Aranda, Manuel; Barshis, Daniel J.; Bay, Line; Berumen, Michael L.; Bourne, David G.; Cantin, Neal; Foret, Sylvain; Matz, Mikhail; Miller, David J.; Moya, Aurelie; Putnam, Hollie M.; Ravasi, Timothy; van Oppen, Madeleine J. H.; Thurber, Rebecca Vega; Vidal-Dupiol, Jeremie; Voolstra, Christian R.; Watson, Sue-Ann; Whitelaw, Emma; Willis, Bette L.; Munday, Philip L.

    2017-01-01

    Pivotal to projecting the fate of coral reefs is the capacity of reef-building corals to acclimatize and adapt to climate change. Transgenerational plasticity may enable some marine organisms to acclimatize over several generations and it has been hypothesized that epigenetic processes and microbial associations might facilitate adaptive responses. However, current evidence is equivocal and understanding of the underlying processes is limited. Here, we discuss prospects for observing transgenerational plasticity in corals and the mechanisms that could enable adaptive plasticity in the coral holobiont, including the potential role of epigenetics and coral-associated microbes. Well-designed and strictly controlled experiments are needed to distinguish transgenerational plasticity from other forms of plasticity, and to elucidate the underlying mechanisms and their relative importance compared with genetic adaptation.

  5. Rapid changes in the gut microbiome during human evolution.

    Science.gov (United States)

    Moeller, Andrew H; Li, Yingying; Mpoudi Ngole, Eitel; Ahuka-Mundeke, Steve; Lonsdorf, Elizabeth V; Pusey, Anne E; Peeters, Martine; Hahn, Beatrice H; Ochman, Howard

    2014-11-18

    Humans are ecosystems containing trillions of microorganisms, but the evolutionary history of this microbiome is obscured by a lack of knowledge about microbiomes of African apes. We sequenced the gut communities of hundreds of chimpanzees, bonobos, and gorillas and developed a phylogenetic approach to reconstruct how present-day human microbiomes have diverged from those of ancestral populations. Compositional change in the microbiome was slow and clock-like during African ape diversification, but human microbiomes have deviated from the ancestral state at an accelerated rate. Relative to the microbiomes of wild apes, human microbiomes have lost ancestral microbial diversity while becoming specialized for animal-based diets. Individual wild apes cultivate more phyla, classes, orders, families, genera, and species of bacteria than do individual humans across a range of societies. These results indicate that humanity has experienced a depletion of the gut flora since diverging from Pan.

  6. Rapid adaptive responses to climate change in corals

    KAUST Repository

    Torda, Gergely

    2017-09-01

    Pivotal to projecting the fate of coral reefs is the capacity of reef-building corals to acclimatize and adapt to climate change. Transgenerational plasticity may enable some marine organisms to acclimatize over several generations and it has been hypothesized that epigenetic processes and microbial associations might facilitate adaptive responses. However, current evidence is equivocal and understanding of the underlying processes is limited. Here, we discuss prospects for observing transgenerational plasticity in corals and the mechanisms that could enable adaptive plasticity in the coral holobiont, including the potential role of epigenetics and coral-associated microbes. Well-designed and strictly controlled experiments are needed to distinguish transgenerational plasticity from other forms of plasticity, and to elucidate the underlying mechanisms and their relative importance compared with genetic adaptation.

  7. Ethnobiology 5: Interdisciplinarity in an Era of Rapid Environmental Change

    Directory of Open Access Journals (Sweden)

    Steve Wolverton

    2013-01-01

    Full Text Available Ethnobiology 5 stems from Eugene Hunn’s four phases of the history of ethnobiology and focuses on the relevance of ethnobiological research in the context of environmental and cultural change.  It refers to a contemporary phase of the field’s historical development.  In this paper, I argue that ethnobiology is preadapted to be a scholarly umbrella for a number of disciplines that concern human-environment interactions, suggesting that one goal of Ethnobiology 5 is to bridge traditional academic boundaries in order to broaden the community of ethnobiologists. Another goal of Ethnobiology 5 is to capitalize on and communicate the relevance of ethnobiological scholarship for solving problems related to contemporary environmental and cultural crises.  Indeed, ethnobiology is not a subfield of any traditional discipline and by the nature of its name bridges humanities, social science, and science.  Ethnobiology has always been interdisciplinary in terms of its subject matter, yet its community of scholars is relatively small compared to mission-driven disciplines, such as conservation biology.  Venues for publication and presentation of ethnobiological research, as well as how ethnobiologists portray their research, are critical to growing ethnobiology.

  8. Coral Reefs Under Rapid Climate Change and Ocean Acidification

    Science.gov (United States)

    Hoegh-Guldberg, O.; Mumby, P. J.; Hooten, A. J.; Steneck, R. S.; Greenfield, P.; Gomez, E.; Harvell, C. D.; Sale, P. F.; Edwards, A. J.; Caldeira, K.; Knowlton, N.; Eakin, C. M.; Iglesias-Prieto, R.; Muthiga, N.; Bradbury, R. H.; Dubi, A.; Hatziolos, M. E.

    2007-12-01

    Atmospheric carbon dioxide concentration is expected to exceed 500 parts per million and global temperatures to rise by at least 2°C by 2050 to 2100, values that significantly exceed those of at least the past 420,000 years during which most extant marine organisms evolved. Under conditions expected in the 21st century, global warming and ocean acidification will compromise carbonate accretion, with corals becoming increasingly rare on reef systems. The result will be less diverse reef communities and carbonate reef structures that fail to be maintained. Climate change also exacerbates local stresses from declining water quality and overexploitation of key species, driving reefs increasingly toward the tipping point for functional collapse. This review presents future scenarios for coral reefs that predict increasingly serious consequences for reef-associated fisheries, tourism, coastal protection, and people. As the International Year of the Reef 2008 begins, scaled-up management intervention and decisive action on global emissions are required if the loss of coral-dominated ecosystems is to be avoided.

  9. Climate Change: Science, Health and the Environment

    Centers for Disease Control (CDC) Podcasts

    2007-04-10

    Climate Change: Science, Health and the Environment Howard Frumkin, MD, DrPH, Director of CDC's National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, discusses the science of climate change, the potential for shifts in the natural world to affect our wellbeing, and the challenges of emerging issues in environmental health.  Created: 4/10/2007 by CDC National Center for Environmental Health.   Date Released: 4/13/2007.

  10. Climate change and health in Earth's future

    Science.gov (United States)

    Bowles, Devin C.; Butler, Colin D.; Friel, Sharon

    2014-02-01

    Threats to health from climate change are increasingly recognized, yet little research into the effects upon health systems is published. However, additional demands on health systems are increasingly documented. Pathways include direct weather impacts, such as amplified heat stress, and altered ecological relationships, including alterations to the distribution and activity of pathogens and vectors. The greatest driver of demand on future health systems from climate change may be the alterations to socioeconomic systems; however, these "tertiary effects" have received less attention in the health literature. Increasing demands on health systems from climate change will impede health system capacity. Changing weather patterns and sea-level rise will reduce food production in many developing countries, thus fostering undernutrition and concomitant disease susceptibility. Associated poverty will impede people's ability to access and support health systems. Climate change will increase migration, potentially exposing migrants to endemic diseases for which they have limited resistance, transporting diseases and fostering conditions conducive to disease transmission. Specific predictions of timing and locations of migration remain elusive, hampering planning and misaligning needs and infrastructure. Food shortages, migration, falling economic activity, and failing government legitimacy following climate change are also "risk multipliers" for conflict. Injuries to combatants, undernutrition, and increased infectious disease will result. Modern conflict often sees health personnel and infrastructure deliberately targeted and disease surveillance and eradication programs obstructed. Climate change will substantially impede economic growth, reducing health system funding and limiting health system adaptation. Modern medical care may be snatched away from millions who recently obtained it.

  11. Impact of organisational change on mental health

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  12. Climate change and health: new challenges for epidemiology and public health

    International Nuclear Information System (INIS)

    Pascal, Mathilde; Beaudeau, Pascal; Laaidi, Karine; Pirard, Philippe; Vautard, Robert

    2015-01-01

    Climate change contributes to a rapid and deep modification of the environment. In the same time, other factors such as population increase, ageing or urbanization increase the vulnerability to various environmental and health risks. Chains of complex interactions are impacting populations' health and well-being. Developing prevention measures is an asset to reduce the health impacts of present climate change (through adaptation measures) and to limit the intensity of future impacts (through mitigation measures). Mitigation will result in major changes in several sectors, for instance housing, transports or agriculture. Taking into account the potential health impacts is important to avoid choices impairing human health, and to maximize health co-benefits. In this paper we propose a reflection on how present and future climate change in France challenges epidemiology and public health in the next few years. While many questions remain unanswered, there is a consensus on the importance of the links between climate change and human health, that can be summarized into three points: 1) climate change already impacts human health, 2) adaptation and mitigation are needed to reduce those impacts, 3) adaptation and mitigation can rely on immediate measures that would be beneficial for health and for climate. An integrated and interdisciplinary approach is essential to tackle the complexity of the issue, of its implications for public health, for research, surveillance and intervention. (authors)

  13. Changes in the etiology of valvular heart disease in the rapidly aging Korean population.

    Science.gov (United States)

    Jang, Shin Yi; Ju, Eun-Young; Seo, Su Ra; Choi, Ji Yeon; Park, Sung-Ji; Kim, Duk-Kyung; Park, Seung Woo

    2014-06-15

    The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65 years or older compared with groups aged 20-44 years or 45-64 years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65 years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Does rapid urbanization aggravate health disparities? Reflections on the epidemiological transition in Pune, India

    Directory of Open Access Journals (Sweden)

    Mareike Kroll

    2014-09-01

    Full Text Available Background: Rapid urbanization in low- and middle-income countries reinforces risk and epidemiological transition in urban societies, which are characterized by high socioeconomic gradients. Limited availability of disaggregated morbidity data in these settings impedes research on epidemiological profiles of different population subgroups. Objective: The study aimed to analyze the epidemiological transition in the emerging megacity of Pune with respect to changing morbidity and mortality patterns, also taking into consideration health disparities among different socioeconomic groups. Design: A mixed-methods approach was used, comprising secondary analysis of mortality data, a survey among 900 households in six neighborhoods with different socioeconomic profiles, 46 in-depth interviews with laypeople, and expert interviews with 37 health care providers and 22 other health care workers. Results: The mortality data account for an epidemiological transition with an increasing number of deaths due to non-communicable diseases (NCDs in Pune. The share of deaths due to infectious and parasitic diseases remained nearly constant, though the cause of deaths changed considerably within this group. The survey data and expert interviews indicated a slightly higher prevalence of diabetes and hypertension among higher socioeconomic groups, but a higher incidence and more frequent complications and comorbidities in lower socioeconomic groups. Although the self-reported morbidity for malaria, gastroenteritis, and tuberculosis did not show a socioeconomic pattern, experts estimated the prevalence in lower socioeconomic groups to be higher, though all groups in Pune would be affected. Conclusions: The rising burden of NCDs among all socioeconomic groups and the concurrent persistence of communicable diseases pose a major challenge for public health. Improvement of urban health requires a stronger focus on health promotion and disease prevention for all

  15. Global Climate Change and Children's Health.

    Science.gov (United States)

    Ahdoot, Samantha; Pacheco, Susan E

    2015-11-01

    Rising global temperature is causing major physical, chemical, and ecological changes across the planet. There is wide consensus among scientific organizations and climatologists that these broad effects, known as climate change, are the result of contemporary human activity. Climate change poses threats to human health, safety, and security. Children are uniquely vulnerable to these threats. The effects of climate change on child health include physical and psychological sequelae of weather disasters, increased heat stress, decreased air quality, altered disease patterns of some climate-sensitive infections, and food, water, and nutrient insecurity in vulnerable regions. Prompt implementation of mitigation and adaptation strategies will protect children against worsening of the problem and its associated health effects. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health. Copyright © 2015 by the American Academy of Pediatrics.

  16. Preferred ecosystem characteristics: their food and health relevance to China's rapid urbanisation.

    Science.gov (United States)

    Gibson, Valerie; Zhu, Yong-Guan; Ge, Rubing; Wahlqvist, Mark L

    2015-01-01

    For most of its history, China has supported a growing population through food systems which have been mutually inclusive of people and their locality. This trajectory has required adequate ecosystem maintenance or humanised reformulation and a high degree of recyclable nutrient flow. The 'tipping point' in habitat sustainability has come with the size and demographic structure of China's population to one that is ageing, with modernisation of its infrastructure and increased expectations of better livelihoods, standards of living and health. In order to meet these expectations, China has embarked on rapid urbanisation for upwards of 300 million people over the next 15-20 years and to do so taking account of the environmental limitations. The process will radically change rural as well as urban China and the systems which connect them. Chief among these will be ecosystems in number and type along with the food and health systems integral to them. To minimise ecological damage and optimise the benefits to people and place, describing, monitoring and managing the process will be paramount. The present paper is a situational analysis of health as it may be ecologically favoured or disordered (Ecosystem Health Disorders) and of the food systems on which the environment and health depend. An effort is made to enumerate the current situation in China in a way that might enable the optimisation of humanised ecosystems.

  17. Changing the Care Process: A New Concept in Iranian Rural Health Care

    Directory of Open Access Journals (Sweden)

    Abbas Abbaszadeh, RN, BSCN, PhD

    2013-03-01

    Conclusion: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.

  18. Digital Inclusion & Health Communication: A Rapid Review of Literature.

    Science.gov (United States)

    Borg, Kim; Boulet, Mark; Smith, Liam; Bragge, Peter

    2018-06-11

    Information and communication technologies can be a valuable tool for enhancing health communication. However, not everyone is utilising the wide suite of digital opportunities. This disparity has the potential to exacerbate existing social and health inequalities, particularly among vulnerable groups such as those who are in poor health and the elderly. This review aimed to systematically identify the common barriers to, and facilitators of, digital inclusion. A comprehensive database search yielded 969 citations. Following screening, seven systematic reviews and three non-systematic reviews were identified. Collectively, the reviews found that physical access continues to be a barrier to digital inclusion. However, provision of access alone is insufficient, as digital ability and attitude were also potential barriers. Social support, direct user experience and collaborative learning/design were identified as key strategies to improve inclusion. These review findings provide guidance for health communication practitioners in designing and implementing effective programmes in the digital environment.

  19. Climate change and human health: a One Health approach.

    Science.gov (United States)

    Patz, Jonathan A; Hahn, Micah B

    2013-01-01

    Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

  20. Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy.

    Science.gov (United States)

    Moulton, Anthony Drummond; Schramm, Paul John

    Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.

  1. Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy

    Science.gov (United States)

    Moulton, Anthony Drummond; Schramm, Paul John

    2017-01-01

    Context Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Objective Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Methods Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Findings Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. Conclusions A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic

  2. Long-term culture change related to rapid response system implementation.

    Science.gov (United States)

    Stevens, Jennifer; Johansson, Anna; Lennes, Inga; Hsu, Douglas; Tess, Anjala; Howell, Michael

    2014-12-01

    Increasing attention to patient safety in training hospitals may come at the expense of trainee autonomy and professional growth. This study sought to examine changes in medical trainees' self-reported behaviour after the institution-wide implementation of a rapid response system. We conducted a two-point cross-sectional survey of medical trainees in 2006, during the implementation of a rapid response system, and in 2010, in a single academic medical centre. A novel instrument was used to measure trainee likelihood of calling for supervisory assistance, perception of autonomy, and comfort in managing decompensating patients. Non-parametric tests to assess for change were used and year of training was evaluated as an effect modifier. Response rates were 38% in 2006 and 70% in 2010. After 5 years of the full implementation of the rapid response system, residents were significantly more likely to report calling their attending physicians for assistance (rising from 40% to 65% of relevant situations; p autonomy at 5 years after the implementation of the rapid response system. These changes were mirrored in the actual use of the rapid response system, which increased by 41% during the 5-year period after adjustment for patient volume (p < 0.0001). A primary team-focused implementation of a rapid response system was associated with durable changes in resident physicians' reported behaviour, including increased comfort with involving more experienced physicians and managing unstable patients. © 2014 John Wiley & Sons Ltd.

  3. Changing living conditions, life style and health

    DEFF Research Database (Denmark)

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    . The aim of the paper is to illustrate the influence of environmental change on living conditions and life style and some of the mechanisms through which such changes affect physical and mental health. The interrelationship between environmental and societal change is illustrated by an example from a small......Human health is the result of the interaction of genetic, nutritional, socio-cultural, economic, physical infrastructure and ecosystem factors. All of the individual, social, cultural and socioeconomic factors are influenced by the environment they are embedded in and by changes in this environment...... community in Greenland, where changing environmental conditions have influenced fishing and employment opportunities to the extent that the size of the population has changed dramatically. The link between social change and health is shown with reference to studies on education, housing and occupation...

  4. Health Behavior Change Challenge: Understanding Stages of Change

    Science.gov (United States)

    Sullivan, Claire F.

    2011-01-01

    This semester-long activity requires students to reflect on their own strengths and weaknesses in attempting to take on a personally meaningful health behavior change challenge. This assignment affords them the opportunity to take a deeper look at theory and health concepts learned throughout the semester and to see how it has informed their own…

  5. Rapid changes in the range limits of Scots pine 4000 years ago

    International Nuclear Information System (INIS)

    Gear, A.J.; Huntley, B.

    1991-01-01

    Paleoecological data provide estimates of response rates to past climate changes. Fossil Pinus sylvestris stumps in far northern Scotland demonstrate former presence of pine trees where conventional pollen evidence of pine forests is lacking. Radiocarbon, dendrochronological, and fine temporal-resolution palynological data show that pine forest were present for about four centuries some 4,000 years ago; the forests expanded and then retreated rapidly some 70 to 80 kilometers. Despite the rapidity of this response to climate change, it occurred at rates slower by an order of magnitude than those necessary to maintain equilibrium with forecast climate changes attributed to the greenhouse effect

  6. Understanding rapid theoretical change in particle physics: a month-by-month co-citation analysis

    International Nuclear Information System (INIS)

    Sullivan, D.; Koester, D.; White, D.H.; Kern, R.

    1979-01-01

    While co-citation analysis has proved a powerful tool in the study of changes in intellectual foci in science, no one has ever used the technique to study very rapid changes in the theoretical structure of a scientific field. This paper presents month-by-month co-citation analyses of key phases in the weak-electromagnetic unification research program within particle physics, and shows that these analyses capture and illuminate very rapid intellectual changes. These data provide yet another illustration of the utility of co-citation analysis for understanding the history of science. 8 figures

  7. Rapid climate change did not cause population collapse at the end of the European Bronze Age.

    Science.gov (United States)

    Armit, Ian; Swindles, Graeme T; Becker, Katharina; Plunkett, Gill; Blaauw, Maarten

    2014-12-02

    The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological (14)C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change.

  8. Curioser and Curioser: New Concepts in the Rapidly Changing Landscape of Educational Administration.

    Science.gov (United States)

    Fowler, Frances C.

    1999-01-01

    The new "Handbook" assumes that society is changing rapidly and educational administration must change with it. This article critiques chapters on four concepts: ideology, the new consumerism, social capital, and the new institutionalism. Consumerism is pure 19th-century liberalism/individualism; social capital theory and…

  9. Climate change and health in British Columbia

    International Nuclear Information System (INIS)

    Ostry, A.; Ogborn, M.; British Columbia Univ., Vancouver, BC; Takaro, T.; Bassil, K.; Allen, D.

    2008-11-01

    This document described the models that scientists use to investigate the links between climate change and health. It then reviewed the evidence for possible impacts of climate change on human health. Most models conceptualize that climate change will affect the health of British Columbians directly through physical and biological pathways, and indirectly through complex socio-economic and environmental pathways. The direct physical and biological pathways will be the easiest to investigate, monitor and attribute to climate change, while the indirect socio-economic pathways will be more complex to investigate but will have the most impact. This document also provided guidance for a program of research and policy directions to better predict future impacts of climate change on health in BC and to enhance adaptation to these changes. The document suggested that basic research is needed to develop a made in BC model and infrastructure for climate change and health investigations. Currently, rural and remote forestry-dependent and Aboriginal communities in mountain pine infected zones are particularly vulnerable. However, it was concluded that although there is strong evidence for shifts in climate in BC, no direct evidence exists on the impact of climate change on human health in BC. refs., tabs., figs

  10. The climate change convention and human health.

    Science.gov (United States)

    Rowbotham, E J

    1995-01-01

    The United Nations Framework Convention on Climate Change, signed at Rio in June 1992, is intended to minimize climate change and its impact. Much of its text is ambiguous and it is not specifically directed to health considerations. It is, however, recognized that adverse effects of climate change on health are a concern of humankind, and health is an integral part of the Convention. The Convention includes commitments by the developed countries to reduce emissions of greenhouse gases and to increase public awareness of these commitments. The significance of the Convention in these respects is discussed critically and future developments considered.

  11. Using rapid assessment and response to operationalise physical activity strategic health communication campaigns in Tonga.

    Science.gov (United States)

    Turk, Tahir; Latu, Netina; Cocker-Palu, Elizabeth; Liavaa, Villiami; Vivili, Paul; Gloede, Sara; Simons, Allison

    2013-04-01

    The aim of the present study was to identify stakeholder and program beneficiary needs and wants in relation to a netball communication strategy in Tonga. In addition, the study aimed to more clearly identify audience segments for targeting of communication campaigns and to identify any barriers or benefits to engaging in the physical activity program. A rapid assessment and response (RAR) methodology was used. The elicitation research encompassed qualitative fieldwork approaches, including semistructured interviews with key informants and focus group discussions with program beneficiaries. Desk research of secondary data sources supported in-field findings. A number of potential barriers to behavioural compliance existed, including cultural factors, gender discrimination, socioeconomic factors, stigmatising attitudes, the threat of domestic violence, infrastructure and training issues. Factors contributing to participation in physical activity included the fun and social aspects of the sport, incentives (including career opportunities, highlighting the health benefits of the activity and the provision of religious and cultural sanctions by local leaders towards the increased physical activity of women. The consultative approach of RAR provided a more in-depth understanding of the need for greater levels of physical activity and opportunities for engagement by all stakeholders. The approach facilitated opportunities for the proposed health behaviours to be realised through the communication strategy. Essential insights for the strategy design were identified from key informants, as well as ensuring future engagement of these stakeholders into the strategy. So what? The expanded use of RAR to inform the design of social marketing interventions is a practical approach to data collection for non-communicable diseases and other health issues in developing countries. The approach allows for the rapid mobilisation of scarce resources for the implementation of more

  12. Feframing Climate Change for Environmental Health.

    Science.gov (United States)

    Weems, Caitlin; Subramaniam, Prithwi Raj

    2017-04-01

    Repeated warnings by the scientific community on the dire consequences of climate change through global warming to the ecology and sustenance of our planet have not been give appropriate attention by the U.S. public. Research has shown that climate change is responsible for catastrophic weather occurrences--such as floods, tornadoes, hurricanes, and heat waves--resulting in environmental and public health issues. The purpose of this report is to examine factors influencing public views on climate change. Theoretical and political perspectives are examined to unpack opinions held by the public in the U.S. on climate change. The Health Belief Model is used as an example to showcase the efficacy of an individual behavior change program in providing the synergy to understand climate change at the microlevel. The concept of reframing is discussed as a strategy to alter how the public views climate change.

  13. Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

    Science.gov (United States)

    Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

    2015-05-01

    Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

  14. Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China.

    Science.gov (United States)

    Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen

    2016-06-14

    With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved. © 2016 American Heart Association, Inc.

  15. Behavioral Health Services in the Changing Landscape of Private Health Plans.

    Science.gov (United States)

    Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

    2016-06-01

    Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

  16. Monitoring changes in seismic velocity related to an ongoing rapid inflation event at Okmok volcano, Alaska

    Science.gov (United States)

    Bennington, Ninfa; Haney, Matt; De Angelis, Silvio; Thurber, Clifford; Freymueller, Jeff

    2015-01-01

    Okmok is one of the most active volcanoes in the Aleutian Arc. In an effort to improve our ability to detect precursory activity leading to eruption at Okmok, we monitor a recent, and possibly ongoing, GPS-inferred rapid inflation event at the volcano using ambient noise interferometry (ANI). Applying this method, we identify changes in seismic velocity outside of Okmok’s caldera, which are related to the hydrologic cycle. Within the caldera, we observe decreases in seismic velocity that are associated with the GPS-inferred rapid inflation event. We also determine temporal changes in waveform decorrelation and show a continual increase in decorrelation rate over the time associated with the rapid inflation event. Themagnitude of relative velocity decreases and decorrelation rate increases are comparable to previous studies at Piton de la Fournaise that associate such changes with increased production of volatiles and/ormagmatic intrusion within the magma reservoir and associated opening of fractures and/or fissures. Notably, the largest decrease in relative velocity occurs along the intrastation path passing nearest to the center of the caldera. This observation, along with equal amplitude relative velocity decreases revealed via analysis of intracaldera autocorrelations, suggests that the inflation sourcemay be located approximately within the center of the caldera and represent recharge of shallow magma storage in this location. Importantly, there is a relative absence of seismicity associated with this and previous rapid inflation events at Okmok. Thus, these ANI results are the first seismic evidence of such rapid inflation at the volcano.

  17. Systems Thinking for Transformational Change in Health

    Science.gov (United States)

    Willis, Cameron D.; Best, Allan; Riley, Barbara; Herbert, Carol P.; Millar, John; Howland, David

    2014-01-01

    Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

  18. Rapid ecosystem change challenges the adaptive capacity of Local Environmental Knowledge.

    Science.gov (United States)

    Fernández-Llamazares, Álvaro; Díaz-Reviriego, Isabel; Luz, Ana C; Cabeza, Mar; Pyhälä, Aili; Reyes-García, Victoria

    2015-03-01

    The use of Local Environmental Knowledge has been considered as an important strategy for adaptive management in the face of Global Environmental Change. However, the unprecedented rates at which global change occurs may pose a challenge to the adaptive capacity of local knowledge systems. In this paper, we use the concept of the shifting baseline syndrome to examine the limits in the adaptive capacity of the local knowledge of an indigenous society facing rapid ecosystem change. We conducted semi-structured interviews regarding perceptions of change in wildlife populations and in intergenerational transmission of knowledge amongst the Tsimane', a group of hunter-gatherers of Bolivian Amazonia ( n = 300 adults in 13 villages). We found that the natural baseline against which the Tsimane' measure ecosystem changes might be shifting with every generation as a result of (a) age-related differences in the perception of change and (b) a decrease in the intergenerational sharing of environmental knowledge. Such findings suggest that local knowledge systems might not change at a rate quick enough to adapt to conditions of rapid ecosystem change, hence potentially compromising the adaptive success of the entire social-ecological system. With the current pace of Global Environmental Change, widening the gap between the temporal rates of on-going ecosystem change and the timescale needed for local knowledge systems to adjust to change, efforts to tackle the shifting baseline syndrome are urgent and critical for those who aim to use Local Environmental Knowledge as a tool for adaptive management.

  19. Rapidly changing treatment options adding burden to the management of typhoid fever

    Directory of Open Access Journals (Sweden)

    Jaspal Kaur

    2015-01-01

    Full Text Available Typhoid fever continues to be a global public health problem. It is caused by the facultative intracellular organisms Salmonella enteric serotype Typhi and Salmonella paratyphi. Antimicrobial therapy is the mainstay for treatment of typhoid fever. Chloramphenicol, ampicillin, and cotrimoxazole had been in use for decades for treating enteric fever. But the emergence and rapid spread of drug resistance has resulted in rapid shift of treatment options from chloramphenicol to fluoroquinolones to third generation cephalosporins to azithromycin with tigecycline and carbapenems in line, thus adding burden to the health-care sector in developing countries. Rational and judicious antibiotic prescribing practices by health professionals are necessary to prevent further development of drug resistance and help in re-emergence of sensitive strains.

  20. Applying Lean principles and Kaizen rapid improvement events in public health practice.

    Science.gov (United States)

    Smith, Gene; Poteat-Godwin, Annah; Harrison, Lisa Macon; Randolph, Greg D

    2012-01-01

    This case study describes a local home health and hospice agency's effort to implement Lean principles and Kaizen methodology as a rapid improvement approach to quality improvement. The agency created a cross-functional team, followed Lean Kaizen methodology, and made significant improvements in scheduling time for home health nurses that resulted in reduced operational costs, improved working conditions, and multiple organizational efficiencies.

  1. Engaging Chicago residents in climate change action: Results from Rapid Ethnographic Inquiry

    Science.gov (United States)

    Lynne M. Westphal; Jennifer. Hirsch

    2010-01-01

    Addressing climate change requires action at all levels of society, from neighborhood to international levels. Using Rapid Ethnography rooted in Asset Based Community Development theory, we investigated climate-friendly attitudes and behaviors in two Chicago neighborhoods in order to assist the City with implementation of its Climate Action Plan. Our research suggests...

  2. Computed tomographic demonstration of rapid changes in fatty infiltration of the liver

    International Nuclear Information System (INIS)

    Bashist, B.; Hecht, H.L.; Harely, W.D.

    1982-01-01

    Two alcoholic patients in whom computed tomography (CT) demonstrated reversal of fatty infiltration of the liver are described. The rapid reversibility of fatty infiltration can be useful in monitoring alcoholics with fatty livers. Focal fatty infiltration can mimic focal hepatic lesions and repeat scans can be utilized to assess changes in CT attenuation values when this condition is suspected

  3. Equity in health in unequal societies: meeting health needs in contexts of social change.

    Science.gov (United States)

    Bloom, G

    2001-09-01

    The paper explores the implications for health policy of the segmentation of society into social groups with very different levels of income and wealth. Discourses on equity in health are presently dominated by a debate between 'European' and 'American' models of health delivery. This has led to a focus on ideal outcomes rather than practical options for organising and financing health services in poor countries undergoing rapid change. The paper argues for a more explicit acknowledgement of the dynamic character of health development and the political nature of the negotiations regarding the use of government powers. Unregulated markets for health care are neither equitable nor efficient. Government must play a role in supporting the organisation of health services used by different social groups. Countries with low levels of inequality may be able to provide universal access to relatively sophisticated health services. Otherwise, governments need to operate within a segmented system. This means the negotiation of strategies to reduce the burden of sickness and premature death, whilst meeting the needs of different social groups. The discussion is organised in terms of the powers of government to require individuals and institutions to transfer resources for social uses, enforce regulations and generate and disseminate information. The paper concludes that governments committed to equity-enhancing health development need to increase their capacity to facilitate coalition building and manage change. It proposes an international public health legal framework that might include a definition of minimum standards for certain health services, to be underwritten by national and international financial commitments.

  4. Ecological public health and climate change policy.

    Science.gov (United States)

    Morris, George P

    2010-01-01

    The fact that health and disease are products of a complex interaction of factors has long been recognized in public health circles. More recently, the term 'ecological public health' has been used to characterize an era underpinned by the paradigm that, when it comes to health and well-being, 'everything matters'. The challenge for policy makers is one of navigating this complexity to deliver better health and greater equality in health. Recent work in Scotland has been concerned to develop a strategic approach to environment and health. This seeks to embrace complexity within that agenda and recognize a more subtle relationship between health and place but remain practical and relevant to a more traditional hazard-focused environmental health approach. The Good Places, Better Health initiative is underpinned by a new problem-framing approach using a conceptual model developed for that purpose. This requires consideration of a wider social, behavioural etc, context. The approach is also used to configure the core systems of the strategy which gather relevant intelligence, subject it to a process of evaluation and direct its outputs to a broad policy constituency extending beyond health and environment. This paper highlights that an approach, conceived and developed to deliver better health and greater equality in health through action on physical environment, also speaks to a wider public health agenda. Specifically it offers a way to help bridge a gap between paradigm and policy in public health. The author considers that with development, a systems-based approach with close attention to problem-framing/situational modelling may prove useful in orchestrating what is a necessarily complex policy response to mitigate and adapt to climate change.

  5. Rapid stress-induced transcriptomic changes in the brain depend on beta-adrenergic signaling.

    Science.gov (United States)

    Roszkowski, Martin; Manuella, Francesca; von Ziegler, Lukas; Durán-Pacheco, Gonzalo; Moreau, Jean-Luc; Mansuy, Isabelle M; Bohacek, Johannes

    2016-08-01

    Acute exposure to stressful experiences can rapidly increase anxiety and cause neuropsychiatric disorders. The effects of stress result in part from the release of neurotransmitters and hormones, which regulate gene expression in different brain regions. The fast neuroendocrine response to stress is largely mediated by norepinephrine (NE) and corticotropin releasing hormone (CRH), followed by a slower and more sustained release of corticosterone. While corticosterone is an important regulator of gene expression, it is not clear which stress-signals contribute to the rapid regulation of gene expression observed immediately after stress exposure. Here, we demonstrate in mice that 45 min after an acute swim stress challenge, large changes in gene expression occur across the transcriptome in the hippocampus, a region sensitive to the effects of stress. We identify multiple candidate genes that are rapidly and transiently altered in both males and females. Using a pharmacological approach, we show that most of these rapidly induced genes are regulated by NE through β-adrenergic receptor signaling. We find that CRH and corticosterone can also contribute to rapid changes in gene expression, although these effects appear to be restricted to fewer genes. These results newly reveal a widespread impact of NE on the transcriptome and identify novel genes associated with stress and adrenergic signaling. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Integrated ocean management as a strategy to meet rapid climate change: the Norwegian case.

    Science.gov (United States)

    Hoel, Alf Håkon; Olsen, Erik

    2012-02-01

    The prospects of rapid climate change and the potential existence of tipping points in marine ecosystems where nonlinear change may result from them being overstepped, raises the question of strategies for coping with ecosystem change. There is broad agreement that the combined forces of climate change, pollution and increasing economic activities necessitates more comprehensive approaches to oceans management, centering on the concept of ecosystem-based oceans management. This article addresses the Norwegian experience in introducing integrated, ecosystem-based oceans management, emphasizing how climate change, seen as a major long-term driver of change in ecosystems, is addressed in management plans. Understanding the direct effects of climate variability and change on ecosystems and indirect effects on human activities is essential for adaptive planning to be useful in the long-term management of the marine environment.

  7. Social Change and Health Policy in Venezuela

    Directory of Open Access Journals (Sweden)

    Nuramy J. Gutiérrez

    2008-07-01

    Full Text Available This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.

  8. Organisational Change, Health and the Labour Market

    DEFF Research Database (Denmark)

    Bhatti, Yosef; Gørtz, Mette; Holm Pedersen, Lene

    This research examines the effects of organisational change on employee health and labour market outcomes. Previous studies looking into organisational change in the private sector indicate that the larger the size and depth of organisational change, the larger the detrimental consequences...... to the employees. This study contributes to the literature on four main dimensions. First, we extend the analysis of organisational change to a public sector setting. Second, while previous findings remain inconclusive regarding causal effects due to problems of endogeneity, our analysis contributes to research...

  9. A bioinspired color-changing polystyrene microarray as a rapid qualitative sensor for methanol and ethanol

    International Nuclear Information System (INIS)

    Kuo, Wen-Kai; Weng, Hsueh-Ping; Hsu, Jyun-Jheng; Yu, Hsin Her

    2016-01-01

    Polystyrene (PS) microspheres were synthesized by emulsifier-free emulsion polymerization and arranged in an array of closely packed, opal-like photonic crystals by slow self-assembly through dip-coating. This periodic array of PS microspheres was then employed as a rapid qualitative sensor for methanol and ethanol. Both solvents could be detected rapidly based on the routes of their reflection coordinates in the chromaticity diagram or directly by the naked eye on the basis of the change in color within 1 min once a solvent sample had been placed on the PS photochromic sensor. This opal-like PS sensor can thus not only be employed as a rapid sensor for methanol and ethanol but can also be used as a powerful tool for the fast screening of illicit drugs and toxic chemicals during forensic investigations. - Highlights: • Opal-like array of polystyrene (PS) microspheres is synthesized by self-assembly. • This periodic PS array is used as a rapid sensor for methanol and ethanol. • Solvents are detected by routes of reflection coordinates in chromaticity diagram. • They are also detected directly by naked eye based on change in color of sensor. • The color change is irreversible for methanol but reversible for ethanol.

  10. A bioinspired color-changing polystyrene microarray as a rapid qualitative sensor for methanol and ethanol

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, Wen-Kai, E-mail: wkkuo@nfu.edu.tw [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Weng, Hsueh-Ping, E-mail: sherry.weng7949@gmail.com [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Hsu, Jyun-Jheng, E-mail: k88520x@gmail.com [Graduate Institute of Electro-Optical and Materials Science, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China); Yu, Hsin Her, E-mail: hhyu@nfu.edu.tw [Department of Biotechnology, National Formosa University, 64 Wenhua Road, Huwei, Yunlin 63208, Taiwan (China)

    2016-04-15

    Polystyrene (PS) microspheres were synthesized by emulsifier-free emulsion polymerization and arranged in an array of closely packed, opal-like photonic crystals by slow self-assembly through dip-coating. This periodic array of PS microspheres was then employed as a rapid qualitative sensor for methanol and ethanol. Both solvents could be detected rapidly based on the routes of their reflection coordinates in the chromaticity diagram or directly by the naked eye on the basis of the change in color within 1 min once a solvent sample had been placed on the PS photochromic sensor. This opal-like PS sensor can thus not only be employed as a rapid sensor for methanol and ethanol but can also be used as a powerful tool for the fast screening of illicit drugs and toxic chemicals during forensic investigations. - Highlights: • Opal-like array of polystyrene (PS) microspheres is synthesized by self-assembly. • This periodic PS array is used as a rapid sensor for methanol and ethanol. • Solvents are detected by routes of reflection coordinates in chromaticity diagram. • They are also detected directly by naked eye based on change in color of sensor. • The color change is irreversible for methanol but reversible for ethanol.

  11. Why Health Promotion Needs to Change.

    Science.gov (United States)

    Terry, Paul E

    2018-01-01

    If you ask most health professionals why they do what they do, they invariably speak of being of service. And being of service, for population health workers, becomes ever more meaningful as our work touches ever more lives. To wit, "Kaizen," a Japanese term meaning "change for better," sits shoulder to shoulder with our life's purpose. Health promotion professionals are high performers getting great results but we need to start working on our work. What would it take to increase our impact by 50%? And when we change our processes to accomplish that, what would we change next to get another 50% improvement? Only by stepping back and examining our processes can we see the time and motion required to make what's working now work better and be more accessible to more people next time.

  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. The Future of Coral Reefs Subject to Rapid Climate Change: Lessons from Natural Extreme Environments

    Directory of Open Access Journals (Sweden)

    Emma F. Camp

    2018-02-01

    Full Text Available Global climate change and localized anthropogenic stressors are driving rapid declines in coral reef health. In vitro experiments have been fundamental in providing insight into how reef organisms will potentially respond to future climates. However, such experiments are inevitably limited in their ability to reproduce the complex interactions that govern reef systems. Studies examining coral communities that already persist under naturally-occurring extreme and marginal physicochemical conditions have therefore become increasingly popular to advance ecosystem scale predictions of future reef form and function, although no single site provides a perfect analog to future reefs. Here we review the current state of knowledge that exists on the distribution of corals in marginal and extreme environments, and geographic sites at the latitudinal extremes of reef growth, as well as a variety of shallow reef systems and reef-neighboring environments (including upwelling and CO2 vent sites. We also conduct a synthesis of the abiotic data that have been collected at these systems, to provide the first collective assessment on the range of extreme conditions under which corals currently persist. We use the review and data synthesis to increase our understanding of the biological and ecological mechanisms that facilitate survival and success under sub-optimal physicochemical conditions. This comprehensive assessment can begin to: (i highlight the extent of extreme abiotic scenarios under which corals can persist, (ii explore whether there are commonalities in coral taxa able to persist in such extremes, (iii provide evidence for key mechanisms required to support survival and/or persistence under sub-optimal environmental conditions, and (iv evaluate the potential of current sub-optimal coral environments to act as potential refugia under changing environmental conditions. Such a collective approach is critical to better understand the future survival of

  14. 'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

    Science.gov (United States)

    Harper, S L; Edge, V L; Cunsolo Willox, A

    2012-03-01

    Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

  15. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Directory of Open Access Journals (Sweden)

    Yasuhiro Homma

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  16. The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

    Science.gov (United States)

    Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

    2018-03-01

    Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

  17. Rapid change of field line connectivity and reconnection in stochastic magnetic fields

    International Nuclear Information System (INIS)

    Huang, Yi-Min; Bhattacharjee, A.; Boozer, Allen H.

    2014-01-01

    Magnetic fields without a direction of continuous symmetry have the generic feature that neighboring field lines exponentiate away from each other and become stochastic, and hence the ideal constraint of preserving magnetic field line connectivity becomes exponentially sensitive to small deviations from ideal Ohm's law. The idea of breaking field line connectivity by stochasticity as a mechanism for fast reconnection is tested with numerical simulations based on reduced magnetohydrodynamics equations with a strong guide field line-tied to two perfectly conducting end plates. Starting from an ideally stable force-free equilibrium, the system is allowed to undergo resistive relaxation. Two distinct phases are found in the process of resistive relaxation. During the quasi-static phase, rapid change of field line connectivity and strong induced flow are found in regions of high field line exponentiation. However, although the field line connectivity of individual field lines can change rapidly, the overall pattern of field line mapping appears to deform gradually. From this perspective, field line exponentiation appears to cause enhanced diffusion rather than reconnection. In some cases, resistive quasi-static evolution can cause the ideally stable initial equilibrium to cross a stability threshold, leading to formation of intense current filaments and rapid change of field line mapping into a qualitatively different pattern. It is in this onset phase that the change of field line connectivity is more appropriately designated as magnetic reconnection. Our results show that rapid change of field line connectivity appears to be a necessary, but not a sufficient condition for fast reconnection.

  18. Climate Change and Developing-Country Cities: Implications For Environmental Health and Equity

    OpenAIRE

    Campbell-Lendrum, Diarmid; Corvalán, Carlos

    2007-01-01

    Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilitie...

  19. Frequent job change and associated health.

    Science.gov (United States)

    Metcalfe, Chris; Davey Smith, George; Sterne, Jonathan A C; Heslop, Pauline; Macleod, John; Hart, Carole

    2003-01-01

    The contemporary labour market is widely regarded as having become more "flexible". It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a "preview" of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.

  20. Ambient air pollution, climate change, and population health in China.

    Science.gov (United States)

    Kan, Haidong; Chen, Renjie; Tong, Shilu

    2012-07-01

    As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Changing living conditions, life style and health

    DEFF Research Database (Denmark)

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    Human health is the result of the interaction of genetic, nutritional, socio-cultural, economic, physical infrastructure and ecosystem factors. All of the individual, social, cultural and socioeconomic factors are influenced by the environment they are embedded in and by changes in this environme...

  2. Effects of high latitude protected areas on bird communities under rapid climate change.

    Science.gov (United States)

    Santangeli, Andrea; Rajasärkkä, Ari; Lehikoinen, Aleksi

    2017-06-01

    Anthropogenic climate change is rapidly becoming one of the main threats to biodiversity, along with other threats triggered by human-driven land-use change. Species are already responding to climate change by shifting their distributions polewards. This shift may create a spatial mismatch between dynamic species distributions and static protected areas (PAs). As protected areas represent one of the main pillars for preserving biodiversity today and in the future, it is important to assess their contribution in sheltering the biodiversity communities, they were designated to protect. A recent development to investigate climate-driven impacts on biological communities is represented by the community temperature index (CTI). CTI provides a measure of the relative temperature average of a community in a specific assemblage. CTI value will be higher for assemblages dominated by warm species compared with those dominated by cold-dwelling species. We here model changes in the CTI of Finnish bird assemblages, as well as changes in species densities, within and outside of PAs during the past four decades in a large boreal landscape under rapid change. We show that CTI has markedly increased over time across Finland, with this change being similar within and outside PAs and five to seven times slower than the temperature increase. Moreover, CTI has been constantly lower within than outside of PAs, and PAs still support communities, which show colder thermal index than those outside of PAs in the 1970s and 1980s. This result can be explained by the higher relative density of northern species within PAs than outside. Overall, our results provide some, albeit inconclusive, evidence that PAs may play a role in supporting the community of northern species. Results also suggest that communities are, however, shifting rapidly, both inside and outside of PAs, highlighting the need for adjusting conservation measures before it is too late. © 2016 John Wiley & Sons Ltd.

  3. [Changes necessary for continuing health reform: I. The "external" change].

    Science.gov (United States)

    Martín Martín, J; de Manuel Keenoy, E; Carmona López, G; Martínez Olmos, J

    1990-01-01

    The article analyzes the need to obtain support from all actors if the reform of the health system is to be finalized. The relevant groups are the government, professional groups, workers, the population, civil servants, managers and firms with interests in the health field. It is necessary to develop a social marketing strategy that reinforces and broadens the current supports to change. Basic elements would be: Develop new service to satisfy users' needs; orient the services to defined "market" segments; position new services or "re-position" the existing ones in order to communicate their advantages; develop a plan of marketing based on promotion, prize and place focused on the role of health professionals as the main service sellers.

  4. New type of Piezoresistive Pressure Sensors for Environments with Rapidly Changing Temperature

    Directory of Open Access Journals (Sweden)

    Tykhan Myroslav

    2017-03-01

    Full Text Available The theoretical aspects of a new type of piezo-resistive pressure sensors for environments with rapidly changing temperatures are presented. The idea is that the sensor has two identical diaphragms which have different coefficients of linear thermal expansion. Therefore, when measuring pressure in environments with variable temperature, the diaphragms will have different deflection. This difference can be used to make appropriate correction of the sensor output signal and, thus, to increase accuracy of measurement. Since physical principles of sensors operation enable fast correction of the output signal, the sensor can be used in environments with rapidly changing temperature, which is its essential advantage. The paper presents practical implementation of the proposed theoretical aspects and the results of testing the developed sensor.

  5. Changing health behaviors with social marketing.

    Science.gov (United States)

    Suarez-Almazor, M E

    2011-08-01

    Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.

  6. Environmental impacts of rapid water level changes; Miljoekonsekvenser av raske vannstandsendringer

    Energy Technology Data Exchange (ETDEWEB)

    Arnekleiv, Jo Vegar; Bakken, Tor Haakon; Bogen, Jim; Boensnes, Truls Erik; Elster, Margrethe; Harby, Atle; Kutznetsova, Yulia; Saltveit, Svein Jakob; Sauterleute, Julian; Stickler, Morten; Sundt, Haakon; Tjomsland, Torulv; Ugedal, Ola

    2012-07-01

    This report summarizes the state of knowledge of the environmental impacts of power driving and rapid water level changes and describes possible mitigation measures. The report assesses the environmental effects of possible increased power installation in Mauranger and Tonstad power plants, based on existing data and knowledge. At Straumsmo plants in Barduelva there are collected some physical data and the environmental impact of existing power driving is considered. (eb)

  7. Renewal and change for health care executives.

    Science.gov (United States)

    Burke, G C; Bice, M O

    1991-01-01

    Health care executives must consider renewal and change within their own lives if they are to breathe life into their own institutions. Yet numerous barriers to executive renewal exist, including time pressures, fatigue, cultural factors, and trustee attitudes. This essay discusses such barriers and suggests approaches that health care executives may consider for programming renewal into their careers. These include self-assessment for professional and personal goals, career or job change, process vs. outcome considerations, solitude, networking, lifelong education, surrounding oneself with change agents, business travel and sabbaticals, reading outside the field, physical exercise, mentoring, learning from failures, a sense of humor, spiritual reflection, and family and friends. Renewal is a continuous, lifelong process requiring constant learning. Individual executives would do well to develop a framework for renewal in their careers and organizations.

  8. Rapid psychological assessment of depression and its relationship with physical health among urban elderly

    OpenAIRE

    Pavithra Cheluvaraj; Mangesh Balu Nanaware; Surya Prakasa Rao

    2016-01-01

    Background Old age is associated with increased occurrence of a wide array of Psychological impairments or losses, which might contribute to physical disabilities. As Depression has been identified as the most common aberration its rapid assessment would be able to identify the quality of individual and family life of the elderly. Aims To assess psychological health status with respect to depression among geriatric urban community, and the relationship of depression with health perce...

  9. Health Rights and Equity-oriented Health System Change in ...

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

    The private sector is the largest health provider in India, and unregulated private ... and girls in the last two decades, yet gender inequality and gender-based ... View moreIWRA/IDRC webinar on climate change and adaptive water ... Socially equitable climate action is essential to strengthen the resilience of all people, ...

  10. History in health: health promotion's underexplored tool for change.

    Science.gov (United States)

    Madsen, Wendy

    2018-01-01

    This paper outlined an argument as to why history and historians should be included in a healthy settings approach. Qualitative descriptive study. A narrative review of the literature across a broad cross-section of history, health promotion and public health disciplines was undertaken. Three reasons for including history were identified relating to the social role of history as a means of analysing social memory, of changing social narratives and by raising social consciousness. This allowed for a distinction between history in health and history of health. Precedents of this social role can be found in the fields of feminist and postcolonial histories, oral history and museums in health. Reasons for why historians and health promotion practitioners and researchers have not previously had working relationships were explored, as were some of the factors that would need to be considered for such relationships to work well, including the need to recognise different languages, different understandings of the role of history, and a potential lack of awareness of the health implications of historical work. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. Observation of reversible, rapid changes in drug susceptibility of hypoxic tumor cells in a microfluidic device

    Energy Technology Data Exchange (ETDEWEB)

    Germain, Todd; Ansari, Megan; Pappas, Dimitri, E-mail: d.pappas@ttu.edu

    2016-09-14

    Hypoxia is a major stimulus for increased drug resistance and for survival of tumor cells. Work from our group and others has shown that hypoxia increases resistance to anti-cancer compounds, radiation, and other damage-pathway cytotoxic agents. In this work we utilize a microfluidic culture system capable of rapid switching of local oxygen concentrations to determine changes in drug resistance in prostate cancer cells. We observed rapid adaptation to hypoxia, with drug resistance to 2 μM staurosporine established within 30 min of hypoxia. Annexin-V/Sytox Green apoptosis assays over 9 h showed 78.0% viability, compared to 84.5% viability in control cells (normoxic cells with no staurosporine). Normoxic cells exposed to the same staurosporine concentration had a viability of 48.6% after 9 h. Hypoxia adaptation was rapid and reversible, with Hypoxic cells treated with 20% oxygen for 30 min responding to staurosporine with 51.6% viability after drug treatment for 9 h. Induction of apoptosis through the receptor-mediated pathway, which bypasses anti-apoptosis mechanisms induced by hypoxia, resulted in 39.4 ± 7% cell viability. The rapid reversibility indicates co-treatment of oxygen with anti-cancer compounds may be a potential therapeutic target. - Highlights: • Microfluidic system switches rapidly between normoxia and hypoxia (5 min). • Observation of rapid adaptation of PC3 cells to hypoxia and normoxia (30 min). • Drug susceptibility in tumor cells restored after chip switched to normoxia for 30 min.

  12. Development of flexural vibration inspection techniques to rapidly assess the structural health of rural bridge systems

    Science.gov (United States)

    Brian K. Brashaw; Robert Vatalaro; Xiping Wang; Kevin Sarvela; James P. Wacker

    2008-01-01

    Approximately 4,000 vehicle bridges in the State of Minnesota contain structural timber members. Recent research at the University of Minnesota Duluth Natural Resources Research Institute (UMD NRRI) has been conducted on vibration testing of timber bridges as a means of developing rapid in-place testing techniques for assessing the structural health of bridges. The...

  13. Time and change in health care.

    Science.gov (United States)

    Waterworth, Susan

    2017-10-02

    Purpose The purpose of this paper is to explore the dimensions of temporality that are rarely considered in the literature on leading change. Design/methodology/approach The analysis is informed by Adams' (1995) social theory of time encompassing temporality, timing and tempo. This will illustrate the complexities of time as they relate to the individual, teams and organisation. Findings This paper demonstrates the multidimensional nature of time: temporality, timing and tempo, and how each of these can contribute to our understanding of the temporal nature and complexity of change within the health system. A framework to inform much-needed research in the area of time and change is presented. Practical implications Challenging assumptions that there is only one common time, that is clock time, can provide opportunities for further discussion and understanding of how various people view time and the influence this has on leading and participating in change in health care. Originality/value There is limited literature on the temporal dimensions of change at an organisational, team and individual level. The perspective offered in this paper presents the multidimensional nature of time and the influence this has on understanding the temporal nature of change and critically identifies some key areas for future research.

  14. RAPID SPECTRAL CHANGES OF CYGNUS X-1 IN THE LOW/HARD STATE WITH SUZAKU

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, S.; Makishima, K. [Cosmic Radiation Laboratory, Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198 (Japan); Negoro, H. [Department of Physics, College of Science and Technology, Nihon University, 1-8 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8308 (Japan); Torii, S.; Noda, H. [Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Mineshige, S. [Department of Astronomy, Kyoto University, Kitashirakawa Oiwake-cho, Sakyo-ku, Kyoto 606-8502 (Japan)

    2013-04-20

    Rapid spectral changes in the hard X-ray on a timescale down to {approx}0.1 s are studied by applying a ''shot analysis'' technique to the Suzaku observations of the black hole binary Cygnus X-1, performed on 2008 April 18 during the low/hard state. We successfully obtained the shot profiles, covering 10-200 keV with the Suzaku HXD-PIN and HXD-GSO detector. It is notable that the 100-200 keV shot profile is acquired for the first time owing to the HXD-GSO detector. The intensity changes in a time-symmetric way, though the hardness changes in a time-asymmetric way. When the shot-phase-resolved spectra are quantified with the Compton model, the Compton y-parameter and the electron temperature are found to decrease gradually through the rising phase of the shot, while the optical depth appears to increase. All the parameters return to their time-averaged values immediately within 0.1 s past the shot peak. We have not only confirmed this feature previously found in energies below {approx}60 keV, but also found that the spectral change is more prominent in energies above {approx}100 keV, implying the existence of some instant mechanism for direct entropy production. We discuss possible interpretations of the rapid spectral changes in the hard X-ray band.

  15. [Developmental changes of rapid automatized naming and Hiragana reading of Japanese in elementary-school children].

    Science.gov (United States)

    Kobayashi, Tomoka; Inagaki, Masumi; Gunji, Atsuko; Yatabe, Kiyomi; Kita, Yosuke; Kaga, Makiko; Gotoh, Takaaki; Koike, Toshihide

    2011-11-01

    Two hundred and seven Japanese elementary school children aged from 6 (Grade 1) to 12 (Grade 6) years old were tested for their abilities to name numbers and pictured objects along with reading Hiragana characters and words. These children all showed typical development and their classroom teachers judged that they were not having any problems with reading or writing. The children were randomly divided into two groups, the first group was assigned to two naming tasks;the rapid automatized naming (RAN) of "numbers" and "pictured objects," the second group was assigned to two rapid alternative stimulus (RAS) naming tasks using numbers and pictured objects. All children were asked to perform two reading tasks that were written in Hiragana script: single mora reading task and four syllable word reading task. The total articulation time for naming and reading and performance in terms of accuracy were measured for each task. Developmental changes in these variables were evaluated. The articulation time was significantly longer for the first graders, and it gradually shortened as they moved through to the upper grades in all tasks. The articulation time reached a plateau in the 5th grade for the number naming, while gradual change continued after drastic change in the lower grades for the pictured object naming. The articulation times for the single mora reading and RAN of numbers correlated strongly. The articulation time for the RAS naming was significantly longer compared to that for the RAN, though there were very few errors. The RAS naming showed the highest correlation with the four syllable word reading. This study demonstrated that the performance in rapid automatized naming of numbers and pictures were closely related with performance on reading tasks. Thus Japanese children with reading disorders such as developmental dyslexia should also be evaluated for rapid automatized naming.

  16. Observation of reversible, rapid changes in drug susceptibility of hypoxic tumor cells in a microfluidic device.

    Science.gov (United States)

    Germain, Todd; Ansari, Megan; Pappas, Dimitri

    2016-09-14

    Hypoxia is a major stimulus for increased drug resistance and for survival of tumor cells. Work from our group and others has shown that hypoxia increases resistance to anti-cancer compounds, radiation, and other damage-pathway cytotoxic agents. In this work we utilize a microfluidic culture system capable of rapid switching of local oxygen concentrations to determine changes in drug resistance in prostate cancer cells. We observed rapid adaptation to hypoxia, with drug resistance to 2 μM staurosporine established within 30 min of hypoxia. Annexin-V/Sytox Green apoptosis assays over 9 h showed 78.0% viability, compared to 84.5% viability in control cells (normoxic cells with no staurosporine). Normoxic cells exposed to the same staurosporine concentration had a viability of 48.6% after 9 h. Hypoxia adaptation was rapid and reversible, with Hypoxic cells treated with 20% oxygen for 30 min responding to staurosporine with 51.6% viability after drug treatment for 9 h. Induction of apoptosis through the receptor-mediated pathway, which bypasses anti-apoptosis mechanisms induced by hypoxia, resulted in 39.4 ± 7% cell viability. The rapid reversibility indicates co-treatment of oxygen with anti-cancer compounds may be a potential therapeutic target. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. [Climate change, floods and health intervention].

    Science.gov (United States)

    Furu, Peter; Tellier, Siri; Vestergaard, Lasse S

    2017-05-15

    Climate change and variability are considered some of the biggest threats to human health in the 21st century. Extreme weather events such as floods and storms are examples of natural hazards resulting in highest number of disasters and with considerable mortality and morbidity among vulnerable communities. A coordinated, well-planned management of health interventions must be taken for timely action in the response, recovery, prevention and preparedness phases of disasters. Roles and responsibilities of international as well as national organizations and authorities are discussed.

  18. Sustaining organizational culture change in health systems.

    Science.gov (United States)

    Willis, Cameron David; Saul, Jessie; Bevan, Helen; Scheirer, Mary Ann; Best, Allan; Greenhalgh, Trisha; Mannion, Russell; Cornelissen, Evelyn; Howland, David; Jenkins, Emily; Bitz, Jennifer

    2016-01-01

    The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed leadership; promote staff engagement; create collaborative relationships; and continuously assess and learn from change. These principles interact with contextual elements such as local power distributions, pre-existing values and beliefs and readiness to engage. Mechanisms influencing how these principles sustain cultural change include activation of a shared sense of urgency and fostering flexible levels of engagement. The principles identified in this review, along with the contexts and mechanisms that influence their effectiveness, are useful domains for policy and practice leaders to explore when grappling with cultural change. These principles are sufficiently broad to allow local flexibilities in adoption and application. This is the first study to adopt a realist approach for understanding how changes in organizational culture may be sustained. Through doing so, this review highlights the broad principles by which organizational action may be organized within enabling contextual settings.

  19. Climate Change, Soils, and Human Health

    Science.gov (United States)

    Brevik, Eric C.

    2013-04-01

    According to the Intergovernmental Panel on Climate Change, global temperatures are expected to increase 1.1 to 6.4 degrees C during the 21st century and precipitation patterns will be altered by climate change (IPCC, 2007). Soils are intricately linked to the atmospheric/climate system through the carbon, nitrogen, and hydrologic cycles. Altered climate will, therefore, have an effect on soil processes and properties. Studies into the effects of climate change on soil processes and properties are still incomplete, but have revealed that climate change will impact soil organic matter dynamics including soil organisms and the multiple soil properties that are tied to organic matter, soil water, and soil erosion. The exact direction and magnitude of those impacts will be dependent on the amount of change in atmospheric gases, temperature, and precipitation amounts and patterns. Recent studies give reason to believe at least some soils may become net sources of atmospheric carbon as temperatures rise; this is particularly true of high latitude regions with permanently frozen soils. Soil erosion by both wind and water is also likely to increase. These soil changes will lead to both direct and indirect impacts on human health. Possible indirect impacts include temperature extremes, food safety and air quality issues, increased and/or expanded disease incidences, and occupational health issues. Potential direct impacts include decreased food security and increased atmospheric dust levels. However, there are still many things we need to know more about. How climate change will affect the nitrogen cycle and, in turn, how the nitrogen cycle will affect carbon sequestration in soils is a major research need, as is a better understanding of soil water-CO2 level-temperature relationships. Knowledge of the response of plants to elevated atmospheric CO2 given limitations in nutrients like nitrogen and phosphorus and how that affects soil organic matter dynamics is a critical

  20. Evolution under changing climates: climatic niche stasis despite rapid evolution in a non-native plant.

    Science.gov (United States)

    Alexander, Jake M

    2013-09-22

    A topic of great current interest is the capacity of populations to adapt genetically to rapidly changing climates, for example by evolving the timing of life-history events, but this is challenging to address experimentally. I use a plant invasion as a model system to tackle this question by combining molecular markers, a common garden experiment and climatic niche modelling. This approach reveals that non-native Lactuca serriola originates primarily from Europe, a climatic subset of its native range, with low rates of admixture from Asia. It has rapidly refilled its climatic niche in the new range, associated with the evolution of flowering phenology to produce clines along climate gradients that mirror those across the native range. Consequently, some non-native plants have evolved development times and grow under climates more extreme than those found in Europe, but not among populations from the native range as a whole. This suggests that many plant populations can adapt rapidly to changed climatic conditions that are already within the climatic niche space occupied by the species elsewhere in its range, but that evolution to conditions outside of this range is more difficult. These findings can also help to explain the prevalence of niche conservatism among non-native species.

  1. More rapid climate change promotes evolutionary rescue through selection for increased dispersal distance.

    Science.gov (United States)

    Boeye, Jeroen; Travis, Justin M J; Stoks, Robby; Bonte, Dries

    2013-02-01

    Species can either adapt to new conditions induced by climate change or shift their range in an attempt to track optimal environmental conditions. During current range shifts, species are simultaneously confronted with a second major anthropogenic disturbance, landscape fragmentation. Using individual-based models with a shifting climate window, we examine the effect of different rates of climate change on the evolution of dispersal distances through changes in the genetically determined dispersal kernel. Our results demonstrate that the rate of climate change is positively correlated to the evolved dispersal distances although too fast climate change causes the population to crash. When faced with realistic rates of climate change, greater dispersal distances evolve than those required for the population to keep track of the climate, thereby maximizing population size. Importantly, the greater dispersal distances that evolve when climate change is more rapid, induce evolutionary rescue by facilitating the population in crossing large gaps in the landscape. This could ensure population persistence in case of range shifting in fragmented landscapes. Furthermore, we highlight problems in using invasion speed as a proxy for potential range shifting abilities under climate change.

  2. Rapid area change in pitch-up manoeuvres of small perching birds.

    Science.gov (United States)

    Polet, D T; Rival, D E

    2015-10-26

    Rapid pitch-up has been highlighted as a mechanism to generate large lift and drag during landing manoeuvres. However, pitching rates had not been measured previously in perching birds, and so the direct applicability of computations and experiments to observed behaviour was not known. We measure pitch rates in a small, wild bird (the black-capped chickadee; Poecile atricapillus), and show that these rates are within the parameter range used in experiments. Pitching rates were characterized by the shape change number, a metric comparing the rate of frontal area increase to acceleration. Black-capped chickadees increase the shape change number during perching in direct proportion to their total kinetic and potential energy at the start of the manoeuvre. The linear relationship between dissipated energy and shape change number is in accordance with a simple analytical model developed for two-dimensional pitching and decelerating airfoils. Black-capped chickadees use a wing pitch-up manoeuvre during perching to dissipate energy quickly while maintaining lift and drag through rapid area change. It is suggested that similar pitch-and-decelerate manoeuvres could be used to aid in the controlled, precise landings of small manoeuvrable air vehicles.

  3. Using Rapid Ethnography to Support the Design and Implementation of Health Information Technologies.

    Science.gov (United States)

    Ackerman, Sara; Gleason, Nathaniel; Gonzales, Ralph

    2015-01-01

    Ethnography is the defining practice - and art - of anthropology. Among health information technology (IT) developers, however, ethnography remains a little used and undervalued mode of inquiry and representation. In this chapter we demonstrate that ethnography can make important contributions to the design and implementation of more user-oriented health IT devices and systems. In particular, we propose 'rapid ethnography' as a pragmatic strategy that draws on classic ethnographic methods, but emphasizes shorter periods of fieldwork and quick turnaround of findings to inform (re)design, programming and implementation efforts. Rapid ethnography is theoretically and empirically situated in science and technology studies' explorations of a) the entanglement of social and technical dimensions of technology use; b) how getting tools to 'work' requires aligning interests across a wide range of human and non-human actors; and c) the ways in which humans and technology transform each other as they interact. We provide two detailed case studies to illustrate the evolution and uses of rapid ethnography at a U.S. academic medical center. By providing deeper insights into the experiences of users, and the contexts and communities in which new tools are introduced, rapid ethnography can serve as a valuable component of Techno-Anthropology and health IT innovation.

  4. Operational research leading to rapid national policy change: tuberculosis-diabetes collaboration in India.

    Science.gov (United States)

    Kumar, A M V; Satyanarayana, S; Wilson, N C; Chadha, S S; Gupta, D; Nair, S; Zachariah, R; Kapur, A; Harries, A D

    2014-06-21

    In 2011, bi-directional screening for tuberculosis (TB) and diabetes mellitus (DM) was recommended by the World Health Organization (WHO), although how best to implement the activity was not clear. In India, with early engagement of national programme managers and all important stakeholders, a countrywide, multicentre operational research (OR) project was designed in October 2011 and completed in 2012. The results led to a rapid national policy decision to routinely screen all TB patients for DM in September 2012. The process, experience and enablers of implementing this unique and successful collaborative model of operational research are presented.

  5. Health effects of global climate change

    International Nuclear Information System (INIS)

    Ghauri, B.; Salam, M.; Mirza I.

    1992-01-01

    This paper identifies potential health problems that may arise from global climates changes caused by increasing green house gases and depletion in the ozone layer. The mankind is responsible for saving or destroying the environment. There are many forms which can pollute the environment like greenhouse activities. The greenhouse gases like carbon dioxide, methane and ozone etc. cause pollutants in the environment. (A.B.)

  6. Rapidly reversible redox transformation in nanophase manganese oxides at room temperature triggered by changes in hydration.

    Science.gov (United States)

    Birkner, Nancy; Navrotsky, Alexandra

    2014-04-29

    Chemisorption of water onto anhydrous nanophase manganese oxide surfaces promotes rapidly reversible redox phase changes as confirmed by calorimetry, X-ray diffraction, and titration for manganese average oxidation state. Surface reduction of bixbyite (Mn2O3) to hausmannite (Mn3O4) occurs in nanoparticles under conditions where no such reactions are seen or expected on grounds of bulk thermodynamics in coarse-grained materials. Additionally, transformation does not occur on nanosurfaces passivated by at least 2% coverage of what is likely an amorphous manganese oxide layer. The transformation is due to thermodynamic control arising from differences in surface energies of the two phases (Mn2O3 and Mn3O4) under wet and dry conditions. Such reversible and rapid transformation near room temperature may affect the behavior of manganese oxides in technological applications and in geologic and environmental settings.

  7. Rapid changes in gene expression direct rapid shifts in intestinal form and function in the Burmese python after feeding

    OpenAIRE

    Andrew, Audra L.; Card, Daren C.; Ruggiero, Robert P.; Schield, Drew R.; Adams, Richard H.; Pollock, David D.; Secor, Stephen M.; Castoe, Todd A.

    2015-01-01

    Snakes provide a unique and valuable model system for studying the extremes of physiological remodeling because of the ability of some species to rapidly upregulate organ form and function upon feeding. The predominant model species used to study such extreme responses has been the Burmese python because of the extreme nature of postfeeding response in this species. We analyzed the Burmese python intestine across a time series, before, during, and after feeding to understand the patterns and ...

  8. Designing Work, Family & Health Organizational Change Initiatives.

    Science.gov (United States)

    Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

    2014-01-01

    For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

  9. Rapid qualitative research methods during complex health emergencies: A systematic review of the literature.

    Science.gov (United States)

    Johnson, Ginger A; Vindrola-Padros, Cecilia

    2017-09-01

    The 2013-2016 Ebola outbreak in West Africa highlighted both the successes and limitations of social science contributions to emergency response operations. An important limitation was the rapid and effective communication of study findings. A systematic review was carried out to explore how rapid qualitative methods have been used during global heath emergencies to understand which methods are commonly used, how they are applied, and the difficulties faced by social science researchers in the field. We also asses their value and benefit for health emergencies. The review findings are used to propose recommendations for qualitative research in this context. Peer-reviewed articles and grey literature were identified through six online databases. An initial search was carried out in July 2016 and updated in February 2017. The PRISMA checklist was used to guide the reporting of methods and findings. The articles were assessed for quality using the MMAT and AACODS checklist. From an initial search yielding 1444 articles, 22 articles met the criteria for inclusion. Thirteen of the articles were qualitative studies and nine used a mixed-methods design. The purpose of the rapid studies included: the identification of causes of the outbreak, and assessment of infrastructure, control strategies, health needs and health facility use. The studies varied in duration (from 4 days to 1 month). The main limitations identified by the authors were: the low quality of the collected data, small sample sizes, and little time for cross-checking facts with other data sources to reduce bias. Rapid qualitative methods were seen as beneficial in highlighting context-specific issues that need to be addressed locally, population-level behaviors influencing health service use, and organizational challenges in response planning and implementation. Recommendations for carrying out rapid qualitative research in this context included the early designation of community leaders as a point of

  10. Exposure science in an age of rapidly changing climate: challenges and opportunities

    Science.gov (United States)

    LaKind, Judy S; Overpeck, Jonathan; Breysse, Patrick N; Backer, Lorrie; Richardson, Susan D; Sobus, Jon; Sapkota, Amir; Upperman, Crystal R; Jiang, Chengsheng; Beard, C Ben; Brunkard, J M; Bell, Jesse E; Harris, Ryan; Chretien, Jean-Paul; Peltier, Richard E; Chew, Ginger L; Blount, Benjamin C

    2016-01-01

    Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science—Exposures in an Evolving Environment—brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct “consequential science”—doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health. PMID:27485992

  11. Selected physical, biological and biogeochemical implications of a rapidly changing Arctic Marginal Ice Zone

    Science.gov (United States)

    Barber, David G.; Hop, Haakon; Mundy, Christopher J.; Else, Brent; Dmitrenko, Igor A.; Tremblay, Jean-Eric; Ehn, Jens K.; Assmy, Philipp; Daase, Malin; Candlish, Lauren M.; Rysgaard, Søren

    2015-12-01

    The Marginal Ice Zone (MIZ) of the Arctic Ocean is changing rapidly due to a warming Arctic climate with commensurate reductions in sea ice extent and thickness. This Pan-Arctic review summarizes the main changes in the Arctic ocean-sea ice-atmosphere (OSA) interface, with implications for primary- and secondary producers in the ice and the underlying water column. Changes in the Arctic MIZ were interpreted for the period 1979-2010, based on best-fit regressions for each month. Trends of increasingly open water were statistically significant for each month, with quadratic fit for August-November, illustrating particularly strong seasonal feedbacks in sea-ice formation and decay. Geographic interpretations of physical and biological changes were based on comparison of regions with significant changes in sea ice: (1) The Pacific Sector of the Arctic Ocean including the Canada Basin and the Beaufort, Chukchi and East Siberian seas; (2) The Canadian Arctic Archipelago; (3) Baffin Bay and Hudson Bay; and (4) the Barents and Kara seas. Changes in ice conditions in the Barents sea/Kara sea region appear to be primarily forced by ocean heat fluxes during winter, whereas changes in the other sectors appear to be more summer-autumn related and primarily atmospherically forced. Effects of seasonal and regional changes in OSA-system with regard to increased open water were summarized for photosynthetically available radiation, nutrient delivery to the euphotic zone, primary production of ice algae and phytoplankton, ice-associated fauna and zooplankton, and gas exchange of CO2. Changes in the physical factors varied amongst regions, and showed direct effects on organisms linked to sea ice. Zooplankton species appear to be more flexible and likely able to adapt to variability in the onset of primary production. The major changes identified for the ice-associated ecosystem are with regard to production timing and abundance or biomass of ice flora and fauna, which are related to

  12. Miles to go before we sleep: education, technology, and the changing paradigms in health information.

    Science.gov (United States)

    Cleveland, Ana D

    2011-01-01

    This lecture discusses a philosophy of educating health information professionals in a rapidly changing health care and information environment. Education for health information professionals must be based upon a solid foundation of the changing paradigms and trends in health care and health information, as well as technological advances, to produce a well-prepared information workforce to meet the demands of health-related environments. Educational programs should begin with the core principles of library and information sciences and expand in interdisciplinary collaborations. A model of the health care environment is presented to serve as a framework for developing educational programs for health information professionals. Interdisciplinary and collaborative relationships-which merge health care, library and information sciences, and other information-related disciplines-should form the basis of education for health information professionals.

  13. Specific changes in rapidly transported proteins during regeneration of the goldfish optic nerve

    International Nuclear Information System (INIS)

    Benowitz, L.I.; Shashoua, V.E.; Yoon, M.G.

    1981-01-01

    Double labeling methods were used to identify changes in the complement of proteins synthesized in the retinal ganglion cells and transported down the optic nerve during the process of axonal regeneration. Eight to 62 days after goldfish underwent a unilateral optic nerve crush, one eye was labeled with [3H]-, the other with [14C]proline. Control and regenerating optic nerves were dissected out and homogenized together after 5 hr, a time which allowed us to examine selectively membrane-bound components which migrate in the rapid phase of axoplasmic transport. Proteins from the two sides were so-purified and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Analysis of the 3H and 14C incorporation patterns along the gels revealed a radical shift away from the normal labeling spectrum during regeneration, with selective changes in labeling at particular molecular weights varying over a 3-fold range. Eight days after crushing the optic nerve, the greatest increases in labeling were seen for material with apparent molecular weights of 24,000 to 27,000, 44,000, and 210,000 daltons. These peaks declined thereafter, and on days 29 to 39, the most prominent increases were at 110,000 to 140,000 daltons. These studies indicate a continuously changing pattern in the synthesis and/or degradation of proteins that are rapidly transported down the optic nerve during regeneration and point to molecular species potential significance in the establishment of the visual map upon the brain

  14. Neurogenomics and the role of a large mutational target on rapid behavioral change.

    Science.gov (United States)

    Stanley, Craig E; Kulathinal, Rob J

    2016-11-08

    Behavior, while complex and dynamic, is among the most diverse, derived, and rapidly evolving traits in animals. The highly labile nature of heritable behavioral change is observed in such evolutionary phenomena as the emergence of converged behaviors in domesticated animals, the rapid evolution of preferences, and the routine development of ethological isolation between diverging populations and species. In fact, it is believed that nervous system development and its potential to evolve a seemingly infinite array of behavioral innovations played a major role in the successful diversification of metazoans, including our own human lineage. However, unlike other rapidly evolving functional systems such as sperm-egg interactions and immune defense, the genetic basis of rapid behavioral change remains elusive. Here we propose that the rapid divergence and widespread novelty of innate and adaptive behavior is primarily a function of its genomic architecture. Specifically, we hypothesize that the broad diversity of behavioral phenotypes present at micro- and macroevolutionary scales is promoted by a disproportionately large mutational target of neurogenic genes. We present evidence that these large neuro-behavioral targets are significant and ubiquitous in animal genomes and suggest that behavior's novelty and rapid emergence are driven by a number of factors including more selection on a larger pool of variants, a greater role of phenotypic plasticity, and/or unique molecular features present in large genes. We briefly discuss the origins of these large neurogenic genes, as they relate to the remarkable diversity of metazoan behaviors, and highlight key consequences on both behavioral traits and neurogenic disease across, respectively, evolutionary and ontogenetic time scales. Current approaches to studying the genetic mechanisms underlying rapid phenotypic change primarily focus on identifying signatures of Darwinian selection in protein-coding regions. In contrast

  15. Experiences of Families Transmitting Values in a Rapidly Changing Society: Implications for Family Therapists.

    Science.gov (United States)

    Akyil, Yudum; Prouty, Anne; Blanchard, Amy; Lyness, Kevin

    2016-06-01

    Intergenerational value transmission affects parent-child relationships and necessitates constant negotiation in families. Families with adolescents from rapidly changing societies face unique challenges in balancing the traditional collectivistic family values that promote harmony with emerging values that promote autonomy. Using modern Turkey as an example of such a culture, the authors examine the transmission process in families that hold more traditional and collectivistic values than their adolescent children. Special consideration is given to generational and cultural differences in the autonomy and relatedness dimensions. © 2015 Family Process Institute.

  16. Wiki management a revolutionary new model for a rapidly changing and collaborative world

    CERN Document Server

    Collins, Rod

    2013-01-01

    We now live in a "wiki" world where mass collaboration is not only possible-it's often the best solution. Conventional management thought assumes that command-and-control is the most effective way to organize the efforts of large numbers of people, but rapid change and increasing complexity have rendered that model obsolete. As a result, most managers today lack the skills and knowledge needed to succeed in an age when networks are proving smarter and faster than hierarchies. Designing organizations for mass collaboration demands a new and very different model-wiki management.

  17. Tropical vegetation evidence for rapid sea level changes associated with Heinrich Events

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Catalina; Dupont, Lydie M, E-mail: catalina@uni-bremen.d, E-mail: dupont@uni-bremen.d [MARUM - Centre for Marine Environmental Sciences, University of Bremen, Leobener Strasse, D-28359 Germany (Germany)

    2010-03-15

    A Cariaco Basin pollen record shows the development of tropical salt marshes during marine isotope stage 3. Rapid and abrupt expansions of salt marsh vegetation in tropical South America are associated with north Atlantic Heinrich Events stadials (HE-stadials). Intervals of salt marsh expansion have an internal structure, which consists of a recurrent alternation of species that starts with pollen increments of Chenopodiaceae, that are followed by increments of grasses, and subsequently by increments of Cyperaceae. This pattern suggests a successional process that is determined by the close relationship between sea-level and plant community dynamics. The salt tolerant Chenopodiaceae, indicate hypersaline intertidal environments, which were most likely promoted by extremely dry atmospheric conditions. Rapid sea-level rise characterizes the onset of HE-stadials, causing the continued recruitment of pioneer species, which are the only ones tolerating rapid rates of disturbance. Once sea-level rise decelerates, marsh plants are able to trap and stabilize sediments, favouring the establishment of more competitive species. These results add to the scarce knowledge on the dynamics of tropical salt marsh ecosystems, and provide independent paleoclimatic evidence on sea-level changes following Antarctic climate variability.

  18. Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action.

    Science.gov (United States)

    Bennett, Hayley; Jones, Rhys; Keating, Gay; Woodward, Alistair; Hales, Simon; Metcalfe, Scott

    2014-11-28

    Human-caused climate change poses an increasingly serious and urgent threat to health and health equity. Under all the climate projections reported in the recent Intergovernmental Panel on Climate Change assessment, New Zealand will experience direct impacts, biologically mediated impacts, and socially mediated impacts on health. These will disproportionately affect populations that already experience disadvantage and poorer health. Without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world will breach its carbon budget and may experience high levels of warming (land temperatures on average 4-7 degrees Celsius higher by 2100). This level of climate change would threaten the habitability of some parts of the world because of extreme weather, limits on working outdoors, and severely reduced food production. However, well-planned action to reduce greenhouse gas emissions could bring about substantial benefits to health, and help New Zealand tackle its costly burden of health inequity and chronic disease.

  19. Extreme Temperature Exceedances Change more Rapidly Under Future Warming in Regions of non-Gaussian Short Temperature Distribution Tails

    Science.gov (United States)

    Loikith, P. C.; Neelin, J. D.; Meyerson, J.

    2017-12-01

    Regions of shorter-than-Gaussian warm and cold side temperature distribution tails are shown to occur in spatially coherent patterns in the current climate. Under such conditions, warming may be manifested in more complex ways than if the underlying distribution were close to Gaussian. For example, under a uniform warm shift, the simplest prototype for future warming, a location with a short warm side tail would experience a greater increase in extreme warm exceedances compared to if the distribution were Gaussian. Similarly, for a location with a short cold side tail, a uniform warm shift would result in a rapid decrease in extreme cold exceedances. Both scenarios carry major societal and environmental implications including but not limited to negative impacts on human and ecosystem health, agriculture, and the economy. It is therefore important for climate models to be able to realistically reproduce short tails in simulations of historical climate in order to boost confidence in projections of future temperature extremes. Overall, climate models contributing to the fifth phase of the Coupled Model Intercomparison Project capture many of the principal observed regions of short tails. This suggests the underlying dynamics and physics occur on scales resolved by the models, and helps build confidence in model projections of extremes. Furthermore, most GCMs show more rapid changes in exceedances of extreme temperature thresholds in regions of short tails. Results therefore suggest that the shape of the tails of the underlying temperature distribution is an indicator of how rapidly a location will experience changes to extreme temperature occurrence under future warming.

  20. Wage and Benefit Changes in Response to Rising Health Insurance Costs

    OpenAIRE

    Dana Goldman; Neeraj Sood; Arleen Leibowitz

    2005-01-01

    Many companies have defined-contribution benefit plans requiring employees to pay the full cost (before taxes) of more generous health insurance choices. Research has shown that employee decisions are quite responsive to these arrangements. What is less clear is how the total compensation package changes when health insurance premiums rise. This paper examines employee compensation decisions during a three-year period when health insurance premiums were rising rapidly. The data come from a si...

  1. Changes in male reproductive health and effects of endocrine disruptors in Scandinavian countries

    Directory of Open Access Journals (Sweden)

    Toppari Jorma

    2002-01-01

    Full Text Available Male reproductive health has deteriorated in many ways during the last decades. The incidence of testicular cancer has rapidly increased in Europe and European-derived populations. Sperm concentrations have declined and sperm motility and morphology have worsened in many areas. Both adverse trends have been shown to be associated with year of birth. Older birth cohorts have better reproductive health than the younger generations. Incidences of cryptorchidism and hypospadias have also increased according to several studies. The reasons for secular trends are unknown, but the rapid pace of the change points to environmental causes. Endocrine disrupting chemicals have been hypothesized to influence male reproductive health.

  2. Relationships of working conditions, health problems and vehicle accidents in bus rapid transit (BRT) drivers.

    Science.gov (United States)

    Gómez-Ortiz, Viviola; Cendales, Boris; Useche, Sergio; Bocarejo, Juan P

    2018-04-01

    The aim of this study was to estimate accident risk rates and mental health of bus rapid transit (BRT) drivers based on psychosocial risk factors at work leading to increased stress and health problems. A cross-sectional research design utilized a self-report questionnaire completed by 524 BRT drivers. Some working conditions of BRT drivers (lack of social support from supervisors and perceived potential for risk) may partially explain Bogota's BRT drivers' involvement in road accidents. Drivers' mental health problems were associated with higher job strain, less support from co-workers, fewer rewards and greater signal conflict while driving. To prevent bus accidents, supervisory support may need to be increased. To prevent mental health problems, other interventions may be needed such as reducing demands, increasing job control, reducing amount of incoming information, simplifying current signals, making signals less contradictory, and revising rewards. © 2018 Wiley Periodicals, Inc.

  3. Rapid changes in protein phosphorylation associated with gravity perception in corn roots

    International Nuclear Information System (INIS)

    McFadden, J.J.; Poovaiah, B.W.

    1987-01-01

    A previous paper from this laboratory showed calcium- and calmodulin-dependent in vivo protein phosphorylation in corn root tips. The authors show that rapid changes in calcium-dependent protein phosphorylation are involved in light-dependent graviperception in corn root tips. Corn seedlings (Zea mays L, cv Merit) were grown in the dark for 3 d, then apical root segments were harvested in dim green light to measure in vivo protein phosphorylation. Segments were incubated with 0.5 mCi 32 P for 1 h, then immediately frozen in liquid N 2 or first treated with either 7 min light, or 7 min light plus 1 mM EGTA and 10 μM A23187. Labeled proteins were separated by 2D gel electrophoresis and detected by autoradiography. Light caused rapid and specific promotion of phosphorylation of 5 polypeptides. The increases in protein phosphorylation were reversed by treating with EGTA and A23187. The authors postulate that these changes in protein phosphorylation are an essential part of the light-dependent gravity response in Merit roots

  4. Changing health inequalities in the Nordic countries?

    Science.gov (United States)

    Lahelma, E; Lundberg, O; Manderbacka, K; Roos, E

    2001-01-01

    The Nordic countries, referring here to Denmark, Finland, Norway, and Sweden, have often been viewed as a group of countries with many features in common, such as geographical location, history, culture, religion, language, and economic and political structures. It has also been habitual to refer to a "Nordic model" of welfare states comprising a large public sector, active labour market policies, high costs for social welfare as well as high taxes, and a general commitment to social equality. Recent research suggests that much of this "Nordicness" appears to remain despite the fact that the Nordic countries have experienced quite different changes during the 1980s and 1990s. How this relates to changes in health inequalities is in the focus of this supplement.

  5. Scoping the proximal and distal dimensions of climate change on health and wellbeing.

    Science.gov (United States)

    Morris, George Paterson; Reis, Stefan; Beck, Sheila Anne; Fleming, Lora Elderkin; Adger, William Neil; Benton, Timothy Guy; Depledge, Michael Harold

    2017-12-05

    The impacts of climate on health and wellbeing occur in time and space and through a range of indirect, complicated mechanisms. This diversity of pathways has major implications for national public health planning and influence on interventions that might help to mitigate and adapt to rapidly changing environmental conditions, nationally and internationally. This paper draws upon evidence from public health and adverse impact studies across climate science, hydrology, agriculture, public health, and the social sciences. It presents a conceptual model to support decision-making by recognizing both the proximal and distal pathways from climate-induced environmental change to national health and wellbeing. The proximal and distal pathways associated with food security, migration and mobility illustrate the diverse climate change influences in different geographic locations over different timescales. We argue that greater realization and articulation of proximal and distal pathways should radically alter how climate change is addressed as a national and international public health challenge.

  6. Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

    Directory of Open Access Journals (Sweden)

    Waiswa Peter

    2010-07-01

    Full Text Available Abstract Background Many malarious countries plan to introduce artemisinin combination therapy (ACT at community level using community health workers (CHWs for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs. Methods The study was conducted in Iganga district using 10 focus group discussions (FGDs with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs. Results CMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred. Conclusion Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical

  7. Environmental health implications of global climate change

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Robert T.; Patz, Jonathan; Gubler, Duane J.; Parson, Edward A.; Vincent, James H.

    2005-07-01

    This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and - associated with all the preceding - the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem. (Author)

  8. Rapidly Assessing Changes in Bone Mineral Balance Using Natural Stable Calcium Isotopes

    Science.gov (United States)

    Morgan, J. L. L.; Gordon, G. W.; Romaniello, S. J.; Skulan, J. L.; Smith, S. M.; Anbar, A. D.

    2011-01-01

    We demonstrate that variations in the Ca isotope ratios in urine rapidly and quantitatively reflect changes in bone mineral balance. This variation occurs because bone formation depletes soft tissue of light Ca isotopes, while bone resorption releases that isotopically light Ca back into soft tissue. In a study of 12 individuals confined to bed rest, a condition known to induce bone resorption, we show that Ca isotope ratios shift in a direction consistent with net bone loss after just 7 days, long before detectible changes in bone density occur. Consistent with this interpretation, the Ca isotope variations track changes observed in N-teleopeptide, a bone resorption biomarker, while bone-specific alkaline phosphatase, a bone formation biomarker, is unchanged. Ca isotopes can in principle be used to quantify net changes in bone mass. Ca isotopes indicate an average loss of 0.62 +/- 0.16 % in bone mass over the course of this 30-day study. The Ca isotope technique should accelerate the pace of discovery of new treatments for bone disease and provide novel insights into the dynamics of bone metabolism.

  9. Monitoring Forest Change in Landscapes Under-Going Rapid Energy Development: Challenges and New Perspectives

    Directory of Open Access Journals (Sweden)

    Paul D. Pickell

    2014-07-01

    Full Text Available The accelerated development of energy resources around the world has substantially increased forest change related to oil and gas activities. In some cases, oil and gas activities are the primary catalyst of land-use change in forested landscapes. We discuss the challenges associated with characterizing ecological change related to energy resource development using North America as an exemplar. We synthesize the major impacts of energy development to forested ecosystems and offer new perspectives on how to detect and monitor anthropogenic disturbance during the Anthropocene. The disturbance of North American forests for energy development has resulted in persistent linear corridors, suppression of historical disturbance regimes, novel ecosystems, and the eradication of ecological memory. Characterizing anthropogenic disturbances using conventional patch-based disturbance measures will tend to underestimate the ecological impacts of energy development. Suitable indicators of anthropogenic impacts in forests should be derived from the integration of multi-scalar Earth observations. Relating these indicators to ecosystem condition will be a capstone in the progress toward monitoring forest change in landscapes undergoing rapid energy development.

  10. Rapid landscape change in 6th century northern Jordan: interdisciplinary geoarchaeological perspectives

    Science.gov (United States)

    Lucke, Bernhard

    2016-04-01

    Landscapes of the ancient fertile crescent are considered affected by soil degradation as result of long-term farming since the Neolithic, and impressive ruins of antiquity led to assumptions that their abandonment must have been conntected with reduced agricultural productivity. In this context, a valley fill near the site of Abila of the Decapolis in northern Jordan was apparently deposited largely during the 6th century AD, and provides evidence for a rapid and intense landscape change during the Late Byzantine period. However, an interdisciplinary case study of land use, soil development, and sediments found that the valley fill cannot be connected with large-scale soil erosion in the vicinity of the site. On the one hand, this is indicated by the distribution of soil development and archaeological material as marker of past land use activity in the past, which suggests that the best soils were and still are used intensively. On the other hand, the sediments seem to point to the occurrence of climatic extremes such as heavy floods, the occurrence of soil creep after water saturation, but also a significant shift to aridity which may have triggered socio-economic changes of subsistence strategies from agriculture to pastoralism. The dates of sediments which are available so far indicate that the climatic change seemingly occurred rapidly within approximately 100 years during the late 6th and early 7th century AD, possibly connected with the "year without sun" or 'Mystery Veil' which the Byzantine historian Procopius described in the year 536 AD. Modern analogies of the Pinatubo eruption in 1991 let it seem possible that a volcanic event, perhaps the outbreak of the Ilopango volcano, was connected with these environmental turbulences. Such events cannot be understood by isolated studies: without a broad interdisciplinary framework, single archives are prone to misinterpretation, and our understanding of the environmental history of Abila is still very limited.

  11. DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

    Science.gov (United States)

    Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

    2015-01-01

    Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

  12. 'Rapid Learning health care in oncology' - an approach towards decision support systems enabling customised radiotherapy'.

    Science.gov (United States)

    Lambin, Philippe; Roelofs, Erik; Reymen, Bart; Velazquez, Emmanuel Rios; Buijsen, Jeroen; Zegers, Catharina M L; Carvalho, Sara; Leijenaar, Ralph T H; Nalbantov, Georgi; Oberije, Cary; Scott Marshall, M; Hoebers, Frank; Troost, Esther G C; van Stiphout, Ruud G P M; van Elmpt, Wouter; van der Weijden, Trudy; Boersma, Liesbeth; Valentini, Vincenzo; Dekker, Andre

    2013-10-01

    An overview of the Rapid Learning methodology, its results, and the potential impact on radiotherapy. Rapid Learning methodology is divided into four phases. In the data phase, diverse data are collected about past patients, treatments used, and outcomes. Innovative information technologies that support semantic interoperability enable distributed learning and data sharing without additional burden on health care professionals and without the need for data to leave the hospital. In the knowledge phase, prediction models are developed for new data and treatment outcomes by applying machine learning methods to data. In the application phase, this knowledge is applied in clinical practice via novel decision support systems or via extensions of existing models such as Tumour Control Probability models. In the evaluation phase, the predictability of treatment outcomes allows the new knowledge to be evaluated by comparing predicted and actual outcomes. Personalised or tailored cancer therapy ensures not only that patients receive an optimal treatment, but also that the right resources are being used for the right patients. Rapid Learning approaches combined with evidence based medicine are expected to improve the predictability of outcome and radiotherapy is the ideal field to study the value of Rapid Learning. The next step will be to include patient preferences in the decision making. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  13. Measuring Land Change in Coastal Zone around a Rapidly Urbanized Bay.

    Science.gov (United States)

    Huang, Faming; Huang, Boqiang; Huang, Jinliang; Li, Shenghui

    2018-05-23

    Urban development is a major cause for eco-degradation in many coastal regions. Understanding urbanization dynamics and underlying driving factors is crucial for urban planning and management. Land-use dynamic degree indices and intensity analysis were used to measure land changes occurred in 1990, 2002, 2009, and 2017 in the coastal zone around Quanzhou bay, which is a rapidly urbanized bay in Southeast China. The comprehensive land-use dynamic degree and interval level intensity analysis both revealed that land change was accelerating across the three time intervals in a three-kilometer-wide zone along the coastal line (zone A), while land change was fastest during the second time interval 2002⁻2009 in a separate terrestrial area within coastal zone (zone B). Driven by urbanization, built-up gains and cropland losses were active for all time intervals in both zones. Mudflat losses were active except in the first time interval in zone A due to the intensive sea reclamation. The gain of mangrove was active while the loss of mangrove is dormant for all three intervals in zone A. Transition level analysis further revealed the similarities and differences in processes within patterns of land changes for both zones. The transition from cropland to built-up was systematically targeted and stationary while the transition from woodland to built-up was systematically avoiding transition in both zones. Built-up tended to target aquaculture for the second and third time intervals in zone A but avoid Aquaculture for all intervals in zone B. Land change in zone A was more significant than that in zone B during the second and third time intervals at three-level intensity. The application of intensity analysis can enhance our understanding of the patterns and processes in land changes and suitable land development plans in the Quanzhou bay area. This type of investigation is useful to provide information for developing sound land use policy to achieve urban sustainability in

  14. Rapid Land Cover Map Updates Using Change Detection and Robust Random Forest Classifiers

    Directory of Open Access Journals (Sweden)

    Konrad J. Wessels

    2016-10-01

    Full Text Available The paper evaluated the Landsat Automated Land Cover Update Mapping (LALCUM system designed to rapidly update a land cover map to a desired nominal year using a pre-existing reference land cover map. The system uses the Iteratively Reweighted Multivariate Alteration Detection (IRMAD to identify areas of change and no change. The system then automatically generates large amounts of training samples (n > 1 million in the no-change areas as input to an optimized Random Forest classifier. Experiments were conducted in the KwaZulu-Natal Province of South Africa using a reference land cover map from 2008, a change mask between 2008 and 2011 and Landsat ETM+ data for 2011. The entire system took 9.5 h to process. We expected that the use of the change mask would improve classification accuracy by reducing the number of mislabeled training data caused by land cover change between 2008 and 2011. However, this was not the case due to exceptional robustness of Random Forest classifier to mislabeled training samples. The system achieved an overall accuracy of 65%–67% using 22 detailed classes and 72%–74% using 12 aggregated national classes. “Water”, “Plantations”, “Plantations—clearfelled”, “Orchards—trees”, “Sugarcane”, “Built-up/dense settlement”, “Cultivation—Irrigated” and “Forest (indigenous” had user’s accuracies above 70%. Other detailed classes (e.g., “Low density settlements”, “Mines and Quarries”, and “Cultivation, subsistence, drylands” which are required for operational, provincial-scale land use planning and are usually mapped using manual image interpretation, could not be mapped using Landsat spectral data alone. However, the system was able to map the 12 national classes, at a sufficiently high level of accuracy for national scale land cover monitoring. This update approach and the highly automated, scalable LALCUM system can improve the efficiency and update rate of regional land

  15. Rapid progress or lengthy process? electronic personal health records in mental health

    Directory of Open Access Journals (Sweden)

    Denis Mike

    2011-07-01

    Full Text Available Abstract A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs.

  16. A rapid evidence review on the effectiveness of institutional health partnerships.

    Science.gov (United States)

    Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

    2015-12-14

    Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically

  17. Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion.

    Science.gov (United States)

    Baka, Zeliha Muge; Akin, Mehmet; Ucar, Faruk Izzet; Ileri, Zehra

    2015-01-01

    The aims of this study were to quantitatively evaluate the changes in arch widths and buccolingual inclinations of the posterior teeth after asymmetric rapid maxillary expansion (ARME) and to compare the measurements between the crossbite and the noncrossbite sides with cone-beam computed tomography (CBCT). From our clinic archives, we selected the CBCT records of 30 patients with unilateral skeletal crossbite (13 boys, 14.2 ± 1.3 years old; 17 girls, 13.8 ± 1.3 years old) who underwent ARME treatment. A modified acrylic bonded rapid maxillary expansion appliance including an occlusal locking mechanism was used in all patients. CBCT records had been taken before ARME treatment and after a 3-month retention period. Fourteen angular and 80 linear measurements were taken for the maxilla and the mandible. Frontally clipped CBCT images were used for the evaluation. Paired sample and independent sample t tests were used for statistical comparisons. Comparisons of the before-treatment and after-retention measurements showed that the arch widths and buccolingual inclinations of the posterior teeth increased significantly on the crossbite side of the maxilla and on the noncrossbite side of the mandible (P ARME treatment, the crossbite side of the maxilla and the noncrossbite side of the mandible were more affected than were the opposite sides. Copyright © 2015. Published by Elsevier Inc.

  18. Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain.

    Science.gov (United States)

    Demiris, G

    2016-05-20

    Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges.

  19. Portable rapid gas content measurement - an opportunity for a step change in the coal industry?

    International Nuclear Information System (INIS)

    Beamish, Basil; Kizil, Mehmet; Gu, Ming

    2013-01-01

    The last major advance in gas content measurement for coal seams was the introduction of the quick crush technique in the early 1990s. This is a laboratory test method that has proven very reliable over the years. Recent laboratory testing using a portable quick crushing device, known as the portable gas content analyser, has produced consistent gas content results for a set of core samples obtained from a single borehole that intersected four coal seams. The retained gas content values obtained for the seams show the same increasing gas content pattern and gas composition change with depth as the standard quick crush technique. Use of the portable gas content analyser provides the opportunity to produce rapid, reliable gas content measurement of coal that could be developed for assessing gas compliance cores and outburst-prone conditions at a mine site.

  20. Phase field modeling of rapid crystallization in the phase-change material AIST

    Science.gov (United States)

    Tabatabaei, Fatemeh; Boussinot, Guillaume; Spatschek, Robert; Brener, Efim A.; Apel, Markus

    2017-07-01

    We carry out phase field modeling as a continuum simulation technique in order to study rapid crystallization processes in the phase-change material AIST (Ag4In3Sb67Te26). In particular, we simulate the spatio-temporal evolution of the crystallization of a molten area of the phase-change material embedded in a layer stack. The simulation model is adapted to the experimental conditions used for recent measurements of crystallization rates by a laser pulse technique. Simulations are performed for substrate temperatures close to the melting temperature of AIST down to low temperatures when an amorphous state is involved. The design of the phase field model using the thin interface limit allows us to retrieve the two limiting regimes of interface controlled (low temperatures) and thermal transport controlled (high temperatures) dynamics. Our simulations show that, generically, the crystallization velocity presents a maximum in the intermediate regime where both the interface mobility and the thermal transport, through the molten area as well as through the layer stack, are important. Simulations reveal the complex interplay of all different contributions. This suggests that the maximum switching velocity depends not only on material properties but also on the precise design of the thin film structure into which the phase-change material is embedded.

  1. Spectroscopic sensitivity of real-time, rapidly induced phytochemical change in response to damage.

    Science.gov (United States)

    Couture, John J; Serbin, Shawn P; Townsend, Philip A

    2013-04-01

    An ecological consequence of plant-herbivore interactions is the phytochemical induction of defenses in response to insect damage. Here, we used reflectance spectroscopy to characterize the foliar induction profile of cardenolides in Asclepias syriaca in response to damage, tracked in vivo changes and examined the influence of multiple plant traits on cardenolide concentrations. Foliar cardenolide concentrations were measured at specific time points following damage to capture their induction profile. Partial least-squares regression (PLSR) modeling was employed to calibrate cardenolide concentrations to reflectance spectroscopy. In addition, subsets of plants were either repeatedly sampled to track in vivo changes or modified to reduce latex flow to damaged areas. Cardenolide concentrations and the induction profile of A. syriaca were well predicted using models derived from reflectance spectroscopy, and this held true for repeatedly sampled plants. Correlations between cardenolides and other foliar-related variables were weak or not significant. Plant modification for latex reduction inhibited an induced cardenolide response. Our findings show that reflectance spectroscopy can characterize rapid phytochemical changes in vivo. We used reflectance spectroscopy to identify the mechanisms behind the production of plant secondary metabolites, simultaneously characterizing multiple foliar constituents. In this case, cardenolide induction appears to be largely driven by enhanced latex delivery to leaves following damage. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

  2. Rapid evolution of phenology during range expansion with recent climate change.

    Science.gov (United States)

    Lustenhouwer, Nicky; Wilschut, Rutger A; Williams, Jennifer L; van der Putten, Wim H; Levine, Jonathan M

    2018-02-01

    Although climate warming is expected to make habitat beyond species' current cold range edge suitable for future colonization, this new habitat may present an array of biotic or abiotic conditions not experienced within the current range. Species' ability to shift their range with climate change may therefore depend on how populations evolve in response to such novel environmental conditions. However, due to the recent nature of thus far observed range expansions, the role of rapid adaptation during climate change migration is only beginning to be understood. Here, we evaluated evolution during the recent native range expansion of the annual plant Dittrichia graveolens, which is spreading northward in Europe from the Mediterranean region. We examined genetically based differentiation between core and edge populations in their phenology, a trait that is likely under selection with shorter growing seasons and greater seasonality at northern latitudes. In parallel common garden experiments at range edges in Switzerland and the Netherlands, we grew plants from Dutch, Swiss, and central and southern French populations. Population genetic analysis following RAD-sequencing of these populations supported the hypothesized central France origins of the Swiss and Dutch range edge populations. We found that in both common gardens, northern plants flowered up to 4 weeks earlier than southern plants. This differentiation in phenology extended from the core of the range to the Netherlands, a region only reached from central France over approximately the last 50 years. Fitness decreased as plants flowered later, supporting the hypothesized benefits of earlier flowering at the range edge. Our results suggest that native range expanding populations can rapidly adapt to novel environmental conditions in the expanded range, potentially promoting their ability to spread. © 2017 John Wiley & Sons Ltd.

  3. Net Ecosystem Exchange of CO2 with Rapidly Changing High Arctic Landscapes

    Science.gov (United States)

    Emmerton, C. A.

    2015-12-01

    High Arctic landscapes are expansive and changing rapidly. However our understanding of their functional responses and potential to mitigate or enhance anthropogenic climate change is limited by few measurements. We collected eddy covariance measurements to quantify the net ecosystem exchange (NEE) of CO2 with polar semidesert and meadow wetland landscapes at the highest-latitude location measured to date (82°N). We coupled these rare data with ground and satellite vegetation production measurements (Normalized Difference Vegetation Index; NDVI) to evaluate the effectiveness of upscaling local to regional NEE. During the growing season, the dry polar semidesert landscape was a near zero sink of atmospheric CO2 (NEE: -0.3±13.5 g C m-2). A nearby meadow wetland accumulated over two magnitudes more carbon (NEE: -79.3±20.0 g C m-2) than the polar semidesert landscape, and was similar to meadow wetland NEE at much more southern latitudes. Polar semidesert NEE was most influenced by moisture, with wetter surface soils resulting in greater soil respiration and CO2 emissions. At the meadow wetland, soil heating enhanced plant growth, which in turn increased CO2 uptake. Our upscaling assessment found that polar semidesert NDVI measured on site was low (mean: 0.120-0.157) and similar to satellite measurements (mean: 0.155-0.163). However, weak plant growth resulted in poor satellite NDVI-NEE relationships and created challenges for remotely-detecting changes in the cycling of carbon on the polar semidesert landscape. The meadow wetland appeared more suitable to assess plant production and NEE via remote-sensing, however high Arctic wetland extent is constrained by topography to small areas that may be difficult to resolve with large satellite pixels. We predict that until summer precipitation and humidity increases substantially, climate-related changes of dry high Arctic landscapes may be restricted by poor soil moisture retention, and therefore have some inertia against

  4. Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

    Science.gov (United States)

    Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

    2013-06-13

    China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

  5. Dental Education Required for the Changing Health Care Environment.

    Science.gov (United States)

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  6. Changing planet, changing health: how the climate crisis threatens our health and what we can do about it

    National Research Council Canada - National Science Library

    Epstein, Paul R; Ferber, Dan

    2011-01-01

    .... Brilliantly connecting stories of real people with cutting-edge scientific and medical information, Changing Planet, Changing Health brings us to places like Mozambique, Honduras, and the United...

  7. Global environmental change: what can health care providers and the environmental health community do about it now?

    Science.gov (United States)

    Schwartz, Brian S; Parker, Cindy; Glass, Thomas A; Hu, Howard

    2006-12-01

    The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.

  8. Rapid spread of complex change: a case study in inpatient palliative care

    Directory of Open Access Journals (Sweden)

    Filipski Marta I

    2009-12-01

    Full Text Available Abstract Background Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC. Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Methods Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Results Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. Conclusions A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

  9. A decade of rapid change: Biocultural influences on child growth in highland Peru.

    Science.gov (United States)

    Oths, Kathryn S; Smith, Hannah N; Stein, Max J; Lazo Landivar, Rodrigo J

    2018-03-01

    In the past decade many areas of Peru have been undergoing extreme environmental, economic, and cultural change. In the highland hamlet of Chugurpampa, La Libertad, climate change has ruined harvests and led to frequent periods of migration to the coast in search of livelihood. This biocultural research examines how the changes could be affecting the growth of children who maintain residence in the highlands. Clinical records from the early 2000s were compared to those from the early 2010s. Charts were randomly selected to record anthropometric data, netting a sample of 75 children ages 0-60 months of age. Analysis of covariance was run to compare mean stature, weight, and BMI between cohorts. Percentage of children who fall below the -2 threshold for z-scores for height and weight were compared by age and cohort. A significant secular trend in growth was found, with children born more recently larger than those born a decade before. The effect is most notable in the first year of life, with the growth advantage attenuated by the age of 3 for height and age 4 for weight. While children were unlikely to be stunted from 0 to 3 years of age, 44% of the later cohort were stunted and 11% were underweight from 4 to 5 years of age. Three possible explanations for the rapid shift are entertained: more time spent on the coast during gestation and early childhood, which may attenuate the effect of hypoxia on child growth; dietary change; and increased use of biomedicine. © 2017 Wiley Periodicals, Inc.

  10. Rapid changes in the level of Kluane Lake in Yukon Territory over the last millennium

    Science.gov (United States)

    Clague, John J.; Luckman, Brian H.; Van Dorp, Richard D.; Gilbert, Robert; Froese, Duane; Jensen, Britta J. L.; Reyes, Alberto V.

    2006-09-01

    The level of Kluane Lake, the largest lake in Yukon Territory, was lower than at present during most of the Holocene. The lake rose rapidly in the late seventeenth century to a level 12 m above present, drowning forest and stranding driftwood on a conspicuous high-stand beach, remnants of which are preserved at the south end of the lake. Kluane Lake fell back to near its present level by the end of the eighteenth century and has fluctuated within a range of about 3 m over the last 50 yr. The primary control on historic fluctuations in lake level is the discharge of Slims River, the largest source of water to the lake. We use tree ring and radiocarbon ages, stratigraphy and sub-bottom acoustic data to evaluate two explanations for the dramatic changes in the level of Kluane Lake. Our data support the hypothesis of Hugh Bostock, who suggested in 1969 that the maximum Little Ice Age advance of Kaskawulsh Glacier deposited large amounts of sediment in the Slims River valley and established the present course of Slims River into Kluane Lake. Bostock argued that these events caused the lake to rise and eventually overflow to the north. The overflowing waters incised the Duke River fan at the north end of Kluane Lake and lowered the lake to its present level. This study highlights the potentially dramatic impacts of climate change on regional hydrology during the Little Ice Age in glacierised mountains.

  11. A Behavior Change Framework of Health Socialization and Identity

    Science.gov (United States)

    Stanley, Christopher T.; Stanley, Lauren H. K.

    2017-01-01

    An individual's identity related to health is critically important in terms of the adoption and maintenance of health behaviors, and guides approaches to health change across the lifespan. This article presents a review of the literature and proposes a health socialization and health identity framework, which may be used to clarify challenges in…

  12. A new oxidation flow reactor for measuring secondary aerosol formation of rapidly changing emission sources

    Science.gov (United States)

    Simonen, Pauli; Saukko, Erkka; Karjalainen, Panu; Timonen, Hilkka; Bloss, Matthew; Aakko-Saksa, Päivi; Rönkkö, Topi; Keskinen, Jorma; Dal Maso, Miikka

    2017-04-01

    Oxidation flow reactors (OFRs) or environmental chambers can be used to estimate secondary aerosol formation potential of different emission sources. Emissions from anthropogenic sources, such as vehicles, often vary on short timescales. For example, to identify the vehicle driving conditions that lead to high potential secondary aerosol emissions, rapid oxidation of exhaust is needed. However, the residence times in environmental chambers and in most oxidation flow reactors are too long to study these transient effects ( ˜ 100 s in flow reactors and several hours in environmental chambers). Here, we present a new oxidation flow reactor, TSAR (TUT Secondary Aerosol Reactor), which has a short residence time ( ˜ 40 s) and near-laminar flow conditions. These improvements are achieved by reducing the reactor radius and volume. This allows studying, for example, the effect of vehicle driving conditions on the secondary aerosol formation potential of the exhaust. We show that the flow pattern in TSAR is nearly laminar and particle losses are negligible. The secondary organic aerosol (SOA) produced in TSAR has a similar mass spectrum to the SOA produced in the state-of-the-art reactor, PAM (potential aerosol mass). Both reactors produce the same amount of mass, but TSAR has a higher time resolution. We also show that TSAR is capable of measuring the secondary aerosol formation potential of a vehicle during a transient driving cycle and that the fast response of TSAR reveals how different driving conditions affect the amount of formed secondary aerosol. Thus, TSAR can be used to study rapidly changing emission sources, especially the vehicular emissions during transient driving.

  13. Rapid changes in water hardness and alkalinity: Calcite formation is lethal to Daphnia magna.

    Science.gov (United States)

    Bogart, Sarah J; Woodman, Samuel; Steinkey, Dylan; Meays, Cindy; Pyle, Greg G

    2016-07-15

    There is growing concern that freshwater ecosystems may be negatively affected by ever-increasing anthropogenic inputs of extremely hard, highly alkaline effluent containing large quantities of Ca(2+), Mg(2+), CO3(2-), and HCO3(-) ions. In this study, the toxicity of rapid and extreme shifts in water hardness (38-600mg/L as CaCO3) and alkalinity (30-420mg/L as CaCO3) to Daphnia magna was tested, both independently and in combination. Within these ranges, where no precipitation event occurred, shifts in water hardness and/or alkalinity were not toxic to D. magna. In contrast, 98-100% of D. magna died within 96h after exposure to 600mg/L as CaCO3 water hardness and 420mg/L as CaCO3 alkalinity (LT50 of 60h with a 95% CI of 54.2-66.0h). In this treatment, a CaCO3 (calcite) precipitate formed in the water column which was ingested by and thoroughly coated the D. magna. Calcite collected from a mining impacted stream contained embedded organisms, suggesting field streams may also experience similar conditions and possibly increased mortality as observed in the lab tests. Although further investigation is required to determine the exact fate of aquatic organisms exposed to rapid calcite precipitation in the field, we caution that negative effects may occur more quickly or at lower concentrations of water hardness and alkalinity in which we observed effects in D. magna, because some species, such as aquatic insects, are more sensitive than cladocerans to changes in ionic strength. Our results provide evidence that both calcite precipitation and the major ion balance of waters should be managed in industrially affected ecosystems and we support the development of a hardness+alkalinity guideline for the protection of aquatic life. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  14. Scaling up success to improve health: Towards a rapid assessment guide for decision makers

    Directory of Open Access Journals (Sweden)

    Jason Paltzer

    2015-01-01

    Full Text Available Introduction Evidence-based health interventions exist and are effectively implemented throughout resource-limited settings. The literature regarding scale-up strategies and frameworks is growing. The purpose of this paper is to identify and systematically document the variation in scale-up strategies to develop a rapid assessment tool for decision-makers looking to identify the most appropriate strategy for their organizational and environmental contexts. Methods A list of scale-up strategies and frameworks were identified through an in-depth literature review and conversations with scale-up and quality improvement leaders. The literature search included a broad range of terms that might be used interchangeably with scale-up of best practices. Terms included: implementation research, knowledge translation, translational research, quality improvement research, health systems improvement, scale-up, best practices, improvement collaborative, and community based research. Based on this research, 18 strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related strategies. We interviewed the key contact for four of the nine strategies to obtain additional information regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that facilitate or hinder the strategy’s success in scaling up health-related interventions were identified. Results Common features of scale-up strategies include: 1 the development of context-specific evidence; 2 collaborative partnerships; 3 iterative processes; and 4 shared decision-making. Facilitating factors include strong leadership, community engagement, communication, government collaboration, and a focus on

  15. Measuring Land Change in Coastal Zone around a Rapidly Urbanized Bay

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    Faming Huang

    2018-05-01

    Full Text Available Urban development is a major cause for eco-degradation in many coastal regions. Understanding urbanization dynamics and underlying driving factors is crucial for urban planning and management. Land-use dynamic degree indices and intensity analysis were used to measure land changes occurred in 1990, 2002, 2009, and 2017 in the coastal zone around Quanzhou bay, which is a rapidly urbanized bay in Southeast China. The comprehensive land-use dynamic degree and interval level intensity analysis both revealed that land change was accelerating across the three time intervals in a three-kilometer-wide zone along the coastal line (zone A, while land change was fastest during the second time interval 2002–2009 in a separate terrestrial area within coastal zone (zone B. Driven by urbanization, built-up gains and cropland losses were active for all time intervals in both zones. Mudflat losses were active except in the first time interval in zone A due to the intensive sea reclamation. The gain of mangrove was active while the loss of mangrove is dormant for all three intervals in zone A. Transition level analysis further revealed the similarities and differences in processes within patterns of land changes for both zones. The transition from cropland to built-up was systematically targeted and stationary while the transition from woodland to built-up was systematically avoiding transition in both zones. Built-up tended to target aquaculture for the second and third time intervals in zone A but avoid Aquaculture for all intervals in zone B. Land change in zone A was more significant than that in zone B during the second and third time intervals at three-level intensity. The application of intensity analysis can enhance our understanding of the patterns and processes in land changes and suitable land development plans in the Quanzhou bay area. This type of investigation is useful to provide information for developing sound land use policy to achieve urban

  16. Cumulative effects of rapid climate and land-use changes on the Yamal Peninsula, Russia

    Science.gov (United States)

    Walker, D. A.; Leibman, M. O.; Forbes, B. C.; Epstein, H. E.

    2008-12-01

    Our principal goal is to develop better, more far-looking tools to predict the cumulative effects of resource development, climate-change, and traditional land use. Here we use remote sensing, climate-change analyses, socio-economic analyses, and vegetation-change models to examine the cumulative effects of climate change, gas development, and reindeer herding on the Yamal Peninsula in northwest Siberia as part of the Northern Eurasia Earth Science Partnership Initiative (NEESPI). We find: 1. Direct (planned) impacts of industrial activities on the Yamal Peninsula are currently local and limited in extent, but this is changing rapidly as extensive gas fields are developed and land and sea transportation corridors are developed to get the gas to market. Indirect impacts of the development at Bovanenkovo, the largest gas field, exceed the direct impacts by a factor of three, and the total area of influence of the development on the reindeer pasturelands (e.g., area where migration routes and access to pasturelands is affected) exceeds the direct impacts by a factor of about 40. 2. The trend in land-surface temperatures has co-varied with the trend in sea-ice. Low sea ice in the preceding December-March period is correlated to warmer land temperature the following summer. The sea- ice trends in the Kara Sea-Yamal region are tied to variation in the North Atlantic Oscillation index. 4. Only a small greening response to warming has been detected on the Yamal in comparison with some other areas in the Arctic (e.g. Northern Alaska). The actual effects of climate-change on vegetation are currently hard to document at the ground level because of lack of baseline and long-term ground observations and difficulty of excluding reindeer in these studies. 5. There is high potential for extensive landscape effects due to unstable sandy soils, and extremely ice-rich permafrost near the surface on slopes. 6. Two different vegetation modeling approaches are being used to predict

  17. Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?

    Science.gov (United States)

    Schwartz, Brian S.; Parker, Cindy; Glass, Thomas A.; Hu, Howard

    2006-01-01

    The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations. PMID:17185267

  18. Rapid psychological assessment of depression and its relationship with physical health among urban elderly

    Directory of Open Access Journals (Sweden)

    Pavithra Cheluvaraj

    2016-07-01

    Full Text Available Background Old age is associated with increased occurrence of a wide array of Psychological impairments or losses, which might contribute to physical disabilities. As Depression has been identified as the most common aberration its rapid assessment would be able to identify the quality of individual and family life of the elderly. Aims To assess psychological health status with respect to depression among geriatric urban community, and the relationship of depression with health perception and physical health status has been explored. Methods A cross-sectional total geriatric population survey consisting of 254 elderly has been carried out at urban field practice area. A standard geriatric depression scale (Short form has been utilized to assess psychological status. Detailed physical examination and investigations with special reference to Diabetes, Hypertension and Visual defects was carried out. Data was analyzed to find out the relationship of various socio-demographic factors, physical morbidities with depression. Results Out of 254 elderly examined, 32 per cent females and 23 per cent males were found to be suffering from depressive disorders. When assessed for individual health status perception, 25 per cent felt to have good health. Out of 190 geriatric subjects perceiving fair to bad health, 110 were found to be suffering from depression (p<0.001. Depression was also found to be associated with history of hospital admission in the previous year (p<0.05, low vision (p<0.05, diabetes (p<0.01 and hypertension (p<0.01. Conclusion Depression among geriatric age group is associated with physical illness and perception of health.

  19. Microradiometers Reveal Ocean Health, Climate Change

    Science.gov (United States)

    2013-01-01

    When NASA researcher Stanford Hooker is in the field, he pays close attention to color. For Hooker, being in the field means being at sea. On one such research trip to the frigid waters of the Arctic, with a Coast Guard icebreaker looming nearby and the snow-crusted ice shelf a few feet away, Hooker leaned over the edge of his small boat and lowered a tethered device into the bright turquoise water, a new product devised by a NASA partner and enabled by a promising technology for oceanographers and atmospheric scientists alike. Color is a function of light. Pure water is clear, but the variation in color observed during a visit to the beach or a flight along a coastline depends on the water s depth and the constituents in it, how far down the light penetrates and how it is absorbed and scattered by dissolved and suspended material. Hooker cares about ocean color because of what it can reveal about the health of the ocean, and in turn, the health of our planet. "The main thing we are interested in is the productivity of the water," Hooker says. The seawater contains phytoplankton, microscopic plants, which are the food base for the ocean s ecosystems. Changes in the water s properties, whether due to natural seasonal effects or human influence, can lead to problems for delicate ecosystems such as coral reefs. Ocean color can inform researchers about the quantities and distribution of phytoplankton and other materials, providing clues as to how the world ocean is changing. NASA s Coastal Zone Color Scanner, launched in 1978, was the first ocean color instrument flown on a spacecraft. Since then, the Agency s ocean color research capabilities have become increasingly sophisticated with the launch of the SeaWiFS instrument in 1997 and the twin MODIS instruments carried into orbit on NASA s Terra (1999) and Aqua (2002) satellites. The technology provides sweeping, global information on ocean color on a scale unattainable by any other means. One issue that arises from

  20. Europe's Southeastern Gateway: Responding to Rapidly Changing Patterns of World Shipping. The University's Role

    Directory of Open Access Journals (Sweden)

    Roger E. HAMLIN

    2012-12-01

    Full Text Available World trade and transportation are changing dramatically. Energy prices and transport sustainability concerns are reinvigorating ocean freighter shipping. An ever-increasing portion of trade is in containers, and container ships are getting larger quickly. Many ports, nations and continents are not keeping up with ship size increases putting them at a trade disadvantage. Major canals and seaways must also upgrade or be rendered obsolete, causing a change in the pattern of world trade. Ports have to do more than expand vessel size limits. Port regions must also invest in infrastructure that improves multi-modal access to the port and augments hand-off of containers to smaller seaway ships, trains and trucks. With heightened security and evolving emphasis on flexible and efficient logistics, ports must become high-tech logistics hubs with improved real-time data about port throughput. Constanţa, Romania provides an example of an attempt to respond to this rapid change. Near the Danube Delta, on the Black Sea, Constanţa offers a potential southeastern gateway to Europe for the Black Sea, the Eastern Mediterranean and beyond. Ships from Asia, entering via the Suez Canal can easily access Constanţa, and thus save more than ten days of shipping time for destinations in southeastern Europe compared to shipping through Rotterdam or Hamburg. But Constanţa needs to make all the improvements mentioned above. Universities have several roles in this endeavor, including identifying and forecasting trends, providing the technical knowledge to develop high-tech logistics hubs, pursing publicprivate partnerships for infrastructure development and offering training.

  1. Rapid Environmental Change Drives Increased Land Use by an Arctic Marine Predator.

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    Todd C Atwood

    Full Text Available In the Arctic Ocean's southern Beaufort Sea (SB, the length of the sea ice melt season (i.e., period between the onset of sea ice break-up in summer and freeze-up in fall has increased substantially since the late 1990s. Historically, polar bears (Ursus maritimus of the SB have mostly remained on the sea ice year-round (except for those that came ashore to den, but recent changes in the extent and phenology of sea ice habitat have coincided with evidence that use of terrestrial habitat is increasing. We characterized the spatial behavior of polar bears spending summer and fall on land along Alaska's north coast to better understand the nexus between rapid environmental change and increased use of terrestrial habitat. We found that the percentage of radiocollared adult females from the SB subpopulation coming ashore has tripled over 15 years. Moreover, we detected trends of earlier arrival on shore, increased length of stay, and later departure back to sea ice, all of which were related to declines in the availability of sea ice habitat over the continental shelf and changes to sea ice phenology. Since the late 1990s, the mean duration of the open-water season in the SB increased by 36 days, and the mean length of stay on shore increased by 31 days. While on shore, the distribution of polar bears was influenced by the availability of scavenge subsidies in the form of subsistence-harvested bowhead whale (Balaena mysticetus remains aggregated at sites along the coast. The declining spatio-temporal availability of sea ice habitat and increased availability of human-provisioned resources are likely to result in increased use of land. Increased residency on land is cause for concern given that, while there, bears may be exposed to a greater array of risk factors including those associated with increased human activities.

  2. Dynamic Performance of Maximum Power Point Trackers in TEG Systems Under Rapidly Changing Temperature Conditions

    Science.gov (United States)

    Man, E. A.; Sera, D.; Mathe, L.; Schaltz, E.; Rosendahl, L.

    2016-03-01

    Characterization of thermoelectric generators (TEG) is widely discussed and equipment has been built that can perform such analysis. One method is often used to perform such characterization: constant temperature with variable thermal power input. Maximum power point tracking (MPPT) methods for TEG systems are mostly tested under steady-state conditions for different constant input temperatures. However, for most TEG applications, the input temperature gradient changes, exposing the MPPT to variable tracking conditions. An example is the exhaust pipe on hybrid vehicles, for which, because of the intermittent operation of the internal combustion engine, the TEG and its MPPT controller are exposed to a cyclic temperature profile. Furthermore, there are no guidelines on how fast the MPPT must be under such dynamic conditions. In the work discussed in this paper, temperature gradients for TEG integrated in several applications were evaluated; the results showed temperature variation up to 5°C/s for TEG systems. Electrical characterization of a calcium-manganese oxide TEG was performed at steady-state for different input temperatures and a maximum temperature of 401°C. By using electrical data from characterization of the oxide module, a solar array simulator was emulated to perform as a TEG. A trapezoidal temperature profile with different gradients was used on the TEG simulator to evaluate the dynamic MPPT efficiency. It is known that the perturb and observe (P&O) algorithm may have difficulty accurately tracking under rapidly changing conditions. To solve this problem, a compromise must be found between the magnitude of the increment and the sampling frequency of the control algorithm. The standard P&O performance was evaluated experimentally by using different temperature gradients for different MPPT sampling frequencies, and efficiency values are provided for all cases. The results showed that a tracking speed of 2.5 Hz can be successfully implemented on a TEG

  3. DNA microarray unravels rapid changes in transcriptome of MK-801 treated rat brain

    Science.gov (United States)

    Kobayashi, Yuka; Kulikova, Sofya P; Shibato, Junko; Rakwal, Randeep; Satoh, Hiroyuki; Pinault, Didier; Masuo, Yoshinori

    2015-01-01

    AIM: To investigate the impact of MK-801 on gene expression patterns genome wide in rat brain regions. METHODS: Rats were treated with an intraperitoneal injection of MK-801 [0.08 (low-dose) and 0.16 (high-dose) mg/kg] or NaCl (vehicle control). In a first series of experiment, the frontoparietal electrocorticogram was recorded 15 min before and 60 min after injection. In a second series of experiments, the whole brain of each animal was rapidly removed at 40 min post-injection, and different regions were separated: amygdala, cerebral cortex, hippocampus, hypothalamus, midbrain and ventral striatum on ice followed by DNA microarray (4 × 44 K whole rat genome chip) analysis. RESULTS: Spectral analysis revealed that a single systemic injection of MK-801 significantly and selectively augmented the power of baseline gamma frequency (30-80 Hz) oscillations in the frontoparietal electroencephalogram. DNA microarray analysis showed the largest number (up- and down- regulations) of gene expressions in the cerebral cortex (378), midbrain (376), hippocampus (375), ventral striatum (353), amygdala (301), and hypothalamus (201) under low-dose (0.08 mg/kg) of MK-801. Under high-dose (0.16 mg/kg), ventral striatum (811) showed the largest number of gene expression changes. Gene expression changes were functionally categorized to reveal expression of genes and function varies with each brain region. CONCLUSION: Acute MK-801 treatment increases synchrony of baseline gamma oscillations, and causes very early changes in gene expressions in six individual rat brain regions, a first report. PMID:26629322

  4. Climate change and health ? what?s the problem?

    OpenAIRE

    Anstey, Matthew HR

    2013-01-01

    The scientific consensus is that global warming is occurring and is largely the result of greenhouse gas emissions from human activity. This paper examines the health implications of global warming, the current socio-political attitudes towards action on climate change and highlight the health co-benefits of reducing greenhouse gas emissions. In addition, policy development for climate change and health should embrace health systems strengthening, commencing by incorporating climate change ta...

  5. Three dimensional evaluation of alveolar bone changes in response to different rapid palatal expansion activation rates

    Directory of Open Access Journals (Sweden)

    Brian LaBlonde

    Full Text Available ABSTRACT Introduction: The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. Methods: The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group. Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. Results: RPE activation rates of 0.5 mm per day (Group 1 and 0.8 mm per day (Group 2 caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01. Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01. Conclusion: Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day.

  6. Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study

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    Ivor M D′Souza

    2015-01-01

    Full Text Available Introduction: Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation between transverse expansion and changes in the arch perimeter, arch width and arch length. Methods: For this purpose, 10 subjects (five males, five females were selected who had been treated by rapid maxillary expansion (RME using hyrax rapid palatal expander followed by fixed mechanotherapy (PEA. Pretreatment (T1, postexpansion (T2, and posttreatment (T3 dental models were compared for dental changes brought about by RME treatment and its stability at the end of fixed mechanotherapy. After model measurements were made, the changes between T1-T2, T2-T3 and T1-T3 were determined for each patient. The mean difference between T1-T2, T2-T3 and T1-T3 were compared to assess the effects of RME on dental arch measurements. Results are expressed as mean ± standard deviation and are compared by repeated measures analysis of variance followed by a post-hoc test. Arch perimeter changes are correlated with changes in arch widths at the canine, premolar and molar

  7. Organizing and managing care in a changing health system.

    Science.gov (United States)

    Kohn, L T

    2000-04-01

    To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

  8. Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2006-08-01

    Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

  9. How to change environmental conditions for health.

    Science.gov (United States)

    Commers, Matthew J; Gottlieb, Nell; Kok, Gerjo

    2007-03-01

    Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because environments are the complex systems through which people are both empowered and exercise their empowerment. If public-health professionals are to play a significant role in influencing environments for health, they need analytical instruments that enable them to link specific environmental conditions with the actions necessary to improve them. These instruments must also enable public-health professionals to identify points of leverage for stimulating key actors to take the actions necessary to make environments more promoting of health. This article first presents one such analytical instrument. Then, building on examples relating to socio-economic health inequities, the analytical instrument is applied to reveal how it can add value to health professionals' effectiveness in planning interventions for more health-promoting environments.

  10. A multiple-proxy approach to understanding rapid Holocene climate change in Southeast Greenland

    Science.gov (United States)

    Davin, S. H.; Bradley, R. S.; Balascio, N. L.; de Wet, G.

    2012-12-01

    The susceptibility of the Arctic to climate change has made it an excellent workshop for paleoclimatological research. Although there have been previous studies concerning climate variability carried out in the Arctic, there remains a critical dearth of knowledge due the limited number of high-resolution Holocene climate-proxy records available from this region. This gap skews our understanding of observed and predicted climate change, and fuels uncertainty both in the realms of science and policy. This study takes a comprehensive approach to tracking Holocene climate variability in the vicinity of Tasiilaq, Southeast Greenland using a ~5.6 m sediment core from Lower Sermilik Lake. An age-depth model for the core has been established using 8 radiocarbon dates, the oldest of which was taken at 4 m down core and has been been dated to approximately 6.2 kyr BP. The bottom meter of the core below the final radiocarbon date contains a transition from cobbles and coarse sand to organic-rich laminations, indicating the termination of direct glacial influence and therefore likely marking the end of the last glacial period in this region. The remainder of the core is similarly organic-rich, with light-to-dark brown laminations ranging from 0.5 -1 cm in thickness and riddled with turbidites. Using this core in tandem with findings from an on-site assessment of the geomorphic history of the locale we attempt to assess and infer the rapid climatic shifts associated with the Holocene on a sub-centennial scale. Such changes include the termination of the last glacial period, the Mid-Holocene Climatic Optimum, the Neoglacial Period, the Medieval Climatic Optimum, and the Little Ice Age. A multiple proxy approach including magnetic susceptibility, bulk organic geochemistry, elemental profiles acquired by XRF scanning, grain-size, and spectral data will be used to characterize the sediment and infer paleoclimate conditions. Additionally, percent biogenic silica by weight has been

  11. Rapid changes in genetic architecture of behavioural syndromes following colonization of a novel environment.

    Science.gov (United States)

    Karlsson Green, K; Eroukhmanoff, F; Harris, S; Pettersson, L B; Svensson, E I

    2016-01-01

    Behavioural syndromes, that is correlated behaviours, may be a result from adaptive correlational selection, but in a new environmental setting, the trait correlation might act as an evolutionary constraint. However, knowledge about the quantitative genetic basis of behavioural syndromes, and the stability and evolvability of genetic correlations under different ecological conditions, is limited. We investigated the quantitative genetic basis of correlated behaviours in the freshwater isopod Asellus aquaticus. In some Swedish lakes, A. aquaticus has recently colonized a novel habitat and diverged into two ecotypes, presumably due to habitat-specific selection from predation. Using a common garden approach and animal model analyses, we estimated quantitative genetic parameters for behavioural traits and compared the genetic architecture between the ecotypes. We report that the genetic covariance structure of the behavioural traits has been altered in the novel ecotype, demonstrating divergence in behavioural correlations. Thus, our study confirms that genetic correlations behind behaviours can change rapidly in response to novel selective environments. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

  12. Rapid Temperature Changes and the Early Activity on Comet 67P/Churyumov-Gerasimenko

    Science.gov (United States)

    Alí-Lagoa, V.; Delbo', M.; Libourel, G.

    2015-09-01

    The so-called “early activity” of comet 67P/Churyumov-Gerasimenko has been observed to originate mostly in parts of the concave region or “neck” between its two lobes. Since activity is driven by the sublimation of volatiles, this is a puzzling result because this area is less exposed to the Sun and is therefore expected to be cooler on average. We used a thermophysical model that takes into account thermal inertia, global self-heating, and shadowing, to compute surface temperatures of the comet. We found that, for every rotation in the 2014 August-December period, some parts of the neck region undergo the fastest temperature variations of the comet’s surface precisely because they are shadowed by their surrounding terrains. Our work suggests that these fast temperature changes are correlated to the early activity of the comet, and we put forward the hypothesis that erosion related to thermal cracking is operating at a high rate on the neck region due to these rapid temperature variations. This may explain why the neck contains some ice—as opposed to most other parts of the surface—and why it is the main source of the comet’s early activity. In a broader context, these results indicate that thermal cracking can operate faster on atmosphereless bodies with significant concavities than implied by currently available estimates.

  13. Rapid modification in the olfactory signal of ants following a change in reproductive status

    Science.gov (United States)

    Cuvillier-Hot, Virginie; Renault, Valérie; Peeters, Christian

    2005-02-01

    In insect societies, the presence and condition of egg-layers can be assessed with pheromones. Exocrine secretions are expected to vary in time in order to give up-to-date information on an individual’s reproductive physiology. In the queenless monogynous ant Streblognathus peetersi, we allowed a previously infertile high-ranking worker to accede to the alpha rank, thus triggering the onset of her oogenesis (15 replicates). We then studied her interactions with an established egg-layer from the same colony after different durations, ranging from 20 h to several days. Even though her eggs are only ready to be laid after 30 days, the new alpha was recognised within 1 2 days. Detection occurred at a distance of a few millimetres, suggesting the involvement of a pheromone with low volatility, such as cuticular hydrocarbons. When the new alpha had differentiated for >48 h, she was attacked by the established egg-layer. In all cases, low-ranking workers eventually immobilised one of the two alphas: the new alpha was the target if she had differentiated only recently, suggesting that police workers select the dominant worker with the “less fertile” odour. Using the behaviour of ants as our measure, we demonstrate that a dominant’s olfactory signal changes rapidly with a modification in her social status, and it occurs well before the onset of egg-laying.

  14. Qualification Testing Versus Quantitative Reliability Testing of PV - Gaining Confidence in a Rapidly Changing Technology: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, Sarah [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Repins, Ingrid L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hacke, Peter L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Jordan, Dirk [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kempe, Michael D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Whitfield, Kent [Underwriters Laboratories; Phillips, Nancy [DuPont; Sample, Tony [European Commission; Monokroussos, Christos [TUV Rheinland; Hsi, Edward [Swiss RE; Wohlgemuth, John [PowerMark Corporation; Seidel, Peter [First Solar; Jahn, Ulrike [TUV Rheinland; Tanahashi, Tadanori [National Institute of Advanced Industrial Science and Technology; Chen, Yingnan [China General Certification Center; Jaeckel, Bengt [Underwriters Laboratories; Yamamichi, Masaaki [RTS Corporation

    2017-10-05

    Continued growth of PV system deployment would be enhanced by quantitative, low-uncertainty predictions of the degradation and failure rates of PV modules and systems. The intended product lifetime (decades) far exceeds the product development cycle (months), limiting our ability to reduce the uncertainty of the predictions for this rapidly changing technology. Yet, business decisions (setting insurance rates, analyzing return on investment, etc.) require quantitative risk assessment. Moving toward more quantitative assessments requires consideration of many factors, including the intended application, consequence of a possible failure, variability in the manufacturing, installation, and operation, as well as uncertainty in the measured acceleration factors, which provide the basis for predictions based on accelerated tests. As the industry matures, it is useful to periodically assess the overall strategy for standards development and prioritization of research to provide a technical basis both for the standards and the analysis related to the application of those. To this end, this paper suggests a tiered approach to creating risk assessments. Recent and planned potential improvements in international standards are also summarized.

  15. Modeling cavitation in a rapidly changing pressure field - application to a small ultrasonic horn.

    Science.gov (United States)

    Žnidarčič, Anton; Mettin, Robert; Dular, Matevž

    2015-01-01

    Ultrasonic horn transducers are frequently used in applications of acoustic cavitation in liquids. It has been observed that if the horn tip is sufficiently small and driven at high amplitude, cavitation is very strong, and the tip can be covered entirely by the gas/vapor phase for longer time intervals. A peculiar dynamics of the attached cavity can emerge with expansion and collapse at a self-generated frequency in the subharmonic range, i.e. below the acoustic driving frequency. The term "acoustic supercavitation" was proposed for this type of cavitation Žnidarčič et al. (2014) [1]. We tested several established hydrodynamic cavitation models on this problem, but none of them was able to correctly predict the flow features. As a specific characteristic of such acoustic cavitation problems lies in the rapidly changing driving pressures, we present an improved approach to cavitation modeling, which does not neglect the second derivatives in the Rayleigh-Plesset equation. Comparison with measurements of acoustic supercavitation at an ultrasonic horn of 20kHz frequency revealed a good agreement in terms of cavity dynamics, cavity volume and emitted pressure pulsations. The newly developed cavitation model is particularly suited for simulation of cavitating flow in highly fluctuating driving pressure fields. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Changes in soft tissue nasal widths associated with rapid maxillary expansion in prepubertal and postpubertal subjects.

    Science.gov (United States)

    Johnson, Bret M; McNamara, James A; Bandeen, Roger L; Baccetti, Tiziano

    2010-11-01

    To evaluate changes in the soft tissue width of the nose induced by rapid maxillary expansion (RME). Data on greater alar cartilage (GAC) and alar base (AB) widths were compared with a normative sample within the same age range. This prospective study consisted of an RME sample of 79 patients treated with an RME protocol. Mean age at the start of RME treatment was 13.5 years; average duration of treatment was 6.7 months. Patients were grouped into prepubertal and postpubertal groups based on their cervical vertebral maturation (CVM) stage. AB and GAC widths were determined at three separate time points. The normative sample consisted of 437 orthodontically untreated whites, aged 10-16 years. A repeated measures analysis of variance (ANOVA) was used to determine group differences. In addition, independent sample t-tests were used to compare posttreatment nasal width values vs the untreated normative sample. Increases in AB and GAC widths of the nose in the RME sample were less than 1.5 mm. No significant differences were noted in width changes between the prepubertal and postpubertal subgroups. Comparisons of T3 values showed that on average nasal width increases were greater in the RME group than in untreated norms by 1.7 mm for the GAC measure (statistically significant), and by less than 1 mm for the AB measure. RME has no significant clinical effects on the widths of the apical base and the greater alar cartilage of the nose; no differences were observed between the two maturational subgroups.

  17. Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review.

    Science.gov (United States)

    Gossip, Kate; Gouda, Hebe; Lee, Yong Yi; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez Soto, Eliana

    2017-06-29

    Local health departments are often at the forefront of a disaster response, attending to the immediate trauma inflicted by the disaster and also the long term health consequences. As the frequency and severity of disasters are projected to rise, monitoring and evaluation (M&E) efforts are critical to help local health departments consolidate past experiences and improve future response efforts. Local health departments often conduct M&E work post disaster, however, many of these efforts fail to improve response procedures. We undertook a rapid realist review (RRR) to examine why M&E efforts undertaken by local health departments do not always result in improved disaster response efforts. We aimed to complement existing frameworks by focusing on the most basic and pragmatic steps of a M&E cycle targeted towards continuous system improvements. For these purposes, we developed a theoretical framework that draws on the quality improvement literature to 'frame' the steps in the M&E cycle. This framework encompassed a M&E cycle involving three stages (i.e., document and assess, disseminate and implement) that must be sequentially completed to learn from past experiences and improve future disaster response efforts. We used this framework to guide our examination of the literature and to identify any context-mechanism-outcome (CMO) configurations which describe how M&E may be constrained or enabled at each stage of the M&E cycle. This RRR found a number of explanatory CMO configurations that provide valuable insights into some of the considerations that should be made when using M&E to improve future disaster response efforts. Firstly, to support the accurate documentation and assessment of a disaster response, local health departments should consider how they can: establish a culture of learning within health departments; use embedded training methods; or facilitate external partnerships. Secondly, to enhance the widespread dissemination of lessons learned and facilitate

  18. Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety.

    Science.gov (United States)

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Llewellyn, Dawn; Williamson, Robert G; Carson, Chris A

    2017-06-01

    Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal. Phase I was implemented within three months of assuming management of the facility and involved a redesign of flow, space utilization, and clinical protocols. Phase II was implemented three months later and improved the provider staffing model. Organizational changes such as the development of shift leads and daily huddles were implemented to sustain change and create an environment supportive of future improvements. Post-Phase I, there were significant decreases (pre vs. post and one-year post) in median door-to-door dwell time (343 min vs. 118 and 99), calls to security for behavioral emergencies (13.5 per month vs. 4.3 and 4.8), and staff injuries (3.3 per month vs. 1.2 and 1.2). Post-Phase II, there were decreases in median door-to-doctor time (8.2 hours vs. 1.6 and 1.4) and hours on diversion (90% vs. 17% and 34%). Lean methods can positively affect safety and throughput and are complementary to patient-centered clinical goals in a behavioral health setting. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  19. Reducing health risks from indoor exposures in rapidly developing urban China.

    Science.gov (United States)

    Zhang, Yinping; Mo, Jinhan; Weschler, Charles J

    2013-07-01

    Over the past two decades there has been a large migration of China's population from rural to urban regions. At the same time, residences in cities have changed in character from single-story or low-rise buildings to high-rise structures constructed and furnished with many synthetic materials. As a consequence, indoor exposures (to pollutants with outdoor and indoor sources) have changed significantly. We briefly discuss the inferred impact that urbanization and modernization have had on indoor exposures and public health in China. We argue that growing adverse health costs associated with these changes are not inevitable, and we present steps that could be taken to reduce indoor exposures to harmful pollutants. As documented by China's Ministry of Health, there have been significant increases in morbidity and mortality among urban residents over the past 20 years. Evidence suggests that the population's exposure to air pollutants has contributed to increases in lung cancer, cardiovascular disease, pulmonary disease, and birth defects. Whether a pollutant has an outdoor or an indoor source, most exposure to the pollutant occurs indoors. Going forward, indoor exposures can be reduced by limiting the ingress of outdoor pollutants (while providing adequate ventilation with clean air), minimizing indoor sources of pollutants, updating government policies related to indoor pollution, and addressing indoor air quality during a building's initial design. Taking the suggested steps could lead to significant reductions in morbidity and mortality, greatly reducing the societal costs associated with pollutant derived ill health.

  20. Understanding and managing change in health care organizations.

    Science.gov (United States)

    Nagaike, K

    1997-01-01

    Change impacts affected people and often causes difficulties. Health care organizations, locally and nationally, have undergone tremendous change to deliver quality services in a more effective and efficient manner in a competitive environment, with varying degrees of success. This article presents Robbins's categories of change and relates them to current changes in health care organizations. It discusses areas to consider to develop adaptable plans and to assist affected employees to better deal with these changes throughout the transition.

  1. The human health chapter of climate change and ozone depletion ...

    African Journals Online (AJOL)

    Climate change is one of the greatest emerging threats of the 21st century. There is much scientific evidence that climate change is giving birth to direct health events including more frequent weather extremes, increase in epidemics, food and water scarcity. Indirect risks to health are related to changes in temperature and ...

  2. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru

    Science.gov (United States)

    García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.

    2013-01-01

    Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV

  3. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru.

    Directory of Open Access Journals (Sweden)

    Patricia J García

    Full Text Available Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening.The study was implemented from September 2009-November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability.Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the "two for one strategy", offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%.Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1 engaging the authorities; (2 dissipating tensions between providers and identifying champions; (3 training according to the needs; (4 providing monitoring, supervision, support and recognition; (5 sharing results and discussing actions together; (6 consulting and obtaining feedback from users; and (7 integrating with other services such as with rapid HIV testing.

  4. Lake ecosystem response to rapid lateglacial climate changes in lake sediments from northern Poland

    Science.gov (United States)

    Słowiński, Michał; Zawiska, Izabela; Ott, Florian; Noryśkiewicz, Agnieszka M.; Apolinarska, Karina; Lutyńska, Monika; Michczyńska, Danuta J.; Brauer, Achim; Wulf, Sabine; Skubała, Piotr; Błaszkiewicz, Mirosław

    2013-04-01

    During the Late Glacial Period environment changes were triggered by climatic oscillations which in turn controlled processes like, for example, permafrost thawing, vegetation development and ground water circulation. These environmental changes are ideally recorded in lake sediments and thus can be reconstructed applying a multi-poxy approach. Here, we present the results from the Trzechowskie paleolake, located in the northern Polish lowlands (eastern part of the Pomeranian Lakeland). The site is situated on the outwash plain of the Wda River, which was formed during the Pomeranian phase of the Vistulian glaciation ca 16,000 14C yrs BP. The depression of the Trzechowskie lake basin formed after melting of a buried ice block during the Allerød (13903±170 cal yrs BP). We reconstructed environmental changes in the Trzechowskie paleolake and its catchment using biotic proxies (macrofossils, pollen, cladocera, diatoms, oribatidae mite) and geochemical proxies (δ18O, δ13C, loss-on-ignition (LOI), CaCO3 content). In addition, we carried out µ-XRF element core scanning. The chronology has been established by means of biostratigraphyAMS14C dating on plant macro remains, varve counting in laminated intervals and the late Allerød Laacher See Tephra isochrone. Our results showed that biogenic accumulation in the lake started during the Bølling. Development of coniferous forest during the Allerød with dominance of Pinus sylvestris lead to leaching of carbonates in the catchment due to low pH increasing the flux of Ca ions into the lake. In consequence calcite precipitating in the lake increased as evidences by increasing CaCO3 contents. Both biotic and physical proxies clearly reflect the rapid decrease in productivity at the onset of the Younger Dryas. We compare the data from the Trzechowskie paleolake with the Meerfelder Maar and Rehwiese lake records based on tephrochronological synchronization using the Laacher See Tephra. This study is a contribution to the

  5. Reducing Health Risks from Indoor Exposures in Rapidly Developing Urban China

    DEFF Research Database (Denmark)

    Zhang, Yinping; Mo, Jinhan; Weschler, Charles J.

    2013-01-01

    associated with these changes are not inevitable, and we present steps that could be taken to reduce indoor exposures to harmful pollutants. Discussion: As documented by China's Ministry of Health, there have been significant increases in morbidity and mortality among urban residents over the past 20 years...... exposures can be reduced by limiting the ingress of outdoor pollutants (while providing adequate ventilation with clean air), minimizing indoor sources of pollutants, updating government policies related to indoor pollution, and addressing indoor air quality during a building's initial design. Conclusions......: Taking the suggested steps could lead to significant reductions in morbidity and mortality, greatly reducing the societal costs associated with pollutant derived ill health....

  6. Health care delivery in Malaysia: changes, challenges and champions

    Science.gov (United States)

    Thomas, Susan; Beh, LooSee; Nordin, Rusli Bin

    2011-01-01

    Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care. PMID:28299064

  7. A pilot biomedical engineering course in rapid prototyping for mobile health.

    Science.gov (United States)

    Stokes, Todd H; Venugopalan, Janani; Hubbard, Elena N; Wang, May D

    2013-01-01

    Rapid prototyping of medically assistive mobile devices promises to fuel innovation and provides opportunity for hands-on engineering training in biomedical engineering curricula. This paper presents the design and outcomes of a course offered during a 16-week semester in Fall 2011 with 11 students enrolled. The syllabus covered a mobile health design process from end-to-end, including storyboarding, non-functional prototypes, integrated circuit programming, 3D modeling, 3D printing, cloud computing database programming, and developing patient engagement through animated videos describing the benefits of a new device. Most technologies presented in this class are open source and thus provide unlimited "hackability". They are also cost-effective and easily transferrable to other departments.

  8. Rapid change of ion energy distribution and floating potential at L/H transition in the JFT-2M tokamak

    International Nuclear Information System (INIS)

    Miura, Y.; Nagashima, K.; Okano, F.

    1994-01-01

    Rapid changes of the main ion energy distribution at transitions from L-to-H, H-to-L and during ELMs are studied with the time of flight neutral measurement in the JFT-2M tokamak. The change of the main ion energy distribution after sawtooth crash during an L-mode phase is also studied. The change of the ion energy distribution just after sawtooth crash is the same as that at L/H-transition. The floating potential measured in the SOL also shows the rapid jump to more positive just after the sawtooth crash (at the same time of the change of an ion energy distribution). This shows the increase of ion outflux in the SOL and might correspond to the change of the ion energy distribution. This may be the reason why most of H-modes are triggered by a sawtooth. (author)

  9. Climate Change, Indoor Environment and Health

    Science.gov (United States)

    Climate change is becoming a driving force for improving energy efficiency because saving energy can help reduce the greenhouse gas emissions that contribute to climate change. However, it is important to balance energy saving measures with ventilation...

  10. Health, Energy Efficiency and Climate Change

    Science.gov (United States)

    Climate change is becoming a driving force for improving energy efficiency because saving energy can help reduce the greenhouse gas emissions that contribute to climate change. However, it is important to balance energy saving measures with ventilation...

  11. Climate Change, Economic Growth, and Health

    NARCIS (Netherlands)

    Ikefuji, M.; Magnus, J.R.; Sakamoto, H.

    2010-01-01

    This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled ‘West’ (cold and rich), ‘China’ (cold and poor), ‘India’ (warm and poor), and ‘Africa’ (warm and very poor). We introduce health impacts into a simple integrated

  12. Extremely rapid directional change during Matuyama-Brunhes geomagnetic polarity reversal

    Science.gov (United States)

    Sagnotti, Leonardo; Scardia, Giancarlo; Giaccio, Biagio; Liddicoat, Joseph C.; Nomade, Sebastien; Renne, Paul R.; Sprain, Courtney J.

    2014-11-01

    We report a palaeomagnetic investigation of the last full geomagnetic field reversal, the Matuyama-Brunhes (M-B) transition, as preserved in a continuous sequence of exposed lacustrine sediments in the Apennines of Central Italy. The palaeomagnetic record provides the most direct evidence for the tempo of transitional field behaviour yet obtained for the M-B transition. 40Ar/39Ar dating of tephra layers bracketing the M-B transition provides high-accuracy age constraints and indicates a mean sediment accumulation rate of about 0.2 mm yr-1 during the transition. Two relative palaeointensity (RPI) minima are present in the M-B transition. During the terminus of the upper RPI minimum, a directional change of about 180 ° occurred at an extremely fast rate, estimated to be less than 2 ° per year, with no intermediate virtual geomagnetic poles (VGPs) documented during the transit from the southern to northern hemisphere. Thus, the entry into the Brunhes Normal Chron as represented by the palaeomagnetic directions and VGPs developed in a time interval comparable to the duration of an average human life, which is an order of magnitude more rapid than suggested by current models. The reported investigation therefore provides high-resolution integrated palaeomagnetic and radioisotopic data that document the fine details of the anatomy and tempo of the M-B transition in Central Italy that in turn are crucial for a better understanding of Earth's magnetic field, and for the development of more sophisticated models that are able to describe its global structure and behaviour.

  13. Diverse multi-decadal changes in streamflow within a rapidly urbanizing region

    Science.gov (United States)

    Diem, Jeremy E.; Hill, T. Chee; Milligan, Richard A.

    2018-01-01

    The impact of urbanization on streamflow depends on a variety of factors (e.g., climate, initial land cover, inter-basin transfers, water withdrawals, wastewater effluent, etc.). The purpose of this study is to examine trends in streamflow from 1986 to 2015 in a range of watersheds within the rapidly urbanizing Atlanta, GA metropolitan area. This study compares eight watersheds over three decades, while minimizing the influence of inter-annual precipitation variability. Population and land-cover data were used to analyze changes over approximately twenty years within the watersheds. Precipitation totals for the watersheds were estimated using precipitation totals at nearby weather stations. Multiple streamflow variables, such as annual streamflow, frequencies of high-flow days (HFDs), flashiness, and precipitation-adjusted streamflow, for the eight streams were calculated using daily streamflow data. Variables were tested for significant trends from 1986 to 2015 and significant differences between 1986-2000 and 2001-2015. Flashiness increased for all streams without municipal water withdrawals, and the four watersheds with the largest increase in developed land had significant increases in flashiness. Significant positive trends in precipitation-adjusted mean annual streamflow and HFDs occurred for the two watersheds (Big Creek and Suwanee Creek) that experienced the largest increases in development, and these were the only watersheds that went from majority forest land in 1986 to majority developed land in 2015. With a disproportionate increase in HFD occurrence during summer, Big Creek and Suwannee Creek also had a reduction in intra-annual variability of HFD occurrence. Watersheds that were already substantially developed at the beginning of the period and did not have wastewater discharge had declining streamflow. The most urbanized watershed (Peachtree Creek) had a significant decrease in streamflow, and a possible cause of the decrease was increasing

  14. Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

    OpenAIRE

    Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

    2013-01-01

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within...

  15. Nurses leading change to advance health.

    Science.gov (United States)

    Polansky, Patricia; Gorski, Mary Sue; Green, Alexia; Perez, G Adriana; Wise, Robert P

    The article includes a review of selected past and current leadership initiatives as well as a summary of three leadership meetings convened by The Center to Champion Nursing in America, a partnership of the Robert Wood Johnson Foundation (RWJF), AARP and the AARP Foundation. These "Leadership in Action" meetings were designed to address the Campaign for Action's (CFA) goal to increase the number of nurse leaders in health- and health care-related boardrooms at the local, state and national levels. RWJF supported key nursing organizations in initial discussions around integrating state and national efforts to get more nurses onto boards leading to a active vibrant coalition making significant progress. This article concludes with a call to action encouraging all nurses to consider board service as an essential component of improving health and health care and to do their part to help build a Culture of Health in the United States. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Climate changes, floods, and health consequences].

    Science.gov (United States)

    Michelozzi, Paola; de' Donato, Francesca

    2014-02-01

    In the European Region, floods are the most common natural disaster, causing extensive damage and disruption. In Italy, it has been estimated that over 68% of municipalities are at high hydrogeological risk and with the recent intense rainfall events local populations have been facing severe disruptions. The health consequences of floods are wide ranging and are dependent upon the vulnerability of the environment and the local population. Health effects can be a direct or indirect consequence of flooding. The immediate health impacts of floods include drowning, heart attacks, injuries and hypothermia. The indirect effects include, injuries and infections, water-borne infectious disease, mental health problems, respiratory disease and allergies in both the medium and long term after a flood. Future efforts should be addressed to integrate health preparedness and prevention measures into emergency flood plans and hydrological warning systems.

  17. Rapid assessment response (RAR study: drug use and health risk - Pretoria, South Africa

    Directory of Open Access Journals (Sweden)

    Trautmann Franz

    2011-06-01

    Full Text Available Abstract Background Within a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research. Methods A Rapid Assessment and Response (RAR methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI participants, 63 drug user KI participants (49 males, 14 females and 21 KI service providers (8 male, 13 female. Results and Discussion Adverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information. Conclusions The implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to

  18. Understanding Breast Changes: A Health Guide for Women

    Science.gov (United States)

    ... and Conditions Understanding Breast Changes: Health Guide for Women can be printed or viewed as a booklet, ... During Your Lifetime That Are Not Cancer Most women have changes in the breasts at different times ...

  19. Rapid Assessment of Small Changes to Major Gun and Projectile Dynamic Parameters

    National Research Council Canada - National Science Library

    Erline, Thomas

    1997-01-01

    The U.S. Navy's 5-in 54-cal. (5"/54) gun system Mark (Mk) 45 was subjected to first-order dynamic analysis tools that allowed rapid assessment of ballistic dispersion of a typical naval high explosive projectile...

  20. USGS Environmental health science strategy: providing environmental health science for a changing world: public review release

    Science.gov (United States)

    Bright, Patricia R.; Buxton, Herbert T.; Balistrieri, Laurie S.; Barber, Larry B.; Chapelle, Francis H.; Cross, Paul C.; Krabbenhoft, David P.; Plumlee, Geoffrey S.; Sleeman, Jonathan M.; Tillitt, Donald E.; Toccalino, Patricia L.; Winton, James R.

    2012-01-01

    . - Systematically characterize the sources, occurrence, transport and fate of environmental contaminants to guide efforts to manage and mitigate contamination. * Strategic Science Action 2. - Evaluate the threats of contamination on the health of the environment, fish, wildlife, and people, and inform the associated management and protection efforts. * Strategic Science Action 3. - Characterize potential human exposure to support establishment of health-based standards or guidelines and contamination-reduction efforts. Goal 3: Reduce the impact of pathogens on the environment, fish, wildlife, and people. * Strategic Science Action 1. - Determine the biotic and abiotic factors that control the ecology of infectious diseases affecting natural populations of aquatic and terrestrial species and potential transmission to other animals and humans. * Strategic Science Action 2. - Establish how natural and anthropogenic environmental changes affect the distribution and severity of infectious diseases in natural populations of aquatic and terrestrial species and potential transmission to other animals and humans. * Strategic Science Action 3. - Develop surveillance systems to identify changing patterns of disease activity in priority geographic areas. Goal 4: Discover the complex interactions and combined effects of exposure to contaminants and pathogens. * Strategic Science Action 1. - Identify how exposure to one class of disease agents (contaminants or pathogens) can make an organism more susceptible to effects from exposure to the other class of disease agents. * Strategic Science Action 2. - Implement interdisciplinary studies that characterize the effects of combined exposure to pathogens and contaminants. Goal 5: Prepare for and respond to the environmental impacts and related health threats of natural and anthropogenic disasters. * Strategic Science Action 1. - Establish a formal interdisciplinary science capability to rapidly assess the environmental health risks associated with

  1. Assessment of the Health Impacts of Climate Change in Kiribati

    Science.gov (United States)

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

  2. Climate Change, Public Health, and Policy: A California Case Study

    Science.gov (United States)

    Smith, Jason A.

    2018-01-01

    Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California’s progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions. PMID:29072936

  3. Climate Change, Public Health, and Policy: A California Case Study.

    Science.gov (United States)

    Ganesh, Chandrakala; Smith, Jason A

    2018-04-01

    Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California's progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions.

  4. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

  5. Rapid health assessments of evacuation centres in areas affected by Typhoon Haiyan

    Directory of Open Access Journals (Sweden)

    Ruth Alma Ramos

    2015-11-01

    Full Text Available Introduction: Typhoon Haiyan caused thousands of deaths and catastrophic destruction, leaving many homeless in Region 8 of the Philippines. A team from the Philippine Field Epidemiology Training Program conducted a rapid health assessment survey of evacuation centres severely affected by Haiyan. Methods: A descriptive study was conducted whereby a convenience sample of evacuation centres were assessed on the number of toilets per evacuee, sanitation, drinking-water, food supply source and medical services. Results: Of the 20 evacuation centres assessed, none had a designated manager. Most were located in schools (70% with the estimated number of evacuees ranging from 15 to 5000 per centre. Only four (20% met the World Health Organization standard for number of toilets per evacuee; none of the large evacuation centres had even half the recommended number of toilets. All of the evacuation centres had available drinking-water. None of the evacuation centres had garbage collection, vector control activities or standby medical teams. Fourteen (70% evacuation centres had onsite vaccination activities for measles, tetanus and polio virus. Many evacuation centres were overcrowded. Conclusion: Evacuation centres are needed in almost every disaster. They should be safely located and equipped with the required amenities. In disaster-prone areas such as the Philippines, schools and community centres should not be designated as evacuation centres unless they are equipped with adequate sanitation services.

  6. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

    Directory of Open Access Journals (Sweden)

    Eric Miller

    2015-06-01

    Full Text Available Immunochromatographic rapid diagnostic tests (RDTs have demonstrated significant potential for use as point-of- care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

  7. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health

    Directory of Open Access Journals (Sweden)

    Eric Miller

    2015-06-01

    Full Text Available Immunochromatographic rapid diagnostic tests (RDTs have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

  8. Addressing Barriers to the Development and Adoption of Rapid Diagnostic Tests in Global Health.

    Science.gov (United States)

    Miller, Eric; Sikes, Hadley D

    Immunochromatographic rapid diagnostic tests (RDTs) have demonstrated significant potential for use as point-of-care diagnostic tests in resource-limited settings. Most notably, RDTs for malaria have reached an unparalleled level of technological maturity and market penetration, and are now considered an important complement to standard microscopic methods of malaria diagnosis. However, the technical development of RDTs for other infectious diseases, and their uptake within the global health community as a core diagnostic modality, has been hindered by a number of extant challenges. These range from technical and biological issues, such as the need for better affinity agents and biomarkers of disease, to social, infrastructural, regulatory and economic barriers, which have all served to slow their adoption and diminish their impact. In order for the immunochromatographic RDT format to be successfully adapted to other disease targets, to see widespread distribution, and to improve clinical outcomes for patients on a global scale, these challenges must be identified and addressed, and the global health community must be engaged in championing the broader use of RDTs.

  9. Comparative Effectiveness Research, Genomics-Enabled Personalized Medicine, and Rapid Learning Health Care: A Common Bond

    Science.gov (United States)

    Ginsburg, Geoffrey S.; Kuderer, Nicole M.

    2012-01-01

    Despite stunning advances in our understanding of the genetics and the molecular basis for cancer, many patients with cancer are not yet receiving therapy tailored specifically to their tumor biology. The translation of these advances into clinical practice has been hindered, in part, by the lack of evidence for biomarkers supporting the personalized medicine approach. Most stakeholders agree that the translation of biomarkers into clinical care requires evidence of clinical utility. The highest level of evidence comes from randomized controlled clinical trials (RCTs). However, in many instances, there may be no RCTs that are feasible for assessing the clinical utility of potentially valuable genomic biomarkers. In the absence of RCTs, evidence generation will require well-designed cohort studies for comparative effectiveness research (CER) that link detailed clinical information to tumor biology and genomic data. CER also uses systematic reviews, evidence-quality appraisal, and health outcomes research to provide a methodologic framework for assessing biologic patient subgroups. Rapid learning health care (RLHC) is a model in which diverse data are made available, ideally in a robust and real-time fashion, potentially facilitating CER and personalized medicine. Nonetheless, to realize the full potential of personalized care using RLHC requires advances in CER and biostatistics methodology and the development of interoperable informatics systems, which has been recognized by the National Cancer Institute's program for CER and personalized medicine. The integration of CER methodology and genomics linked to RLHC should enhance, expedite, and expand the evidence generation required for fully realizing personalized cancer care. PMID:23071236

  10. Community Changes Address Common Health Threat

    Centers for Disease Control (CDC) Podcasts

    2013-09-30

    This podcast helps residents living in multiunit housing, like apartments and condos, understand the threat of secondhand smoke. It also helps residents understand what steps they can take to breathe a little easier if involuntarily exposed to secondhand smoke.  Created: 9/30/2013 by Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 9/30/2013.

  11. Impacts of Climate Change on Inequities in Child Health

    Directory of Open Access Journals (Sweden)

    Charmian M. Bennett

    2014-12-01

    Full Text Available This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

  12. Climate Change and Health: Nurses as Drivers of Climate Action

    Directory of Open Access Journals (Sweden)

    Cara Cook

    2018-02-01

    Full Text Available Changes to Earth’s climate are occurring globally at unprecedented rates with significant impacts to human and population health, including increased likelihood of mental health illnesses, food and water insecurity, insect-borne and heat-related illnesses, and respiratory diseases. Those in the health sector are seeing the challenges patients and community members are experiencing as a result of current and projected climate threats. Health professionals, including nurses, have an opportunity to lead the charge to significantly improve society’s response to climate change and foster the strategies needed to promote health. This article highlights the current work of the Alliance of Nurses for Healthy Environments, a national nursing organization focused solely on environmental health concerns, in inspiring and empowering nurses across the country to engage in action to reduce their climate impact, move climate solutions forward, and improve the ability of health care institutions and communities to respond to the health impacts of climate change.

  13. Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review.

    Science.gov (United States)

    Lo Giudice, Antonino; Barbato, Ersilia; Cosentino, Leandro; Ferraro, Claudia Maria; Leonardi, Rosalia

    2017-08-10

    During rapid maxillary expansion (RME), heavy forces are transmitted to the maxilla by the anchored teeth causing buccal inclination and buccal bone loss of posterior teeth. To systematically review the literature in order to investigate whether RME causes periodontal sequelae, assessed by cone-beam computed tomography (CBCT). Fifteen electronic databases and reference lists of studies were searched up to March 2017. To be included in the systematic review, articles must be human studies on growing subjects, with transversal maxillary deficiency treated with RME and with assessment of buccal bone loss by CBCT images. Only randomized and non-randomized trials were included. Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, evaluated linear measurements, observation period, CBCT settings), and study outcomes (loss of buccal bone thickness and marginal bone) were reported according to the PRISMA statement. On the basis of the applied inclusion criteria, only six articles, three randomized clinical trials and three controlled clinical trials were included. An individual analysis of the selected articles was undertaken. The risks of bias of the six trials were scored as medium to low. The results of the present systematic review are based on a limited number of studies and only one study included a control group. In all considered studies, significant loss of buccal bone thickness and marginal bone level were observed in anchored teeth, following RME. Further prospective studies correlating the radiological data of bone loss to the periodontal soft tissues reaction after RME are required. A preliminary evaluation of the patient-related risk factors for RR may be advisable when considering to administering RME. This systematic review was registered in the National Institute of Health Research database with an

  14. Changing disease profile and preventive health care in India: Issues of economy, equity and effectiveness

    Directory of Open Access Journals (Sweden)

    Salma Kaneez

    2015-01-01

    Full Text Available The importance of preventive health care practices has increasingly been recognized in the wake of changing disease profile in India. The disease burden has been shifting from communicable to non-communicable diseases as a result of greater focus on achieving competitiveness in a fast globalizing economy. The rapid pace of social and technological changes has led to adverse life style choices resulting in higher incidence of heart diseases, diabetes, obesity, cancer, and deteriorating inter-personal relations and psychological well-being among individuals. Most of these health risks can considerably be reduced through disseminating science-based information on health promotion and disease prevention including exercise, nutrition, smoking and tobacco cessation, immunization, counseling, fostering good habits of health and hygiene, disease screening and preventive medicine. Prior evidences indicate that preventive health interventions can improve health outcomes in a great deal. In a regressive health delivery system of India where major health expenses on curative health is met by out-of-pocket money, preventive health services hold promise to be cost efficient, clinically effective and equity promoting. This article, therefore, examines in depth the issues and prospects of preventive and promotive health care services in realizing optimum health care needs of the people.

  15. Climate Change and Health: Transcending Silos to Find Solutions.

    Science.gov (United States)

    Machalaba, Catherine; Romanelli, Cristina; Stoett, Peter; Baum, Sarah E; Bouley, Timothy A; Daszak, Peter; Karesh, William B

    2015-01-01

    Climate change has myriad implications for the health of humans, our ecosystems, and the ecological processes that sustain them. Projections of rising greenhouse gas emissions suggest increasing direct and indirect burden of infectious and noninfectious disease, effects on food and water security, and other societal disruptions. As the effects of climate change cannot be isolated from social and ecological determinants of disease that will mitigate or exacerbate forecasted health outcomes, multidisciplinary collaboration is critically needed. The aim of this article was to review the links between climate change and its upstream drivers (ie, processes leading to greenhouse gas emissions) and health outcomes, and identify existing opportunities to leverage more integrated global health and climate actions to prevent, prepare for, and respond to anthropogenic pressures. We conducted a literature review of current and projected health outcomes associated with climate change, drawing on findings and our collective expertise to review opportunities for adaptation and mitigation across disciplines. Health outcomes related to climate change affect a wide range of stakeholders, providing ready collaborative opportunities for interventions, which can be differentiated by addressing the upstream drivers leading to climate change or the downstream effects of climate change itself. Although health professionals are challenged with risks from climate change and its drivers, the adverse health outcomes cannot be resolved by the public health community alone. A phase change in global health is needed to move from a passive responder in partnership with other societal sectors to drive innovative alternatives. It is essential for global health to step outside of its traditional boundaries to engage with other stakeholders to develop policy and practical solutions to mitigate disease burden of climate change and its drivers; this will also yield compound benefits that help address

  16. Organizational Adaptation to the Rapidly Changing External Environment: A Case Study of Strategic Marketing at Notre Dame College in Ohio

    Science.gov (United States)

    Brown, Shawn M.

    2012-01-01

    This thesis examined the role of strategic marketing in organizational adaptation to a rapidly changing and competitive external environment among institutions of higher education. Colleges and universities adapt to external pressures as open systems operating within a broader external environment (Bess & Dee, 2008; Keller, 1983). How does…

  17. Neolithisation of the Aegean and Southeast Europe during the 6600–6000 calBC period of Rapid Climate Change

    Directory of Open Access Journals (Sweden)

    Bernhard Weninger

    2014-12-01

    Full Text Available In extension of the recently established ‘Rapid Climate Change (RCC Neolithisation Model’ (Clare 2013, in the present paper we demonstrate the existence of a remarkable coincidence between the exact (decadel-scale entry and departure dates of the Neolithic into/from the Aegean (~6600/6050 calBC with begin/end of RCC-conditions.

  18. Culture and cognition in health systems change.

    Science.gov (United States)

    Evans, Jenna M; Baker, G Ross; Berta, Whitney; Barnsley, Jan

    2015-01-01

    Large-scale change involves modifying not only the structures and functions of multiple organizations, but also the mindsets and behaviours of diverse stakeholders. This paper focuses on the latter: the informal, less visible, and often neglected psychological and social factors implicated in change efforts. The purpose of this paper is to differentiate between the concepts of organizational culture and mental models, to argue for the value of applying a shared mental models (SMM) framework to large-scale change, and to suggest directions for future research. The authors provide an overview of SMM theory and use it to explore the dynamic relationship between culture and cognition. The contributions and limitations of the theory to change efforts are also discussed. Culture and cognition are complementary perspectives, providing insight into two different levels of the change process. SMM theory draws attention to important questions that add value to existing perspectives on large-scale change. The authors outline these questions for future research and argue that research and practice in this domain may be best served by focusing less on the potentially narrow goal of "achieving consensus" and more on identifying, understanding, and managing cognitive convergences and divergences as part of broader research and change management programmes. Drawing from both cultural and cognitive paradigms can provide researchers with a more complete picture of the processes by which coordinated action are achieved in complex change initiatives in the healthcare domain.

  19. Using health psychology to help patients: theories of behaviour change.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-09-08

    Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change.

  20. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  1. Climate change, food, water and population health in China.

    Science.gov (United States)

    Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-10-01

    Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

  2. Impacts of Climate Change on Human Health in the United ...

    Science.gov (United States)

    Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

  3. Public health adaptation to climate change in OECD countries

    NARCIS (Netherlands)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine

  4. Climate change impacts health in Tunisia | IDRC - International ...

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

    2012-03-26

    Mar 26, 2012 ... Research is showing that climate change is having major impacts on human health. Weather-related disasters are on the rise and water- and vector-borne diseases are spreading. Strategies to adapt to the effects of climate change may also pose unforeseen health risks. Read more about a project in ...

  5. Health-related mobile apps and behaviour change

    African Journals Online (AJOL)

    Kathryn van Boom

    Health-related mobile apps and behaviour change. While our knowledge about physical activity and health, physical performance and the risk of injury increases in leaps and bounds, the conversion of this information into action and changed behaviour lags behind. There seems to be a sticking point which often causes a ...

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

    Science.gov (United States)

    Paavola, Jouni

    2017-12-05

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

  7. The American Public Health Association's 2017 Year of Climate Change and Health: Time for Action.

    Science.gov (United States)

    DeJarnett, Natasha; Robb, Katherine; Castellanos, Ivana; Dettman, Louise; Patel, Surili S

    2017-10-26

    Climate change is today's greatest public health threat. 1 As the nation's leading voice in public health, the American Public Health Association (APHA) has demonstrated an enduring commitment to climate change as a health issue. As far back as the mid-1920s, AJPH reported on the health impacts of climate change. 2-4 Shaping the development of future organizational efforts, APHA members created the organization's first policy statement on climate change in 1995 (updated in 2007 and 2015). APHA continued to bring attention to climate change and public health, making it the theme of National Public Health Week 2008. Since then, evidence of climate change's causes and effects has mounted, but politicization of the issue and low prioritization by the public has made progress toward mitigation and adaptation slow. (Am J Public Health. Published online ahead of print October 26, 2017: e1-e2. doi:10.2105/AJPH.2017.304168).

  8. Peer Mentoring for Health Behavior Change: A Systematic Review

    Science.gov (United States)

    Petosa, R. L.; Smith, Laureen H.

    2014-01-01

    Background: Peer mentoring can be a powerful complement to health instruction. Mentoring has been used to change health behaviors and promote sustainable lifestyle patterns in adults and, more recently, among adolescents. Purpose: This article reviews the use of peer mentoring to promote health practices and describes how this approach can be used…

  9. Ethical Theories for Promoting Health through Behavioral Change.

    Science.gov (United States)

    O'Connell, Janelle K.; Price, James H.

    1983-01-01

    Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to health behavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)

  10. Climate Change in the US: Potential Consequences for Human Health

    Science.gov (United States)

    Maynard, Nancy G.

    2001-01-01

    The U.S. National Assessment identified five major areas of consequences of climate change in the United States: temperature-related illnesses and deaths, health effects related to extreme weather events, air pollution-related health effects, water- and food-borne diseases, and insect-, tick-, and rodent-borne diseases. The U.S. National Assessment final conclusions about these potential health effects will be described. In addition, a summary of some of the new tools for studying human health aspects of climate change as well as environment-health linkages through remotely sensed data and observations will be provided.

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

    Science.gov (United States)

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

    2012-08-01

    Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.

  12. Roundtable on health and climate change : Strategic plan on health and climate change : a framework for collaborative action, final report

    International Nuclear Information System (INIS)

    2001-03-01

    Climate change will have a significant impact on human health, arising from direct effects such as increased extreme weather events, and indirect effects resulting from changes in ecological systems on which humans depend. This paper is a compilation of discussions and input from the many stakeholders and representatives that contributed to the Roundtable on Health and Climate Change held in September 2000. The goal of the Roundtable was to raise the profile and inform policy makers of the health issues associated with climate change and to engage the health sector in the National Implementation Strategy on Climate Change. The strategic framework for collaborative action in addressing the health implications of climate change were presented. The strategic plan is based on the following key principles: (1) incorporating both mitigation and adaptation in all aspects of the plan, (2) maximizing co-benefits, associated with climate change and other key health priorities, (3) building on existing capacity within governments and non-governmental organizations, (4) forming multi-disciplinary alliances, (5) emphasizing collaboration and cooperation, and (6) recognizing the shared responsibility for action on climate change. The major recommendation from the Roundtable was to urge governments to place a high priority on the implementation of measures that will reduce greenhouse gas emissions in Canada, thereby improving health of Canadians. It was recommended that governments should insist that all analyses and modeling of climate change policy options include the assessment and consideration of health implications. 1 tab

  13. Organizational change theory: implications for health promotion practice.

    Science.gov (United States)

    Batras, Dimitri; Duff, Cameron; Smith, Ben J

    2016-03-01

    Sophisticated understandings of organizational dynamics and processes of organizational change are crucial for the development and success of health promotion initiatives. Theory has a valuable contribution to make in understanding organizational change, for identifying influential factors that should be the focus of change efforts and for selecting the strategies that can be applied to promote change. This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners. Theoretically derived considerations for practitioners who seek to foster organizational change include the extent to which the initiative is modifiable to fit with the internal context; the amount of time that is allocated to truly institutionalize change; the ability of the agents of change to build short-term success deliberately into their implementation plan; whether or not the shared group experience of action for change is positive or negative and the degree to which agencies that are the intended recipients of change are resourced to focus on internal factors. In reviewing theories of organizational change, the article also addresses strategies for facilitating the adoption of key theoretical insights into the design and implementation of health promotion initiatives in diverse organizational settings. If nothing else, aligning health promotion with organizational change theory promises insights into what it is that health promoters do and the time that it can take to do it effectively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Rapid fluvial aggradation in response to climate change in northwestern Argentina

    Science.gov (United States)

    Wickert, Andrew; Schildgen, Taylor; Strecker, Manfred

    2015-04-01

    River channels near the edge of the northwestern Argentine Andes are rapidly aggrading at present, with preliminary estimates suggesting rates of ~20 cm yr-1. This mirrors cycles of extensive aggradation over the past 100,000 years that formed pronounced fill terraces along regional valley networks and record periods in which in which climate-driven sediment supply overcame uplift-driven river incision (Robinson et al, 2005). Here we use the new SedFlow model (Heimann et al., 2014) to help us understand the causes and spread of aggradation across these basins in the modern system, with the additional eventual goal to better interpret the geologic record. We provide field-derived grain-size distributions, field-measured and remotely-sensed channel widths and valley slopes, and a variety of possible sediment source locations and amounts as inputs to SedFlow, which routes sediment through the fluvial channel network to produce time-evolving predictions of aggradation and incision. We compare these predictions against changes in topography measured by IceSAT (Zwally et al., 2014) and field surveys. We initially test the system response to a series of isolated sediment inputs to observe interactions between tributary systems and the mainstem river. Recent observations indicate that debris-flow induced landslides are important contributors to aggradation in these rivers (Cencetti and Rivelli, 2011). These and other sediment production and transport processes are likely driven by variations in the El Niño Southern Oscillation (ENSO) (Bookhagen and Strecker, 2009). Therefore, we then run SedFlow with sediment inputs distributed across the landscape based on locations where ENSO influences may trigger enhanced landsliding. These model experiments help us towards our end goal of providing a more quantitative basis to interpret field observations of landscape response to changing patterns of precipitation. References: Bookhagen, B. and Strecker, M.: Amazonia: Landscape and

  15. Financing reform and structural change in the health services industry.

    Science.gov (United States)

    Higgins, C W; Phillips, B U

    1986-08-01

    This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.

  16. Quality of Life, Sleep, and Health of Air Traffic Controllers With Rapid Counterclockwise Shift Rotation.

    Science.gov (United States)

    Sonati, Jaqueline Girnos; De Martino, Milva Maria Figueiredo; Vilarta, Roberto; da Silva Maciel, Érika; Sonati, Renato José Ferreira; Paduan, Paulo Cézar

    2016-08-01

    Rotating shiftwork is common for air traffic controllers and usually causes sleep deprivation, biological adaptations, and life changes for these workers. This study assessed quality of life, the sleep, and the health of 30 air traffic controllers employed at an international airport in Brazil. The objective was to identify health and quality of life concerns of these professionals. The results identified physical inactivity, overweight, excess body fat, low scores for physical and social relationships, and sleep deprivation for workers in all four workshifts. In conclusion, these workers are at risk for chronic non-transmittable diseases and compromised work performance, suggesting the need for more rest time before working nightshifts and work environments that stimulate physical activity and healthy diets. © 2016 The Author(s).

  17. We really need to talk: adapting FDA processes to rapid change.

    Science.gov (United States)

    Lykken, Sara

    2013-01-01

    The rapidly evolving realm of modern commerce strains traditional regulatory paradigms. This paper traces the historical evolution of FDA crisis-response regulation and provides examples of ways in which the definitions and procedures resulting from that past continue to be challenged by new products as market entrants, some in good faith and others not, take actions that create disconnects between actual product and marketing controls and those that consumers might expect. The paper then explores some of the techniques used by other federal agencies that have faced similar challenges in environments characterized by rapid innovation, and draws from this analysis suggestions for improvement of the FDA's warning letter system.

  18. Health Behaviour Change Through Computer Games: Characterising Interventions.

    Science.gov (United States)

    Poultney, Nathan; Maeder, Anthony; Ginige, Jeewani Anupama

    2016-01-01

    Recently games in the form of video, computer, or mobile apps have been utilised as an effective component of interventions for health behaviour change. This paper provides an overview of related projects reported in peer-review literature in the period 2006 to 2016. Nine highly relevant references were considered for analysis. The findings are presented according to 3 dimensions of characterisation: health intention, behaviour change principle, and health purpose.

  19. How well does climate change and human health research match the demands of policymakers? A scoping review.

    Science.gov (United States)

    Hosking, Jamie; Campbell-Lendrum, Diarmid

    2012-08-01

    In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help

  20. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    Natalya Vasilyevna Krivenko

    2013-03-01

    Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

  1. Planning a change project in mental health nursing.

    Science.gov (United States)

    Thorpe, Rebecca

    2015-09-02

    This article outlines a plan for a change project to improve the quality of physical health care on mental health wards. The plan was designed to improve the monitoring and recording of respiratory rates on mental health wards, through the implementation of a training programme for staff. A root cause analysis was used to explore the reasons for the low incidence of respiratory rate measurement on mental health wards, and the results of this establish the basis of the proposed change project and its aims and objectives. The article describes how the project could be implemented using a change management model, as well as how its effects could be measured and evaluated. Potential barriers to the planned change project are discussed, including the human dimensions of change. The article suggests methods to overcome such barriers, discusses the value of leadership as an important factor, and examines the principles of clinical governance in the context of the planned change project.

  2. An ill wind? Climate change, migration, and health.

    Science.gov (United States)

    McMichael, Celia; Barnett, Jon; McMichael, Anthony J

    2012-05-01

    Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Climate-change-related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change.

  3. Extended impacts of climate change on health and wellbeing

    International Nuclear Information System (INIS)

    Thomas, Felicity; Sabel, Clive E.; Morton, Katherine; Hiscock, Rosemary; Depledge, Michael H.

    2014-01-01

    Highlights: • Incorporates wellbeing into understandings of climate change impacts on health. • Considers a range of secondary impacts of climate change on health and wellbeing. • Examines co-benefits and dis-benefits of climate change adaptation and mitigation strategies for health and wellbeing. • Emphasises the spatially and socially differentiated repercussions of adaptation and mitigation measures. - Abstract: Anthropogenic climate change is progressively transforming the environment despite political and technological attempts to reduce greenhouse gas emissions to tackle global warming. Here we propose that greater insight and understanding of the health-related impacts of climate change can be gained by integrating the positivist approaches used in public health and epidemiology, with holistic social science perspectives on health in which the concept of ‘wellbeing’ is more explicitly recognised. Such an approach enables us to acknowledge and explore a wide range of more subtle, yet important health-related outcomes of climate change. At the same time, incorporating notions of wellbeing enables recognition of both the health co-benefits and dis-benefits of climate change adaptation and mitigation strategies across different population groups and geographical contexts. The paper recommends that future adaptation and mitigation policies seek to ensure that benefits are available for all since current evidence suggests that they are spatially and socially differentiated, and their accessibility is dependent on a range of contextually specific socio-cultural factors

  4. Beyond naturalness: Adapting wilderness stewardship to an era of rapid global change

    Science.gov (United States)

    David N. Cole

    2012-01-01

    Climate change and its effects are writ large across wilderness landscapes. They always have been and always will be (see Figure 1). But contemporary change is different. For the first time, the pace and direction of climate change appear to be driven significantly by human activities (IPCC 2007), and this change is playing out across landscapes already affected by...

  5. Integrated Theory of Health Behavior Change: Background and Intervention Development

    OpenAIRE

    RYAN, POLLY

    2009-01-01

    An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In ...

  6. Detecting and Attributing Health Burdens to Climate Change.

    Science.gov (United States)

    Ebi, Kristie L; Ogden, Nicholas H; Semenza, Jan C; Woodward, Alistair

    2017-08-07

    Detection and attribution of health impacts caused by climate change uses formal methods to determine a ) whether the occurrence of adverse health outcomes has changed, and b ) the extent to which that change could be attributed to climate change. There have been limited efforts to undertake detection and attribution analyses in health. Our goal was to show a range of approaches for conducting detection and attribution analyses. Case studies for heatwaves, Lyme disease in Canada, and Vibrio emergence in northern Europe highlight evidence that climate change is adversely affecting human health. Changes in rates and geographic distribution of adverse health outcomes were detected, and, in each instance, a proportion of the observed changes could, in our judgment, be attributed to changes in weather patterns associated with climate change. The results of detection and attribution studies can inform evidence-based risk management to reduce current, and plan for future, changes in health risks associated with climate change. Gaining a better understanding of the size, timing, and distribution of the climate change burden of disease and injury requires reliable long-term data sets, more knowledge about the factors that confound and modify the effects of climate on health, and refinement of analytic techniques for detection and attribution. At the same time, significant advances are possible in the absence of complete data and statistical certainty: there is a place for well-informed judgments, based on understanding of underlying processes and matching of patterns of health, climate, and other determinants of human well-being. https://doi.org/10.1289/EHP1509.

  7. Communication and relationship skills for rapid response teams at hamilton health sciences.

    Science.gov (United States)

    Cziraki, Karen; Lucas, Janie; Rogers, Toni; Page, Laura; Zimmerman, Rosanne; Hauer, Lois Ann; Daniels, Charlotte; Gregoroff, Susan

    2008-01-01

    Rapid response teams (RRT) are an important safety strategy in the prevention of deaths in patients who are progressively failing outside of the intensive care unit. The goal is to intervene before a critical event occurs. Effective teamwork and communication skills are frequently cited as critical success factors in the implementation of these teams. However, there is very little literature that clearly provides an education strategy for the development of these skills. Training in simulation labs offers an opportunity to assess and build on current team skills; however, this approach does not address how to meet the gaps in team communication and relationship skill management. At Hamilton Health Sciences (HHS) a two-day program was developed in collaboration with the RRT Team Leads, Organizational Effectiveness and Patient Safety Leaders. Participants reflected on their conflict management styles and considered how their personality traits may contribute to team function. Communication and relationship theories were reviewed and applied in simulated sessions in the relative safety of off-site team sessions. The overwhelming positive response to this training has been demonstrated in the incredible success of these teams from the perspective of the satisfaction surveys of the care units that call the team, and in the multi-phased team evaluation of their application to practice. These sessions offer a useful approach to the development of the soft skills required for successful RRT implementation.

  8. Climate Change, Wildland Fires and Public Health

    Science.gov (United States)

    Climate change is contributing to an increase in the severity of wildland fires. The annual acreage burned in the U.S. has risen steadily since 1985, and the fire season has lengthened. Wildland fires impair air quality by producing massive quantities of particulate air polluta...

  9. Designing serious video games for health behavior change: current status and future directions.

    Science.gov (United States)

    Thompson, Debbe

    2012-07-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player's knowledge and skill, ways in which personal mastery experiences can be incorporated into a video game environment, using game characters and avatars to promote observational learning, creating personalized experiences through tailoring, and the importance of achieving a balance between "fun-ness" and "seriousness." The article concludes with suggestions for future research needed to inform this rapidly growing field. © 2012 Diabetes Technology Society.

  10. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  11. Climate change and the possible health effects on older Australians.

    Science.gov (United States)

    Saniotis, Arthur; Irvine, Rod

    2010-01-01

    Climate change is an important issue for Australia. Climate change research forecasts that Australia will experience accelerated warming due to anthrogenic activities. Australia's aging society will face special challenges that demand current attention. This paper discusses two issues in relation to climate change and older Australians: first, pharmacology and autoregulation; and second, mental health among older Australians.

  12. Automatic change detection in RapidEye data using the combined MAD and kernel MAF methods

    DEFF Research Database (Denmark)

    Nielsen, Allan Aasbjerg; Hecheltjen, Antje; Thonfeld, Frank

    2010-01-01

    The IR-MAD components show changes for a large part of the entire subset. Especially phenological changes in the agricultural fields surrounding the open pit are predominant. As opposed to this, kMAF components focus more on changes in the open-cast mine (and changes due to the two clouds...... and their shadows, not visible in the zoom). Ground data were available from bucket-wheel excavators on the extraction side (to the northwest in the open pit) in terms of elevation data for both dates. No ground data were available for changes due to backfill (southeastern part of the open pit) or changes due...

  13. Change in vision, visual disability, and health after cataract surgery.

    Science.gov (United States)

    Helbostad, Jorunn L; Oedegaard, Maria; Lamb, Sarah E; Delbaere, Kim; Lord, Stephen R; Sletvold, Olav

    2013-04-01

    Cataract surgery improves vision and visual functioning; the effect on general health is not established. We investigated if vision, visual functioning, and general health follow the same trajectory of change the year after cataract surgery and if changes in vision explain changes in visual disability and general health. One-hundred forty-eight persons, with a mean (SD) age of 78.9 (5.0) years (70% bilateral surgery), were assessed before and 6 weeks and 12 months after surgery. Visual disability and general health were assessed by the CatQuest-9SF and the Short Formular-36. Corrected binocular visual acuity, visual field, stereo acuity, and contrast vision improved (P visual acuity evident up to 12 months (P = 0.034). Cataract surgery had an effect on visual disability 1 year later (P visual disability and general health 6 weeks after surgery. Vision improved and visual disability decreased in the year after surgery, whereas changes in general health and visual functioning were short-term effects. Lack of associations between changes in vision and self-reported disability and general health suggests that the degree of vision changes and self-reported health do not have a linear relationship.

  14. Reform, change, and continuity in Finnish health care.

    Science.gov (United States)

    Häkkinen, Unto; Lehto, Juhani

    2005-01-01

    This article describes some essential aspects of the Finnish political and governmental system and the evolution of the basic institutional elements of the health care system. We examine the developments that gave rise to a series of health care reforms and reform proposals in the late 1980s and early 1990s and relate them to changes in health care expenditure, structure, and performance. Finally, we discuss the relationship between policy changes, reforms, and health system changes and the strength of neo-institutional theory in explaining both continuity and change. Much of the change in Finnish health care can be explained by institutional path dependency. The tradition of strong but small local authorities and the lack of legitimate democratic regional authorities as well as the coexistence of a dominant Beveridge-style health system with a marginal Bismarckian element explain the specific path of Finnish health care reform. Public responsibility for health care has been decentralized to smaller local authorities (known as municipalities) more than in any other country. Even an exceptionally deep economic recession in the early 1990s did not lead to systems change; rather, the economic imperative was met by the traditional centralized policy pattern. Some of the developments of the 1990s are, however, difficult to explain by institutional theory. Thus, there is a need for testing alternative theories as well.

  15. Diaper Need: A Change for Better Health.

    Science.gov (United States)

    Porter, Sallie; Steefel, Lorraine

    2015-01-01

    Although diapers are essential for child health, nearly one in three American families cannot afford them (National Diaper Bank Network, 2013). A gap referred to as diaper need, the difference between the numbers of diapers infants require to stay clean and comfortable less the amount of diapers a family can afford without cutting back on other basic essentials, can have severe consequences for infants parents, and society. Within the context of the need for and economics of diapers, these severe consequences alert pediatric nurses to the impact they can have to bridge the diaper gap, thereby helping to alleviate diaper-related conditions and providing holistic, family-centered care.

  16. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    Science.gov (United States)

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health

  17. Understanding and managing organizational change: implications for public health management.

    Science.gov (United States)

    Thompson, Jon M

    2010-01-01

    Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.

  18. Changing Work, Changing Health: Can Real Work-Time Flexibility Promote Health Behaviors and Well-Being?

    Science.gov (United States)

    Moen, Phyllis; Kelly, Erin L.; Tranby, Eric; Huang, Qinlei

    2012-01-01

    This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees’ schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees’ health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors. PMID:22144731

  19. Changing work, changing health: can real work-time flexibility promote health behaviors and well-being?

    Science.gov (United States)

    Moen, Phyllis; Kelly, Erin L; Tranby, Eric; Huang, Qinlei

    2011-12-01

    This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees' schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees' health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors.

  20. Climate Change and Health in India

    Indian Academy of Sciences (India)

    “Climate change is the defining challenge of our age” Ban Ki Moon, UN Secretary – General (2007) · Slide 3 · Slide 4 · Slide 5 · Slide 6 · Slide 7 · Slide 8 · All Hazard Hotspots/Population Density · Heat Waves · Heat Waves in India · Extreme Weather Events · Extreme weather Events · Slide 14 · 'All time record rain in ...

  1. Lifestyle Assessment: Helping Patients Change Health Behaviors

    OpenAIRE

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

    This article is the second in a series of six on lifestyle assessment and behavior change. The first article presented an assessment tool called FANTASTIC, which has been tested for reliability and is currently in wide use. After assessment, family physicians must help patients decide to change—and give them guidance on how to change—unhealthy behaviors. This article explains how the family physician can use educational, behavioral and relaxation strategies to increase patients' motivation, m...

  2. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review.

    OpenAIRE

    Fitzpatrick-Lewis, D; Ganann, R; Krishnaratne, S; Ciliska, D; Kouyoumdjian, F; Hwang, SW

    2011-01-01

    Abstract Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databas...

  3. Methoxychlor and Vinclozolin Induce Rapid Changes in Intercellular and Intracellular Signaling in Liver Progenitor Cells.

    Science.gov (United States)

    Babica, Pavel; Zurabian, Rimma; Kumar, Esha R; Chopra, Rajus; Mianecki, Maxwell J; Park, Joon-Suk; Jaša, Libor; Trosko, James E; Upham, Brad L

    2016-09-01

    Methoxychlor (MXC) and vinclozolin (VIN) are well-recognized endocrine disrupting chemicals known to alter epigenetic regulations and transgenerational inheritance; however, non-endocrine disruption endpoints are also important. Thus, we determined the effects of MXC and VIN on the dysregulation of gap junctional intercellular communication (GJIC) and activation of mitogen-activated protein kinases (MAPKs) in WB-F344 rat liver epithelial cells. Both chemicals induced a rapid dysregulation of GJIC at non-cytotoxic doses, with 30 min EC50 values for GJIC inhibition being 10 µM for MXC and 126 µM for VIN. MXC inhibited GJIC for at least 24 h, while VIN effects were transient and GJIC recovered after 4 h. VIN induced rapid hyperphosphorylation and internalization of gap junction protein connexin43, and both chemicals also activated MAPK ERK1/2 and p38. Effects on GJIC were not prevented by MEK1/2 inhibitor, but by an inhibitor of phosphatidylcholine-specific phospholipase C (PC-PLC), resveratrol, and in the case of VIN, also, by a p38 inhibitor. Estrogen (ER) and androgen receptor (AR) modulators (estradiol, ICI 182,780, HPTE, testosterone, flutamide, VIN M2) did not attenuate MXC or VIN effects on GJIC. Our data also indicate that the effects were elicited by the parental compounds of MXC and VIN. Our study provides new evidence that MXC and VIN dysregulate GJIC via mechanisms involving rapid activation of PC-PLC occurring independently of ER- or AR-dependent genomic signaling. Such alterations of rapid intercellular and intracellular signaling events involved in regulations of gene expression, tissue development, function and homeostasis, could also contribute to transgenerational epigenetic effects of endocrine disruptors. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Land use change monitoring in Maryland using a probabilistic sample and rapid photointerpretation

    Science.gov (United States)

    Tonya Lister; Andrew Lister; Eunice Alexander

    2014-01-01

    The U.S. state of Maryland needs to monitor land use change in order to address land management objectives. This paper presents a change detection method that, through automation and standard geographic information system (GIS) techniques, facilitates the estimation of landscape change via photointerpretation. Using the protocols developed, we show a net loss of forest...

  5. Rapid lung MRI in children with pulmonary infections: Time to change our diagnostic algorithms.

    Science.gov (United States)

    Sodhi, Kushaljit Singh; Khandelwal, Niranjan; Saxena, Akshay Kumar; Singh, Meenu; Agarwal, Ritesh; Bhatia, Anmol; Lee, Edward Y

    2016-05-01

    To determine the diagnostic utility of a new rapid MRI protocol, as compared with computed tomography (CT) for the detection of various pulmonary and mediastinal abnormalities in children with suspected pulmonary infections. Seventy-five children (age range of 5 to 15 years) with clinically suspected pulmonary infections were enrolled in this prospective study, which was approved by the institutional ethics committee. All patients underwent thoracic MRI (1.5T) and CT (64 detector) scan within 48 h of each other. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were evaluated with CT as a standard of reference. Inter-observer agreement was measured with the kappa coefficient. MRI with a new rapid MRI protocol demonstrated sensitivity, specificity, PPV, and NPV of 100% for detecting pulmonary consolidation, nodules (>3 mm), cyst/cavity, hyperinflation, pleural effusion, and lymph nodes. The kappa-test showed almost perfect agreement between MRI and multidetector CT (MDCT) in detecting thoracic abnormalities (k = 0.9). No statistically significant difference was observed between MRI and MDCT for detecting thoracic abnormalities by the McNemar test (P = 0.125). Rapid lung MRI was found to be comparable to MDCT for detecting thoracic abnormalities in pediatric patients with clinically suspected pulmonary infections. It has a great potential as the first line cross-sectional imaging modality of choice in this patient population. However, further studies will be helpful for confirmation of our findings. © 2015 Wiley Periodicals, Inc.

  6. Earth as humans’ habitat: global climate change and the health of populations

    Science.gov (United States)

    McMichael, Anthony J

    2014-01-01

    Human-induced climate change, with such rapid and continuing global-scale warming, is historically unprecedented and signifies that human pressures on Earth’s life-supporting natural systems now exceed the planet’s bio-geo-capacity. The risks from climate change to health and survival in populations are diverse, as are the social and political ramifications. Although attributing observed health changes in a population to the recent climatic change is difficult, a coherent pattern of climate- and weather-associated changes is now evident in many regions of the world. The risks impinge unevenly, especially on poorer and vulnerable regions, and are amplified by pre-existing high rates of climate-sensitive diseases and conditions. If, as now appears likely, the world warms by 3-5oC by 2100, the health consequences, directly and via massive social and economic disruption, will be severe. The health sector has an important message to convey, comparing the health risks and benefits of enlightened action to avert climate change and to achieve sustainable ways of living versus the self-interested or complacent inaction. PMID:24596901

  7. Earth as Humans’ Habitat: Global Climate Change and the Health of Populations

    Directory of Open Access Journals (Sweden)

    Anthony J McMichael

    2014-01-01

    Full Text Available Human-induced climate change, with such rapid and continuing global-scale warming, is historically unprecedented and signifies that human pressures on Earth’s life-supporting natural systems now exceed the planet’s bio-geo-capacity. The risks from climate change to health and survival in populations are diverse, as are the social and political ramifications. Although attributing observed health changes in a population to the recent climatic change is difficult, a coherent pattern of climate- and weather-associated changes is now evident in many regions of the world. The risks impinge unevenly, especially on poorer and vulnerable regions, and are amplified by pre-existing high rates of climate-sensitive diseases and conditions. If, as now appears likely, the world warms by 3-5oC by 2100, the health consequences, directly and via massive social and economic disruption, will be severe. The health sector has an important message to convey, comparing the health risks and benefits of enlightened action to avert climate change and to achieve sustainable ways of living versus the self-interested or complacent inaction.

  8. Global Governance for Health: how to motivate political change?

    Science.gov (United States)

    McNeill, D; Ottersen, O P

    2015-07-01

    In this article, we address a central theme that was discussed at the Durham Health Summit: how can politics be brought back into global health governance and figure much more prominently in discussions around policy? We begin by briefly summarizing the report of the Lancet - University of Oslo Commission on Global Governance for Health: 'The Political Origins of Health Inequity' Ottersen et al. In order to provide compelling evidence of the central argument, the Commission selected seven case studies relating to, inter alia, economic and fiscal policy, food security, and foreign trade and investment agreements. Based on an analysis of these studies, the report concludes that the problems identified are often due to political choices: an unwillingness to change the global system of governance. This raises the question: what is the most effective way that a report of this kind can be used to motivate policy-makers, and the public at large, to demand change? What kind of moral or rational argument is most likely to lead to action? In this paper we assess the merits of various alternative perspectives: health as an investment; health as a global public good; health and human security; health and human development; health as a human right; health and global justice. We conclude that what is required in order to motivate change is a more explicitly political and moral perspective - favouring the later rather than the earlier alternatives just listed. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. The Effects of Climate Change on Cardiac Health.

    Science.gov (United States)

    De Blois, Jonathan; Kjellstrom, Tord; Agewall, Stefan; Ezekowitz, Justin A; Armstrong, Paul W; Atar, Dan

    2015-01-01

    The earth's climate is changing and increasing ambient heat levels are emerging in large areas of the world. An important cause of this change is the anthropogenic emission of greenhouse gases. Climate changes have a variety of negative effects on health, including cardiac health. People with pre-existing medical conditions such as cardiovascular disease (including heart failure), people carrying out physically demanding work and the elderly are particularly vulnerable. This review evaluates the evidence base for the cardiac health consequences of climate conditions, with particular reference to increasing heat exposure, and it also explores the potential further implications. © 2015 S. Karger AG, Basel.

  10. Health co-benefits in mortality avoidance from implementation of the mass rapid transit (MRT) system in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Kwan, Soo Chen; Tainio, Marko; Woodcock, James; Hashim, Jamal Hisham

    2016-03-01

    The mass rapid transit (MRT) is the largest transport infrastructure project under the national key economic area (NKEA) in Malaysia. As urban rail is anticipated to be the future spine of public transport network in the Greater Kuala Lumpur city, it is important to mainstream climate change mitigation and public health benefits in the local transport development. This study quantifies the health co-benefits in terms of mortality among the urbanites when the first line of the 150 km MRT system in Kuala Lumpur commences by 2017. Using comparative health risk assessment, we estimated the potential health co-benefits from the establishment of the MRT system. We estimated the reduced CO2 emissions and air pollution (PM2.5) exposure reduction among the general population from the reduced use of motorized vehicles. Mortality avoided from traffic incidents involving motorcycles and passenger cars, and from increased physical activity from walking while using the MRT system was also estimated. A total of 363,130 tonnes of CO2 emissions could be reduced annually from the modal shift from cars and motorcycles to the MRT system. Atmospheric PM2.5 concentration could be reduced 0.61 μg/m3 annually (2%). This could avoid a total of 12 deaths, mostly from cardio-respiratory diseases among the city residents. For traffic injuries, 37 deaths could be avoided annually from motorcycle and passenger cars accidents especially among the younger age categories (aged 15-30). One additional death was attributed to pedestrian walking. The additional daily physical activity to access the MRT system could avoid 21 deaths among its riders. Most of the mortality avoided comes from cardiovascular diseases. Overall, a total of 70 deaths could be avoided annually among both the general population and the MRT users in the city. The implementation of the MRT system in Greater Kuala Lumpur could bring substantial health co-benefits to both the general population and the MRT users mainly from the

  11. Assessing health systems for type 1 diabetes in sub-Saharan Africa: developing a 'Rapid Assessment Protocol for Insulin Access'

    DEFF Research Database (Denmark)

    Beran, David; Yudkin, John S; de Courten, Maximilian

    2006-01-01

    In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol...... for the gathering of other data through site visits, discussions, and document reviews....

  12. Health workers' compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Kabaghe, Alinune N.; Visser, Benjamin J.; Spijker, Rene; Phiri, Kamija S.; Grobusch, Martin P.; van Vugt, Michèle

    2016-01-01

    The World Health Organization recommends malaria to be confirmed by either microscopy or a rapid diagnostic test (RDT) before treatment. The correct use of RDTs in resource-limited settings facilitates basing treatment onto a confirmed diagnosis; contributes to speeding up considering a correct

  13. The Future of Occupational Health Nursing in a Changing Health Care System.

    Science.gov (United States)

    McCauley, Linda; Peterman, Katherine

    2017-04-01

    Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.

  14. A replicated climate change field experiment reveals rapid evolutionary response in an ecologically important soil invertebrate

    DEFF Research Database (Denmark)

    Bataillon, Thomas; Galtier, Nicolas; Bernard, Aurelien

    2016-01-01

    to climate change in a common annelid worm using a controlled replicated experiment where climatic conditions were manipulated in a natural setting. Analyzing the transcribed genome of 15 local populations, we found that about 12% of the genetic polymorphisms exhibit differences in allele frequencies......Whether species can respond evolutionarily to current climate change is crucial for the persistence of many species. Yet, very few studies have examined genetic responses to climate change in manipulated experiments carried out innatural field conditions. We examined the evolutionary response...... associated to changes in soil temperature and soil moisture. This shows an evolutionaryresponse to realistic climate change happening over short-time scale, and calls for incorporating evolution into modelspredicting future response of species to climate change. It also shows that designed climate change...

  15. Climate change and health: temperature and health impacts

    CSIR Research Space (South Africa)

    Matooane, M

    2009-03-01

    Full Text Available /heat waves are anticipated to increase in frequency and magnitude in the 21st century. excessive temperatures lead to excess morbidity and mortality (all cause, respiratory, cardiovascular system mortality). Figure 1 depicts the impact of summer 2003... mortality temperature threshold below or above which every 1?C change increases mortality by ~4% and ~0.5%, respectively (mcmichael, et al., 2008). temperature-related mortality rates (all cause, cardiovascular and respiratory) are modified by many...

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

    Science.gov (United States)

    Guzzone, F.; Setegn, S.

    2013-12-01

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

  17. Roundtable on health and climate change : summary proceedings, final report

    International Nuclear Information System (INIS)

    2001-02-01

    The gradual warming of the earth's atmosphere is expected to increase the frequency and severity of droughts, winter storms and tornadoes, change the pattern and distribution of many diseases and allergens, and cause a rise in the number of very hot days in larger cities, exasperating existing smog problems. This paper provides highlights of the Roundtable on Health and Climate Change held in September 2000. The discussions focused on the fact that climatic and environmental factors are important determinants of human and ecosystem health. The major findings and outcomes that received the most attention during the Roundtable process were presented. The panellists addressed the following five themes linking health and climate change: (1) health impacts and costs of climate change, (2) health implications of reducing emissions, (3) climate change scenarios, (4) the role of the health sector, and (5) collaborative and coordinated approaches. Each theme reflected the mandate of public health which is to prevent disease, ease suffering and heal the sick. Several actions were recommended by the panelists for collaborative action between health professionals, special interest groups and all levels of government and the private sector

  18. Changes in Employed People’s Health Satisfaction

    Directory of Open Access Journals (Sweden)

    Monika Jungbauer-Gans

    2013-09-01

    Full Text Available The article examines for Germany whether the subjective satisfaction with health has changed over the course of time. It is analysed whether a drop in health satisfaction can be observed and whether this can be explained by changing employment circumstances. Labour market research has documented a change in the employment situation in detail, which can be subsumed under the keyword of precarisation. In the theoretical section we will portray the current state of research concerning the development of the employment situation and emphasize the significance of gainful employment for health. The empirical analyses of the article are based on data of employed people in the German Socio-Economic Panel Study (SOEP of the years 1985, 1996 and 2009. The data show a significantly declining health satisfaction between 1985 and 2009 in Western Germany and no noteworthy change in Eastern Germany between 1996 and 2009. The Blinder/Oaxaca decomposition is used in the analyses to better differentiate the effect of the changed employment situation on the drop in health satisfaction. The analyses indeed reveal changing effects of the employment situation. In Western Germany, a significant percentage of the lesser health satisfaction can be attributed to an increasing number of workers in precarious employment situations. Workplace security is of primary significance for explaining the declining health satisfaction in Western Germany.

  19. 'Rapid Learning health care in oncology' - An approach towards decision support systems enabling customised radiotherapy'

    NARCIS (Netherlands)

    Lambin, P.; Roelofs, E.; Reymen, B.; Velazquez, E.R.; Buijsen, J.; Zegers, C.M.; Carvalho, S.; Leijenaar, R.T.; Nalbantov, G.; Oberije, C.; Marshall, M.; Hoebers, F.; Troost, E.G.C.; Stiphout, R.G.; Elmpt, W. van; Weijden, T.T. van der; Boersma, L.; Valentini, V.; Dekker, A.

    2013-01-01

    PURPOSE: An overview of the Rapid Learning methodology, its results, and the potential impact on radiotherapy. MATERIAL AND RESULTS: Rapid Learning methodology is divided into four phases. In the data phase, diverse data are collected about past patients, treatments used, and outcomes. Innovative

  20. Perspectives of Patients With Cancer on the Ethics of Rapid-Learning Health Systems.

    Science.gov (United States)

    Jagsi, Reshma; Griffith, Kent A; Sabolch, Aaron; Jones, Rochelle; Spence, Rebecca; De Vries, Raymond; Grande, David; Bradbury, Angela R

    2017-07-10

    Purpose To inform the evolving implementation of CancerLinQ and other rapid-learning systems for oncology care, we sought to evaluate perspectives of patients with cancer regarding ethical issues. Methods Using the GfK Group online research panel, representative of the US population, we surveyed 875 patients with cancer; 621 (71%) responded. We evaluated perceptions of appropriateness (scored from 1 to 10; 10, very appropriate) using scenarios and compared responses by age, race, and education. We constructed a scaled measure of comfort with secondary use of deidentified medical information and evaluated its correlates in a multivariable model. Results Of the sample, 9% were black and 9% Hispanic; 38% had completed high school or less, and 59% were age ≥ 65 years. Perceptions of appropriateness were highest when consent was obtained and university researchers used data to publish a research study (weighted mean appropriateness, 8.47) and lowest when consent was not obtained and a pharmaceutical company used data for marketing (weighted mean appropriateness, 2.7). Most respondents (72%) thought secondary use of data for research was very important, although those with lower education were less likely to endorse this (62% v 78%; P < .001). Overall, 35% believed it was necessary to obtain consent each time such research was to be performed; this proportion was higher among blacks/Hispanics than others (48% v 33%; P = .02). Comfort with the use of deidentified information from medical records varied by scenario and overall was associated with distrust in the health care system. Conclusion Perceptions of patients with cancer regarding secondary data use depend on the user and the specific use of the data, while also frequently differing by patient sociodemographic factors. Such information is critical to inform ongoing efforts to implement oncology learning systems.

  1. Workplace Financial Wellness Programs Help Employees Manage Health Care Changes.

    Science.gov (United States)

    Meyer, Cynthia; Smith, Michael C

    Employers and employees are navigating major changes in health insurance benefits, including the move to high-deductible health plans in conjunction with health savings accounts (HSAs). The HSA offers unique benefits that could prove instrumental in helping workers both navigate current health care expenses and build a nest egg for much larger health care costs in retirement. Yet employees often don't understand the HSA and how to best use it. How can employers help employees make wise benefits choices that work for their personal financial circumstances?

  2. Community benefits in a changing health care market.

    Science.gov (United States)

    1997-07-01

    Market changes in the health industry--mergers, acquisitions, and other transactions--are eliminating many of the traditional sources of care for people who have no insurance or poor coverage. There are fewer public or private nonprofit hospitals with a charitable mission. Moreover, through Medicaid contracting, a portion of the funds that once supported broad public health goals now go to private HMOs that serve only their own members. Advocates are responding with the demand that health providers--nonprofit and for-profit, hospitals and health plans--collaborate with the residents of communities where they do business to improve people's health.

  3. Changes in retiree health benefits: results of a national survey.

    Science.gov (United States)

    de Lissovoy, G; Kasper, J D; Di Carlo, S; Gabel, J

    1990-01-01

    Employers are increasingly concerned by the cost of health benefits provided to retired workers. One reason is that the Financial Accounting Standards Board (FASB), the organization that establishes "generally accepted accounting principles," has proposed altering the way firms report expenditures for retiree medical coverage on financial statements. We recently completed a national survey of business firms offering retiree health benefits to address three issues: 1) What is the current structure of retiree health benefit plans? 2) What changes are firms planning to implement in the structure of their retiree health benefits? 3) To what extent are these changes due to the FASB proposal? The FASB reporting proposal is only one factor underlying these changes. More important is the real financial pressure on firms due to the accelerating cost of retiree health care.

  4. Social and health dimensions of climate change in the Amazon.

    Science.gov (United States)

    Brondízio, Eduardo S; de Lima, Ana C B; Schramski, Sam; Adams, Cristina

    2016-07-01

    The Amazon region has been part of climate change debates for decades, yet attention to its social and health dimensions has been limited. This paper assesses literature on the social and health dimensions of climate change in the Amazon. A conceptual framework underscores multiple stresses and exposures created by interactions between climate change and local social-environmental conditions. Using the Thomson-Reuter Web of Science, this study bibliometrically assessed the overall literature on climate change in the Amazon, including Physical Sciences, Social Sciences, Anthropology, Environmental Science/Ecology and Public, Environmental/Occupational Health. From this assessment, a relevant sub-sample was selected and complemented with literature from the Brazilian database SciELO. This sample discusses three dimensions of climate change impacts in the region: livelihood changes, vector-borne diseases and microbial proliferation, and respiratory diseases. This analysis elucidates imbalance and disconnect between ecological, physical and social and health dimensions of climate change and between continental and regional climate analysis, and sub-regional and local levels. Work on the social and health implications of climate change in the Amazon falls significantly behind other research areas, limiting reliable information for analytical models and for Amazonian policy-makers and society at large. Collaborative research is called for.

  5. Rapid change in the defense of flightless young by a mourning dove parent

    Science.gov (United States)

    Berdeen, James; Otis, D.L.

    2011-01-01

    We report that an adult-sized Zenaida macroura (Mourning Dove), presumably a parent, rapidly decreased risk taken in defense of a juvenile as the likelihood of predation to the juvenile increased. We attribute this decrease in risk taken to (1) the parent's perception that the risk of predation had increased to the extent that a continuation of defensive behaviors would not prevent the death of the juvenile, and (2) its attempt to minimize its own risk of death. It may be that there is a threshold beyond which Mourning Dove parents will forgo the risk of additional defense of offspring in favor of making another reproductive attempt.

  6. Use of malaria rapid diagnostic tests by community health workers in Afghanistan: cluster randomised trial.

    Science.gov (United States)

    Leslie, Toby; Rowland, Mark; Mikhail, Amy; Cundill, Bonnie; Willey, Barbara; Alokozai, Asif; Mayan, Ismail; Hasanzai, Anwar; Baktash, Sayed Habibullah; Mohammed, Nader; Wood, Molly; Rahimi, Habib-U-Rahman; Laurent, Baptiste; Buhler, Cyril; Whitty, Christopher J M

    2017-07-07

    The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use of malaria rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within health services in south and central Asia. mRDTs could allow CHWs to diagnose malaria accurately, improving treatment of febrile illness. A cluster randomised trial in community health services was undertaken in Afghanistan. The primary outcome was the proportion of suspected malaria cases correctly treated for polymerase chain reaction (PCR)-confirmed malaria and PCR negative cases receiving no antimalarial drugs measured at the level of the patient. CHWs from 22 clusters (clinics) received standard training on clinical diagnosis and treatment of malaria; 11 clusters randomised to the intervention arm received additional training and were provided with mRDTs. CHWs enrolled cases of suspected malaria, and the mRDT results and treatments were compared to blind-read PCR diagnosis. In total, 256 CHWs enrolled 2400 patients with 2154 (89.8%) evaluated. In the intervention arm, 75.3% (828/1099) were treated appropriately vs. 17.5% (185/1055) in the control arm (cluster adjusted risk ratio: 3.72, 95% confidence interval 2.40-5.77; p < 0.001). In the control arm, 85.9% (164/191) with confirmed Plasmodium vivax received chloroquine compared to 45.1% (70/155) in the intervention arm (p < 0.001). Overuse of chloroquine in the control arm resulted in 87.6% (813/928) of those with no malaria (PCR negative) being treated vs. 10.0% (95/947) in the intervention arm, p < 0.001. In the intervention arm, 71.4% (30/42) of patients with P. falciparum did not receive artemisinin-based combination therapy, partly because operational sensitivity of the RDTs was low (53.2%, 38.1-67.9). There was high concordance between recorded RDT result and CHW prescription decisions: 826/950 (87.0%) with a negative test were not prescribed an antimalarial. Co

  7. Does Rapid and Sustained Economic Growth Lead to Convergence in Health Resources: The Case of China From 1980 to 2010.

    Science.gov (United States)

    Liang, Di; Zhang, Donglan; Huang, Jiayan; Schweitzer, Stuart

    2016-01-01

    China's rapid and sustained economic growth offers an opportunity to ask whether the advantages of growth diffuse throughout an economy, or remain localized in areas where the growth has been the greatest. A critical policy area in China has been the health system, and health inequality has become an issue that has led the government to broaden national health insurance programs. This study investigates whether health system resources and performance have converged over the past 30 years across China's 31 provinces. To examine geographic variation of health system resources and performance at the provincial level, we measure the degree of sigma convergence and beta convergence in indicators of health system resources (structure), health services utilization (process), and outcome. All data are from officially published sources: the China Health Statistics Year Book and the China Statistics Year Book. Sigma convergence is found for resource indicators, whereas it is not observed for either process or outcome indicators, indicating that disparities only narrowed in health system resources. Beta convergence is found in most indicators, except for 2 procedure indicators, reflecting that provinces with poorer resources were catching up. Convergence found in this study probably reflects the mixed outcome of government input, and market forces. Thus, left alone, the equitable distribution of health care resources may not occur naturally during a period of economic growth. Governmental and societal efforts are needed to reduce geographic health variation and promote health equity. © The Author(s) 2016.

  8. Transforming medical professionalism to fit changing health needs

    Directory of Open Access Journals (Sweden)

    Starfield Barbara

    2009-10-01

    Full Text Available Abstract Background The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs. Discussion Medical leaders, supported by health policy makers, can consciously activate the self-regulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1 defining and categorizing the health needs of the population; (2 reorganizing the specialty domains around the needs of population groups; (3 reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation. Summary Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.

  9. Climate Change and Public Health Policy: Translating the Science

    OpenAIRE

    Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

    2013-01-01

    Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible i...

  10. Public Health Adaptation to Climate Change in OECD Countries

    Science.gov (United States)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning. PMID:27618074

  11. Public Health Adaptation to Climate Change in OECD Countries.

    Science.gov (United States)

    Austin, Stephanie E; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D; Parker, Stephen; Fleury, Manon D

    2016-09-07

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

  12. One Health/EcoHealth capacity building programs in South and South East Asia: a mixed method rapid systematic review.

    Science.gov (United States)

    Chatterjee, Pranab; Chauhan, Abhimanyu Singh; Joseph, Jessy; Kakkar, Manish

    2017-09-29

    Although One Health (OH) or EcoHealth (EH) have been acknowledged to provide comprehensive and holistic approaches to study complex problems, like zoonoses and emerging infectious diseases, there remains multiple challenges in implementing them in a problem-solving paradigm. One of the most commonly encountered barriers, especially in low- and middle-income countries, is limited capacity to undertake OH/EH inquiries. A rapid review was undertaken to conduct a situation analysis of the existing OH/EH capacity building programs, with a focused analysis of those programs with extensive OH engagement, to help map the current efforts in this area. A listing of the OH/EH projects/initiatives implemented in South Asia (SA) and South East Asia (SEA) was done, followed by analysis of documents related to the projects, available from peer-reviewed or grey literature sources. Quantitative data was extracted using a data extraction format, and a free listing of qualitative themes was undertaken. In SEA, 13 unique OH/EH projects, with 37 capacity building programs, were identified. In contrast, in SA, the numbers were 8 and 11 respectively. In SA, programs were oriented to develop careers in program management, whereas, in SEA, the emphasis was on research. Two thirds of the programs in SEA had extensive OH engagement, whereas only one third of those in SA did. The target for the SEA programs was wider, including a population more representative of OH stakes. SEA program themes reveal utilization of multiple approaches, usually in shorter terms, and are growing towards integration with the traditional curricula. Such convergence of themes was lacking in SA programs. In both regions, the programs were driven by external donor agencies, with minimal local buy-in. There is limited investment in research capacity building in both SA and SEA. The situation appears to be more stark in SA, whilst SEA has been able to use the systematic investment and support to develop the OH

  13. Rapid forest change in the interior west presents analysis opportunities and challenges

    Science.gov (United States)

    John D. Shaw

    2007-01-01

    A recent drought has caused compositional and structural changes in Interior West forests. Recent periodic and annual inventory data provide an opportunity to analyze forest changes on a grand scale. This "natural experiment" also provides opportunities to test the effectiveness of Forest Inventory and Analysis (FIA) methodologies. It also presents some...

  14. Climate change and wildlife health: direct and indirect effects

    Science.gov (United States)

    Hofmeister, Erik K.; Moede Rogall, Gail; Wesenberg, Katherine; Abbott, Rachel C.; Work, Thierry M.; Schuler, Krysten; Sleeman, Jonathan M.; Winton, James

    2010-01-01

    Climate change will have significant effects on the health of wildlife, domestic animals, and humans, according to scientists. The Intergovernmental Panel on Climate Change projects that unprecedented rates of climate change will result in increasing average global temperatures; rising sea levels; changing global precipitation patterns, including increasing amounts and variability; and increasing midcontinental summer drought (Intergovernmental Panel on Climate Change, 2007). Increasing temperatures, combined with changes in rainfall and humidity, may have significant impacts on wildlife, domestic animal, and human health and diseases. When combined with expanding human populations, these changes could increase demand on limited water resources, lead to more habitat destruction, and provide yet more opportunities for infectious diseases to cross from one species to another.

  15. A rapid infusion protocol is safe for total dose iron polymaltose: time for change.

    Science.gov (United States)

    Garg, M; Morrison, G; Friedman, A; Lau, A; Lau, D; Gibson, P R

    2011-07-01

    Intravenous correction of iron deficiency by total dose iron polymaltose is inexpensive and safe, but current protocols entail prolonged administration over more than 4 h. This results in reduced patient acceptance, and hospital resource strain. We aimed to assess prospectively the safety of a rapid intravenous protocol and compare this with historical controls. Consecutive patients in whom intravenous iron replacement was indicated were invited to have up to 1.5 g iron polymaltose by a 58-min infusion protocol after an initial 15-min test dose without pre-medication. Infusion-related adverse events (AE) and delayed AE over the ensuing 5 days were also prospectively documented and graded as mild, moderate or severe. One hundred patients, 63 female, mean age 54 (range 18-85) years were studied. Thirty-four infusion-related AE to iron polymaltose occurred in a total of 24 patients--25 mild, 8 moderate and 1 severe; higher than previously reported for a slow protocol iron infusion. Thirty-one delayed AE occurred in 26 patients--26 mild, 3 moderate and 2 severe; similar to previously reported. All but five patients reported they would prefer iron replacement through the rapid protocol again. The presence of inflammatory bowel disease (IBD) predicted infusion-related reactions (54% vs 14% without IBD, P cost, resource utilization and time benefits for the patient and hospital system. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  16. Rapid transformation of two libraries using Kotter's Eight Steps of Change.

    Science.gov (United States)

    Wheeler, Terrie R; Holmes, Kristi L

    2017-07-01

    Two new directors were each charged by their institutions to catalyze transformational change in their libraries and to develop dynamic and evolving information ecosystems ready for the information challenges of the future. The directors approached this transformational change using a strategic, forward-looking approach. This paper presents examples of actions that served as catalysts for change at the two libraries using Kotter's Eight Steps of Change as a framework. Small and large changes are critical for successfully transforming library services, resources, and personnel. Libraries are faced with incredible pressure to adapt to meet emerging and intensifying information needs on today's academic medical campuses. These pressures offer an opportunity for libraries to accelerate their evolution at the micro and macro levels. This commentary reports the expansion of new services and areas of support, enhancement of professional visibility of the libraries on their campuses, and overall, a more positive and productive environment at the respective institutions.

  17. Systemic range shift lags among a pollinator species assemblage following rapid climate change

    DEFF Research Database (Denmark)

    Bedford, Felicity E.; Whittaker, Robert J.; Kerr, Jeremy T.

    2012-01-01

    Contemporary climate change is driving widespread geographical range shifts among many species. If species are tracking changing climate successfully, then leading populations should experience similar climatic conditions through time as new populations establish beyond historical range margins....... Here, we investigate geographical range shifts relative to changing climatic conditions among a particularly well-sampled assemblage of butterflies in Canada. We assembled observations of 81 species and measured their latitudinal displacement between two periods: 1960–1975 (a period of little climate...... change) and 1990–2005 (a period with large climate change). We find an unexpected trend for species’ northern borders to shift progressively less relative to increasing minimum winter temperatures in northern Canada. This study demonstrates a novel, systemic latitudinal gradient in lags among a large...

  18. RAPID PENUMBRA AND LORENTZ FORCE CHANGES IN AN X1.0 SOLAR FLARE

    International Nuclear Information System (INIS)

    Xu, Zhe; Jiang, Yunchun; Yang, Jiayang; Yang, Bo; Bi, Yi

    2016-01-01

    We present observations of the violent changes in photospheric magnetic structures associated with an X1.1 flare, which occurred in a compact δ-configuration region in the following part of AR 11890 on 2013 November 8. In both central and peripheral penumbra regions of the small δ sunspot, these changes took place abruptly and permanently in the reverse direction during the flare: the inner/outer penumbra darkened/disappeared, where the magnetic fields became more horizontal/vertical. Particularly, the Lorentz force (LF) changes in the central/peripheral region had a downward/upward and inward direction, meaning that the local pressure from the upper atmosphere was enhanced/released. It indicates that the LF changes might be responsible for the penumbra changes. These observations can be well explained as the photospheric response to the coronal field reconstruction within the framework of the magnetic implosion theory and the back reaction model of flares

  19. Climate Change and Public Health Policy: Translating the Science

    Science.gov (United States)

    Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

    2013-01-01

    Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character. PMID:24452252

  20. Climate change and public health policy: translating the science.

    Science.gov (United States)

    Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

    2013-12-19

    Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

  1. Climate Change and Public Health Policy: Translating the Science

    Directory of Open Access Journals (Sweden)

    Marieta Braks

    2013-12-01

    Full Text Available Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

  2. Public Health Adaptation to Climate Change in Large Cities: A Global Baseline.

    Science.gov (United States)

    Araos, Malcolm; Austin, Stephanie E; Berrang-Ford, Lea; Ford, James D

    2016-01-01

    Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation. © The Author(s) 2015.

  3. Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

    Science.gov (United States)

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

    Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

  4. The Future of Nursing: Leading Change, Advancing Health

    Science.gov (United States)

    National Academies Press, 2011

    2011-01-01

    "The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single…

  5. Social Integration and Health Behavioral Change in San Luis, Honduras

    Science.gov (United States)

    McQuestion, Michael J.; Calle, Ana Quijano; Drasbek, Christopher; Harkins, Thomas; Sagastume, Lourdes J.

    2010-01-01

    This study explores the effects of social integration on behavioral change in the course of an intensive, community-based public health intervention. The intervention trained volunteers and mobilized local organizations to promote 16 key family health practices in rural San Luis, Honduras, during 2004 to 2006. A mixed methods approach is used.…

  6. Emotional responses to behavioral economic incentives for health behavior change

    NARCIS (Netherlands)

    van der Swaluw, Koen; Lambooij, Mattijs S.; Mathijssen, Jolanda J.P.; Zeelenberg, Marcel; Polder, Johan J.; Prast, Henriëtte M.

    2018-01-01

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals

  7. Emotional Responses to Behavioral Economic Incentives for Health Behavior Change

    NARCIS (Netherlands)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda; Zeelenberg, Marcel; Polder, Johan; Prast, Henriette

    2018-01-01

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals

  8. The Challenge of Behaviour Change and Health Promotion

    Directory of Open Access Journals (Sweden)

    Glenn Laverack

    2017-10-01

    Full Text Available The evidence about the effectiveness of behaviour change approaches—what works and what does not work—is unclear. What we do know is that single interventions that target a specific behavioural risk have little impact on the determinants that actually cause poor health, especially for vulnerable people. This has not prevented health promoters from continuing to invest in behaviour change interventions which are widely used in a range of programs. The future of behaviour change and health promotion is through the application of a comprehensive strategy with three core components: (1 a behaviour change approach; (2 a strong policy framework that creates a supportive environment and (3 the empowerment of people to gain more control over making healthy lifestyle decisions. This will require the better planning of policy interventions and the coordination of agencies involved in behaviour change and empowerment activities at the community level, with government to help develop policy at the national level.

  9. Health Behaviour Change Support Systems: Past Research and Future Challenges

    OpenAIRE

    Mettler, Tobias

    2015-01-01

    The emergence of mobile devices and social technologies has opened up new possibilities for health promotion and disease prevention. By means of emotional stimuli, motivation, and persuasion health behaviour change support systems (HBCSS) aim at influencing users to improve their health and wellbeing. This article presents the results of a bibliometric analysis related to the existing HBCSS body of knowledge. A total of 51 research studies were analysed with a look at their topical and theore...

  10. Influences of sex and activity level on physiological changes in individual adult sockeye salmon during rapid senescence.

    Science.gov (United States)

    Hruska, Kimberly A; Hinch, Scott G; Healey, Michael C; Patterson, David A; Larsson, Stefan; Farrell, Anthony P

    2010-01-01

    A noninvasive biopsy protocol was used to sample plasma and gill tissue in individual sockeye salmon (Oncorhynchus nerka) during the critical life stage associated with spawning-arrival at a spawning channel through senescence to death several days later. Our main objective was to characterize the physiological changes associated with rapid senescence in terms of the physiological stress/cortisol hypersecretion model and the energy exhaustion model. Salmon lived an average of 5 d in the spawning channel, during which time there were three major physiological trends that were independent of sexual status: a large increase in plasma indicators of stress and exercise (i.e., lactate and cortisol), a decrease in the major plasma ions (i.e., Cl(-) and Na(+)) and osmolality, and a decrease in gross somatic energy reserves. Contrary to a generalized stress response, plasma glucose decreased in approximately 2/3 of the fish after arrival, as opposed to increasing. Furthermore, plasma cortisol levels at spawning-ground arrival were not correlated with the degree of ionoregulatory changes during rapid senescence. One mechanism of mortality in some fish may involve the exhaustion of energy reserves, resulting in the inability to mobilize plasma glucose. Sex had a significant modulating effect on the degree of physiological change. Females exhibited a greater magnitude of change for gross somatic energy, osmolality, and plasma concentrations of Cl(-), Na(+), cortisol, testosterone, 11-ketotestosterone, 17,20beta-progesterone, and estradiol. The activity level of an individual on the spawning grounds appeared to influence the degree of some physiological changes during senescence. For example, males that received a greater frequency of attacks exhibited larger net decreases in plasma 11-ketotestosterone while on the spawning grounds. These results suggest that rapid senescence on spawning grounds is influenced by multiple physiological processes and perhaps behavior. This study

  11. Health behavior change in hearing healthcare: a discussion paper

    Directory of Open Access Journals (Sweden)

    Vinaya K. C. Manchaiah

    2012-02-01

    Full Text Available Health behavior change (HBC refers to facilitating changes to habits and/or behavior related to health. In healthcare practice, it is quite common that the interactions between practitioner and patient involve conversations related to HBC. This could be mainly in relation to the practitioner trying to directly persuade the patients to make some changes in their health behavior. However, the patients may not be motivated to do so as they do not see this change as important. For this reason, direct persuasion may result in a breakdown of communication. In such instances, alternative approaches and means of indirect persuasion, such as empowering the patient and their family members, could be helpful. Furthermore, there are several models and/or theories proposed which explain the health behavior and also provide a structured framework for health behavior change. Many such models/approaches have been proven effective in facilitating HBC and health promotion in areas such as cessation of smoking, weight loss and so on. This paper provides an overview of main models/theories related to HBC and some insights into how these models/approaches could be adapted to facilitate behavior change in hearing healthcare, mainly in relation to: i hearing help-seeking and hearing-aid uptake; and ii hearing conservation in relation to music-induced hearing loss (MIHL. In addition, elements of current research related to this area and future directions are highlighted.

  12. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

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

  13. Integrated Theory of Health Behavior Change: background and intervention development.

    Science.gov (United States)

    Ryan, Polly

    2009-01-01

    An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.

  14. Change your ways : Fostering health attitudes toward change through selective exposure to online health messages

    NARCIS (Netherlands)

    Westerwick, Axel; Johnson, Benjamin K.; Knobloch-Westerwick, Silvia

    2017-01-01

    Health information is often sought online, despite varying credibility of online sources, and may shape health behaviors. This investigation builds on the Selective Exposure Self- and Affect-Management model to examine selective exposure to online health information from low- and high-credibility

  15. Health risks of climate change in the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

    Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

  16. Protecting health from climate change: Preparedness of medical interns

    Directory of Open Access Journals (Sweden)

    Majra Jai

    2009-01-01

    Full Text Available Context : Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff. Aims : To study the preparedness of medical interns to meet the challenge of protecting health from climate change. Settings and Design: Medical colleges in a coastal town. Cross-sectional study. Materials and Methods: A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded. Statistical Analysis Used: Proportions, percentage, Chi-test. Results : About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%, eight (6%, and 17 (13%, respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge. Conclusions : Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.

  17. Television, disordered eating, and young women in Fiji: negotiating body image and identity during rapid social change.

    Science.gov (United States)

    Becker, Anne E

    2004-12-01

    Although the relationship between media exposure and risk behavior among youth is established at a population level, the specific psychological and social mechanisms mediating the adverse effects of media on youth remain poorly understood. This study reports on an investigation of the impact of the introduction of television to a rural community in Western Fiji on adolescent ethnic Fijian girls in a setting of rapid social and economic change. Narrative data were collected from 30 purposively selected ethnic Fijian secondary school girls via semi-structured, open-ended interviews. Interviews were conducted in 1998, 3 years after television was first broadcast to this region of Fiji. Narrative data were analyzed for content relating to response to television and mechanisms that mediate self and body image in Fijian adolescents. Data in this sample suggest that media imagery is used in both creative and destructive ways by adolescent Fijian girls to navigate opportunities and conflicts posed by the rapidly changing social environment. Study respondents indicated their explicit modeling of the perceived positive attributes of characters presented in television dramas, but also the beginnings of weight and body shape preoccupation, purging behavior to control weight, and body disparagement. Response to television appeared to be shaped by a desire for competitive social positioning during a period of rapid social transition. Understanding vulnerability to images and values imported with media will be critical to preventing disordered eating and, potentially, other youth risk behaviors in this population, as well as other populations at risk.

  18. Methodology for benzodiazepine receptor binding assays at physiological temperature. Rapid change in equilibrium with falling temperature

    International Nuclear Information System (INIS)

    Dawson, R.M.

    1986-01-01

    Benzodiazepine receptors of rat cerebellum were assayed with [ 3 H]-labeled flunitrazepam at 37 0 C, and assays were terminated by filtration in a cold room according to one of three protocols: keeping each sample at 37 degrees C until ready for filtration, taking the batch of samples (30) into the cold room and filtering sequentially in the order 1-30, and taking the batch of 30 samples into the cold room and filtering sequentially in the order 30-1. the results for each protocol were substantially different from each other, indicating that rapid disruption of equilibrium occurred as the samples cooled in the cold room while waiting to be filtered. Positive or negative cooperativity of binding was apparent, and misleading effects of gamma-aminobutyric acid on the affinity of diazepam were observed, unless each sample was kept at 37 0 C until just prior to filtration

  19. Rapid estimation of the moment magnitude of large earthquake from static strain changes

    Science.gov (United States)

    Itaba, S.

    2014-12-01

    The 2011 off the Pacific coast of Tohoku earthquake, of moment magnitude (Mw) 9.0, occurred on March 11, 2011. Based on the seismic wave, the prompt report of the magnitude which the Japan Meteorological Agency announced just after earthquake occurrence was 7.9, and it was considerably smaller than an actual value. On the other hand, using nine borehole strainmeters of Geological Survey of Japan, AIST, we estimated a fault model with Mw 8.7 for the earthquake on the boundary between the Pacific and North American plates. This model can be estimated about seven minutes after the origin time, and five minute after wave arrival. In order to grasp the magnitude of a great earthquake earlier, several methods are now being suggested to reduce the earthquake disasters including tsunami (e.g., Ohta et al., 2012). Our simple method of using strain steps is one of the strong methods for rapid estimation of the magnitude of great earthquakes.

  20. Examination of rapid phase change in copper wires to improve material models and understanding of burst

    Science.gov (United States)

    Olles, Joseph; Garasi, Christopher; Ball, J. Patrick

    2017-11-01

    Electrically-pulsed wires undergo multiple phase changes including a postulated metastable phase resulting in explosive wire growth. Simulations using the MHD approximation attempt to account for the governing physics, but lack the material properties (equations-of-state and electrical conductivity) to accurately predict the phase evolution of the exploding (bursting) wire. To explore the dynamics of an exploding copper wire (in water), we employ a digital micro-Schlieren streak photography technique. This imaging quantifies wire expansion and shock waves emitted from the wire during phase changes. Using differential voltage probes, a Rogowski coil, and timing fiducials, the phase change of the wire is aligned with electrical power and energy deposition. Time-correlated electrical diagnostics and imaging allow for detailed validation of MHD simulations, comparing observed phases with phase change details found in the material property descriptions. In addition to streak imaging, a long exposure image is taken to capture axial striations along the length of the wire. These images are used to compare with results from 3D MHD simulations which propose that these perturbations impact the rate of wire expansion and temporal change in phases. If successful, the experimental data will identify areas for improvement in the material property models, and modeling results will provide insight into the details of phase change in the wire with correlation to variations in the electrical signals.

  1. Climate Change and the Health of Indigenous Communities | IDRC ...

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

    Indigenous people are among the most directly affected by climate change. Yet, there is limited understanding of the health dimensions of climate change and opportunities for adaptation among indigenous populations. Researchers have tended to focus on other vulnerable regions or on populations as a whole.

  2. Complex systems and health behavior change: insights from cognitive science.

    Science.gov (United States)

    Orr, Mark G; Plaut, David C

    2014-05-01

    To provide proof-of-concept that quantum health behavior can be instantiated as a computational model that is informed by cognitive science, the Theory of Reasoned Action, and quantum health behavior theory. We conducted a synthetic review of the intersection of quantum health behavior change and cognitive science. We conducted simulations, using a computational model of quantum health behavior (a constraint satisfaction artificial neural network) and tested whether the model exhibited quantum-like behavior. The model exhibited clear signs of quantum-like behavior. Quantum health behavior can be conceptualized as constraint satisfaction: a mitigation between current behavioral state and the social contexts in which it operates. We outlined implications for moving forward with computational models of both quantum health behavior and health behavior in general.

  3. ‘Gamification’ for Health Behaviour Change in Smartphone Apps

    Directory of Open Access Journals (Sweden)

    Elizabeth Ann Edwards

    2015-09-01

    Full Text Available Background: Gamification techniques are showing promise in promoting healthy behaviours and delivering health promotion advice, however, their use in Mobile-Health is relatively new. Gamification involves using ‘gaming’ elements such as badges, leader boards, health-related challenges, rewards, ability to ‘level up’ and use of avatars to motivate and engage people to change health behavior. Gamification techniques may also overlap with validated health behaviour change techniques (BCTs, however, few apps appear to apply the techniques systematically or to define the BCTs they include. Aim: We aimed a to assess the number apps that incorporate gamification to modify health behaviors, b to examine the BCT repertoire and combinations used in these apps c to consider associations with user satisfaction. Methods: English-language health apps that contain gamification techniques were identified through a systematic search of the official Apple and Google Play store and the NHS health apps library. Top rated free and paid Medical, Health & Wellness, Health & Fitness apps as defined by Apple and Google Play stores were searched. Apps were coded for BCTs according to the Michie et al. taxonomy. The taxonomy comprises 16 categories and 93 individual BCTs. BCT coding was conducted by two trained researchers (EE, JL who scored independently and then cross-checked for discrepancies. BCT numbers, user ratings and app pricing were compared. We explored the association between number of BCTs per app, user and NHS libraries’ ratings and price. We also investigated, which of the 16 BCT categories and the individual 93 BCTs and their combinations were most commonly used. Results: 1,680 Medical, Health & Wellness or Health & Fitness Apps were reviewed and seventy containing gamification techniques were identified. The mean number of BCTs used was 12.5 (range 1-24. There was no correlation between number of BCTs, customer ratings, NHS library app rating or

  4. Health status of refugees settled in Alberta: changes since arrival.

    Science.gov (United States)

    Maximova, Katerina; Krahn, Harvey

    2010-01-01

    This paper sought to examine which pre- and post-migration factors might be associated with changes in refugees' health status. Using linear regression, the associations between pre- and post-migration factors and changes in self-rated mental and physical health status were examined in 525 refugees from the 1998 Settlement Experiences of Refugees in Alberta study. Having spent time in a refugee camp and having held professional/managerial jobs in one's home country were associated with a greater decline in mental health status since arrival in Canada. Having completed a university degree in one's home country was associated with a greater decline in physical health status. Being employed was associated with greater improvements in mental health status. Perceived economic hardship was associated with greater declines in physical health status. A higher number of settlement services received during the first year in Canada was associated with greater improvements in both mental and physical health status. Longer residence in Canada was associated with greater declines in physical health status but not in mental health status. While little can be done to alter refugees' pre-migration experiences, public policies can affect many post-migration experiences in order to mitigate the negative health consequences associated with resettlement. Results of this study point to the need for continued provision of settlement services to assist refugees with job training, labour market access, and credential recognition, as well as counseling for refugees who experienced the trauma of living in a refugee camp.

  5. Climate change and health effects in Northwest Alaska

    Directory of Open Access Journals (Sweden)

    Michael Brubaker

    2011-10-01

    Full Text Available This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities.In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weather-related injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects.The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses.The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska.Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate.The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures.

  6. Ecosystem change and human health: implementation economics and policy.

    Science.gov (United States)

    Pattanayak, S K; Kramer, R A; Vincent, J R

    2017-06-05

    Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  7. Rapid shifts in Atta cephalotes fungus-garden enzyme activity after a change in fungal substrate (Attini, Formicidae)

    DEFF Research Database (Denmark)

    Kooij, P W; Schiøtt, M; Boomsma, J J

    2011-01-01

    Fungus gardens of the basidiomycete Leucocoprinus gongylophorus sustain large colonies of leaf-cutting ants by degrading the plant material collected by the ants. Recent studies have shown that enzyme activity in these gardens is primarily targeted toward starch, proteins and the pectin matrix......, we measured the changes in enzyme activity after a controlled shift in fungal substrate offered to six laboratory colonies of Atta cephalotes. An ant diet consisting exclusively of grains of parboiled rice rapidly increased the activity of endo-proteinases and some of the pectinases attacking...... from the rice diet, relative to the leaf diet controls. Enzyme activity in the older, bottom sections of fungus gardens decreased, indicating a faster processing of the rice substrate compared to the leaf diet. These results suggest that leaf-cutting ant fungus gardens can rapidly adjust enzyme...

  8. Human adaptation responses to a rapidly changing Arctic: A research context for building system resilience

    Science.gov (United States)

    Chapin, T.; Brinkman, T. J.

    2016-12-01

    Although human behavior accounts for more uncertainty in future trajectories in climate change than do biophysical processes, most climate-change research fails to include human actions in research design and implementation. This is well-illustrated in the Arctic. At the global scale, arctic processes strongly influence the strength of biophysical feedbacks between global human emissions and the rate of climate warming. However, most human actions in the arctic have little effect on these feedbacks, so research can contribute most effectively to reduction in arctic warming through improved understanding of the strength of arctic-global biophysical feedbacks, as in NASA's ABoVE program, and its effective communication to policy makers and the public. In contrast, at the local to regional scale within the arctic, human actions may influence the ecological and societal consequences of arctic warming, so research benefits from active stakeholder engagement in research design and implementation. Human communities and other stakeholders (government and NGOs) respond heterogeneously to socioeconomic and environmental change, so research that documents the range of historical and current adaptive responses to change provides insights on the resilience (flexibility of future options) of social-ecological processes in the arctic. Alaskan communities have attempted a range of adaptive responses to coastal erosion (e.g., seasonal migration, protection in place, relocation), wildfire (fire suppression to use of fire to manage wildlife habitat or landscape heterogeneity), declining sea ice (e.g., new hunting technology, sea ice observations and predictions), and changes in wildlife and fish availability (e.g., switch to harvest of alternative species, harvest times, or harvest locations). Research that draws on both traditional and western knowledge facilitates adaptation and predictions of the likely societal consequences of climate change in the Arctic. Effective inclusion of

  9. Schools, climate change and health promotion: a vital alliance.

    Science.gov (United States)

    Boon, Helen; Brown, Lawrence; Clark, Brenton; Pagliano, Paul; Tsey, Komla; Usher, Kim

    2011-12-01

    Through an ongoing project, we have been reviewing the literature addressing school planning for climate change related ecological disruptions and disasters, particularly for the special needs of children with disabilities. We have also examined related state education department policies from across Australia. Our preliminary results suggest scant attention has been paid either by researchers or educational policy makers to the needs of children with disabilities and their caregivers in response to climate change induced disaster scenarios. Here, we advocate for better preparedness among institutions serving children with disabilities to support their health in the context of climate change, and describe how health promotion principles can be brought to bear on this issue.

  10. A Review of Frameworks for Developing Environmental Health Indicators for Climate Change and Health

    Science.gov (United States)

    Hambling, Tammy; Weinstein, Philip; Slaney, David

    2011-01-01

    The role climate change may play in altering human health, particularly in the emergence and spread of diseases, is an evolving area of research. It is important to understand this relationship because it will compound the already significant burden of diseases on national economies and public health. Authorities need to be able to assess, anticipate, and monitor human health vulnerability to climate change, in order to plan for, or implement action to avoid these eventualities. Environmental health indicators (EHIs) provide a tool to assess, monitor, and quantify human health vulnerability, to aid in the design and targeting of interventions, and measure the effectiveness of climate change adaptation and mitigation activities. Our aim was to identify the most suitable framework for developing EHIs to measure and monitor the impacts of climate change on human health and inform the development of interventions. Using published literature we reviewed the attributes of 11 frameworks. We identified the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework as the most suitable one for developing EHIs for climate change and health. We propose the use of EHIs as a valuable tool to assess, quantify, and monitor human health vulnerability, design and target interventions, and measure the effectiveness of climate change adaptation and mitigation activities. In this paper, we lay the groundwork for the future development of EHIs as a multidisciplinary approach to link existing environmental and epidemiological data and networks. Analysis of such data will contribute to an enhanced understanding of the relationship between climate change and human health. PMID:21845162

  11. Analysing changes of health inequalities in the Nordic welfare states

    DEFF Research Database (Denmark)

    Lahelma, Eero; Kivelä, Katariina; Roos, Eva

    2002-01-01

    -standing illness and perceived health were analysed by age, gender, employment status and educational attainment. First, age-adjusted overall prevalence percentages were calculated. Second, changes in the magnitude of relative health inequalities were studied using logistic regression analysis. Within each country......This study examined changes over time in relative health inequalities among men and women in four Nordic countries, Denmark, Finland, Norway and Sweden. A serious economic recession burst out in the early 1990s particularly in Finland and Sweden. We ask whether this adverse social structural......'development influenced health inequalities by employment status and educational attainment, i.e. whether the trends in health inequalities were similar or dissimilar between the Nordic countries. The data derived from comparable interview surveys carried out in 1986/87 and 1994/95 in the four countries. Limiting long...

  12. The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda

    Science.gov (United States)

    Workman, Annabelle; Blashki, Grant; Bowen, Kathryn J.; Karoly, David J.; Wiseman, John

    2018-01-01

    A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda. PMID:29617317

  13. The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda.

    Science.gov (United States)

    Workman, Annabelle; Blashki, Grant; Bowen, Kathryn J; Karoly, David J; Wiseman, John

    2018-04-04

    A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda.

  14. Managing organizational change: strategies for the female health care supervisor.

    Science.gov (United States)

    Davies, G

    1990-07-01

    In responding to resistance to change in the current health care organization, the new female supervisor can learn to support her staff in encountering and accepting these changes. The strategies and skills discussed above are characteristic of a supervisory style that may naturally occur for women, but also can be incorporated into the leadership style of men in health care management today. Health care leaders of tomorrow must work from an androgynous framework in which the behavior patterns and responses of each gender are learned and used appropriately by both men and women. Sargent suggests that the best managers are androgynous and that this is the inevitable wave of the future. Whether man or woman, a supervisor should learn, accept, and use methods that are characteristic of both sexes to be successful in managing people. Women and men must learn from each other's strengths and share these diverse skills. Given that women now outnumber men in health care management positions and organizations are changing to a more nurturing environment, the androgynous supervisor will be the successful leader of the future. Finally, women in health care supervisory positions have the potential to bring change where it is badly needed. Women in these roles often have a system wide view of health care policy issues that recognizes less federal commitment to social programs. Many women in health care positions believe that the issues of children, women, the elderly, the poor, and the homeless need focused attention. The growing number of women in health care supervisory and leadership roles is an important factor in changing national health policy for the benefit of these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. An Ill Wind? Climate Change, Migration, and Health

    Science.gov (United States)

    Barnett, Jon

    2012-01-01

    Background: Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. Objectives: In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. Methods: This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Discussion: Climate-change–related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Conclusions: Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change. PMID:22266739

  16. Help Preferences Among Employees Who Wish to Change Health Behaviors.

    Science.gov (United States)

    Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L

    2014-08-01

    To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e., wellness service). Respondents to an electronic questionnaire who acknowledged wishing to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4,431), and physical activity (n = 5,179) were asked to choose up to three help alternatives on a predefined list. In descending order, smokers preferred help from nicotine gum, no help, and help and support from family and friends. Alcohol consumers preferred no help or help and support from family and friends or "other" forms. Employees who wanted to change eating habits preferred a free fruit bowl, free nutritional guidance, and healthy food at work. Employees who wanted to change physical activity patterns preferred exercise at work, offers of free exercise, and exercise in a social/collegial context. Wishing to change health behaviors is not always accompanied by perceiving a need for assistance. The no-help option was selected fairly frequently and mostly in relation to alcohol and smoking. A fruit bowl was the most preferred option for help, followed by exercise at work and free exercise. Help from traditional health services was ranked low, possibly reflecting that they are primarily viewed as a solution for stopping disease rather than promoting health. © 2013 Society for Public Health Education.

  17. Rapid changes in corticospinal excitability during force field adaptation of human walking

    DEFF Research Database (Denmark)

    Barthélemy, Dorothy; Alain, S; Grey, Michael James

    2012-01-01

    measured changes in motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in the tibialis anterior (TA) muscle before, during, and after subjects adapted to a force field applied to the ankle joint during treadmill walking. When the force field assisted dorsiflexion during...... the swing phase of the step cycle, subjects adapted by decreasing TA EMG activity. In contrast, when the force field resisted dorsiflexion, they increased TA EMG activity. After the force field was removed, normal EMG activity gradually returned over the next 5 min of walking. TA MEPs elicited in the early...... be explained by changes in background TA EMG activity. These effects seemed specific to walking, as similar changes in TA MEP were not seen when seated subjects were tested during static dorsiflexion. These observations suggest that the corticospinal tract contributes to the adaptation of walking...

  18. Implications of rapid environmental change for polar bear behavior and sociality

    Science.gov (United States)

    Atwood, Todd C.

    2017-01-01

    Historically, the Arctic sea ice has functioned as a structural barrier that has limited the nature and extent of interactions between humans and polar bears (Ursus maritimus). However, declining sea ice extent, brought about by global climate change, is increasing the potential for human-polar bear interactions. Loss of sea ice habitat is driving changes to both human and polar bear behavior—it is facilitating increases in human activities (e.g., offshore oil and gas exploration and extraction, trans-Arctic shipping, recreation), while also causing the displacement of bears from preferred foraging habitat (i.e., sea ice over biologically productive shallow) to land in some portions of their range. The end result of these changes is that polar bears are spending greater amounts of time in close proximity to people. Coexistence between humans and polar bears will require imposing mechanisms to manage further development, as well as mitigation strategies that reduce the burden to local communities.

  19. The gender perspective in climate change and global health

    Directory of Open Access Journals (Sweden)

    Birgitta Evengård

    2010-12-01

    Full Text Available Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policy-making concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms ‘climate change,’ ‘health,’ ‘gender,’ and ‘policy.’ Climate change and health-related policy documents of the World Health Organization (WHO and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study's viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.

  20. Unbounded boundaries and shifting baselines: Estuaries and coastal seas in a rapidly changing world

    Science.gov (United States)

    Little, S.; Spencer, K. L.; Schuttelaars, H. M.; Millward, G. E.; Elliott, M.

    2017-11-01

    This Special Issue of Estuarine, Coastal and Shelf Science presents contributions from ECSA 55; an international symposium organised by the Estuarine and Coastal Sciences Association (ECSA) and Elsevier on the broad theme of estuaries and coastal seas in times of intense change. The objectives of the SI are to synthesise, hypothesise and illustrate the impacts of global change on estuaries and coastal seas through learning lessons from the past, discussing the current and forecasting for the future. It is highlighted here that establishing impacts and assigning cause to the many pressures of global change is and will continue to be a formidable challenge in estuaries and coastal seas, due in part to: (1) their complexity and unbounded nature; (2) difficulties distinguishing between human-induced changes and natural variations and; (3) multiple pressures and effects. The contributing authors have explored a number of these issues over a range of disciplines. The complexity and connectivity of estuaries and coastal seas have been investigated through studies of physicochemical and ecological components, whilst the human imprint on the environment has been identified through a series of predictive, contemporary, historical and palaeo approaches. The impact of human activities has been shown to occur over a range of spatial and temporal scales, requiring the development of integrated management approaches. These 30 articles provide an important contribution to our understanding and assessment of the impacts of global change. The authors highlight methods for essential management/mitigation of the consequences of global change and provide a set of directions, ideas and observations for future work. These include the need to consider: (1) the cumulative, synergistic and antagonistic effects of multiple pressures; (2) the importance of unbounded boundaries and connectivity across the aquatic continuum; (3) the value of combining cross-disciplinary palaeo, contemporary and

  1. Monitoring the welfare of polar bear populations in a rapidly changing Arctic

    Science.gov (United States)

    Atwood, Todd C.; Duncan, Colleen G.; Patyk, Kelly A.; Sonsthagen, Sarah A.

    2017-01-01

    Most programs for monitoring the welfare of wildlife populations support efforts aimed at reaching discrete management objectives, like mitigating conflict with humans. While such programs can be effective, their limited scope may preclude systemic evaluations needed for large-scale conservation initiatives, like the recovery of at-risk species. We discuss select categories of metrics that can be used to monitor how polar bears (Ursus maritimus) are responding to the primary threat to their long-term persistence—loss of sea ice habitat due to the unabated rise in atmospheric greenhouse gas (GHG; e.g., CO2) concentrations—that can also provide information on ecosystem function and health. Monitoring key aspects of polar bear population dynamics, spatial behavior, health and resiliency can provide valuable insight into ecosystem state and function, and could be a powerful tool for achieving Arctic conservation objectives, particularly those that have transnational policy implications.

  2. Rapid morphological changes and loss of collagen following experimental acute colonic obstruction

    DEFF Research Database (Denmark)

    Krarup, Peter-Martin; Rehn, Martin; Sand-Dejmek, Janna

    2013-01-01

    Anastomosis of an acutely obstructed colon is associated with an increased risk of dehiscence. In experimental models, acute obstruction decreases collagen in the colonic wall, but the time course and propagation along the colon of the biochemical changes are unknown. Furthermore, there is a pauc......Anastomosis of an acutely obstructed colon is associated with an increased risk of dehiscence. In experimental models, acute obstruction decreases collagen in the colonic wall, but the time course and propagation along the colon of the biochemical changes are unknown. Furthermore...

  3. Applying social marketing in health care: communicating evidence to change consumer behavior.

    Science.gov (United States)

    Evans, W Douglas; McCormack, Lauren

    2008-01-01

    Social marketing uses commercial marketing strategies to change individual and organizational behavior and policies. It has been effective on a population level across a wide range of public health and health care domains. There is limited evidence of the effectiveness of social marketing in changing health care consumer behavior through its impact on patient-provider interaction or provider behavior. Social marketers need to identify translatable strategies (e.g., competition analysis, branding, and tailored messages) that can be applied to health care provider and consumer behavior. Three case studies from social marketing illustrate potential strategies to change provider and consumer behavior. Countermarketing is a rapidly growing social marketing strategy that has been effective in tobacco control and may be effective in countering pharmaceutical marketing using specific message strategies. Informed decision making is a useful strategy when there is medical uncertainty, such as in prostate cancer screening and treatment. Pharmaceutical industry marketing practices offer valuable lessons for developing competing messages to reach providers and consumers. Social marketing is an effective population-based behavior change strategy that can be applied in individual clinical settings and as a complement to reinforce messages communicated on a population level. There is a need for more research on message strategies that work in health care and population-level effectiveness studies.

  4. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data.

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason S; Mutz, Jacqueline M; Carrington, Angela R; Lai, Ki; Davis, Lisa S; Youngblood, Josh E; Rauschuber, Mark R; Flores, Kathryn A; Sara, Evan J; Bhat, Deepa G; Willett, DuWayne L

    2017-01-01

    Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch. Such an approach will not scale to meet the emerging demand for specialty registries to support population health and value-based care. To determine if the creation of EHR-based specialty registries could be markedly accelerated by employing (a) a finite core set of EHR data collection principles and methods, (b) concurrent engineering of data extraction and data warehouse design using a common dimensional data model for all registries, and (c) agile development methods commonly employed in new product development. We adopted as guiding principles to (a) capture data as a byproduct of care of the patient, (b) reinforce optimal EHR use by clinicians, (c) employ a finite but robust set of EHR data capture tool types, and (d) leverage our existing technology toolkit. Registries were defined by a shared condition (recorded on the Problem List) or a shared exposure to a procedure (recorded on the Surgical History) or to a medication (recorded on the Medication List). Any EHR fields needed - either to determine registry membership or to calculate a registry-associated clinical quality measure (CQM) - were included in the enterprise data warehouse (EDW) shared dimensional data model. Extract-transform-load (ETL) code was written to pull data at defined "grains" from the EHR into the EDW model. All calculated CQM values were stored in a single Fact table in the EDW crossing all registries. Registry-specific dashboards were created in the EHR to display both

  5. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Directory of Open Access Journals (Sweden)

    Åsa Holmner

    2012-06-01

    Full Text Available Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

  6. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Science.gov (United States)

    Holmner, Åsa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

    2012-01-01

    Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT)’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies. PMID:22679398

  7. Long-distance gene flow and adaptation of forest trees to rapid climate change

    Science.gov (United States)

    Kremer, Antoine; Ronce, Ophélie; Robledo-Arnuncio, Juan J; Guillaume, Frédéric; Bohrer, Gil; Nathan, Ran; Bridle, Jon R; Gomulkiewicz, Richard; Klein, Etienne K; Ritland, Kermit; Kuparinen, Anna; Gerber, Sophie; Schueler, Silvio

    2012-01-01

    Forest trees are the dominant species in many parts of the world and predicting how they might respond to climate change is a vital global concern. Trees are capable of long-distance gene flow, which can promote adaptive evolution in novel environments by increasing genetic variation for fitness. It is unclear, however, if this can compensate for maladaptive effects of gene flow and for the long-generation times of trees. We critically review data on the extent of long-distance gene flow and summarise theory that allows us to predict evolutionary responses of trees to climate change. Estimates of long-distance gene flow based both on direct observations and on genetic methods provide evidence that genes can move over spatial scales larger than habitat shifts predicted under climate change within one generation. Both theoretical and empirical data suggest that the positive effects of gene flow on adaptation may dominate in many instances. The balance of positive to negative consequences of gene flow may, however, differ for leading edge, core and rear sections of forest distributions. We propose future experimental and theoretical research that would better integrate dispersal biology with evolutionary quantitative genetics and improve predictions of tree responses to climate change. PMID:22372546

  8. Evolution and behavioural responses to human-induced rapid environmental change.

    Science.gov (United States)

    Sih, Andrew; Ferrari, Maud C O; Harris, David J

    2011-03-01

    Almost all organisms live in environments that have been altered, to some degree, by human activities. Because behaviour mediates interactions between an individual and its environment, the ability of organisms to behave appropriately under these new conditions is crucial for determining their immediate success or failure in these modified environments. While hundreds of species are suffering dramatically from these environmental changes, others, such as urbanized and pest species, are doing better than ever. Our goal is to provide insights into explaining such variation. We first summarize the responses of some species to novel situations, including novel risks and resources, habitat loss/fragmentation, pollutants and climate change. Using a sensory ecology approach, we present a mechanistic framework for predicting variation in behavioural responses to environmental change, drawing from models of decision-making processes and an understanding of the selective background against which they evolved. Where immediate behavioural responses are inadequate, learning or evolutionary adaptation may prove useful, although these mechanisms are also constrained by evolutionary history. Although predicting the responses of species to environmental change is difficult, we highlight the need for a better understanding of the role of evolutionary history in shaping individuals' responses to their environment and provide suggestion for future work.

  9. Are plant species able to keep pace with the rapidly changing climate?

    Directory of Open Access Journals (Sweden)

    Sarah Cunze

    Full Text Available Future climate change is predicted to advance faster than the postglacial warming. Migration may therefore become a key driver for future development of biodiversity and ecosystem functioning. For 140 European plant species we computed past range shifts since the last glacial maximum and future range shifts for a variety of Intergovernmental Panel on Climate Change (IPCC scenarios and global circulation models (GCMs. Range shift rates were estimated by means of species distribution modelling (SDM. With process-based seed dispersal models we estimated species-specific migration rates for 27 dispersal modes addressing dispersal by wind (anemochory for different wind conditions, as well as dispersal by mammals (dispersal on animal's coat - epizoochory and dispersal by animals after feeding and digestion - endozoochory considering different animal species. Our process-based modelled migration rates generally exceeded the postglacial range shift rates indicating that the process-based models we used are capable of predicting migration rates that are in accordance with realized past migration. For most of the considered species, the modelled migration rates were considerably lower than the expected future climate change induced range shift rates. This implies that most plant species will not entirely be able to follow future climate-change-induced range shifts due to dispersal limitation. Animals with large day- and home-ranges are highly important for achieving high migration rates for many plant species, whereas anemochory is relevant for only few species.

  10. Rapid pacing results in changes in atrial but not in ventricular refractoriness

    NARCIS (Netherlands)

    Schoonderwoerd, BA; Van Gelder, IC; Tieleman, RG; Bel, KJ; Crijns, HJGM

    It is well known that atrial tachycardia causes atrial electrical remodeling, characterized by shortening of atrial effective refractory periods (AERPs) and loss of physiological adaptation of AERP to rate. However, the nature and time course of changes in ventricular effective refractory periods

  11. Linguistic Mechanisms Cause Rapid Behavior Change. Part Two: How Linguistic Frames Affect Motivation

    Science.gov (United States)

    Yeager, Joseph; Sommer, Linda

    2007-01-01

    Written and spoken language contains inherent mechanisms driving motivation. Accessing and modifying psycholinguistic mechanisms, links language frames to changes in behavior within the context of motivational profiling. For example, holding an object like an imported apple feels safe until one is informed it was grown in a toxic waste dump.…

  12. Challenge and Response, Strategies for Survival in a Rapidly Changing Forest Products Industry

    Science.gov (United States)

    Al Schuler; Craig Adair; Paul Winistorfer

    2005-01-01

    The U.S. has long been the world's largest market for wood and wood products, fueled by its demand for wood-frame housing. But forest product markets are changing, both in terns of where the products originate (domestically or abroad),and what products are being produced and consumed.

  13. Rapid species responses to changes in climate require stringent climate protection targets

    NARCIS (Netherlands)

    Vliet, van A.J.H.; Leemans, R.

    2006-01-01

    The Avoiding Dangerous Climate Change book consolidates the scientific findings of the Exeter conference and gives an account of the most recent developments on critical thresholds and key vulnerabilities of the climate system, impacts on human and natural systems, emission pathways and

  14. Rapid evolution of phenology during range expansion with recent climate change

    NARCIS (Netherlands)

    Lustenhouwer, N.; Wilschut, R.A.; Williams, J.L.; van der Putten, W.H.; Levine, J.M.

    2018-01-01

    Although climate warming is expected to make habitat beyond species’ current cold range edge suitable for future colonization, this new habitat may present an array of biotic or abiotic conditions not experienced within the current range. Species’ ability to shift their range with climate change may

  15. The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda

    OpenAIRE

    Annabelle Workman; Grant Blashki; Kathryn J. Bowen; David J. Karoly; John Wiseman

    2018-01-01

    A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate chan...

  16. Nurses' occupational health as a driver for curriculum change emphasising health promotion: an historical research study.

    Science.gov (United States)

    Wood, Pamela J

    2014-05-01

    Reasons stated for curriculum change in nursing education are usually shifts in knowledge, care delivery, roles, regulatory standards and population health needs. In New Zealand in the 1930s, a curriculum change was driven instead by the need to protect and promote nurses' health. Tuberculosis was an international occupational health risk among nurses. Mary Lambie, New Zealand's chief nurse, considered nursing a "hazardous profession". One remedy she instituted was curriculum change in the national nurse training programme to emphasise health promotion among nurses. Global nursing issues today also impact on nurses' health. Curriculum changes again address this by promoting self-care and resilience. To examine how international and national concern for nurses' occupational health drove a curriculum change in New Zealand nurse training in the 1930s. Historical Research International occupational health reports (1930s), Lambie's annual reports (1932-1950), and questions and examiners' comments in a new state examination (1940s-1950s), were analysed to identify the reasons for and direction of the curriculum change. Findings were interpreted within international and national concerns and measures related to occupational health in nursing. Lambie used the political leverage of international and national worry over tuberculosis as a nursing occupational health risk to protect nurses' health more generally. In 1933 she revised the first year of the three-year national nursing curriculum to emphasise personal hygiene and bacteriology related to cross-infection, and in 1938 introduced a State Preliminary Examination at the end of the first year of training to test this knowledge. Analysis of examinations, 1940s-1950s, confirms that the curriculum change driver was a concern to make nursing a less "hazardous profession". Nurse educators today should be aware of the variety of factors that can lead to curriculum change in nursing. In addition, concern for nurses' health

  17. Climate change, air pollution and human health in Sydney, Australia: A review of the literature

    Science.gov (United States)

    Dean, Annika; Green, Donna

    2018-05-01

    Sydney is Australia’s largest city and is growing rapidly. Although Sydney’s air quality is relatively good compared to the major cities in many industrialised countries, particulate matter (PM) and ozone (O3) occasionally exceed the national health standards and are the cause of premature mortalities and hospital admissions. Numerous studies from overseas (e.g. North America and continental Europe) suggest that climate change may impact air quality to the detriment of human health. There is limited knowledge about how climate change may impact air quality in Sydney. This study reviews the available literature on the impacts of climate change on air quality related health impacts in Sydney to identify knowledge and research gaps. Where no studies are available for Sydney, it draws on relevant studies from other Australian cities and overseas. Our findings summarise what is known about how climate change may impact air quality in Sydney and where research gaps exist. This approach can facilitate research agendas, policies and planning strategies that mitigate public health impacts and tackle climate change and air pollution in a coordinated way.

  18. Health impact assessment as an agent of policy change: improving the health impacts of the mayor of London's draft transport strategy.

    Science.gov (United States)

    Mindell, J; Sheridan, L; Joffe, M; Samson-Barry, H; Atkinson, S

    2004-03-01

    To increase the positive and mitigate the negative health impacts of the mayor's draft transport strategy for London. A rapid prospective health impact assessment (HIA) of the penultimate draft of the strategy, using a review commissioned by the regional director of public health; an appraisal of congestion charging; and a participatory workshop. Two audits of changes were performed to assess the impact on policy of the HIA process. Regional government policy development. Recommendations from the rapid HIA were fed back into the drafting process. Changes (a) between the penultimate draft and the draft for public consultation and (b) between that and the final mayoral strategy. The draft transport strategy published for consultation differed in a number of respects from the previous version. Almost all the recommendations from the HIA were incorporated into the final strategy. Significant changes included promoting sustainable travel plans for workplaces and schools; giving priority to infrastructure and services that benefit London's deprived communities; increased emphasis on promoting walking and cycling and reducing reliance on private cars; and a commitment to track the health impacts of the final strategy and its implementation. Specific additions included re-allocating road space. HIA was successful in influencing the transport strategy for London, resulting in several improvements from a health viewpoint. HIA is an effective method both for bringing about significant change in policy proposals and in increasing policy makers' understanding of determinants of health and hence in changing attitudes of policy makers.

  19. Rapid characterisation of vegetation structure to predict refugia and climate change impacts across a global biodiversity hotspot.

    Directory of Open Access Journals (Sweden)

    Antonius G T Schut

    Full Text Available Identification of refugia is an increasingly important adaptation strategy in conservation planning under rapid anthropogenic climate change. Granite outcrops (GOs provide extraordinary diversity, including a wide range of taxa, vegetation types and habitats in the Southwest Australian Floristic Region (SWAFR. However, poor characterization of GOs limits the capacity of conservation planning for refugia under climate change. A novel means for the rapid identification of potential refugia is presented, based on the assessment of local-scale environment and vegetation structure in a wider region. This approach was tested on GOs across the SWAFR. Airborne discrete return Light Detection And Ranging (LiDAR data and Red Green and Blue (RGB imagery were acquired. Vertical vegetation profiles were used to derive 54 structural classes. Structural vegetation types were described in three areas for supervised classification of a further 13 GOs across the region. Habitat descriptions based on 494 vegetation plots on and around these GOs were used to quantify relationships between environmental variables, ground cover and canopy height. The vegetation surrounding GOs is strongly related to structural vegetation types (Kappa = 0.8 and to its spatial context. Water gaining sites around GOs are characterized by taller and denser vegetation in all areas. The strong relationship between rainfall, soil-depth, and vegetation structure (R(2 of 0.8-0.9 allowed comparisons of vegetation structure between current and future climate. Significant shifts in vegetation structural types were predicted and mapped for future climates. Water gaining areas below granite outcrops were identified as important putative refugia. A reduction in rainfall may be offset by the occurrence of deeper soil elsewhere on the outcrop. However, climate change interactions with fire and water table declines may render our conclusions conservative. The LiDAR-based mapping approach presented

  20. Developmental origins, behaviour change and the new public health

    Science.gov (United States)

    Barker, Mary

    2016-01-01

    A developmental approach to public health focuses attention on better nourishing girls and young women, especially those of low socio-economic status, to improve mothers’ nutrition and thereby the health of future generations. There have been significant advances in the behavioural sciences that may allow us to understand and support dietary change in young women and their children in ways that have not previously been possible. This paper describes some of these advances and aims to show how they inform this new approach to public health. The first of these has been to work out what is effective in supporting behaviour change which has been achieved by careful and detailed analysis of behaviour change techniques used by practitioners in intervention, and of the effectiveness of these in supporting change. There is also a new understanding of the role that social and physical environments play in shaping our behaviours, and that behaviour is influenced by automatic processes and ‘habits’ as much as by reflective processes and rational decisions. To be maximally effective, interventions therefore have to address both influences on behaviour. An approach developed in Southampton aims to motivate, support and empower young women to make better food choices, but also to change the culture in which those choices are being made. Empowerment is the basis of the new public health. An empowered public demand for better access to better food can go a long way towards improving maternal, infant and family nutrition, and therefore the health of generations to come. PMID:26152930

  1. Developmental origins, behaviour change and the new public health.

    Science.gov (United States)

    Barker, M

    2015-10-01

    A developmental approach to public health focuses attention on better nourishing girls and young women, especially those of low socio-economic status, to improve mothers' nutrition and thereby the health of future generations. There have been significant advances in the behavioural sciences that may allow us to understand and support dietary change in young women and their children in ways that have not previously been possible. This paper describes some of these advances and aims to show how they inform this new approach to public health. The first of these has been to work out what is effective in supporting behaviour change, which has been achieved by careful and detailed analysis of behaviour change techniques used by practitioners in intervention, and of the effectiveness of these in supporting change. There is also a new understanding of the role that social and physical environments play in shaping our behaviours, and that behaviour is influenced by automatic processes and 'habits' as much as by reflective processes and rational decisions. To be maximally effective, interventions therefore have to address both influences on behaviour. An approach developed in Southampton aims to motivate, support and empower young women to make better food choices, but also to change the culture in which those choices are being made. Empowerment is the basis of the new public health. An empowered public demand for better access to better food can go a long way towards improving maternal, infant and family nutrition, and therefore the health of generations to come.

  2. Purchasing power: business and health policy change in Massachusetts.

    Science.gov (United States)

    Bergthold, L A

    1988-01-01

    As in many states around the country, health care costs in Massachusetts had risen to an unprecedented proportion of the state budget by the early 1980s. State health policymakers realized that dramatic changes were needed in the political process to break provider control over health policy decisions. This paper presents a case study of policy change in Massachusetts between 1982 and 1988. State officials formulated a strategy to mobilize corporate interests, which were already awakening to the problems of high health care costs, as a countervailing power to the political monopoly of provider interests. Once mobilized, business interests became organized politically and even became dominant at times, controlling both the policy agenda and its process. Ultimately, business came to be viewed as a permanent part of the coalitions and commissions that helped formulate state health policy. Although initially allied with provider interests, business eventually forged a stronger alliance with the state, an alliance that has the potential to force structural change in health care politics in Massachusetts for years to come. The paper raises questions about the consequences of such alliances between public and private power for both the content and the process of health policymaking at the state level.

  3. Regional Climate Change and Development of Public Health Decision Aids

    Science.gov (United States)

    Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

    2011-12-01

    According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

  4. Strain on the san andreas fault near palmdale, california: rapid, aseismic change.

    Science.gov (United States)

    Savage, J C; Prescott, W H; Lisowski, M; King, N E

    1981-01-02

    Frequently repeated strain measurements near Palmdale, California, during the period from 1971 through 1980 indicate that, in addition to a uniform accumulation of right-lateral shear strain (engineering shear, 0.35 microradian per year) across the San Andreas fault, a 1-microstrain contraction perpendicular to the fault that accumulated gradually during the interval 1974 through 1978 was aseismically released between February and November 1979. Subsequently (November 1979 to March 1980), about half of the contraction was recovered. This sequence of strain changes can be explained in terms of south-southwestward migration of a slip event consisting of the south-southwestward movement of the upper crust on a horizontal detachment surface at a depth of 10 to 30 kilometers. The large strain change in 1979 corresponds to the passage of the slip event beneath the San Andreas fault.

  5. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham

    2016-01-01

    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children ...-randomized trials were conducted in two contrasting areas of moderate-to-high and low malaria transmission in rural Uganda. Each trial examined the effectiveness of mRDTs in the management of malaria and targeting of ACTs by CHWs comparing two diagnostic approaches: (i) presumptive clinical diagnosis of malaria...

  6. Rapid response of a marine mammal species to holocene climate and habitat change.

    Directory of Open Access Journals (Sweden)

    Mark de Bruyn

    2009-07-01

    Full Text Available Environmental change drives demographic and evolutionary processes that determine diversity within and among species. Tracking these processes during periods of change reveals mechanisms for the establishment of populations and provides predictive data on response to potential future impacts, including those caused by anthropogenic climate change. Here we show how a highly mobile marine species responded to the gain and loss of new breeding habitat. Southern elephant seal, Mirounga leonina, remains were found along the Victoria Land Coast (VLC in the Ross Sea, Antarctica, 2,500 km from the nearest extant breeding site on Macquarie Island (MQ. This habitat was released after retreat of the grounded ice sheet in the Ross Sea Embayment 7,500-8,000 cal YBP, and is within the range of modern foraging excursions from the MQ colony. Using ancient mtDNA and coalescent models, we tracked the population dynamics of the now extinct VLC colony and the connectivity between this and extant breeding sites. We found a clear expansion signal in the VLC population approximately 8,000 YBP, followed by directional migration away from VLC and the loss of diversity at approximately 1,000 YBP, when sea ice is thought to have expanded. Our data suggest that VLC seals came initially from MQ and that some returned there once the VLC habitat was lost, approximately 7,000 years later. We track the founder-extinction dynamics of a population from inception to extinction in the context of Holocene climate change and present evidence that an unexpectedly diverse, differentiated breeding population was founded from a distant source population soon after habitat became available.

  7. Currency and Competence of Occupational Therapists and Consumers with Rapidly Changing Technology

    OpenAIRE

    Steel, Emily J.; Buchanan, Ricky; Layton, Natasha; Wilson, Erin

    2017-01-01

    Assistive technology was once a specialised field of practice, involving products designed for populations with specific impairments or functional goals. In Australia, occupational therapists have, at times, functioned as gatekeepers to public funding, prescribing products from a predefined list. An expanding range of accessible mainstream products available via international and online markets has changed the meaning and application of assistive technology for many people with disability. In...

  8. Symptoms and Mucosal Changes Stable During Rapid Increase of Pediatric Celiac Disease in Norway.

    Science.gov (United States)

    Beitnes, Ann-Christin R; Vikskjold, Florin B; Jóhannesdóttir, Gróa B; Perminow, Gøri; Olbjørn, Christine; Andersen, Solveig N; Bentsen, Beint S; Rugtveit, Jarle; Størdal, Ketil

    2017-04-01

    We aimed to study whether the incidence of pediatric celiac disease (CD) in South-Eastern Norway changed from 2000 to 2010. We also examined whether there was a change in symptoms and histopathological morphology in the duodenal biopsies during the same period. In 3 hospitals in South-Eastern Norway, records from pediatric patients (0-14.9 years) diagnosed with CD during two 3-year periods (2000-2002 and 2008-2010) were reviewed. Only cases with a duodenal biopsy diagnosis of CD classified as Marsh grade 2 and 3a-c were included. Frequencies of symptoms, anthropometric data, and laboratory results were compared, in addition to re-examinations of histological sections from one of the hospitals. A total of 400 cases were diagnosed with a female to male ratio of 1.5:1. The incidence rate for 2000 to 2002 was 15.9 cases per 100,000 person-years (95% confidence interval 12.8-19.4), compared with 45.5 cases per 100,000 person-years during 2008 to 2010 (95% confidence interval 40.5-50.9), P symptoms and the distribution of histopathological changes were similar in the 2 periods, whereas weight z scores and hemoglobin levels were significantly lower in the first period. We found a 3-fold increase in the incidence rate for CD in the Norwegian pediatric population during the decade 2000 to 2010. Slightly higher weight and hemoglobin levels at diagnosis in the latter period may be due to improved CD awareness. Unaltered relative frequencies of symptoms and histopathological changes in the gut, however, suggest a true increase of CD in Norwegian children.

  9. Historical legacies accumulate to shape future biodiversity in an era of rapid global change

    Czech Academy of Sciences Publication Activity Database

    Essl, F.; Dullinger, S.; Rabitsch, W.; Hulme, P. E.; Pyšek, Petr; Wilson, J. R. U.; Richardson, D. M.

    2015-01-01

    Roč. 21, č. 5 (2015), s. 534-547 ISSN 1366-9516 R&D Projects: GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : biological invasions * global change * time lags Subject RIV: EH - Ecology, Behaviour Impact factor: 4.566, year: 2015

  10. Rapid response of a marine mammal species to holocene climate and habitat change.

    Science.gov (United States)

    de Bruyn, Mark; Hall, Brenda L; Chauke, Lucas F; Baroni, Carlo; Koch, Paul L; Hoelzel, A Rus

    2009-07-01

    Environmental change drives demographic and evolutionary processes that determine diversity within and among species. Tracking these processes during periods of change reveals mechanisms for the establishment of populations and provides predictive data on response to potential future impacts, including those caused by anthropogenic climate change. Here we show how a highly mobile marine species responded to the gain and loss of new breeding habitat. Southern elephant seal, Mirounga leonina, remains were found along the Victoria Land Coast (VLC) in the Ross Sea, Antarctica, 2,500 km from the nearest extant breeding site on Macquarie Island (MQ). This habitat was released after retreat of the grounded ice sheet in the Ross Sea Embayment 7,500-8,000 cal YBP, and is within the range of modern foraging excursions from the MQ colony. Using ancient mtDNA and coalescent models, we tracked the population dynamics of the now extinct VLC colony and the connectivity between this and extant breeding sites. We found a clear expansion signal in the VLC population approximately 8,000 YBP, followed by directional migration away from VLC and the loss of diversity at approximately 1,000 YBP, when sea ice is thought to have expanded. Our data suggest that VLC seals came initially from MQ and that some returned there once the VLC habitat was lost, approximately 7,000 years later. We track the founder-extinction dynamics of a population from inception to extinction in the context of Holocene climate change and present evidence that an unexpectedly diverse, differentiated breeding population was founded from a distant source population soon after habitat became available.

  11. Next Generation of Renewable Electricity Policy: How Rapid Change is Breaking Down Conventional Policy Categories

    Energy Technology Data Exchange (ETDEWEB)

    Couture, T. D. [E3 Analytics, Berlin (Germany); Jacobs, D. [International Energy Transition (IET), Boston, MA (United States); Rickerson, W. [Meister Consultants Group, Boston, MA (United States); Healey, V. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-02-01

    A number of policies have been used historically in order to stimulate the growth of the renewable electricity sector. This paper examines four of these policy instruments: competitive tendering, sometimes called renewable electricity auctions, feed-in tariffs, net metering and net billing, and tradable renewable energy certificates. In recent years, however, a number of changes to both market circumstances and to policy priorities have resulted in numerous policy innovations, including the emergence of policy hybrids. With no common language for these evolving policy mechanisms, policymakers have generally continued to use the same traditional policy labels, occasionally generating confusion as many of these new policies no longer look, or act, like their traditional predecessors. In reviewing these changes, this paper makes two separate but related claims: first, policy labels themselves are breaking down and evolving. As a result, policy comparisons that rely on the conventional labels may no longer be appropriate, or advisable. Second, as policymakers continue to adapt, we are in effect witnessing the emergence of the next generation of renewable electricity policies, a change that could have significant impacts on investment, as well as on market growth in both developed and developing countries.

  12. Health in South Africa: changes and challenges since 2009.

    Science.gov (United States)

    Mayosi, Bongani M; Lawn, Joy E; van Niekerk, Ashley; Bradshaw, Debbie; Abdool Karim, Salim S; Coovadia, Hoosen M

    2012-12-08

    Since the 2009 Lancet Health in South Africa Series, important changes have occurred in the country, resulting in an increase in life expectancy to 60 years. Historical injustices together with the disastrous health policies of the previous administration are being transformed. The change in leadership of the Ministry of Health has been key, but new momentum is inhibited by stasis within the health management bureaucracy. Specific policy and programme changes are evident for all four of the so-called colliding epidemics: HIV and tuberculosis; chronic illness and mental health; injury and violence; and maternal, neonatal, and child health. South Africa now has the world's largest programme of antiretroviral therapy, and some advances have been made in implementation of new tuberculosis diagnostics and treatment scale-up and integration. HIV prevention has received increased attention. Child mortality has benefited from progress in addressing HIV. However, more attention to postnatal feeding support is needed. Many risk factors for non-communicable diseases have increased substantially during the past two decades, but an ambitious government policy to address lifestyle risks such as consumption of salt and alcohol provide real potential for change. Although mortality due to injuries seems to be decreasing, high levels of interpersonal violence and accidents persist. An integrated strategic framework for prevention of injury and violence is in progress but its successful implementation will need high-level commitment, support for evidence-led prevention interventions, investment in surveillance systems and research, and improved human-resources and management capacities. A radical system of national health insurance and re-engineering of primary health care will be phased in for 14 years to enable universal, equitable, and affordable health-care coverage. Finally, national consensus has been reached about seven priorities for health research with a commitment to

  13. Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial

    Directory of Open Access Journals (Sweden)

    Christian D. Helfrich

    2018-04-01

    Full Text Available IntroductionOrganizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time.MethodsWe analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions; change valence (valuing health promotion; information assessment (demands and resources to implement health promotion; change commitment (an intention to implement health promotion; and change efficacy (a belief in shared ability to implement health promotion. We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time.ResultsOnly context and change commitment met reliability thresholds. Change commitment declined significantly for both control (−0.39 and interventions sites (−0.29 from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention. Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1 intervention sites exhibited significantly smaller change in

  14. Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

    Science.gov (United States)

    Helfrich, Christian D; Kohn, Marlana J; Stapleton, Austin; Allen, Claire L; Hammerback, Kristen Elizabeth; Chan, K C Gary; Parrish, Amanda T; Ryan, Daron E; Weiner, Bryan J; Harris, Jeffrey R; Hannon, Peggy A

    2018-01-01

    Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites

  15. Object-based change detection in rapid urbanization regions with remotely sensed observations: a case study of Shenzhen, China

    Science.gov (United States)

    He, Lihuang; Dong, Guihua; Wang, Wei-Min; Yang, Lijun; Liang, Hong

    2013-10-01

    China, the most populous country on Earth, has experienced rapid urbanization which is one of the main causes of many environmental and ecological problems. Therefore, the monitoring of rapid urbanization regions and the environment is of critical importance for their sustainable development. In this study, the object-based classification is employed to detect the change of land cover in Shenzhen, which is located in South China and has been urbanized rapidly in recent three decades. First, four Landsat TM images, which were acquired on 1990, 2000 and 2010, respectively, are selected from the image database. Atmospheric corrections are conducted on these images with improved dark-object subtraction technique and surface meteorological observations. Geometric correction is processed with ground control points derived from topographic maps. Second, a region growing multi-resolution segmentation and a soft nearest neighbour classifier are used to finish object-based classification. After analyzing the fraction of difference classes over time series, we conclude that the comparison of derived land cover classes with socio-economic statistics demonstrates the strong positive correlation between built-up classes and urban population as well as gross GDP and GDPs in second and tertiary industries. Two different mechanisms of urbanization, namely new land development and redevelopment, are revealed. Consequently, we found that, the districts of Shenzhen were urbanized through different mechanisms.

  16. Threshold and resilience management of coupled urbanization and water environmental system in the rapidly changing coastal region

    International Nuclear Information System (INIS)

    Li, Yangfan; Li, Yi; Wu, Wei

    2016-01-01

    The concept of thresholds shows important implications for environmental and resource management. Here we derived potential landscape thresholds which indicated abrupt changes in water quality or the dividing points between exceeding and failing to meet national surface water quality standards for a rapidly urbanizing city on the Eastern Coast in China. The analysis of landscape thresholds was based on regression models linking each of the seven water quality variables to each of the six landscape metrics for this coupled land-water system. We found substantial and accelerating urban sprawl at the suburban areas between 2000 and 2008, and detected significant nonlinear relations between water quality and landscape pattern. This research demonstrated that a simple modeling technique could provide insights on environmental thresholds to support more-informed decision making in land use, water environmental and resilience management. - Graphical abstract: Fig. Threshold models and resilience management for water quality. Display Omitted - Highlights: • Coupling urbanization and water environmental system. • Developing threshold models of the coupled land-water systems. • Nonlinear relations between water quality variables and landscape metrics. • Enhancing resilience management of coastal rapid urbanization. - We develop environmental threshold models and provide their implications on resilience management for a coupled land-water system with rapid urbanization.

  17. Cone-beam computed tomography evaluation of dental, skeletal, and alveolar bone changes associated with bonded rapid maxillary expansion

    Directory of Open Access Journals (Sweden)

    Namrata Dogra

    2016-01-01

    Full Text Available Aims and Objectives: To evaluate skeletal changes in maxilla and its surrounding structures, changes in the maxillary dentition and maxillary alveolar bone changes produced by bonded rapid maxillary expansion (RME using cone-beam computed tomography (CBCT. Materials and Methods: The sample consisted of 10 patients (6 males and 4 females with age range 12 to 15 years treated with bonded RME. CBCT scans were performed at T1 (pretreatment and at T2 (immediately after expansion to evaluate the dental, skeletal, and alveolar bone changes. Results: RME treatment increased the overall skeletal parameters such as interorbital, zygomatic, nasal, and maxillary widths. Significant increases in buccal maxillary width was observed at first premolar, second premolar, and first molar level. There was a significant increase in arch width both on the palatal side and on the buccal side. Significant tipping of right and left maxillary first molars was seen. There were significant reductions in buccal bone plate thickness and increase in palatal bone plate thickness. Conclusions: Total expansion achieved with RME was a combination of dental, skeletal and alveolar bone changes. At the first molar level, 28.45% orthopedic, 16.03% alveolar bone bending, and 55.5% orthodontic changes were observed.

  18. Exposure to Fine Particulate Matter Leads to Rapid Heart Rate Variability Changes

    Directory of Open Access Journals (Sweden)

    Michael Riediker

    2018-01-01

    Full Text Available Introduction: Heart Rate Variability (HRV reflects the adaptability of the heart to internal and external stimuli. Reduced HRV is a predictor of post-infarction mortality. We previously found in road maintenance workers HRV-increases several hours after exposure to fine particulate matter (PM2.5. This seemed to conflict with studies where PM-exposure acutely reduced HRV. We therefore assessed whether time from exposure to HRV-assessment could explain the differences observed.Methods: On five non-consecutive days, workers carried nephelometers providing 1-min-interval PM2.5-exposure. Five-min HRV-intervals of SDNN (Standard Deviation of Normal to Normal beat intervals and pNN50 (Percentage of the interval differences exceeding 50 ms were extracted from 24-h electrocardiograms (ECGs. Following 60 min PM2.5-exposure, changes in HRV-parameters were assessed during 120-min visually and by regression analysis with control for time at work, at home, and during the night using autoregressive integrating moving average (ARIMA models to account for autocorrelation of the time-series. Additional controls included changing the time windows and including body mass index (BMI and age in the models.Result: Pattern analysis of 12,669 data points showed high modulation of mean, standard deviation (SD, and time trend of HRV (SDNN and pNN50 at low, and much reduced modulation at high PM2.5-exposures. The time trend following exposure was highly symmetrical, resembling a funnel plot. Regression analysis showed significant associations of decreasing SDNN and pNN50 (average, SD, and absolute value of time trend with increasing PM2.5-exposure, which remained significant when controlling for activity phases. Changing time windows did not change the pattern of response. Including BMI and age did not change the results.Conclusions: The reduced modulation of HRV following PM2.5-exposure is striking. It suggests strong interference with homeostatic controls. Such an

  19. The Interplay of Climate Change and Air Pollution on Health.

    Science.gov (United States)

    Orru, H; Ebi, K L; Forsberg, B

    2017-12-01

    Air pollution significantly affects health, causing up to 7 million premature deaths annually with an even larger number of hospitalizations and days of sick leave. Climate change could alter the dispersion of primary pollutants, particularly particulate matter, and intensify the formation of secondary pollutants, such as near-surface ozone. The purpose of the review is to evaluate the recent evidence on the impacts of climate change on air pollution and air pollution-related health impacts and identify knowledge gaps for future research. Several studies modelled future ozone and particulate matter concentrations and calculated the resulting health impacts under different climate scenarios. Due to climate change, ozone- and fine particle-related mortalities are expected to increase in most studies; however, results differ by region, assumed climate change scenario and other factors such as population and background emissions. This review explores the relationships between climate change, air pollution and air pollution-related health impacts. The results highly depend on the climate change scenario used and on projections of future air pollution emissions, with relatively high uncertainty. Studies primarily focused on mortality; projections on the effects on morbidity are needed.

  20. Climate Change, Human Health, and Biomedical Research: Analysis of the National Institutes of Health Research Portfolio

    Science.gov (United States)

    Balbus, John M.; Christian, Carole; Haque, Ehsanul; Howe, Sally E.; Newton, Sheila A.; Reid, Britt C.; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P.

    2013-01-01

    Background: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. Objectives: In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. Methods: A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. Results: This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Conclusions: Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH’s strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health. PMID:23552460

  1. Climate change, human health, and biomedical research: analysis of the National Institutes of Health research portfolio.

    Science.gov (United States)

    Jessup, Christine M; Balbus, John M; Christian, Carole; Haque, Ehsanul; Howe, Sally E; Newton, Sheila A; Reid, Britt C; Roberts, Luci; Wilhelm, Erin; Rosenthal, Joshua P

    2013-04-01

    According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health. In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio. A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective. This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate. Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH's strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health.

  2. Millennial health care: change you can believe in.

    Science.gov (United States)

    Pingleton, Susan K

    2012-07-01

    A millennium is 1,000 years. In little over a decade after the beginning of the new millennium in 2000, remarkable changes have occurred in health-care education and health-care delivery. A new millennial generation of students, trainees, junior faculty, and young practicing physicians has come of age. The numbers of women in medicine have vastly increased. Technology has impacted education with an array of educational content-delivery techniques vastly different from the usual broadcast method of teaching. New curricula have expanded to encompass teamwork with interprofessional education of the entire team. Outcomes of educational efforts now include not only knowledge transfer but also performance improvement. Delivery of health care is also dramatically different. The sentinel driver of the quality and patient safety moment, To Err Is Human, was published only 12 years ago, yet fundamental changes in expectations and measurement for health-care quality and safety have occurred to alter the health-care landscape. Financing health care has become a prime issue in the current state of the US economy. New themes in health-care delivery include teamwork and highly functioning teams to improve patient safety, the dramatic increase in palliative care and end-of-life care, and the expanded role of nursing in health-care delivery. Each issue emanating since the beginning of the millennium does not have a right vs wrong implication. This discussion is an apolitical "environmental scan" with the purpose of illuminating these dramatic changes and then outlining the implications for health-care education and health-care delivery in the coming years.

  3. Rapid behavioural gregarization in the desert locust, Schistocerca gregaria entails synchronous changes in both activity and attraction to conspecifics.

    Science.gov (United States)

    Rogers, Stephen M; Cullen, Darron A; Anstey, Michael L; Burrows, Malcolm; Despland, Emma; Dodgson, Tim; Matheson, Tom; Ott, Swidbert R; Stettin, Katja; Sword, Gregory A; Simpson, Stephen J

    2014-06-01

    Desert Locusts can change reversibly between solitarious and gregarious phases, which differ considerably in behaviour, morphology and physiology. The two phases show many behavioural differences including both overall levels of activity and the degree to which they are attracted or repulsed by conspecifics. Solitarious locusts perform infrequent bouts of locomotion characterised by a slow walking pace, groom infrequently and actively avoid other locusts. Gregarious locusts are highly active with a rapid walking pace, groom frequently and are attracted to conspecifics forming cohesive migratory bands as nymphs and/or flying swarms as adults. The sole factor driving the onset of gregarization is the presence of conspecifics. In several previous studies concerned with the mechanism underlying this transformation we have used an aggregate measure of behavioural phase state, Pgreg, derived from logistic regression analysis, which combines and weights several behavioural variables to characterise solitarious and gregarious behaviour. Using this approach we have analysed the time course of behavioural change, the stimuli that induce gregarization and the key role of serotonin in mediating the transformation. Following a recent critique that suggested that using Pgreg may confound changes in general activity with genuine gregarization we have performed a meta-analysis examining the time course of change in the individual behaviours that we use to generate Pgreg. We show that the forced crowding of solitarious locusts, tactile stimulation of the hind femora, and the short-term application of serotonin each induce concerted changes in not only locomotion-related variables but also grooming frequency and attraction to other locusts towards those characteristic of long-term gregarious locusts. This extensive meta-analysis supports and extends our previous conclusions that solitarious locusts undergo a rapid behavioural gregarization upon receiving appropriate stimulation for

  4. Changes in health indicators related to health promotion and microcredit programs in the Dominican Republic.

    Science.gov (United States)

    Dohn, Anita L; Chávez, Andrea; Dohn, Michael N; Saturria, Luis; Pimentel, Carlos

    2004-03-01

    To assess the impact of health promotion programs and microcredit programs on three communities in the Dominican Republic. One community had only the health promotion program, one community had only the microcredit program, and one community had both a health promotion program and a microcredit program. This pilot project examined the hypothesis that the largest changes in 11 health indicators that were studied would be in the community with both a health promotion program and a microcredit program, that there would be intermediate changes in the community with only a health promotion program, and that the smallest changes would be in the community with only a microcredit program. The health promotion programs used community volunteers to address two major concerns: (1) the prevalent causes of mortality among children under 5 years of age and (2) women's health (specifically breast and cervical cancer screening). The microcredit program made small loans to individuals to start or expand small businesses. Outcome measures were based on comparisons for 11 health indicators from baseline community surveys (27 households surveyed in each of the three communities, done in December 2000 and January 2001) and from follow-up surveys (also 27 households surveyed in each of the three communities, in June and July 2002, after the health promotion program had been operating for about 13 months). Households were randomly chosen during both the baseline and follow-up surveys, without regard to their involvement in the microcredit or health promotion programs. The health indicators improved in all three communities. However, the degree of change was different among the communities (P microcredit and health promotion programs had the largest changes for 10 of the 11 health indicators. Multisector development is known to be important on a macroeconomic scale. The results of this pilot project support the view that multisector development is also important on a microeconomic level

  5. Defining health diplomacy: changing demands in the era of globalization.

    Science.gov (United States)

    Katz, Rebecca; Kornblet, Sarah; Arnold, Grace; Lief, Eric; Fischer, Julie E

    2011-09-01

    Accelerated globalization has produced obvious changes in diplomatic purposes and practices. Health issues have become increasingly preeminent in the evolving global diplomacy agenda. More leaders in academia and policy are thinking about how to structure and utilize diplomacy in pursuit of global health goals. In this article, we describe the context, practice, and components of global health diplomacy, as applied operationally. We examine the foundations of various approaches to global health diplomacy, along with their implications for the policies shaping the international public health and foreign policy environments. Based on these observations, we propose a taxonomy for the subdiscipline. Expanding demands on global health diplomacy require a delicate combination of technical expertise, legal knowledge, and diplomatic skills that have not been systematically cultivated among either foreign service or global health professionals. Nonetheless, high expectations that global health initiatives will achieve development and diplomatic goals beyond the immediate technical objectives may be thwarted by this gap. The deepening links between health and foreign policy require both the diplomatic and global health communities to reexamine the skills, comprehension, and resources necessary to achieve their mutual objectives. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

  6. Defining Health Diplomacy: Changing Demands in the Era of Globalization

    Science.gov (United States)

    Katz, Rebecca; Kornblet, Sarah; Arnold, Grace; Lief, Eric; Fischer, Julie E

    2011-01-01

    Context: Accelerated globalization has produced obvious changes in diplomatic purposes and practices. Health issues have become increasingly preeminent in the evolving global diplomacy agenda. More leaders in academia and policy are thinking about how to structure and utilize diplomacy in pursuit of global health goals. Methods: In this article, we describe the context, practice, and components of global health diplomacy, as applied operationally. We examine the foundations of various approaches to global health diplomacy, along with their implications for the policies shaping the international public health and foreign policy environments. Based on these observations, we propose a taxonomy for the subdiscipline. Findings: Expanding demands on global health diplomacy require a delicate combination of technical expertise, legal knowledge, and diplomatic skills that have not been systematically cultivated among either foreign service or global health professionals. Nonetheless, high expectations that global health initiatives will achieve development and diplomatic goals beyond the immediate technical objectives may be thwarted by this gap. Conclusions: The deepening links between health and foreign policy require both the diplomatic and global health communities to reexamine the skills, comprehension, and resources necessary to achieve their mutual objectives. PMID:21933277

  7. Health marketing and behavioral change: a review of the literature.

    Science.gov (United States)

    Chichirez, Cristina-Mihaela; Purcărea, Victor Lorin

    2018-01-01

    Health marketing as a part of social marketing, must influence individuals, voluntarily, through various social programmes, in order to accept, reject, modify or abandon a behavior in favour of a healthier lifestyle. Acting on individual behavior change, social marketing can influence the behaviour of those who decide public policies, with positive effects in social change. In time, in order to understand and predict a behavior, a number of theories, models and tactics were developed with the aim to identify factors and mechanisms with the greatest impact in the changing process. Cognitive- social theories proved to be more effective, because they offer guidelines for conducting research in behavioral change.

  8. Health marketing and behavioral change: a review of the literature

    Science.gov (United States)

    Chichirez, Cristina-Mihaela; Purcărea, Victor Lorin

    2018-01-01

    Health marketing as a part of social marketing, must influence individuals, voluntarily, through various social programmes, in order to accept, reject, modify or abandon a behavior in favour of a healthier lifestyle. Acting on individual behavior change, social marketing can influence the behaviour of those who decide public policies, with positive effects in social change. In time, in order to understand and predict a behavior, a number of theories, models and tactics were developed with the aim to identify factors and mechanisms with the greatest impact in the changing process. Cognitive- social theories proved to be more effective, because they offer guidelines for conducting research in behavioral change. PMID:29696059

  9. The Boltysh crater record of rapid vegetation change during the Dan-C2 hyperthermal event.

    Science.gov (United States)

    Jolley, D. W.; Daly, R.; Gilmour, I.; Gilmour, M.; Kelley, S. P.

    2012-04-01

    Analysis of a cored borehole drilled through the sedimentary fill of the 24km wide Boltysh meteorite crater, Ukraine has yielded a unique, high resolution record spanning algae records. These records reflect environmental change from the K/Pg1 to the post Dan-C2 Danian. Leading into the CIE, warm temperate gymnosperm - angiosperm - fern communities are replaced by precipitation limited (winterwet) plant communities within the negative CIE. Winterwet plant communities dominate the negative CIE, but are replaced within the isotope recovery stage by warm temperate floras. These in turn give way to cooler temperate floras in the post positive CIE section of the uppermost crater fill. The distribution of temperate taxa about the negative CIE represents the broadest scale of oscillatory variation in the palynofloras. Shorter frequency oscillations are evident from diversity and botanical group distributions reflecting changes in moisture availability over several thousand years. Detailed analysis of variability within one of these oscillations records plant community cyclicity across the inception of the negative CIE. This short term cyclicity provides evidence that the replacement of warm termperate by winterwet floras occurred in a stepwise manner at the negative CIE suggesting cumulative atmospheric forcing. At <1mm scale, lamination within the negative CIE showed no obvious lithological or colour differences, and are not seasonal couplets. However, palynofloral analysis of laminations from within the negative CIE has yielded evidence of annual variation identifying the potential for recoding changes in 'paleoweather' across a major hyperthermal event. [1] Jolley, D. W. et al. (2010) Geology 38, 835-838.

  10. High Resolution Topography of Age-Related Changes in Non-Rapid Eye Movement Sleep Electroencephalography.

    Directory of Open Access Journals (Sweden)

    Kate E Sprecher

    Full Text Available Sleeping brain activity reflects brain anatomy and physiology. The aim of this study was to use high density (256 channel electroencephalography (EEG during sleep to characterize topographic changes in sleep EEG power across normal aging, with high spatial resolution. Sleep was evaluated in 92 healthy adults aged 18-65 years old using full polysomnography and high density EEG. After artifact removal, spectral power density was calculated for standard frequency bands for all channels, averaged across the NREM periods of the first 3 sleep cycles. To quantify topographic changes with age, maps were generated of the Pearson's coefficient of the correlation between power and age at each electrode. Significant correlations were determined by statistical non-parametric mapping. Absolute slow wave power declined significantly with increasing age across the entire scalp, whereas declines in theta and sigma power were significant only in frontal regions. Power in fast spindle frequencies declined significantly with increasing age frontally, whereas absolute power of slow spindle frequencies showed no significant change with age. When EEG power was normalized across the scalp, a left centro-parietal region showed significantly less age-related decline in power than the rest of the scalp. This partial preservation was particularly significant in the slow wave and sigma bands. The effect of age on sleep EEG varies substantially by region and frequency band. This non-uniformity should inform the design of future investigations of aging and sleep. This study provides normative data on the effect of age on sleep EEG topography, and provides a basis from which to explore the mechanisms of normal aging as well as neurodegenerative disorders for which age is a risk factor.

  11. Coastal regime shifts: rapid responses of coastal wetlands to changes in mangrove cover.

    Science.gov (United States)

    Guo, Hongyu; Weaver, Carolyn; Charles, Sean P; Whitt, Ashley; Dastidar, Sayantani; D'Odorico, Paolo; Fuentes, Jose D; Kominoski, John S; Armitage, Anna R; Pennings, Steven C

    2017-03-01

    Global changes are causing broad-scale shifts in vegetation communities worldwide, including coastal habitats where the borders between mangroves and salt marsh are in flux. Coastal habitats provide numerous ecosystem services of high economic value, but the consequences of variation in mangrove cover are poorly known. We experimentally manipulated mangrove cover in large plots to test a set of linked hypotheses regarding the effects of changes in mangrove cover. We found that changes in mangrove cover had strong effects on microclimate, plant community, sediment accretion, soil organic content, and bird abundance within 2 yr. At higher mangrove cover, wind speed declined and light interception by vegetation increased. Air and soil temperatures had hump-shaped relationships with mangrove cover. The cover of salt marsh plants decreased at higher mangrove cover. Wrack cover, the distance that wrack was distributed from the water's edge, and sediment accretion decreased at higher mangrove cover. Soil organic content increased with mangrove cover. Wading bird abundance decreased at higher mangrove cover. Many of these relationships were non-linear, with the greatest effects when mangrove cover varied from zero to intermediate values, and lesser effects when mangrove cover varied from intermediate to high values. Temporal and spatial variation in measured variables often peaked at intermediate mangrove cover, with ecological consequences that are largely unexplored. Because different processes varied in different ways with mangrove cover, the "optimum" cover of mangroves from a societal point of view will depend on which ecosystem services are most desired. © 2016 by the Ecological Society of America.

  12. One Health for a changing world: new perspectives from Africa.

    Science.gov (United States)

    Cunningham, Andrew A; Scoones, Ian; Wood, James L N

    2017-07-19

    The concept of One Health, which aims to drive improvements in human, animal and ecological health through an holistic approach, has been gaining increasing support and attention in recent years. While this concept has much appeal, there are few examples where it has been successfully put into practice. This Special Issue explores the challenges in African contexts, with papers looking at the complex interactions between ecosystems, diseases and poverty dynamics; at underlying social and political dimensions; at the potentials for integrative modelling; and at the changes in policy and practice required to realise a One Health approach. This introductory paper offers an overview of the 11 papers, coming from diverse disciplinary perspectives, that each explore how a One Health approach can work in a world of social, economic and environmental change. © 2017 The Author(s).

  13. Extended impacts of climate change on health and wellbeing

    DEFF Research Database (Denmark)

    Thomas, Felicity; Sabel, Clive E.; Morton, Katherine

    2014-01-01

    adaptation and mitigation policies seek to ensure that benefits are available for all since current evidence suggests that they are spatially and socially differentiated, and their accessibility is dependent on a range of contextually specific socio-cultural factors. (C) 2014 Elsevier Ltd. All rights...... by integrating the positivist approaches used in public health and epidemiology, with holistic social science perspectives on health in which the concept of 'wellbeing' is more explicitly recognised. Such an approach enables us to acknowledge and explore a wide range of more subtle, yet important health......-related outcomes of climate change. At the same time, incorporating notions of wellbeing enables recognition of both the health co-benefits and dis-benefits of climate change adaptation and mitigation strategies across different population groups and geographical contexts. The paper recommends that future...

  14. Late mental health changes in tortured refugees in multidisciplinary treatment

    DEFF Research Database (Denmark)

    Carlsson, Jessica Mariana; Olsen, Dorte Reff; Kastrup, Marianne

    2010-01-01

    to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life......-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort......The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted...

  15. Adapting to the effects of climate change on Inuit health.

    Science.gov (United States)

    Ford, James D; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-06-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks-one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context.

  16. Adapting to the Effects of Climate Change on Inuit Health

    Science.gov (United States)

    Ford, James D.; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-01-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks—one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context. PMID:24754615

  17. A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

    Science.gov (United States)

    Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

    2011-10-01

    The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative

  18. Climate change and developing-country cities: implications for environmental health and equity.

    Science.gov (United States)

    Campbell-Lendrum, Diarmid; Corvalán, Carlos

    2007-05-01

    Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity.

  19. Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

    Science.gov (United States)

    Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

    2017-12-11

    To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks.