WorldWideScience

Sample records for rapidly rising health

  1. RAPIDLY RISING TRANSIENTS IN THE SUPERNOVA—SUPERLUMINOUS SUPERNOVA GAP

    Energy Technology Data Exchange (ETDEWEB)

    Arcavi, Iair; Howell, D. Andrew [Las Cumbres Observatory Global Telescope, 6740 Cortona Dr., Suite 102, Goleta, CA 93111 (United States); Wolf, William M. [Department of Physics, University of California, Santa Barbara, CA 93106 (United States); Bildsten, Lars; McCully, Curtis; Valenti, Stefano [Kavli Institute for Theoretical Physics, University of California, Santa Barbara, CA 93106 (United States); Leloudas, Giorgos; Gal-Yam, Avishay; Katz, Boaz [Department of Particle Physics and Astrophysics, The Weizmann Institute of Science, Rehovot, 76100 (Israel); Hardin, Delphine; Astier, Pierre; Balland, Cristophe [LPNHE, CNRS-IN2P3 and University of Paris VI and VII, F-75005 Paris (France); Prajs, Szymon; Sullivan, Mark [School of Physics and Astronomy, University of Southampton, Southampton, SO17 1BJ (United Kingdom); Perley, Daniel A. [Dark Cosmology Centre, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, DK-2100 Copenhagen (Denmark); Svirski, Gilad [Racah Institute for Physics, The Hebrew University, Jerusalem 91904 (Israel); Cenko, S. Bradley [Astrophysics Science Division, NASA Goddard Space Flight Center, Mail Code 661, Greenbelt, MD 20771 (United States); Lidman, Chris [Australian Astronomical Observatory, P.O. Box 915, North Ryde, NSW 1670 (Australia); Carlberg, Ray G. [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H8 (Canada); Conley, Alex, E-mail: iarcavi@lcogt.net [Center for Astrophysics and Space Astronomy, University of Colorado, 389 UCB, Boulder, CO 80309-389 (United States); and others

    2016-03-01

    We present observations of four rapidly rising (t{sub rise} ≈ 10 days) transients with peak luminosities between those of supernovae (SNe) and superluminous SNe (M{sub peak} ≈ −20)—one discovered and followed by the Palomar Transient Factory (PTF) and three by the Supernova Legacy Survey. The light curves resemble those of SN 2011kl, recently shown to be associated with an ultra-long-duration gamma-ray burst (GRB), though no GRB was seen to accompany our SNe. The rapid rise to a luminous peak places these events in a unique part of SN phase space, challenging standard SN emission mechanisms. Spectra of the PTF event formally classify it as an SN II due to broad Hα emission, but an unusual absorption feature, which can be interpreted as either high velocity Hα (though deeper than in previously known cases) or Si ii (as seen in SNe Ia), is also observed. We find that existing models of white dwarf detonations, CSM interaction, shock breakout in a wind (or steeper CSM), and magnetar spin down cannot readily explain the observations. We consider the possibility that a “Type 1.5 SN” scenario could be the origin of our events. More detailed models for these kinds of transients and more constraining observations of future such events should help to better determine their nature.

  2. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

    The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

  3. 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

  4. Study on rapid evacuation in high-rise buildings

    Directory of Open Access Journals (Sweden)

    Xin Zhang

    2017-06-01

    Full Text Available More and more high rising buildings emerged in modern cities, but emergency evacuation of tall buildings has been a worldwide difficult problem. In this paper, a new evacuation device for high rising buildings in fire accident was proposed and studied. This device mainly consisted of special spiral slideway and shunt valve. People in this device could fast slide down to the first floor under gravity without any electric power and physical strength, which is suitable for various emergency evacuation including mobility-impaired persons. The plane simulation test has shown that human being in alternative clockwise and counterclockwise movement will not become dizzy. The evacuated people should wear protection pad, which can prevent slider from being injured by surface friction with the slide, and eliminate the friction coefficient difference caused by different clothes and slide surface. The calculation results show that the evacuation speed of the new device is much faster than traditional staircases. Moreover, such new evacuation device can also be used as a means of vertical transportation in high-rise buildings partly. People can take it from any floor to ground floor directly, which not only save time for waiting for the lifts but also save the power. The new evacuation system is of simple structure, easy to use, and suitable for evacuation and partly used as vertical downwards traffic, which shows light on solving world-wide difficulties on fast evacuation in high-rise buildings.

  5. Finland: Scandinavia's top gas user sees demand rising rapidly

    International Nuclear Information System (INIS)

    Nielsen, H.H.

    1992-01-01

    The rising demand for natural gas in Finland which already uses more gas than any other Nordic country is noted. The natural gas market which is based on sales to large industries and for heating is compared to the market in Denmark which is geared to small private heating customers. Imports of Norwegian gas allowing increased sales for power generation in Finland, and the influence of the impending Finnish application for membership of the EC on the gas market are considered. (UK)

  6. 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...

  7. POPULATION HEALTH AND THE RISE OF CONSUMERISM.

    Science.gov (United States)

    2015-09-01

    Earlier this summer, we convened a panel of health care executives and industry experts to consider how hospitals can balance the demands of high-value, more efficient care with the emergence of the savvy health care consumer. Their insights and words of advice are eye-opening.

  8. Technological innovations and the rise of social inequalities in health.

    Science.gov (United States)

    Weiss, Daniel; Eikemo, Terje Andreas

    2017-11-01

    Social inequalities in health have been categorised as a human-rights issue that requires action. Unfortunately, these inequalities are on the rise in many countries, including welfare states. Various theories have been offered to explain the persistence (and rise) of these inequalities over time, including the social determinants of health and fundamental cause theory. Interestingly, the rise of modern social inequalities in health has come at a time of great technological innovation. This article addresses whether these technological innovations are significantly influencing the persistence of modern social inequalities in health. A theoretical argument is offered for this potential connection and is discussed alongside the typical social determinants of health perspective and the increasingly popular fundamental cause perspective. This is followed by a proposed research agenda for further investigation of the potential role that technological innovations may play in influencing social inequalities in health.

  9. Rapid sea level rise in the aftermath of a Neoproterozoic snowball Earth.

    Science.gov (United States)

    Myrow, P M; Lamb, M P; Ewing, R C

    2018-04-19

    Earth's most severe climate changes occurred during global-scale snowball-Earth glaciations, which profoundly altered Earth's atmosphere, oceans, and biosphere. Extreme rates of glacio-eustatic sea-level rise are a fundamental prediction of the snowball Earth hypothesis, but supporting geologic evidence is lacking. We use paleohydraulic analysis of wave ripples and tidal laminae of the Elatina Formation, Australia - deposited following the Marinoan glaciation ca. 635Ma - to show that water depths of 9-16m remained nearly constant for ~100yrs throughout 27m of sediment accumulation. This accumulation rate was too great to have been accommodated by subsidence, and instead indicates an extraordinarily rapid rate of sea-level rise (0.2-0.27m/yr). Our results substantiate a fundamental prediction of snowball Earth models of rapid deglaciation during the early transition to a super-greenhouse climate. Copyright © 2018, American Association for the Advancement of Science.

  10. The rise of private health insurande in Denmark

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Engel

    2011-01-01

    The Danish healthcare system has since the early 1970s been tax financed and with free and equal access to health care. It still is, but within the last decade there has been an exponential growth in the number of private health insurances – from less than 50.000 in 2002 to approximately 1.......1 million in 2010. These private health insurances to great extent cover the same kind of treatments that can be obtained through the public tax financed system, but without the waiting lists that has been the an unsolvable problem for the public health care system over the past two decades. The rise...... of private health insurances in Denmark means that alongside the public healthcare institution there has grown a private institutional layer. The existence of this private institutional layer raises questions of what kind of influence the new private institutions can have on the existing public healthcare...

  11. Population Aging in Iran and Rising Health Care Costs

    Directory of Open Access Journals (Sweden)

    Mohammad Mirzaie

    2017-09-01

    Conclusion Based on the results of this research, it can be said that people throughout their life cycle always allocate a percentage of their total spending to health care costs, but the percentage of this allocation is different at different ages. In a way the demand for healthcare costs increases with aging, it rises significantly in the old age. At the macro level, due to an increase in the percentage of elderly in the population over the next decade, there will also be an increase in the share of health care costs.

  12. Rapidly Rising Optical Transients from the Birth of Binary Neutron Stars

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    Hotokezaka, Kenta; Kashiyama, Kazumi; Murase, Kohta

    2017-11-01

    We study optical counterparts of a new-born pulsar in a double neutron star system like PSR J0737-3039A/B. This system is believed to have ejected a small amount of mass of { O }(0.1 {M}⊙ ) at the second core-collapse supernova. We argue that the initial spin of the new-born pulsar can be determined by the orbital period at the time when the second supernova occurs. The spin angular momentum of the progenitor is expected to be similar to that of the He-burning core, which is tidally synchronized with the orbital motion, and then the second remnant may be born as a millisecond pulsar. If the dipole magnetic field strength of the nascent pulsar is comparable with that inferred from the current spin-down rate of PSR J0737-3039B, the initial spin-down luminosity is comparable to the luminosity of super-luminous supernovae. We consider thermal emission arising from the supernova ejecta driven by the relativistic wind from such a new-born pulsar. The resulting optical light curves have a rise time of ˜10 days and a peak luminosity of ˜1044 erg s-1. The optical emission may last for a month to several months, due to the reprocessing of X-rays and UV photons via photoelectric absorption. These features are broadly consistent with those of the rapidly rising optical transients. The high spin-down luminosity and small ejecta mass are favorable for the progenitor of the repeating fast radio burst, FRB 121102. We discuss a possible connection between new-born double pulsars and fast radio bursts.

  13. 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

  14. Rapid evolution of a marsh tidal creek network in response to sea level rise.

    Science.gov (United States)

    Hughes, Z. J.; Fitzgerald, D. M.; Mahadevan, A.; Wilson, C. A.; Pennings, S. C.

    2008-12-01

    In the Santee River Delta (SRD), South Carolina, tidal creeks are extending rapidly onto the marsh platform. A time-series of aerial photographs establishes that these channels were initiated in the 1950's and are headward eroding at a rate of 1.9 m /yr. Short-term trends in sea level show an average relative sea level rise (RSLR) of 4.6 mm/yr over a 20-year tide gauge record from nearby Winyah Bay and Charleston Harbor (1975-1995). Longer-term (85-year) records in Charleston suggest a rate of 3.2 mm/yr. RSLR in the SRD is likely even higher as sediment cores reveal that the marsh is predominantly composed of fine-grained sediment, making it highly susceptible to compaction and subsidence. Furthermore, loss in elevation will have been exacerbated by the decrease in sediment supply due to the damming of the Santee River in 1939. The rapid rate of headward erosion indicates that the marsh platform is in disequilibrium; unable to keep pace with RSLR through accretionary processes and responding to an increased volume and frequency of inundation through the extension of the drainage network. The observed tidal creeks show no sinuosity and a distinctive morphology associated with their young age and biological mediation during their evolution. Feedbacks between tidal flow, vegetation and infauna play a strong role in the morphological development of the creeks. The creek heads are characterized by a region denuded of vegetation, the edges of which are densely populated and burrowed by Uca Pugnax (fiddler crab). Crab burrowing destabilizes sediment, destroys rooting and impacts drainage. Measured infiltration rates are three orders of magnitude higher in the burrowed regions than in a control area (1000 ml/min and 0.6 ml/min respectively). Infiltration of oxygenated water enhances decomposition of organic matter and root biomass is reduced within the creek head (marsh=4.3 kg/m3, head=0.6 kg/m3). These processes lead to the removal and collapse of the soils, producing

  15. Coral reef growth in an era of rapidly rising sea level: predictions and suggestions for long-term research

    Energy Technology Data Exchange (ETDEWEB)

    Buddemeier, R W; Smith, S V

    1988-01-01

    Coral reef growth is intimately linked to sea level. It has been postulated that over the next century, sea level will rise at a probable average rate of 15 mm/year, in response to fossil fuel emissions, heating, and melting of the Antarctic ice cap. This predicted rate of sea level rise is five times the present modal rate of vertical accretion on coral reef flats and 50% greater than the maximum vertical accretion rates apparently attained by coral reefs. We use these predictions and observations to offer the following hypothesis for reef growth over the next century. The vertical accretion rates of protected reef flats will accelerate from the present modal rate up to the maximum rate, in response to the more rapidly rising sea level. This more rapid vertical accretion rate will be insufficient to keep up with sea level rise, if present predictions prove to be correct. Less protected reef flats will slow their rate of growth as they become inundated and subjected to erosion by progressively larger waves. This projected sea level rise and postulated reef response will provide an opportunity for long- term studies of the response of coral reef systems to a predictable and measurable forcing function.

  16. Temperature and humidity based projections of a rapid rise in global heat stress exposure during the 21st century

    Science.gov (United States)

    Coffel, Ethan D.; Horton, Radley M.; de Sherbinin, Alex

    2018-01-01

    As a result of global increases in both temperature and specific humidity, heat stress is projected to intensify throughout the 21st century. Some of the regions most susceptible to dangerous heat and humidity combinations are also among the most densely populated. Consequently, there is the potential for widespread exposure to wet bulb temperatures that approach and in some cases exceed postulated theoretical limits of human tolerance by mid- to late-century. We project that by 2080 the relative frequency of present-day extreme wet bulb temperature events could rise by a factor of 100-250 (approximately double the frequency change projected for temperature alone) in the tropics and parts of the mid-latitudes, areas which are projected to contain approximately half the world’s population. In addition, population exposure to wet bulb temperatures that exceed recent deadly heat waves may increase by a factor of five to ten, with 150-750 million person-days of exposure to wet bulb temperatures above those seen in today’s most severe heat waves by 2070-2080. Under RCP 8.5, exposure to wet bulb temperatures above 35 °C—the theoretical limit for human tolerance—could exceed a million person-days per year by 2080. Limiting emissions to follow RCP 4.5 entirely eliminates exposure to that extreme threshold. Some of the most affected regions, especially Northeast India and coastal West Africa, currently have scarce cooling infrastructure, relatively low adaptive capacity, and rapidly growing populations. In the coming decades heat stress may prove to be one of the most widely experienced and directly dangerous aspects of climate change, posing a severe threat to human health, energy infrastructure, and outdoor activities ranging from agricultural production to military training.

  17. On the Rapid Rise of Social Networking Sites: New Findings and Policy Implications

    Science.gov (United States)

    Livingstone, Sonia; Brake, David R

    2010-01-01

    Social networking sites have been rapidly adopted by children and, especially, teenagers and young people worldwide, enabling new opportunities for the presentation of the self, learning, construction of a wide circle of relationships, and the management of privacy and intimacy. On the other hand, there are also concerns that social networking…

  18. Coral mass spawning predicted by rapid seasonal rise in ocean temperature

    KAUST Repository

    Keith, Sally A.; Maynard, Jeffrey A.; Edwards, Alasdair J.; Guest, James R.; Bauman, Andrew G.; van Hooidonk, Ruben; Heron, Scott F.; Berumen, Michael L.; Bouwmeester, Jessica; Piromvaragorn, Srisakul; Rahbek, Carsten; Baird, Andrew H.

    2016-01-01

    Coral spawning times have been linked to multiple environmental factors; however, to what extent these factors act as generalized cues across multiple species and large spatial scales is unknown. We used a unique dataset of coral spawning from 34 reefs in the Indian and Pacific Oceans to test if month of spawning and peak spawning month in assemblages of Acropora spp. can be predicted by sea surface temperature (SST), photosynthetically available radiation, wind speed, current speed, rainfall or sunset time. Contrary to the classic view that high mean SST initiates coral spawning, we found rapid increases in SST to be the best predictor in both cases (month of spawning: R2 = 0.73, peak: R2 = 0.62). Our findings suggest that a rapid increase in SST provides the dominant proximate cue for coral mass spawning over large geographical scales. We hypothesize that coral spawning is ultimately timed to ensure optimal fertilization success.

  19. Coral mass spawning predicted by rapid seasonal rise in ocean temperature

    KAUST Repository

    Keith, Sally A.

    2016-05-11

    Coral spawning times have been linked to multiple environmental factors; however, to what extent these factors act as generalized cues across multiple species and large spatial scales is unknown. We used a unique dataset of coral spawning from 34 reefs in the Indian and Pacific Oceans to test if month of spawning and peak spawning month in assemblages of Acropora spp. can be predicted by sea surface temperature (SST), photosynthetically available radiation, wind speed, current speed, rainfall or sunset time. Contrary to the classic view that high mean SST initiates coral spawning, we found rapid increases in SST to be the best predictor in both cases (month of spawning: R2 = 0.73, peak: R2 = 0.62). Our findings suggest that a rapid increase in SST provides the dominant proximate cue for coral mass spawning over large geographical scales. We hypothesize that coral spawning is ultimately timed to ensure optimal fertilization success.

  20. Projections of rapidly rising surface temperatures over Africa under low mitigation

    International Nuclear Information System (INIS)

    Engelbrecht, Francois; Bopape, Mary-Jane; Naidoo, Mogesh; Garland, Rebecca; Adegoke, Jimmy; Thatcher, Marcus; McGregor, John; Katzfey, Jack; Werner, Micha; Ichoku, Charles; Gatebe, Charles

    2015-01-01

    An analysis of observed trends in African annual-average near-surface temperatures over the last five decades reveals drastic increases, particularly over parts of the subtropics and central tropical Africa. Over these regions, temperatures have been rising at more than twice the global rate of temperature increase. An ensemble of high-resolution downscalings, obtained using a single regional climate model forced with the sea-surface temperatures and sea-ice fields of an ensemble of global circulation model (GCM) simulations, is shown to realistically represent the relatively strong temperature increases observed in subtropical southern and northern Africa. The amplitudes of warming are generally underestimated, however. Further warming is projected to occur during the 21st century, with plausible increases of 4–6 °C over the subtropics and 3–5 °C over the tropics by the end of the century relative to present-day climate under the A2 (a low mitigation) scenario of the Special Report on Emission Scenarios. High impact climate events such as heat-wave days and high fire-danger days are consistently projected to increase drastically in their frequency of occurrence. General decreases in soil-moisture availability are projected, even for regions where increases in rainfall are plausible, due to enhanced levels of evaporation. The regional dowscalings presented here, and recent GCM projections obtained for Africa, indicate that African annual-averaged temperatures may plausibly rise at about 1.5 times the global rate of temperature increase in the subtropics, and at a somewhat lower rate in the tropics. These projected increases although drastic, may be conservative given the model underestimations of observed temperature trends. The relatively strong rate of warming over Africa, in combination with the associated increases in extreme temperature events, may be key factors to consider when interpreting the suitability of global mitigation targets in terms of

  1. Accelerated relative sea-level rise and rapid coastal erosion: Testing a causal relationship for the Louisiana barrier islands

    Science.gov (United States)

    List, J.H.; Sallenger, A.H.; Hansen, M.E.; Jaffe, B.E.

    1997-01-01

    The role of relative sea-level rise as a cause for the rapid erosion of Louisiana's barrier island coast is investigated through a numerical implementation of a modified Bruun rule that accounts for the low percentage of sand-sized sediment in the eroding Louisiana shoreface. Shore-normal profiles from 150 km of coastline west of the Mississippi delta are derived from bathymetric surveys conducted during the 1880s. 1930s and 1980s. An RMS difference criterion is employed to test whether an equilibrium profile form is maintained between survey years. Only about half the studied profiles meet the equilibrium Criterion this represents a significant limitation on the potential applicability of the Bruun rule. The profiles meeting the equilibrium criterion, along with measured rates of relative sea-level rise, are used to hindcast shoreline retreat rates at 37 locations within the study area. Modeled and observed shoreline retreat rates show no significant correlation. Thus in terms of the Bruun approach relative sea-level rise has no power for hindcasting (and presumably forecasting) rates of coastal erosion for the Louisiana barrier islands.

  2. Early Childhood Dental Caries: A Rising Dental Public Health Crisis

    Science.gov (United States)

    Gomez, Grace Felix

    2013-01-01

    The aim of this article is to examine the literature and review the risk factors and disparities contributing to early childhood caries (ECC), which is a major health problem among preschoolers in the United States of America. A search was conducted using MEDLINE, PubMed, Google Scholar, and the Cochrane Library databases and the key terms…

  3. Rosid radiation and the rapid rise of angiosperm-dominated forests

    Science.gov (United States)

    Wang, Hengchang; Moore, Michael J.; Soltis, Pamela S.; Bell, Charles D.; Brockington, Samuel F.; Alexandre, Roolse; Davis, Charles C.; Latvis, Maribeth; Manchester, Steven R.; Soltis, Douglas E.

    2009-01-01

    The rosid clade (70,000 species) contains more than one-fourth of all angiosperm species and includes most lineages of extant temperate and tropical forest trees. Despite progress in elucidating relationships within the angiosperms, rosids remain the largest poorly resolved major clade; deep relationships within the rosids are particularly enigmatic. Based on parsimony and maximum likelihood (ML) analyses of separate and combined 12-gene (10 plastid genes, 2 nuclear; >18,000 bp) and plastid inverted repeat (IR; 24 genes and intervening spacers; >25,000 bp) datasets for >100 rosid species, we provide a greatly improved understanding of rosid phylogeny. Vitaceae are sister to all other rosids, which in turn form 2 large clades, each with a ML bootstrap value of 100%: (i) eurosids I (Fabidae) include the nitrogen-fixing clade, Celastrales, Huaceae, Zygophyllales, Malpighiales, and Oxalidales; and (ii) eurosids II (Malvidae) include Tapisciaceae, Brassicales, Malvales, Sapindales, Geraniales, Myrtales, Crossosomatales, and Picramniaceae. The rosid clade diversified rapidly into these major lineages, possibly over a period of ferns. PMID:19223592

  4. Rapid further heating of tokamak plasma by fast-rising magnetic pulse

    International Nuclear Information System (INIS)

    Inoue, N.; Nihei, H.; Yamazaki, K.; Ichimura, M.; Morikawa, J.; Hoshino, K.; Uchida, T.

    1977-01-01

    The object of the experiment was to study the rapid further heating of a tokamak plasma and its influence on confinement. For this purpose, a high-voltage theta-pinch pulse was applied to a tokamak plasma and production of a high-temperature (keV) plasma was ensured within a microsecond. The magnetic pulse is applied at the plasma current maximum parallel or antiparallel to the study toroidal field. In either case, the pulsed field quickly penetrates the plasma and the plasma resistivity estimated from the penetration time is about 100 times larger than the classical. A burst of energetic neutrals of approximately 1 μs duration was observed and the energy distribution had two components of the order of 1 keV and 0.1 keV in the antiparallel case. Doppler broadening measurement shows heating of ions to a temperature higher than 200 eV; however, the line profile is not always Maxwellian distribution. The X-rays disappear at the moment of applying the magnetic pulse and reappear about 100 μs later with an intensive burst, while both energy levels are the same (approximately 100 keV). (author)

  5. 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

  6. The Rise and Fall of Protein Malnutrition in Global Health.

    Science.gov (United States)

    Semba, Richard D

    2016-01-01

    From the 1950s to the mid-1970s, United Nations (UN) agencies were focused on protein malnutrition as the major worldwide nutritional problem. The goal of this review is to examine this era of protein malnutrition, the reasons for its demise, and the aftermath. The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a 'protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as 'The Great Protein Fiasco', declaring that the 'protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a 'protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting. Key Messages: It may be time to re-include protein and return protein malnutrition in the global health agenda using a balanced approach that includes all protective nutrients. © 2016 S. Karger AG, Basel.

  7. 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.

  8. Large sharing networks and unusual injection practices explain the rapid rise in HIV among IDUs in Sargodha, Pakistan

    Directory of Open Access Journals (Sweden)

    Qureshi Salman U

    2009-06-01

    Full Text Available Abstract Background Of the nearly 100,000 street-based IDUs in Pakistan, 20% have HIV. We investigated the recent rise in HIV prevalence from 12 to 52% among IDUs in Sargodha despite > 70% coverage with syringe exchanges. Methods We interviewed approximately 150 IDUs and 30 outreach workers in focus group discussions. Results We found six rural and 28 urban injecting locations. Urban locations have about 20–30 people at any time and about 100 daily; rural locations have twice as many (national average: 4–15. About half of the IDUs started injecting within the past 2 years and are not proficient at injecting themselves. They use street injectors, who have 15–16 clients daily. Heroin is almost exclusively the drug used. Most inject 5–7 times daily. Nearly all injectors claim to use fresh syringes. However, they load, inject and share using a locally developed method called scale. Most Pakistani IDUs prefer to double pump drug the syringe, which allows mixing of blood with drug in the syringe. The injector injects 3 ml and keeps 2 ml (the scale as injection fee. The injector usually pools all the leftover scale (now with some blood mixed with drug either for his own use or to sell it. Most IDUs backload the scale they buy into their own fresh syringes. Discussion Use of an unprecedented method of injecting drugs that largely bypasses fresh syringes, larger size of sharing networks, higher injection frequency and near universal use of street injectors likely explain for the rapid rise in HIV prevalence among IDUs in Sargodha despite high level provision of fresh syringes. This had been missed by us and the national surveillance, which is quantitative. We have addressed this by hiring injectors as peer outreach workers and increasing syringe supply. Our findings highlight both the importance of qualitative research and operations research to enrich the quality of HIV prevention programs.

  9. Sedimentary Evidence for a Rapid Sea Level Rise at 7,600 cal yr BP from North-Central Cuba

    Science.gov (United States)

    Peros, M. C.; Agosta G'meiner, A. M.; Collins, S.

    2016-12-01

    A lack of high-resolution relative sea level (RSL) proxy data has meant that the pattern of early Holocene RSL change in the Caribbean is poorly understood. A RSL curve published by Toscano and Macintyre (2003) using inter-tidal mangrove peats and submerged corals suggests RSL underwent a relatively fast and `smooth' curvilinear increase during the Holocene. However, others, such as Blanchon and Shaw (1995), suggest that RSL increased rapidly at around 7600 cal yr BP, in response to the final stages of the melting of the Laurentide Ice Sheet (melt water pulse 1C or catastrophic rise event 3). We investigated this question using multi-proxy data from a flooded sinkhole (Cenote Jennifer) on the north coast of central Cuba. Cenote Jennifer is located 7 m above mean sea level and 2 km from the Bahamas Channel and appears to have a high degree of connectivity with the ocean through a network of underground caverns. The water depth is 13 m and the bottommost 5 m is anoxic. A sediment core collected from Cenote Jennifer was studied using loss-on-ignition, pollen analysis, high-resolution XRF core-scanning, and grain size analysis. An age-depth model was generated for the core by AMS dating. The results show that the bottommost stratigraphic unit ( 9000 to 7600 cal yr BP) is a fine-grained carbonate-rich mud (i.e., marl). This unit abruptly transitions into finely laminated organic-rich sediment from 7600 cal yr BP to the present. The pollen analysis shows that the sinkhole supported a cattail (Typha) community until 7600 cal yr BP, indicating low water levels ( 1 m). At 7600 cal yr BP, the cattail community disappeared and the vegetation of the surrounding bedrock became dominated by a thorny coastal scrubland. In addition, a 3 cm thick fining-upward siliciclastic unit is present immediately above the marl-organic contact, suggesting: 1) a marine sediment source given the limestone-dominated nature of the region, and 2) the presence of a short-duration, high

  10. Rising inequalities in income and health in China: who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-12-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Rising inequalities in income and health in China: Who is left behind?

    Science.gov (United States)

    Baeten, Steef; Van Ourti, Tom; van Doorslaer, Eddy

    2013-01-01

    In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991–2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to health disparities between rich and poor. We find that health disparities in China relate to rising income inequality and in particular to the adverse health and income experience of older (wo)men, but not to the growth rate of average incomes over the last decades. These findings suggest that replacement incomes and pensions at older ages may be one of the most important policy levers for reducing health disparities between rich and poor Chinese. PMID:24189450

  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. Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997-2011.

    Science.gov (United States)

    Zhao, Zhuhui; Sun, Chengjun; Wang, Chunfang; Li, Pin; Wang, Wei; Ye, Jun; Gu, Xuefan; Wang, Xiaodong; Shen, Shuixian; Zhi, Dijing; Lu, Zhong; Ye, Rong; Cheng, Ruoqian; Xi, Li; Li, Xiaojing; Zheng, Zhangqian; Zhang, Miaoying; Luo, Feihong

    2014-12-01

    The aim of this study was to investigate incidence trend of childhood type 1 diabetes in Shanghai, a megalopolis in east China. We established a population-based retrospective registry for the disease in the city's registered population during 1997-2011 and collected 622 incident type 1 diabetes in children aged 0-14 years. Standardized incidence rates and 95 % CI were estimated by applying the capture-recapture method and assuming Poisson distribution. Incidence trend was analyzed using the Poisson regression model. The mean annual incidence of childhood type 1 diabetes was 3.1 per 100,000 person-years. We did not observe significant difference in incidence between boys and girls. The incidence is unstable and had a mean annual increase 14.2 % per year during the studied period. A faster annual increase was observed in boys, warmer seasons, and in the outer regions of the city. If present trends continue, the number of new type 1 diabetes cases will double from 2016 to 2020, and prevalent cases will sextuple by 2025. Our results showed the incidence of childhood type 1 diabetes was rising rapidly in Shanghai. More studies are needed to analyze incidence changes in other regions of China for appropriate allocation of healthcare resources.

  14. Linking research to practice: the rise of evidence-based health sciences librarianship.

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

  15. Lung Cancer in a Rural Area of China: Rapid Rise in Incidence and Poor Improvement in Survival.

    Science.gov (United States)

    Yang, Juan; Zhu, Jian; Zhang, Yong-Hui; Chen, Yong-Sheng; Ding, Lu-Lu; Kensler, Thomas W; Chen, Jian-Guo

    2015-01-01

    Lung cancer has been a major health problem in developed countries for several decades, and has emerged recently as the leading cause of cancer death in many developing countries. The incidence of lung cancer appears to be increasing more rapidly in rural than in urban areas of China. This paper presents the trends of lung cancer incidence and survival derived from a 40-year population-based cancer monitoring program in a rural area, Qidong, China. The Qidong cancer registration data of 1972- 2011 were used to calculate the crude rate, age-standardized rate by Chinese population (CASR) and by world population (WASR), birth cohort rates, and other descriptive features. Active and passive methods were used to construct the data set, with a deadline of the latest follow-up of April 30, 2012. The total number of lung cancer cases was 15,340, accounting for 16.5% of all sites combined. The crude incidence rate, CASR and WASR of this cancer were 34.1, 15.7 and 25.4 per 100,000, respectively. Males had higher crude rates than females (49.7 vs 19.0). Rapidly increasing trends were found in annual percent change resulting in lung cancer being a number one cancer site after year 2010 in Qidong. Birth cohort analysis showed incidence rates have increased for all age groups over 24 years old. The 5 year observed survival rates were 3.55% in 1973-1977, 3.92 in 1983-1987, 3.69% in 1993-1997, and 6.32% in 2003-2007. Males experienced poorer survival than did females. Lung cancer has become a major cancer-related health problem in this rural area. The rapid increases in incidence likely result from an increased cigarette smoking rate and evolving environmental risk factors. Lung cancer survival, while showing some improvement in prognosis, still remains well below that observed in the developed areas of the world.

  16. Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

    Science.gov (United States)

    Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

    2008-10-01

    Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

  17. 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...

  18. Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives.

    Science.gov (United States)

    Wilson, Anne; Whitaker, Nancy; Whitford, Deirdre

    2012-05-31

    Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice.

  19. Linking research to practice: the rise of evidence-based health sciences librarianship*

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

  20. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-01-01

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. PMID:28812811

  1. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Directory of Open Access Journals (Sweden)

    Ewen Speed

    2017-04-01

    Full Text Available Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism.

  2. 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.

  3. Rising labor costs, earnings management, and financial performance of health care providers around the world.

    Science.gov (United States)

    Dong, Gang Nathan

    2015-01-01

    Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor. We collected the financial information of health care provider in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects. The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability. The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial booktax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

  4. Unequal ‘Partners’. AIDS, Academia, and the Rise of Global Health

    Directory of Open Access Journals (Sweden)

    Johanna T. Crane

    2010-12-01

    Full Text Available The last decade has seen the proliferation of “global health” departments, centers, programs, and majors across top research universities in North America and Europe. This trend has been particularly pronounced in the United States, where it is connected to America′s new role as a major sponsor of HIV treatment in Africa. This paper describes the rise of “global health” as a research, funding, and training priority within U.S. academic medicine, and the increasing desirability of “global health partnerships” with institutions in sub-Saharan Africa. Leading spokespersons emphasize that “partnership” with poor nations is central to the mission of global health, an ethic that distinguishes it from older, more paternalistic traditions of international health and tropical medicine. However, at the same time, the field of academic global health depends on steep inequalities for its very existence, as it is the opportunity to work in impoverished, low-tech settings with high disease burdens that draws North American researchers and clinicians to global health programs and ensures their continued funding. This paradox – in which inequality is both a form of suffering to be redressed and a professional, knowledge-generating, opportunity to be exploited – makes the partnerships to which global health aspires particularly challenging.

  5. The rise of global health diplomacy: An interdisciplinary concept linking health and international relations.

    Science.gov (United States)

    Chattu, Vijay Kumar

    2017-01-01

    Global health diplomacy (GHD) is relatively a very new field that has yet to be clearly defined and developed though there are various definitions given by different experts from foreign policy, global health, diplomacy, international relations, governance, and law. With the intensification of globalization and increasing gaps between countries, new and reemerging health threats such as HIV/AIDS, tuberculosis, influenza, severe acute respiratory syndrome, Ebola, and Zika and a gradual rethinking on security concepts framed a new political context. The health problems addressed diplomatically have also become diverse ranging from neglected tropical diseases, infectious diseases, sale of unsafe, counterfeit drugs to brain drain crisis. We see that global health has become more diverse as the actors widened and also the interests appealing not only to the traditional humanitarian ideals associated with health but also to the principles grounded in national and global security. Recently, we are witnessing the increased priority given to the GHD because the issue of health is discussed by various actors outside the WHO to shape the global policy for health determinants. In fact, the area of health has become the part of UN Summit Diplomacy involving the G8, G20, BRICS, and the EU. The recent WHO Pandemic Influenza Framework, UN High Level Framework on Prevention and Control of Noncommunicable Diseases, and the WHO Framework Convention on Tobacco Control are some of the examples of long-term negotiation processes for agreements that took place.

  6. A current-pulsed power supply with rapid rising and falling edges for magnetic perturbation coils on the J-TEXT tokamak

    International Nuclear Information System (INIS)

    Yan, M.X.; Rao, B.; Ding, Y.H.; Hu, Q.M.; Hu, F.R.; Li, D.; Li, M.; Ji, X.K.; Xu, G.; Zheng, W.; Jiang, Z.H.

    2017-01-01

    Highlights: • The power supply is required to have rapid rising and falling edges. • A modified topology based on the buck chopper of current-pulsed power supply is presented and analyzed. • An entity meeting the electrical requirements has been constructed. • The spike voltage of IGBT is qualitatively analyzed. - Abstract: This study presents the design and principle of a current-pulsed power supply (CPPS) for the tearing mode (TM) feedback control of the J-TEXT tokamak. CPPS is a new method of stabilizing large magnetic islands and accelerating mode rotation through the use of modulated magnetic perturbation. In this application, continuous magnetic perturbation pulse trains with frequency of 1 kHz to kHz, amplitude of 0.25 G, and duty ratio of 20%–50% are required generating via in-vessel magnetic coils. A modified topology based on buck chopper is raised to satisfy the demands of inductive load. This modified topology is characterized by high frequency, rapid rising and falling edges, and large amplitude of current pulses. Appropriate RCD snubber circuit is applied to protect the Insulated Gate Bipolar Transistor (IGBT) switch device. Equipment with peak current that reaches 1 kA, frequency that ranges from 1 kHz to 3 kHz, and rising and falling time within 100 μs was constructed and applied to physical experiment.

  7. A current-pulsed power supply with rapid rising and falling edges for magnetic perturbation coils on the J-TEXT tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Yan, M.X. [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan 430074 (China); College of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China); Rao, B., E-mail: borao@hust.edu.cn [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan 430074 (China); College of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China); Ding, Y.H.; Hu, Q.M.; Hu, F.R.; Li, D.; Li, M.; Ji, X.K.; Xu, G.; Zheng, W.; Jiang, Z.H. [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan 430074 (China); College of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China)

    2017-02-15

    Highlights: • The power supply is required to have rapid rising and falling edges. • A modified topology based on the buck chopper of current-pulsed power supply is presented and analyzed. • An entity meeting the electrical requirements has been constructed. • The spike voltage of IGBT is qualitatively analyzed. - Abstract: This study presents the design and principle of a current-pulsed power supply (CPPS) for the tearing mode (TM) feedback control of the J-TEXT tokamak. CPPS is a new method of stabilizing large magnetic islands and accelerating mode rotation through the use of modulated magnetic perturbation. In this application, continuous magnetic perturbation pulse trains with frequency of 1 kHz to kHz, amplitude of 0.25 G, and duty ratio of 20%–50% are required generating via in-vessel magnetic coils. A modified topology based on buck chopper is raised to satisfy the demands of inductive load. This modified topology is characterized by high frequency, rapid rising and falling edges, and large amplitude of current pulses. Appropriate RCD snubber circuit is applied to protect the Insulated Gate Bipolar Transistor (IGBT) switch device. Equipment with peak current that reaches 1 kA, frequency that ranges from 1 kHz to 3 kHz, and rising and falling time within 100 μs was constructed and applied to physical experiment.

  8. Rising U.S. income inequality, gender and individual self-rated health, 1972-2004.

    Science.gov (United States)

    Zheng, Hui

    2009-11-01

    The effect of income inequality on health has been a contested topic among social scientists. Most previous research is based on cross-sectional comparisons rather than temporal comparisons. Using data from the General Social Survey and the U.S. Census Bureau, this study examines how rising income inequality affects individual self-rated health in the U.S. from 1972 to 2004. Data are analyzed using hierarchical generalized linear models. The findings suggest a significant association between income inequality and individual self-rated health. The dramatic increase in income inequality from 1972 to 2004 increases the odds of worse self-rated health by 9.4 percent. These findings hold for three measures of income inequality: the Gini coefficient, the Atkinson Index, and the Theil entropy index. Results also suggest that overall income inequality and gender-specific income inequality harm men's, but not women's, self-rated health. These findings also hold for the three measures of income inequality. These findings suggest that inattention to gender composition may explain apparent discrepancies across previous studies.

  9. Population health in an era of rising income inequality: USA, 1980-2015.

    Science.gov (United States)

    Bor, Jacob; Cohen, Gregory H; Galea, Sandro

    2017-04-08

    Income inequality in the USA has increased over the past four decades. Socioeconomic gaps in survival have also increased. Life expectancy has risen among middle-income and high-income Americans whereas it has stagnated among poor Americans and even declined in some demographic groups. Although the increase in income inequality since 1980 has been driven largely by soaring top incomes, the widening of survival inequalities has occurred lower in the distribution-ie, between the poor and upper-middle class. Growing survival gaps across income percentiles since 2001 reflect falling real incomes among poor Americans as well as an increasingly strong association between low income and poor health. Changes in individual risk factors such as smoking, obesity, and substance abuse play a part but do not fully explain the steeper gradient. Distal factors correlated with rising inequality including unequal access to technological innovations, increased geographical segregation by income, reduced economic mobility, mass incarceration, and increased exposure to the costs of medical care might have reduced access to salutary determinants of health among low-income Americans. Having missed out on decades of income growth and longevity gains, low-income Americans are increasingly left behind. Without interventions to decouple income and health, or to reduce inequalities in income, we might see the emergence of a 21st century health-poverty trap and the further widening and hardening of socioeconomic inequalities in health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. 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.

  11. Evaluating Maternal and Child Health and Leadership Competencies of Emerging MCH Leaders: The MCHC/RISE-UP Experience.

    Science.gov (United States)

    Belcher, Harolyn M E; Stone, Jacqueline D; McFadden, Jenese A; Hemmingson, Tyler A; Kreutzer, Cary; Harris, Lisa G; Wheeler, Barbara Y; Van Osdel, Joanne; Avila, Margaret; Yorker, Beatrice; Hoffman, Beth R; Turner-Musa, Jocelyn O

    2015-12-01

    This study examines maternal and child health core competencies and leadership characteristics of undergraduate students following participation in the Maternal and Child Health Careers/Research Initiatives for Student Enhancement-Undergraduate Program (MCHC/RISE-UP). MCHC/RISE-UP is a 10-week public health leadership program designed to promote diversity in public health workforce through mentored research, community engagement and advocacy, and clinical experiences for undergraduate students. The MCHC/RISE-UP is a national consortium of University Centers for Excellence in Developmental Disabilities including, (1) Kennedy Krieger Institute (Kennedy Krieger, lead institution) partnering with Morgan State University, a Historically Black University, (2) the University of South Dakota partnering with Tribal Serving Institutions; and (3) the University of Southern California Children's Hospital-Los Angeles and their partner institution, California State University Los Angeles, a Hispanic Serving Institution. Eighty-four junior and senior undergraduates and recent baccalaureate degree students who participated in the MCHC/RISE-UP worked on 48 maternal and child health projects. Following the MCHC/RISE-UP, students demonstrated statistically significant improvements in all maternal and child health core competencies. Transformational leadership characteristics also increased (mean increase 9.4, 95% CI 7.2-11.8; p leadership programs may extend the reach and recruitment of diverse students into the maternal and child health field. Experiential, didactic, and mentored learning opportunities may enhance student integration of maternal and child health competencies and transformational leadership characteristics.

  12. The rise of neoliberalism: how bad economics imperils health and what to do about it.

    Science.gov (United States)

    Labonté, Ronald; Stuckler, David

    2016-03-01

    The 2008 global financial crisis, precipitated by high-risk, under-regulated financial practices, is often seen as a singular event. The crisis, its recessionary consequences, bank bailouts and the adoption of 'austerity' measures can be seen as a continuation of a 40-year uncontrolled experiment in neoliberal economics. Although public spending and recapitalisation of failing banks helped prevent a 1930s-style Great Depression, the deep austerity measures that followed have stifled a meaningful recovery for the majority of populations. In the short term, these austerity measures, especially cuts to health and social protection systems, pose major health risks in those countries under its sway. Meanwhile structural changes to the global labour market, increasing under-employment in high-income countries and economic insecurity elsewhere, are likely to widen health inequities in the longer term. We call for four policy reforms to reverse rising inequalities and their harms to public health. First is re-regulating global finance. Second is rejecting austerity as an empirically and ethically unjustified policy, especially given now clear evidence of its deleterious health consequences. Third, there is a need to restore progressive taxation at national and global scales. Fourth is a fundamental shift away from the fossil fuel economy and policies that promote economic growth in ways that imperil environmental sustainability. This involves redistributing work and promoting fairer pay. We do not suggest these reforms will be politically feasible or even achievable in the short term. They nonetheless constitute an evidence-based agenda for strong, public health advocacy and practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. 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

  14. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy.

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-02-12

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for 'fake news' and 'alternative facts' with the intention of inciting fear and hatred of 'the other' and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  15. The rise and fall of democratic universalism: health care reform in Italy, 1978-1994.

    Science.gov (United States)

    Ferrera, M

    1995-01-01

    In 1978, a sweeping reform created the first national health service of continental Europe: Italy's Servizio Sanitario Nazionale. This new scheme was based on the principle of "full democratic universalism": The state would provide free and equal benefits to every citizen and the organization of public health would subject to popular control, essentially through political parties. However, the severe problems encountered in implementing the reform design and rapidly increasing health expenditures soon eroded any consensus on this principle. Thus the 1980s and early 1990s witnessed a gradual shift to "conditional and well managed universalism." These latter principles stress the need to differentiate access to care according to some criterion to regulate demand and the need for efficient use of scarce resources through adequate valorization of managerial skills and the use of "market-type" incentives. An elaborated system of user copayments was introduced gradually, and in 1992 a "reform of the reform" profoundly changed the organizational framework of the Servizio Sanitario Nazionale. The new government elected in the spring of 1994 announced ambitious plans to partially dismantle public universal insurance. Although these plans may prove difficult, the potential to form an anti-universalistic coalition seems strong in the contemporary Italian health care arena.

  16. Structural health monitoring on medium rise reinforced concrete building using ambient vibration method

    Science.gov (United States)

    Kamarudin, A. F.; Mokhatar, S. N.; Zainal Abidin, M. H.; Daud, M. E.; Rosli, M. S.; Ibrahim, A.; Ibrahim, Z.; Noh, M. S. Md

    2018-04-01

    Monitoring of structural health from initial stage of building construction to its serviceability is an ideal practise to assess for any structural defects or damages. Structural integrity could be intruded by natural destruction or structural deterioration, and worse if without remedy action on monitoring, building re-assessment or maintenance is taken. In this study the application of ambient vibration (AV) testing is utilized to evaluate the health of eighth stories medium rise reinforced concrete building in Universiti Tun Hussein Onn Malaysia (UTHM), based comparison made between the predominant frequency, fo, determined in year 2012 and 2017. For determination of fo, popular method of Fourier Amplitude Spectra (FAS) was used to transform the ambient vibration time series by using 1 Hz tri-axial seismometer sensors and City SharkII data recorder. From the results, it shows the first mode frequencies from FAS curves indicate at 2.04 Hz in 2012 and 1.97 Hz in 2017 with only 3.14% of frequency reduction. However, steady state frequencies shown at the second and third modes frequencies of 2.42 Hz and 3.31 Hz by both years. Two translation mode shapes were found at the first and second mode frequencies in the North-South (NS-parallel to building transverse axis) and East-West (EsW-parallel to building longitudinal axis) components, and the torsional mode shape shows as the third mode frequency in both years. No excessive deformation amplitude was found at any selective floors based on comparison made between three mode shapes produced, that could bring to potential feature of structural deterioration. Low percentages of natural frequency disparity within five years of duration interval shown by the first mode frequencies under ambient vibration technique was considered in good health state, according to previous researchers recommendation at acceptable percentages below 5 to 10% over the years.

  17. Recent rapid rise of a permethrin knock down resistance allele in Aedes aegypti in México.

    Science.gov (United States)

    García, Gustavo Ponce; Flores, Adriana E; Fernández-Salas, Ildefonso; Saavedra-Rodríguez, Karla; Reyes-Solis, Guadalupe; Lozano-Fuentes, Saul; Guillermo Bond, J; Casas-Martínez, Mauricio; Ramsey, Janine M; García-Rejón, Julián; Domínguez-Galera, Marco; Ranson, Hilary; Hemingway, Janet; Eisen, Lars; Black IV, William C

    2009-10-13

    -2008 collections, which ranged from 45.7% (+ or - 2.00% CI95) in the state of Veracruz to 51.2% (+ or - 4.36% CI95) in the Yucatán peninsula and 14.5% (+ or - 2.23% CI95) in and around Tapachula in the state of Chiapas. Spatial heterogeneity was also evident at smaller geographic scales. For example within the city of Chetumal, Quintana Roo, Ile1,016 frequencies varied from 38.3%-88.3%. A linear regression analysis based on seven collections from 2007 revealed that the frequency of Ile1,016 homozygotes accurately predicted knockdown rate for mosquitoes exposed to permethrin in a bioassay (R(2) = 0.98). We have recorded a dramatic increase in the frequency of the Ile1,016 mutation in the voltage-gated sodium channel gene of Ae. aegypti in México from 1996 to 2009. This may be related to heavy use of permethrin-based insecticides in mosquito control programs. Spatial heterogeneity in Ile1,016 frequencies in 2007 and 2008 collections may reflect differences in selection pressure or in the initial frequency of Ile1,016. The rapid recent increase in Ile1,016 is predicted by a simple model of positive directional selection on a recessive allele. Unfortunately this model also predicts rapid fixation of Ile1,016 unless there is negative fitness associated with Ile1,016 in the absence of permethrin. If so, then spatial refugia of susceptible Ae. aegypti or rotational schedules of different classes of adulticides could be established to slow or prevent fixation of Ile1,016.

  18. Recent rapid rise of a permethrin knock down resistance allele in Aedes aegypti in México.

    Directory of Open Access Journals (Sweden)

    Gustavo Ponce García

    heterogeneity in Ile1,016 frequencies among 2007-2008 collections, which ranged from 45.7% (+ or - 2.00% CI95 in the state of Veracruz to 51.2% (+ or - 4.36% CI95 in the Yucatán peninsula and 14.5% (+ or - 2.23% CI95 in and around Tapachula in the state of Chiapas. Spatial heterogeneity was also evident at smaller geographic scales. For example within the city of Chetumal, Quintana Roo, Ile1,016 frequencies varied from 38.3%-88.3%. A linear regression analysis based on seven collections from 2007 revealed that the frequency of Ile1,016 homozygotes accurately predicted knockdown rate for mosquitoes exposed to permethrin in a bioassay (R(2 = 0.98. CONCLUSIONS: We have recorded a dramatic increase in the frequency of the Ile1,016 mutation in the voltage-gated sodium channel gene of Ae. aegypti in México from 1996 to 2009. This may be related to heavy use of permethrin-based insecticides in mosquito control programs. Spatial heterogeneity in Ile1,016 frequencies in 2007 and 2008 collections may reflect differences in selection pressure or in the initial frequency of Ile1,016. The rapid recent increase in Ile1,016 is predicted by a simple model of positive directional selection on a recessive allele. Unfortunately this model also predicts rapid fixation of Ile1,016 unless there is negative fitness associated with Ile1,016 in the absence of permethrin. If so, then spatial refugia of susceptible Ae. aegypti or rotational schedules of different classes of adulticides could be established to slow or prevent fixation of Ile1,016.

  19. 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

  20. Health impacts of rapid economic changes in Thailand.

    Science.gov (United States)

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

    2000-09-01

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

  1. Mental health issues from rising sea level in a remote coastal region of the Solomon Islands: current and future.

    Science.gov (United States)

    Asugeni, James; MacLaren, David; Massey, Peter D; Speare, Rick

    2015-12-01

    There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands. A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level. Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed. Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  2. 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.

  3. The Rise of Mental Health Nursing : A History of Psychiatric Care in Dutch Asylums, 1890-1920

    NARCIS (Netherlands)

    Boschma, Geertje

    2003-01-01

    The Rise of Mental Health Nursing onderzoekt de tegenstrijdigheden in de op het ziekenhuis georiënteerde inrichtingszorg, die rond 1900 opkwam. Bovendien illustreert het boek de sociale complexiteit van de psychiatrische zorg. Op basis van archiefmateriaal uit vier Nederlandse psychiatrische

  4. 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.

  5. 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.

  6. Plasma concentrations of inflammatory cytokines rise rapidly during ECMO-related SIRS due to the release of preformed stores in the intestine.

    Science.gov (United States)

    McILwain, R Britt; Timpa, Joseph G; Kurundkar, Ashish R; Holt, David W; Kelly, David R; Hartman, Yolanda E; Neel, Mary Lauren; Karnatak, Rajendra K; Schelonka, Robert L; Anantharamaiah, G M; Killingsworth, Cheryl R; Maheshwari, Akhil

    2010-01-01

    Extracorporeal membrane oxygenation (ECMO) is a life-saving support system used in neonates and young children with severe cardiorespiratory failure. Although ECMO has reduced mortality in these critically ill patients, almost all patients treated with ECMO develop a systemic inflammatory response syndrome (SIRS) characterized by a 'cytokine storm', leukocyte activation, and multisystem organ dysfunction. We used a neonatal porcine model of ECMO to investigate whether rising plasma concentrations of inflammatory cytokines during ECMO reflect de novo synthesis of these mediators in inflamed tissues, and therefore, can be used to assess the severity of ECMO-related SIRS. Previously healthy piglets (3-week-old) were subjected to venoarterial ECMO for up to 8 h. SIRS was assessed by histopathological analysis, measurement of neutrophil activation (flow cytometry), plasma cytokine concentrations (enzyme immunoassays), and tissue expression of inflammatory genes (PCR/western blots). Mast cell degranulation was investigated by measurement of plasma tryptase activity. Porcine neonatal ECMO was associated with systemic inflammatory changes similar to those seen in human neonates. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) concentrations rose rapidly during the first 2 h of ECMO, faster than the tissue expression of these cytokines. ECMO was associated with increased plasma mast cell tryptase activity, indicating that increased plasma concentrations of inflammatory cytokines during ECMO may result from mast cell degranulation and associated release of preformed cytokines stored in mast cells. TNF-alpha and IL-8 concentrations rose faster in plasma than in the peripheral tissues during ECMO, indicating that rising plasma levels of these cytokines immediately after the initiation of ECMO may not reflect increasing tissue synthesis of these cytokines. Mobilization of preformed cellular stores of inflammatory cytokines such as in mucosal mast cells may have

  7. 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

  8. 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

  9. [The League of Nations Health Organization and the rise of Latin American participation, 1920-40].

    Science.gov (United States)

    Weindling, Paul

    2006-01-01

    The League of Nations Health Organization collaborated with Latin American specialists in public health and infectious diseases from the early 1920s to the outbreak of the Second World War. The League developed studies of infant health and nutrition, and leprosy. The approach was expert-oriented, and designed to develop public health on a scientific basis. There were conferences, tours and reports in Latin America. This paper demonstrates that the Latin American collaboration with the Health Organization was extensive and multi-faceted.

  10. Health tourism on the rise? Evidence from the Balance of Payments Statistics.

    Science.gov (United States)

    Loh, Chung-Ping A

    2014-09-01

    The study assesses the presence and magnitude of global trends in health tourism using health-related travel (HRT) spending reported in the International Monetary Fund's Balance of Payments Statistics database. Linear regression and quantile regression are applied to estimate secular trends of the import and export of HRT based on a sample of countries from 2003 to 2009. The results show that from 2003 to 2009 the import and export of health tourism rose among countries with a high volume of such activities (accounting for the upper 40% of the countries), but not among those with a low volume. The uneven growth in health tourism has generated greater contrast between countries with high and low volumes of health tourism activities. However, the growth in the total import of health tourism did not outpace the population growth, implying that in general the population's tendency to engage in health tourism remained static.

  11. Chance findings about early holocene tidal marshes of Grays Harbor, Washington, in relation to rapidly rising seas and great subduction earthquakes

    Science.gov (United States)

    Phipps, James B.; Hemphill-Haley, Eileen; Atwater, Brian F.

    2015-06-18

    Tidal marshes commonly build upward apace with gradual rise in the level of the sea. It is expected, however, that few tidal marshes will keep up with accelerated sea-level rise later in this century. Tidal marshes have been drowned, moreover, after subsiding during earthquakes.

  12. Oceans and Human Health: A Rising Tide of Challenges and Opportunities for Europe

    OpenAIRE

    Fleming, L. E.; Mcdonough, N.; Austen, M.; Mee, L.; Moore, Michelle; Hess, Philipp; Depledge, M. H.; White, M.; Philippart, Katja; Bradbrook, P.; Smalley, A.

    2014-01-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders, business, and non governmental organisations from Europe and the US to review the recent interdisciplinary and cutting edge research in oceans and human health specifically the growing evidence of the...

  13. Oceans and human health: a rising tide of challenges and opportunities for Europe

    NARCIS (Netherlands)

    Fleming, L.E.; McDonough, N.; Austen, M.; Mee, L.; Moore, M.; Hess, P.; Depledge, M.H.; White, M.; Philippart, K.; Bradbrook, P.; Smalley, A.

    2014-01-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders,

  14. 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

  15. Social Media Channels in Health Care Research and Rising Ethical Issues.

    Science.gov (United States)

    Azer, Samy A

    2017-11-01

    Social media channels such as Twitter, Facebook, and LinkedIn have been used as tools in health care research, opening new horizons for research on health-related topics (e.g., the use of mobile social networking in weight loss programs). While there have been efforts to develop ethical guidelines for internet-related research, researchers still face unresolved ethical challenges. This article investigates some of the risks inherent in social media research and discusses how researchers should handle challenges related to confidentiality, privacy, and consent when social media tools are used in health-related research. © 2017 American Medical Association. All Rights Reserved.

  16. 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. …

  17. Globalization and the rise of precarious employment: the new frontier for workplace health promotion.

    Science.gov (United States)

    Caldbick, Sam; Labonte, Ronald; Mohindra, K S; Ruckert, Arne

    2014-06-01

    Global market integration over the past three decades has led to labour market restructuring in most countries around the world. Employment flexibility has been emphasized as a way for employers to restructure their organizations to remain globally competitive. This flexibility has resulted in the growth of precarious employment, which has been exacerbated by the global financial crisis and resulting recession in 2007/2008, and the ongoing economic uncertainty throughout much of the world. Precarious employment may result in short and long-term health consequences for many workers. This presents a deeper and more structural determinant of health than what health promoters have traditionally considered. It calls for a different understanding of workplace health promotion research and intervention that goes beyond enabling healthier lifestyle choices or advocating safer workplace conditions to ensuring adequate social protection floors that provide people with sufficient resources to lead healthy lives, and for advocacy for taxation justice to finance such protection.

  18. Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook.

    Science.gov (United States)

    Barik, Debasis; Arokiasamy, Perianayagam

    2016-01-01

    With ongoing demographic transition, epidemiological transition has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31% in 1990 to 45% in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases such as diabetes and hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004) and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70%) in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future.

  19. Rising Health Expenditure due to Non-communicable Diseases in India: An Outlook

    Directory of Open Access Journals (Sweden)

    Debasis Barik

    2016-11-01

    Full Text Available Abstract: With ongoing demographic transition, epidemiological transition in India has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31 per cent in 1990 to 45 per cent in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases like diabetes, hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004 and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70 per cent in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future.

  20. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    Directory of Open Access Journals (Sweden)

    Sorenson C

    2013-05-01

    Full Text Available Corinna Sorenson,1,2 Michael Drummond,2,3 Beena Bhuiyan Khan1 1LSE Health, London School of Economics and Political Science, London, UK; 2European Health Technology Institute for Socioeconomic Research, Brussels, Belgium; 3Centre for Health Economics, University of York, York, UK Abstract: Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in

  1. Oceans and Human Health: a rising tide of challenges and opportunities for Europe.

    Science.gov (United States)

    Fleming, L E; McDonough, N; Austen, M; Mee, L; Moore, M; Hess, P; Depledge, M H; White, M; Philippart, K; Bradbrook, P; Smalley, A

    2014-08-01

    The European Marine Board recently published a position paper on linking oceans and human health as a strategic research priority for Europe. With this position paper as a reference, the March 2014 Cornwall Oceans and Human Health Workshop brought together key scientists, policy makers, funders, business, and non governmental organisations from Europe and the US to review the recent interdisciplinary and cutting edge research in oceans and human health specifically the growing evidence of the impacts of oceans and seas on human health and wellbeing (and the effects of humans on the oceans). These impacts are a complex mixture of negative influences (e.g. from climate change and extreme weather to harmful algal blooms and chemical pollution) and beneficial factors (e.g. from natural products including seafood to marine renewable energy and wellbeing from interactions with coastal environments). Integrated approaches across disciplines, institutions, and nations in science and policy are needed to protect both the oceans and human health and wellbeing now and in the future. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. 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…

  3. After Some Breast Cancer Treatments, Risk for Other Health Conditions May Rise

    Science.gov (United States)

    ... Skin Care Dining & Beverage Personal Care Services Sports & Outdoors Frequently Asked Questions 25th Anniversary Campaign Donors Share ... did not track how severe the co-existing health conditions were. What ... cases, the benefit of taking these treatments outweighs the potential risk ...

  4. Rising Poverty, Declining Health: The Nutritional Status of the Rural Poor.

    Science.gov (United States)

    Public Voice for Food and Health Policy, Washington, DC.

    Using five key indicators of nutritional status (dietary intake, biochemical tests for circulating levels of nutrients or their metabolites, anthropometric measures, low birth weight and infant mortality rates, and food, health, and income assistance program participation rates and benefit levels), this 1-year research project identified national,…

  5. Modern trends in the health care system of Russia: drop or rise

    Directory of Open Access Journals (Sweden)

    Yuliya Zh. Sadykova

    2017-01-01

    Full Text Available In the period of the existence of post-soviet Russia, the health care system has remained and remains one of the most important and, at the same time, the problem element of it. We have to admit that not always medical services, offered by our state, are positive, if we consider them, for example, through the concept of “quality”. Undoubtedly, this is determined by the existing medical structure, starting with the number of different hospital establishments and ending with the degree of qualification and competence of medical specialists.Thus, the purpose of this article is a comprehensive analysis of the healthcare system that was established in the Russian Federation in 1990–2015, the object of the study is the entire Russian health care system, and the subject is specific statistical data on the hospital beds and hospitals in Russia.Problems of health development, as well as various methodological issues of statistical research, including the accounting of hospital facilities, hospital beds, doctors in the context of specialties, morbidity are considered in the works of both domestic and foreign scientists (V.Medic, M. Tokmachev, G. Ulumbekova, S. Banin, McKee Martin and others.The main directions of development of the national medicine for the specified period of time, its characteristic features and problems of concern that cause dysfunction in the work of the health care protection mechanism for the citizens were identified in the context of the dynamics in such statistical indexes as the total number of hospital and outpatient clinics, hospital beds in them, the number of doctors and the state of morbidity of the population, published by the Federal State Statistics Service.As a research task, attempts were made to assess the impact of changes in these indexes on the state of Russian health care over the period as a whole. Moreover, the work revealed the main content concepts on this topic, explained the nominal structure of the

  6. New joints: Private providers and rising demand in the English National Health Service

    OpenAIRE

    Kelly, Elaine; Stoye, George

    2015-01-01

    Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands the service at all. We explore this issue by considering how demand for elective surgery responds following the entry of private providers into the market for publicly funded health care in England. For ...

  7. The rise of Zika infection and microcephaly: what can we learn from a public health emergency?

    Science.gov (United States)

    McCloskey, B; Endericks, T

    2017-09-01

    To consider why Zika was declared a Public Health Emergency of International Concern (PHEIC), why it stopped being one and what we can learn from this for the future. This paper reviews the sequence of events and evidence base for the decision to declare Zika a PHEIC, the global response to this, the challenges in maintaining an evidence-based approach to outbreak response and identifies learning outcomes. Evidence review, all published articles in reputable UK and international journals were identified. The association between Zika virus infection and congenital malformations including microcephaly became a PHEIC on 1st February 2016 and was declared to be no longer an emergency in November 2016. This shaped the global response led by WHO in the first global emergency since Ebola in West Africa. The response to Zika highlights important issues and lessons for future outbreaks that might pose an international risk. Particular challenges arose in trying to maintain an evidence-based approach to public risk communication when the evidence is unclear or still evolving. The Zika incident also demonstrates the importance of public health practitioners and agencies understanding the political context in which outbreaks must be managed and understanding the competing factors that shape the political response. Copyright © 2017 The Royal Society for Public Health. All rights reserved.

  8. Gender and leadership for health literacy to combat the epidemic rise of noncommunicable diseases.

    Science.gov (United States)

    Manhanzva, Rufaro; Marara, Praise; Duxbury, Theodore; Bobbins, Amy Claire; Pearse, Noel; Hoel, Erik; Mzizi, Thandi; Srinivas, Sunitha C

    2017-08-01

    Until recently, the noncommunicable diseases (NCDs) epidemic has been considered only a significant burden to men in high-income countries. However, latest figures indicate that half of all NCD-related deaths affect women, especially in low- and middle-income countries (LMICs), with global responses to the NCD epidemic overlooking the significance of women and girls in their approaches and programs. This case study highlights the burden of disease challenging South Africa that disproportionately affects women in the country and suggests that the country, along with other LMICs internationally, requires a shift in the gender-based leadership of health literacy and self-empowerment.

  9. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    Science.gov (United States)

    Sorenson, Corinna; Drummond, Michael; Bhuiyan Khan, Beena

    2013-01-01

    Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses) were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices) had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in better value in health care and broader socioeconomic benefits. PMID:23807855

  10. 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.

  11. Is there a relationship between the rise in thyroid and neurodevelopmental health effects in North America and the rise in concentrations of PBDEs in the environment? An update

    Energy Technology Data Exchange (ETDEWEB)

    Muir, T. [Environment Canada, Burlington, ON (Canada)

    2004-09-15

    In a previous paper on this question, data on an apparently rising prevalence of hypothyroidism, and neurodevelopmental deficits in children was presented. In this context, the issue of the potential for the observed, exponentially increasing levels of PBDEs in the environment to contribute to this expressed clinical burden of disease was raised. This potential contribution was raised because of evidence that the toxicological endpoints of concern for PBDEs include thyroid hormone disruption and neurodevelopmental deficits, and are similar to those seen earlier for PCBs, and DDT. As well, structural and toxicological similarities to PBBs, PCDDs, PCDFs are also part of the concern. Also raised as issues for further research were two things. First, there is a need in risk assessment to move beyond the focus on the average or median body burden, tissue or human milk concentrations, to account for the population distribution of the concentrations, and the percentiles in the tails of the distribution, particularly the high exposure portion. Second, interactions and additive exposures to and effects of the above mentioned, and other compounds or substances, (e.g. perchlorate, mercury, lead) need to be considered when talking about the ''safety'' of individual compounds. The aim of this paper is to examine - using Monte Carlo methods applied to the reported human milk (lipid weight) concentrations - the probability distributions, and the population percentiles, of the times required for PBDEs to reach a critical value of 1250 ng/g found by the Jacobsons, for PCBs, to be associated with learning impairments, intellectual deficits, and IQ loss in the offspring. In addition, historical body burdens of PCBs and DDT will be taken from the literature, and using estimates derived here of the distribution of the 2002 human milk levels of these compounds, the times required for PBDEs, plus PCBs and DDT, to reach 1250 ng/g will be simulated. Finally, note will

  12. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods

    Science.gov (United States)

    Harrold, Joanne; Halford, Jason; Boyland, Emma

    2018-01-01

    Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children’s channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue. PMID:29558457

  13. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods

    Directory of Open Access Journals (Sweden)

    Rosa Whalen

    2018-03-01

    Full Text Available Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts (n = 18,888 in 2008, n = 6664 in 2010 from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4% to 2010 (23.2%. Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8% where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%. Health-related (e.g., health/nutrition, weight loss/diet appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children’s channels in 2010. Implicit (physical activity and explicit (health claims health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue.

  14. The Health Halo Trend in UK Television Food Advertising Viewed by Children: The Rise of Implicit and Explicit Health Messaging in the Promotion of Unhealthy Foods.

    Science.gov (United States)

    Whalen, Rosa; Harrold, Joanne; Child, Simon; Halford, Jason; Boyland, Emma

    2018-03-20

    Monitoring the creative content within food marketing to children is strongly advocated by public health authorities, but few studies address the prevalence of health-related messaging in television adverts. Food and beverage adverts ( n = 18,888 in 2008, n = 6664 in 2010) from UK television channels popular with children were coded and analyzed. Physical-activity depiction displayed an 18.8 percentage point increase from 2008 (4.4%) to 2010 (23.2%). Of the food adverts containing physical-activity depiction in 2010, 81.1% were for non-core foods. The appearance of health claims in food adverts in 2010 increased 4.1 percentage points from 2008 levels (20.7% to 24.8%) where the majority of food adverts featuring health and nutrition claims were for non-core foods (58.3%). Health-related (e.g., health/nutrition, weight loss/diet) appeals were used in 17.1% of food adverts during peak child-viewing times, rising to 33.0% of adverts shown on dedicated children's channels in 2010. Implicit (physical activity) and explicit (health claims) health messages are increasingly prevalent in UK television food advertising viewed by children, and are frequently used to promote unhealthy foods. Policy makers in the UK should consider amendments to the existing statutory approach in order to address this issue.

  15. Microfossil measures of rapid sea-level rise: Timing of response of two microfossil groups to a sudden tidal-flooding experiment in Cascadia

    Science.gov (United States)

    Horton, B.P.; Milker, Yvonne; Dura, T.; Wang, Kelin; Bridgeland, W.T.; Brophy, Laura S.; Ewald, M.; Khan, Nicole; Engelhart, S.E.; Nelson, Alan R.; Witter, Robert C.

    2017-01-01

    Comparisons of pre-earthquake and post-earthquake microfossils in tidal sequences are accurate means to measure coastal subsidence during past subduction earthquakes, but the amount of subsidence is uncertain, because the response times of fossil taxa to coseismic relative sea-level (RSL) rise are unknown. We measured the response of diatoms and foraminifera to restoration of a salt marsh in southern Oregon, USA. Tidal flooding following dike removal caused an RSL rise of ∼1 m, as might occur by coseismic subsidence during momentum magnitude (Mw) 8.1–8.8 earthquakes on this section of the Cascadia subduction zone. Less than two weeks after dike removal, diatoms colonized low marsh and tidal flats in large numbers, showing that they can record seismically induced subsidence soon after earthquakes. In contrast, low-marsh foraminifera took at least 11 months to appear in sizeable numbers. Where subsidence measured with diatoms and foraminifera differs, their different response times may provide an estimate of postseismic vertical deformation in the months following past megathrust earthquakes.

  16. 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.

  17. 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.

  18. Community Psychology as a Process of Citizen Participation in Health Policy Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Taggart, Danny

    2017-06-25

    This brief commentary discusses a recent paper by Speed and Mannion that explores "The Rise of post truth populism in liberal democracies: challenges for health policy." It considers their assertion that through meaningful democratic engagement in health policy, some of the risks brought about by an exclusionary populist politics can be mediated. With an overview of what participation means in modern healthcare policy and implementation, the field of community psychology is presented as one way to engage marginalized groups at risk of exploitation or exclusion by nativist populist policy. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  19. Rising equity

    International Nuclear Information System (INIS)

    Burr, M.T.

    1992-01-01

    This article reports on the results of a financial rankings survey of the independent energy industry indicating that lenders and investors provided more than five billion dollars in capital for new, private power projects during the first six months of 1992. The topics of the article include rising equity requirements, corporate finance, mergers and acquisitions, project finance investors, revenue bonds, project finance lenders for new projects, project finance lenders for restructurings, and project finance advisors

  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. 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

  2. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013.

    Science.gov (United States)

    Mumtaz, Sarwat; Bahk, Jinwook; Khang, Young-Ho

    2017-01-01

    Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section) in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS) conducted during 1990 to 2013. All these surveys are nationally representative surveys of ever-married women aged 15-49 years with a sample size of 6611, 10,023, and 13,558 women in 1990-1991, 2006-2007, and 2012-2013, respectively, with an overall response rate of over 90%. The unit of analysis for this study was women with their most recent live birth in the five years preceding the surveys. Bivariate analyses and multivariable logistic regression models were employed to investigate the prevalence of cesarean sections according to selected sociodemographic characteristics of women. C-section rates were found to have increased during this period, with an especially significant rise from 2.7% in 1990-1991 to 15.8% in 2012-2013 with lower utilization among the non-educated women (7.5%), compared with the women with higher education (40.3%). C-section rates ranged from 5.5% in the poorest women to 35.3% in the richest women. Only 11.5% of the rural women had a C-section compared to 25.6% of the urban women. A greater likelihood of having a cesarean section was observed in the richest, highly educated, and urban-living women while there was no significant difference observed in cesarean section rates between the private and public sectors in all three surveys. To improve maternal health, routine monitoring and evaluation of the provision of emergency obstetric services are needed to address the underuse of C-section in poor and rural areas and

  3. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013.

    Directory of Open Access Journals (Sweden)

    Sarwat Mumtaz

    Full Text Available Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS conducted during 1990 to 2013. All these surveys are nationally representative surveys of ever-married women aged 15-49 years with a sample size of 6611, 10,023, and 13,558 women in 1990-1991, 2006-2007, and 2012-2013, respectively, with an overall response rate of over 90%. The unit of analysis for this study was women with their most recent live birth in the five years preceding the surveys. Bivariate analyses and multivariable logistic regression models were employed to investigate the prevalence of cesarean sections according to selected sociodemographic characteristics of women. C-section rates were found to have increased during this period, with an especially significant rise from 2.7% in 1990-1991 to 15.8% in 2012-2013 with lower utilization among the non-educated women (7.5%, compared with the women with higher education (40.3%. C-section rates ranged from 5.5% in the poorest women to 35.3% in the richest women. Only 11.5% of the rural women had a C-section compared to 25.6% of the urban women. A greater likelihood of having a cesarean section was observed in the richest, highly educated, and urban-living women while there was no significant difference observed in cesarean section rates between the private and public sectors in all three surveys. To improve maternal health, routine monitoring and evaluation of the provision of emergency obstetric services are needed to address the underuse of C-section in poor and

  4. 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...

  5. 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...

  6. 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.

  7. HFE p.C282Y homozygosity predisposes to rapid serum ferritin rise after menopause: A genotype-stratified cohort study of hemochromatosis in Australian women.

    Science.gov (United States)

    Warne, Charles D; Zaloumis, Sophie G; Bertalli, Nadine A; Delatycki, Martin B; Nicoll, Amanda J; McLaren, Christine E; Hopper, John L; Giles, Graham G; Anderson, Greg J; Olynyk, John K; Powell, Lawrie W; Allen, Katrina J; Gurrin, Lyle C

    2017-04-01

    Women who are homozygous for the p.C282Y mutation in the HFE gene are at much lower risk of iron overload-related disease than p.C282Y homozygous men, presumably because of the iron-depleting effects of menstruation and pregnancy. We used data from a population cohort study to model the impact of menstruation cessation at menopause on serum ferritin (SF) levels in female p.C282Y homozygotes, with p.C282Y/p.H63D simple or compound heterozygotes and those with neither p.C282Y nor p.H63D mutations (HFE wild types) as comparison groups. A sample of the Melbourne Collaborative Cohort Study was selected for the "HealthIron" study (n = 1438) including all HFE p.C282Y homozygotes plus a random sample stratified by HFE-genotype (p.C282Y and p.H63D). The relationship between the natural logarithm of SF and time since menopause was examined using linear mixed models incorporating spline smoothing. For p.C282Y homozygotes, SF increased by a factor of 3.6 (95% CI (1.8, 7.0), P HFE genotype groups increase more gradually and did not show a distinction between premenopausal and postmenopausal SF levels. Only p.C282Y homozygotes had predicted SF exceeding 200 μg/L postmenopause, but the projected SF did not increase the risk of iron overload-related disease. These data provide the first documented evidence that physiological blood loss is a major factor in determining the marked gender difference in expression of p.C282Y homozygosity. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  8. 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.

  9. 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.

  10. 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

  11. Rise of Health Consumerism in China and Its Effects on Physicians' Professional Identity and the Physician-Patient Relationship and Communication.

    Science.gov (United States)

    Tang, Lu; Guan, Mengfei

    2018-05-01

    The physician-patient relationship in China is highly strained. This study examined the professional identity of physicians and their perceptions of the physician-patient relationship against the backdrop of the rise of health consumerism in China. Structured interviews with 29 physicians found that the marketization of medical care and the rise of health consumerism caused physicians to have a conflicted professional identity. The traditional bureaucratic relationship between physicians and patients based on implicit trust was gradually replaced by an arm's length relationship characterized by self-interest, opportunism, and mistrust. In addition, the transition from physician-centered communication to patient-centered communication in China was tenacious. Theoretical and practical implications of the current study are discussed.

  12. 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.

  13. 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

  14. 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.

  15. Dietary Health Behaviors of Women Living in High Rise Dwellings: A Case Study of an Urban Community in Malaysia

    OpenAIRE

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2012-01-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women?s diet quality. A total of 128 w...

  16. 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.

  17. '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.

  18. Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

    Science.gov (United States)

    Turner-Wilson, Angela L; Mills, Anne M; Rees, Karen

    2017-10-01

    This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 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.

  20. 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

  1. 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.

  2. The Rise and Need for Mobile Apps for Maternal and Child Health Care in China: Survey Based on App Markets.

    Science.gov (United States)

    Zhang, Puhong; Dong, Le; Chen, Huan; Chai, Yanling; Liu, Jianbo

    2018-06-08

    Mobile health services are thriving in the field of maternal and child health in China due to expansions in the field of electronic health and the introduction of the two-child policy. There are numerous maternal and child health apps in computer stores, but the exact number of apps, number of downloads, and features of these apps is not known. This study aimed to explore the use of maternal and child health apps in Android and iOS app stores and to describe the key functional features of the most popular apps, with the purpose of providing insight into further research and development of maternal and child health mobile health products. The researchers conducted a search in the 3 most popular Android app stores (Tencent MyApp, Baidu Mobile Assistant, and 360 Mobile Assistant) and the iTunes App Store in China. All apps regarding family planning (contraception and preparing for pregnancy), pregnancy and perinatal care, neonatal care and health, and development for children under 6 years were included in the initial analysis. Maternal and child health mobile apps with predominant features of product marketing, children's songs, animation, or games were excluded from the study. The 50 most frequently used apps in each of the Android stores as well as the iTunes store (a total of 78 deduplicated apps) were selected and downloaded for an in-depth analysis. A total of 5276 Android apps and 877 iOS apps developed for maternal and child health care were identified. Of the 78 most frequently used apps, 43 (55%) apps focused on one stage of MCH care, mainly targeting child care (25 apps) and before pregnancy care (11 apps), whereas 35 (45%) of the apps covered 2 or more stages, most of which (32 apps) included both pregnancy and child care services. The app features that were commonly adopted by the popular apps were health education, communication, health status self-monitoring, a diary, reminders, and counseling. Within the app feature of "health status self

  3. Dietary health behaviors of women living in high rise dwellings: a case study of an urban community in Malaysia.

    Science.gov (United States)

    Karupaiah, Tilakavati; Swee, Winnie Chee Siew; Liew, Siew Ying; Ng, Boon Koon; Chinna, Karuthan

    2013-02-01

    Diet-related non-communicable disease (DR-NCD) occurrence is a serious problem amongst Malaysian women and urbanization is probably a challenge to their achieving the nutritional environment conducive to healthy eating. This case study aimed to determine diet quality of an urban community using women respondents from high rise dwellings in Kuala Lumpur. The sample consisted of 135 households and a healthy eating index (HEI) scale was used to evaluate the women's diet quality. A total of 128 women (Malays = 45, Chinese = 56, Indian = 27) participated. Total HEI score was significantly different (P 0.05) regardless of ethnicity. Income strata (ρ = 0.159, P = 0.048) and eating out frequency (ρ = -0.149, P = 0.046) also independently affected HEI scores. Income negatively correlated with sodium restriction score (ρ = -0.294, P = 0.001) but positively with cereals (ρ = 0.181; P = 0.025), fruits (ρ = 0.178; P = 0.022), dairy products (ρ = 0.198; P = 0.013) and food variety (ρ = 0.219, P = 0.007). Decreased vegetable intake (ρ = -0.320; P diet quality of urban women.

  4. 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.

  5. 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

  6. 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.

  7. This Is My (Post) Truth, Tell Me Yours Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Powell, Martin

    2017-05-15

    This is a commentary on the article 'The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.' It critically examines two of its key concepts: populism and 'post truth.' This commentary argues that there are different types of populism, with unclear links to impacts, and that in some ways, 'post-truth' has resonances with arguments advanced in the period at the beginning of the British National Health Service (NHS). In short, 'post-truth' populism' may be 'déjà vu all over again,' and there are multiple (post) truths: this is my (post) truth, tell me yours. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  8. The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

    Science.gov (United States)

    Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

    2010-11-01

    In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

  9. 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.

  10. Rising to the human rights challenge in compulsory treatment--new approaches to mental health law in Australia.

    Science.gov (United States)

    Callaghan, Sascha; Ryan, Christopher J

    2012-07-01

    To analyse, and explain to Australasian psychiatrists, recent proposed changes to the terms of coercive treatment for mental illness in Tasmania and Victoria and to place the proposals in the context of a broader human rights framework that is likely to impact the future shape of mental health legislation more generally. The Australian law reform proposals are reviewed against the requirements of numerous human rights instruments, including the recently ratified United Nations Convention on the Rights of Persons with Disabilities. Ethical and legal arguments are made to support the proposed changes and to introduce others, taking into account academic commentary on mental health law and recent empirical work on the ability to usefully categorise patients by their likelihood of harm to self and others. The Victorian and Tasmanian draft mental health bills propose a new basis for compulsory psychiatric treatment in Australasia. If they become law, coercive psychiatric treatment could only be applied to patients who lack decision-making capacity. The Tasmanian draft bill also sets a new benchmark for timely independent review of compulsory treatment. However both jurisdictions propose to retain an 'additional harm' test which must be satisfied before patients may be treated without consent. This differs from non-psychiatric cases, where if patients are unable to consent to medical treatment for themselves, they will be entitled to receive coercive treatment if it is in their best interests. The proposed changes under the Tasmanian and Victorian draft mental health bills will ensure that, in line with local and international human rights obligations, only patients who lack decision-making capacity may be coercively treated for mental illness. However the continuing 'additional harm' criteria may breach human rights obligations by imposing a discriminatory threshold for care on patients who are unable to consent to treatment for themselves. This could be avoided by

  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. Walking in the high-rise city: a Health Enhancement and Pedometer-determined Ambulatory (HEPA program in Hong Kong

    Directory of Open Access Journals (Sweden)

    Leung AYM

    2014-08-01

    Full Text Available Angela YM Leung,1,2 Mike KT Cheung,3 Michael A Tse,4 Wai Chuen Shum,5 BJ Lancaster,1,6 Cindy LK Lam7 1School of Nursing, 2Research Centre on Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, 3Centre on Research and Advocacy, Hong Kong Society for Rehabilitation, 4Institute of Human Performance, University of Hong Kong, 5Sheng Kung Hui Holy Carpenter Church Social Services, Hong Kong Special Administrative Region, People’s Republic of China; 6School of Nursing, Vanderbilt University, Nashville, TN, USA; 7Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China Abstract: Due to the lack of good infrastructure in the public estates, many older adults in urban areas are sedentary. The Health Enhancement and Pedometer-Determined Ambulatory (HEPA program was developed to assist older adults with diabetes and/or hypertension to acquire walking exercise habits and to build social support, while engaged in regular physical activity. This study aimed to describe the HEPA program and to report changes in participants’ walking capacity and body strength after 10-week walking sessions. A pre- and postintervention design was used. Pedometers were used to measure the number of steps taken per day before and after the 10-week intervention. Upper and lower body strength, lower body flexibility, and quality of life were assessed. A total of 205 older adults completed the program and all health assessments. After the 10-week intervention, the average number of steps per day increased by 36%, from 6,591 to 8,934. Lower body strength, upper body strength, and aerobic fitness increased significantly after 10 weeks, along with improvement in the 12-item Short Form Health Survey (SF™-12 physical and mental health component summary scores. A social support network was built in the neighborhood, and the local environment was

  13. Human Factors in Green Office Building Design: The Impact of Workplace Green Features on Health Perceptions in High-Rise High-Density Asian Cities

    Directory of Open Access Journals (Sweden)

    Fei Xue

    2016-10-01

    Full Text Available There is a growing concern about human factors in green building, which is imperative in high-rise high-density urban environments. This paper describes our attempts to explore the influence of workplace green features (such as green certification, ventilation mode, and building morphology on health perceptions (personal sensation, sensorial assumptions, healing performance based on a survey in Hong Kong and Singapore. The results validated the relationship between green features and health perceptions in the workplace environment. Remarkably, participants from the air-conditioned offices revealed significant higher concerns about health issues than those participants from the mixed-ventilated offices. The mixed-ventilation design performs as a bridge to connect the indoor environment and outdoor space, which enables people to have contact with nature. Additionally, the preferred building morphology of the workplace is the pattern of a building complex instead of a single building. The complex form integrates the configuration of courtyards, podium gardens, green terrace, public plaza, and other types of open spaces with the building clusters, which contributes to better health perceptions. This research contributes to the rationalization and optimization of passive climate-adaptive design strategies for green buildings in high-density tropical or subtropical cities.

  14. 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

  15. 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.

  16. How effects of chemicals might differ from those of radiations in giving rise to genetic ill-health in man

    International Nuclear Information System (INIS)

    Evans, H.J.

    1980-01-01

    Possible differences between the effects of the two groups of agents are considered. Two types of genetic damage are discussed. The first type involves mutational changes induced in germ cells or germ cell precursors which are then transmitted to the products of conception and to any resultant offspring and their descendants. The second kind is that damage sustained by the genome in somatic cells which is transmitted to daughter cells. Such somatic mutations are not heritable in the familiar sense, but they are transmitted to descendant cells within the body. It is concluded that a greater heterogeneity is expected in mutagenic response to chemical mutagens than to radiations in human populations, that the spectrum of mutations following chemical exposure may be quite different from that following radiation exposure, and that for many chemical agents, and in contrast to ionising radiations, one might expect a greater burden of genetic ill-health due to increased frequencies of mildly deleterious recessive and polygenic mutations. (Auth.)

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea.

    Science.gov (United States)

    Choi, Eun Kyung; Lee, Jong-Koo

    2016-12-01

    This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH) was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC) was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in disease control. The

  7. Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea

    Directory of Open Access Journals (Sweden)

    Eun Kyung CHOI

    2016-12-01

    Full Text Available This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in

  8. The Far Right Challenge Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Halikiopoulou, Daphne

    2017-07-11

    Speed and Mannion make a good case that the rise of populism poses significant challenges for health policy. This commentary suggests that the link between populism and health policy should be further nuanced in four ways. First, a deconstruction of the term populism itself and a focus on the far right dimension of populist politics; second, a focus on the supply side and more specifically the question of nationalism and the 'national preference'; third, the dynamics of party competition during economic crisis; and fourth the question of policy, and more specifically the extent to which certain labour market policies are able to mediate demand for the far right. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  9. Populism, Exclusion, Post-truth. Some Conceptual Caveats Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    De Cleen, Benjamin

    2017-07-15

    In their editorial, Speed and Mannion identify two main challenges "the rise of post-truth populism" poses for health policy: the populist threat to inclusive healthcare policies, and the populist threat to well-designed health policies that draw on professional expertise and research evidence. This short comment suggests some conceptual clarifications that might help in thinking through more profoundly these two important issues. It argues that we should approach right-wing populism as a combination of a populist down/up (people/elite) axis with an exclusionary nationalist in/out (member/non-member) axis. And it raises some questions regarding the equation between populism, demagogy and the rejection of expertise and scientific knowledge. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  10. Rapid Spread of Zika Virus in The Americas--Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games.

    Science.gov (United States)

    Petersen, Eskild; Wilson, Mary E; Touch, Sok; McCloskey, Brian; Mwaba, Peter; Bates, Matthew; Dar, Osman; Mattes, Frank; Kidd, Mike; Ippolito, Giuseppe; Azhar, Esam I; Zumla, Alimuddin

    2016-03-01

    Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. 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.

  12. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    Science.gov (United States)

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

  13. 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...

  14. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico

    Science.gov (United States)

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  15. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico.

    Science.gov (United States)

    León-de la O, Dante Israel; Thorsteinsdóttir, Halla; Calderón-Salinas, José Víctor

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  16. 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....

  17. 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

  18. '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

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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...

  5. 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

  6. 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. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

  7. 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

    Directory of Open Access Journals (Sweden)

    Marleen Kraaij-Dirkzwager

    2017-12-01

    Full Text Available 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. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS, and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

  8. A rapid appraisal of the status of mental health support in post-rape care services in the Western Cape

    Directory of Open Access Journals (Sweden)

    Naeemah Abrahams

    2017-01-01

    Full Text Available Background: Despite the well-known impact of rape on mental health and the widespread problem of rape in South Africa, mental health services for rape victims are scant and not a priority for acute-phase services. Survivors encounter multiple mental health struggles in this period including adherence to the post-exposure prophylaxis drugs to prevent HIV and finding support from important others. We have little information on what mental health is provided, by whom and how it is integrated into the post-rape package of care. Aim: The aim of the study was to do a rapid appraisal of mental health services for rape survivors to gain a better understanding of the current acute and long-term (secondary mental health services. Method: We conducted a qualitative study using a rapid assessment with a purposive sample of 14 rape survivors and 43 service providers recruited from post-rape sexual assault services in urban and rural Western Cape Province. Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. The data were coded thematically for analysis. Results: Survivors of rape experienced a range of emotional difficulties and presented varying levels of distress and various levels of coping. Receiving support and care from others assisted them, but the poor integration of mental health within post-rape services meant few received formal mental health support or effective referrals. Multiple factors contributed to the poor integration: mental health was not given the same level of priority as other rape services (i.e. clinical care, including forensic management, the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of care, the poor linkages to ongoing mental healthcare, and the mental health challenges caused by vicarious trauma and compassion fatigue. Conclusion: Providing effective

  9. Rise, stagnation, and rise of Danish women's life expectancy

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune; Rau, Roland; Jeune, Bernard

    2016-01-01

    Health conditions change from year to year, with a general tendency in many countries for improvement. These conditions also change from one birth cohort to another: some generations suffer more adverse events in childhood, smoke more heavily, eat poorer diets, etc., than generations born earlier...... favor forecasts that hinge on cohort differences. We use a combination of age decomposition and exchange of survival probabilities between countries to study the remarkable recent history of female life expectancy in Denmark, a saga of rising, stagnating, and now again rising lifespans. The gap between...... female life expectancy in Denmark vs. Sweden grew to 3.5 y in the period 1975-2000. When we assumed that Danish women born 1915-1945 had the same survival probabilities as Swedish women, the gap remained small and roughly constant. Hence, the lower Danish life expectancy is caused by these cohorts...

  10. 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.

  11. Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

    Science.gov (United States)

    Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L

    2017-03-01

    The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. 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.

  13. Rapid Learning health care in oncology’ – An approach towards decision support systems enabling customised radiotherapy’

    International Nuclear Information System (INIS)

    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.; Stiphout, Ruud G.P.M. van; Elmpt, Wouter van; Weijden, Trudy van der; Boersma, Liesbeth; Valentini, Vincenzo; Dekker, Andre

    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 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. Conclusion: 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

  14. Can mobile phone technology support a rapid sharing of information on novel psychoactive substances among health and other professionals internationally?

    Science.gov (United States)

    Simonato, Pierluigi; Bersani, Francesco S; Santacroce, Rita; Cinosi, Eduardo; Schifano, Fabrizio; Bersani, Giuseppe; Martinotti, Giovanni; Corazza, Ornella

    2017-05-01

    The diffusion of novel psychoactive substances (NPSs), combined with the ability of the Internet to act as an online marketplace, has led to unprecedented challenges for governments, health agencies, and substance misuse services. Despite increasing research, there is a paucity of reliable information available to professionals working in the field. The paper will present the pilot results of the first mobile application (SMAIL) for rapid information sharing on NPSs among health professionals. The development of SMAIL was divided into 2 parts: (a) the creation of the application for registered users, enabling them to send an SMS or email with the name or "street name" of an NPS and receive within seconds emails or SMS with the information, when available and (b) the development of a database to support the incoming requests. One hundred twenty-two professionals based in 22 countries used the service over the pilot period of 16 months (from May 2012 to September 2013). Five hundred fifty-seven enquires were made. Users received rapid information on NPSs, and 61% of them rated the service as excellent. This is the right time to use mobile phone technologies for rapid information sharing and prevention activities on NPSs. Copyright © 2017 John Wiley & Sons, Ltd.

  15. The development of a model of psychological first aid for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA.

    Science.gov (United States)

    Everly, George S; Lee McCabe, O; Semon, Natalie L; Thompson, Carol B; Links, Jonathan M

    2014-01-01

    The Johns Hopkins Center for Public Health Preparedness, which houses the Centers for Disease Control and Prevention-funded Preparedness and Emergency Response Learning Center, has been addressing the challenge of disaster-caused behavioral health surge by conducting training programs in psychological first aid (PFA) for public health professionals. This report describes our approach, named RAPID-PFA, and summarizes training evaluation data to determine if relevant knowledge, skills, and attitudes are imparted to trainees to support effective PFA delivery. In the wake of disasters, there is an increase in psychological distress and dysfunction among survivors and first responders. To meet the challenges posed by this surge, a professional workforce trained in PFA is imperative. More than 1500 participants received a 1-day RAPID-PFA training. Pre-/postassessments were conducted to measure (a) required knowledge to apply PFA; (b) perceived self-efficacy, that is, belief in one's own ability, to apply PFA techniques; and (c) confidence in one's own resilience in a crisis context. Statistical techniques were used to validate the extent to which the survey successfully measured individual PFA constructs, that is, unidimensionality, and to quantify the reliability of the assessment tool. Statistically significant pre-/postimprovements were observed in (a) knowledge items supportive of PFA delivery, (b) perceived self-efficacy to apply PFA interventions, and (c) confidence about being a resilient PFA provider. Cronbach alpha coefficients ranging from 0.87 to 0.90 suggested that the self-reported measures possessed sufficient internal consistency. Findings were consistent with our pilot work, and with our complementary research initiatives validating a variant of RAPID-PFA with faith communities. The RAPID-PFA model promises to be a broadly applicable approach to extending community behavioral health surge capacity. Relevant next steps include evaluating the effectiveness

  16. Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

    Directory of Open Access Journals (Sweden)

    Putthasri Weerasak

    2010-06-01

    Full Text Available Abstract Background Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. Methods The study relied on the Systemic Rapid Assessment (SYSRA toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. Results The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission

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

    Directory of Open Access Journals (Sweden)

    de Courten Maximilian

    2006-02-01

    Full Text Available Abstract Background 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. Methods The Rapid Assessment Protocol for Insulin Access draws on the principles of Rapid Assessment Protocols which have been developed and implemented in several different areas. This protocol was adapted through a thorough literature review on diabetes, chronic condition management and medicine supply in developing countries. A visit to three countries in sub-Saharan Africa and meetings with different experts in the field of diabetes helped refine the questionnaires. Following the development of the questionnaires these were tested with various people familiar with diabetes and/or healthcare in developing countries. The Protocol was piloted in Mozambique then refined and had two further iterations in Zambia and Mali. Translations of questionnaires were made into local languages when necessary, with back translation to ensure precision. Results In each country the protocol was implemented in 3 areas – the capital city, a large urban centre and a predominantly rural area and their respective surroundings. Interviews were carried out by local teams trained on how to use the tool. Data was then collected and entered into a database for analysis. Conclusion The Rapid Assessment Protocol for Insulin Access was developed to provide a situational analysis of Type 1 diabetes, in order to make recommendations to the national Ministries of Health and Diabetes Associations. It provided valuable information on patients' access to insulin, syringes, monitoring and care. It was thus able to sketch a picture of the health care system with regards to its ability to

  18. 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....

  19. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East...

  20. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali; Jakobsen, Peter Viggo

    2010-01-01

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East...

  1. A rapid appraisal of the status of mental health support in post-rape ...

    African Journals Online (AJOL)

    Data were collected using semi-structured in-depth interviews and observations of survivor sessions with counsellors, nurses and doctors. ... (i.e. clinical care, including forensic management), the inadequate capacity of service providers to provide mental healthcare, including mental health illiteracy, the lack of continuity of ...

  2. Rapid review programs to support health care and policy decision making: a descriptive analysis of processes and methods.

    Science.gov (United States)

    Polisena, Julie; Garritty, Chantelle; Kamel, Chris; Stevens, Adrienne; Abou-Setta, Ahmed M

    2015-03-14

    Health care decision makers often need to make decisions in limited timeframes and cannot await the completion of a full evidence review. Rapid reviews (RRs), utilizing streamlined systematic review methods, are increasingly being used to synthesize the evidence with a shorter turnaround time. Our primary objective was to describe the processes and methods used internationally to produce RRs. In addition, we sought to understand the underlying themes associated with these programs. We contacted representatives of international RR programs from a broad realm in health care to gather information about the methods and processes used to produce RRs. The responses were summarized narratively to understand the characteristics associated with their processes and methods. The summaries were compared and contrasted to highlight potential themes and trends related to the different RR programs. Twenty-nine international RR programs were included in our sample with a broad organizational representation from academia, government, research institutions, and non-for-profit organizations. Responses revealed that the main objectives for RRs were to inform decision making with regards to funding health care technologies, services and policy, and program development. Central themes that influenced the methods used by RR programs, and report type and dissemination were the imposed turnaround time to complete a report, resources available, the complexity and sensitivity of the research topics, and permission from the requestor. Our study confirmed that there is no standard approach to conduct RRs. Differences in processes and methods across programs may be the result of the novelty of RR methods versus other types of evidence syntheses, customization of RRs for various decision makers, and definition of 'rapid' by organizations, since it impacts both the timelines and the evidence synthesis methods. Future research should investigate the impact of current RR methods and reporting to

  3. Accidents Preventive Practice for High-Rise Construction

    Directory of Open Access Journals (Sweden)

    Goh Kai Chen

    2016-01-01

    Full Text Available The demand of high-rise projects continues to grow due to the reducing of usable land area in Klang Valley, Malaysia. The rapidly development of high-rise projects has leaded to the rise of fatalities and accidents. An accident that happened in a construction site can cause serious physical injury. The accidents such as people falling from height and struck by falling object were the most frequent accidents happened in Malaysian construction industry. The continuous growth of high-rise buildings indicates that there is a need of an effective safety and health management. Hence, this research aims to identify the causes of accidents and the ways to prevent accidents that occur at high-rise building construction site. Qualitative method was employed in this research. Interview surveying with safety officers who are involved in highrise building project in Kuala Lumpur were conducted in this research. Accidents were caused by man-made factors, environment factors or machinery factors. The accidents prevention methods were provide sufficient Personal Protective Equipment (PPE, have a good housekeeping, execute safety inspection, provide safety training and execute accidents investigation. In the meanwhile, interviewees have suggested the new prevention methods that were develop a proper site layout planning and de-merit and merit system among sub-contractors, suppliers and even employees regarding safety at workplace matters. This research helps in explaining the causes of accidents and identifying area where prevention action should be implemented, so that workers and top management will increase awareness in preventing site accidents.

  4. Overview of Provisional Peer-Reviewed Toxicity Values (PPRTVs), Alternative Methods in Human Health Risk Assessment, and the RapidTox Dashboard

    Science.gov (United States)

    This poster provides an overview of three key lines of ongoing work at EPA/ORD/NCEA-CIN: Provisional Peer-Reviewed Toxicity Values (PPRTVs), Alternative Methods in Human Health Risk Assessment, and the RapidTox Dashboard collaboration.

  5. Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California.

    Science.gov (United States)

    Ackerman, Sara L; Sarkar, Urmimala; Tieu, Lina; Handley, Margaret A; Schillinger, Dean; Hahn, Kenneth; Hoskote, Mekhala; Gourley, Gato; Lyles, Courtney

    2017-09-01

    US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45). Our findings demonstrate that the health systems devoted considerable effort to enlisting staff support for portal adoption and integrating portal-related work into clinic routines. Although all health systems had achieved, or were close to achieving, MU benchmarks, patients faced numerous barriers to portal use and our participants were uncertain how to achieve and sustain "meaningful use" as defined by and for their patients. Health systems' efforts to achieve MU certification united clinic staff under a shared ethos of improved quality of care. However, MU's assumptions about patients' demand for electronic access to health information and ability to make use of it directed clinics' attention to enrollment and message routing rather than to the relevance and usability of a tool that is minimally adaptable to the safety net context. We found a mismatch between MU-based metrics of patient engagement and the priorities and needs of safety net patient populations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  6. Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

    Science.gov (United States)

    Hawkes, Michael; Katsuva, Jean Paul; Masumbuko, Claude K

    2009-12-23

    Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Prospective cohort study, satisfaction questionnaire and decision analysis. Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

  7. Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Katsuva Jean

    2009-12-01

    Full Text Available Abstract Background Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs, have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Methods Prospective cohort study, satisfaction questionnaire and decision analysis. Results Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. Conclusions CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

  8. 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).

  9. Feasibility of rapid ethical assessment for the Ethiopian health research ethics review system.

    Science.gov (United States)

    Addissie, Adamu; Davey, Gail; Newport, Melanie; Farsides, Bobbie; Feleke, Yeweyenhareg

    2015-01-01

    One of the challenges in the process of ethical medical research in developing countries, including Ethiopia, is translating universal principles of medical ethics into appropriate informed consent documents and their implementation. Rapid Ethical Assessment (REA) has been suggested as a feasible approach to meet this application gap. In the past few years REA has been employed in few research project in Ethiopia and have been found to be a useful and practical approach. Feasibility assessment of REA for the Ethiopian research setting was conducted between 2012-2013 in order to inform the subsequent introduction of REA into research ethics review and governance system in the country. REA was found to be an appropriate, relevant and feasible venture. We argue that REA can be integrated as part of the ethics review and governance system in Ethiopia. REA tools and techniques are considered relevant and acceptable to the Ethiopian research community, with few practical challenges anticipated in their implementation. REA are considered feasible for integration in the Ethiopian ethics review system.

  10. Applying green analytical chemistry for rapid analysis of drugs: Adding health to pharmaceutical industry

    Directory of Open Access Journals (Sweden)

    Nazrul Haq

    2017-02-01

    Full Text Available Green RP-HPLC method for a rapid analysis of olmesartan medoxomil (OLM in bulk drugs, self-microemulsifying drug delivery system (SMEDDS and marketed tablets was developed and validated in the present investigation. The chromatographic identification was achieved on Lichrosphere 250 × 4.0 mm RP C8 column having a 5 μm packing as a stationary phase using a combination of green solvents ethyl acetate:ethanol (50:50% v/v as a mobile phase, at a flow rate of 1.0 mL/min with UV detection at 250 nm. The proposed method was validated for linearity, selectivity, accuracy, precision, reproducibility, robustness, sensitivity and specificity. The utility of the proposed method was verified by an assay of OLM in SMEDDS and commercial tablets. The proposed method was found to be selective, precise, reproducible, accurate, robust, sensitive and specific. The amount of OLM in SMEDDS and commercial tablets was found to be 101.25% and 98.67% respectively. The proposed method successfully resolved OLM peak in the presence of its degradation products which indicated stability-indicating property of the proposed method. These results indicated that the proposed method can be successfully employed for a routine analysis of OLM in bulk drugs and commercial formulations.

  11. Consumerism and wellness: rising tide, falling cost.

    Science.gov (United States)

    Domaszewicz, Alexander

    2008-01-01

    Annual employer-sponsored health plan cost increases have been slowing incrementally due to slowing health care utilization--a phenomenon very likely tied to the proliferation of health management activities, wellness programs and other consumerism strategies. This article describes the sharp rise in recent years of consumer-directed health plans (CDHPs) and explains what developments must happen for genuine consumer-directed health care to realize its full potential. These developments include gathering transparent health care information, increasing consumer demand for that information and creating truly intuitive data solutions that allow consumers to easily access information in order to make better health care decisions.

  12. The Rise of Iran

    DEFF Research Database (Denmark)

    Jakobsen, Peter Viggo; Rahigh-Aghsan, Ali

    2010-01-01

    Iran is viewed by many as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle...... East, and its brand of Shi‘ism has very limited appeal outside of Iran. Second, growing internal political and economic instability will seriously limit Iran's bid for regional dominance. Third, the failure to stop the Iranian nuclear program has led analysts to underestimate the ability of the other...... regional powers and the West to balance Iran and contain its influence, even if it acquires nuclear weapons. If these limitations on Iranian power are taken into account the rise seems destined to be a short one....

  13. Contemporary sea level rise.

    Science.gov (United States)

    Cazenave, Anny; Llovel, William

    2010-01-01

    Measuring sea level change and understanding its causes has considerably improved in the recent years, essentially because new in situ and remote sensing observations have become available. Here we report on most recent results on contemporary sea level rise. We first present sea level observations from tide gauges over the twentieth century and from satellite altimetry since the early 1990s. We next discuss the most recent progress made in quantifying the processes causing sea level change on timescales ranging from years to decades, i.e., thermal expansion of the oceans, land ice mass loss, and land water-storage change. We show that for the 1993-2007 time span, the sum of climate-related contributions (2.85 +/- 0.35 mm year(-1)) is only slightly less than altimetry-based sea level rise (3.3 +/- 0.4 mm year(-1)): approximately 30% of the observed rate of rise is due to ocean thermal expansion and approximately 55% results from land ice melt. Recent acceleration in glacier melting and ice mass loss from the ice sheets increases the latter contribution up to 80% for the past five years. We also review the main causes of regional variability in sea level trends: The dominant contribution results from nonuniform changes in ocean thermal expansion.

  14. Programme level implementation of malaria rapid diagnostic tests (RDTs) use: outcomes and cost of training health workers at lower level health care facilities in Uganda.

    Science.gov (United States)

    Kyabayinze, Daniel J; Asiimwe, Caroline; Nakanjako, Damalie; Nabakooza, Jane; Bajabaite, Moses; Strachan, Clare; Tibenderana, James K; Van Geetruyden, Jean Pierre

    2012-04-20

    The training of health workers in the use of malaria rapid diagnostic tests (RDTs) is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs) where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model). A cross-sectional evaluation of the health workers' competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD) prescriptions pre and post training. The direct costs relating to the training processes were also documented. Overall, 135 health workers were trained including 63 (47%) nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80%) of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16%) participants who were peer-trained by their trained colleagues. Only 9 (14%) did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112), with the main cost drivers being trainee travel and per

  15. Programme level implementation of malaria rapid diagnostic tests (RDTs use: outcomes and cost of training health workers at lower level health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Kyabayinze Daniel J

    2012-04-01

    Full Text Available Abstract Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model. A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47% nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80% of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16% participants who were peer-trained by their trained colleagues. Only 9 (14% did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112, with the

  16. 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.

  17. 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.

  18. 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

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

    Science.gov (United States)

    2011-01-01

    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 databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. Conclusions These studies

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

    Science.gov (United States)

    Fitzpatrick-Lewis, Donna; Ganann, Rebecca; Krishnaratne, Shari; Ciliska, Donna; Kouyoumdjian, Fiona; Hwang, Stephen W

    2011-08-10

    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. A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. These studies provide important new evidence regarding

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

    Directory of Open Access Journals (Sweden)

    Kouyoumdjian Fiona

    2011-08-01

    Full Text Available 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 databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations

  2. Rapid immune colloidal gold strip for cetacean meat restraining illegal trade and consumption: implications for conservation and public health.

    Science.gov (United States)

    Lo, Chieh; Chin, Li-Te; Chu, Chi-Shih; Wang, Yu-Ting; Chan, Kun-Wei; Yang, Wei-Cheng

    2013-01-01

    The consumption of cetacean meat is geographically common and often of undetermined sustainability. Besides, it can expose humans to contaminants and zoonotic pathogens. The illegality of possessing cetacean meat was likely under-reported in some countries due to lack of attention paid by the officials although DNA analysis of market products helped to show such practices. We developed two monoclonal antibodies against synthetic peptides of myoglobin (Mb) for constructing a rapid immune colloidal gold strip. Only cetacean Mb is capable of binding to both antibodies and presents positive signal while the Mb from other animals can bind only 1 of the antibodies and presents negative result. The strip for cetacean meat would be an applicable and cost-effective test for field inspectors and even the general public. It contributes to increase the reporting capacity and coverage of illegal cetacean meat possession, which has implications for global cetacean conservation and public health.

  3. Coal prices rise

    International Nuclear Information System (INIS)

    McLean, A.

    2001-01-01

    Coking and semi hard coking coal price agreements had been reached, but, strangely enough, the reaching of common ground on semi soft coking coal, ultra low volatile coal and thermal coal seemed some way off. More of this phenomenon later, but suffice to say that, traditionally, the semi soft and thermal coal prices have fallen into place as soon as the hard, or prime, coking coal prices have been determined. The rise and rise of the popularity of the ultra low volatile coals has seen demand for this type of coal grow almost exponentially. Perhaps one of the most interesting facets of the coking coal settlements announced to date is that the deals appear almost to have been preordained. The extraordinary thing is that the preordination has been at the prescience of the sellers. Traditionally, coking coal price fixing has been the prerogative of the Japanese Steel Mills (JSM) cartel (Nippon, NKK, Kawasaki, Kobe and Sumitomo) who presented a united front to a somewhat disorganised force of predominantly Australian and Canadian sellers. However, by the time JFY 2001 had come round, the rules of the game had changed

  4. Rising workload or rising work pressure in general practice in the Netherlands.

    NARCIS (Netherlands)

    Bakker, D.H. de; Hutten, J.B.F.; Steultjens, M.; Schellevis, F.

    2002-01-01

    Background: General practice in the Netherlands seems to be in a crisis. Worries about shortages of GP's, the first strike of general practitioners in 2001 and the rapid increase of triage systems in out of hours care are signs that work pressure and/or workload are rising. But systematic evidence

  5. Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

    Science.gov (United States)

    Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

    2016-09-01

    In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

  6. What telomeres say about activity and health: A rapid review: Ce que les télomères révèlent au sujet de l'activité et de la santé : revue rapide.

    Science.gov (United States)

    To-Miles, Flora Y L; Backman, Catherine L

    2016-04-06

    Empirical studies on occupation as a determinant of health could be advanced with research incorporating biological measures of health. Telomere length and telomerase function are promising biomarkers of the interaction of genetics, lifestyle, and behaviour; however, they have not been used in occupational therapy research. This paper reviews current evidence on the role of physical and mindfulness activities in sustaining telomeres. The findings are applied to the study of occupation, health, and aging. A rapid review was conducted with an evidence synthesis of 23 studies published from 2008 to 2014. Mindfulness activities may preserve telomeres, slow cell senescence and death, and sustain health through mediating life stressors. Inconsistencies exist for the effect of physical activities on telomeres. Similar research examining a range of occupations may help to identify the health-promoting benefits of occupation and inform lifestyle interventions. © CAOT 2016.

  7. Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Joanita Nangendo

    Full Text Available The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% of people living with HIV are unaware of their status. The current HIV testing policy which is strictly blood-based poses several challenges including: a need for high level laboratory skills, stringent waste disposal needs, and painful sample collection. It is envisaged that introduction of a rapid, painless HIV oral fluid test as a potential alternative is likely to increase the number of people testing. The aim of this study was to determine the diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending Kisenyi Health Centre IV in Kampala.We conducted a cross-sectional study among 440 adults recruited consecutively at Kisenyi Health Centre IV from January to March 2016. The diagnostic accuracy of the HIV oral test was assessed by comparing to the national HIV serial testing algorithm. We also assessed for acceptability among patients and health care workers (HCWs by triangulating responses from a structured questionnaire, three focus group discussions and seven key informant interviews. Acceptability was defined as willingness to take the test at the time of the study and intention for future use of the test if it was availed. The prevalence of HIV infection among study participants was 14.8%. The HIV oral fluid test was highly accurate with sensitivity of 100% (95% CI; 94.5-100.0, specificity of 100% (95% CI; 99.0-100.0, positive predictive value (PPV of 100% (95% CI; 94.5-100.0 and negative predictive value (NPV of 100% (95% CI; 99.0-100.0. Acceptability of HIV oral testing was also high at 87.0% (95% CI; 83.6-89.9. Participants preferred HIV oral testing because it was: pain free (91%, n = 399 and did not require blood draw (82%, n = 360.The HIV oral fluid test has high diagnostic accuracy and acceptability. HIV oral testing is a suitable addition to the national HIV testing strategies with the potential of increasing access to HIV testing services in

  8. The rise of Chrome

    Directory of Open Access Journals (Sweden)

    Jonathan Tamary

    2015-10-01

    Full Text Available Since Chrome’s initial release in 2008 it has grown in market share, and now controls roughly half of the desktop browsers market. In contrast with Internet Explorer, the previous dominant browser, this was not achieved by marketing practices such as bundling the browser with a pre-loaded operating system. This raises the question of how Chrome achieved this remarkable feat, while other browsers such as Firefox and Opera were left behind. We show that both the performance of Chrome and its conformance with relevant standards are typically better than those of the two main contending browsers, Internet Explorer and Firefox. In addition, based on a survey of the importance of 25 major features, Chrome product managers seem to have made somewhat better decisions in selecting where to put effort. Thus the rise of Chrome is consistent with technical superiority over the competition.

  9. Plume rise predictions

    International Nuclear Information System (INIS)

    Briggs, G.A.

    1976-01-01

    Anyone involved with diffusion calculations becomes well aware of the strong dependence of maximum ground concentrations on the effective stack height, h/sub e/. For most conditions chi/sub max/ is approximately proportional to h/sub e/ -2 , as has been recognized at least since 1936 (Bosanquet and Pearson). Making allowance for the gradual decrease in the ratio of vertical to lateral diffusion at increasing heights, the exponent is slightly larger, say chi/sub max/ approximately h/sub e/ - 2 . 3 . In inversion breakup fumigation, the exponent is somewhat smaller; very crudely, chi/sub max/ approximately h/sub e/ -1 . 5 . In any case, for an elevated emission the dependence of chi/sub max/ on h/sub e/ is substantial. It is postulated that a really clever ignorant theoretician can disguise his ignorance with dimensionless constants. For most sources the effective stack height is considerably larger than the actual source height, h/sub s/. For instance, for power plants with no downwash problems, h/sub e/ is more than twice h/sub s/ whenever the wind is less than 10 m/sec, which is most of the time. This is unfortunate for anyone who has to predict ground concentrations, for he is likely to have to calculate the plume rise, Δh. Especially when using h/sub e/ = h/sub s/ + Δh instead of h/sub s/ may reduce chi/sub max/ by a factor of anywhere from 4 to infinity. Factors to be considered in making plume rise predictions are discussed

  10. Rising statin use and effect on ischemic stroke outcome

    Directory of Open Access Journals (Sweden)

    Haymore Joseph

    2004-03-01

    Full Text Available Abstract Background Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome. Methods This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score Results There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22% of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03. After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2–6.7 of a good outcome at the time of hospital discharge. Conclusions The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.

  11. Market Economy under Rapid Globalization and Rising Productivity

    OpenAIRE

    Konov, Joshua Ioji

    2012-01-01

    Market economy of enhancing business laws in contracting, bonding, insuring, legal corporate structures , e.g. will marginalize the economic agents and tools that make market competition unfair, empower small and medium businesses and investors, and boost business activities, fiscal strength, employment, and capital transmission. Keynesian capital infusion will extend its market effect in such higher security marketplace.

  12. 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.

  13. HiRISE: The People's Camera

    Science.gov (United States)

    McEwen, A. S.; Eliason, E.; Gulick, V. C.; Spinoza, Y.; Beyer, R. A.; HiRISE Team

    2010-12-01

    The High Resolution Imaging Science Experiment (HiRISE) camera, orbiting Mars since 2006 on the Mars Reconnaissance Orbiter (MRO), has returned more than 17,000 large images with scales as small as 25 cm/pixel. From it’s beginning, the HiRISE team has followed “The People’s Camera” concept, with rapid release of useful images, explanations, and tools, and facilitating public image suggestions. The camera includes 14 CCDs, each read out into 2 data channels, so compressed images are returned from MRO as 28 long (up to 120,000 line) images that are 1024 pixels wide (or binned 2x2 to 512 pixels, etc.). This raw data is very difficult to use, especially for the public. At the HiRISE operations center the raw data are calibrated and processed into a series of B&W and color products, including browse images and JPEG2000-compressed images and tools to make it easy for everyone to explore these enormous images (see http://hirise.lpl.arizona.edu/). Automated pipelines do all of this processing, so we can keep up with the high data rate; images go directly to the format of the Planetary Data System (PDS). After students visually check each image product for errors, they are fully released just 1 month after receipt; captioned images (written by science team members) may be released sooner. These processed HiRISE images have been incorporated into tools such as Google Mars and World Wide Telescope for even greater accessibility. 51 Digital Terrain Models derived from HiRISE stereo pairs have been released, resulting in some spectacular flyover movies produced by members of the public and viewed up to 50,000 times according to YouTube. Public targeting began in 2007 via NASA Quest (http://marsoweb.nas.nasa.gov/HiRISE/quest/) and more than 200 images have been acquired, mostly by students and educators. At the beginning of 2010 we released HiWish (http://www.uahirise.org/hiwish/), opening HiRISE targeting to anyone in the world with Internet access, and already more

  14. Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool.

    Science.gov (United States)

    Cozendey-Silva, Eliana Napoleão; da Silva, Cintia Ribeiro; Larentis, Ariane Leites; Wasserman, Julio Cesar; Rozemberg, Brani; Teixeira, Liliane Reis

    2016-09-05

    Periodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT), proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version. A cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience's comprehension. Both the translated and the original versions' concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E) mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions. The translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil.

  15. Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool

    Directory of Open Access Journals (Sweden)

    Eliana Napoleão Cozendey-Silva

    2016-09-01

    Full Text Available Abstract Background Periodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT, proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version. Methods A cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience’s comprehension. Results Both the translated and the original versions’ concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions. Conclusion The translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil

  16. HIV rapid diagnostic testing by lay providers in a key population-led health service programme in Thailand.

    Science.gov (United States)

    Wongkanya, Rapeeporn; Pankam, Tippawan; Wolf, Shauna; Pattanachaiwit, Supanit; Jantarapakde, Jureeporn; Pengnongyang, Supabhorn; Thapwong, Prasopsuk; Udomjirasirichot, Apichat; Churattanakraisri, Yutthana; Prawepray, Nanthika; Paksornsit, Apiluk; Sitthipau, Thidadaow; Petchaithong, Sarayut; Jitsakulchaidejt, Raruay; Nookhai, Somboon; Lertpiriyasuwat, Cheewanan; Ongwandee, Sumet; Phanuphak, Praphan; Phanuphak, Nittaya

    2018-01-01

    Introduction:  Rapid diagnostic testing (RDT) for HIV has a quick turn-around time, which increases the proportion of people testing who receive their result. HIV RDT in Thailand has traditionally been performed only by medical technologists (MTs), which is a barrier to its being scaled up. We evaluated the performance of HIV RDT conducted by trained lay providers who were members of, or worked closely with, a group of men who have sex with men (MSM) and with transgender women (TG) communities, and compared it to tests conducted by MTs. Methods:  Lay providers received a 3-day intensive training course on how to perform a finger-prick blood collection and an HIV RDT as part of the Key Population-led Health Services (KPLHS) programme among MSM and TG. All the samples were tested by lay providers using Alere Determine HIV 1/2. HIV-reactive samples were confirmed by DoubleCheckGold Ultra HIV 1&2 and SD Bioline HIV 1/2. All HIV-positive and 10% of HIV-negative samples were re-tested by MTs using Serodia HIV 1/2. Results:  Of 1680 finger-prick blood samples collected and tested using HIV RDT by lay providers in six drop-in centres in Bangkok, Chiang Mai, Chonburi and Songkhla, 252 (15%) were HIV-positive. MTs re-tested these HIV-positive samples and 143 randomly selected HIV-negative samples with 100% concordant test results. Conclusion:  Lay providers in Thailand can be trained and empowered to perform HIV RDT as they were found to achieve comparable results in sample testing with MTs. Based on the task-shifting concept, this rapid HIV testing performed by lay providers as part of the KPLHS programme has great potential to enhance HIV prevention and treatment programmes among key at-risk populations.

  17. 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

  18. Addressing healthcare needs of people living below the poverty line: a rapid assessment of the Andhra Pradesh Health Insurance Scheme.

    Science.gov (United States)

    Rao, M; Ramachandra, S S; Bandyopadhyay, S; Chandran, A; Shidhaye, R; Tamisettynarayana, S; Thippaiah, A; Sitamma, M; Sunil George, M; Singh, V; Sivasankaran, S; Bangdiwala, S I

    2011-01-01

    Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme. Copyright 2011, NMJI.

  19. 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.

  20. Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right?; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”

    Directory of Open Access Journals (Sweden)

    Ronald Labonté

    2017-09-01

    Full Text Available Solomon Benatar offers an important critique of the limited frame that sets the boundaries of much of what is referred to as ‘global health.’ In placing his comments within a criticism of increasing poverty (or certainly income and wealth inequalities and the decline in our environmental commons, he locates our health inequities within the pathology of our present global economy. In that respect it is a companion piece to an editorial I published around the same time. Both Benatar’s and my paralleling arguments take on a new urgency in the wake of the US presidential election. Although not a uniquely American event (the xenophobic right has been making inroads in many parts of the world, the degree of vitriol expressed by the President-elect of the world’s (still most powerful and militarized country is being used to further legitimate the policies of right-extremist parties in Europe while providing additional justification for the increasingly autocratic politics of leaders (elected or otherwise in many other of the world’s nations. To challenge right-populism’s rejection of the predatory inequalities that 4 years of (neo-liberal globalization have created demands strong and sustained left populism built, in part, on the ecocentric frame advocated by Benatar.

  1. Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand

    Directory of Open Access Journals (Sweden)

    David Briggs

    2015-12-01

    Full Text Available An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (inactivity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality: 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs. An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt accounted for 21% of deaths. Motorcycles (1 per cent of vkt are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development.

  2. Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers.

    Science.gov (United States)

    Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

    2012-03-01

    To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality.

  3. Public Health Surveillance via Template Management in Electronic Health Records: Tri-Service Workflow's Rapid Response to an Infectious Disease Crisis.

    Science.gov (United States)

    Berkley, Holly; Barnes, Matthew; Carnahan, David; Hayhurst, Janet; Bockhorst, Archie; Neville, James

    2017-03-01

    To describe the use of template-based screening for risk of infectious disease exposure of patients presenting to primary care medical facilities during the 2014 West African Ebola virus outbreak. The Military Health System implemented an Ebola risk-screening tool in primary care settings in order to create early notifications and early responses to potentially infected persons. Three time-sensitive, evidence-based screening questions were developed and posted to Tri-Service Workflow (TSWF) AHLTA templates in conjunction with appropriate training. Data were collected in January 2015, to assess the adoption of the TSWF-based Ebola risk-screening tool. Among encounters documented using TSWF templates, 41% of all encounters showed use of the TSWF-based Ebola risk-screening questions by the fourth day. The screening rate increased over the next 3 weeks, and reached a plateau at approximately 50%. This report demonstrates the MHS capability to deploy a standardized, globally applicable decision support aid that could be seen the same day by all primary care clinics across the military health direct care system, potentially improving rapid compliance with screening directives. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  4. Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right? Comment on "Politics, Power, Poverty and Global Health: Systems and Frames".

    Science.gov (United States)

    Labonté, Ronald

    2017-01-17

    Solomon Benatar offers an important critique of the limited frame that sets the boundaries of much of what is referred to as 'global health.' In placing his comments within a criticism of increasing poverty (or certainly income and wealth inequalities) and the decline in our environmental commons, he locates our health inequities within the pathology of our present global economy. In that respect it is a companion piece to an editorial I published around the same time. Both Benatar's and my paralleling arguments take on a new urgency in the wake of the US presidential election. Although not a uniquely American event (the xenophobic right has been making inroads in many parts of the world), the degree of vitriol expressed by the President-elect of the world's (still) most powerful and militarized country is being used to further legitimate the policies of right-extremist parties in Europe while providing additional justification for the increasingly autocratic politics of leaders (elected or otherwise) in many other of the world's nations. To challenge right-populism's rejection of the predatory inequalities that 4 years of (neo)-liberal globalization have created demands strong and sustained left populism built, in part, on the ecocentric frame advocated by Benatar. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  5. Learning from a Rapid Health Impact Assessment of a proposed maternity service reconfiguration in the English NHS.

    Science.gov (United States)

    Fell, Greg; Haroon, Sophie

    2008-04-25

    Within many parts of the country, the NHS is undertaking reconfiguration of services. Such proposals can prove a tipping point and provoke public protest, often with significant involvement of local and national politicians. We undertook a rapid Health Impact Assessment (HIA) of a proposed reconfiguration of maternity services in Huddersfield and Halifax in England. The aim of the HIA was to help the PCT Boards to assess the reconfiguration's possible consequences on access to maternity services, and maternal and infant health outcomes across different socio-economic groups in Kirklees. We report on the findings of the HIA and the usefulness of the process to decision making. This HIA used routine maternity data for 2004-2005 in Huddersfield, in addition to published evidence. Standard HIA techniques were used. We re-highlighted the socio economic differences in smoking status at booking and quitting during pregnancy. We focused on the key concerns of the public, that of adverse obstetric events on a Midwife Led Unit (MLU) with distant obstetric cover. We estimate that twenty percent of women giving birth in a MLU may require urgent transfer to obstetric care during labour. There were no significant socio economic differences. Much of the risk can be mitigated though robust risk management policies. Additional travelling distances and costs could affect lower socio-economic groups the greatest because of lower car ownership and geographical location in relation to the units. There is potential that with improved community antenatal and post natal care, population outcomes could improve significantly, the available evidence supports this view. Available evidence suggests that maternity reconfiguration towards enhanced community care could have many potential benefits but carries risk. Investment is needed to realise the former and mitigate the latter. The usefulness of this Health Impact Assessment may have been impeded by its timing, and the politically charged

  6. Anticipating demand for emergency health services due to medication-related adverse events after rapid mass prophylaxis campaigns.

    Science.gov (United States)

    Hupert, Nathaniel; Wattson, Daniel; Cuomo, Jason; Benson, Samuel

    2007-03-01

    Mass prophylaxis against infectious disease outbreaks carries the risk of medication-related adverse events (MRAEs). The authors sought to define the relationship between the rapidity of mass prophylaxis dispensing and the subsequent demand for emergency health services due to predictable MRAEs. The authors created a spreadsheet-based computer model that calculates scenario-specific predicted daily MRAE rates from user inputs by applying a probability distribution to the reported timing of MRAEs. A hypothetical two- to ten-day prophylaxis campaign for one million people using recent data from both smallpox vaccination and anthrax chemoprophylaxis campaigns was modeled. The length of a mass prophylaxis campaign plays an important role in determining the subsequent intensity in emergency services utilization due to real or suspected adverse events. A two-day smallpox vaccination scenario would produce an estimated 32,000 medical encounters and 1,960 hospitalizations, peaking at 5,246 health care encounters six days after the start of the campaign; in contrast, a ten-day campaign would lead to 41% lower peak surge, with a maximum of 3,106 encounters on the busiest day, ten days after initiation of the campaign. MRAEs with longer lead times, such as those associated with anthrax chemoprophylaxis, exhibit less variability based on campaign length (e.g., 124 out of an estimated 1,400 hospitalizations on day 20 after a two-day campaign versus 103 on day 24 after a ten-day campaign). The duration of a mass prophylaxis campaign may have a substantial impact on the timing and peak number of clinically significant MRAEs, with very short campaigns overwhelming existing emergency department (ED) capacity to treat real or suspected medication-related injuries. While better reporting of both incidence and timing of MRAEs in future prophylaxis campaigns should improve the application of this model to community-based emergency preparedness planning, these results highlight the need

  7. Learning from a Rapid Health Impact Assessment of a proposed maternity service reconfiguration in the English NHS

    Directory of Open Access Journals (Sweden)

    Haroon Sophie

    2008-04-01

    Full Text Available Abstract Background Within many parts of the country, the NHS is undertaking reconfiguration of services. Such proposals can prove a tipping point and provoke public protest, often with significant involvement of local and national politicians. We undertook a rapid Health Impact Assessment (HIA of a proposed reconfiguration of maternity services in Huddersfield and Halifax in England. The aim of the HIA was to help the PCT Boards to assess the reconfiguration's possible consequences on access to maternity services, and maternal and infant health outcomes across different socio-economic groups in Kirklees. We report on the findings of the HIA and the usefulness of the process to decision making. Methods This HIA used routine maternity data for 2004–2005 in Huddersfield, in addition to published evidence. Standard HIA techniques were used. Results We re-highlighted the socio economic differences in smoking status at booking and quitting during pregnancy. We focused on the key concerns of the public, that of adverse obstetric events on a Midwife Led Unit (MLU with distant obstetric cover. We estimate that twenty percent of women giving birth in a MLU may require urgent transfer to obstetric care during labour. There were no significant socio economic differences. Much of the risk can be mitigated though robust risk management policies. Additional travelling distances and costs could affect lower socio-economic groups the greatest because of lower car ownership and geographical location in relation to the units. There is potential that with improved community antenatal and post natal care, population outcomes could improve significantly, the available evidence supports this view. Conclusion Available evidence suggests that maternity reconfiguration towards enhanced community care could have many potential benefits but carries risk. Investment is needed to realise the former and mitigate the latter. The usefulness of this Health Impact Assessment

  8. The Rise and Fall of Universal Salt Iodization in Vietnam: Lessons Learned for Designing Sustainable Food Fortification Programs With a Public Health Impact.

    Science.gov (United States)

    Codling, Karen; Quang, Nguyen Vinh; Phong, Le; Phuong, Do Hong; Quang, Nguyen Dinh; Bégin, France; Mathisen, Roger

    2015-12-01

    In 2005, more than 90% of Vietnamese households were using adequately iodized salt, and urinary iodine concentration among women of reproductive age was in the optimal range. However, household coverage declined thereafter to 45% in 2011, and urinary iodine concentration levels indicated inadequate iodine intake. To review the strengths and weaknesses of the Vietnamese universal salt iodization program from its inception to the current day and to discuss why achievements made by 2005 were not sustained. Qualitative review of program documents and semistructured interviews with national stakeholders. National legislation for mandatory salt iodization was revoked in 2005, and the political importance of the program was downgraded with consequential effects on budget, staff, and authority. The Vietnamese salt iodization program, as it was initially designed and implemented, was unsustainable, as salt iodization was not practiced as an industry norm but as a government-funded activity. An effective and sustainable salt iodization program needs to be reestablished for the long-term elimination of iodine deficiency, building upon lessons learned from the past and programs in neighboring countries. The new program will need to include mandatory legislation, including salt for food processing; industry responsibility for the cost of fortificant; government commitment for enforcement through routine food control systems and monitoring of iodine status through existing health/nutrition assessments; and intersectoral collaboration and management of the program. Many of the lessons would apply equally to universal salt iodization programs in other countries and indeed to food fortification programs in general. © The Author(s) 2015.

  9. The Rising Burden of Diabetes and Hypertension in Southeast Asian and African Regions: Need for Effective Strategies for Prevention and Control in Primary Health Care Settings

    Directory of Open Access Journals (Sweden)

    Viswanathan Mohan

    2013-01-01

    Full Text Available Aim. To review the available literature on burden of diabetes mellitus (DM and hypertension (HTN and its coexistence in Southeast Asian (SEA and the African (AFR regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million, while the AFR region had the smallest number (14.7 million. Screening studies identified high proportions (>50% of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India to 78.4% in Thailand in the SEA region and ranging from 9.7% in Nigeria to 70.4% in Morocco in the AFR region. There is evidence that by lifestyle modification both DM and HTN can be prevented. Conclusion. To meet the twin challenge of DM and HTN in developing countries, PHCs will have to be strengthened with a concerted and multipronged effort to provide promotive, preventive, curative, and rehabilitative services.

  10. Socioecological Aspects of High-rise Construction

    Science.gov (United States)

    Eichner, Michael; Ivanova, Zinaida

    2018-03-01

    In this article, the authors consider the socioecological problems that arise in the construction and operation of high-rise buildings. They study different points of view on high-rise construction and note that the approaches to this problem are very different. They also analyse projects of modern architects and which attempts are made to overcome negative impacts on nature and mankind. The article contains materials of sociological research, confirming the ambivalent attitude of urban population to high-rise buildings. In addition, one of the author's sociological survey reveals the level of environmental preparedness of the university students, studying in the field of "Construction of unique buildings and structures", raising the question of how future specialists are ready to take into account socioecological problems. Conclusion of the authors: the construction of high-rise buildings is associated with huge social and environmental risks, negative impact on the biosphere and human health. This requires deepened skills about sustainable design methods and environmental friendly construction technologies of future specialists. Professor M. Eichner presents in the article his case study project results on implementation of holistic eco-sustainable construction principles for mixed-use high-rise building in the metropolis of Cairo.

  11. Socioecological Aspects of High-rise Construction

    Directory of Open Access Journals (Sweden)

    Eichner Michael

    2018-01-01

    Full Text Available In this article, the authors consider the socioecological problems that arise in the construction and operation of high-rise buildings. They study different points of view on high-rise construction and note that the approaches to this problem are very different. They also analyse projects of modern architects and which attempts are made to overcome negative impacts on nature and mankind. The article contains materials of sociological research, confirming the ambivalent attitude of urban population to high-rise buildings. In addition, one of the author’s sociological survey reveals the level of environmental preparedness of the university students, studying in the field of "Construction of unique buildings and structures", raising the question of how future specialists are ready to take into account socioecological problems. Conclusion of the authors: the construction of high-rise buildings is associated with huge social and environmental risks, negative impact on the biosphere and human health. This requires deepened skills about sustainable design methods and environmental friendly construction technologies of future specialists. Professor M. Eichner presents in the article his case study project results on implementation of holistic eco-sustainable construction principles for mixed-use high-rise building in the metropolis of Cairo.

  12. Validation of the Spanish version of the fibromyalgia rapid screening tool to detect fibromyalgia in primary care health centres.

    Science.gov (United States)

    Casanueva, Benigno; Belenguer, Rafael; Moreno-Muelas, José V; Urtiaga, Javier; Urtiaga, Blanca; Hernández, José L; Pina, Trinitario; González-Gay, Miguel A

    2016-01-01

    To investigate the reliability and validity of the Spanish version of the Fibromyalgia Rapid Screening Tool (FiRST), a brief questionnaire for the detection of fibromyalgia (FM) in patients with diffuse chronic pain seen at primary care health centres. The original FiRST French questionnaire was adapted to a Spanish version following the guidelines of the Rheumatology Spanish Society Study Group of FM, and the help provided by professors of French and Spanish Language. In a prospective and multicentre study, patients with chronic pain were initially divided into two groups: a group that included patients that had been diagnosed with FM according to the 1990 ACR criteria and the 2010 ACR preliminary criteria (n=404), and a non-FM (control) group composed of rheumatoid arthritis (RA) (n=147) and osteoarthritis (OA) (n=219) patients. Patients from the FM group were evaluated by assessing tender point assessment, Widespread Pain Index (WPI), Symptom Severity Scale (SSS), FiRST questionnaire and Fibromyalgia Impact Questionnaire (FIQ). The non-FM group was evaluated by means of FiRST, WPI and SSS. Sensitivity, specificity and predictive value as well as the correlation between the global score and other parameters were assessed. 356 of 404 FM (88.1%) patients who met the 1990 ACR criteria and the ACR 2010 preliminary criteria had a positive FiRST. In the control group (AR plus OA), only 16 (4.4%) subjects had a positive FiRST. The sensitivity value was 92% (95% confidence interval CI: 88.9-95.1), specificity 87.4% (95% CI: 80.8-94.0), positive predictive value 95.7% (95% CI: 93.3-98.1), and negative predictive value 78.2% (95% CI: 70.6-85.9). A significant correlation between the total FiRST score (patients with score 5 or 6) and WPI (pFIQ (p<0.0001) was found. FiRST questionnaire is a useful tool for the detection of FM in primary care health centres.

  13. [Rapid determination of illicit beta2-agonist additives in health foods and traditional Chinese patent medicines with DCBI-MS/MS method].

    Science.gov (United States)

    Hou, Yu-Lan; Wu, Shuang; Wang, Hua; Zhao, Yong; Liao, Peng; Tian, Qing-Qing; Sun, Wen-Jian; Chen, Bo

    2013-01-01

    A novel rapid method for detection of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines was developed with the desorption corona beam ionization mass spectrometry (DCBI-MS) technique. The DCBI conditions including temperature and sample volume were optimized according to the resulting mass spectra intensity. Matrix effect on 9 beta2-agonists additives was not significant in the proposed rapid determination procedure. All of the 9 target molecules were detected within 1 min. Quantification was achieved based on the typical fragment ion in MS2 spectra of each analyte. The method showed good linear coefficients in the range of 1-100 mg x L(-1) for all analytes. The relative deviation values were between 14.29% and 25.13%. Ten claimed antitussive and antiasthmatic health foods and traditional Chinese patent medicines from local pharmacies were analyzed. All of them were negative with the proposed DCBI-MS method. Without tedious sample pretreatments, the developed DCBI-MS is simple, rapid and sensitive for rapid qualification and semi-quantification of the illicit beta2-agonist additives in health foods and traditional Chinese patent medicines.

  14. Updating Maryland's sea-level rise projections

    Science.gov (United States)

    Boesch, Donald F.; Atkinson, Larry P.; Boicourt, William C.; Boon, John D.; Cahoon, Donald R.; Dalrymple, Robert A.; Ezer, Tal; Horton, Benjamin P.; Johnson, Zoe P.; Kopp, Robert E.; Li, Ming; Moss, Richard H.; Parris, Adam; Sommerfield, Christopher K.

    2013-01-01

    With its 3,100 miles of tidal shoreline and low-lying rural and urban lands, “The Free State” is one of the most vulnerable to sea-level rise. Historically, Marylanders have long had to contend with rising water levels along its Chesapeake Bay and Atlantic Ocean and coastal bay shores. Shorelines eroded and low-relief lands and islands, some previously inhabited, were inundated. Prior to the 20th century, this was largely due to the slow sinking of the land since Earth’s crust is still adjusting to the melting of large masses of ice following the last glacial period. Over the 20th century, however, the rate of rise of the average level of tidal waters with respect to land, or relative sea-level rise, has increased, at least partially as a result of global warming. Moreover, the scientific evidence is compelling that Earth’s climate will continue to warm and its oceans will rise even more rapidly. Recognizing the scientific consensus around global climate change, the contribution of human activities to it, and the vulnerability of Maryland’s people, property, public investments, and natural resources, Governor Martin O’Malley established the Maryland Commission on Climate Change on April 20, 2007. The Commission produced a Plan of Action that included a comprehensive climate change impact assessment, a greenhouse gas reduction strategy, and strategies for reducing Maryland’s vulnerability to climate change. The Plan has led to landmark legislation to reduce the state’s greenhouse gas emissions and a variety of state policies designed to reduce energy consumption and promote adaptation to climate change.

  15. On Capillary Rise and Nucleation

    Science.gov (United States)

    Prasad, R.

    2008-01-01

    A comparison of capillary rise and nucleation is presented. It is shown that both phenomena result from a balance between two competing energy factors: a volume energy and a surface energy. Such a comparison may help to introduce nucleation with a topic familiar to the students, capillary rise. (Contains 1 table and 3 figures.)

  16. The rise and fall of the ridge

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, Paul [Brookhaven National Laboratory, Upton, NY 11973 (United States)

    2011-04-01

    Recent data from heavy ion collisions at RHIC show unexpectedly large near-angle correlations that broaden longitudinally with centrality. The amplitude of this ridge-like correlation rises rapidly with centrality, reaches a maximum, and then falls in the most central collisions. In this talk we explain how this behavior can be easily understood in a picture where final momentum-space correlations are driven by initial coordinate space density fluctuations. We propose {nu}{sub n}{sup 2}/{epsilon}{sub n,part}{sup 2} as a useful way to study these effects and explain what it tells us about the collision dynamics.

  17. Plume rise from multiple sources

    International Nuclear Information System (INIS)

    Briggs, G.A.

    1975-01-01

    A simple enhancement factor for plume rise from multiple sources is proposed and tested against plume-rise observations. For bent-over buoyant plumes, this results in the recommendation that multiple-source rise be calculated as [(N + S)/(1 + S)]/sup 1/3/ times the single-source rise, Δh 1 , where N is the number of sources and S = 6 (total width of source configuration/N/sup 1/3/ Δh 1 )/sup 3/2/. For calm conditions a crude but simple method is suggested for predicting the height of plume merger and subsequent behavior which is based on the geometry and velocity variations of a single buoyant plume. Finally, it is suggested that large clusters of buoyant sources might occasionally give rise to concentrated vortices either within the source configuration or just downwind of it

  18. Health care prices, the federal budget, and economic growth.

    Science.gov (United States)

    Monaco, R M; Phelps, J H

    1995-01-01

    Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.

  19. Are rapid diagnostic tests more accurate in diagnosis of plasmodium falciparum malaria compared to microscopy at rural health centres?

    Directory of Open Access Journals (Sweden)

    Magnussen Pascal

    2010-12-01

    Full Text Available Abstract Background Prompt, accurate diagnosis and treatment with artemisinin combination therapy remains vital to current malaria control. Blood film microscopy the current standard test for diagnosis of malaria has several limitations that necessitate field evaluation of alternative diagnostic methods especially in low income countries of sub-Saharan Africa where malaria is endemic. Methods The accuracy of axillary temperature, health centre (HC microscopy, expert microscopy and a HRP2-based rapid diagnostic test (Paracheck was compared in predicting malaria infection using polymerase chain reaction (PCR as the gold standard. Three hundred patients with a clinical suspicion of malaria based on fever and or history of fever from a low and high transmission setting in Uganda were consecutively enrolled and provided blood samples for all tests. Accuracy of each test was calculated overall with 95% confidence interval and then adjusted for age-groups and level of transmission intensity using a stratified analysis. The endpoints were: sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV. This study is registered with Clinicaltrials.gov, NCT00565071. Results Of the 300 patients, 88(29.3% had fever, 56(18.7% were positive by HC microscopy, 47(15.7% by expert microscopy, 110(36.7% by Paracheck and 89(29.7% by PCR. The overall sensitivity >90% was only shown by Paracheck 91.0% [95%CI: 83.1-96.0]. The sensitivity of expert microscopy was 46%, similar to HC microscopy. The superior sensitivity of Paracheck compared to microscopy was maintained when data was stratified for transmission intensity and age. The overall specificity rates were: Paracheck 86.3% [95%CI: 80.9-90.6], HC microscopy 93.4% [95%CI: 89.1-96.3] and expert microscopy 97.2% [95%CI: 93.9-98.9]. The NPV >90% was shown by Paracheck 95.8% [95%CI: 91.9-98.2]. The overall PPV was Conclusion The HRP2-based RDT has shown superior sensitivity compared to

  20. Gasoline Prices and Their Relationship to Rising Motorcycle Fatalities, 1990–2007

    Science.gov (United States)

    Stimpson, Jim P.; Hilsenrath, Peter E.

    2009-01-01

    Motor vehicle accidents are the leading cause of death among young adults. Although automobile fatalities have declined in recent years, motorcycle fatalities are rapidly increasing. The purpose of our research was to quantify the relationship between changing fuel prices and motorcycle fatalities. Our findings suggest that people increasingly rely on motorcycles to reduce their fuel costs in response to rising gasoline prices. We estimate that use of motorcycles and scooters instead of 4-wheeled vehicles results in over 1500 additional motorcycle fatalities annually for each dollar increase in gas prices. Motorcycle safety should receive more attention as a leading public health issue. PMID:19696374

  1. The rise of neglected tropical diseases in the "new Texas"

    Science.gov (United States)

    2018-01-01

    Within the last five years, the State of Texas has experienced either transmission or outbreaks of Ebola, chikungunya, West Nile, and Zika virus infections. Autochthonous transmission of neglected parasitic and bacterial diseases has also become increasingly reported. The rise of such emerging and neglected tropical diseases (NTDs) has not occurred by accident but instead reflects rapidly evolving changes and shifts in a “new” Texas beset by modern and globalizing forces that include rapid expansions in population together with urbanization and human migrations, altered transportation patterns, climate change, steeply declining vaccination rates, and a new paradigm of poverty known as “blue marble health.” Summarized here are the major NTDs now affecting Texas. In addition to the vector-borne viral diseases highlighted above, there also is a high level of parasitic infections, including Chagas disease, trichomoniasis, and possibly leishmaniasis and toxocariasis, as well as typhus-group rickettsiosis, a vector-borne bacterial infection. I also highlight some of the key shifts in emerging and neglected disease patterns, partly due to an altered and evolving economic and ecological landscape in the new Texas, and provide some preliminary disease burden estimates for the major prevalent and incident NTDs. PMID:29346369

  2. The rise of neglected tropical diseases in the "new Texas".

    Directory of Open Access Journals (Sweden)

    Peter J Hotez

    2018-01-01

    Full Text Available Within the last five years, the State of Texas has experienced either transmission or outbreaks of Ebola, chikungunya, West Nile, and Zika virus infections. Autochthonous transmission of neglected parasitic and bacterial diseases has also become increasingly reported. The rise of such emerging and neglected tropical diseases (NTDs has not occurred by accident but instead reflects rapidly evolving changes and shifts in a "new" Texas beset by modern and globalizing forces that include rapid expansions in population together with urbanization and human migrations, altered transportation patterns, climate change, steeply declining vaccination rates, and a new paradigm of poverty known as "blue marble health." Summarized here are the major NTDs now affecting Texas. In addition to the vector-borne viral diseases highlighted above, there also is a high level of parasitic infections, including Chagas disease, trichomoniasis, and possibly leishmaniasis and toxocariasis, as well as typhus-group rickettsiosis, a vector-borne bacterial infection. I also highlight some of the key shifts in emerging and neglected disease patterns, partly due to an altered and evolving economic and ecological landscape in the new Texas, and provide some preliminary disease burden estimates for the major prevalent and incident NTDs.

  3. 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.

  4. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data*. An Agile Framework.

    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

    2017-06-14

    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

  5. Rise of a cold plume

    International Nuclear Information System (INIS)

    Kakuta, Michio

    1977-06-01

    The rise of smoke from the stacks of two research reactors in normal operation was measured by photogrametric method. The temperature of effluent gas is less than 20 0 C higher than that of the ambient air (heat emission of the order 10 4 cal s -1 ), and the efflux velocity divided by the wind speed is between 0.5 and 2.8 in all 16 smoke runs. The field data obtained within downwind distance of 150m are compared with those by plume rise formulas presently available. Considering the shape of bending-over plume, the Briggs' formula for 'jet' gives a reasonable explanation of the observed plume rise. (auth.)

  6. Taking Her Breath Away: The Rise of COPD in Women

    Science.gov (United States)

    ... Disparities Taking Her Breath Away: The Rise of COPD in Women Disparities in Lung Health Series More ... the U.S. live with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Millions more ...

  7. 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.

  8. Rapid Evidence Assessment of the Literature (REAL(©)): streamlining the systematic review process and creating utility for evidence-based health care.

    Science.gov (United States)

    Crawford, Cindy; Boyd, Courtney; Jain, Shamini; Khorsan, Raheleh; Jonas, Wayne

    2015-11-02

    Systematic reviews (SRs) are widely recognized as the best means of synthesizing clinical research. However, traditional approaches can be costly and time-consuming and can be subject to selection and judgment bias. It can also be difficult to interpret the results of a SR in a meaningful way in order to make research recommendations, clinical or policy decisions, or practice guidelines. Samueli Institute has developed the Rapid Evidence Assessment of the Literature (REAL) SR process to address these issues. REAL provides up-to-date, rigorous, high quality SR information on health care practices, products, or programs in a streamlined, efficient and reliable manner. This process is a component of the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™) program developed by Samueli Institute, which aims at answering the question of "What works?" in health care. The REAL process (1) tailors a standardized search strategy to a specific and relevant research question developed with various stakeholders to survey the available literature; (2) evaluates the quantity and quality of the literature using structured tools and rulebooks to ensure objectivity, reliability and reproducibility of reviewer ratings in an independent fashion and; (3) obtains formalized, balanced input from trained subject matter experts on the implications of the evidence for future research and current practice. Online tools and quality assurance processes are utilized for each step of the review to ensure a rapid, rigorous, reliable, transparent and reproducible SR process. The REAL is a rapid SR process developed to streamline and aid in the rigorous and reliable evaluation and review of claims in health care in order to make evidence-based, informed decisions, and has been used by a variety of organizations aiming to gain insight into "what works" in health care. Using the REAL system allows for the facilitation of recommendations on appropriate next steps in policy, funding

  9. Declining poverty, rising inequality | IDRC - International ...

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

    2011-07-08

    Jul 8, 2011 ... In three decades of rapid economic growth, China has lifted hundreds of ... Regional disparities persist, and pockets of deep poverty remain, ... CASE STUDY: Nepal — A cleaner city and better health in Kathmandu ... Young China Scholars Poverty Research Network: A bridge linking China and Canada.

  10. How did Japanese rural dwellers become rapidly healthier in the two decades following World War II?: Examining the diverse policy interventions that improved the population's health.

    Science.gov (United States)

    Yuasa, Motoyuki

    2017-01-01

    policies implemented in Japan as well as the integration of various policies and programs addressing livelihoods, economics, and education greatly improved the population's health in a relatively short time. These non-health initiatives intersected with a wide range of health determinants. Verifying these hypotheses in detail would help develop effective measures for international aid to poverty-stricken regions. It also encourages alternative ways through which Japan could overcome its present-day challenges such as a rapidly aging population with limited access to national schemes for social security.

  11. Risk of tuberculosis in high-rise and high density dwellings: An exploratory spatial analysis

    International Nuclear Information System (INIS)

    Lai, Poh-Chin; Low, Chien-Tat; Tse, Wing-Sze Cindy; Tsui, Chun-Kan; Lee, Herman; Hui, Pak-Kwan

    2013-01-01

    Studies have shown that socioeconomic and environmental factors have direct/indirect influences on TB. This research focuses on TB prevalence of Hong Kong in relation to its compact urban development comprising of high-rise and high-density residential dwellings caused by rapid population growth and limited land resources. It has been postulated that occupants living on higher levels of a building would benefit from better ventilation and direct sunlight and thus less likely to contract infectious respiratory diseases. On the contrary, those on lower floors amid the dense clusters of high-rises are more susceptible to TB infection because of poorer air quality from street-level pollution and lesser exposure to direct sunlight. However, there have not been published studies to support these claims. As TB continues to threaten public health in Hong Kong, this study seeks to understand the effects of housing development on TB occurrences in an urban setting. -- Highlights: ► We examined association between TB prevalence and floor levels using sky view factor. ► TB is more prevalent on lower floors and relationship manifested in taller buildings. ► Floor level and building height jointly affect sky view factors at diseased locations. ► GIS framework is effective in associating disease prevalence in an urban setting. -- Research on TB prevalence of Hong Kong and its compact urban development with public health implications for Asian cities in pursuit of high-rise urban living

  12. “Enemies of the People?” Public Health in the Era of Populist Politics; Comment on “The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy”

    Directory of Open Access Journals (Sweden)

    Martin McKee

    2017-11-01

    Full Text Available In this commentary, we review the growth of populist politics, associated with exploitation of what has been termed fake news. We explore how certain words have been used in similar contexts historically, in particular the term “enemy of the people,” especially with regard to public health. We then set out 6 principles for public health professionals faced with these situations. First, using their epidemiological skills, they can provide insights into the reasons underlying the growth of populist politics. Second using their expertise in modelling and health impact assessment, they can anticipate and warn about the consequences of populist policies. Third, they can support the institutions that are necessary for effective public health. Fourth they can reclaim the narrative, rejecting hatred and division, to promote social solidarity. Fifth, they can support fact checking and the use of evidence. Finally, they should always remember the lessons of history, and in particular, the way that public health has, on occasions, collaborated with totalitarian and genocidal regimes.

  13. "Enemies of the People?" Public Health in the Era of Populist Politics Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    McKee, Martin; Stuckler, David

    2017-04-15

    In this commentary, we review the growth of populist politics, associated with exploitation of what has been termed fake news. We explore how certain words have been used in similar contexts historically, in particular the term "enemy of the people," especially with regard to public health. We then set out 6 principles for public health professionals faced with these situations. First, using their epidemiological skills, they can provide insights into the reasons underlying the growth of populist politics. Second using their expertise in modelling and health impact assessment, they can anticipate and warn about the consequences of populist policies. Third, they can support the institutions that are necessary for effective public health. Fourth they can reclaim the narrative, rejecting hatred and division, to promote social solidarity. Fifth, they can support fact checking and the use of evidence. Finally, they should always remember the lessons of history, and in particular, the way that public health has, on occasions, collaborated with totalitarian and genocidal regimes. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  14. Factors associated with shift work disorder in nurses working with rapid-rotation schedules in Japan: the nurses' sleep health project.

    Science.gov (United States)

    Asaoka, Shoichi; Aritake, Sayaka; Komada, Yoko; Ozaki, Akiko; Odagiri, Yuko; Inoue, Shigeru; Shimomitsu, Teruichi; Inoue, Yuichi

    2013-05-01

    Workers who meet the criteria for shift work disorder (SWD) have elevated levels of risk for various health and behavioral problems. However, the impact of having SWD on shiftworkers engaged in rapid-rotation schedules is unknown. Moreover, the risk factors for the occurrence of SWD remain unclear. To clarify these issues, we conducted a questionnaire-based, cross-sectional survey on a sample of shiftworking nurses. Responses were obtained from 1202 nurses working at university hospitals in Tokyo, Japan, including 727 two-shift workers and 315 three-shift workers. The questionnaire included items relevant to age, gender, family structure, work environment, health-related quality of life (QOL), diurnal type, depressive symptoms, and SWD. Participants who reported insomnia and/or excessive sleepiness for at least 1 mo that was subjectively relevant to their shiftwork schedules were categorized as having SWD. The prevalence of SWD in the sampled shiftworking nurses was 24.4%; shiftworking nurses with SWD showed lower health-related QOL and more severe depressive symptoms, with greater rates of both actual accidents/errors and near misses, than those without SWD. The results of logistic regression analyses showed that more time spent working at night, frequent missing of nap opportunities during night work, and having an eveningness-oriented chronotype were significantly associated with SWD. The present study indicated that SWD might be associated with reduced health-related QOL and decreased work performance in shiftworking nurses on rapid-rotation schedules. The results also suggested that missing napping opportunities during night work, long nighttime working hours, and the delay of circadian rhythms are associated with the occurrence of SWD among shiftworking nurses on rapid-rotation schedules.

  15. “Stop, You’re Killing us!” An Alternative Take on Populism and Public Health; Comment on “The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy”

    Directory of Open Access Journals (Sweden)

    Ted Schrecker

    2017-11-01

    Full Text Available Ewen Speed and Russell Mannion correctly identify several contours of the challenges for health policy in what it is useful to think of as a post-democratic era. I argue that the problem for public health is not populism per se, but rather the distinctive populism of the right coupled with the failure of the left to develop compelling counternarratives. Further, defences of ‘science’ must be tempered by recognition of the unavoidably political dimensions of the (misuse of scientific findings in public policy.

  16. “Stop, you’re killing us!” An alternative take on populism and public health ; comment on “The rise of post-truth populism in pluralist liberal democracies : challenges for health policy”.

    OpenAIRE

    Schrecker, Ted

    2017-01-01

    Ewen Speed and Russell Mannion correctly identify several contours of the challenges for health policy in what it is useful to think of as a post-democratic era. I argue that the problem for public health is not populism per se, but rather the distinctive populism of the right coupled with the failure of the left to develop compelling counternarratives. Further, defences of ‘science’ must be tempered by recognition of the unavoidably political dimensions of the (mis)use of scientific findings...

  17. Statement of the ICN on the World Health Assembly technical discussions on strategies for Health for All in the face of rapid urbanization (May 1991).

    Science.gov (United States)

    1991-01-01

    National associations of nurses are represented by the International Council of Nurses (ICN). This ICN statement reaffirms a commitment to primary health care (PHC) and the WHO "Health for All" goals. Support for environmental and health programs in urban areas is reaffirmed, and attention is paid to the needs of the poorest and most disadvantaged people. Specific directions of the ICN include: 1) overcoming economic and social barriers in order to improve primary health care in cities (rural approaches which by-pass first level care may be successful in cities), 2) holding health care workers responsible for promoting health and environmental consciousness, and 3) involving and educating women for work in community health and environmental projects. Family health can be improved by improving literacy among women. In some developing countries, efforts have been directed to community mobilization in PHC programs. The results of such efforts have been positive for enhancing health in cities. On May 12th of every year, nurses celebrate International Nurses Day. The focus this year is on mental health. Another area of activity is involvement in interdisciplinary and government programs. One such collaborative project with the WHO AIDS groups in Africa is training trainers in workshops. The outcome is a well-informed health care population which can train other health workers and the public about HIV transmission and patient care. A project which has been ongoing for 4 years is overcoming the legal barriers which inhibit nurses from full participation in PHC. ICN recommends that health care workers be educated better in PHC and in intersectoral cooperation, community participation, and disease prevention. Healthy lifestyles, proper nutrition, and disease prevention need to be promoted in school health programs. Children can be taught to be responsible for their own health. Health education can benefit from the use of media such as radio and television. Interdisciplinary

  18. Situation of Linkage between Sexual and Reproductive Health and HIV-Related Policies in Islamic Republic of Iran – A Rapid Assessment in 2011–2

    Directory of Open Access Journals (Sweden)

    Ghobad Moradi

    2015-03-01

    Full Text Available The number of sexual transmission of HIV is increasing globally. Sexual and Reproductive Health (SRH issues and HIV/AIDS related problems are rooted in common grounds such as poverty, gender inequality, and social exclusion. As a result, international health organizations have suggested the integration of SRH services with HIV/AIDS services as a strategy to control HIV and to improve people’s access to SRH services. The aim of this study was to evaluate the relationship between reproductive health and HIV/AIDS services at policy-making level in Islamic Republic of Iran (IRI. This study was conducted in 2011–2 and was a rapid assessment based on guidelines provided by the World Health Organization (WHO, United Nations Programme on HIV/AIDS (UNAIDS, Family Health International Association, and some other international organizations. In this rapid assessment we used different methods such as a review of literature and documents, visiting and interviewing professionals and experts in family health and HIV/AIDS programs, and experts working in some NonGovernmental Organizations (NGOs. Overall, based on the results obtained in this study, in most cases there was not much linkage between HIV/AIDS policies and SRH policies in Iran. Since integration of HIV/AIDS services and SRH services is recommended as a model and an appropriate response to HIV epidemics worldwide, likewise to control the HIV/AIDS epidemic in Iran it is required to integrate HIV/AIDS and SRH services at all levels, particularly at the policy-making level.

  19. The development and pilot testing of a rapid assessment tool to improve local public health system capacity in Australia

    Directory of Open Access Journals (Sweden)

    Lin Vivian

    2009-11-01

    Full Text Available Abstract Background To operate effectively the public health system requires infrastructure and the capacity to act. Public health's ability to attract funding for infrastructure and capacity development would be enhanced if it was able to demonstrate what level of capacity was required to ensure a high performing system. Australia's public health activities are undertaken within a complex organizational framework that involves three levels of government and a diverse range of other organizations. The question of appropriate levels of infrastructure and capacity is critical at each level. Comparatively little is known about infrastructure and capacity at the local level. Methods In-depth interviews were conducted with senior managers in two Australian states with different frameworks for health administration. They were asked to reflect on the critical components of infrastructure and capacity required at the local level. The interviews were analyzed to identify the major themes. Workshops with public health experts explored this data further. The information generated was used to develop a tool, designed to be used by groups of organizations within discrete geographical locations to assess local public health capacity. Results Local actors in these two different systems pointed to similar areas for inclusion for the development of an instrument to map public health capacity at the local level. The tool asks respondents to consider resources, programs and the cultural environment within their organization. It also asks about the policy environment - recognizing that the broader environment within which organizations operate impacts on their capacity to act. Pilot testing of the tool pointed to some of the challenges involved in such an exercise, particularly if the tool were to be adopted as policy. Conclusion This research indicates that it is possible to develop a tool for the systematic assessment of public health capacity at the local level

  20. The development and pilot testing of a rapid assessment tool to improve local public health system capacity in Australia.

    Science.gov (United States)

    Bagley, Prue; Lin, Vivian

    2009-11-15

    To operate effectively the public health system requires infrastructure and the capacity to act. Public health's ability to attract funding for infrastructure and capacity development would be enhanced if it was able to demonstrate what level of capacity was required to ensure a high performing system. Australia's public health activities are undertaken within a complex organizational framework that involves three levels of government and a diverse range of other organizations. The question of appropriate levels of infrastructure and capacity is critical at each level. Comparatively little is known about infrastructure and capacity at the local level. In-depth interviews were conducted with senior managers in two Australian states with different frameworks for health administration. They were asked to reflect on the critical components of infrastructure and capacity required at the local level. The interviews were analyzed to identify the major themes. Workshops with public health experts explored this data further. The information generated was used to develop a tool, designed to be used by groups of organizations within discrete geographical locations to assess local public health capacity. Local actors in these two different systems pointed to similar areas for inclusion for the development of an instrument to map public health capacity at the local level. The tool asks respondents to consider resources, programs and the cultural environment within their organization. It also asks about the policy environment - recognizing that the broader environment within which organizations operate impacts on their capacity to act. Pilot testing of the tool pointed to some of the challenges involved in such an exercise, particularly if the tool were to be adopted as policy. This research indicates that it is possible to develop a tool for the systematic assessment of public health capacity at the local level. Piloting the tool revealed some concerns amongst participants

  1. A rapid method for assessing social versus independent interest in health issues: a case study of 'bird flu' and 'swine flu'.

    Science.gov (United States)

    Bentley, R Alexander; Ormerod, Paul

    2010-08-01

    Effective communication strategies regarding health issues are affected by the way in which the public obtain their knowledge, particularly whether people become interested independently, or through their social networks. This is often investigated through localized ethnography or surveys. In rapidly-evolving situations, however, there may also be a need for swift, case-specific assessment as a guide to initial strategy development. With this aim, we analyze real-time online data, provided by the new 'Google Trends' tool, concerning Internet search frequency for health-related issues. To these data we apply a simple model to characterise the effective degree of social transmission versus decisions made individually. As case examples, we explore two rapidly-evolved issues, namely the world-wide interest in avian influenza, or 'bird flu', in 2005, and in H1N1, or 'swine flu', from late April to early May 2009. The 2005 'bird flu' scare demonstrated almost pure imitation for two months initially, followed by a spike of independent decision that corresponded with an announcement by US president George Bush. For 'swine flu' in 2009, imitation was the more prevalent throughout. Overall, the results show how interest in health scares can spread primarily by social means, and that engaging more independent decisions at the population scale may require a dramatic announcement to push a populace over the 'tipping point'. Copyright 2010 Elsevier Ltd. All rights reserved.

  2. The Rise of Blog Nation

    Science.gov (United States)

    Lum, Lydia

    2005-01-01

    This article reports on the growth of blogs in popular culture, and the fact that they are becoming more widely accepted in the media industry. The rise and popularity of blogs--short for "Web logs"--are causing journalism educators to overhaul their teachings. In fact, blogging's influence varies from one university program to the next, just like…

  3. Finding Rising and Falling Words

    NARCIS (Netherlands)

    Tjong Kim Sang, E.

    2016-01-01

    We examine two different methods for finding rising words (among which neologisms) and falling words (among which archaisms) in decades of magazine texts (millions of words) and in years of tweets (billions of words): one based on correlation coefficients of relative frequencies and time, and one

  4. Can Social Inclusion Policies Reduce Health Inequalities in Sub-Saharan Africa?—A Rapid Policy Appraisal

    Science.gov (United States)

    Palha de Sousa, César A.D; Molomo, Boitumelo G

    2009-01-01

    The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries—Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate parti-cipation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating

  5. Can social inclusion policies reduce health inequalities in sub-Saharan Africa?--A rapid policy appraisal.

    Science.gov (United States)

    Rispel, Laetitia C; de Sousa, César A D Palha; Molomo, Boitumelo G

    2009-08-01

    The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries--Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate participation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating

  6. Family medicine’s rapid establishment and early leadership role in Qatar’s health care system

    Directory of Open Access Journals (Sweden)

    Verjee MA

    2013-08-01

    Full Text Available Mohamud A Verjee,1 Mariam Ali Abdulmalik,2 Michael D Fetters31Department of Medical Education, Weill Cornell Medical College in Qatar, Qatar Foundation – Education City, Doha, Qatar; 2Primary Health Care Corporation, Doha, Qatar; 3Department of Family Medicine, University of Michigan, Michigan, USAAbstract: Family medicine is a focus of health care in Qatar, and it has emerged as a primary care pioneer in the Arabian Gulf Region. Strong governmental financial support has underpinned family medicine development in the country, and through proactive health care policy, free or highly affordable health care is available to all citizens and expatriates in primary health care centers and hospitals. An Ivy League and world-class medical school, Weill Cornell Medical College in New York established a second campus in Qatar in 2001, and enrolled its first students in 2002. The inaugural class graduated in 2008, including one graduate who matched to a family medicine residency in the United States. The College has already earned a reputation for an emphasis on cultural sensitivity in the curriculum. Qatar also has a well-established family medicine residency program overseen by the Primary Health Care Corporation. Its inaugural class of family medicine residents began training in 1995 and graduated in 1999. In contrast to a trend of fluctuating interest in family medicine training in many developed countries, the demand for residency slots in Qatar has been consistently high. Since November 2012, the Accreditation Council for Graduate Medical Education-International has approved all hospital-based residency positions. Formed in 2012, the Primary Health Care Corporation is dedicated to achieving accreditation for the family medicine residency in the near future. In 2011, Qatar’s 147 family physicians comprised about 18% of the total physician workforce. Through extended hours of operation at health centers, patients have ready access for acute care

  7. "Stop, You're Killing us!" An Alternative Take on Populism and Public Health Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Schrecker, Ted

    2017-04-26

    Ewen Speed and Russell Mannion correctly identify several contours of the challenges for health policy in what it is useful to think of as a post-democratic era. I argue that the problem for public health is not populism per se, but rather the distinctive populism of the right coupled with the failure of the left to develop compelling counternarratives. Further, defences of 'science' must be tempered by recognition of the unavoidably political dimensions of the (mis)use of scientific findings in public policy. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  8. Rapid screening test for gestational diabetes: public health need, market requirement, initial product design, and experimental results

    Science.gov (United States)

    Weigl, Bernhard H.; Zwisler, Greg; Peck, Roger; Abu-Haydar, Elizabeth

    2013-03-01

    Gestational diabetes is a global epidemic where many urban areas in Southeast Asia have found prevalence rates as high as 20%, exceeding the highest prevalence rates in the developed world. It can have serious and life-threatening consequences for mothers and babies. We are developing two variants of a new, simple, low-cost rapid test for screening for gestational diabetes mellitus for use primarily in low-resource settings. The pair of assays, both semiquantitative rapid diagnostic strip tests for glycated albumin, require neither fasting nor an oral glucose challenge test. One variant is an extremely simple strip test to estimate the level of total glycated albumin in blood. The other, which is slightly more complex and expensive, is a test that determines the ratio of glycated albumin to total albumin. The screening results can be used to refer women to receive additional care during delivery to avoid birth complications as well as counseling on diet and exercise during and after pregnancy. Results with the latter test may also be used to start treatment with glucose-lowering drugs. Both assays will be read visually. We present initial results of a preliminary cost-performance comparison model evaluating the proposed test versus existing alternatives. We also evaluated user needs and schematic paper microfluidics-based designs aimed at overcoming the challenge of visualizing relatively narrow differences between normal and elevated levels of glycated albumin in blood.

  9. World medical schools: The sum also rises.

    Science.gov (United States)

    Rigby, Perry G; Gururaja, Ramnarayan P

    2017-06-01

    There is a worldwide shortage of doctors, which is true in most countries and on most continents. To enumerate the number of medical schools in the world at two different times, showing the trends and relating this to population is a beginning. The number is actually going up and has done so for some time; this has increased the supply of physicians and broadened healthcare delivery. The number to count for geographic and regional information about the medical schools relates directly to the supply of doctors. Regions were chosen from WHO and Foundation for the Advancement of International Medical Education and Research data to illustrate geographic distributions, physicians per patient and kinetics. The number of medical schools has consistently been rising around the world. However, world order is reverting to disorder, considering wars, disease and beleaguered stand-offs. None. Eight countries contain 40% of medical schools; however, several locations are rising faster than the rest. Some regions are stable, but sub-Saharan Africa, the Caribbean, South Asia and South America have increased the most in percentage recently, but not uniformly. Medical schools are related not only by geography, political boundaries and population but are concentrated in some regions. Graduate Medical Education positions appear to be short on a worldwide basis, as well as in some regions and countries. The number of medical schools is increasing worldwide and the identification of rapidly rising geographic areas is useful in exploring, planning and comparing regions. Controversy continues in a variety of locations, especially concerning Graduate Medical Education. In addition to funding, faculty candidates and accreditation, new schools are confronting a variety of choices in standards and quality, sizing and regional concerns.

  10. How Big Data, Comparative Effectiveness Research, and Rapid-Learning Health-Care Systems Can Transform Patient Care in Radiation Oncology.

    Science.gov (United States)

    Sanders, Jason C; Showalter, Timothy N

    2018-01-01

    Big data and comparative effectiveness research methodologies can be applied within the framework of a rapid-learning health-care system (RLHCS) to accelerate discovery and to help turn the dream of fully personalized medicine into a reality. We synthesize recent advances in genomics with trends in big data to provide a forward-looking perspective on the potential of new advances to usher in an era of personalized radiation therapy, with emphases on the power of RLHCS to accelerate discovery and the future of individualized radiation treatment planning.

  11. Health inequalities during 20 years of rapid economic development in China (1980-2000): a mortality analysis.

    Science.gov (United States)

    Zheng, XiaoYing; Song, XinMing; Chen, Gong; You, YunZhong; Ren, Qiang; Liu, JuFen; Zhang, Lei; Tan, LingFang; Wei, JiHong; Chen, QiuYuan

    2011-08-01

    To examine the influence of China's economic reforms on population health and regional mortality rates. Longitudinal study measuring the mortality trends and their regional variations. Using data from the three most recent national censuses, we used the model life table to adjust the mortality levels within the population for each census, and to calculate life expectancy. We then examined the variation in patterns of mortality and population health by economic status, region and gender from 1980-2000. Life expectancy varied with economic status, province, and gender. Results showed that, although life expectancy in China had increased overall since the early 1980s, regional differences became more pronounced. Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions. Differences in life expectancy are primarily related to differences in regional economic development, which in turn exacerbate regional health inequalities. Therefore, it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  12. Rapid EHR development and implementation using web and cloud-based architecture in a large home health and hospice organization.

    Science.gov (United States)

    Weaver, Charlotte A; Teenier, Pamela

    2014-01-01

    Health care organizations have long been limited to a small number of major vendors in their selection of an electronic health record (EHR) system in the national and international marketplace. These major EHR vendors have in common base systems that are decades old, are built in antiquated programming languages, use outdated server architecture, and are based on inflexible data models [1,2]. The option to upgrade their technology to keep pace with the power of new web-based architecture, programming tools and cloud servers is not easily undertaken due to large client bases, development costs and risk [3]. This paper presents the decade-long efforts of a large national provider of home health and hospice care to select an EHR product, failing that to build their own and failing that initiative to go back into the market in 2012. The decade time delay had allowed new technologies and more nimble vendors to enter the market. Partnering with a new start-up company doing web and cloud based architecture for the home health and hospice market, made it possible to build, test and implement an operational and point of care system in 264 home health locations across 40 states and three time zones in the United States. This option of "starting over" with the new web and cloud technologies may be posing a next generation of new EHR vendors that retells the Blackberry replacement by iPhone story in healthcare.

  13. Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

    Science.gov (United States)

    Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

    2006-01-01

    During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

  14. Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study.

    Science.gov (United States)

    Gershon, Robyn R M; Qureshi, Kristine A; Rubin, Marcie S; Raveis, Victoria H

    2007-01-01

    Due to the fact that most high-rise structures (i.e., >75 feet high, or eight to ten stories) are constructed with extensive and redundant fire safety features, current fire safety procedures typically only involve limited evacuation during minor to moderate fire emergencies. Therefore, full-scale evacuation of high-rise buildings is highly unusual and consequently, little is known about how readily and rapidly high-rise structures can be evacuated fully. Factors that either facilitate or inhibit the evacuation process remain under-studied. This paper presents results from the qualitative phase of the World Trade Center Evacuation Study, a three-year, five-phase study designed to improve our understanding of the individual, organizational, and environmental factors that helped or hindered evacuation from the World Trade Center (WTC) Towers 1 and 2, on 11 September 2001. Qualitative data from semi-structured, in-depth interviews and focus groups involving WTC evacuees were collected and analyzed. On the individual level, factors that affected evacuation included perception of risk (formed largely by sensory cues), preparedness training, degree of familiarity with the building, physical condition, health status, and footwear. Individual behavior also was affected by group behavior and leadership. At the organizational level, evacuation was affected by worksite preparedness planning, including the training and education of building occupants, and risk communication. The environmental conditions affecting evacuation included smoke, flames, debris, general condition and degree of crowdedness on staircases, and communication infrastructure systems (e.g., public address, landline, cellular and fire warden's telephones). Various factors at the individual, organizational, and environmental levels were identified that affected evacuation. Interventions that address the barriers to evacuation may improve the full-scale evacuation of other high-rise buildings under extreme

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

    Science.gov (United States)

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

    2007-11-01

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

  16. Health Improvements Have Been More Rapid and Widespread in China than in India: A Comparative Analysis of Health and Socioeconomic Trends from 1960 to 2011

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2012-11-01

    Full Text Available ObjectivesWe examined differences between China and India in key health and socioeconomic indicators, including life expectancy, infant and child mortality, non-communicable disease mortality from cancer, cardiovascular diseases (CVD, and diabetes, Human Development Index, Gender Inequality Index, material living conditions, and health expenditure.MethodsData on health and social indicators came from various World Health Organization and United Nations databases on global health and development statistics, including the GLOBOCAN cancer database. Mortality trends were modeled by log-linear regression, and differences in rates and relative risks were tested for statistical significance.ResultsAlthough both countries have made marked improvements, India lags behind China on several key health indicators. Differential rates of mortality decline during 1960-2009 have led to a widening health gap between China and India. In 2009 the infant mortality rate in India was 50 deaths per 1,000 live births, 3 times greater than the rate for China. Sixty-six out of 1,000 Indian children died before reaching their 5th birthday, compared with 19 children in China. China’s life expectancy is 9 years longer than India’s. Life expectancy at birth in India increased from 42 years in 1960 to 65 years in 2009, while life expectancy in China increased from 47 years in 1960 to 74 years in 2009. Major health concerns for China include high rates of stomach, liver, and lung cancer, CVD, and smoking prevalence. Globally, India ranked 90th and China 102nd in life satisfaction.Conclusions and Public Health Implications:India’s less favorable health profile compared to China is largely attributable to its higher rates of mortality from communicable diseases and maternal and perinatal conditions. Further health gains can be achieved by reducing social inequality, greater investments in human development and health services, and by prevention and control of chronic

  17. Structural violence and marginalisation. The sexual and reproductive health experiences of separated young people on the move. A rapid review with relevance to the European humanitarian crisis.

    Science.gov (United States)

    Mason-Jones, A J; Nicholson, P

    2018-05-01

    To explore the main sexual and reproductive health (SRH) issues for separated young migrants. We conducted a rapid review. The search for articles published between 2000 and June 2017 including peer-reviewed and 'grey' published literature from a range of databases including MEDLINE, AMED, Embase, ASSIA, Scopus, Web of Science and websites of international organisations (Missing Children Alliance, United Nations Population Fund (UNFPA), World Health Organization (WHO), United Nations Human Rights Council (UNHRC), Human Rights Watch, United Nations Children's Fund (UNICEF) and FBX Centre for Health and Human Rights) took place over 4 months. Themes emerging from the included studies and articles were synthesised. We found 44 articles from a range of countries of which 64% were peer-reviewed and 36% were from 'grey' literature. Structural violence and marginalisation were the key analytical themes that emerged and included young people's vulnerability to violence, unmet knowledge and service needs, barriers and stigma and poor SRH outcomes. This is the first known review to summarise the key SRH issues for separated young migrants. As Europe hosts the greatest number of separated young people in recent history, their unique SRH concerns risk being overlooked. Public health practitioners and policy makers are encouraged to challenge the gaps that exist in their services. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Social and environmental determinants of child health in Mongolia across years of rapid economic growth: 2000-2010.

    Science.gov (United States)

    Joshi, Nehal; Bolorhon, Bolormaa; Narula, Indermohan; Zhu, Shihua; Manaseki-Hollan, Semira

    2017-10-30

    To understand the effect of economic growth on health, we investigated the trend in socio-economic and regional determinants of child health in Mongolia. This Central Asian country had the fastest economic growth amongst low and middle-income countries (LMICs) from 2000 to 2010 and a healthcare system in transition. Data was from Mongolian multiple indicator cluster surveys (MICS) in 2000, 2005 and 2010. Child nutrition/growth was measured by height-for-age z-score (HAZ), weight-for-age z-score (WAZ), prevalence of stunted (HAZ economic and environmental health determinants on each outcome in each year; 2000, 2005 and 2010. T-tests were used to measure significant change in HAZ and WAZ over the decade. Overall, from 2000 to 2010, there was a significant improvement (p economic factors increased on both stunting and weight. In 2000, region was a significant determinant: children living in three provinces were significantly more likely to be stunted and less likely to be immunised than Ulaanbaatar, but this was not significant by 2010. By 2010, none of the factors were significant determinants of immunisation in children. In 2000, economic status had no effect on stunting (OR = 0.91; 95%CI:0.49,1.66), however by 2010, children in the poorest economic quintile were 4 times more likely to be stunted than the richest (OR = 0.24; 95% CI:0.13,0.45; p Economic growth in Mongolia from 2000 to 2010 resulted in an increase in the effect of social determinants of child health; whilst focused policy improved access to immunisation. Children with less educated mothers and lower household incomes should be targeted in interventions to reduce health inequity.

  19. Eliciting a policy response for the rising epidemic of overweight-obesity in India.

    Science.gov (United States)

    Khandelwal, S; Reddy, K S

    2013-11-01

    India is experiencing multiple transitions with respect to nutrition patterns, epidemiology and demography. Along with staggering childhood undernutrition, a rapid rise in chronic diseases and their risk factors including overweight-obesity (O-O), among all sections of society, is compounding India's health challenges. We present an overview of the O-O scenario (prevalence, determinants) and profile existing initiatives to address this modifiable risk factor in India. Urgent attention from all sectors, committed resources, policy support and targeted actions are warranted to combat the dual burden of malnutrition. The health systems should be reoriented and strengthened, in addition to enabling actions in other sectors, to address prevention and control of non-communicable diseases and associated risk factors like O-O. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  20. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care.

    Science.gov (United States)

    Paton, Fiona; Wright, Kath; Ayre, Nigel; Dare, Ceri; Johnson, Sonia; Lloyd-Evans, Brynmor; Simpson, Alan; Webber, Martin; Meader, Nick

    2016-01-01

    Crisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery. To evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway. Electronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies. When guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority. Systematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis. One review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support

  1. 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

  2. Development of molecular tools for rapid detection and quantification of indoor airborne molds to assess their impact on public health

    OpenAIRE

    Libert, Xavier

    2017-01-01

    Currently, contamination of the indoor environment by fungi is suggested to be a public health problem, although scientific evidence on the causal link is still limited. The monitoring of indoor airborne fungal contamination is a common tool to help understanding the link between fungi in houses and respiratory problems. Classical monitoring methods, based on cultivation and microscopic identification, have some limitations. For example, uncultivable or dead fungi (“unknown” fraction) cannot ...

  3. 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

  4. 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.

  5. Drivers of Pontocaspian Biodiversity Rise and Demise

    Science.gov (United States)

    Wesselingh, Frank; Flecker, Rachel; Wilke, Thomas; Leroy, Suzanne; Krijgsman, Wout; Stoica, Marius

    2015-04-01

    In the past two million years, the region of the Black Sea Basin, Caspian Basin and adjacent Anatolia and the Balkans were the stage of the evolution of a unique brackish water fauna, the so-called Pontocaspian fauna. The fauna is the result of assembly of genera with a Paratethyan origin and Anatolian origins during the Early Pleistocene. The rapid diversification of the Pontocaspian fauna is the result of the very dynamic nature of the lakes (the Caspian Sea is technically a lake) and seas in the region in the past two million years. In most times the various lake basins were isolated (like today), but in other episodes connections existed. Regional and global climate as well as the regional tectonic regimes were main drivers of lake basin evolution. Over the past 80 years a major biodiversity crisis is hitting the Pontocaspian faunas due to environmental degradation, pollution and invasive species. In the new EU-ETN PRIDE (Drivers of Pontocaspian Biodiversity Rise and Demise)we will be documenting the geological context of past diversifications and turnover events. We present examples of rapid turnover (biodiversity crises) in the Quaternary, assess driving forces and draw implications for the nature of the current human-mediated biodiversity crisis in the region.

  6. DESI-MS2: a rapid and innovative method for trace analysis of six cytostatic drugs in health care setting.

    Science.gov (United States)

    Fabrizi, Giovanni; Fioretti, Marzia; Rocca, Lucia Mainero; Curini, Roberta

    2012-05-01

    With the aim of establishing exposure levels for hospital personnel preparing and administering cytostatic drugs (CDs), here, we present an innovative screening method based on the use of the desorption electrospray ionization (DESI) interface coupled with a hybrid quadrupole linear ion trap mass spectrometer. A rapid, simple, and sensitive procedure was developed for the simultaneous surface monitoring of cyclophosphamide, dacarbazine, methotrexate, vincristine, gemcitabine, and cytarabine. Since analytes were in the solid state, a novel approach based on the use of passive samplers was combined with the direct analysis of wipes. A PTFE-printed glass slide was used as a passive sampler, while hydrophobic centers of Swiffer® cloths were judged extremely efficient as wipe samplers. After the sampling period, the CD collectors were directly processed with the DESI-MS system without any further treatment. MS/MS confirmatory analysis was conducted using selected reaction monitoring in the positive ion mode and detection limits were evaluated. Values were at the picograms per square millimeter levels on the passive collector and at the picograms per square centimeter levels for the wipe ones. Direct determination on solid-state samples combined with mass spectrometry selectivity provided a powerful tool so far unapplied to occupational hygiene.

  7. The Application of the Real Options Method for the Evaluation of High-Rise Construction Projects

    Science.gov (United States)

    Izotov, Aleksandr; Rostova, Olga; Dubgorn, Alissa

    2018-03-01

    The paper is devoted to the problem of evaluation of high-rise construction projects in a rapidly changing environment. The authors proposed an algorithm for constructing and embedding real options in high-rise construction projects, which makes it possible to increase the flexibility of managing multi-stage projects that have the ability to adapt to changing conditions of implementation.

  8. Is sea-level rising?

    Digital Repository Service at National Institute of Oceanography (India)

    Unnikrishnan, A.S.

    correction in the estimation of trends obtained for tide gauge records. The altimeter data permits to prepare spatial maps of sea-level rise trends. We present a map prepared for the Indian Ocean (Figure 4) north of 10oS , which shows a fairly uniform... drawn information from research papers published by the author and report of the IPCC AR5 WG1 Chapter 13: Sea Level Changes, in which the author has served as a ‘Lead Author’. Figure1 is prepared using data from the University of Colorado. Nerem, R...

  9. The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment.

    Science.gov (United States)

    McGovern, Ruth; Gilvarry, Eilish; Addison, Michelle; Alderson, Hayley; Geijer-Simpson, Emma; Lingam, Raghu; Smart, Debbie; Kaner, Eileen

    2018-01-01

    Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. We searched the international literature using rigorous systematic methods to identify studies examining parental substance misuse and adverse outcomes in children. The inclusion criteria were cross-sectional, longitudinal, case-control, and cohort studies; of children aged 0-18 years whose parents are high-risk substance misusers; reporting on their health, psychological, substance use, educational, and social outcomes. We identified 36 papers (from 33 unique studies), most of which were assessed as being of medium to high methodological quality ( N= 28). Parental nondependent substance misuse was found to be associated with adversity in children, with strong evidence of an association with externalizing difficulties ( N = 7 papers, all finding an association) and substance use ( N = 23 papers, all finding an association) in adolescents and some evidence of adverse health outcomes in early childhood ( N = 6/8 papers finding an association). There is less evidence of an association between parental substance misuse and adverse educational and social outcomes. The body of evidence was largest for parental alcohol misuse, with research examining the impact of parental illicit drug use being limited. Methodological limitations restrict our ability to make causal inference. Nonetheless, the prevalence of adverse outcomes in children whose parents are nondependent substance misusers highlights the need for practitioners to intervene with this population before a parent has developed substance dependency.

  10. Early experiences on the feasibility, acceptability, and use of malaria rapid diagnostic tests at peripheral health centres in Uganda-insights into some barriers and facilitators

    Directory of Open Access Journals (Sweden)

    Asiimwe Caroline

    2012-01-01

    Full Text Available Abstract Background While feasibility of new health technologies in well-resourced healthcare settings is extensively documented, it is largely unknown in low-resourced settings. Uganda's decision to deploy and scale up malaria rapid diagnostic tests (mRDTs in public health facilities and at the community level provides a useful entry point for documenting field experience, acceptance, and predictive variables for technology acceptance and use. These findings are important in informing implementation of new health technologies, plans, and budgets in low-resourced national disease control programmes. Methods A cross-sectional qualitative descriptive study at 21 health centres in Uganda was undertaken in 2007 to elucidate the barriers and facilitators in the introduction of mRDTs as a new diagnostic technology at lower-level health facilities. Pre-tested interview questionnaires were administered through pre-structured patient exit interviews and semi-structured health worker interviews to gain an understanding of the response to this implementation. A conceptual framework on technology acceptance and use was adapted for this study and used to prepare the questionnaires. Thematic analysis was used to generate themes from the data. Results A total of 52 of 57 health workers (92% reported a belief that a positive mRDT result was true, although only 41 of 57 (64% believed that treatment with anti-malarials was justified for every positive mRDT case. Of the same health workers, only 49% believed that a negative mRDT result was truly negative. Factors linked to these findings were related to mRDT acceptance and use, including the design and characteristics of the device, availability and quality of mRDT ancillary supplies, health worker capacity to investigate febrile cases testing negative with the device and provide appropriate treatment, availability of effective malaria treatments, reliability of the health commodity supply chain, existing national

  11. 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

    NARCIS (Netherlands)

    Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

    2017-01-01

    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

  12. 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.

    NARCIS (Netherlands)

    Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

    2017-01-01

    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

  13. Sea Level Rise Data Discovery

    Science.gov (United States)

    Quach, N.; Huang, T.; Boening, C.; Gill, K. M.

    2016-12-01

    Research related to sea level rise crosses multiple disciplines from sea ice to land hydrology. The NASA Sea Level Change Portal (SLCP) is a one-stop source for current sea level change information and data, including interactive tools for accessing and viewing regional data, a virtual dashboard of sea level indicators, and ongoing updates through a suite of editorial products that include content articles, graphics, videos, and animations. The architecture behind the SLCP makes it possible to integrate web content and data relevant to sea level change that are archived across various data centers as well as new data generated by sea level change principal investigators. The Extensible Data Gateway Environment (EDGE) is incorporated into the SLCP architecture to provide a unified platform for web content and science data discovery. EDGE is a data integration platform designed to facilitate high-performance geospatial data discovery and access with the ability to support multi-metadata standard specifications. EDGE has the capability to retrieve data from one or more sources and package the resulting sets into a single response to the requestor. With this unified endpoint, the Data Analysis Tool that is available on the SLCP can retrieve dataset and granule level metadata as well as perform geospatial search on the data. This talk focuses on the architecture that makes it possible to seamlessly integrate and enable discovery of disparate data relevant to sea level rise.

  14. Rapid surveillance for health events following a mass meningococcal B vaccine program in a university setting: A Canadian Immunization Research Network study.

    Science.gov (United States)

    Langley, J M; MacDougall, D M; Halperin, B A; Swain, A; Halperin, S A; Top, K A; McNeil, S A; MacKinnon-Cameron, D; Marty, K; De Serres, G; Dubé, E; Bettinger, J A

    2016-07-25

    An outbreak of Neisseria meningitidis serotype B infection occurred at a small residential university; public health announced an organizational vaccination program with the 4-component Meningococcal B (4CMenB) vaccine (Bexsero(TM), Novartis/GlaxoSmithKline Inc.) several days later. Since there were limited published data on reactogenicity of 4CMenB in persons over 17years of age, this study sought to conduct rapid surveillance of health events in vaccinees and controls using an online survey. Vaccine uptake was 84.7% for dose 1 (2967/3500) and 70% (2456/3500) for dose 2; the survey response rates were 33.0% (987/2967) and 18.7% (459/2456) in dose 1 and dose 1 recipients respectively, and 12% in unvaccinated individuals (63/533). Most students were 20-29years of age (vaccinees, 64.0%; controls, 74.0). A new health problem or worsening of an existing health problem was reported by 30.0% and 30.3% of vaccine recipients after doses 1 and 2 respectively; and by 15.9% of controls. These health problems interfered with the ability to perform normal activities in most vaccinees reporting these events (74.7% post dose 1; 62.6% post dose 2), and in 60% of controls. The health problems led to a health care provider visit (including emergency room) in 12.8% and 14.4% of vaccinees post doses 1 and 2, respectively and in 40% of controls. The most common reactions in vaccinees were injection site reactions (20.6% post dose 1, 16.1% post dose 20 and non-specific systemic complaints (22.6% post dose 1, 17.6% post dose 2). No hospitalizations were reported. An online surveillance program during an emergency meningococcal B vaccine program was successfully implemented, and detected higher rates of health events in vaccinees compared to controls, and high rates of both vaccinees and controls seeking medical attention. The types of adverse events reported by young adult vaccinees were consistent with those previously. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Building China’s soft power for a peaceful rise

    OpenAIRE

    Li, Xin; Worm, Verner

    2009-01-01

    With China’s rapid economic progress and steady increase in its international influence, China has gradually embarked on the soft power idea and has made developing its soft power as its national strategy. We argue that China’s soft power strategy is in accordance to Chinese Confucian culture and political value and fits well with its grand strategy of peaceful rise. Based on existing conceptualizations of soft power, we expanded the sources of soft power to six pillars: cul...

  16. A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting.

    Science.gov (United States)

    Addissie, Adamu; Davey, Gail; Newport, Melanie J; Addissie, Thomas; MacGregor, Hayley; Feleke, Yeweyenhareg; Farsides, Bobbie

    2014-05-02

    Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders

  17. Plume rise measurements at Turbigo

    Energy Technology Data Exchange (ETDEWEB)

    Anfossi, D

    1982-01-01

    This paper presents analyses of plume measurements obtained during that campaign by the ENEL ground-based Lidar. The five stacks of Turbigo Power Plant have different heights and emission parameters and their plumes usually combine, so a model for multiple sources was used to predict the plume rises. These predictions are compared with the observations. Measurements of sigma/sub v/ and sigma/sub z/ over the first 1000 m are compared with the curves derived from other observations in the Po Valley, using the no-lift balloon technique over the same range of downwind distance. Skewness and kurtosis distributions are shown, both along the vertical and the horizontal directions. In order to show the plume structure in more detail, we present two examples of Lidar-derived cross sections and the corresponding vertically and horizontally integrated concentration profiles.

  18. Superphenix set to rise again

    International Nuclear Information System (INIS)

    Dorozynski, A.

    1993-01-01

    Superphenix, France's seemingly jinxed fast breeder reactor, which has not produced a single kilowatt of energy in more than 3 years, looks set to rise up next year like the mythical bird it is named after. The $5 billion reactor, the largest fast breeder in the world, has just been given the seal of approval by a public commission ordered by the government to look at the pros and cons of restarting. It still has hoops to jump through: a safety check and approval from the ministries of industries and environment. But the consortium of French, Italian, and German power utilities that run the plant are confident they can get it running by next summer. The Superphenix that rises out of the ashes will, however, be a different species of bird from the one planned 20 years ago. The consortium plans to turn the reactor into a debreeder, one that will incinerate more plutonium than it produces and so eat into Europe's plutonium stockpile. Calculations by Superphenix staff and the Atomic Energy Commission indicate that a plutonivorous fast breeder could incinerate 15 to 25 kilograms of plutonium while producing 1 billion kilowatt-hours of electricity-scarcely enough to make a dent in the tonnes of plutonium produced by Electricite de France's reactors each year. The Superphenix consortium is anxious to get the reactor back on line. The annual cost of upkeep and repair of the idle plant and salaries for its 700 staff may reach $140 million this year, 20% more than if the plant was running normally. If restarted, the existing core and a second one ready on the shelf will generate electricity worth $1.3 billion

  19. Large Volcanic Rises on Venus

    Science.gov (United States)

    Smrekar, Suzanne E.; Kiefer, Walter S.; Stofan, Ellen R.

    1997-01-01

    Large volcanic rises on Venus have been interpreted as hotspots, or the surface manifestation of mantle upwelling, on the basis of their broad topographic rises, abundant volcanism, and large positive gravity anomalies. Hotspots offer an important opportunity to study the behavior of the lithosphere in response to mantle forces. In addition to the four previously known hotspots, Atla, Bell, Beta, and western Eistla Regiones, five new probable hotspots, Dione, central Eistla, eastern Eistla, Imdr, and Themis, have been identified in the Magellan radar, gravity and topography data. These nine regions exhibit a wider range of volcano-tectonic characteristics than previously recognized for venusian hotspots, and have been classified as rift-dominated (Atla, Beta), coronae-dominated (central and eastern Eistla, Themis), or volcano-dominated (Bell, Dione, western Eistla, Imdr). The apparent depths of compensation for these regions ranges from 65 to 260 km. New estimates of the elastic thickness, using the 90 deg and order spherical harmonic field, are 15-40 km at Bell Regio, and 25 km at western Eistla Regio. Phillips et al. find a value of 30 km at Atla Regio. Numerous models of lithospheric and mantle behavior have been proposed to interpret the gravity and topography signature of the hotspots, with most studies focusing on Atla or Beta Regiones. Convective models with Earth-like parameters result in estimates of the thickness of the thermal lithosphere of approximately 100 km. Models of stagnant lid convection or thermal thinning infer the thickness of the thermal lithosphere to be 300 km or more. Without additional constraints, any of the model fits are equally valid. The thinner thermal lithosphere estimates are most consistent with the volcanic and tectonic characteristics of the hotspots. Estimates of the thermal gradient based on estimates of the elastic thickness also support a relatively thin lithosphere (Phillips et al.). The advantage of larger estimates of

  20. Rising prices squeeze gas marketer

    Energy Technology Data Exchange (ETDEWEB)

    Lunan, D.

    2000-06-19

    Apollo Gas, a Toronto-based gas marketer, is considering options to enhance unit holder value, including sale of its 21,000 gas supply contracts, just weeks after it was forced out of the Alberta market by rising gas prices. Although the company had reported first quarter revenues of more than $15 million and earnings through that period of about $2.1 million, increases of 33 per cent and 38 per cent respectively over the same period in 1999, the company is resigned to the fact that such performance markers are not likely to be reached again in the foreseeable future, hence the decision to sell. About 95 per cent of Apollo's current transportation service volumes are matched to existing fixed-price supply contract which are due to expire in November 2000. After that, it is about 75 per cent matched for the balance of the term of its customer contracts (mostly five years). This means that the company is exposed to market prices that are likely to continue to increase. If this prediction holds true, Apollo would be forced to purchase the unhedged volumes of gas it needs to service its customers in the spot market at prices higher than prices the company is charging to its customers.

  1. Rising prices squeeze gas marketer

    International Nuclear Information System (INIS)

    Lunan, D.

    2000-01-01

    Apollo Gas, a Toronto-based gas marketer, is considering options to enhance unit holder value, including sale of its 21,000 gas supply contracts, just weeks after it was forced out of the Alberta market by rising gas prices. Although the company had reported first quarter revenues of more than $15 million and earnings through that period of about $2.1 million, increases of 33 per cent and 38 per cent respectively over the same period in 1999, the company is resigned to the fact that such performance markers are not likely to be reached again in the foreseeable future, hence the decision to sell. About 95 per cent of Apollo's current transportation service volumes are matched to existing fixed-price supply contract which are due to expire in November 2000. After that, it is about 75 per cent matched for the balance of the term of its customer contracts (mostly five years). This means that the company is exposed to market prices that are likely to continue to increase. If this prediction holds true, Apollo would be forced to purchase the unhedged volumes of gas it needs to service its customers in the spot market at prices higher than prices the company is charging to its customers

  2. Wikis and collaborative writing applications in health care: a scoping review

    NARCIS (Netherlands)

    Archambault, P.M.; Belt, T.H. van de; Grajales, F.J., 3rd; Faber, M.J.; Kuziemsky, C.E.; Gagnon, S.; Bilodeau, A.; Rioux, S.; Nelen, W.L.D.M.; Gagnon, M.P.; Turgeon, A.F.; Aubin, K.; Gold, I.; Poitras, J.; Eysenbach, G.; Kremer, J.A.M.; Legare, F.

    2013-01-01

    BACKGROUND: Collaborative writing applications (eg, wikis and Google Documents) hold the potential to improve the use of evidence in both public health and health care. The rapid rise in their use has created the need for a systematic synthesis of the evidence of their impact as knowledge

  3. State trends in premiums and deductibles, 2003-2009: how building on the Affordable Care Act will help stem the tide of rising costs and eroding benefits.

    Science.gov (United States)

    Schoen, Cathy; Stremikis, Kristof; How, Sabrina K H; Collins, Sara R

    2010-12-01

    Rapidly rising health insurance costs have strained U.S. families and employers in recent years. This issue brief examines data for all states on changes in private employer premiums and deductibles for 2003 and 2009. The analysis finds that premiums for businesses and their employees increased 41 percent across states from 2003 to 2009, while per-person deductibles jumped 77 percent in large as well as small firms. If these trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 79 percent by 2020, to more than $23,000. The authors describe how health reform offers the potential to reduce insurance cost growth while improving value and protection. If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends.

  4. The rise of colliding beams

    International Nuclear Information System (INIS)

    Richter, B.

    1992-06-01

    It is a particular pleasure for me to have this opportunity to review for you the rise of colliding beams as the standard technology for high-energy-physics accelerators. My own career in science has been intimately tied up in the transition from the old fixed-target technique to colliding-beam work. I have led a kind of double life both as a machine builder and as an experimenter, taking part in building and using the first of the colliding-beam machines, the Princeton-Stanford Electron-Electron Collider, and building the most recent advance in the technology, the Stanford Linear Collider. The beginning was in 1958, and in the 34 years since there has been a succession of both electron and proton colliders that have increased the available center-of-mass energy for hard collisions by more than a factor of 1000. For the historians here, I regret to say that very little of this story can be found in the conventional literature. Standard operating procedure for the accelerator physics community has been publication in conference proceedings, which can be obtained with some difficulty, but even more of the critical papers are in internal laboratory reports that were circulated informally and that may not even have been preserved. In this presentation I shall review what happened based on my personal experiences and what literature is available. I can speak from considerable experience on the electron colliders, for that is the topic in which I was most intimately involved. On proton colliders my perspective is more than of an observer than of a participant, but I have dug into the literature and have been close to many of the participants

  5. Community Laboratory Testing for Cryptosporidium: Multicenter Study Retesting Public Health Surveillance Stool Samples Positive for Cryptosporidium by Rapid Cartridge Assay with Direct Fluorescent Antibody Testing.

    Directory of Open Access Journals (Sweden)

    Dawn M Roellig

    Full Text Available Cryptosporidium is a common cause of sporadic diarrheal disease and outbreaks in the United States. Increasingly, immunochromatography-based rapid cartridge assays (RCAs are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Disease Control and Prevention (CDC, the Association of Public Health Laboratories (APHL, and four state health departments evaluated RCA-positive samples obtained during routine Cryptosporidium testing. All samples underwent "head to head" re-testing using both RCA and direct fluorescence assay (DFA. Community level results from three sites indicated that 54.4% (166/305 of Meridian ImmunoCard STAT! positives and 87.0% (67/77 of Remel Xpect positives were confirmed by DFA. When samples were retested by RCA at state laboratories and compared with DFA, 83.3% (155/186 of Meridian ImmunoCard STAT! positives and 95.2% (60/63 of Remel Xpect positives were confirmed. The percentage of confirmed community results varied by site: Minnesota, 39.0%; New York, 63.9%; and Wisconsin, 72.1%. The percentage of confirmed community results decreased with patient age; 12.5% of community positive tests could be confirmed by DFA for patients 60 years of age or older. The percentage of confirmed results did not differ significantly by sex, storage temperature, time between sample collection and testing, or season. Findings from this study demonstrate a lower confirmation rate of community RCA positives when compared to RCA positives identified at state laboratories. Elucidating the causes of decreased test performance in order to improve overall community laboratory performance of these tests is critical for understanding the epidemiology of cryptosporidiosis in the United States (US.

  6. Preliminary enquiry into the availability, price and quality of malaria rapid diagnostic tests in the private health sector of six malaria-endemic countries.

    Science.gov (United States)

    Albertini, A; Djalle, D; Faye, B; Gamboa, D; Luchavez, J; Mationg, M L; Mwangoka, G; Oyibo, W; Bennett, J; Incardona, S; Lee, E

    2012-02-01

    This enquiry aimed to provide a snap-shot of availability, price and quality of malaria rapid diagnostic tests (RDTs) in private health facilities at selected sites in six malaria-endemic countries in Africa, South East Asia and South America. In each study site, data collectors surveyed private healthcare facilities which were selected based on accessibility from their home institution. Using a questionnaire, information was recorded about the facility itself and the malaria RDT(s) available. Where possible, a small number of RDTs were procured and quality control tested using a standardized procedure. Of the 324 private healthcare facilities visited, 35 outlets (mainly private clinics and hospitals) were found to supply 10 different types of RDTs products. RDT prices across the six countries ranged from US$1.00 to $16.81. Five of the 14 malaria RDTs collected failed quality control testing. In the private outlets sampled, the availability of RDTs was limited. Some of the RDTs whose quality we tested demonstrated inadequate sensitivity. This presents a number of risks. Given the more widespread distribution of antimalarials currently planned for private sector facilities, parasite-based diagnosis in this sector will be essential to adhere to the WHO guidelines for effective case management of malaria. Considerable regulation and quality control are also necessary to assure the availability of accurate and reliable RDTs, as well as adequate case management and provider adherence to RDT results. Public sector engagement is likely to be essential in this process. © 2011 Blackwell Publishing Ltd.

  7. A rapid assessment of a community health worker pilot programme to improve the management of hypertension and diabetes in Emfuleni sub-district of Gauteng Province, South Africa.

    Science.gov (United States)

    Ndou, Tshipfuralo; van Zyl, Greer; Hlahane, Salamina; Goudge, Jane

    2013-01-24

    Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. Using a rapid assessment, this study examines the outcomes of a pilot CHW programme to improve the management of hypertension and diabetes in Gauteng province, South Africa. A record review compared outcomes of patients receiving home visits (n56) with a control group (n168) attending the clinic, matched, as far as possible, on age, gender, and condition. Focus group discussions and semi-structured interviews with CHWs, patients, district, clinic, and NGO staff were used to obtain descriptions of the functioning of the programme and patient experiences. Despite the greater age and co-morbidity among those in the pilot programme, the findings suggest that control of hypertension was improved by CHW home visits in comparison to usual clinic care. However, too few doctor visits, insufficient monitoring of patient outcomes by clinic staff, and a poor procurement process for supplies required by the CHWs hampered the programme's activities. The role of CHWs in the management of hypertension should be given greater consideration, with larger studies being conducted to provide more robust evidence. Adequate training, supervision, and operational support will be required to ensure success of any CHW programme.

  8. Mind the Gap: Social Media Engagement by Public Health Researchers

    OpenAIRE

    Keller, Brett; Labrique, Alain; Jain, Kriti M; Pekosz, Andrew; Levine, Orin

    2014-01-01

    Background The traditional vertical system of sharing information from sources of scientific authority passed down to the public through local health authorities and clinicians risks being made obsolete by emerging technologies that facilitate rapid horizontal information sharing. The rise of Public Health 2.0 requires professional acknowledgment that a new and substantive forum of public discourse about public health exists on social media, such as forums, blogs, Facebook, and Twitter. Objec...

  9. Statistics of EMIC Rising Tones Observed by the Van Allen Probes

    Science.gov (United States)

    Sigsbee, K. M.; Kletzing, C.; Smith, C. W.; Santolik, O.

    2017-12-01

    We will present results from an ongoing statistical study of electromagnetic ion cyclotron (EMIC) wave rising tones observed by the Van Allen Probes. Using data from the Electric and Magnetic Field Instrument Suite and Integrated Science (EMFISIS) fluxgate magnetometer, we have identified orbits by both Van Allen Probes with EMIC wave events from the start of the mission in fall 2012 through fall 2016. Orbits with EMIC wave events were further examined for evidence of rising tones. Most EMIC wave rising tones were found during H+ band EMIC wave events. In Fourier time-frequency power spectrograms of the fluxgate magnetometer data, H+ band rising tones generally took the form of triggered emission type events, where the discrete rising tone structures rapidly rise in frequency out of the main band of observed H+ EMIC waves. A smaller percentage of EMIC wave rising tone events were found in the He+ band, where rising tones may appear as discrete structures with a positive slope embedded within the main band of observed He+ EMIC waves, similar in appearance to whistler-mode chorus elements. Understanding the occurrence rate and properties of rising tone EMIC waves will provide observational context for theoretical studies indicating that EMIC waves exhibiting non-linear behavior, such as rising tones, may be more effective at scattering radiation belt electrons than ordinary EMIC waves.

  10. International School Children's Health Needs: School Nurses' Views in Europe

    Science.gov (United States)

    Hansson, Annika; Clausson, Eva; Janlov, Ann-Christin

    2012-01-01

    Rapid globalization and the integration of national economies have contributed to the sharp rise in enrollment in international schools. How does this global nomadism affect international school children and their individual health needs? This study attempts to find an answer by interviewing 10 school nurses, with varying degrees of experience in…

  11. The rise of moral cognition.

    Science.gov (United States)

    Greene, Joshua D

    2015-02-01

    The field of moral cognition has grown rapidly in recent years thanks in no small part to Cognition. Consistent with its interdisciplinary tradition, Cognition encouraged the growth of this field by supporting empirical research conducted by philosophers as well as research native to neighboring fields such as social psychology, evolutionary game theory, and behavioral economics. This research has been exceptionally diverse both in its content and methodology. I argue that this is because morality is unified at the functional level, but not at the cognitive level, much as vehicles are unified by shared function rather than shared mechanics. Research in moral cognition, then, has progressed by explaining the phenomena that we identify as "moral" (for high-level functional reasons) in terms of diverse cognitive components that are not specific to morality. In light of this, research on moral cognition may continue to flourish, not as the identification and characterization of distinctive moral processes, but as a testing ground for theories of high-level, integrative cognitive function. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Rising consumption of meat and milk in developing countries has created a new food revolution.

    Science.gov (United States)

    Delgado, Christopher L

    2003-11-01

    People in developing countries currently consume on average one-third the meat and one-quarter of the milk products per capita compared to the richer North, but this is changing rapidly. The amount of meat consumed in developing countries over the past has grown three times as much as it did in the developed countries. The Livestock Revolution is primarily driven by demand. Poor people everywhere are eating more animal products as their incomes rise above poverty level and as they become urbanized. By 2020, the share of developing countries in total world meat consumption will expand from 52% currently to 63%. By 2020, developing countries will consume 107 million metric tons (mmt) more meat and 177 mmt more milk than they did in 1996/1998, dwarfing developed-country increases of 19 mmt for meat and 32 mmt for milk. The projected increase in livestock production will require annual feed consumption of cereals to rise by nearly 300 mmt by 2020. Nonetheless, the inflation-adjusted prices of livestock and feed commodities are expected to fall marginally by 2020, compared to precipitous declines in the past 20 y. Structural change in the diets of billions of people is a primal force not easily reversed by governments. The incomes and nutrition of millions of rural poor in developing countries are improving. Yet in many cases these dietary changes also create serious environmental and health problems that require active policy involvement to prevent irreversible consequences.

  13. Mathematical modeling of the Phoenix Rising pathway.

    Directory of Open Access Journals (Sweden)

    Chad Liu

    2014-02-01

    Full Text Available Apoptosis is a tightly controlled process in mammalian cells. It is important for embryogenesis, tissue homoeostasis, and cancer treatment. Apoptosis not only induces cell death, but also leads to the release of signals that promote rapid proliferation of surrounding cells through the Phoenix Rising (PR pathway. To quantitatively understand the kinetics of interactions of different molecules in this pathway, we developed a mathematical model to simulate the effects of various changes in the PR pathway on the secretion of prostaglandin E2 (PGE2, a key factor for promoting cell proliferation. These changes include activation of caspase 3 (C3, caspase 7 (C7, and nuclear factor κB (NFκB. In addition, we simulated the effects of cyclooxygenase-2 (COX2 inhibition and C3 knockout on the level of secreted PGE2. The model predictions on PGE2 in MEF and 4T1 cells at 48 hours after 10-Gray radiation were quantitatively consistent with the experimental data in the literature. Compared to C7, the model predicted that C3 activation was more critical for PGE2 production. The model also predicted that PGE2 production could be significantly reduced when COX2 expression was blocked via either NFκB inactivation or treatment of cells with exogenous COX2 inhibitors, which led to a decrease in the rate of conversion from arachidonic acid to prostaglandin H2 in the PR pathway. In conclusion, the mathematical model developed in this study yielded new insights into the process of tissue regrowth stimulated by signals from apoptotic cells. In future studies, the model can be used for experimental data analysis and assisting development of novel strategies/drugs for improving cancer treatment or normal tissue regeneration.

  14. The Development of Innovative Online Problem-Based Learning: A Leadership Course for Leaders in European Public Health

    Science.gov (United States)

    de Jong, Nynke; Könings, Karen D.; Czabanowska, Katarzyna

    2014-01-01

    The shift to a knowledge information society has given rise to a need for lifelong learning programmes. Such programmes are especially relevant for public health professionals, whose dynamic field of practice is subject to changes due to rapidly developing technologies, evolving expectations of the labour market and new health treats. Lifelong…

  15. The Rise of Big Data in Oncology.

    Science.gov (United States)

    Fessele, Kristen L

    2018-05-01

    To describe big data and data science in the context of oncology nursing care. Peer-reviewed and lay publications. The rapid expansion of real-world evidence from sources such as the electronic health record, genomic sequencing, administrative claims and other data sources has outstripped the ability of clinicians and researchers to manually review and analyze it. To promote high-quality, high-value cancer care, big data platforms must be constructed from standardized data sources to support extraction of meaningful, comparable insights. Nurses must advocate for the use of standardized vocabularies and common data elements that represent terms and concepts that are meaningful to patient care. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Regional approaches in high-rise construction

    Science.gov (United States)

    Iconopisceva, O. G.; Proskurin, G. A.

    2018-03-01

    The evolutionary process of high-rise construction is in the article focus. The aim of the study was to create a retrospective matrix reflecting the tasks of the study such as: structuring the most iconic high-rise objects within historic boundaries. The study is based on contemporary experience of high-rise construction in different countries. The main directions and regional specifics in the field of high-rise construction as well as factors influencing the further evolution process are analyzed. The main changes in architectural stylistics, form-building, constructive solutions that focus on the principles of energy efficiency and bio positivity of "sustainable buildings", as well as the search for a new typology are noted. The most universal constructive methods and solutions that turned out to be particularly popular are generalized. The new typology of high-rises and individual approach to urban context are noted. The results of the study as a graphical scheme made it possible to represent the whole high-rise evolution. The new spatial forms of high-rises lead them to new role within the urban environments. Futuristic hyperscalable concepts take the autonomous urban space functions itself and demonstrate us how high-rises can replace multifunctional urban fabric, developing it inside their shells.

  17. 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

  18. Management of uncomplicated malaria in febrile under five-year-old children by community health workers in Madagascar: reliability of malaria rapid diagnostic tests

    Directory of Open Access Journals (Sweden)

    Ratsimbasoa Arsène

    2012-03-01

    Full Text Available Abstract Background Early diagnosis, as well as prompt and effective treatment of uncomplicated malaria, are essential components of the anti-malaria strategy in Madagascar to prevent severe malaria, reduce mortality and limit malaria transmission. The purpose of this study was to assess the performance of the malaria rapid diagnostic tests (RDTs used by community health workers (CHWs by comparing RDT results with two reference methods (microscopy and Polymerase Chain Reaction, PCR. Methods Eight CHWs in two districts, each with a different level of endemic malaria transmission, were trained to use RDTs in the management of febrile children under five years of age. RDTs were performed by CHWs in all febrile children who consulted for fever. In parallel, retrospective parasitological diagnoses were made by microscopy and PCR. The results of these different diagnostic methods were analysed to evaluate the diagnostic performance of the RDTs administered by the CHWs. The stability of the RDTs stored by CHWs was also evaluated. Results Among 190 febrile children with suspected malaria who visited CHWs between February 2009 and February 2010, 89.5% were found to be positive for malaria parasites by PCR, 51.6% were positive by microscopy and 55.8% were positive by RDT. The performance accuracy of the RDTs used by CHWs in terms of sensitivity, specificity, positive and negative predictive values was greater than 85%. Concordance between microscopy and RDT, estimated by the Kappa value was 0.83 (95% CI: 0.75-0.91. RDTs stored by CHWs for 24 months were capable of detecting Plasmodium falciparum in blood at a level of 200 parasites/μl. Conclusion Introduction of easy-to-use diagnostic tools, such as RDTs, at the community level appears to be an effective strategy for improving febrile patient management and for reducing excessive use of anti-malarial drugs.

  19. Clinician Perspectives of Barriers to Effective Implementation of a Rapid Response System in an Academic Health Centre: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    John Rihari-Thomas

    2017-08-01

    Full Text Available Background Systemic and structural issues of rapid response system (RRS models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses experience and negotiate care for deteriorating patients within the RRS. Methods Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis. Results Thirty-four participants (21 physicians and 13 registered nurses [RNs] participated in six focus groups over five weeks in 2014. Implementing the RRS in daily practice was a process of informal communication and negotiation in spite of standardised protocols. Themes highlighted several systems or organisational-level barriers to an effective RRS, including (1 responsibility is inversely proportional to clinical experience; (2 actions around system flexibility contribute to deviation from protocol; (3 misdistribution of resources leads to perceptions of inadequate staffing levels inhibiting full optimisation of the RRS; and (4 poor communication and documentation of RRS increases clinician workloads. Conclusion Implementing a RRS is complex and multifactorial, influenced by various inter- and intra-professional factors, staffing models and organisational culture. The RRS is not a static model; it is both reflexive and iterative, perpetually transforming to meet healthcare consumer and provider demands and local unit contexts and needs. Requiring more than just a strong initial implementation phase, new models of care such as a RRS demand good governance processes, ongoing support and regular evaluation and refinement. Cultural, organizational and professional factors, as well as systems-based processes, require consideration if RRSs are to achieve their intended outcomes in dynamic healthcare settings.

  20. Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training

    Directory of Open Access Journals (Sweden)

    Mulholland Kurt

    2008-08-01

    Full Text Available Abstract Background Introduction of artemisinin combination therapy (ACT has boosted interest in parasite-based malaria diagnosis, leading to increased use of rapid diagnostic tests (RDTs, particularly in rural settings where microscopy is limited. With donor support, national malaria control programmes are now procuring large quantities of RDTs. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. RDT use by volunteer community health workers (CHWs is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. This Zambia-based study was designed to determine: (i whether Zambian CHWs could prepare and interpret RDTs accurately and safely using manufacturer's instructions alone; (ii whether simple, mostly pictorial instructions (a "job aid" could raise performance to adequate levels; and (iii whether a brief training programme would produce further improvement. Methods The job aid and training programme were based on formative research with 32 CHWs in Luangwa District. The study team then recruited three groups of CHWs in Chongwe and Chibombo districts. All had experience treating malaria based on clinical diagnosis, but only six had prior RDT experience. Trained observers used structured observation checklists to score each participant's preparation of three RDTs. Each also read 10 photographs showing different test results. The first group (n = 32 was guided only by manufacturer's instructions. The second (n = 21 used only the job aid. The last (n = 26 used the job aid after receiving a three-hour training. Results Mean scores, adjusted for education, age, gender and experience, were 57% of 16 RDT steps correctly completed for group 1, 80% for group 2, and 92% for group 3. Mean percentage of test

  1. Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training.

    Science.gov (United States)

    Harvey, Steven A; Jennings, Larissa; Chinyama, Masela; Masaninga, Fred; Mulholland, Kurt; Bell, David R

    2008-08-22

    Introduction of artemisinin combination therapy (ACT) has boosted interest in parasite-based malaria diagnosis, leading to increased use of rapid diagnostic tests (RDTs), particularly in rural settings where microscopy is limited. With donor support, national malaria control programmes are now procuring large quantities of RDTs. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. RDT use by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. This Zambia-based study was designed to determine: (i) whether Zambian CHWs could prepare and interpret RDTs accurately and safely using manufacturer's instructions alone; (ii) whether simple, mostly pictorial instructions (a "job aid") could raise performance to adequate levels; and (iii) whether a brief training programme would produce further improvement. The job aid and training programme were based on formative research with 32 CHWs in Luangwa District. The study team then recruited three groups of CHWs in Chongwe and Chibombo districts. All had experience treating malaria based on clinical diagnosis, but only six had prior RDT experience. Trained observers used structured observation checklists to score each participant's preparation of three RDTs. Each also read 10 photographs showing different test results. The first group (n = 32) was guided only by manufacturer's instructions. The second (n = 21) used only the job aid. The last (n = 26) used the job aid after receiving a three-hour training. Mean scores, adjusted for education, age, gender and experience, were 57% of 16 RDT steps correctly completed for group 1, 80% for group 2, and 92% for group 3. Mean percentage of test results interpreted correctly were 54% (group 1

  2. The Rise of Mobile Technology on the Financial Sector in Zimbabwe

    OpenAIRE

    Paul Mupfiga; Tafadzwa Padare

    2017-01-01

    The emergence of technology has revolted the way that the financial industry operates and the increasing use of mobile gadgets has changed the banking system from the traditional brick and mortar building to a virtual system. The sudden rise in use and innovation of smart mobile phones, mobile personal computers, tablets and various other mobile electronic gadgets has resulted in the rise of mobile financial products. Rapid quickening innovative headways are making completely new business sug...

  3. Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

    Science.gov (United States)

    Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

    2017-07-28

    Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

  4. Rapid assessment of assignments using plagiarism detection software.

    Science.gov (United States)

    Bischoff, Whitney R; Abrego, Patricia C

    2011-01-01

    Faculty members most often use plagiarism detection software to detect portions of students' written work that have been copied and/or not attributed to their authors. The rise in plagiarism has led to a parallel rise in software products designed to detect plagiarism. Some of these products are configurable for rapid assessment and teaching, as well as for plagiarism detection.

  5. Rapid road repair vehicle

    Science.gov (United States)

    Mara, Leo M.

    1998-01-01

    Disclosed is a rapid road repair vehicle capable of moving over a surface to be repaired at near normal posted traffic speeds to scan for and find an the high rate of speed, imperfections in the pavement surface, prepare the surface imperfection for repair by air pressure and vacuum cleaning, applying a correct amount of the correct patching material to effect the repair, smooth the resulting repaired surface, and catalog the location and quality of the repairs for maintenance records of the road surface. The rapid road repair vehicle can repair surface imperfections at lower cost, improved quality, at a higher rate of speed than was was heretofor possible, with significantly reduced exposure to safety and health hazards associated with this kind of road repair activities in the past.

  6. Rising tides, rising gates: The complex ecogeomorphic response of coastal wetlands to sea-level rise and human interventions

    Science.gov (United States)

    Sandi, Steven G.; Rodríguez, José F.; Saintilan, Neil; Riccardi, Gerardo; Saco, Patricia M.

    2018-04-01

    Coastal wetlands are vulnerable to submergence due to sea-level rise, as shown by predictions of up to 80% of global wetland loss by the end of the century. Coastal wetlands with mixed mangrove-saltmarsh vegetation are particularly vulnerable because sea-level rise can promote mangrove encroachment on saltmarsh, reducing overall wetland biodiversity. Here we use an ecogeomorphic framework that incorporates hydrodynamic effects, mangrove-saltmarsh dynamics, and soil accretion processes to assess the effects of control structures on wetland evolution. Migration and accretion patterns of mangrove and saltmarsh are heavily dependent on topography and control structures. We find that current management practices that incorporate a fixed gate for the control of mangrove encroachment are useful initially, but soon become ineffective due to sea-level rise. Raising the gate, to counteract the effects of sea level rise and promote suitable hydrodynamic conditions, excludes mangrove and maintains saltmarsh over the entire simulation period of 100 years

  7. Coastal sea level rise with warming above 2 °C.

    Science.gov (United States)

    Jevrejeva, Svetlana; Jackson, Luke P; Riva, Riccardo E M; Grinsted, Aslak; Moore, John C

    2016-11-22

    Two degrees of global warming above the preindustrial level is widely suggested as an appropriate threshold beyond which climate change risks become unacceptably high. This "2 °C" threshold is likely to be reached between 2040 and 2050 for both Representative Concentration Pathway (RCP) 8.5 and 4.5. Resulting sea level rises will not be globally uniform, due to ocean dynamical processes and changes in gravity associated with water mass redistribution. Here we provide probabilistic sea level rise projections for the global coastline with warming above the 2 °C goal. By 2040, with a 2 °C warming under the RCP8.5 scenario, more than 90% of coastal areas will experience sea level rise exceeding the global estimate of 0.2 m, with up to 0.4 m expected along the Atlantic coast of North America and Norway. With a 5 °C rise by 2100, sea level will rise rapidly, reaching 0.9 m (median), and 80% of the coastline will exceed the global sea level rise at the 95th percentile upper limit of 1.8 m. Under RCP8.5, by 2100, New York may expect rises of 1.09 m, Guangzhou may expect rises of 0.91 m, and Lagos may expect rises of 0.90 m, with the 95th percentile upper limit of 2.24 m, 1.93 m, and 1.92 m, respectively. The coastal communities of rapidly expanding cities in the developing world, and vulnerable tropical coastal ecosystems, will have a very limited time after midcentury to adapt to sea level rises unprecedented since the dawn of the Bronze Age.

  8. A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food.

    Science.gov (United States)

    Abubakar, I; Irvine, L; Aldus, C F; Wyatt, G M; Fordham, R; Schelenz, S; Shepstone, L; Howe, A; Peck, M; Hunter, P R

    2007-09-01

    To determine the diagnostic accuracy of tests for the rapid diagnosis of bacterial food poisoning in clinical and public health practice and to estimate the cost-effectiveness of these assays in a hypothetical population in order to inform policy on the use of these tests. Studies evaluating diagnostic accuracy of rapid tests were retrieved using electronic databases and handsearching reference lists and key journals. Hospital laboratories and test manufacturers were contacted for cost data, and clinicians involved in the care of patients with food poisoning were invited to discuss the conclusions of this review using the nominal group technique. A systematic review of the current medical literature on assays used for the rapid diagnosis of bacterial food poisoning was carried out. Specific organisms under review were Salmonella, Campylobacter, Escherichia coli O157, Staphylococcus aureus, Clostridium perfringens and Bacillus cereus. Data extraction was undertaken using standardised data extraction forms. Where a sufficient number of studies evaluating comparable tests were identified, meta-analysis was performed. A decision analytic model was developed, using effectiveness data from the review and cost data from hospitals and manufacturers, which contributed to an assessment of the cost-effectiveness of rapid tests in a hypothetical UK population. Finally, diagnostic accuracy and cost-effectiveness results were presented to a focus group of GPs, microbiologists and consultants in communicable disease control, to assess professional opinion on the use of rapid tests in the diagnosis of food poisoning. Good test performance levels were observed with rapid test methods, especially for polymerase chain reaction (PCR) assays. The estimated levels of diagnostic accuracy using the area under the curve of the summary receiver operating characteristic curve was very high. Indeed, although traditional culture is the natural reference test to use for comparative statistical

  9. Fiber Reinforced Concrete (FRC) for High Rise Construction: Case Studies

    Science.gov (United States)

    Gharehbaghi, Koorosh; Chenery, Rhea

    2017-12-01

    Due to its material element, Fiber Reinforced Concrete (FRC) could be stronger than traditional Concrete. This is due to FRC internal material compounds and elements. Furthermore, FRC can also significantly improve flexural strength when compared to traditional Concrete. This improvement in flexural strength can be varied depending on the actual fibers used. Although not new, FRC is gradually gaining popularity in the construction industry, in particular for high rise structures. This is due to its flexural strength, especially for high seismic zones, as it will provide a better solution then reinforced Concrete. The main aim of this paper is to investigate the structural importance of FRC for the high rise construction. Although there has been numerous studies and literature in justifying the FRC for general construction; this paper will consider its use specifically for high rise construction. Moreover, this paper will closely investigate eight case studies from Australian and United States as a part of the FRC validation for high rise construction. In doing so, this paper will examine their Structural Health Monitoring (SHM) to determine their overall structural performance.

  10. Rising utilization of inpatient pediatric asthma pathways.

    Science.gov (United States)

    Kaiser, Sunitha V; Rodean, Jonathan; Bekmezian, Arpi; Hall, Matt; Shah, Samir S; Mahant, Sanjay; Parikh, Kavita; Morse, Rustin; Puls, Henry; Cabana, Michael D

    2018-02-01

    Clinical pathways are detailed care plans that operationalize evidence-based guidelines into an accessible format for health providers. Their goal is to link evidence to practice to optimize patient outcomes and delivery efficiency. It is unknown to what extent inpatient pediatric asthma pathways are being utilized nationally. (1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network. (2) Compare characteristics of hospitals with and without pathways. We conducted a descriptive, cross-sectional, survey study of hospitals in the Pediatric Research in Inpatient Settings Network (75% children's hospitals, 25% community hospitals). Our survey determined if each hospital used a pathway and pathway characteristics (e.g. pathway elements, implementation methods). Hospitals with and without pathways were compared using Chi-square tests (categorical variables) and Student's t-tests (continuous variables). Surveys were distributed to 3-5 potential participants from each hospital and 302 (74%) participants responded, representing 86% (106/123) of surveyed hospitals. From 2005-2015, the proportion of hospitals utilizing inpatient asthma pathways increased from 27% to 86%. We found variation in pathway elements, implementation strategies, electronic medical record integration, and compliance monitoring across hospitals. Hospitals with pathways had larger inpatient pediatric programs [mean 12.1 versus 6.1 full-time equivalents, p = 0.04] and were more commonly free-standing children's hospitals (52% versus 23%, p = 0.05). From 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. We found variation in many aspects of pathway design and implementation. Future studies should determine optimal implementation strategies to better support hospital-level efforts in improving pediatric asthma care and outcomes.

  11. Climate Adaptation and Sea Level Rise

    Science.gov (United States)

    EPA supports the development and maintenance of water utility infrastructure across the country. Included in this effort is helping the nation’s water utilities anticipate, plan for, and adapt to risks from flooding, sea level rise, and storm surge.

  12. Rapid mask prototyping for microfluidics.

    Science.gov (United States)

    Maisonneuve, B G C; Honegger, T; Cordeiro, J; Lecarme, O; Thiry, T; Fuard, D; Berton, K; Picard, E; Zelsmann, M; Peyrade, D

    2016-03-01

    With the rise of microfluidics for the past decade, there has come an ever more pressing need for a low-cost and rapid prototyping technology, especially for research and education purposes. In this article, we report a rapid prototyping process of chromed masks for various microfluidic applications. The process takes place out of a clean room, uses a commercially available video-projector, and can be completed in less than half an hour. We quantify the ranges of fields of view and of resolutions accessible through this video-projection system and report the fabrication of critical microfluidic components (junctions, straight channels, and curved channels). To exemplify the process, three common devices are produced using this method: a droplet generation device, a gradient generation device, and a neuro-engineering oriented device. The neuro-engineering oriented device is a compartmentalized microfluidic chip, and therefore, required the production and the precise alignment of two different masks.

  13. Interconnect rise time in superconducting integrating circuits

    International Nuclear Information System (INIS)

    Preis, D.; Shlager, K.

    1988-01-01

    The influence of resistive losses on the voltage rise time of an integrated-circuit interconnection is reported. A distribution-circuit model is used to present the interconnect. Numerous parametric curves are presented based on numerical evaluation of the exact analytical expression for the model's transient response. For the superconducting case in which the series resistance of the interconnect approaches zero, the step-response rise time is longer but signal strength increases significantly

  14. Rapid detection of health-care-associated bloodstream infection in critical care using multipathogen real-time polymerase chain reaction technology: a diagnostic accuracy study and systematic review.

    Science.gov (United States)

    Warhurst, Geoffrey; Dunn, Graham; Chadwick, Paul; Blackwood, Bronagh; McAuley, Daniel; Perkins, Gavin D; McMullan, Ronan; Gates, Simon; Bentley, Andrew; Young, Duncan; Carlson, Gordon L; Dark, Paul

    2015-05-01

    antibiotic exposure. SeptiFast real-time PCR, when compared with culture-proven bloodstream infection at species/genus level, had better specificity (85.8%, 95% CI 83.3% to 88.1%) than sensitivity (50%, 95% CI 39.1% to 60.8%). When compared with pooled diagnostic metrics derived from our systematic review, our clinical study revealed lower test accuracy of SeptiFast real-time PCR, mainly as a result of low diagnostic sensitivity. There was a low prevalence of BC-proven pathogens in these patients (9.2%, 95% CI 7.4% to 11.2%) such that the post-test probabilities of both a positive (26.3%, 95% CI 19.8% to 33.7%) and a negative SeptiFast test (5.6%, 95% CI 4.1% to 7.4%) indicate the potential limitations of this technology in the diagnosis of bloodstream infection. However, latent class analysis indicates that BC has a low sensitivity, questioning its relevance as a reference test in this setting. Using this analysis approach, the sensitivity of the SeptiFast test was low but also appeared significantly better than BC. Blood samples identified as positive by either culture or SeptiFast real-time PCR were associated with a high probability (> 95%) of infection, indicating higher diagnostic rule-in utility than was apparent using conventional analyses of diagnostic accuracy. SeptiFast real-time PCR on blood samples may have rapid rule-in utility for the diagnosis of health-care-associated bloodstream infection but the lack of sensitivity is a significant limiting factor. Innovations aimed at improved diagnostic sensitivity of real-time PCR in this setting are urgently required. Future work recommendations include technology developments to improve the efficiency of pathogen DNA extraction and the capacity to detect a much broader range of pathogens and drug resistance genes and the application of new statistical approaches able to more reliably assess test performance in situation where the reference standard (e.g. blood culture in the setting of high antimicrobial use) is

  15. Opportunities and challenges within urban health and sustainable development

    DEFF Research Database (Denmark)

    Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen

    2017-01-01

    The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...

  16. Travel health prevention.

    Science.gov (United States)

    Korzeniewski, Krzysztof

    All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

  17. Rapidity-density patterns for events in a stochastic-field multiparticle theory

    International Nuclear Information System (INIS)

    Arnold, R.C.

    1976-02-01

    Typical-event rapidity distributions expected at energies of a few TeV are calculated in a stochastic-field multiparticle production theory. Short range rapidity correlations with characteristics of a Van der Waals fluid give rise to ''domain'' patterns in rapidity density, which have the appearance of clusters separated by rapidity gaps

  18. Large Country-Lot Quality Assurance Sampling : A New Method for Rapid Monitoring and Evaluation of Health, Nutrition and Population Programs at Sub-National Levels

    OpenAIRE

    Hedt, Bethany L.; Olives, Casey; Pagano, Marcello; Valadez, Joseph J.

    2008-01-01

    Sampling theory facilitates development of economical, effective and rapid measurement of a population. While national policy maker value survey results measuring indicators representative of a large area (a country, state or province), measurement in smaller areas produces information useful for managers at the local level. It is often not possible to disaggregate a national survey to obt...

  19. Strategic advantages of high-rise construction

    Directory of Open Access Journals (Sweden)

    Yaskova Natalya

    2018-01-01

    Full Text Available Traditional methods to assess the competitiveness of different types of real estate in the context of huge changes of new technological way of life don’t provide building solutions that would be correct from a strategic perspective. There are many challenges due to changes in the consumers’ behavior in the housing area. A multiplicity of life models, a variety of opportunities and priorities, traditions and new trends in construction should be assessed in terms of prospective benefits in the environment of the emerging new world order. At the same time, the mane discourse of high-rise construction mainly relates to its design features, technical innovations, and architectural accents. We need to clarify the criteria for economic evaluation of high-rise construction in order to provide decisions with clear and quantifiable contexts. The suggested approach to assessing the strategic advantage of high-rise construction and the prospects for capitalization of high-rise buildings poses new challenges for the economy to identify adequate quantitative assessment methods of the high-rise buildings economic efficiency, taking into account all stages of their life cycle.

  20. Strategic advantages of high-rise construction

    Science.gov (United States)

    Yaskova, Natalya

    2018-03-01

    Traditional methods to assess the competitiveness of different types of real estate in the context of huge changes of new technological way of life don't provide building solutions that would be correct from a strategic perspective. There are many challenges due to changes in the consumers' behavior in the housing area. A multiplicity of life models, a variety of opportunities and priorities, traditions and new trends in construction should be assessed in terms of prospective benefits in the environment of the emerging new world order. At the same time, the mane discourse of high-rise construction mainly relates to its design features, technical innovations, and architectural accents. We need to clarify the criteria for economic evaluation of high-rise construction in order to provide decisions with clear and quantifiable contexts. The suggested approach to assessing the strategic advantage of high-rise construction and the prospects for capitalization of high-rise buildings poses new challenges for the economy to identify adequate quantitative assessment methods of the high-rise buildings economic efficiency, taking into account all stages of their life cycle.

  1. Climate change, sea-level rise, and conservation: keeping island biodiversity afloat.

    Science.gov (United States)

    Courchamp, Franck; Hoffmann, Benjamin D; Russell, James C; Leclerc, Camille; Bellard, Céline

    2014-03-01

    Island conservation programs have been spectacularly successful over the past five decades, yet they generally do not account for impacts of climate change. Here, we argue that the full spectrum of climate change, especially sea-level rise and loss of suitable climatic conditions, should be rapidly integrated into island biodiversity research and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Rapid shallow breathing

    Science.gov (United States)

    Tachypnea; Breathing - rapid and shallow; Fast shallow breathing; Respiratory rate - rapid and shallow ... Shallow, rapid breathing has many possible medical causes, including: Asthma Blood clot in an artery in the ...

  3. Reconciling projections of the Antarctic contribution to sea level rise

    Science.gov (United States)

    Edwards, Tamsin; Holden, Philip; Edwards, Neil; Wernecke, Andreas

    2017-04-01

    Two recent studies of the Antarctic contribution to sea level rise this century had best estimates that differed by an order of magnitude (around 10 cm and 1 m by 2100). The first, Ritz et al. (2015), used a model calibrated with satellite data, giving a 5% probability of exceeding 30cm by 2100 for sea level rise due to Antarctic instability. The second, DeConto and Pollard (2016), used a model evaluated with reconstructions of palaeo-sea level. They did not estimate probabilities, but using a simple assumption here about the distribution shape gives up to a 5% chance of Antarctic contribution exceeding 2.3 m this century with total sea level rise approaching 3 m. If robust, this would have very substantial implications for global adaptation to climate change. How are we to make sense of this apparent inconsistency? How much is down to the data - does the past tell us we will face widespread and rapid Antarctic ice losses in the future? How much is due to the mechanism of rapid ice loss ('cliff failure') proposed in the latter paper, or other parameterisation choices in these low resolution models (GRISLI and PISM, respectively)? How much is due to choices made in the ensemble design and calibration? How do these projections compare with high resolution, grounding line resolving models such as BISICLES? Could we reduce the huge uncertainties in the palaeo-study? Emulation provides a powerful tool for understanding these questions and reconciling the projections. By describing the three numerical ice sheet models with statistical models, we can re-analyse the ensembles and re-do the calibrations under a common statistical framework. This reduces uncertainty in the PISM study because it allows massive sampling of the parameter space, which reduces the sensitivity to reconstructed palaeo-sea level values and also narrows the probability intervals because the simple assumption about distribution shape above is no longer needed. We present reconciled probabilistic

  4. Beam Induced Pressure Rise at RHIC

    CERN Document Server

    Zhang, S Y; Bai, Mei; Blaskiewicz, Michael; Cameron, Peter; Drees, Angelika; Fischer, Wolfram; Gullotta, Justin; He, Ping; Hseuh Hsiao Chaun; Huang, Haixin; Iriso, Ubaldo; Lee, Roger C; Litvinenko, Vladimir N; MacKay, William W; Nicoletti, Tony; Oerter, Brian; Peggs, Steve; Pilat, Fulvia Caterina; Ptitsyn, Vadim; Roser, Thomas; Satogata, Todd; Smart, Loralie; Snydstrup, Louis; Thieberger, Peter; Trbojevic, Dejan; Wang, Lanfa; Wei, Jie; Zeno, Keith

    2005-01-01

    Beam induced pressure rise in RHIC warm sections is currently one of the machine intensity and luminosity limits. This pressure rise is mainly due to electron cloud effects. The RHIC warm section electron cloud is associated with longer bunch spacings compared with other machines, and is distributed non-uniformly around the ring. In addition to the countermeasures for normal electron cloud, such as the NEG coated pipe, solenoids, beam scrubbing, bunch gaps, and larger bunch spacing, other studies and beam tests toward the understanding and counteracting RHIC warm electron cloud are of interest. These include the ion desorption studies and the test of anti-grazing ridges. For high bunch intensities and the shortest bunch spacings, pressure rises at certain locations in the cryogenic region have been observed during the past two runs. Beam studies are planned for the current 2005 run and the results will be reported.

  5. Rising Long-term Interest Rates

    DEFF Research Database (Denmark)

    Hallett, Andrew Hughes

    Rather than chronicle recent developments in European long-term interest rates as such, this paper assesses the impact of increases in those interest rates on economic performance and inflation. That puts us in a position to evaluate the economic pressures for further rises in those rates......, the first question posed in this assignment, and the scope for overshooting (the second question), and then make some illustrative predictions of future interest rates in the euro area. We find a wide range of effects from rising interest rates, mostly small and mostly negative, focused on investment...... till the emerging European recovery is on a firmer basis and capable of overcoming increases in the cost of borrowing and shrinking fiscal space. There is also an implication that worries about rising/overshooting interest rates often reflect the fact that inflation risks are unequally distributed...

  6. Influence of the Gilbert damping constant on the flux rise time of write head fields

    International Nuclear Information System (INIS)

    Ertl, Othmar; Schrefl, Thomas; Suess, Dieter; Schabes, Manfred E.

    2005-01-01

    Magnetic recording at fast data rates requires write heads with rapid rise times of the magnetic flux during the write process. We present three-dimensional (3D) micromagnetic finite element calculations of an entire ring head including 3D coil geometry during the writing of magnetic bits in granular media. The simulations demonstrate how input current profiles translate into magnetization processes in the head and which in turn generate the write head field. The flux rise time significantly depends on the Gilbert damping constant of the head material. Low damping causes incoherent magnetization processes, leading to long rise times and low head fields. High damping leads to coherent reversal of the magnetization in the head. As a consequence, the gap region can be quickly saturated which causes high head fields with short rise times

  7. The 1988 coal outlook: steadily rising consumption

    Energy Technology Data Exchange (ETDEWEB)

    Soras, C.G.; Stodden, J.R.

    1987-12-01

    Total coal use - domestic and foreign - will reach 910 million tons in 1988, an expansion of 1.3% from an estimated 898 million tons in 1987. The overall rise in consumption will add to inventory needs. Moreover, lower interest rates cut effective carrying costs and further encourage the holding of coal stocks by users. The results will be a gain in inventories of 3.5 tons by the end of 1988. As a result of all these factors, coal production is anticipated to rise by 11.6 million tons, or 1.2%, which projects firm markets in a time of relatively soft economic conditions in the USA. 2 tabs.

  8. The Rise of the Professional Field of Medicine in Sweden

    Directory of Open Access Journals (Sweden)

    Carina Carlhed

    2013-12-01

    Full Text Available This article is an analysis of conditions enabling the rise of the professional field of medicine in Sweden. The analysis is based mainly on second- ary data, while the use of primary data is restricted to official statistics. Primarily, it aims to study the conditions promoting professionalization in medicine. Important exogenous conditions were derived from early emerging nation state administration structures concerning policy and governance of public health, as well as a delegated supervision of professional health activities to the medical profession and the organization of a public national health care system. Professionalization strategies such as social organization of the medical profession and their use of a variety of legitimizing resources as tools for jurisdictional claims are considered as endogenous conditions. Broadly, the analysis shows a close relationship between the growth of professionalization in the field of medicine and the development of state prosperity in the Swedish welfare state. 

  9. [The rise and fall of an physician entrepreneur].

    Science.gov (United States)

    Dörnyei, Sándor

    2002-01-01

    In 1927 one of the most up-to-date and most beautiful sanatoriums of Central Europe was built on the hills of Buda by László Jakab MD (1875-1940), who at that time had already run - since 1909 - a successful health-resort, the rather popular and successful "Liget-Sanatorium": following a period of expansion and flourishing, his enterprise bankrupted. (The building itself was renewed after World War II - it served first as a hospital for tuberculosis patients and later as a university clinic for internal medicine.) This article tells the story of an entrepreneur physician, including his former and more successful attempts to run a health-care business, and gives detailed account of the rise and fall of private health-resort in prewar Hungary.

  10. Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

    Science.gov (United States)

    McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

    2017-08-04

    Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

  11. The Rise of the Digital Public Library

    Science.gov (United States)

    McKendrick, Joseph

    2012-01-01

    There is a growing shift to digital offerings among public libraries. Libraries increasingly are fulfilling roles as technology hubs for their communities, with high demand for technology and career development training resources. Ebooks and other digital materials are on the rise, while print is being scaled back. More libraries are turning to…

  12. Rise time spectroscopy in cadmium telluride detectors

    International Nuclear Information System (INIS)

    Scharager, Claude; Siffert, Paul; Carnet, Bernard; Le Meur, Roger.

    1980-11-01

    By a simultaneous analysis of rise time and pulse amplitude distributions of the signals issued from various cadmium telluride detectors, it is possible to obtain informations about surface and bulk trapping, field distribution within the detectors, as well as charge collection and transport properties. These investigations have been performed on both pure and chlorine doped and materials for various surfaces preparation conditions [fr

  13. How oxygen gave rise to eukaryotic sex

    NARCIS (Netherlands)

    Hörandl, Elvira; Speijer, Dave

    2018-01-01

    9years ago. The large amount of ROS coming from a bacterial endosymbiont gave rise to DNA damage and vast increases in host genome mutation rates. Eukaryogenesis and chromosome evolution represent adaptations to oxidative stress. The host, an archaeon, most probably already had repair mechanisms

  14. Rising Political Consciousness: Transformational Learning in Malaysia.

    Science.gov (United States)

    Kamis, Mazalan; Muhamad, Mazanah

    As part of a larger study (not discussed) ten educated Malaysian citizens were interviewed to find whether their rising political consciousness, over a ten year period (1988-1999), indicated that their transformation was influenced by their culture. The subjects were between 35-45 years old, married, with an average of four children. All were…

  15. Can income redistribution help changing rising inequality?

    NARCIS (Netherlands)

    Salverda, W.

    2014-01-01

    In this article compares the rise in inequality concerning net household incomes in a number of European countries and Canada, the USA and Australia. Two important factors are used to explain this worrying trend: a growing of unequal market incomes and/or a declining redistribution of income through

  16. Why does a spinning egg rise?

    Science.gov (United States)

    Cross, Rod

    2018-03-01

    Experimental and theoretical results are presented concerning the rise of a spinning egg. It was found that an egg rises quickly while it is sliding and then more slowly when it starts rolling. The angular momentum of the egg projected in the XZ plane changed in the same direction as the friction torque, as expected, by rotating away from the vertical Z axis. The latter result does not explain the rise. However, an even larger effect arises from the Y component of the angular momentum vector. As the egg rises, the egg rotates about the Y axis, an effect that is closely analogous to rotation of the egg about the Z axis. Both effects can be described in terms of precession about the respective axes. Steady precession about the Z axis arises from the normal reaction force in the Z direction, while precession about the Y axis arises from the friction force in the Y direction. Precession about the Z axis ceases if the normal reaction force decreases to zero, and precession about the Y axis ceases if the friction force decreases to zero.

  17. Sea level rise : A literature survey

    NARCIS (Netherlands)

    Oude Essink, G.H.P.

    1992-01-01

    In order to assess the impact of sea level rise on Water Management, it is useful to understand the mechanisrns that determine the level of the sea. In this study, a literature survey is executed to analyze these mechanisms. Climate plays a centra! role in these mechanisms, Climate mainly changes

  18. Tube temperature rise limits: Boiling considerations

    Energy Technology Data Exchange (ETDEWEB)

    Vanderwater, R.G.

    1952-03-26

    A revision of tube power limits based on boiling considerations was presented earlier. The limits were given on a basis of tube power versus header pressure. However, for convenience of operation, the limits have been converted from tube power to permissible water temperature rise. The permissible {triangle}t`s water are given in this document.

  19. The economic consequences of oil price rise

    International Nuclear Information System (INIS)

    Lescaroux, Francois

    2006-05-01

    The author discusses the possible consequences of oil barrel price rise. First, he discusses the main results of analysis's which have been performed for thirty years regarding the impact of oil price on economical activity. He proposes interpretations of these studies and of their conclusions, and tries to draw lessons regarding effects which can be expected from the recent evolutions of energy markets

  20. The Enigma of Mercury's Northern Rise

    Science.gov (United States)

    James, P. B.

    2018-05-01

    Various aspects of the "northern rise" make it hard to explain: Its composition and chronology don't stand out from its surroundings, it seems to have uplifted late, and it has a huge gravity anomaly. We'll discuss the possible formation mechanisms.

  1. [The rise and development of general dentistry in China].

    Science.gov (United States)

    Liu, Hongchen

    2016-02-01

    General dentistry is an important part of the dental medicine and general dentists and general dentistry form the basis of clinical dental medicine. China's general dentistry has a long history, which started as an independent specialist in the 1990s. At present, the Chinese general dental medicine has received more and more attention as an independent profession. General dental medical model has been rapidly developed in the general hospital department of dentistry, private practice and community dentistry institutions, dental specialist hospitals and so on. In this paper, we will review the rise and development of China's general dentistry, and report its theoretical characteristics, institutional framework, academic progress, member development report, and look forward to its development in the future.

  2. Public Health and Mental Health Implications of Environmentally Induced Forced Migration.

    Science.gov (United States)

    Shultz, James M; Rechkemmer, Andreas; Rai, Abha; McManus, Katherine T

    2018-03-28

    ABSTRACTClimate change is increasingly forcing population displacement, better described by the phrase environmentally induced forced migration. Rising global temperatures, rising sea levels, increasing frequency and severity of natural disasters, and progressive depletion of life-sustaining resources are among the drivers that stimulate population mobility. Projections forecast that current trends will rapidly accelerate. This will lead to an estimated 200 million climate migrants by the year 2050 and create dangerous tipping points for public health and security.Among the public health consequences of climate change, environmentally induced forced migration is one of the harshest and most harmful outcomes, always involving a multiplicity of profound resource and social losses and frequently exposing migrants to trauma and violence. Therefore, one particular aspect of forced migration, the effects of population displacement on mental health and psychosocial functioning, deserves dedicated focus. Multiple case examples are provided to elucidate this theme. (Disaster Med Public Health Preparedness. 2018;page 1 of 7).

  3. Rapid Decline in Radio Flux Density of Nova Sco 2015 Followed By Rise at High Frequencies

    Science.gov (United States)

    Linford, J.; Nelson, T.; Chomiuk, L.; Sokoloski, J.; Mukai, K.; Finzell, T.; Weston, J.; Rupen, M.; Mioduszewski, A.

    2015-03-01

    We are monitoring Nova Sco 2015 (PNV J17032620-3504140) at radio wavelengths with the Karl G. Jansky Very Large Array (VLA). We have observations from three epochs: 2015 Feb 14.5, 2015 Feb 18.5-19.5, and 2015 Feb 24.6-Mar 01.5.

  4. Populism : polder and prairie: The rapid rise and fall of Pim Fortuyn

    NARCIS (Netherlands)

    Lucardie, Anthonie

    2004-01-01

    DUTCH POLITICS HAS A REPUTATION FOR DULLNESS AND STABILITY. But that was hardly the case in 2002, when Pim Fortuyn entered politics. His party came in second in that year's election, although it had not yet been formally founded and Fortuyn himself had been murdered a few days earlier. Yet it now

  5. The International Experience with Privatization: Its Rapid Rise, Partial Fall and Uncertain Future

    Directory of Open Access Journals (Sweden)

    John Nellis

    2012-01-01

    Full Text Available From a triumphant high in the late 20th century, esteem for privatization has significantly declined, post-2000. Politicians and businesspeople alike now take a more balanced view of its effectiveness, recognizing that privatization must happen in a supportive institutional and policy framework if it is to live up to its potential. They have also come to share a better understanding of the sociopolitical consequences – especially with regard to public opinion – that privatization inevitably brings with it. This paper provides a comprehensive examination of this 21st century global shift in perception, with an emphasis on developing and emerging markets. Through a rich trove of case studies, it accounts for why privatization has slowed, analyzing current and past trends from a variety of sectors worldwide. It also offers a thorough analysis of privatization’s effects on economies, societies and the political process, while giving ample space to critics’ views. Although powerbrokers now tend to view privatization warily, there is good reason to believe that, due to the impact of the ongoing global economic crisis on government budgets, its day will come again. This paper, with its impressively detailed and wide-ranging grasp of the phenomenon, is essential reading for academics, policymakers and economists –the individuals who must grapple with privatization’s implications when that day arrives.

  6. Early to Rise (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-08-20

    Getting enough sleep is important for the development of young bodies and minds. This podcast discusses the topic of delayed start times for high school and middle schools.  Created: 8/20/2015 by MMWR.   Date Released: 8/20/2015.

  7. Early to Rise (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-08-20

    Getting enough sleep is important for the development of young bodies and minds. Unfortunately, because of early school start times, many students aren’t getting enough rest before classes. In this podcast, Dr. Anne Wheaton discusses the importance of students getting enough sleep before school.  Created: 8/20/2015 by MMWR.   Date Released: 8/20/2015.

  8. Early to Rise (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Getting enough sleep is important for the development of young bodies and minds. Unfortunately, because of early school start times, many students aren’t getting enough rest before classes. In this podcast, Dr. Anne Wheaton discusses the importance of students getting enough sleep before school.

  9. Comparing Young Adults to Older Adults in E-Cigarette Perceptions and Motivations for Use: Implications for Health Communication

    Science.gov (United States)

    Cooper, Maria; Harrell, Melissa B.; Perry, Cheryl L.

    2016-01-01

    Purpose: Use of electronic cigarettes ("e-cigarettes" is rapidly rising, and is especially prevalent among young adults. A better understanding of e-cigarette perceptions and motivations for use is needed to inform health communication and educational efforts. This study aims to explore these aspects of use with a focus on comparing…

  10. Rise of oil prices and energy policy

    International Nuclear Information System (INIS)

    2005-01-01

    This document reprints the talk of the press conference given by D. de Villepin, French prime minister, on August 16, 2005 about the alarming rise of oil prices. In his talk, the prime minister explains the reasons of the crisis (increase of worldwide consumption, political tensions in the Middle East..) and presents the strategy and main trends of the French energy policy: re-launching of energy investments in petroleum refining capacities and in the nuclear domain (new generation of power plants), development of renewable energy sources and in particular biofuels, re-launching of the energy saving policy thanks to financial incentives and to the development of clean vehicles and mass transportation systems. In a second part, the prime minister presents his policy of retro-cession of petroleum tax profits to low income workers, and of charge abatement to professionals having an occupation strongly penalized by the rise of oil prices (truckers, farmers, fishermen, taxi drivers). (J.S.)

  11. Compton suppression through rise-time analysis

    International Nuclear Information System (INIS)

    Selvi, S.; Celiktas, C.

    2007-01-01

    We studied Compton suppression for 60 Co and 137 Cs radioisotopes using a signal selection criterion based on contrasting the fall time of the signals composing the photo peak with those composing the Compton continuum. The fall time criterion is employed by using the pulse shape analysis observing the change in the fall times of the gamma-ray pulses. This change is determined by measuring the changes in the rise times related to the fall time of the scintillator and the timing signals related to the fall time of the input signals. We showed that Compton continuum suppression is achieved best via the precise timing adjustment of an analog rise-time analyzer connected to a NaI(Tl) scintillation spectrometer

  12. Microstructure of rapidly solidified materials

    Science.gov (United States)

    Jones, H.

    1984-07-01

    The basic features of rapidly solidified microstructures are described and differences arising from alternative processing strategies are discussed. The possibility of achieving substantial undercooling prior to solidification in processes such as quench atomization and chill block melt spinning can give rise to striking microstructural transitions even when external heat extraction is nominally Newtonian. The increased opportunity in laser and electron beam surface melting for epitaxial growth on the parent solid at an accelerating rate, however, does not exclude the formation of nonequilibrium phases since the required undercooling can be locally attained at the solidification front which is itself advancing at a sufficiently high velocity. The effects of fluid flow indicated particularly in melt spinning and surface melting are additional to the transformational and heat flow considerations that form the present basis for interpretation of such microstructural effects.

  13. The rise of precarious employment in Germany

    OpenAIRE

    Brady, David; Biegert, Thomas

    2017-01-01

    Long considered the classic coordinated market economy featuring employment security and relatively little employment precarity, the German labor market has undergone profound changes in recent decades. We assess the evidence for a rise in precarious employment in Germany from 1984 to 2013. Using data from the German Socio-Economic Panel (SOEP) through the Luxembourg Income Study, we examine low-wage employment, working poverty, and temporary employment. We also analyze changes in the demogra...

  14. Rising sea levels and small island states

    International Nuclear Information System (INIS)

    Leatherman, S.P.

    1994-01-01

    A review is given of the problems small island nations face with respect to sea level rise caused by global warming. Many small island nations are very vulnerable to sea level rise. Particularly at risk are coral reef atolls, which are generally quite small, lie within three metres of current sea levels, and have no land at higher elevations to relocate populations and economic activity. Volcanic islands in the Pacific have high ground, but it is largely rugged, high relief and soil-poor. The most vulnerable islands are those that consist entirely of atolls and reef islands, such as Kirabai, Maldives, Tokelau and Tuvalu. Small island states, which by themselves have little power or influence in world affairs, have banded together to form the Strategic Alliance of Small Island States (AOSIS). This alliance had grown to include 42 states by the time of the 1992 U.N. Earth Summit. Although the greenhouse effect is mainly caused by industrial nations, developing countries will suffer the most from it. Choices of response strategy will depend on environmental, economic and social factors. Most small island nations do not have the resources to fight sea level rise in the way that the Dutch have. Retreat can occur as a gradual process or as catastrophic abandonment. Prohibiting construction close to the water's edge is a good approach. Sea level histories for each island state should be compiled and updated, island geomorphology and settlement patterns should be surveyed to determine risk areas, storm regimes should be determined, and information on coastal impacts of sea level rise should be disseminated to the public

  15. Rugged calorimeter with a fast rise time

    International Nuclear Information System (INIS)

    McMurtry, W.M.; Dolce, S.R.

    1980-01-01

    An intrinsic 1-mil-thick gold foil calorimeter has been developed which rises to 95% of the energy deposited in less than 2 microseconds. This calorimeter is very rugged, and can withstand rough handling without damage. The time constant is long, in the millisecond range, because of its unique construction. Use of this calorimeter has produced 100% data recovery, and agreement with true deposition to less than 10%

  16. CHINA RISE SYNDROMES? DRAFTING NATIONAL SCHOOLS OF INTERNATIONAL RELATIONS IN ASIA

    Directory of Open Access Journals (Sweden)

    Chih-Yu Shih

    2014-01-01

    Full Text Available The rise of China is now one of the primary issues in IR literature. However, this development promotes also changes in the structure of the discipline itself, as it fosters self-reflection in the rapid expansion of the Chinese IR school. Moreover, the quest for Chinese theory of IR provokes other Asian countries to conceptualize their place in the world, in order not to be intellectually submerged by the rising neighbour. This theorizing is enlightened by the national traditions of thinking about international politics, largely overseen in the West. This trend promotes genuine liberalization of the discipline. 

  17. Calcium supplementation and cardiovascular risk: A rising concern.

    Science.gov (United States)

    Tankeu, Aurel T; Ndip Agbor, Valirie; Noubiap, Jean Jacques

    2017-06-01

    Over the past decade, the number of individuals taking calcium supplementation worldwide has been on the rise, especially with the emergence of new pharmaceutical companies specialized in the marketing of dietary supplements; with calcium supplementation being their main business axis. This is mostly because of the established role of calcium in the prevention and treatment of osteoporosis and, to a lesser extent, its role in the prevention of fractures. Recently, a rising body of evidence on the adverse effect of calcium supplementation on nonskeletal, especially cardiovascular, health has been a cause for concern. In fact, a significant number of studies have reported an association between calcium supplementation and adverse cardiovascular events, even though high dietary calcium intake was shown to have a protective effect. The mechanism by which calcium supplementation could cause a cardiovascular event was still unclear until a recent study published in the Journal of the American Heart Association. Combining this recent finding with available data associating calcium supplementation with cardiovascular mortality and all-cause mortality, we call on the need for an evidence-based approach to calcium supplementation, while stressing on the safety of dietary calcium intake over the former on cardiovascular health. ©2017 Wiley Periodicals, Inc.

  18. Early rising children are more active than late risers

    Directory of Open Access Journals (Sweden)

    Jun Kohyama

    2007-01-01

    Full Text Available Jun KohyamaDepartment of Pediatrics, Tokyo Kita Shakai Hoken Hospital, Tokyo, JapanBackground: A low level of physical activity impacts mental as well as physical health. This study investigated the daily lifestyle habits that affect physical activity in young children.Methods: The relationship between physical activity, assessed by means of a Mini-Mitter Actiwatch device, and observed daily lifestyle habits was analyzed for 204 children, aged 12 to 40 months (average: 22.6 months, for whom 6-consecutive-day data from both the Actiwatch and sleep log were obtained.Results: An older age, male gender, and early waking time showed significant positive correlations with physical activity level. Multiple regression analysis revealed that these three variables were significant predictors of physical activity.Conclusion: Promoting an early rising time is suggested to be an important element of cultivating good health in young children.Keywords: physical activity, children, actigraphy, morning light

  19. Risks of rapid decline renal function in patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Yi-Jing; Sheen; Wayne; HH; Sheu

    2014-01-01

    Progressive rising population of diabetes and related nephropathy, namely, diabetic kidney disease and associated end stage renal disease has become a major global public health issue. Results of observational studies indicate that most diabetic kidney disease progresses over decades; however, certain diabetes patients display a rapid decline in renal function, which may lead to renal failure within months. Although the definition of rapid renal function decline remained speculative, in general,it is defined by the decrease of estimated glomerular filtration rate(e GFR) in absolute rate of loss or percent change. Based on the Kidney Disease: Improving Global Outcomes 2012 clinical practice guidelines, a rapid decline in renal function is defined as a sustained declinein e GFR of > 5 m L/min per 1.73 m2 per year. It has been reported that potential factors contributing to a rapid decline in renal function include ethnic/genetic and demographic causes, smoking habits, increased glycated hemoglobin levels, obesity, albuminuria, anemia, low serum magnesium levels, high serum phosphate levels, vitamin D deficiency, elevated systolic blood pressure, pulse pressure, brachial-ankle pulse wave velocity values, retinopathy, and cardiac autonomic neuropathy. This article reviews current literatures in this area and provides insight on the early detection of diabetic subjects who are at risk of a rapid decline in renal function in order to develop a more aggressive approach to renal and cardiovascular protection.

  20. Rapid population growth.

    Science.gov (United States)

    1972-01-01

    At the current rate of population growth, world population by 2000 is expected to reach 7 billion or more, with developing countries accounting for some 5.4 billion, and economically advanced nations accounting for 1.6 billion. 'Population explosion' is the result of falling mortality rates and continuing high birth rates. Many European countries, and Japan, have already completed what is termed as demographic transition, that is, birth rates have fallen to below 20 births per 1000 population, death rates to 10/1000 population, and annual growth rates are 1% or less; annual growth rates for less developed countries ranged from 2 to 3.5%. Less developed countries can be divided into 3 groups: 1) countries with both high birth and death rates; 2) countries with high birth rates and low death rates; and 3) countries with intermediate and declining birth rates and low death rates. Rapid population growth has serious economic consequences. It encourages inequities in income distribution; it limits rate of growth of gross national product by holding down level of savings and capital investments; it exerts pressure on agricultural production and land; and it creates unemployment problems. In addition, the quality of education for increasing number of chidren is adversely affected, as high proportions of children reduce the amount that can be spent for the education of each child out of the educational budget; the cost and adequacy of health and welfare services are affected in a similar way. Other serious consequences of rapid population growth are maternal death and illness, and physical and mental retardation of children of very poor families. It is very urgent that over a billion births be prevented in the next 30 years to reduce annual population growth rate from the current 2% to 1% per year.

  1. A Survey on Use of Rapid Tests and Tuberculosis Diagnostic Practices by Primary Health Care Providers in South Africa: Implications for the Development of New Point-of-Care Tests.

    Directory of Open Access Journals (Sweden)

    Malika Davids

    Full Text Available Effective infectious disease control requires early diagnosis and treatment initiation. Point-of-care testing offers rapid turn-around-times, facilitating same day clinical management decisions. To maximize the benefits of such POC testing programs, we need to understand how rapid tests are used in everyday clinical practice.In this cross-sectional survey study, 400 primary healthcare providers in two cities in South Africa were interviewed on their use of rapid tests in general, and tuberculosis diagnostic practices, between September 2012 and June 2013. Public healthcare facilities were selected using probability-sampling techniques and private healthcare providers were randomly selected from the Health Professional Council of South Africa list. To ascertain differences between the two healthcare sectors 2-sample z-tests were used to compare sample proportions.The numbers of providers interviewed were equally distributed between the public (n = 200 and private sector (n = 200. The most frequently reported tests in the private sector include blood pressure (99.5%, glucose finger prick (89.5% and urine dipstick (38.5%; and in the public sector were pregnancy (100%, urine dipstick (100%, blood pressure (100%, glucose finger prick (99% and HIV rapid test (98%. The majority of TB testing occurs in the public sector, where significantly more providers prefer Xpert MTB/RIF assay, the designated clinical TB diagnostic tool by the national TB program, as compared to the private sector (87% versus 71%, p-value >0.0001. Challenges with regard to TB diagnosis included the long laboratory turn-around-time, difficulty in obtaining sputum samples and lost results. All providers indicated that a new POC test for TB should be rapid and cheap, have good sensitivity and specificity, ease of sample acquisition, detect drug-resistance and work in HIV-infected persons.The existing centralized laboratory services, poor quality assurance, and lack of staff capacity

  2. Rapid learning: a breakthrough agenda.

    Science.gov (United States)

    Etheredge, Lynn M

    2014-07-01

    A "rapid-learning health system" was proposed in a 2007 thematic issue of Health Affairs. The system was envisioned as one that uses evidence-based medicine to quickly determine the best possible treatments for patients. It does so by drawing on electronic health records and the power of big data to access large volumes of information from a variety of sources at high speed. The foundation for a rapid-learning health system was laid during 2007-13 by workshops, policy papers, large public investments in databases and research programs, and developing learning systems. Challenges now include implementing a new clinical research system with several hundred million patients, modernizing clinical trials and registries, devising and funding research on national priorities, and analyzing genetic and other factors that influence diseases and responses to treatment. Next steps also should aim to improve comparative effectiveness research; build on investments in health information technology to standardize handling of genetic information and support information exchange through apps and software modules; and develop new tools, data, and information for clinical decision support. Further advances will require commitment, leadership, and public-private and global collaboration. Project HOPE—The People-to-People Health Foundation, Inc.

  3. [Application of precursor ion scanning method in rapid screening of illegally added phosphodiesterase-5 inhibitors and their unknown derivatives in Chinese traditional patent medicines and health foods].

    Science.gov (United States)

    Sun, Jing; Cao, Ling; Feng, Youlong; Tan, Li

    2014-11-01

    The compounds with similar structure often have similar pharmacological activities. So it is a trend for illegal addition that new derivatives of effective drugs are synthesized to avoid the statutory test. This bring challenges to crack down on illegal addition behavior, however, modified derivatives usually have similar product ions, which allow for precursor ion scanning. In this work, precursor ion scanning mode of a triple quadrupole mass spectrometer was first applied to screen illegally added drugs in complex matrix such as Chinese traditional patent medicines and healthy foods. Phosphodiesterase-5 inhibitors were used as experimental examples. Through the analysis of the structure and mass spectrum characteristics of the compounds, phosphodiesterase-5 inhibitors were classified, and their common product ions were screened by full scan of product ions of typical compounds. Then high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method with precursor ion scanning mode was established based on the optimization of MS parameters. The effect of mass parameters and the choice of fragment ions were also studied. The method was applied to determine actual samples and further refined. The results demonstrated that this method can meet the need of rapid screening of unknown derivatives of phosphodiesterase-5 inhibitors in complex matrix, and prevent unknown derivatives undetected. This method shows advantages in sensitivity, specificity and efficiency, and is worth to be further investigated.

  4. The economic consequences of rising oil prices

    International Nuclear Information System (INIS)

    Lescaroux, F.

    2006-05-01

    In the context of rising crude oil prices observed in the last five years, this paper attempts to shed light on the possible consequences of a costlier barrel. We shall begin with a brief presentation of the main results of the analyses conducted in the last 30 years, concerning the impact of energy prices on economic activity. We shall then interpret these analyses and their conclusions, and try to draw a number of lessons about the anticipated effects of the recent trend in energy prices. (author)

  5. Sea level rise in the Arctic Ocean

    OpenAIRE

    Proshutinsky, Andrey; Pavlov, Vladimir; Bourke, Robert H.

    2001-01-01

    The article of record as published may be found at http://dx.doi.org/10.1029/2000GL012760 About 60 tide-gauge stations in the Kara, Laptev, East-Siberian and Chukchi Seas have recorded the sea level change from the 1950s through 1990s. Over this 40-year period, most of these stations show a significant sea level rise (SLR). In light of global change, this SLR could be a manifestation of warming in the Artic coupled with a decrease of sea ice extent, warming of Atlantic waters, changes in...

  6. Diagnostics from three rising submillimeter bursts

    International Nuclear Information System (INIS)

    Zhou, Ai-Hua; Li, Jian-Ping; Wang, Xin-Dong

    2016-01-01

    In this paper we investigate three novel rising submillimeter (THz) bursts that occurred sequentially in Super Active Region NOAA 10486. The average rising rate of the flux density above 200 GHz is only 20 sfu GHz −1 (corresponding to spectral index α of 1.6) for the THz spectral components of the 2003 October 28 and November 4 bursts, but it attained values of 235 sfu GHz −1 (α = 4.8) in the 2003 November 2 burst. The steeply rising THz spectrum can be produced by a population of highly relativistic electrons with a low-energy cutoff of 1 MeV, but it only requires a low-energy cutoff of 30 keV for the two slowly rising THz bursts, via gyrosynchrotron (GS) radiation based on our numerical simulations of burst spectra in the magnetic dipole field case. The electron density variation is much larger in the THz source than in the microwave (MW) source. It is interesting that the THz source radius decreased by 20%–50% during the decay phase for the three events, but the MW source increased by 28% for the 2003 November 2 event. In the paper we will present a formula that can be used to calculate the energy released by ultrarelativistic electrons, taking the relativistic correction into account for the first time. We find that the energy released by energetic electrons in the THz source exceeds that in the MW source due to the strong GS radiation loss in the THz range, although the modeled THz source area is 3–4 orders smaller than the modeled MW source one. The total energies released by energetic electrons via the GS radiation in radio sources are estimated, respectively, to be 5.2 × 10 33 , 3.9 × 10 33 and 3.7 × 10 32 erg for the October 28, November 2 and 4 bursts, which are 131, 76 and 4 times as large as the thermal energies of 2.9 × 10 31 , 2.1 × 10 31 and 5.2 × 10 31 erg estimated from soft X-ray GOES observations. (paper)

  7. Hydrodynamics in a swarm of rising bubbles

    International Nuclear Information System (INIS)

    Riboux, G.

    2007-04-01

    In many applications, bubbles are used to agitate a liquid in order to enhance mixing and transfer. This work is devoted to the study of the hydrodynamics in a stable bubble column. Experimentally, we have determined the properties of the velocity fluctuations inside and behind a homogeneous swarm of rising bubbles for different bubble sizes and gas volume fractions α: self-similarity in α 0,4 , spectrum in k -3 and integral length scale controlled by buoyancy. Numerically, we have reproduced these properties by means of large-scale simulations, the bubbles being modeled by volume-forces. This confirms that the dynamics is controlled by wake interactions. (author)

  8. The rising home birth trend in America

    OpenAIRE

    Nurlan Aliyev; Chastidy Roldan; Bulent Cakmak

    2015-01-01

    In recent years home birth rates are increased in the whole world, mainly in the United States (US). Between 2004-2012, non-hospital births increasing rate is 89% in the US. Home birth increased especially among the married, non-Hispanic, over 35 years of age, multipar and singleton pregnancies. However the high rate of cesarean birth did not increase in recent years in the US, now it has been stable at 32%. It is reported that the stability of the cesarean rate is related to rising rate of h...

  9. Nuclear costs: why do they keep rising?

    International Nuclear Information System (INIS)

    MacKerron, Gordon

    1992-01-01

    Nuclear power has performed badly in recent years as a new investment everywhere except Japan and Korea. This has mainly been for orthodox financial and economic reasons. Among the factors contributing to this loss of competitiveness, persistently rising real capital costs have been particularly important. While the nuclear industry has believed it could control and reduce capital costs, increasing regulatory stringency has made designs more complex and correspondingly more costly. These cost increasing factors have far outweighed traditional cost reducing factors (like learning). The only lasting way to meet increasing stringency in safety at acceptably low cost is likely to be the development of new and simpler reactor designs. (author)

  10. Low-rise shear wall failure modes

    International Nuclear Information System (INIS)

    Farrar, C.R.; Hashimoto, P.S.; Reed, J.W.

    1991-01-01

    A summary of the data that are available concerning the structural response of low-rise shear walls is presented. This data will be used to address two failure modes associated with the shear wall structures. First, data concerning the seismic capacity of the shear walls with emphasis on excessive deformations that can cause equipment failure are examined. Second, data concerning the dynamic properties of shear walls (stiffness and damping) that are necessary to compute the seismic inputs to attached equipment are summarized. This case addresses the failure of equipment when the structure remains functional. 23 refs

  11. Rapid report on methodology: does loss to follow-up in a cohort study bias associations between early life factors and lifestyle-related health outcomes?

    DEFF Research Database (Denmark)

    Osler, Merete; Kriegbaum, Margit; Christensen, Ulla

    2008-01-01

    -life characteristics and these two health outcomes were calculated in the entire cohort and among responders, and the effect of non-response was described by a Relative Odd Ratio (ROR=OR(responders)/OR(entire cohort)). RESULTS: A low response rate at age 50 years was related to having a single mother at birth, low...... educational attainment at age 18, and low cognitive function at ages 12 and 18. The risk of alcohol overuse and tobacco-related diseases was also highest among non-responders. However, the associations between early-life characteristics and the outcomes were nearly the same in responders as in the entire...

  12. Organic matter content and particle size modifications in mangrove sediments as responses to sea level rise.

    Science.gov (United States)

    Sanders, Christian J; Smoak, Joseph M; Waters, Mathew N; Sanders, Luciana M; Brandini, Nilva; Patchineelam, Sambasiva R

    2012-06-01

    Mangroves sediments contain large reservoirs of organic material (OM) as mangrove ecosystems produce large quantities and rapidly burial OM. Sediment accumulation rates of approximately 2.0 mm year(-1), based on (210)Pb(ex) dating, were estimated at the margin of two well-developed mangrove forest in southern Brazil. Regional data point to a relative sea level (RSL) rise of up to ∼4.0 mm year(-1). This RSL rise in turn, may directly influence the origin and quantity of organic matter (OM) deposited along mangrove sediments. Lithostratigraphic changes show that sand deposition is replacing the mud (<63 μm) fraction and OM content is decreasing in successively younger sediments. Sediment accumulation in coastal areas that are not keeping pace with sea level rise is potentially conducive to the observed shifts in particle size and OM content. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Gas-rise velocities during kicks

    Energy Technology Data Exchange (ETDEWEB)

    White, D.B. (Sedco Forex (FR))

    1991-12-01

    This paper reports on experiments to examine gas migration rates in drilling muds that were performed in a 15-m-long, 200-mm-ID inclinable flow loop where air injection simulates gas entry during a kick. These tests were conducted using a xanthum gum (a common polymer used in drilling fluids) solution to simulate drilling muds as the liquid phase and air as the gas phase. This work represents a significant extension of existing correlations for gas/liquid flows in large pipe diameters with non- Newtonian fluids. Bubbles rise faster in drilling muds than in water despite the increased viscosity. This surprising result is caused by the change in the flow regime, with large slug-type bubbles forming at lower void fractions. The gas velocity is independent of void fraction, thus simplifying flow modeling. Results show that a gas influx will rise faster in a well than previously believed. This has major implications for kick simulation, with gas arriving at the surface earlier than would be expected and the gas outflow rate being higher than would have been predicted. A model of the two-phase gas flow in drilling mud, including the results of this work, has been incorporated into the joint Schlumberger Cambridge Research (SCR)/BP Intl. kick model.

  14. Rising synchrony controls western North American ecosystems

    Science.gov (United States)

    Black, Bryan A.; van der Sleen, Peter; Di Lorenzo, Emanuele; Griffin, Daniel; Sydeman, William J.; Dunham, Jason B.; Rykaczewski, Ryan R.; Garcia-Reyes, Marisol; Safeeq, Mohammad; Arismendi, Ivan; Bograd, Steven J.

    2018-01-01

    Along the western margin of North America, the winter expression of the North Pacific High (NPH) strongly influences interannual variability in coastal upwelling, storm track position, precipitation, and river discharge. Coherence among these factors induces covariance among physical and biological processes across adjacent marine and terrestrial ecosystems. Here, we show that over the past century the degree and spatial extent of this covariance (synchrony) has substantially increased, and is coincident with rising variance in the winter NPH. Furthermore, centuries‐long blue oak (Quercus douglasii) growth chronologies sensitive to the winter NPH provide robust evidence that modern levels of synchrony are among the highest observed in the context of the last 250 years. These trends may ultimately be linked to changing impacts of the El Niño Southern Oscillation on mid‐latitude ecosystems of North America. Such a rise in synchrony may destabilize ecosystems, expose populations to higher risks of extinction, and is thus a concern given the broad biological relevance of winter climate to biological systems.

  15. Rising incidence of Merkel cell carcinoma

    DEFF Research Database (Denmark)

    Lyhne, Dorte; Lock-Andersen, Jørgen; Dahlstrøm, Karin

    2011-01-01

    Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investi......Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark......, and to investigate the incidence. We suggest guidelines for treatment. First we reviewed the medical records of 51 patients diagnosed with MCC from 1995 until 2006 in eastern Denmark. The nation-wide incidence of MCC was extracted from the Danish Cancer Registry for the calculations for the period 1986-2003. We...... reviwed published papers about MCC based on a MEDLINE search. Fourteen of the 51 patients developed recurrence, and 37 (73%) died during the study period. Mean follow-up was 13 months (range 1-122). A total of 153 patients were identified in the Danish Cancer Registry, and showed that incidence rates had...

  16. Colliding Epidemics and the Rise of Cryptococcosis

    Directory of Open Access Journals (Sweden)

    Christina C. Chang

    2015-12-01

    Full Text Available Discovered more than 100 years ago as a human pathogen, the Cryptococcus neoformans–Cryptococcus gattii (C. neoformans–C. gattii complex has seen a large global resurgence in its association with clinical disease in the last 30 years. First isolated in fermenting peach juice, and identified as a human pathogen in 1894 in a patient with bone lesions, this environmental pathogen has now found niches in soil, trees, birds, and domestic pets. Cryptococcosis is well recognized as an opportunistic infection and was first noted to be associated with reticuloendothelial cancers in the 1950s. Since then, advances in transplant immunology, medical science and surgical techniques have led to increasing numbers of solid organ transplantations (SOT and hematological stem cell transplantations being performed, and the use of biological immunotherapeutics in increasingly high-risk and older individuals, have contributed to the further rise in cryptococcosis. Globally, however, the major driver for revivification of cryptococcosis is undoubtedly the HIV epidemic, particularly in Sub-Saharan Africa where access to care and antiretroviral therapy remains limited and advanced immunodeficiency, poverty and malnutrition remains the norm. As a zoonotic disease, environmental outbreaks of both human and animal cryptococcosis have been reported, possibly driven by climate change. This is best exemplified by the resurgence of C. gattii infection in Vancouver Island, Canada, and the Pacific Northwest of the United States since 1999. Here we describe how the colliding epidemics of HIV, transplantation and immunologics, climate change and migration have contributed to the rise of cryptococcosis.

  17. Residential High-Rise Clusters as a Contemporary Planning Challenge in Manama

    Directory of Open Access Journals (Sweden)

    Florian Wiedmann

    2015-08-01

    Full Text Available This paper analyzes the different roots of current residential high-rise clusters emerging in new city districts along the coast of Bahrain’s capital city Manama, and the resulting urban planning and design challenges. Since the local real-estate markets were liberalized in Bahrain in 2003, the population grew rapidly to more than one million inhabitants. Consequently, the housing demand increased rapidly due to extensive immigration. Many residential developments were however constructed for the upper spectrum of the real-estate market, due to speculative tendencies causing a raise in land value. The emerging high-rise clusters are developed along the various waterfronts of Manama on newly reclaimed land. This paper explores the spatial consequences of the recent boom in construction boom and the various challenges for architects and urban planners to enhance urban qualities.

  18. Limits on the adaptability of coastal marshes to rising sea level

    Science.gov (United States)

    Kirwan, Matthew L.; Guntenspergen, Glenn R.; D'Alpaos, Andrea; Morris, James T.; Mudd, Simon M.; Temmerman, Stijn

    2010-01-01

    Assumptions of a static landscape inspire predictions that about half of the world's coastal wetlands will submerge during this century in response to sea-level acceleration. In contrast, we use simulations from five numerical models to quantify the conditions under which ecogeomorphic feedbacks allow coastal wetlands to adapt to projected changes in sea level. In contrast to previous sea-level assessments, we find that non-linear feedbacks among inundation, plant growth, organic matter accretion, and sediment deposition, allow marshes to survive conservative projections of sea-level rise where suspended sediment concentrations are greater than ~20 mg/L. Under scenarios of more rapid sea-level rise (e.g., those that include ice sheet melting), marshes will likely submerge near the end of the 21st century. Our results emphasize that in areas of rapid geomorphic change, predicting the response of ecosystems to climate change requires consideration of the ability of biological processes to modify their physical environment.

  19. Rising natural gas prices : impacts on U.S. industries

    International Nuclear Information System (INIS)

    Henry, D.

    2005-01-01

    The impact of rising natural gas prices on the United States economy and domestic industries was examined in this PowerPoint presentation. Industry comments were solicited on the effects of natural gas prices on their business performance from 2000 to 2004 in order to collect data, and macroeconomic impacts were determined through the use of an inter-industry model. Results of the survey and subsequent model suggested that in 2000 and 2001, real gross domestic product (GDP) growth was depressed by 0.2 per cent because of higher natural gas prices. Between 2000 and 2004, the civilian workforce was lower by 489,000 jobs. It was determined that nitrogenous fertilizer manufacturing was the most gas intensive industry. The results indicated that higher natural gas prices were an additional burden on manufacturing industries, and that the economic performance of natural gas intensive industries was poor between 2000-2004. However, it was just as poor between 1997-2000, when gas prices were relatively low and stable. Natural gas intensive industries passed along price increases in their products to their downstream consumers. Despite job losses, wages in natural gas intensive industries were higher and grew faster than in the rest of the manufacturing industry in the 2000-2004 period. Although capital expenditures declined between 2000 to 2004, they declined more rapidly in the 1997-2000 period. There has been no evidence of a decline in international competitiveness of natural gas intensive industries. It was concluded that rising natural gas prices have had a significant impact on the growth of the economy and workforce. tabs., figs

  20. Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya.

    Science.gov (United States)

    Diggle, Emma; Asgary, Ramin; Gore-Langton, Georgia; Nahashon, Erupe; Mungai, James; Harrison, Rebecca; Abagira, Abdullahi; Eves, Katie; Grigoryan, Zoya; Soti, David; Juma, Elizabeth; Allan, Richard

    2014-12-17

    Conventional diagnosis of malaria has relied upon either clinical diagnosis or microscopic examination of peripheral blood smears. These methods, if not carried out exactly, easily result in the over- or under-diagnosis of malaria. The reliability and accuracy of malaria RDTs, even in extremely challenging health care settings, have made them a staple in malaria control programmes. Using the setting of a pilot introduction of malaria RDTs in Greater Garissa, North Eastern Province, Kenya, this study aims to identify and understand perceptions regarding malaria diagnosis, with a particular focus on RDTs, and treatment among community members and health care workers (HCWs). The study was conducted in five districts of Garissa County. Focus group discussions (FGD) were performed with community members that were recruited from health facilities (HFs) supported by the MENTOR Initiative. In-depth interviews (IDIs) and FGDs with HCWs were also carried out. Interview transcripts were then coded and analysed for major themes. Two researchers reviewed all codes, first separately and then together, discussed the specific categories, and finally characterized, described, and agreed upon major important themes. Thirty-four FGDs were carried out with a range of two to eight participants (median of four). Of 157 community members, 103 (65.6%) were women. The majority of participants were illiterate and the highest level of education was secondary school. Some 76% of participants were of Somali ethnicity. Whilst community members and HCWs demonstrated knowledge of aspects of malaria transmission, prevention, diagnosis, and treatment, gaps and misconceptions were identified. Poor adherence to negative RDT results, unfamiliarity and distrust of RDTs, and an inconsistent RDT supply were the main challenges to become apparent in FGDs and IDIs. Gaps in knowledge or incorrect beliefs exist in Greater Garissa and have the potential to act as barriers to complete and correct malaria case

  1. Design of a fast-rise slow-fall magnet modulator

    International Nuclear Information System (INIS)

    Lambiase, R.F.

    1982-01-01

    Brookhaven National Laboratory is now in the process of expanding the capability of the AGS to include the acceleration of polarized protons. One of the requirements to accomplish this is to pulse twelve quadrupole magnets to rapidly cross depolarizing resonances. Having crossed the resonance, the field in the magnet must be maintained so as not to re-cross the resonance. The problem is addressed with two mirror image circuits, one to produce positive pulses, and the other negative. Each of these circuits are further divided into two sections, one to cause the rapid rise, and the other to maintain the slow fall

  2. Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR).

    Science.gov (United States)

    Brodey, Benjamin; Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

    2018-03-23

    The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered

  3. Soil Structure Interaction Effect on High Rise and Low Rise Buildings

    OpenAIRE

    Divya Pathak; PAresh H. SHAH

    2000-01-01

    Effect of supporting soil on the response of structure has been analyzed in the present study. A low rise (G+ 5 storey) and a high rise (G+12 storey) building has been taken for the analysis. For both type of buildings, the response of building with and without consideration of soil structure interaction effect has been compared.Without interaction case is the case in which ends of the structure are assumed to be fixed while in interaction case, structure is assumed to be...

  4. Constraining the Antarctic contribution to interglacial sea-level rise

    Science.gov (United States)

    Naish, T.; Mckay, R. M.; Barrett, P. J.; Levy, R. H.; Golledge, N. R.; Deconto, R. M.; Horgan, H. J.; Dunbar, G. B.

    2015-12-01

    Observations, models and paleoclimate reconstructions suggest that Antarctica's marine-based ice sheets behave in an unstable manner with episodes of rapid retreat in response to warming climate. Understanding the processes involved in this "marine ice sheet instability" is key for improving estimates of Antarctic ice sheet contribution to future sea-level rise. Another motivating factor is that far-field sea-level reconstructions and ice sheet models imply global mean sea level (GMSL) was up to 20m and 10m higher, respectively, compared with present day, during the interglacials of the warm Pliocene (~4-3Ma) and Late Pleistocene (at ~400ka and 125ka). This was when atmospheric CO2 was between 280 and 400ppm and global average surface temperatures were 1- 3°C warmer, suggesting polar ice sheets are highly sensitive to relatively modest increases in climate forcing. Such magnitudes of GMSL rise not only require near complete melt of the Greenland Ice Sheet and the West Antarctic Ice Sheet, but a substantial retreat of marine-based sectors of East Antarctic Ice Sheet. Recent geological drilling initiatives on the continental margin of Antarctica from both ship- (e.g. IODP; International Ocean Discovery Program) and ice-based (e.g. ANDRILL/Antarctic Geological Drilling) platforms have provided evidence supporting retreat of marine-based ice. However, without direct access through the ice sheet to archives preserved within sub-glacial sedimentary basins, the volume and extent of ice sheet retreat during past interglacials cannot be directly constrained. Sediment cores have been successfully recovered from beneath ice shelves by the ANDRILL Program and ice streams by the WISSARD (Whillans Ice Stream Sub-glacial Access Research Drilling) Project. Together with the potential of the new RAID (Rapid Access Ice Drill) initiative, these demonstrate the technological feasibility of accessing the subglacial bed and deeper sedimentary archives. In this talk I will outline the

  5. Sea level rise under the Shared Socioeconomic Pathways (SSPs)

    Science.gov (United States)

    Schleussner, C. F.; Nauels, A.; Rogelj, J.; Mengel, M.; Meinshausen, M.

    2017-12-01

    In order to assess future sea level rise and its impacts, we need to study climate change pathways combined with different scenarios of socioeconomic development. Here, we present Sea Level Rise (SLR) projections for the Shared Socioeconomic Pathway (SSP) storylines and different year-2100 radiative Forcing Targets (FTs). Future SLR is estimated with a comprehensive SLR emulator that accounts for latest research on additional Antarctic rapid discharge dynamics from hydrofracturing and ice cliff instability. Across all baseline scenario realizations (no dedicated climate mitigation), we find 2100 median SLR relative to 1986-2005 of 102 cm (likely range: 77 to 135 cm) for SSP1, 118 cm (90 to 151 cm) for SSP2, 118 cm (91 to 149 cm) for SSP3, 107 cm (81 to 137 cm) for SSP4, and 144 cm (112 to 184 cm) for SSP5. The 2100 sea level responses for combined SSP-FT scenarios is dominated by the mitigation targets and yield median estimates of 68 cm (56 to 87 cm) for FT 2.6 Wm-2, 76 cm (61 to 107 cm) for FT 3.4 Wm-2, 90 cm (68 to 120 cm) for FT 4.5 Wm-2, and 105 cm (79 to 136 cm) for FT 6.0 Wm-2. Average 2081-2100 annual rates of SLR are 6 mm/yr and 19 mm/yr for the FT 2.6 Wm-2 and the baseline scenarios, respectively. Our model setup allows linking scenario-specific emission and socioeconomic indicators to projected SLR. For limiting median 2100 SSP SLR projections to below 80 cm, we find that 2050 cumulative CO2 emissions since pre-industrial should not exceed around 860 GtC, with the global coal phase-out nearly completed. For SSP mitigation scenarios, the median 2050 carbon price of 90 US$2005 tCO2-1 would correspond to a median 2100 SLR of around 80 cm. Our results confirm that rapid and early emission reductions are essential for limiting 2100 SLR.

  6. FIRE EVACUATION FROM HIGH-RISE BUILDINGS

    Directory of Open Access Journals (Sweden)

    Korol'chenko Aleksandr Yakovlevich

    2012-10-01

    Full Text Available The authors argue that no collapse of structures is likely in the event of a fire emergency in multistoried buildings, rather, other fire-related factors may endanger the lives of people inside high-rise buildings exposed to the fire emergency, including open fire, sparks, high ambient temperature, smoke and toxic combustion products, reduced concentration of oxygen, and combined influence of various factors. In case of fire, the temperature inside buildings reaches 1100 °С. It exceeds the temperature of the ambient air acceptable for humans by far (70 °С. The experiments demonstrate that combustion products contain hundreds of toxic chemical compounds. The most hazardous of them include carbon oxide, carbon dioxide, chloride and cyanic hydrogen, aldehydes and acrolein. The author provides the pattern of their influence on the human body. The smoke consists of unburned particles of carbon and aerosols. The size of particles fluctuates within 0.05-50 MMK. Smoke produces a physiological and psychological impact on human beings. It has been proven that dangerous fire factors emerge within the first five to ten minutes of the emergency situation. Evacuation is the principal method of safety assurance. However, the velocity of propagation of smoke and heat is so high that even if the fire prevention system is in operation, people may be blocked both on the floors that are exposed to the fire and those that escape its propagation. New evacuation and rescue methods are recommended by the author. Various ways and methods of use of life-saving facilities are also provided. Safe evacuation is feasible from buildings where the number of stories does not exceed 10- 12. During evacuation, high density human streams are formed inside buildings, therefore, the period of stay in a burning building is increased. The calculations have proven that a two-minute delay of evacuation converts into a safe evacuation of only 13-15% of people. Low reliability of

  7. Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients.

    Science.gov (United States)

    Charmoy, Alexia; Würzner, Grégoire; Ruffieux, Christiane; Hasler, Christopher; Cachat, François; Waeber, Bernard; Burnier, Michel

    2007-10-01

    Cuff inflation at the arm is known to cause an instantaneous rise in blood pressure, which might be due to the discomfort of the procedure and might interfere with the precision of the blood pressure measurement. In this study, we compared the reactive rise in blood pressure induced by cuff inflation when the cuff was placed at the upper arm level and at the wrist. The reactive rise in systolic and diastolic blood pressure to cuff inflation was measured in 34 normotensive participants and 34 hypertensive patients. Each participant was equipped with two cuffs, one around the right upper arm (OMRON HEM-CR19, 22-32 cm) and one around the right wrist (OMRON HEM-CS 19, 17-22 cm; Omron Health Care Europe BV, Hoofddorp, The Netherlands). The cuffs were inflated in a double random order (maximal cuff pressure and position of the cuff) with two maximal cuff pressures: 180 and 240 mmHg. The cuffs were linked to an oscillometric device (OMRON HEM 907; Omron Health Care). Simultaneously, blood pressure was measured continuously at the middle finger of the left hand using photoplethysmography. Three measurements were made at each level of blood pressure at the arm and at the wrist, and the sequence of measurements was randomized. In normotensive participants, no significant difference was observed in the reactive rise in blood pressure when the cuff was inflated either at the arm or at the wrist irrespective of the level of cuff inflation. Inflating a cuff at the arm, however, induced a significantly greater rise in blood pressure than inflating it at the wrist in hypertensive participants for both systolic and diastolic pressures (Pblood pressure response to cuff inflation was independent of baseline blood pressure. The results show that in hypertensive patients, cuff inflation at the wrist produces a smaller reactive rise in blood pressure. The difference between the arm and the wrist is independent of the patient's level of blood pressure.

  8. Examining appropriate diagnosis and treatment of malaria: availability and use of rapid diagnostic tests and artemisinin-based combination therapy in public and private health facilities in south east Nigeria

    Directory of Open Access Journals (Sweden)

    Uzochukwu Benjamin SC

    2010-08-01

    Full Text Available Abstract Background Rapid diagnostic tests (RDTs and Artemisinin-based combination therapy (ACT have been widely advocated by government and the international community as cost-effective tools for diagnosis and treatment of malaria. ACTs are now the first line treatment drug for malaria in Nigeria and RDTs have been introduced by the government to bridge the existing gaps in proper diagnosis. However, it is not known how readily available these RDTs and ACTs are in public and private health facilities and whether health workers are actually using them. Hence, this study investigated the levels of availability and use of RDTs and ACTs in these facilities. Methods The study was undertaken in Enugu state, southeast Nigeria in March 2009. Data was collected from heads of 74 public and private health facilities on the availability and use of RDTs and ACTs. Also, the availability of RDTs and the types of ACTs that were available in the facilities were documented. Results Only 31.1% of the health facilities used RDTs to diagnose malaria. The majority used the syndromic approach. However, 61.1% of healthcare providers were aware of RDTs. RDTs were available in 53.3% of the facilities. Public health facilities and health facilities in the urban areas were using RDTs more and these were mainly bought from pharmacy shops and supplied by NGOs. The main reasons given for non use are unreliability of RDTs, supply issues, costs, preference for other methods of diagnosis and providers' ignorance. ACTs were the drug of choice for most public health facilities and the drugs were readily available in these facilities. Conclusion Although many providers were knowledgeable about RDTs, not many facilities used it. ACTS were readily available and used in public but not private health facilities. However, the reported use of ACTs with limited proper diagnosis implies that there could be high incidence of inappropriate case management of malaria which can also increase

  9. Primary Care Practice Transformation and the Rise of Consumerism.

    Science.gov (United States)

    Shrank, William H

    2017-04-01

    Americans are increasingly demanding the same level of service in healthcare that they receive in other services and products that they buy. This rise in consumerism poses challenges for primary care physicians as they attempt to transform their practices to succeed in a value-based reimbursement landscape, where they are rewarded for managing costs and improving the health of populations. In this paper, three examples of consumer-riven trends are described: retail healthcare, direct and concierge care, and home-based diagnostics and care. For each, the intersection of consumer-driven care and the goals of value-based primary care are explored. If the correct payment and connectivity enablers are in place, some examples of consumer-driven care are well-positioned to support primary care physicians in their mission to deliver high-quality, efficient care for the populations they serve. However, concerns about access and equity make other trends less consistent with that mission.

  10. A Fall Protection System for High-Rise Construction

    Directory of Open Access Journals (Sweden)

    Haluk Çeçen

    2013-01-01

    Full Text Available In construction industry, the number of fatal and nonfatal occupational injuries is higher than other industries. Among causes of these accidents, “falls” play a key role. This situation reveals the importance for carrying out research in fall protection systems. In this paper, a practical, economical, and functional fall protection system is introduced. Following determination and evaluation of existing solutions, weekly brainstorming meetings were held among the responsible project staff (general coordinator, project coordinator, project manager, site manager, and health and safety manager. As a result of these meetings, design criteria were developed. Based on these criteria, the fall protection system for high-rise construction (FPSFHC was developed which satisfied all the specified design criteria. Required materials were procured from local dealers. In this paper, criteria used in design and details of the final design are presented. Field performance of the system is evaluated, and recommendations for further development and standardization of the system are added.

  11. Exploring the unprecedented rise in Danish burglary

    DEFF Research Database (Denmark)

    Sorensen, David W.M.

    2012-01-01

    burglary increased so dramatically. This paper explores four sets of possible explanations for the increase, namely: Changes in public reporting, police recording and insurance practices; changes in population age, drug use and economic recession; increasing crime tourism; and impediments policing caused...... by the National Police Reform of 2007. While some or all of these factors may have contributed to the overall rise, none of them come close to explaining it on their own. This absence of evidence is especially interesting in light of widespread assumptions in the media and among some police about foreign burglary......-year period 2005-2010, plus data on long term crime trends (1990-2010) and other social indicators....

  12. Is the Kingdom of Bicycles Rising Again?

    DEFF Research Database (Denmark)

    Rømer Christensen, Hilda

    2017-01-01

    This article focuses on new types of cycling in postsocialist China, especially mountain and sports biking, and on the particular entanglements of gender and class brought with them. The shift in mobility and biking from the Mao era to the postsocialist China is analyzed in the contexts of cultural......-analytical notions of global assemblages and gendered interpellations. Based on Chinese newspaper materials and fieldwork in Beijing and Shanghai, the article examines the social and gendered implications of the new biking cultures. These new biking practices mainly interpellate new middle-class men...... and masculinities as part of an exclusive leisure culture. If the “Kingdom of the Bicycles” is going to rise again, there is a need for a broader scope that addresses access for all, including women and families, as smart bikers, as well as biking as a daily mode of transportation....

  13. AHP 21: Review: The Sun Rises

    Directory of Open Access Journals (Sweden)

    Mark Bender

    2012-12-01

    Full Text Available The Sun Rises is a model study contextualizing an oral narrative tradition in the social and ritual fabric of a remote community in northeast India. In many ways a companion volume to Himalayan Tribal Tales (Blackburn 2008, the text presents the first substantial translation of a key ritual text of the Apantani Valley dwellers in Arunachal Pradesh, located on the contested border between China (Tibet and India. The Apatani speak a Tibeto-Burman language, practice intensive rice agriculture in carefully terraced fields, and number about 35,000. Their clans populate several centuries-old villages. Until recently, they were separated from the lowlands of Assam and surrounded only by peoples practicing various forms of shifting agriculture. The valley dwellers have increasingly encountered modernization over the last few decades, including Indian and global popular culture, and Christianity. ...

  14. Understanding the Rise of African Business

    DEFF Research Database (Denmark)

    Jorem, Kaja Tvedten; Jeppesen, Søren; Hansen, Michael W.

    of African firm strategy and performance that takes into account the specificities of the African business environment and African firm capabilities. The paper starts by juxtaposing the widespread pessimistic view of African business with more recent, optimistic studies on African firms’ performance....... The latter suggests that profound improvements in African business performance are indeed under way: with the private sector playing a more important role as an engine of growth, with the rise of a capable African entrepreneurial class, and with the emergence of dynamic and competitive African enterprises...... in the literature, the authors suggest an analytical framework for understanding African business performance, underlining the interplay between contextual specificities, firm capabilities, and firm strategy....

  15. Correlates of intimate partner violence against women during a time of rapid social transition in Rwanda: analysis of the 2005 and 2010 demographic and health surveys.

    Science.gov (United States)

    Thomson, Dana R; Bah, Assiatou B; Rubanzana, Wilson G; Mutesa, Leon

    2015-10-28

    In Rwanda, women who self-reported in household surveys ever experiencing intimate partner violence (IPV) increased from 34 % in 2005 to 56 % in 2010. This coincided with a new constitution and majority-female elected parliament in 2003, and 2008 legislation protecting against gender-based violence. The increase in self-reported IPV may reflect improved social power for women, and/or disruptions to traditional gender roles that increased actual IPV. This is a cross-sectional study of IPV in 4338 couples interviewed in the 2005 and 2010 Rwanda Demographic and Health Surveys (RDHSs). Factors associated with physical or sexual IPV in the last 12 months were modeled using manual backward stepwise logistic regression. Analyses were conducted in Stata v13 adjusting for complex survey design. Risk factors for IPV in 2005 (p Rwanda's Isange One Stop Center project, with medical, legal, and psychosocial services for domestic violence victims, is currently scaling to all 44 district hospitals, and police station gender desks reduce barriers to legal reporting of IPV. Additional support to Abunzi mediators to hear IPV cases in communities, and involvement of men in grassroots efforts to redefine masculinity in Rwanda are suggested. Additional research is needed to understand why self-reported IPV has increased in Rwanda, and to evaluate effectiveness of IPV interventions.

  16. Rapid Prototyping Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The ARDEC Rapid Prototyping (RP) Laboratory was established in December 1992 to provide low cost RP capabilities to the ARDEC engineering community. The Stratasys,...

  17. Doubling of coastal flooding frequency within decades due to sea-level rise

    Science.gov (United States)

    Vitousek, Sean; Barnard, Patrick L.; Fletcher, Charles H.; Frazer, Neil; Erikson, Li; Storlazzi, Curt D.

    2017-01-01

    Global climate change drives sea-level rise, increasing the frequency of coastal flooding. In most coastal regions, the amount of sea-level rise occurring over years to decades is significantly smaller than normal ocean-level fluctuations caused by tides, waves, and storm surge. However, even gradual sea-level rise can rapidly increase the frequency and severity of coastal flooding. So far, global-scale estimates of increased coastal flooding due to sea-level rise have not considered elevated water levels due to waves, and thus underestimate the potential impact. Here we use extreme value theory to combine sea-level projections with wave, tide, and storm surge models to estimate increases in coastal flooding on a continuous global scale. We find that regions with limited water-level variability, i.e., short-tailed flood-level distributions, located mainly in the Tropics, will experience the largest increases in flooding frequency. The 10 to 20 cm of sea-level rise expected no later than 2050 will more than double the frequency of extreme water-level events in the Tropics, impairing the developing economies of equatorial coastal cities and the habitability of low-lying Pacific island nations.

  18. Doubling of coastal flooding frequency within decades due to sea-level rise.

    Science.gov (United States)

    Vitousek, Sean; Barnard, Patrick L; Fletcher, Charles H; Frazer, Neil; Erikson, Li; Storlazzi, Curt D

    2017-05-18

    Global climate change drives sea-level rise, increasing the frequency of coastal flooding. In most coastal regions, the amount of sea-level rise occurring over years to decades is significantly smaller than normal ocean-level fluctuations caused by tides, waves, and storm surge. However, even gradual sea-level rise can rapidly increase the frequency and severity of coastal flooding. So far, global-scale estimates of increased coastal flooding due to sea-level rise have not considered elevated water levels due to waves, and thus underestimate the potential impact. Here we use extreme value theory to combine sea-level projections with wave, tide, and storm surge models to estimate increases in coastal flooding on a continuous global scale. We find that regions with limited water-level variability, i.e., short-tailed flood-level distributions, located mainly in the Tropics, will experience the largest increases in flooding frequency. The 10 to 20 cm of sea-level rise expected no later than 2050 will more than double the frequency of extreme water-level events in the Tropics, impairing the developing economies of equatorial coastal cities and the habitability of low-lying Pacific island nations.

  19. Crustal structure of Shatsky Rise from joint refraction and reflection seismic tomography

    Science.gov (United States)

    Korenaga, J.; Sager, W. W.

    2011-12-01

    Shatsky Rise in the western Pacific is one of a few gigantic oceanic plateaus in the world, with a surface area of ˜ 4.8 ± 105~km2 (about the same size as California). In contrast to other large oceanic plateaus formed during the Cretaceous Quite Period, Shatsky Rise formed during the frequent reversals of magnetic polarity, allowing its tectonic environment to be resolved in detail. It was formed at a rapidly spreading ridge-ridge-ridge triple junction, so the effect of lithospheric lid on magma migration is expected to be minimal, thereby facilitating the petrological interpretation of its seismic structure in terms of parental mantle processes. In the summer of 2010, a seismic refraction survey combined with multichannel seismic profiling was conducted across Shatsky Rise. Twenty eight ocean-bottom seismometers were deployed along two crossing perpendicular lines, and all of the instruments were recovered successfully, yielding a large volume of high-quality wide-angle refraction and reflection data, with the source-receiver distance often exceeding 200~km. In this contribution, we present the P-wave velocity structure of the Shatsky Rise crust, which is constructed by joint refraction and reflection travel time tomography, and also discuss its implications for the origin of Shatsky Rise.

  20. Analysis of Sea Level Rise in Action

    Science.gov (United States)

    Gill, K. M.; Huang, T.; Quach, N. T.; Boening, C.

    2016-12-01

    NASA's Sea Level Change Portal provides scientists and the general public with "one-stop" source for current sea level change information and data. Sea Level Rise research is a multidisciplinary research and in order to understand its causes, scientists must be able to access different measurements and to be able to compare them. The portal includes an interactive tool, called the Data Analysis Tool (DAT), for accessing, visualizing, and analyzing observations and models relevant to the study of Sea Level Rise. Using NEXUS, an open source, big data analytic technology developed at the Jet Propulsion Laboratory, the DAT is able provide user on-the-fly data analysis on all relevant parameters. DAT is composed of three major components: A dedicated instance of OnEarth (a WMTS service), NEXUS deep data analytic platform, and the JPL Common Mapping Client (CMC) for web browser based user interface (UI). Utilizing the global imagery, a user is capable of browsing the data in a visual manner and isolate areas of interest for further study. The interfaces "Analysis" tool provides tools for area or point selection, single and/or comparative dataset selection, and a range of options, algorithms, and plotting. This analysis component utilizes the Nexus cloud computing platform to provide on-demand processing of the data within the user-selected parameters and immediate display of the results. A RESTful web API is exposed for users comfortable with other interfaces and who may want to take advantage of the cloud computing capabilities. This talk discuss how DAT enables on-the-fly sea level research. The talk will introduce the DAT with an end-to-end tour of the tool with exploration and animating of available imagery, a demonstration of comparative analysis and plotting, and how to share and export data along with images for use in publications/presentations. The session will cover what kind of data is available, what kind of analysis is possible, and what are the outputs.

  1. Infrared and X-ray bursts from the rapid burster

    International Nuclear Information System (INIS)

    Apparao, K.M.V.; Chitre, S.M.

    1979-01-01

    Studies on sudden bursts from the cosmic X-ray sources are reported. The processes occuring from the rise in luminosity of an x-ray source to its collapse are described. Records of the x-ray burst from the globular cluster NGC 6624 and the 'Rapid Burster' are shown. The Infra-red bursts from the Rapid Burster are also explained. (A.K.)

  2. Is the global rise of asthma an early impact of anthropogenic climate change?

    Directory of Open Access Journals (Sweden)

    Paul John Beggs

    Full Text Available The increase in asthma incidence, prevalence, and morbidity over recent decades presents a significant challenge to public health. Pollen is an important trigger of some types of asthma, and both pollen quantity and season depend on climatic and meteorological variables. Over the same period as the global rise in asthma, there have been considerable increases in atmospheric carbon dioxide concentration and global average surface temperature. We hypothesize anthropogenic climate change as a plausible contributor to the rise in asthma. Greater concentrations of carbon dioxide and higher temperatures may increase pollen quantity and induce longer pollen seasons. Pollen allergenicity can also increase as a result of these changes in climate. Exposure in early life to a more allergenic environment may also provoke the development of other atopic conditions, such as eczema and allergic rhinitis. Although the etiology of asthma is complex, the recent global rise in asthma could be an early health effect of anthropogenic climate change.

  3. Rapid urbanization of red foxes in Estonia: distribution, behaviour, attacks on domestic animals, and health-risks related to zoonotic diseases.

    Science.gov (United States)

    Plumer, Liivi; Davison, John; Saarma, Urmas

    2014-01-01

    Urban areas are becoming increasingly important for wildlife as diminishing natural habitats no longer represent a suitable environment for many species. Red foxes (Vulpes vulpes) are nowadays common in many cities worldwide, and in recent years they have colonized urban areas in Estonia. We used a public web-based questionnaire approach to evaluate the distribution and behaviour of Estonian urban foxes, to detect related problems and to assess health risks to humans and domestic animals. In total, 1205 responses were collected throughout the country. Foxes have colonized the majority of Estonian towns (33 out of 47) in a relatively short period of time, and have already established breeding dens in several towns. Despite their recent arrival, the behaviour of Estonian urban foxes is similar to that reported in longer-established urban fox populations: they are mostly active during night-time, often visit city centres and some also have dens in such locations. Certain characteristics of urban foxes serve as a basis for conflict with humans: foxes have entered houses and attacked domestic animals, killing cats and poultry. About 8% of reported foxes exhibited symptoms of sarcoptic mange, a disease that also infects domestic animals, especially dogs. The proportion of mange-infected foxes was higher in large urban areas. In addition to mange, a substantial fraction of red foxes in Estonia are known to be infected with the life-threatening tapeworm Echinococcus multilocularis, the causative agent of alveolar echinococcosis. Therefore, urban foxes may represent a source of serious infectious disease for pets and humans.

  4. Rapid urbanization of red foxes in Estonia: distribution, behaviour, attacks on domestic animals, and health-risks related to zoonotic diseases.

    Directory of Open Access Journals (Sweden)

    Liivi Plumer

    Full Text Available Urban areas are becoming increasingly important for wildlife as diminishing natural habitats no longer represent a suitable environment for many species. Red foxes (Vulpes vulpes are nowadays common in many cities worldwide, and in recent years they have colonized urban areas in Estonia. We used a public web-based questionnaire approach to evaluate the distribution and behaviour of Estonian urban foxes, to detect related problems and to assess health risks to humans and domestic animals. In total, 1205 responses were collected throughout the country. Foxes have colonized the majority of Estonian towns (33 out of 47 in a relatively short period of time, and have already established breeding dens in several towns. Despite their recent arrival, the behaviour of Estonian urban foxes is similar to that reported in longer-established urban fox populations: they are mostly active during night-time, often visit city centres and some also have dens in such locations. Certain characteristics of urban foxes serve as a basis for conflict with humans: foxes have entered houses and attacked domestic animals, killing cats and poultry. About 8% of reported foxes exhibited symptoms of sarcoptic mange, a disease that also infects domestic animals, especially dogs. The proportion of mange-infected foxes was higher in large urban areas. In addition to mange, a substantial fraction of red foxes in Estonia are known to be infected with the life-threatening tapeworm Echinococcus multilocularis, the causative agent of alveolar echinococcosis. Therefore, urban foxes may represent a source of serious infectious disease for pets and humans.

  5. Rising cyclin-CDK levels order cell cycle events.

    Directory of Open Access Journals (Sweden)

    Catherine Oikonomou

    Full Text Available Diverse mitotic events can be triggered in the correct order and time by a single cyclin-CDK. A single regulator could confer order and timing on multiple events if later events require higher cyclin-CDK than earlier events, so that gradually rising cyclin-CDK levels can sequentially trigger responsive events: the "quantitative model" of ordering.This 'quantitative model' makes predictions for the effect of locking cyclin at fixed levels for a protracted period: at low cyclin levels, early events should occur rapidly, while late events should be slow, defective, or highly variable (depending on threshold mechanism. We titrated the budding yeast mitotic cyclin Clb2 within its endogenous expression range to a stable, fixed level and measured time to occurrence of three mitotic events: growth depolarization, spindle formation, and spindle elongation, as a function of fixed Clb2 level. These events require increasingly more Clb2 according to their normal order of occurrence. Events occur efficiently and with low variability at fixed Clb2 levels similar to those observed when the events normally occur. A second prediction of the model is that increasing the rate of cyclin accumulation should globally advance timing of all events. Moderate (<2-fold overexpression of Clb2 accelerates all events of mitosis, resulting in consistently rapid sequential cell cycles. However, this moderate overexpression also causes a significant frequency of premature mitoses leading to inviability, suggesting that Clb2 expression level is optimized to balance the fitness costs of variability and catastrophe.We conclude that mitotic events are regulated by discrete cyclin-CDK thresholds. These thresholds are sequentially triggered as cyclin increases, yielding reliable order and timing. In many biological processes a graded input must be translated into discrete outputs. In such systems, expression of the central regulator is likely to be tuned to an optimum level, as we

  6. Using environmental heterogeneity to plan for sea-level rise.

    Science.gov (United States)

    Hunter, Elizabeth A; Nibbelink, Nathan P

    2017-12-01

    Environmental heterogeneity is increasingly being used to select conservation areas that will provide for future biodiversity under a variety of climate scenarios. This approach, termed conserving nature's stage (CNS), assumes environmental features respond to climate change more slowly than biological communities, but will CNS be effective if the stage were to change as rapidly as the climate? We tested the effectiveness of using CNS to select sites in salt marshes for conservation in coastal Georgia (U.S.A.), where environmental features will change rapidly as sea level rises. We calculated species diversity based on distributions of 7 bird species with a variety of niches in Georgia salt marshes. Environmental heterogeneity was assessed across six landscape gradients (e.g., elevation, salinity, and patch area). We used 2 approaches to select sites with high environmental heterogeneity: site complementarity (environmental diversity [ED]) and local environmental heterogeneity (environmental richness [ER]). Sites selected based on ER predicted present-day species diversity better than randomly selected sites (up to an 8.1% improvement), were resilient to areal loss from SLR (1.0% average areal loss by 2050 compared with 0.9% loss of randomly selected sites), and provided habitat to a threatened species (0.63 average occupancy compared with 0.6 average occupancy of randomly selected sites). Sites selected based on ED predicted species diversity no better or worse than random and were not resilient to SLR (2.9% average areal loss by 2050). Despite the discrepancy between the 2 approaches, CNS is a viable strategy for conservation site selection in salt marshes because the ER approach was successful. It has potential for application in other coastal areas where SLR will affect environmental features, but its performance may depend on the magnitude of geological changes caused by SLR. Our results indicate that conservation planners that had heretofore excluded low

  7. Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy

    International Nuclear Information System (INIS)

    Sartor, C.I.; Strawderman, M.H.; Lin, X.; Kish, K.E.; McLaughlin, P.W.; Lichter, A.S.; Sandler, H.S.

    1995-01-01

    Objective: A rising PSA following treatment for adenocarcinoma of the prostate indicates eventual clinical failure, but the rate of rise can be quite different from patient to patient, as can the pattern of clinical failure. We sought to determine whether the rate of PSA rise could differentiate future local vs. metastatic failure. Materials and Methods: PSA values from our series of 671 patients treated between 1987 and 1994 with 3-D conformal radiotherapy for localized adenocarcinoma were analyzed. Patients who had a pre-treatment PSA and >4 post-treatment PSA values available, had received no hormonal therapy, and had information detailing clinical outcome were used in this analysis. First site of failure was determined by abnormal DRE or biopsy, abnormal bone scan or radiographic evidence of metastasis as directed by clinical symptoms or follow-up clinical exam. Each patient's PSA pattern was defined by the function PSA(t)=C 1 e - a 1 (t) + C 2 e a 2 (t) where -a 1 relates to the rate of decline and a 2 to the rate of rise, if any. Univariate analysis was used to determine the correlation between initial PSA or rising PSA and clinical failure. Adjacent category logistic regression analysis was used to analyze the rate of rise and pattern of clinical failure. Results: 671 patients were reviewed; 401 patients met the requirements and 2667 PSA values were analyzed. We confirmed the finding of others that pre-treatment PSA is a prognostic indicator: patients presenting with PSA 3-20ng/ml had a relative risk of 9 (p=0.03) and PSA>20ng/ml had a RR of 26 (p=0.002) for clinical failure when compared to presenting PSA 2 >1.5/year predicted metastatic as opposed to local failure when compared to PSA rise with a 2 between 0.5-1.5/yr or 1.5 log(ng/ml)/year vs. 0.5-1.5 log(ng/ml)/yr or <0.5 log(ng/ml)/yr. Conclusions: The rate of rise of PSA following definitive radiotherapy can predict clinical failure patterns, with a rapidly rising PSA indicating metastatic as opposed to

  8. Rapid Tooling via Stereolithography

    OpenAIRE

    Montgomery, Eva

    2006-01-01

    Approximately three years ago, composite stereolithography (SL) resins were introduced to the marketplace, offering performance features beyond what traditional SL resins could offer. In particular, the high heat deflection temperatures and high stiffness of these highly filled resins have opened the door to several new rapid prototyping (RP) applications, including wind tunnel test modelling and, more recently, rapid tooling.

  9. The Rise and Fall of Metronidazole for Clostridium difficile Infection.

    Science.gov (United States)

    Chahine, Elias B

    2018-06-01

    Clostridium difficile is posing urgent health threats. Older studies have shown that metronidazole and vancomycin are equally effective in the treatment of Clostridium difficile infection (CDI). Given its inexpensive cost and low propensity to select antimicrobial resistant organisms, metronidazole became rapidly the drug of choice despite its pharmacokinetic limitations in the treatment of CDI. However, newer studies demonstrated that metronidazole is inferior to vancomycin, prompting clinicians to change their long-standing position on using metronidazole for mild to moderate infections and on reserving vancomycin for severe infections. Moving forward, metronidazole will fall out of favor in the treatment of CDI.

  10. Rate of rise in diastolic blood pressure influences vascular sympathetic response to mental stress.

    Science.gov (United States)

    El Sayed, Khadigeh; Macefield, Vaughan G; Hissen, Sarah L; Joyner, Michael J; Taylor, Chloe E

    2016-12-15

    Research indicates that individuals may experience a rise (positive responders) or fall (negative responders) in muscle sympathetic nerve activity (MSNA) during mental stress. In this study, we examined the early blood pressure responses (including the peak, time of peak and rate of rise in blood pressure) to mental stress in positive and negative responders. Negative MSNA responders to mental stress exhibit a more rapid rise in diastolic pressure at the onset of the stressor, suggesting a baroreflex-mediated suppression of MSNA. In positive responders there is a more sluggish rise in blood pressure during mental stress, which appears to be MSNA-driven. This study suggests that whether MSNA has a role in the pressor response is dependent upon the reactivity of blood pressure early in the task. Research indicates that individuals may experience a rise (positive responders) or fall (negative responders) in muscle sympathetic nerve activity (MSNA) during mental stress. The aim was to examine the early blood pressure response to stress in positive and negative responders and thus its influence on the direction of change in MSNA. Blood pressure and MSNA were recorded continuously in 21 healthy young males during 2 min mental stressors (mental arithmetic, Stroop test) and physical stressors (cold pressor, handgrip exercise, post-exercise ischaemia). Participants were classified as negative or positive responders according to the direction of the mean change in MSNA during the stressor tasks. The peak changes, time of peak and rate of changes in blood pressure were compared between groups. During mental arithmetic negative responders experienced a significantly greater rate of rise in diastolic blood pressure in the first minute of the task (1.3 ± 0.5 mmHg s -1 ) compared with positive responders (0.4 ± 0.1 mmHg s -1 ; P = 0.03). Similar results were found for the Stroop test. Physical tasks elicited robust parallel increases in blood pressure and MSNA across

  11. Why is energy use rising in the freight sector?

    International Nuclear Information System (INIS)

    Mintz, M.; Vyas, A.D.

    1991-01-01

    Trends in transportation sector energy use and carbon dioxide emissions are analyzed with an emphasis on three freight modes -- rail, truck, and marine. A recent set of energy use projections is presented and freight mode energy characteristics are discussed. Transportation sector energy use, which nearly doubled between 1960 and 1985, is projected to grow more slowly during the period 1985 endash 2010. Most of the growth is projected to come from non-personal modes (freight and commercial air). Trends in freight mode energy intensities are discussed and a variety of factors behind these trends are analyzed. Rail and marine modes improved their energy intensities during sudden fuel price rises of the 1970s. Though there is room for further technological improvement, long power plant life cycles preclude rapid penetration of new technologies. Thus, energy intensities in these modes are more likely to improve through operational changes. Because of relatively stable fuel prices, the energy share of truck operating expenses is likely to remain low. Coupled with increasing labor costs, this portends only modest improvements in truck energy efficiency over the next two decades

  12. Influence of rising commodity prices on energy policy

    International Nuclear Information System (INIS)

    Keppo, I.J.

    2009-04-01

    During the past few years we have first witnessed a rapid increase in the prices of commodities and then later, as a consequence of the economic downturn, an even more drastic drop. Simultaneously with the commodity price increase, an increase in the investment costs of power plants was experienced. The rise in material costs was often stated as one of the reasons for this increase. In this study the relationship between commodity costs and energy prices is studied. A bottom-up approach is used for estimating what kind of an impact increased commodity prices alone could be expected to have on the investment costs on the one hand, and how increased energy prices may affect commodity production costs on the other. The results indicate that although the commodity production costs usually have a fairly large energy component, even high increases in commodity prices, and therefore raw material costs of power plant investments, can not explain the recently experienced hikes in power plant investment costs; a doubling of the costs of the main raw material flows could explain an investment cost increase of some 5-10%, depending on the power plant type. This would seem to indicate that other contributing factors, such as bottlenecks in the production of power plant components, may play an important role in the recent investment cost increase

  13. Can salt marshes survive sea level rise ?

    Science.gov (United States)

    Tambroni, N.; Seminara, G.

    2008-12-01

    Stability of salt marshes is a very delicate issue depending on the subtle interplay among hydrodynamics, morphodynamics and ecology. In fact, the elevation of the marsh platform depends essentially on three effects: i) the production of soil associated with sediments resuspended by tidal currents and wind waves in the adjacent tidal flats, advected to the marsh and settling therein; ii) production of organic sediments by the salt marsh vegetation; iii) soil 'loss' driven by sea level rise and subsidence. In order to gain insight into the mechanics of the process, we consider a schematic configuration consisting of a salt marsh located at the landward end of a tidal channel connected at the upstream end with a tidal sea, under different scenarios of sea level rise. We extend the simple 1D model for the morphodynamic evolution of a tidal channel formulated by Lanzoni and Seminara (2002, Journal of Geophysical Research-Oceans, 107, C1) allowing for sediment resuspension in the channel and vegetation growth in the marsh using the depth dependent model of biomass productivity of Spartina proposed by Morris et al. (2002, Ecology, 83, pp. 2869 - 2877). We first focus on the case of a tide dominated salt marsh neglecting wind driven sediment resuspension in the shoal. Results show that the production of biomass plays a crucial role on salt marsh stability and, provided productivity is high enough, it may turn out to be sufficient to counteract the effects of sea level rise even in the absence of significant supply of mineral sediments. The additional effect of wind resuspension is then introduced. Note that the wind action is twofold: on one hand, it generates wind waves the amplitude of which is strongly dependent on shoal depth and wind fetch; on the other hand, it generates currents driven by the surface setup induced by the shear stress acting on the free surface. Here, each contribution is analysed separately. Results show that the values of bottom stress induced by

  14. Rising environmental cadmium levels in developing countries ...

    African Journals Online (AJOL)

    olayemitoyin

    Cadmium (Cd) is a non essential heavy metal belonging to group ... Cd from a contaminated environment leads to various pathological ..... interact with genes that are involved in human ..... Tolonen, M. (1990) Vitamins and minerals in Health.

  15. The rise of patient 3.0

    DEFF Research Database (Denmark)

    Clemensen, Jane; Danbjørg, Dorthe Boe; Damkjær Syse, Mette

    Social media, particularly Facebook (FB), is a new way for patients to find peer patients. By investigating communications within a patient generated FB group over a one year period we looked for evidence of the existence of Patient 3.0 . The indicators for these kinds of activities were where...... in a Facebook group looking for signs of patient 3.0 in the context of health 3.0 (Gagnon, 2012). Qualitative content analysis was conducted on transcripts of postings on the Facebook group site from the period January 2010 to January 2011. These were categorized into themes based on the intentions indicated...... issues they had with both their health care professionals and the health system in general. The material indicates that this group of patients exhibit signs of being what has been described as “Patient 3.0” (Ibid). Their experiences also showcase collisions with the health care system...

  16. Rapid improvement teams.

    Science.gov (United States)

    Alemi, F; Moore, S; Headrick, L; Neuhauser, D; Hekelman, F; Kizys, N

    1998-03-01

    Suggestions, most of which are supported by empirical studies, are provided on how total quality management (TQM) teams can be used to bring about faster organizationwide improvements. Ideas are offered on how to identify the right problem, have rapid meetings, plan rapidly, collect data rapidly, and make rapid whole-system changes. Suggestions for identifying the right problem include (1) postpone benchmarking when problems are obvious, (2) define the problem in terms of customer experience so as not to blame employees nor embed a solution in the problem statement, (3) communicate with the rest of the organization from the start, (4) state the problem from different perspectives, and (5) break large problems into smaller units. Suggestions for having rapid meetings include (1) choose a nonparticipating facilitator to expedite meetings, (2) meet with each team member before the team meeting, (3) postpone evaluation of ideas, and (4) rethink conclusions of a meeting before acting on them. Suggestions for rapid planning include reducing time spent on flowcharting by focusing on the future, not the present. Suggestions for rapid data collection include (1) sample patients for surveys, (2) rely on numerical estimates by process owners, and (3) plan for rapid data collection. Suggestions for rapid organizationwide implementation include (1) change membership on cross-functional teams, (2) get outside perspectives, (3) use unfolding storyboards, and (4) go beyond self-interest to motivate lasting change in the organization. Additional empirical investigations of time saved as a consequence of the strategies provided are needed. If organizations solve their problems rapidly, fewer unresolved problems may remain.

  17. 77 FR 26280 - Patient Safety Organizations: Voluntary Relinquishment From CareRise LLC

    Science.gov (United States)

    2012-05-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety... relinquishment from CareRise LLC of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) authorizes the listing of PSOs, which are entities or...

  18. Temporal variation of accumulation rates on a natural salt marsh in the 20th century determined by 137Cs chronologies – the impact of sea level rise and increased inundation frequency

    DEFF Research Database (Denmark)

    Andersen, Thorbjørn Joest; Svinth, Steffen; Pejrup, Morten

    2011-01-01

    Salt marshes are potentially threatened by sea level rise if sediment supply is unable to balance the rising sea. A rapid sea level rise is one of the pronounced effects of global warming and global sea level is at present rising at an elevated rate of about 3.4 mm y-1 on average. This increasing...... in sediment deposition is significant and gives reason for concern as it may be the first sign of a sedimentation deficiency which could be threatening this and other salt marshes in the case of a rapidly rising sea level. Our work demonstrates that the assumption of a constant relationship between salt marsh...... with salt marsh accretion is most probably not valid in the present case study and it may well be that this is also the case for many other salt marshes, especially if sea level continues to rise rapidly as indicated by some climate change scenarios....

  19. Rapid fish stock depletion in previously unexploited seamounts: the ...

    African Journals Online (AJOL)

    Rapid fish stock depletion in previously unexploited seamounts: the case of Beryx splendens from the Sierra Leone Rise (Gulf of Guinea) ... A spectral analysis and red-noise spectra procedure (REDFIT) algorithm was used to identify the red-noise spectrum from the gaps in the observed time-series of catch per unit effort by ...

  20. Modeling the Effects of Sea-Level Rise on Groundwater Levels in Coastal New Hampshire

    Science.gov (United States)

    Jacobs, J. M.; Knott, J. F.; Daniel, J.; Kirshen, P. H.

    2017-12-01

    Coastal communities with high population density and low topography are vulnerable from sea-level rise (SLR) caused by climate change. Groundwater in coastal communities will rise with sea level impacting water quality, the structural integrity of infrastructure, and natural ecosystem health. SLR-induced groundwater rise has been studied in areas of high aquifer transmissivity and in low-lying areas immediately along the coast. In this regional study, we investigate SLR-induced groundwater rise in a coastal area characterized by shallow unconsolidated deposits overlying fractured bedrock, typical of the glaciated northeast United States. MODFLOW, a numerical groundwater-flow model, is used with groundwater observations, lidar topography, surface-water hydrology, and groundwater withdrawals to investigate SLR-induced changes in groundwater levels and vadose-zone thickness in New Hampshire's Seacoast. The SLR groundwater signal is detected up to 5 km from the coast, more than 3 times farther inland than projected surface-water flooding associated with SLR. Relative groundwater rise ranges from 38 to 98% of SLR within 1 km of the shoreline and drops below 4% between 4 and 5 km from the coast. The largest magnitude of SLR-induced groundwater rise occurs in the marine and estuarine deposits and land areas with tidal water bodies on three sides. In contrast, groundwater rise is dampened near streams. Groundwater inundation caused by 2 m of SLR is projected to contribute 48% of the total land inundation area in the City of Portsmouth with consequences for built and natural resources. Freshwater wetlands are projected to expand 3% by year 2030 increasing to 25% by year 2100 coupled with water-depth increases. These results imply that underground infrastructure and natural resources in coastal communities will be impacted by rising groundwater much farther inland than previously thought when considering only surface-water flooding from SLR.

  1. Sea level rise and the geoid: factor analysis approach

    OpenAIRE

    Song, Hongzhi; Sadovski, Alexey; Jeffress, Gary

    2013-01-01

    Sea levels are rising around the world, and this is a particular concern along most of the coasts of the United States. A 1989 EPA report shows that sea levels rose 5-6 inches more than the global average along the Mid-Atlantic and Gulf Coasts in the last century. The main reason for this is coastal land subsidence. This sea level rise is considered more as relative sea level rise than global sea level rise. Thus, instead of studying sea level rise globally, this paper describes a statistical...

  2. Gas demand to rise in the Usa

    International Nuclear Information System (INIS)

    Anon.

    2000-01-01

    Could US consumption of natural gas rise by as much as 13 quadrillion Btu (quads) over the next 20 years? A new study conducted for the American Gas Foundation by Washington Policy and Analysis says it's certainly a possibility if appropriate policies are implemented. 'Fueling the Future: Natural Gas and New Technologies for a Cleaner 21. Century', confirms what natural gas industry professionals have long suspected: changes in US energy policy that favor increased use of natural gas could improve air quality, conserve energy and reduce reliance on imported oil from politically unstable countries. Consequently, the study forecasts that the environmental, economic and efficiency advantages of natural gas-combined with advances in gas-related technologies and the introduction of new end-use technologies - could help push. US gas consumption into the 35-quad range over the next two decades. Currently, American gas demand is close to 22 quads a year. The study tracks two scenarios: a 'current projection', which shows gas demand reaching nearly 30 quads by 2020, and an 'accelerated projection', which foresees demand topping 35 quads by then based on the adoption of national policies encouraging greater use of natural gas. (authors)

  3. The Rise of Islamic Feminism in Kuwait

    Directory of Open Access Journals (Sweden)

    Haya al-Mughni

    2012-01-01

    Full Text Available The paper examines the emergence of Islamic Feminism in Kuwait, based on the writings and personal accounts of leading Islamist women activists.  It begins with an analysis of the socio-political factors that led to the creation of Islamic groups in the 1980s. It then outlines the role of women in the growth of the Islamic movement and shows how the contradictions between women’s contributions to the Islamic cause and the secondary role they play within the Islamic organizations controlled by men were conducive to the rise of Islamic feminism in the 1990s. The paper also demonstrates how the involvement of islamist women in the struggle for suffrage forging a coalition with liberal women activists had played a decisive role in changing the position of islamist groups towards the enfranchisement of women. The last two sections of the paper look at the participation of islamist women activists in the re-definition of the dichotomy between the public and private spheres and at their involvement in the process of interpretation of Islamic sources, known as Ijtihâd. The paper concludes that the engagement of islamist women activists in the discourse of women’s rights can be powerful agent of change towards a more egalitarian society.

  4. China's rising hydropower demand challenges water sector.

    Science.gov (United States)

    Liu, Junguo; Zhao, Dandan; Gerbens-Leenes, P W; Guan, Dabo

    2015-07-09

    Demand for hydropower is increasing, yet the water footprints (WFs) of reservoirs and hydropower, and their contributions to water scarcity, are poorly understood. Here, we calculate reservoir WFs (freshwater that evaporates from reservoirs) and hydropower WFs (the WF of hydroelectricity) in China based on data from 875 representative reservoirs (209 with power plants). In 2010, the reservoir WF totaled 27.9 × 10(9) m(3) (Gm(3)), or 22% of China's total water consumption. Ignoring the reservoir WF seriously underestimates human water appropriation. The reservoir WF associated with industrial, domestic and agricultural WFs caused water scarcity in 6 of the 10 major Chinese river basins from 2 to 12 months annually. The hydropower WF was 6.6 Gm(3) yr(-1) or 3.6 m(3) of water to produce a GJ (10(9) J) of electricity. Hydropower is a water intensive energy carrier. As a response to global climate change, the Chinese government has promoted a further increase in hydropower energy by 70% by 2020 compared to 2012. This energy policy imposes pressure on available freshwater resources and increases water scarcity. The water-energy nexus requires strategic and coordinated implementations of hydropower development among geographical regions, as well as trade-off analysis between rising energy demand and water use sustainability.

  5. The rise and fall of refineries

    International Nuclear Information System (INIS)

    Chretien, D.

    2002-01-01

    This paper described the rise and fall of refineries in Montreal. Well before Calgary, Montreal was the hub of activity for oil refineries because Montreal was the principle consuming market for petroleum products in Canada. The location was good, particularly since the soil was clay which helped prevent soil infiltration of petroleum. The first refinery in Montreal was constructed in 1916 by Esso, followed by Texaco in 1921 and Gulf in 1931. Initially oil was shipped by boat to the Port of Montreal from Saudi Arabia. Later, the petroleum came mostly from Venezuela. At the beginning of the 1980s many refineries were closed because they became obsolete and upgrading them would have been too costly. Only 3 refineries remain in Quebec, of which 2 are in Montreal. They are owned by Shell and PetroCanada. The third refinery in Quebec is in St-Romuald and is owned by UltraMar. One of the major contributing factors to the decline of the refining industry in Montreal was the decision in 1984 by former Prime Minister Trudeau to force Canadian provinces to purchase their petroleum from Alberta. This caused the petrochemical industry to locate in Sarnia in Ontario, leaving the Montreal refining centre to become obsolete. 3 figs

  6. Rapid response systems.

    Science.gov (United States)

    Lyons, Patrick G; Edelson, Dana P; Churpek, Matthew M

    2018-07-01

    Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. Articles written in English and published in PubMed. Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement. Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. The rise of artificial intelligence and the uncertain future for physicians.

    Science.gov (United States)

    Krittanawong, C

    2018-02-01

    Physicians in everyday clinical practice are under pressure to innovate faster than ever because of the rapid, exponential growth in healthcare data. "Big data" refers to extremely large data sets that cannot be analyzed or interpreted using traditional data processing methods. In fact, big data itself is meaningless, but processing it offers the promise of unlocking novel insights and accelerating breakthroughs in medicine-which in turn has the potential to transform current clinical practice. Physicians can analyze big data, but at present it requires a large amount of time and sophisticated analytic tools such as supercomputers. However, the rise of artificial intelligence (AI) in the era of big data could assist physicians in shortening processing times and improving the quality of patient care in clinical practice. This editorial provides a glimpse at the potential uses of AI technology in clinical practice and considers the possibility of AI replacing physicians, perhaps altogether. Physicians diagnose diseases based on personal medical histories, individual biomarkers, simple scores (e.g., CURB-65, MELD), and their physical examinations of individual patients. In contrast, AI can diagnose diseases based on a complex algorithm using hundreds of biomarkers, imaging results from millions of patients, aggregated published clinical research from PubMed, and thousands of physician's notes from electronic health records (EHRs). While AI could assist physicians in many ways, it is unlikely to replace physicians in the foreseeable future. Let us look at the emerging uses of AI in medicine. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Shapes and rising velocities of single bubbles rising through an inner subchannel

    International Nuclear Information System (INIS)

    Tomiyama, Akio; Nakahara, Yusuke; Adachi, Yoshihiro; Hosokawa, Shigeo

    2003-01-01

    Shapes and velocities of single air bubbles rising through stagnant and flowing waters in an inner subchannel are measured by making use of fluorocarbon tubes. It is confirmed that (1) bubble shapes and motions in the subchannel are by far different from those in simple geometry, and they depend on the ratio λ of the bubble diameter to the subchannel hydraulic diameter, (2) when λ > 0.9, a part of a bubble intrudes into neighboring subchannels, and thereby a kind of void drift takes place even with a single bubble, (3) the terminal velocity V T of a small bubble (λ T for cell-Taylor bubbles (λ > 0.9) is presented, and (5) the rising velocity V B in laminar an turbulent flow conditions are well evaluated by substituting the proposed V T models and the ratio of the maximum liquid velocity to the mean liquid velocity into the Nicklin correlation. (author)

  9. The Rise of Concussions in the Adolescent Population.

    Science.gov (United States)

    Zhang, Alan L; Sing, David C; Rugg, Caitlin M; Feeley, Brian T; Senter, Carlin

    2016-08-01

    Concussion injuries have been highlighted to the American public through media and research. While recent studies have shown increased traumatic brain injuries (TBIs) diagnosed in emergency departments across the United States, no studies have evaluated trends in concussion diagnoses across the general US population in various age groups. To evaluate the current incidence and trends in concussions diagnosed across varying age groups and health care settings in a large cross-sectional population. Descriptive epidemiological study. Administrative health records of 8,828,248 members of a large private-payer insurance group in the United States were queried. Patients diagnosed with concussion from years 2007 through 2014 were stratified by year of diagnosis, age group, sex, classification of concussion, and health care setting of diagnosis (eg, emergency department vs physician's office). Chi-square testing was used for statistical analysis. From a cohort of 8,828,248 patients, 43,884 patients were diagnosed with a concussion. Of these patients, 55% were male and over 32% were in the adolescent age group (10-19 years old). The highest incidence of concussion was seen in patients aged 15 to 19 years (16.5/1000 patients), followed by those aged 10 to 14 years (10.5/1000 patients), 20 to 24 years (5.2/1000 patients), and 5 to 9 years (3.5/1000 patients). Overall, there was a 60% increase in concussion incidence from 2007 to 2014. The largest increases were in the 10- to 14-year (143%) and 15- to 19-year (87%) age groups. Based on International Classification of Disease-9th Revision classification, 29% of concussions were associated with some form of loss of consciousness. Finally, 56% of concussions were diagnosed in the emergency department and 29% in a physician's office, with the remainder in urgent care clinics or inpatient settings. The incidence of concussion diagnosed in the general US population is increasing, driven largely by a substantial rise in the adolescent

  10. Influence of plume rise on the consequences of radioactive material releases

    International Nuclear Information System (INIS)

    Russo, A.J.; Wayland, J.R.; Ritchie, L.T.

    1977-01-01

    Estimates of health consequences resulting from a postulated nuclear reactor accident can be strongly dependent on the buoyant rise of the plume of released radioactive material. The sensitivity of the consequences of a postulated accident to two different plume rise models has been investigated. The results of these investigations are the subject of this report. One of the models includes the effects of emission angle, momentum, and radioactive heating of the released material. The difference in the consequence estimates from the two models can exceed an order of magnitude under some conditions, but in general the results are similar

  11. Economic vulnerability to sea-level rise along the northern U.S. Gulf Coast

    Science.gov (United States)

    Thatcher, Cindy A.; Brock, John C.; Pendleton, Elizabeth A.

    2013-01-01

    The northern Gulf of Mexico coast of the United States has been identified as highly vulnerable to sea-level rise, based on a combination of physical and societal factors. Vulnerability of human populations and infrastructure to projected increases in sea level is a critical area of uncertainty for communities in the extremely low-lying and flat northern gulf coastal zone. A rapidly growing population along some parts of the northern Gulf of Mexico coastline is further increasing the potential societal and economic impacts of projected sea-level rise in the region, where observed relative rise rates range from 0.75 to 9.95 mm per year on the Gulf coasts of Texas, Louisiana, Mississippi, Alabama, and Florida. A 1-m elevation threshold was chosen as an inclusive designation of the coastal zone vulnerable to relative sea-level rise, because of uncertainty associated with sea-level rise projections. This study applies a Coastal Economic Vulnerability Index (CEVI) to the northern Gulf of Mexico region, which includes both physical and economic factors that contribute to societal risk of impacts from rising sea level. The economic variables incorporated in the CEVI include human population, urban land cover, economic value of key types of infrastructure, and residential and commercial building values. The variables are standardized and combined to produce a quantitative index value for each 1-km coastal segment, highlighting areas where human populations and the built environment are most at risk. This information can be used by coastal managers as they allocate limited resources for ecosystem restoration, beach nourishment, and coastal-protection infrastructure. The study indicates a large amount of variability in index values along the northern Gulf of Mexico coastline, and highlights areas where long-term planning to enhance resiliency is particularly needed.

  12. The rise and fall of gluten!

    Science.gov (United States)

    Aziz, Imran; Branchi, Federica; Sanders, David S

    2015-08-01

    Mankind has existed for 2·5 million years but only in the last 10,000 years have we been exposed to wheat. Wheat was first cultivated in the Fertile Crescent (South Western Asia) with a farming expansion that lasted from about 9000BC to 4000BC. Thus it could be considered that wheat (and gluten) is a novel introduction to man's diet! Prior to 1939 the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus it was agreed in 1941 that there was a need to establish a Nutrition Society. The very roots of the society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded 5-fold. Perhaps as a result the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. CD now affects 1 % or more of all adults, for which the treatment is a strict lifelong gluten-free diet. However, there is a growing body of evidence to show that a far greater proportion of individuals without coeliac disease are taking a gluten-free diet of their own volition. This clinical entity has been termed non-coeliac gluten sensitivity (NCGS), although the condition is fraught with complexities due to overlap with other gluten-based constituents that can also trigger similar clinical symptoms. This review will explore the relationship between gluten, the rising prevalence of modern coeliac disease, and the new entity of NCGS along with its associated uncertainties.

  13. An inexorable rise in intellectual disability?

    NARCIS (Netherlands)

    Michiel Ras; Isolde Woittiez; Hetty van Kempen; Klarita Sadiraj

    2010-01-01

    Original title: Steeds meer verstandelijk gehandicapten? Demand for intellectual disability care has grown strongly in the Netherlands in recent years. Partly at the request of the Dutch Ministry of Health, Welfare and Sport, the Netherlands Institute for Social Research/SCP measured the

  14. The challenges of rapid urbanization on sustainable development of ...

    African Journals Online (AJOL)

    The challenges of rapid urbanization on sustainable development of Nyanya, Federal Capital ... PROMOTING ACCESS TO AFRICAN RESEARCH ... unaffordable health care facilities, poor environmental health and traffic congestion on the ...

  15. Methods and problems in assessing the impacts of accelerated sea-level rise

    Science.gov (United States)

    Nicholls, Robert J.; Dennis, Karen C.; Volonte, Claudio R.; Leatherman, Stephen P.

    1992-06-01

    Accelerated sea-level rise is one of the more certain responses to global warming and presents a major challenge to mankind. However, it is important to note that sea-level rise is only manifest over long timescales (decades to centuries). Coastal scientists are increasingly being called upon to assess the physical, economic and societal impacts of sea-level rise and hence investigate appropriate response strategies. Such assessments are difficult in many developing countries due to a lack of physical, demographic and economic data. In particular, there is a lack of appropriate topographic information for the first (physical) phase of the analysis. To overcome these difficulties we have developed a new rapid and low-cost reconnaissance technique: ``aerial videotape-assisted vulnerability analysis'' (AVA). It involves: 1) videotaping the coastline from a small airplane; 2) limited ground-truth measurements; and 3) archive research. Combining the video record with the ground-truth information characterizes the coastal topography and, with an appropriate land loss model, estimates of the physical impact for different sea-level rise scenarios can be made. However, such land loss estimates raise other important questions such as the appropriate seaward limit of the beach profile. Response options also raise questions such as the long-term costs of seawalls. Therefore, realistic low and high estiimates were developed. To illustrate the method selected results from Senegal, Uruguay and Venezuela are presented.

  16. Effects of Sea Level Rise on Groundwater Flow Paths in a Coastal Aquifer System

    Science.gov (United States)

    Morrissey, S. K.; Clark, J. F.; Bennett, M. W.; Richardson, E.; Stute, M.

    2008-05-01

    Changes in groundwater flow in the Floridan aquifer system, South Florida, from the rise in sea level at the end of the last glacial period may be indicative of changes coastal aquifers will experience with continued sea level rise. As sea level rises, the hydraulic head near the coast increases. Coastal aquifers can therefore experience decreased groundwater gradients (increased residence times) and seawater intrusion. Stable isotopes of water, dissolved noble gas temperatures, radiocarbon and He concentrations were analyzed in water collected from 68 wells in the Floridan aquifer system throughout South Florida. Near the recharge area, geochemical data along groundwater flow paths in the Upper Floridan aquifer show a transition from recently recharged groundwater to glacial-aged water. Down gradient from this transition, little variation is apparent in the stable isotopes and noble gas recharge temperatures, indicating that most of the Upper Floridan aquifer contains groundwater recharged during the last glacial period. The rapid 120-meter rise in sea level marking the end of the last glacial period increased the hydraulic head in the Floridan aquifer system near the coast, slowing the flow of groundwater from the recharge area to the ocean and trapping glacial-aged groundwater. The raised sea level also flooded half of the Florida platform and caused seawater to intrude into the Lower Floridan. This circulation of seawater in the Lower Floridan continues today as our data indicate that the groundwater is similar to modern seawater with a freshwater component entering vertically from the recharge area to the Upper Floridan.

  17. Calculation of high-rise construction limitations for non-resident housing fund in megacities

    Directory of Open Access Journals (Sweden)

    Iliashenko Oksana

    2018-01-01

    Full Text Available The paper is devoted to topical issues of urban planning in terms of high-rise construction of a non-resident housing stock in relation to megacities. We consider this issue taking into account the limitations of natural, communal and social resources. The problem is especially acute for the overwhelming majority of the state capitals, as well as cities with historical heritage that are of great interest due to the rapid development of tourism and the high mobility of the population in the world. The growth of the population of many states capitals led to the use of high-rise buildings as a non-resident housing stock. However, there are a number of restrictions on the high-rise construction of non-resident housing stock in megacities. The authors formalize the problem of determining the optimal ratio of the volume of urban buildings belonging to the high-rise buildings types and intended for non-residents to a common housing fund. We conduct economic calculations to determine the quantitative indicators. It can be used as the basis for administrative measures aimed at limiting the people flow arriving with the intention of temporarily deploying in megacities.

  18. The Rise of Mobile Technology on the Financial Sector in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Paul Mupfiga

    2017-07-01

    Full Text Available The emergence of technology has revolted the way that the financial industry operates and the increasing use of mobile gadgets has changed the banking system from the traditional brick and mortar building to a virtual system. The sudden rise in use and innovation of smart mobile phones, mobile personal computers, tablets and various other mobile electronic gadgets has resulted in the rise of mobile financial products. Rapid quickening innovative headways are making completely new business suggestions, for example, crowd financing, shared loaning, advanced monetary forms, versatile managing an account, online speculation and new instalment frameworks. Zimbabwe's mobile technology use is currently on the rise too as mobile service providers like Econet are enabling the connection between consumers and financial related products. Despite the fact that innovation without a doubt brings benefits, prominent specialized disappointments in the money related part lately are disturbing and several negative factors are to some extent affecting production. Drawbacks like cybercrime, resistance to change, and compatibility of mobile gadgets are affecting the information technology environment. This paper highlights the rise of mobile technology in the financial sector in Zimbabwe.

  19. Calculation of high-rise construction limitations for non-resident housing fund in megacities

    Science.gov (United States)

    Iliashenko, Oksana; Krasnov, Sergey; Sergeev, Sergey

    2018-03-01

    The paper is devoted to topical issues of urban planning in terms of high-rise construction of a non-resident housing stock in relation to megacities. We consider this issue taking into account the limitations of natural, communal and social resources. The problem is especially acute for the overwhelming majority of the state capitals, as well as cities with historical heritage that are of great interest due to the rapid development of tourism and the high mobility of the population in the world. The growth of the population of many states capitals led to the use of high-rise buildings as a non-resident housing stock. However, there are a number of restrictions on the high-rise construction of non-resident housing stock in megacities. The authors formalize the problem of determining the optimal ratio of the volume of urban buildings belonging to the high-rise buildings types and intended for non-residents to a common housing fund. We conduct economic calculations to determine the quantitative indicators. It can be used as the basis for administrative measures aimed at limiting the people flow arriving with the intention of temporarily deploying in megacities.

  20. The Rising Rate of Rural Hospital Closures.

    Science.gov (United States)

    Kaufman, Brystana G; Thomas, Sharita R; Randolph, Randy K; Perry, Julie R; Thompson, Kristie W; Holmes, George M; Pink, George H

    2016-01-01

    Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critical access hospitals (CAHs) and other rural hospitals (ORHs). Differences were tested using Pearson's chi-square (categorical variables) and Wilcoxon rank test of medians. The relationships between negative operating margin and (1) market factors and (2) utilization/staffing factors were explored using logistic regression. In 2009, CAHs that subsequently closed from 2010 through 2014 had, in general, lower levels of profitability, liquidity, equity, patient volume, and staffing. In addition, ORHs that closed had smaller market shares and operated in markets with smaller populations compared to ORHs that remained open. Odds of unprofitability were associated with both market and utilization factors. Although half of the closed hospitals ceased providing health services altogether, the remainder have since converted to an alternative health care delivery model. Financial and market characteristics appear to be associated with closure of rural hospitals from 2010 through 2014, suggesting that it is possible to identify hospitals at risk of closure. As closure rates show no sign of abating, it is important to study the drivers of distress in rural hospitals, as well as the potential for alternative health care delivery models. © 2015 National Rural Health Association.

  1. An inexorable rise in intellectual disability?

    OpenAIRE

    Michiel Ras; Isolde Woittiez; Hetty van Kempen; Klarita Sadiraj

    2010-01-01

    Original title: Steeds meer verstandelijk gehandicapten? Demand for intellectual disability care has grown strongly in the Netherlands in recent years. Partly at the request of the Dutch Ministry of Health, Welfare and Sport, the Netherlands Institute for Social Research/SCP measured the number of people with intellectual disabilities applying for care. The results are contained in this report. Our inventory reveals that demand for intellectual disability care has risen by an average of 9% pe...

  2. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013. Scientific Opinion on the substantiation of a health claim related to Preservation ® and “ rapid recovery of cellular activity post stress ” pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    Following an application from ICP Ltd, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Malta, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific...... substantiation of a health claim related to Preservation® and “rapid recovery of cellular activity post stress”. The Panel considers that Preservation®, which contains an extract of prickly pear cactus Opuntia ficus-indica, is sufficiently characterised. The claimed effect is “rapid recovery of cellular activity...

  3. Sun Radio Interferometer Space Experiment (SunRISE)

    Science.gov (United States)

    Kasper, Justin C.; SunRISE Team

    2018-06-01

    The Sun Radio Interferometer Space Experiment (SunRISE) is a NASA Heliophysics Explorer Mission of Opportunity currently in Phase A. SunRISE is a constellation of spacecraft flying in a 10-km diameter formation and operating as the first imaging radio interferometer in space. The purpose of SunRISE is to reveal critical aspects of solar energetic particle (SEP) acceleration at coronal mass ejections (CMEs) and transport into space by making the first spatially resolved observations of coherent Type II and III radio bursts produced by electrons accelerated at CMEs or released from flares. SunRISE will focus on solar Decametric-Hectometric (DH, 0.1 space before major SEP events, but cannot be seen on Earth due to ionospheric absorption. This talk will describe SunRISE objectives and implementation. Presented on behalf of the entire SunRISE team.

  4. Rising prevalence of back pain in Austria: considering regional disparities.

    Science.gov (United States)

    Großschädl, Franziska; Stolz, Erwin; Mayerl, Hannes; Rásky, Éva; Freidl, Wolfgang; Stronegger, Willibald J

    2016-01-01

    Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults. A secondary data analysis based on five nationally representative cross-sectional surveys (1973-2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality. A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria. Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East-West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.

  5. Rise and Shock: Optimal Defibrillator Placement in a High-rise Building.

    Science.gov (United States)

    Chan, Timothy C Y

    2017-01-01

    Out-of-hospital cardiac arrests (OHCA) in high-rise buildings experience lower survival and longer delays until paramedic arrival. Use of publicly accessible automated external defibrillators (AED) can improve survival, but "vertical" placement has not been studied. We aim to determine whether elevator-based or lobby-based AED placement results in shorter vertical distance travelled ("response distance") to OHCAs in a high-rise building. We developed a model of a single-elevator, n-floor high-rise building. We calculated and compared the average distance from AED to floor of arrest for the two AED locations. We modeled OHCA occurrences using floor-specific Poisson processes, the risk of OHCA on the ground floor (λ 1 ) and the risk on any above-ground floor (λ). The elevator was modeled with an override function enabling direct travel to the target floor. The elevator location upon override was modeled as a discrete uniform random variable. Calculations used the laws of probability. Elevator-based AED placement had shorter average response distance if the number of floors (n) in the building exceeded three quarters of the ratio of ground-floor OHCA risk to above-ground floor risk (λ 1 /λ) plus one half (n ≥ 3λ 1 /4λ + 0.5). Otherwise, a lobby-based AED had shorter average response distance. If OHCA risk on each floor was equal, an elevator-based AED had shorter average response distance. Elevator-based AEDs travel less vertical distance to OHCAs in tall buildings or those with uniform vertical risk, while lobby-based AEDs travel less vertical distance in buildings with substantial lobby, underground, and nearby street-level traffic and OHCA risk.

  6. Does a Rise in Income Inequality Lead to Rises in Transportation Inequality and Mobility Practice Inequality?

    Directory of Open Access Journals (Sweden)

    Joko Purwanto

    2016-06-01

    Full Text Available Social and economic inequalities have sharpened in the late 20th century. During this period, Europe has witnessed a rising unemployment rate, a declining wages for the least qualified workers, a slowing of income growth, and an increasing gap between the richest and the poorest. Based on the hypothesis of the relation between socio-economic condition and mobility behaviour, it is necessary to ask how these socio-economic inequalities manifest themselves in transportation: does a rise in income inequality lead to a rise in transportation inequality and mobility practice inequality? This question is particularly relevant today as some European countries are facing high socio-economic inequalities following the financial crisis that started in 2008. Using results from transport, car ownership and mobility surveys as well as household surveys from the Paris (Île-de-France region between eighties and late nineties, this paper tries to answer this question. The results show how inequalities in transportation and mobility practice have decreased during the period in spite of an increase in income inequalities. We find that the evolution of socio-economic inequality, most specifically income inequality was simply one of the determining factors of the evolution of inequalities in transportation and mobility practice. In fact, the most important role in that evolution is not played by the evolution of income inequality but by the evolution of elasticity between transportation and income. Reducing the effects of this elasticity should be the main target of transport policies to diminish inequality in transportation and mobility practice.

  7. Rise and Fall of Tios-Tieion

    Science.gov (United States)

    Aksoy, Erman; Yıldırım, Şahin

    2017-10-01

    The existence or endurance of the city is determined by social, economic, cultural, and technological factors. Therefore, transportation connections become physical signifiers of the relation between two spaces. Nevertheless, the potential for change in transportation is more dynamic when compared to other factors. Change in the infrastructure and systems of transportation become evident at the urban scale more rapidly. In addition to leading to the formation of new cities or to socio-cultural and economic development in the already-existent cities, this dynamic structure may also cause the decrease in economic power, and even the desertion of settlements. Furthermore, it functions as a leading, even determining, parameter in the formation of space, thereby in economic and social development. The fact that, throughout history, centres of communication and commerce were established at intersection, stopping and lodging points of transportation links and/or their development into residential areas attests to this interaction. In the commercial centres and life of the city, the effects of regional transportation networks and technologies surface relatively. By means of the analytical method, this study focuses on how, within the history of settlements, population increases due to the choice of location based on transportation and strategic significance, and how urban functions vary accordingly. As such, the interaction between urban development and transportation links for the Ancient City of Tios will be analysed, and the signifiers for urban development will be designated.

  8. Progressive Collapse of High-Rise Buildings from Fire

    Directory of Open Access Journals (Sweden)

    Pershakov Valerii

    2016-01-01

    Full Text Available Considers ensuring the stability of structures of high-rise buildings against progressive collapse due to fire, proposed measures to ensure the stability of high-rise buildings due to progressive collapse. The analysis of large fires in high-rise buildings with progressive collapse and review of the literature on the issue of progressive collapse. The analysis of the Ukrainian normative documents on progressive collapse resistance.

  9. Rising damp in building walls: the wall base ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, A.S.; Delgado, J.M.P.Q.; Freitas, V.P. de [Faculdade de Engenharia da Universidade do Porto, Laboratorio de Fisica das Construcoes (LFC), Departamento de Engenharia Civil, Porto (Portugal)

    2012-12-15

    This work intends to validate a new system for treating rising damp in historic buildings walls. The results of laboratory experiments show that an efficient way of treating rising damp is by ventilating the wall base, using the HUMIVENT technique. The analytical model presented describes very well the observed features of rising damp in walls, verified by laboratory tests, who contributed for a simple sizing of the wall base ventilation system that will be implemented in historic buildings. (orig.)

  10. Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Hazel Gardner

    2015-09-01

    Full Text Available Rapid economic and cultural transition in the United Arab Emirates (UAE has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother’s education level, employment status and early introduction of complementary foods.

  11. Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates.

    Science.gov (United States)

    Gardner, Hazel; Green, Katherine; Gardner, Andrew

    2015-09-02

    Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother's education level, employment status and early introduction of complementary foods.

  12. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... and utilize the benefits of different types of health insurance services. Conclusion: The findings ..... improvements in access and quality of care, and the ... the 'rising tide' of and information technology.

  13. Salt marsh persistence is threatened by predicted sea-level rise

    Science.gov (United States)

    Crosby, Sarah C.; Sax, Dov F.; Palmer, Megan E.; Booth, Harriet S.; Deegan, Linda A.; Bertness, Mark D.; Leslie, Heather M.

    2016-11-01

    Salt marshes buffer coastlines and provide critical ecosystem services from storm protection to food provision. Worldwide, these ecosystems are in danger of disappearing if they cannot increase elevation at rates that match sea-level rise. However, the magnitude of loss to be expected is not known. A synthesis of existing records of salt marsh elevation change was conducted in order to consider the likelihood of their future persistence. This analysis indicates that many salt marshes did not keep pace with sea-level rise in the past century and kept pace even less well over the past two decades. Salt marshes experiencing higher local sea-level rise rates were less likely to be keeping pace. These results suggest that sea-level rise will overwhelm most salt marshes' capacity to maintain elevation. Under the most optimistic IPCC emissions pathway, 60% of the salt marshes studied will be gaining elevation at a rate insufficient to keep pace with sea-level rise by 2100. Without mitigation of greenhouse gas emissions this potential loss could exceed 90%, which will have substantial ecological, economic, and human health consequences.

  14. 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.

  15. 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

  16. The social values at risk from sea-level rise

    International Nuclear Information System (INIS)

    Graham, Sonia; Barnett, Jon; Fincher, Ruth; Hurlimann, Anna; Mortreux, Colette; Waters, Elissa

    2013-01-01

    Analysis of the risks of sea-level rise favours conventionally measured metrics such as the area of land that may be subsumed, the numbers of properties at risk, and the capital values of assets at risk. Despite this, it is clear that there exist many less material but no less important values at risk from sea-level rise. This paper re-theorises these multifarious social values at risk from sea-level rise, by explaining their diverse nature, and grounding them in the everyday practices of people living in coastal places. It is informed by a review and analysis of research on social values from within the fields of social impact assessment, human geography, psychology, decision analysis, and climate change adaptation. From this we propose that it is the ‘lived values’ of coastal places that are most at risk from sea-level rise. We then offer a framework that groups these lived values into five types: those that are physiological in nature, and those that relate to issues of security, belonging, esteem, and self-actualisation. This framework of lived values at risk from sea-level rise can guide empirical research investigating the social impacts of sea-level rise, as well as the impacts of actions to adapt to sea-level rise. It also offers a basis for identifying the distribution of related social outcomes across populations exposed to sea-level rise or sea-level rise policies

  17. The social values at risk from sea-level rise

    Energy Technology Data Exchange (ETDEWEB)

    Graham, Sonia, E-mail: sonia.graham@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Barnett, Jon, E-mail: jbarn@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Fincher, Ruth, E-mail: r.fincher@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Hurlimann, Anna, E-mail: anna.hurlimann@unimelb.edu.au [Faculty of Architecture, Building and Planning, The University of Melbourne, Architecture and Planning Building, Parkville, Victoria 3010 (Australia); Mortreux, Colette, E-mail: colettem@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Waters, Elissa, E-mail: elissa.waters@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia)

    2013-07-15

    Analysis of the risks of sea-level rise favours conventionally measured metrics such as the area of land that may be subsumed, the numbers of properties at risk, and the capital values of assets at risk. Despite this, it is clear that there exist many less material but no less important values at risk from sea-level rise. This paper re-theorises these multifarious social values at risk from sea-level rise, by explaining their diverse nature, and grounding them in the everyday practices of people living in coastal places. It is informed by a review and analysis of research on social values from within the fields of social impact assessment, human geography, psychology, decision analysis, and climate change adaptation. From this we propose that it is the ‘lived values’ of coastal places that are most at risk from sea-level rise. We then offer a framework that groups these lived values into five types: those that are physiological in nature, and those that relate to issues of security, belonging, esteem, and self-actualisation. This framework of lived values at risk from sea-level rise can guide empirical research investigating the social impacts of sea-level rise, as well as the impacts of actions to adapt to sea-level rise. It also offers a basis for identifying the distribution of related social outcomes across populations exposed to sea-level rise or sea-level rise policies.

  18. Organizing vertical layout environments: a forward-looking development strategy for high-rise building projects

    Science.gov (United States)

    Magay, A. A.; Bulgakova, E. A.; Zabelina, S. A.

    2018-03-01

    The article highlights issues surrounding development of high rise buildings. With the rapid increase of the global population there has been a trend for people to migrate into megacities and has caused the expansion of big city territories. This trend, coupled with the desire for a comfortable living environment, has resulted in numerous problems plaguing the megacity. This article proposes that a viable solution to the problems facing megacities is to create vertical layout environments. Potential options for creating vertical layout environments are set out below including the construction of buildings with atriums. Further, the article puts forth suggested spatial organization of the environment as well as optimal landscaping of high-rise buildings and constructions for the creation of vertical layout environments. Finally, the persuasive reasons for the adoption of vertical layout environments is that it will decrease the amount of developed urban areas, decrease traffic and increase environmental sustainability.

  19. A Cultural Diffusion Model for the Rise and Fall of Programming Languages.

    Science.gov (United States)

    Valverde, Sergi; Solé, Ricard V

    2015-07-01

    Our interaction with complex computing machines is mediated by programming languages (PLs), which constitute one of the major innovations in the evolution of technology. PLs allow flexible, scalable, and fast use of hardware and are largely responsible for shaping the history of information technology since the rise of computers in the 1950s. The rapid growth and impact of computers were followed closely by the development of PLs. As occurs with natural, human languages, PLs have emerged and gone extinct. There has been always a diversity of coexisting PLs that compete somewhat while occupying special niches. Here we show that the statistical patterns of language adoption, rise, and fall can be accounted for by a simple model in which a set of programmers can use several PLs, decide to use existing PLs used by other programmers, or decide not to use them. Our results highlight the influence of strong communities of practice in the diffusion of PL innovations.

  20. Current-day matters of administration and law in the field of high-rise construction

    Science.gov (United States)

    Voskresenskaya, Elena; Snetkov, Vitaly; Tebryaev, Alexander

    2018-03-01

    The article touches upon main reasons for high-rise construction: increase in energy consumption and limited availability of site in the big cities of Russia. Increase in energy consumption is related with construction, transportation and applying of ventilation and air conditioning systems. Nowadays, there are developed a lot of design and engineer solutions, that include autonomous systems as well as passive methods with low energy consumption rate, which are interrelated with local climate conditions. Certain architectural solutions contribute to energy consumption decrease: building orientation with respect to the cardinal directions, taking into account the prevailing cold wind directions, maximum glazing of the southern facades and minimum glazing of the northern ones, what plays a big role in hard climate conditions. Limited availability of site for construction in the big cities resulted in rapid development of the high-rise construction, which today prevails in terms of quantitative indicators of civil engineering.

  1. Vertical cities - the new form of high-rise construction evolution

    Science.gov (United States)

    Akristiniy, Vera A.; Boriskina, Yulia I.

    2018-03-01

    The article considers the basic principles of the vertical cities formation for the creation of a comfortable urban environment in conditions of rapid population growth and limited territories. As urban growth increases, there is a need for new concepts and approaches to urban space planning through the massive introduction of high-rise construction. The authors analyzed and systematized the list of high-tech solutions for arrangement the space of vertical cities, which are an integral part of the creation of the methodology for forming a high-rise buildings. Their concept differs in scale, presence of the big areas of public spaces, tendencies to self-sufficiency and sustainability, opportunity to offer the new unique comfortable environment to the population living in them.

  2. Behavior of pressure rise and condensation caused by water evaporation under vacuum at high temperature

    International Nuclear Information System (INIS)

    Takase, Kazuyuki; Kunugi, Tomoaki; Yamazaki, Seiichiro; Fujii, Sadao

    1998-01-01

    Pressure rise and condensation characteristics during the ingress-of-coolant event (ICE) in fusion reactors were investigated using the preliminary ICE apparatus with a vacuum vessel (VV), an additional tank (AT) and an isolation valve (IV). A surface of the AT was cooled by water at RT. The high temperature and pressure water was injected into the VV which was heated up to 250degC and pressure and temperature transients in the VV were measured. The pressure increased rapidly with an injection time of the water because of the water evaporation. After the IV was opened and the VV was connected with the AT, the pressure in the VV decreased suddenly. From a series of the experiments, it was confirmed that control factors on the pressure rise were the flushing evaporation and boiling heat transfer in the VV, and then, condensation of the vapor after was effective to the depressurization in the VV. (author)

  3. Taming the EHR (Electronic Health Record) - There is Hope

    Science.gov (United States)

    DiAngi, YT; Longhurst, CA; Payne, TH

    2016-01-01

    With increasing diffusion of EHR technology over the last half decade, clinician burnout is rising. As healthcare is a complex and highly regulated field, the rapid and mass adoption of EHR technology has created disruption for highly skilled workers such as clinicians. Although, much has been written about dissatisfaction with the EHR (electronic health record), a paucity of immediate solutions exists in the literature. This article suggests three actionable steps health systems and clinicians can make to expedite gains from and mitigate the effect of the EHR on clinical practice. PMID:27830215

  4. The rise of novelty in ecosystems.

    Science.gov (United States)

    Radeloff, Volker C; Williams, John W; Bateman, Brooke L; Burke, Kevin D; Carter, Sarah K; Childress, Evan S; Cromwell, Kara J; Gratton, Claudio; Hasley, Andrew O; Kraemer, Benjamin M; Latzka, Alexander W; Marin-Spiotta, Erika; Meine, Curt D; Munoz, Samuel E; Neeson, Thomas M; Pidgeon, Anna M; Rissman, Adena R; Rivera, Ricardo J; Szymanski, Laura M; Usinowicz, Jacob

    2015-12-01

    Rapid and ongoing change creates novelty in ecosystems everywhere, both when comparing contemporary systems to their historical baselines, and predicted future systems to the present. However, the level of novelty varies greatly among places. Here we propose a formal and quantifiable definition of abiotic and biotic novelty in ecosystems, map abiotic novelty globally, and discuss the implications of novelty for the science of ecology and for biodiversity conservation. We define novelty as the degree of dissimilarity of a system, measured in one or more dimensions relative to a reference baseline, usually defined as either the present or a time window in the past. In this conceptualization, novelty varies in degree, it is multidimensional, can be measured, and requires a temporal and spatial reference. This definition moves beyond prior categorical definitions of novel ecosystems, and does not include human agency, self-perpetuation, or irreversibility as criteria. Our global assessment of novelty was based on abiotic factors (temperature, precipitation, and nitrogen deposition) plus human population, and shows that there are already large areas with high novelty today relative to the early 20th century, and that there will even be more such areas by 2050. Interestingly, the places that are most novel are often not the places where absolute changes are largest; highlighting that novelty is inherently different from change. For the ecological sciences, highly novel ecosystems present new opportunities to test ecological theories, but also challenge the predictive ability of ecological models and their validation. For biodiversity conservation, increasing novelty presents some opportunities, but largely challenges. Conservation action is necessary along the entire continuum of novelty, by redoubling efforts to protect areas where novelty is low, identifying conservation opportunities where novelty is high, developing flexible yet strong regulations and policies, and

  5. Rapid world modeling

    International Nuclear Information System (INIS)

    Little, Charles; Jensen, Ken

    2002-01-01

    Sandia National Laboratories has designed and developed systems capable of large-scale, three-dimensional mapping of unstructured environments in near real time. This mapping technique is called rapid world modeling and has proven invaluable when used by prototype systems consisting of sensory detection devices mounted on mobile platforms. These systems can be deployed into previously unmapped environments and transmit real-time 3-D visual images to operators located remotely. This paper covers a brief history of the rapid world modeling system, its implementation on mobile platforms, and the current state of the technology. Applications to the nuclear power industry are discussed. (author)

  6. JINR rapid communications

    International Nuclear Information System (INIS)

    1998-01-01

    The present collection of rapid communications from JINR, Dubna, contains seven separate records on relativistic multiparticle processes in the central rapidity region at asymptotically high energies, a new experimental study of charged K→3π decays, pre-Cherenkov radiation as a phenomenon of 'light barrier', stable S=-2 H dibaryon found in Dubna, calculation of Green functions and gluon top in some unambiguous gauges, a method of a fast selection of inelastic nucleus-nucleus collisions for the CMS experiment and the manifestation of jet quenching in differential distributions of the total transverse energy in nucleus-nucleus collisions

  7. Rapid microbiology - raising awareness.

    Science.gov (United States)

    Bailie, Jonathan

    2016-01-01

    A 'high-level overview' of some of the emerging rapid microbiology technologies designed to help healthcare engineering and infection control teams working in hospitals and other healthcare facilities more rapidly identify potentially hazardous levels of waterborne microorganisms in their water systems, enabling them to take prompt remedial action, and a look at the some of the 'pros and cons' of such testing techniques, was given by Nalco technical director, Howard Barnes, the vice-chair of the Legionella Control Association (LCA), at a recent LCA open day. HEJ editor, Jonathan Bailie, reports.

  8. JINR rapid communications

    International Nuclear Information System (INIS)

    1998-01-01

    The present collection of rapid communications from JINR, Dubna, contains seven separate records on invisible Z-boson width and restrictions on next-to-minimal supersymmetric standard model, cosmic test of honeycomb drift chambers, fission of 209 Bi, 232 Th, 235 U, 238 U and 237 Np in a spallation neutron field, rapid screening of spontaneous and radiation-induced structural changes at the vestigial gene of Drosophila melanogaster by polymerase chain reaction, gamma-ray multiplicities in sub-barrier fission of 226 Th and the decay constants of the scalar and pseudoscalar mesons in the quark models with quasilocal interaction

  9. Society and health effects of aspects an overview of nuclear energy

    OpenAIRE

    Mehmet Soykenar; Sabahat Coskun

    2015-01-01

    Today a