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Sample records for health assessment document

  1. HEALTH ASSESSMENT DOCUMENT FOR POLYCYCLIC ORGANIC MATTER

    EPA Science Inventory

    The document responds to Section 122 of the Clean Air Act as Amended August 1977, which requires the Administrator to decide whether atmospheric emissions of polycyclic organic matter (POM) potentially endanger public health. This document reviews POM data on chemical and physica...

  2. NONCARCINOGENIC EFFECTS OF CHROMIUM: UPDATE TO HEALTH ASSESSMENT DOCUMENT

    EPA Science Inventory

    This 1990 document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these o...

  3. Health assessment document for manganese. Final report

    SciTech Connect

    Bilinski, H.; Bruins, R.J.F.; Erdreich, L.; Fugas, M.; Kello, D.

    1984-08-01

    The document evaluates data on occurrence, sources, and transport of manganese in the environment and data on metabolism, pharmacokinetics, laboratory toxicological and epidemiologic studies to determine the nature and dose response relationship of potential health effects on humans. Nationwide air sampling data indicate that mean manganese concentrations have declined from 0.11 micrograms per cu. m. in 1953-1957 to 0.033 micrograms per cu. m. in 1982. The effects of major concern to humans exposed to manganese are on neurological and on pulmonary function. The CNS effects have been observed in humans at exposure levels above 5 mg/cu. m. and are incapacitating and generally irreversible. Data are equivocal between 1 and 5 mg/cu. m. but suggest decreased prevalence. There are no reports of these effects below 0.3 mg/cu. m. exposure. Pneumonia and chronic bronchitis occur at levels which are associated with neurological effects. Reduced lung function has been reported in children exposed to an estimated 3-11 micrograms per cu. m. from emission of a ferromanganese plant. However, studies of workers exposed to 40 micrograms per cu. m. did not show respiratory symptoms. Animal studies qualitatively support pulmonary effects of manganese exposure. Respiratory symptoms occur at lower levels than neurological symptoms and are therefore considered to be the critical effect based on available data.

  4. HEALTH ASSESSMENT DOCUMENT FOR CHROMIUM. FINAL REPORT

    EPA Science Inventory

    The full document represents a comprehensive data base that considers all sources of chromium in the environment, the likelihood for its exposure to humans, and the possible consequences to man and lower organisms from its absorption. This information is integrated into a format ...

  5. HEALTH ASSESSMENT DOCUMENT FOR TOLUENE. FINAL REPORT

    EPA Science Inventory

    The health effect of primary concern with regard to exposures of humans to toluene is dysfunction of the central nervous system (CNS). Occupational exposures in the range of 200 to 1,500 ppm have elicited dose-related CNS alterations. Although myelotoxicity was previously attribu...

  6. HEALTH ASSESSMENT DOCUMENT FOR POLYCHLORINATED DIBENZO-P-DIOXINS (1985)

    EPA Science Inventory

    The health assessment document on polychlorinated dibenzo-p-dioxins discusses multimedia environmental issues pertaining to the most toxic chlorinated dioxins, namely, 2,3,7,8-tetrachloro-; 1,2,3,7,8-pentachloro-; 1,2,3,6,7,8-hexachloro-; and 1,2,3,7,8,9-hexachlorodibenzo-p-dioxi...

  7. Evaluation and use of epidemiological evidence for environmental health risk assessment: WHO guideline document.

    PubMed Central

    2000-01-01

    Environmental health risk assessment is increasingly being used in the development of environmental health policies, public health decision making, the establishment of environmental regulations, and research planning. The credibility of risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. It is, therefore, imperative that the processes and methods used to evaluate the evidence and estimate health risks are clear, explicit, and based on valid epidemiological theory and practice. Epidemiological Evidence for Environmental Health Risk Assessment is a World Health Organization (WHO) guideline document. The primary target audiences of the guidelines are expert review groups that WHO (or other organizations) might convene in the future to evaluate epidemiological evidence on the health effects of environmental factors. These guidelines identify a set of processes and general approaches to assess available epidemiological information in a clear, consistent, and explicit manner. The guidelines should also help in the evaluation of epidemiological studies with respect to their ability to support risk assessment and, consequently, risk management. Conducting expert reviews according to such explicit guidelines would make health risk assessment and subsequent risk management and risk communication processes more readily understood and likely to be accepted by policymakers and the public. It would also make the conclusions reached by reviews more readily acceptable as a basis for future WHO guidelines and other recommendations, and would provide a more rational basis for setting priorities for future research. PMID:11049823

  8. Evaluation and use of epidemiological evidence for environmental health risk assessment: WHO guideline document.

    PubMed

    2000-10-01

    Environmental health risk assessment is increasingly being used in the development of environmental health policies, public health decision making, the establishment of environmental regulations, and research planning. The credibility of risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. It is, therefore, imperative that the processes and methods used to evaluate the evidence and estimate health risks are clear, explicit, and based on valid epidemiological theory and practice. Epidemiological Evidence for Environmental Health Risk Assessment is a World Health Organization (WHO) guideline document. The primary target audiences of the guidelines are expert review groups that WHO (or other organizations) might convene in the future to evaluate epidemiological evidence on the health effects of environmental factors. These guidelines identify a set of processes and general approaches to assess available epidemiological information in a clear, consistent, and explicit manner. The guidelines should also help in the evaluation of epidemiological studies with respect to their ability to support risk assessment and, consequently, risk management. Conducting expert reviews according to such explicit guidelines would make health risk assessment and subsequent risk management and risk communication processes more readily understood and likely to be accepted by policymakers and the public. It would also make the conclusions reached by reviews more readily acceptable as a basis for future WHO guidelines and other recommendations, and would provide a more rational basis for setting priorities for future research. PMID:11049823

  9. Noncarcinogenic effects of chromium: Update to health-assessment document. Final report

    SciTech Connect

    Victery, W.; Lee, S.D.; Mushak, P.; Piscator, M.

    1990-04-01

    The document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these oxidation states and amounts at submicrogram ambient air levels, the degree of human exposure to chromium in the environment, both short-term and long-term, in vivo reduction of Cr (VI) to Cr (III), and effects from environmentally relevant levels on pulmonary function and renal function. Trivalent chromium is chemically stable; Cr (VI) is readily reduced to Cr (III). Oxidation state of chromium in ambient air depends on proximity to sources emitting one form over the other. Reliable monitoring methods to speciate oxidation states at ambient air levels below 1 microgram/cu m are not available. Ambient levels of total chromium (obtained from EPA's National Air Data Branch) range from a high of 0.6 microgram/cu m to below the detection limit of 0.005 microgram/cu m. Reduction of hexavalent chromium in vivo occurs in several organ systems and therefore, small amounts of inhaled Cr (VI) will be reduced before systemic absorption can occur. Trivalent chromium is an essential trace metal which potentiates actions of insulin-mediated glucose transport.

  10. An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness.

    PubMed

    Ford, Heath; Trent, Shane; Wickizer, Stephen

    2016-03-25

    Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy's (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts. PMID:27073273

  11. An Assessment of State Board of Pharmacy Legal Documents for Public Health Emergency Preparedness

    PubMed Central

    Trent, Shane; Wickizer, Stephen

    2016-01-01

    Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy’s (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts. PMID:27073273

  12. Demographic, Clinical, and Health System Characteristics Associated With Pain Assessment Documentation and Pain Severity in U.S. Military Patients in Combat Zone Emergency Departments, 2010-2013.

    PubMed

    Blackman, Virginia Schmied; Cooper, Bruce A; Puntillo, Kathleen; Franck, Linda S

    2016-01-01

    Emergency department (ED) pain assessment documentation in trauma patients is critical to ED pain care. This retrospective, cross-sectional study used trauma registry data to evaluate U.S. military combat zone trauma patients injured between 2010 and 2013 requiring ≥ 24-hr inpatient care. Study aims were to identify the frequency of combat zone ED pain assessment documentation and describe pain severity. Secondary aims were to construct statistical models to explain variation in pain assessment documentation and pain severity.Pain scores were documented in 60.5% (n = 3,339) of the 5,518 records evaluated. The proportion of records with ED pain scores increased yearly. Pain assessment documentation was associated with documentation of ED vital signs, comprehensive facility, more recent year, prehospital (PH) heart rate of 60-100 beats/min, ED Glasgow Coma Scale score of 15 vs. 14, blunt trauma, and lower injury severity score (ISS).Pain severity scores ranged from 0 to 10; mean = 5.5 (SD = 3.1); median = 6. Higher ED pain scores were associated with Army service compared with Marine Corps, no documented PH vital signs, higher PH pain score, ED respiratory rate < 12 or >16, moderate or severe ISS compared with minor ISS, treatment in a less-equipped facility, and injury in 2011 or 2012 vs. 2010. The pain severity model explained 20.4% of variance in pain severity.Overall, frequency of pain assessment documentation in combat-zone EDs improved yearly, but remained suboptimal. Pain severity was poorly predicted by demographic, clinical, and health system variables available from the trauma registry, emphasizing the importance of individual assessment. PMID:27618374

  13. A comparison of mental state examination documentation by junior clinicians in electronic health records before and after the introduction of a semi-structured assessment template (OPCRIT+)

    PubMed Central

    Lobo, Sarah E.M.; Rucker, James; Kerr, Madeleine; Gallo, Fidel; Constable, Giles; Hotopf, Matthew; Stewart, Robert; Broadbent, Matthew; Baggaley, Martin; Lovestone, Simon; McGuffin, Peter; Amarasinghe, Myanthi; Newman, Stuart; Schumann, Gunter; Brittain, Philip J.

    2015-01-01

    Objectives The mental state examination (MSE) provides crucial information for healthcare professionals in the assessment and treatment of psychiatric patients as well as potentially providing valuable data for mental health researchers accessing electronic health records (EHRs). We wished to establish if improvements could be achieved in the documenting of MSEs by junior doctors within a large United Kingdom mental health trust following the introduction of an EHR based semi-structured MSE assessment template (OPCRIT+). Methods First, three consultant psychiatrists using a modified version of the Physician Documentation Quality Instrument-9 (PDQI-9) blindly rated fifty MSEs written using OPCRIT+ and fifty normal MSEs written with no template. Second, we conducted an audit to compare the frequency with which individual components of the MSE were documented in the normal MSEs compared with the OPCRIT + MSEs. Results PDQI-9 ratings indicated that the OPCRIT + MSEs were more ‘Thorough’, ‘Organized’, ‘Useful’ and ‘Comprehensible’ as well as being of an overall higher quality than the normal MSEs. The audit identified that the normal MSEs contained fewer mentions of the individual components of ‘Thought content’, ‘Anxiety’ and ‘Cognition & Insight’. Conclusions These results indicate that a semi-structured assessment template significantly improves the quality of MSE recording by junior doctors within EHRs. Future work should focus on whether such improvements translate into better patient outcomes and have the ability to improve the quality of information available on EHRs to researchers. PMID:26033569

  14. Annex II technical documentation assessed.

    PubMed

    van Drongelen, A W; Roszek, B; van Tienhoven, E A E; Geertsma, R E; Boumans, R T; Kraus, J J A M

    2005-12-01

    Annex II of the Medical Device Directive (MDD) is used frequently by manufacturers to obtain CE-marking. This procedure relies on a full quality assurance system and does not require an assessment of the individual medical device by a Notified Body. An investigation into the availability and the quality of technical documentation for Annex II devices revealed severe shortcomings, which are reported here. PMID:16419921

  15. Documenting the Effects of Armed Conflict on Population Health.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2016-01-01

    War and other forms of armed conflict have profound adverse effects on population health. It is important to document these effects to inform the general public and policy makers about the consequences of armed conflict, provide services to meet the needs of affected populations, protect human rights and document violations of international humanitarian law, and help to prevent future armed conflict. Documentation can be accomplished with surveillance, epidemiological surveys, and rapid assessment. Challenges include inadequate or absent data systems, social breakdown, forced migration, reporting biases, and the fog of war. The adverse effects of the Iraq War on population health demonstrate how the effects of armed conflict on population health can be documented. We recommend the establishment of an independent mechanism, operated by the United Nations or a multilateral organization, to investigate and document the effects of armed conflict on population health. PMID:26989827

  16. Advanced Materials Laboratory hazards assessment document

    SciTech Connect

    Barnett, B.; Banda, Z.

    1995-10-01

    The Department of Energy Order 55OO.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the AML. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distance at which a postulated facility event will produce consequences exceeding the Early Severe Health Effects threshold is 23 meters. The highest emergency classification is a General Emergency. The Emergency Planning Zone is a nominal area that conforms to DOE boundaries and physical/jurisdictional boundaries such as fence lines and streets.

  17. HEALTH EFFECTS ASSESSMENT FOR ACRYLONITRILE

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  18. Health Effects Assessment for Bromomethane

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  19. Health Effects Assessment for Ammonia

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  20. HEALTH ASSESSMENT DOCUMENT FOR VERMICULITE

    EPA Science Inventory

    Vermiculite is a nonfibrous silicate mineral with multiple consumer uses that has been shown to contain various concentrations of asbestiform fibers. ermiculite is a micaceous hydrate of magnesium-iron-aluminum silicates with the ability to exfoliate or expand up to 20 times its ...

  1. PUREX Deactivation Health and Safety documentation

    SciTech Connect

    Dodd, E.N. III

    1995-01-01

    The purpose of the PUREX Deactivation Project is to establish a passively safe and environmentally secure configuration of PUREX at the Hanford Site, and to preserve that configuration for a 10-year horizon. The 10-year horizon is used to predict future maintenance requirements and represents they typical time duration expended to define, authorize, and initiate the follow-on Decontamination and Decommissioning (D&D) activities. This document was prepared to increase attention to worker safety issues during the deactivation project and, as such, identifies the documentation and programs associated with PUREX Deactivation Health and Safety.

  2. Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document (Final Report)

    EPA Science Inventory

    This final report is a resource document that provides concepts, methods and data sources to assist in the conduct of multi-chemical, population-focused cumulative risk assessments. It is not guidance, but rather a presentation of information that could assist in the development ...

  3. Inpatient Falls: Improving assessment, documentation, and management.

    PubMed

    Nelson, Eleanor; Reynolds, Patrick

    2015-01-01

    A frequently occurring job during on-call and out-of-hours shifts is reviewing a patient following a fall with this often being the responsibility of the most junior and inexperienced doctors. Following a pilot audit we identified inconsistencies in medical assessment and documentation, with 50% of expected data points not recorded. Failure to complete a thorough assessment can lead to missed injuries, prolonged length of stay, and litigation. Using the plan, do, study, act (PDSA) cycle model this project sought to address this through providing teaching to junior doctors and the development of a pro-forma. Three style cycles of data collection were performed; a formal baseline dataset, after delivering a teaching session to new junior doctors and following the trial of the new fall pro-forma. We selected 15 to 17 patient notes to review at random during a one month period for each data collection cycle and compared the medical assessment to the standards outlined by the National Patient Safety Agency (NPSA) guidelines.[1] There were two key areas of improvement identified following the teaching session and introduction of the proforma. Documentation of a fall history was improved by nearly 30% being recorded in 100% of cases after the interventions. Documentation of a thorough musculoskeletal examination was improved from being recorded in just 54% of cases to 77% of cases; it was recorded in 100% of the cases where the proforma was used. The project demonstrated the need to improve documentation and assessment of a patient who has fallen. Initial data collection has shown that assessment and documentation were improved providing teaching to junior doctors and by use of the document. The pro-forma has since been incorporated into hospital policy and now forms the compulsory documentation expected of the doctors and nurses managing patients following a fall. Ensuring easy access to the proforma and re-auditing after editing the document will be the next steps. PMID

  4. HEALTH EFFECTS ASSESSMENT FOR ETHYLBENZENE

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  5. Health Effects Assessment for Naphthalene

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  6. HEALTH EFFECTS ASSESSMENT FOR BENZENE

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  7. Health Assessment Guidance Manual. Draft report

    SciTech Connect

    Not Available

    1990-07-01

    The document is directed to public health physicians, scientists, and engineers employed by The Agency for Toxic Substances and Disease Registry (ATSDR) and other State and Federal agencies who perform health assessments. It sets forth the health assessment process as defined by ATSDR and clarifies the methodologies and guidelines that will be used by ATSDR staff and agents of ATSDR in conducting these health assessments. The individual steps for performing a health assessment are discussed in Chapters 3 through 8 of the document. Chapter 9 discusses how the health assessment report should be written and the format in which it should be presented.

  8. W-320 Department of Health documentation

    SciTech Connect

    Bailey, J.W.

    1998-08-07

    The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system.

  9. HEALTH SECTOR ASSESSMENT

    EPA Science Inventory

    As part of the USGCRP's First National Assessment effort, EPA's Global Change Research Program sponsored the Health Sector Assessment. The Health Sector Assessment was co-chaired by Dr. Jonathan A. Patz, Director of the Program on the Health Effects of Global Environmental Change...

  10. Improving documentation of physical health investigations in an adolescent mental health inpatient unit.

    PubMed

    Horton, David

    2015-01-01

    Physical health investigations, such as blood tests, ECGs, and appropriate radiological tests, are essential in the assessment and management of many patients in inpatient mental health settings. This project took place in a 12-bed adolescent mental health unit in Swindon, UK, where on average at least two-thirds of patients have a diagnosed eating disorder. Multidisciplinary ward rounds provide an appropriate setting for discussion and documentation of physical investigations. Over a two-week period, 22 electronic ward round entries were audited for any documentation of five common investigations - blood tests, ECG, MRI head, DEXA, and ovarian ultrasound. Blood tests were documented in 2/22 (9.1%), ECG, MRI head, DEXA, and ovarian ultrasound were documented in 0/22 (0%). Modifications were made to an electronic ward round template, to include headings for each of these investigations, with free-text boxes as well as drop-down boxes for the radiological tests. Following this, re-audit of 22 ward round entries over a two-week period showed documentation had hugely improved - blood tests were documented in 21/22 (95.5%), with ECG, MRI head, DEXA, and pelvis US all documented in 22/22 (100%). A further audit a month later showed these results were largely sustained. In conclusion, use of a simple, structured ward round template can hugely improve documentation of important physical investigations within mental health settings. PMID:26734411

  11. Improving documentation of physical health investigations in an adolescent mental health inpatient unit

    PubMed Central

    Horton, David

    2015-01-01

    Physical health investigations, such as blood tests, ECGs, and appropriate radiological tests, are essential in the assessment and management of many patients in inpatient mental health settings. This project took place in a 12-bed adolescent mental health unit in Swindon, UK, where on average at least two-thirds of patients have a diagnosed eating disorder. Multidisciplinary ward rounds provide an appropriate setting for discussion and documentation of physical investigations. Over a two-week period, 22 electronic ward round entries were audited for any documentation of five common investigations - blood tests, ECG, MRI head, DEXA, and ovarian ultrasound. Blood tests were documented in 2/22 (9.1%), ECG, MRI head, DEXA, and ovarian ultrasound were documented in 0/22 (0%). Modifications were made to an electronic ward round template, to include headings for each of these investigations, with free-text boxes as well as drop-down boxes for the radiological tests. Following this, re-audit of 22 ward round entries over a two-week period showed documentation had hugely improved - blood tests were documented in 21/22 (95.5%), with ECG, MRI head, DEXA, and pelvis US all documented in 22/22 (100%). A further audit a month later showed these results were largely sustained. In conclusion, use of a simple, structured ward round template can hugely improve documentation of important physical investigations within mental health settings. PMID:26734411

  12. READS: the rapid electronic assessment documentation system.

    PubMed

    Hickey, Ann; Gleeson, Margaret; Kellett, John

    Patient documentation is time consuming and can detract from care. The authors report a novel computer programme that manipulates routinely collected information to quantify nursing workload, along with the reason for admission, functional status, estimates of in-hospital mortality and life expectancy. The programme stores information in a database, and produces a print-out in a situation/background/assessment/recommendation (SBAR) format. The average time taken to enter 629 patient encounters was 6.6 minutes. Pain was the most common presentation for low workload patients, while high workload patients often presented with altered mental status and reduced mobility. There was only a modest correlation between the risk of death and nursing workload. The programme measures nursing workload without further paperwork, and improves routine documentation with a legible brief report that is automatically generated. This report can be shared and provides data that is immediately available for day-to-day care, audit, quality control and service planning. PMID:23249801

  13. Minimizing litigation risk. Documentation strategies in the occupational health setting.

    PubMed

    Baker, S K

    2000-02-01

    When advice is given by telephone, nurses are relying on employees' or clients' own assessments of situations. Nurses do not have the benefit of examination and objective findings. Therefore, every occupational health practice should have a system for keeping a record of telephone calls. Noncompliance should be documented so the nurse is reminded of the need to consider compliance when caring for the client in the future. Documentation of report tracking and follow up, consent, client education, and discharge information contributes to improved quality of care and reduced risk of litigation. Client records should never be altered (i.e., changed) so the original entry is no longer visible. The SLIDE (Single Line, Initials, Date, Explanation) rule should be used. PMID:10865552

  14. Transmission line environmental assessment guidance document

    SciTech Connect

    Jackson, J.; Pentecost, E.; Muzzarelli, J.

    1994-01-01

    Since 1939, U.S. utility companies have been required to obtain a Presidential Permit to construct electric transmission lines that cross a U.S. border and connect with a foreign utility. The purpose of this document is to provide Presidential Permit applicants with two types of guidance: (1) on the type of environmental and project descriptive information needed to assess the potential impacts of the proposed and alternative actions and (2) on compliance with applicable federal and state regulations. The main three chapters present information on the purpose and content of this document (Chapter 1); legislative, regulatory, and consultation requirements for transmission line interconnect projects (Chapter 2); and identification of basic transmission system design parameters and environmental data requirements for analysis of potential impacts of the proposed action (Chapter 3). Chapter 3 also includes information on possible techniques or measures to mitigate impacts. Appendix A presents an overview of NEPA requirements and DOE`s implementing procedures. Appendix B summarizes information on legislation that may be applicable to transmission line projects proposed in Presidential Permit applications.

  15. HEALTH EFFECTS ASSESSMENT FOR VANADIUM AND COMPOUNDS

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  16. HEALTH EFFECTS ASSESSMENT FOR TIN AND COMPOUNDS

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  17. Health effects of risk-assessment categories

    SciTech Connect

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  18. Health and Environmental Effects Document for L-Butanol

    EPA Science Inventory

    Health and Environmental Effects Documents (HEEDS) are prepared for the Office of Solid Waste and Emergency Response (OSWER). This document series is intended to support listings under the Resource Conservation and Recovery Act (RCRA) as well as to provide health-related limits a...

  19. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT FOR BENZOIC ACID

    EPA Science Inventory

    Health and Environmental Effects Documents (HEEDS) are prepared for the Office of Solid Waste and Emergency Response (OSWER). his document series is intended to support listings under the Resource Conservation and Recovery Act (RCRA) as well as to provide health-related limits an...

  20. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT FOR BORON AND BORON COMPOUNDS

    EPA Science Inventory

    Health and Environmental Effects Documents (HEEDS) are prepared for the Office of Solid Waste and Emergency Response (OSWER). his document series is intended to support listings under the Resource Conservation and Recovery Act (RCRA) as well as to provide health-related limits an...

  1. RECOMMENDATIONS FOR AND DOCUMENTATION OF BIOLOGICAL VALUES FOR USE IN RISK ASSESSMENT

    EPA Science Inventory

    The document was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste and Emergency Response. The document consists of an extensive compliation of values gleaned from published li...

  2. Challenges of Documenting Schoolchildren's Psychosocial Health: A Qualitative Study.

    PubMed

    Clausson, Eva K; Berg, Agneta; Janlöv, Ann-Christin

    2015-06-01

    The aim of this study was to explore school nurses' experience of challenges related to documenting schoolchildren's psychosocial health in Sweden. Six focus group discussions were carried out. Areas for discussions included questions about situations, especially challenging to document as well as what constrains and/or facilitates documenting psychosocial health problem issues. Qualitative content analysis was used for interpreting the data. The analysis resulted in one overarching theme: having to do one's duty and being afraid of doing wrong; and three subthemes: uncertainty related to one's own ability, concerns related to future consequences, and strategies to handle the documentation. School nurses relying on their intuition and using a structured documentation model may increase the opportunities for a reliable documentation. To further develop their professional skills with regular, clinical supervision can be of great importance. This in turn may increase contributions to research and development for the benefit of schoolchildren's psychosocial health. PMID:25061093

  3. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

    This report contains information from a fall 1991 health occupations assessment of 1,021 health-related employers in Eastern Iowa and the Illinois Quad Cities area. Twelve chapters present comprehensive results of all surveys; results of 10 labor market survey instruments developed for chiropractic offices, dentists' offices, emergency medical…

  4. Integration of clinical research documentation in electronic health records.

    PubMed

    Broach, Debra

    2015-04-01

    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration. PMID:25636041

  5. Review of the US Consumer Product Safety Commission's health effects and exposure assessment documents on nitrogen dioxide. Report of the Clean Air Scientific Advisory Committee. Final report

    SciTech Connect

    Not Available

    1988-05-09

    At the request of the Consumer Product Safety Commission, the Clean Air Scientific Advisory Committee conducted a review on the potential health hazards associated with exposure to 0.1 to 1.0 ppm nitrogen dioxide generated by unvented indoor combustion sources. The committee concluded that: (1) repeated peak exposures at concentrations of 0.3 ppm of nitrogen dioxide may cause health effects in some individuals; (2) the population groups that appear most sensitive to nitrogen dioxide exposure include children, chronic bronchitics, asthmatics, and individuals with emphysema; and (3) the most direct evidence regarding lung damage associated with nitrogen dioxide is obtained from animal studies.

  6. Challenges of Documenting Schoolchildren's Psychosocial Health: A Qualitative Study

    ERIC Educational Resources Information Center

    Clausson, Eva K.; Berg, Agneta; Janlöv, Ann-Christin

    2015-01-01

    The aim of this study was to explore school nurses' experience of challenges related to documenting schoolchildren's psychosocial health in Sweden. Six focus group discussions were carried out. Areas for discussions included questions about situations, especially challenging to document as well as what constrains and/or facilitates documenting…

  7. Sandia Lightning Simulation Facility Building 888. Hazards assessment document

    SciTech Connect

    Banda, Z.; Barnett, B.

    1994-10-01

    The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Sandia Lightning Simulation Facility, Building 888. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distance at which a postulated facility event will produce consequences exceeding the Early Severe Health Effects threshold is 23 meters. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 65 meters.

  8. Sandia Administrative Micrographics Facility, Building 802: Hazards assessment document

    SciTech Connect

    Swihart, A.

    1994-12-01

    The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Sandia Administrative Micrographics Facility, Building 802. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distance at which a postulated facility event will produce consequences exceeding the Early Severe Health Effects threshold is 33 meters. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 75 meters.

  9. Simulation Technology Laboratory Building 970 hazards assessment document

    SciTech Connect

    Wood, C.L.; Starr, M.D.

    1994-11-01

    The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Simulation Technology Laboratory, Building 970. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distances at which a postulated facility event will produce consequences exceeding the ERPG-2 and Early Severe Health Effects thresholds are 78 and 46 meters, respectively. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 100 meters.

  10. HEALTH EFFECTS ASSESSMENT FOR GLYCOL ETHERS

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  11. HEALTH EFFECTS ASSESSMENT FOR TRIVALENT CHROMIUM

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  12. RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

    EPA Science Inventory

    Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. ...

  13. Documenting Student Performance through Effective Performance Assessments: Workshop Summary. Horticulture.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Agricultural Education Curriculum Materials Service.

    This document contains materials about and from a workshop that was conducted to help Ohio horticulture teachers learn to document student competence through effective performance assessments. The document begins with background information about the workshop and a list of workshop objectives. Presented next is a key to the 40 performance…

  14. Advantages of Coordinated School Health Portfolios: Documenting and Showcasing Achievements

    ERIC Educational Resources Information Center

    Shipley, Meagan; Lohrmann, David; Barnes, Priscilla; O'Neill, Jim

    2013-01-01

    Background: Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams'…

  15. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  16. Using Reflection Documents to Assess Student Learning

    ERIC Educational Resources Information Center

    Powell, Larkin A.

    2009-01-01

    Traditional assessment methods such as tests and essays may not be adequate to evaluate students' ability to solve problems and think critically. I developed a qualitative assessment technique for a junior-level Wildlife Management Techniques course that incorporated written responses in a pre- and post-course reflection exercise. I provided the…

  17. HEALTH ASSESSMENT DOCUMENT FOR ACRYLONITRILE (REVISED DRAFT)

    EPA Science Inventory

    Acrylonitrile is readily absorbed in animals following ingestion or inhalation, while dermal absorption is poor (1%) compared to that of the lungs. Acrylonitrile is metabolized to cyanide, which is transformed to thiocyanic acid and by cyanoethylation of sulfhydryl groups to S-(2...

  18. Health-assessment document for vermiculite

    SciTech Connect

    Not Available

    1991-09-01

    Vermiculite is a nonfibrous silicate mineral with multiple consumer uses that has been shown to contain various concentrations of asbestiform fibers. Vermiculite is a micaceous hydrate of magnesium-iron-aluminum silicates with the ability to exfoliate or expand up to 20 times its original size at high temperatures. It has high-cation-exchange capacity and a very low thermal conductivity. Most of the vermiculite mined and beneficiated is exfoliated and used in construction aggregates, insulation, and agricultural applications. Exposure to vermiculite occurs mainly via the inhalation route. Nonoccupational exposure to vermiculite is high. In 1979, approximately 13 million persons were estimated to have been exposed to vermiculite. The carcinogenicity classification for vermiculite is D. However, the weight of evidence for asbestos-contaminated vermiculite is sufficient to show a causal relationship for increased lung cancer in miners and millers.

  19. Health Assessment Document for Ethylene Oxide

    EPA Science Inventory

    The largest single use of ethylene oxide is as an intermediate in the synthesis of ethylene glycol. However, small amounts of this epoxide are used as a sterilant or pesticide in commodities, pharmaceuticals, medical devices, tobacco, and other items, representing a considerable ...

  20. Health Assessment Document for Acrylonitrile (Final Report)

    EPA Science Inventory

    Acute acrylonitrile intoxication in humans, like many volatile organic compounds, results in irritation of the eyes and nose, weakness, labored breathing, dizziness, impaired judgement, cyanosis, nausea, and convulsions. Unlike many of these other organics, acrylonitrile causes s...

  1. 76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... AGENCY Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment... availability of the chlorpyrifos registration review; preliminary human health risk assessment. This document... for the chlorpyrifos reregistration review, preliminary human health risk assessment, established...

  2. Description of Spreadsheet Calculations for Populating Data Tables of the Ecological Risk Assessment (Appendix B of the Human Health and Ecological Risk Assessment Document) for the Explosives Waste Treatment Facility (EWTF) at Site 300

    SciTech Connect

    Daniels, J

    2007-10-01

    This ecological risk assessment (ERA) is a supplement to the human health risk assessment (HRA) for the Explosive Waste Treatment Facility (EWTF). The EWTF is located near the center of Site 300 in a small, isolated canyon (see Figures 2 through 6 in the text). The ERA described in detail in Appendix B was prepared in accordance with guidance on currently accepted practice provided by the Human and Ecological Risk Division (HERD) at the Department of Toxic Substances Control (DSTC) of the State of California Environmental Protection Agency (CalEPA) in Sacramento, California. The technical basis for this ERA is an analysis that involves a series of screening calculations to assess each of 21 contaminants of potential ecological concern (CPECs) for its potential to produce an adverse ecological impact in particular wildlife species, including vegetation, considered representative receptors of ecological interest (RREI) in the trophic levels of the food network at Site 300. This series of screening calculations is designed to illustrate whether CPECs identified as being of possible consequence in the most conservative screening calculation actually may be of lesser or no significance when more information is considered in subsequent screening calculations.

  3. ACIDIC DEPOSITION PHENOMENON AND ITS EFFECTS: CRITICAL ASSESSMENT DOCUMENT

    EPA Science Inventory

    The Acidic Deposition Phenomenon and Its Effects: Critical Assessment Document (CAD) is a summary, integration, and interpretation of the current scientific understanding of acidic deposition. It is firmly based upon The Acidic Deposition Phenomenon and Its Effects: Critical Asse...

  4. Documentation of torture victims, assessment of the start procedure for medico-legal documentation.

    PubMed

    Mandel, Lene; Worm, Lise

    2007-01-01

    A Pilot Study was performed at the Rehabilitation and Research Centre for Torture Victims (RCT) in Copenhagen in order to explore the possibilities for adding a medico-legal documentation component to the rehabilitation of torture victims already taking place. It describes the process and results on implementing medico-legal documentation in a rehabilitative setting. A modified version of the Guidelines in the Istanbul Protocol was developed on the basis of the review of literature and current practices described in "Documentation of torture victims, implementation of medico-legal protocols". The modified guidelines were tested on five clients. The aim was twofold: 1) To assess the client's attitude towards the idea of adding a documentation component to the rehabilitation process and: 2) To assess the practical circumstances of implementing the Istanbul Protocol in the everyday life of a rehabilitation centre. Results show that all five clients were positive towards the project and found comfort in being able to contribute to the fight against impunity. Also, the Pilot Study demonstrated that a large part of the medico-legal documentation was already obtained in the rehabilitation process. It was however not accessible due to lack of systematization and a data registering system. There are thus important synergies in collecting data for rehabilitation and documentation but a joint database system is necessary to realize these synergies. PMID:19289892

  5. Comprehensibility of Health-Related Documents for Older Adults with Different Levels of Health Literacy: A Systematic Review.

    PubMed

    Koops van 't Jagt, Ruth; Hoeks, John C J; Jansen, Carel J M; de Winter, Andrea F; Reijneveld, Sijmen A

    2016-01-01

    A systematic review was conducted to assess the available evidence for the effectiveness of interventions aiming to improve the comprehensibility of health-related documents in older adults (≥50) with different levels of health literacy. Seven databases were searched (2005 forward), and references in relevant reviews were checked. The selection procedure was conducted by 2 independent reviewers. Data extraction and assessment of the quality of the resulting studies were conducted by 1 reviewer and checked for accuracy by a 2nd reviewer. A total of 38 intervention studies had a study population of older adults (n = 35) or made an explicit comparison between age groups, including older adults (n = 3). Inconsistent evidence was found for the importance of design features to enhance the comprehensibility of health-related documents. Only for narratives and multiple-feature revisions (e.g., combining revisions in textual and visual characteristics) did the included studies provide evidence that they may be effective for older adults. Using narrative formats and/or multiple-feature revisions of health-related documents seem to be promising strategies for enhancing the comprehensibility of health-related documents for older adults. The lack of consistent evidence for effective interventions stresses the importance of (a) replication and (b) the use of standardized research methodologies. PMID:26594852

  6. 75 FR 1793 - Study Team for the Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Study Team for the Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and...

  7. SUMMARY REVIEW OF THE HEALTH EFFECTS ASSOCIATED WITH COPPER: HEALTH ISSUE ASSESSMENT

    EPA Science Inventory

    The Health Assessment Summary Document is a brief review of the scientific knowledge on copper. The emphasis of the document is on inhalation exposure from atmospheric copper and the environmental, ecological and health effects from the species of copper expected to be present in...

  8. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This manual documents the processes to be used to perform the ES H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy.

  9. Assessing health apps.

    PubMed

    2016-07-01

    A survey commissioned by the National Institute for Health and Care Excellence aims to explore the way nurses and midwives engage with mobile technologies, such as smartphones, tablets and health apps. It is seeking opinions on how these apps should be evaluated, and about online patient feedback. Results will inform NICE's plan to develop a central process for evaluating and endorsing health apps, which will enable patients, healthcare professionals and hospitals to identify the most useful. Nurses or midwives practising in the UK, and involved with direct patient care are welcome to take part in the survey. PMID:27369711

  10. Health and environmental effects document for batteries: 1980

    SciTech Connect

    Not Available

    1980-11-01

    An evaluation is presented of the ecological and health effects of the near-term electric storage batteries (lead/acid, nickel/zinc, and nickel/iron) as related to electric and hybrid vehicle applications. The storage battery technology is considered in its totality, and emissions are estimated for the complete cycle. For estimating quantities of various emissions, the market penetration is assumed to be 3 x 10/sup 6/ Pb/acid battery-powered vehicles and 8 x 10/sup 6/ each of the Ni/Zn and Ni/Fe battery-powered vehicles on the road by the year 2000. Ecological effects are assessed using the Estimated Permissible Concentration (EPC) approach. Pb, S, Cu, Ni, Cd, Zn, and Sb appear to be the most hazardous emission constituents and exceed EPC values for protection of ecology in one or more of the battery-related industries. More definitive, quantitative estimates of damage to the biota and to the ecosystem are not feasible because of paucity of relevant information. Health effects as a result of increased levels of lead, arsenic, and cadmium in the environment and risks of exposure to arsine, stibine, and antimony trioxide released during charging are assessed. Health effects among the occupationally exposed are also assessed using the toxicological models. Acute and chronic effects of exposure to stibine, arsine, and antimony trioxide are described.

  11. Health impact assessment in Korea

    SciTech Connect

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

    2011-07-15

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

  12. Assess health effects associated with dichloromethane (methylene chloride). Final report

    SciTech Connect

    Not Available

    1988-03-09

    On August 13-14, 1987 the Halogenated Organics Subcommittee of the Science Advisory Board's Environmental Health Committee met in Washington, D.C. to review two documents prepared by EPA's Office of Research and Development that assess health effects associated with dichloromethane (methylene chloride). The documents included: a June 1987 Draft Technical Analysis of New Methods and Data Regarding Dichloromethane: Pharmacokinetics, Mechanism of Action and Epidemiology, a July 1987 Draft Addendum to the Health Assessment Document for Dichloromethane: Pharmacokinetics, Mechanism of Action and Epidemiology. The Subcommittees concluded that the Addendum was one of the best documents it has received in terms of its clarity, coverage of the data and analysis of scientific issues. The document clearly demonstrates the potential utility of pharmacokinetics data in risk assessment.

  13. CP-50 calibration facility radiological safety assessment document

    SciTech Connect

    Chilton, M.W.; Hill, R.L.; Eubank, B.F.

    1980-03-01

    The CP-50 Calibration Facility Radiological Safety Assessment document, prepared at the request of the Nevada Operations Office of the US Department of Energy to satisfy provisions of ERDA Manual Chapter 0531, presents design features, systems controls, and procedures used in the operation of the calibration facility. Site and facility characteristics and routine and non-routine operations, including hypothetical incidents or accidents are discussed and design factors, source control systems, and radiation monitoring considerations are described.

  14. Bioburden assessment and gamma radiation inactivation patterns in parchment documents

    NASA Astrophysics Data System (ADS)

    Nunes, Inês; Mesquita, Nuno; Cabo Verde, Sandra; Carolino, Maria Manuela; Portugal, António; Botelho, Maria Luísa

    2013-07-01

    Parchment documents are part of our cultural heritage and, as historical artifacts that they are, should be preserved. The aim of this study was to validate an appropriate methodology to characterize the bioburden of parchment documents, and to assess the growth and gamma radiation inactivation patterns of the microbiota present in that material. Another goal was to estimate the minimum gamma radiation dose (Dmin) to be applied for the decontamination of parchment as an alternative treatment to the current toxic chemical and non-chemical decontamination methods. Two bioburden assessment methodologies were evaluated: the Swab Method (SM) and the Destructive Method (DM). The recovery efficiency of each method was estimated by artificial contamination, using a Cladosporium cladosporioides spore suspension. The parchment samples' microbiota was typified using morphological methods and the fungal isolates were identified by ITS-DNA sequencing. The inactivation pattern was assessed using the DM after exposure to different gamma radiation doses, and using C. cladosporioides as reference. Based on the applied methodology, parchment samples presented bioburden values lower than 5×103 CFU/cm2 for total microbiota, and lower than 10 CFU/cm2 for fungal propagules. The results suggest no evident inactivation trend for the natural parchment microbiota, especially regarding the fungal community. A minimum gamma radiation dose (Dmin) of 5 kGy is proposed for the decontamination treatment of parchment. Determining the minimal decontamination dose in parchment is essential for a correct application of gamma radiation as an alternative decontamination treatment for this type of documents avoiding the toxicity and the degradation promoted by the traditional chemical and non-chemical treatments.

  15. Advanced Manufacturing Processes Laboratory Building 878 hazards assessment document

    SciTech Connect

    Wood, C.; Thornton, W.; Swihart, A.; Gilman, T.

    1994-07-01

    The introduction of the hazards assessment process is to document the impact of the release of hazards at the Advanced Manufacturing Processes Laboratory (AMPL) that are significant enough to warrant consideration in Sandia National Laboratories` operational emergency management program. This hazards assessment is prepared in accordance with the Department of Energy Order 5500.3A requirement that facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment provides an analysis of the potential airborne release of chemicals associated with the operations and processes at the AMPL. This research and development laboratory develops advanced manufacturing technologies, practices, and unique equipment and provides the fabrication of prototype hardware to meet the needs of Sandia National Laboratories, Albuquerque, New Mexico (SNL/NM). The focus of the hazards assessment is the airborne release of materials because this requires the most rapid, coordinated emergency response on the part of the AMPL, SNL/NM, collocated facilities, and surrounding jurisdiction to protect workers, the public, and the environment.

  16. Glass Formulation and Fabrication Laboratory, Building 864, Hazards assessment document

    SciTech Connect

    Banda, Z.; Wood, C.L.

    1995-08-01

    The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Glass Formulation and Fabrication Laboratory, Building 864. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distances at which a postulated facility event will produce consequences exceeding the ERPG-2 threshold is 96 meters. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 100 meters.

  17. Supplementary Guidance for Conducting Health Risk Assessment of Chemical Mixtures

    EPA Science Inventory

    This document is a supplement to the EPA Guidelines for the Health Risk Assessment of Chemical Mixtures of 1986. The 1986 Guidelines represent the Agency's science policy and are a procedural guide for evaluating data on the health risks from exposures to chemical mixt...

  18. Health and environmental effects document on geothermal energy: 1981

    SciTech Connect

    Layton, D.W.; Anspaugh, L.R.; O'Banion, K.D.

    1981-12-04

    Several of the important health and environmental risks associated with a reference geothermal industry that produces 21,000 MW/sub e/ for 30 y (equivalent to 20 x 10/sup 18/ J) are assessed. The analyses of health effects focus on the risks associated with exposure to hydrogen sulfide, particulate sulfate, benzene, mercury, and radon in air and arsenic in water. Results indicate that emissions of hydrogen sulfide are likely to cause odor-related problems in geothermal resources areas, assuming that no pollution controls are employed. For individuals living within an 80 km radius of the geothermal resources, chronic exposure to particulate sulfate could result in between 0 to 95 premature deaths per 10/sup 18/ J of electricity generated. The mean population risk of leukemia from the inhalation of benzene was calculated to be 3 x 10/sup -2/ cases per 10/sup 18/ J. Exposure to elemental mercury in the atmosphere could produce between 0 and 8.2 cases of tremors per 10/sup 18/ J of electricity. Inhalation of radon and its short-lived daughters poses a mean population risk of 4.2 x 10/sup -1/ lung cancers per 10/sup 18/ J. Analysis of skin cancer risk from the ingestion of surface water contaminated with geothermally derived arsenic suggests that a dose-response model is inconsistent with data showing that arsenic is an essential element and that excessive body burdens do not appear even when arsenic reaches 100 ..mu..g/liter in drinking water. Estimates of occupational health effects were based on rates of accidental deaths and occupational diseases in surrogate industries. According to calculations, there would be 14 accidental deaths per 10/sup 18/ J of electricity and 340 cases of occupational diseases per 10/sup 18/ J. The analysis of the effects of noncondensing gases on vegetation showed that ambient concentrations of hydrogen sulfide and carbon dioxide are more likely to enhance rather than inhibit the growth of plants.

  19. Community health assessment. The first step in community health planning.

    PubMed

    Rice, J A

    1993-01-01

    Hospitals face a paradigm shift: from planning service delivery to population-based community health planning. Comprehensive community health planning is a two-step process: assessment and action, in that order. Assessment identifies community problems and resources; action follows planning, which determines which of those problems should be addressed with which resources. This paper provides an overview of the community assessment process. The first challenge in launching a community health initiative is to identify and recruit partners drawn from the ranks of prominent community organizations, such as school boards, public health agencies, and elected officials. The best enlistment strategies are those that empower persons outside the hospital to take visible control. Defining the community is the first step in analyzing the community. It is important that everyone involved in the assessment process agree on the definition, which should take in those characteristics that make the community unique, including its social systems, environmental factors, and demographics. The next step in the process is developing a community health profile, a set of key community indicators or measures that will help you set priorities, document successes and failures, and monitor trends. There are a number of models available to consult in developing indicators, whether traditional, medically oriented determinants of health or broader parameters, such as housing and public safety. Criteria for selecting indicators include validity, stability and reliability, and responsiveness. Most indicators will be developed using secondary, or already existing, sources of data, such as census data, Medicare and Medicaid files, police records, and hospital admission and exit records. Conducting the community assessment involves putting together a list of problems to be solved and a list of available resources, both of which can be compiled using the same four-step process of gathering and

  20. Health and Environmental Effects Document on Geothermal Energy -- 1982 update

    SciTech Connect

    Layton, David W.; Daniels, Jeffrey I.; Anspaugh, Lynn R.; O'Banion, Kerry D.

    1983-11-30

    We assess several of the important health and environmental risks associated with a reference geothermal industry that produces 21,000 MWe for 30 y (equivalent to 20 x 10{sup 18} J). The analyses of health effects focus on the risks associated with exposure to hydrogen sulfide, particulate sulfate, benzene, mercury, and radon in air and arsenic in food. Results indicate that emissions of hydrogen sulfide are likely to cause odor-related problems in 29 of 51 geothermal resources areas, assuming that no pollution controls are employed. Our best estimates and ranges of uncertainty for the health risks of chronic population exposures to atmospheric pollutants are as follows (risks expressed per 10{sup 18} J of electricity): particulate sulfate, 44 premature deaths (uncertainty range of 0 to 360); benzene, 0.15 leukemias (range of 0 to 0.51); elemental mercury, 14 muscle tremors (range of 0 to 39); and radon, 0.68 lung cancers (range of 0 to 1.8). The ultimate risk of fatal skin cancers as the result of the transfer of waste arsenic to the general population over geologic time ({approx} 100,000 y) was calculated as 41 per 10{sup 18} J. We based our estimates of occupational health effects on rates of accidental deaths together with data on occupational diseases and injuries in surrogate industries. According to our best estimates, there would be 8 accidental deaths per 10{sup 18} J of electricity, 300 cases of occupational diseases per 10{sup 18} J, and 3400 occupational injuries per 10{sup 18}J. The analysis of the effects of noncondensing gases on vegetation showed that ambient concentrations of hydrogen sulfide and carbon dioxide are more likely to enhance rather than inhibit the growth of plants. We also studied the possible consequences of accidental releases of geothermal fluids and concluded that probably less than 5 ha of land would be affected by such releases during the production of 20 x 10{sup 18} J of electricity. Boron emitted from cooling towers in the

  1. Sensor based soil health assessment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quantification and assessment of soil health involves determining how well a soil is performing its biological, chemical, and physical functions relative to its inherent potential. Due to high cost, labor requirements, and soil disturbance, traditional laboratory analyses cannot provide high resolut...

  2. Area 5 Radioactive Waste Management Site Safety Assessment Document

    SciTech Connect

    Horton, K.K.; Kendall, E.W.; Brown, J.J.

    1980-02-01

    The Area 5 Radioactive Waste Management Safety Assessment Document evaluates site characteristics, facilities and operating practices which contribute to the safe handling and storage/disposal of radioactive wastes at the Nevada Test Site. Physical geography, cultural factors, climate and meteorology, geology, hydrology (with emphasis on radionuclide migration), ecology, natural phenomena, and natural resources are discussed and determined to be suitable for effective containment of radionuclides. Also considered, as a separate section, are facilities and operating practices such as monitoring; storage/disposal criteria; site maintenance, equipment, and support; transportation and waste handling; and others which are adequate for the safe handling and storage/disposal of radioactive wastes. In conclusion, the Area 5 Radioactive Waste Management Site is suitable for radioactive waste handling and storage/disposal for a maximum of twenty more years at the present rate of utilization.

  3. Communicating Nursing Care Using the Health Level Seven Consolidated Clinical Document Architecture Release 2 Care Plan.

    PubMed

    Matney, Susan A; Dolin, Gay; Buhl, Lindy; Sheide, Amy

    2016-03-01

    A care plan provides a patient, family, or community picture and outlines the care to be provided. The Health Level Seven Consolidated Clinical Document Architecture (C-CDA) Release 2 Care Plan Document is used to structure care plan data when sharing the care plan between systems and/or settings. The American Nurses Association has recommended the use of two terminologies, Logical Observation Identifiers Names and Codes (LOINC) for assessments and outcomes and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for problems, procedures (interventions), outcomes, and observation findings within the C-CDA. This article describes C-CDA, introduces LOINC and SNOMED CT, discusses how the C-CDA Care Plan aligns with the nursing process, and illustrates how nursing care data can be structured and encoded within a C-CDA Care Plan. PMID:26765657

  4. Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide.

    PubMed

    Denneson, Lauren M; Kovas, Anne E; Britton, Peter C; Kaplan, Mark S; McFarland, Bentson H; Dobscha, Steven K

    2016-06-01

    A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow-up (n = 168; 57%). Fifty-three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide. PMID:26833711

  5. Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

    PubMed Central

    2012-01-01

    Background The increased use and adoption of Electronic Health Records (EHR) causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI), which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA) clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity) and precision (equivalent to positive predictive value) metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches. Conclusions The

  6. Hanford patrol firing range complex safety assessment document

    SciTech Connect

    BENDIXSEN, R.B.

    2001-09-19

    Analysis of the US Department of Energy's Central Training Academy) and other DOE complexes (WSI-SRS 1994, Ballistic Risk Assessment of Wackenhut Services, Inc). This safety analysis document (SAD) satisfies the requirements of DOE 0 440.1A. The preparation, review, and approval of this safety assessment document is in accordance with the guidelines of HNF-PRO-700, Safety Analysis and Technical Safety Requirements.

  7. [Selection of annotated web sites devoted to documentation-health (updated as for July 2001)].

    PubMed

    Mouillet, E

    2001-01-01

    The author presents an annotated selection of web sites devoted to documentation and health. This directory may be used as bookmarks especially by the researchers who work in health, HIV/AIDS infection, and development fields. PMID:11641085

  8. Challenging Assumptions: Teaching, Documenting, Producing and Negotiating "Health"

    ERIC Educational Resources Information Center

    Herrick, Clare

    2010-01-01

    As "health" climbs academic, policy, commercial, non-profit and societal agendas, it has become increasingly subject to scrutiny by geographers. Yet, while health geographers may explore the discursive production, operationalization, deployment and management of health; the role of pedagogical practices has been repeatedly overlooked despite the…

  9. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

    Golbeck, Amanda L.; Ahlers-Schmidt, Carolyn R.; Paschal, Angelia M.

    2005-01-01

    Adult basic education (ABE) is an ideal venue for developing health literacy skills. Literacy and numeracy assessments used in ABE were identified and the most common were examined for health components. Only the Comprehensive Adult Student Assessment System (CASAS) included health. The two most common health literacy assessments used in general…

  10. An Analysis of Free-Text Alcohol Use Documentation in the Electronic Health Record

    PubMed Central

    Garcia-Webb, M.

    2014-01-01

    Summary Background Alcohol use is a significant part of a patient’s history, but details about consumption are not always documented. Electronic Health Record (EHR) systems have the potential to improve assessment of alcohol use and misuse; however, a challenge is that critical information may be documented primarily in free-text rather than in a structured and standardized format, thereby limiting its use. Objective To characterize the use and contents of free-text documentation for alcohol use in the social history module of an EHR. Methods This study involved a retrospective analysis of 500 alcohol use entries that include structured fields as well as a free-text comment field. Two coding schemes were developed and used to analyze these entries for: (1) quantifying the reasons for using free-text comments and (2) categorizing information in the free-text into separate elements. In addition, for entries indicating possible alcohol misuse, a preliminary review of other structured parts of the EHR was conducted to determine if this was also documented elsewhere. Results The top three reasons for using free-text were limited ability to describe alcohol use frequency (75%), amount (22%), and status (18%) with available structured fields. Within the free-text, descriptions of frequency were most common (79%) using words or phrases conveying occasional (61%), daily (13%), or weekly (12%) use. Of the 36 cases suggesting alcohol misuse, 44% had mention of alcohol problems in the problem list or past medical history. Conclusions Based on the early findings, implications for improving the structured collection and use of alcohol use information in the EHR are provided in four areas: (1) system enhancements, (2) user training, (3) decision support, and (4) standards. Next steps include examining how alcohol use is documented in other parts of the EHR (e.g., clinical notes) and how documentation practices vary based on patient, provider, and clinic characteristics. PMID

  11. Disturbance Impact Assessment System (DIAS), version 2.0. System design document

    NASA Astrophysics Data System (ADS)

    Rose, R. B.; Lambert, D. R.

    1993-02-01

    This technical document, actually a system design document or functional description document, covers the Disturbance Impact Assessment System (DIAS). This system is a computer software package designed to assess the effects of solar flares on HF radio communications. The document describes its software functions and their interrelationships. Specifically, the document provides background information on the effects of high levels of solar activity on high-latitude HF missions, outlines the architecture of DIAS, and defines the product that DIAS provides to the user.

  12. Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

    ERIC Educational Resources Information Center

    Farri, Oladimeji Feyisetan

    2012-01-01

    Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

  13. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  14. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  15. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  16. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  17. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  18. Implications of the tobacco industry documents for public health and policy.

    PubMed

    Bero, Lisa

    2003-01-01

    The release of previously secret internal tobacco industry documents has given the public health community unprecedented insight into the industry's motives, strategies, tactics, and data. The documents provide information that is not available from any other source and describe the history of industry activities over the past 50 years. The documents show that the tobacco industry has been engaged in deceiving policy makers and the public for decades. This paper begins with a brief history of the tobacco industry documents and describes the methodological challenges related to locating and analyzing an enormous number of poorly indexed documents. It provides an overview of selected important findings of document research conducted to date, including analyses of industry documents on nicotine and addiction, product design, marketing and promotion, passive smoke, and internal activities. The paper concludes with a discussion of the implications of tobacco document research for public health and the application of such research to fields other than tobacco control. PMID:12415145

  19. CENTER FOR DEVICES AND RADIOLOGICAL HEALTH (CDRH) DOCUMENT DATABASE

    EPA Science Inventory

    The Center for Devices and Radiological Health has established advisory committees to provide independent, professional expertise and technical assistance on the development, safety and effectiveness, and regulation of medical devices and electronic products that produce radiatio...

  20. Assessment and Documentation Considerations for Postsecondary Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Lindstrom, Jennifer H.; Lindstrom, Will

    2011-01-01

    In order to gain access to accommodations and services at colleges and universities, students with learning disabilities must provide documentation of their disabilities, and as students with learning disabilities access higher education at increasing rates, the need for documentation of their disabilities and its impact becomes even more…

  1. Documentation of the Ecological Risk Assessment Computer Model ECORSK.5

    SciTech Connect

    Anthony F. Gallegos; Gilbert J. Gonzales

    1999-06-01

    The FORTRAN77 ecological risk computer model--ECORSK.5--has been used to estimate the potential toxicity of surficial deposits of radioactive and non-radioactive contaminants to several threatened and endangered (T and E) species at the Los Alamos National Laboratory (LANL). These analyses to date include preliminary toxicity estimates for the Mexican spotted owl, the American peregrine falcon, the bald eagle, and the southwestern willow flycatcher. This work has been performed as required for the Record of Decision for the construction of the Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility at LANL as part of the Environmental Impact Statement. The model is dependent on the use of the geographic information system and associated software--ARC/INFO--and has been used in conjunction with LANL's Facility for Information Management and Display (FIMAD) contaminant database. The integration of FIMAD data and ARC/INFO using ECORSK.5 allows the generation of spatial information from a gridded area of potential exposure called an Ecological Exposure Unit. ECORSK.5 was used to simulate exposures using a modified Environmental Protection Agency Quotient Method. The model can handle a large number of contaminants within the home range of T and E species. This integration results in the production of hazard indices which, when compared to risk evaluation criteria, estimate the potential for impact from consumption of contaminants in food and ingestion of soil. The assessment is considered a Tier-2 type of analysis. This report summarizes and documents the ECORSK.5 code, the mathematical models used in the development of ECORSK.5, and the input and other requirements for its operation. Other auxiliary FORTRAN 77 codes used for processing and graphing output from ECORSK.5 are also discussed. The reader may refer to reports cited in the introduction to obtain greater detail on past applications of ECORSK.5 and assumptions used in deriving model parameters.

  2. Equity in public health standards: a qualitative document analysis of policies from two Canadian provinces

    PubMed Central

    2012-01-01

    Introduction Promoting health equity is a key goal of many public health systems. However, little is known about how equity is conceptualized in such systems, particularly as standards of public health practice are established. As part of a larger study examining the renewal of public health in two Canadian provinces, Ontario and British Columbia (BC), we undertook an analysis of relevant public health documents related to equity. The aim of this paper is to discuss how equity is considered within documents that outline standards for public health. Methods A research team consisting of policymakers and academics identified key documents related to the public health renewal process in each province. The documents were analyzed using constant comparative analysis to identify key themes related to the conceptualization and integration of health equity as part of public health renewal in Ontario and BC. Documents were coded inductively with higher levels of abstraction achieved through multiple readings. Sets of questions were developed to guide the analysis throughout the process. Results In both sets of provincial documents health inequities were defined in a similar fashion, as the consequence of unfair or unjust structural conditions. Reducing health inequities was an explicit goal of the public health renewal process. In Ontario, addressing “priority populations” was used as a proxy term for health equity and the focus was on existing programs. In BC, the incorporation of an equity lens enhanced the identification of health inequities, with a particular emphasis on the social determinants of health. In both, priority was given to reducing barriers to public health services and to forming partnerships with other sectors to reduce health inequities. Limits to the accountability of public health to reduce health inequities were identified in both provinces. Conclusion This study contributes to understanding how health equity is conceptualized and incorporated

  3. Migrant and Seasonal Farmworker Health Objectives for the Year 2000. Document in Progress.

    ERIC Educational Resources Information Center

    National Migrant Resource Program, Inc., Austin, TX.

    Compared to the U.S. population, migrant farmworkers have a low life expectancy, high infant mortality rate, and high incidence of malnutrition and parasitic infection. Drawing on Public Health Service health objectives for the nation, this document proposes farmworker-specific objectives for a health promotion and disease prevention agenda. While…

  4. Documentation of Sexual Partner Gender Is Low in Electronic Health Records: Observations, Predictors, and Recommendations to Improve Population Health Management in Primary Care

    PubMed Central

    Yehia, Baligh R.

    2015-01-01

    Abstract The 2011 Institute of Medicine report on LGBT health recommended that sexual orientation and gender identity (SO/GI) be documented in electronic health records (EHRs). Most EHRs cannot document all aspects of SO/GI, but some can record gender of sexual partners. This study sought to determine the proportion of patients who have the gender of sexual partners recorded in the EHR and to identify factors associated with documentation. A retrospective analysis was done of EHR data for 40 family medicine (FM) and general internal medicine (IM) practices, comprising 170,570 adult patients seen in 2012. The primary outcome was EHR documentation of sexual partner gender. Multivariate logistic regression assessed the impact of patient, provider, and practice factors on documentation. In all, 76,767 patients (45%) had the gender of sexual partners recorded, 4.3% of whom had same-gender partners (3.5% of females, 5.6% of males). Likelihood of documentation was independently higher for women; blacks; those with a preventive visit; those with a physician assistant, nurse practitioner, or resident primary care provider (vs. attending); those at urban practices; those at smaller practices; and those at a residency FM practice. Older age and Medicare insurance were associated with lower documentation. Sexual partner gender documentation is important to identify patients for targeted prevention and support, and holds great potential for population health management, yet documentation in the EHR currently is low. Primary care practices should routinely record the gender of sexual partners, and additional work is needed to identify best practices for collecting and using SO/GI data in this setting. (Population Health Management 2015;18:217–222). PMID:25290634

  5. Assessing usage patterns of electronic clinical documentation templates.

    PubMed

    Vawdrey, David K

    2008-01-01

    Many vendors of electronic medical records support structured and free-text entry of clinical documents using configurable templates. At a healthcare institution comprising two large academic medical centers, a documentation management data mart and a custom, Web-accessible business intelligence application were developed to track the availability and usage of electronic documentation templates. For each medical center, template availability and usage trends were measured from November 2007 through February 2008. By February 2008, approximately 65,000 electronic notes were authored per week on the two campuses. One site had 934 available templates, with 313 being used to author at least one note. The other site had 765 templates, of which 480 were used. The most commonly used template at both campuses was a free text note called "Miscellaneous Nursing Note," which accounted for 33.3% of total documents generated at one campus and 15.2% at the other. PMID:18998863

  6. Head Start Oral Health Assessment.

    PubMed

    Reed, Rebecca; York, Jill; Dady, Nadege; Chaviano-Moran, Rosa; Jiang, Shuying; Holtzman, Joseph

    2016-05-01

    Purpose A Head Start program located in Paterson, New Jersey considered establishing a school-based dental clinic to address unmet oral health needs such as access to care and the need for restorative treatment. The purpose of this study was to establish the oral health status of Head Start children, their treatment needs, and parents' interest and willingness to utilize a school-based dental clinic. Description School-based dental care has been used to address access to care issues, particularly among children who live in underserved areas. A 21 item survey was used to correlate the results of an oral exam performed on the Head Start children and the parents' preferences, beliefs and access patterns. Fisher's exact test and Chi squared test were used to study the association among variable with significance levels set at 0.05. Assessment The oral exam revealed a high caries rate amongst all of the children. Parental responses indicated strong support for the establishment of a school-based clinic and identified the need for further parental education. Having a regular source of care was found to be unrelated to treatment needs. Conclusion Further education of the parents regarding the child's oral health is critical to the success and viability of this school-based clinic. PMID:27017227

  7. Health technology assessment and haemophilia.

    PubMed

    Farrugia, A; O'Mahony, B; Cassar, J

    2012-03-01

    Although the funding of rare diseases such as haemophilia in developing countries remains a low priority, pressures on the funding of haemophilia treatment are also emerging in developed economies affected by the global economic downturn and the other demands on health care budgets. This is leading advisory bodies and payers alike to explore the tools of Health Technology Assessment (HTAs) in deriving recommendations for reimbursement policies. In particular, the use of cost utility analysis (CUA) in deriving costs per quality adjusted life year (QALY) for different interventions is being used to rank interventions in order of priorities relative to a threshold cost per QALY. In these exercises, rare chronic disorders such as haemophilia emerge as particularly unattractive propositions for reimbursement, as the accepted methodology of deriving a CUA. For e.g. the use of prophylaxis in haemophilia leads to a range of costs/QALY which exceed the willingness to pay thresholds of most payers. In this commentary, we review the principles utilized in a recent systematic review of the use of haemophilia products carried out in Sweden as part of an HTA. We suggest that ranking haemophilia related interventions with the standard interventions of therapeutics and public health in CUA comparisons is inappropriate. Given that haemophilia treatment is a form of blood replacement therapy, we propose that such comparisons should be made with the interventions of mainstream blood transfusion. We suggest that unequivocally effective treatments such as haemophilia therapies should be assessed differently from mainstream interventions, that new methodologies are required for these kinds of diseases and that evidence of a societal willingness to support people with rare disorders needs to be recognized when reimbursement policies are developed. PMID:22335450

  8. Health and environmental effects document for oil shale: 1984

    SciTech Connect

    Gratt, L.B.; Perry, B.W.; Marine, W.M.; Savitz, D.A.; Chappell, W.R.

    1984-12-31

    The third reported effort to analyze the potential human health and environmental risks of a hypothetical one million barrels-per-day industry has been completed as an aid in the formulation and management of a program of environmental research. The methodology for prioritizing key research needs using the risk magnitude and associated uncertainty has been established and demonstrated. The analysis focused on the recommendations of the National Academy of Science's review of the 1982 oil shale risk analysis. Human health risk measures included accident and disease occurrences, premature fatalities, and life-loss expectancies. The sulfate surrogate model was replaced by a fine-particle surrogate resulting in reduced public risks. The largest uncertainties for expected fatalities are in the occupational sector. Occupational injuries and illnesses have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Silicosis from the dust environment is the worker disease of primary concern, followed by other forms of pneumoconiosis, chronic bronchitis, chronic airway obstruction, internal cancer, and skin cancers, respectively. The current nuisance dust threshold limit value of 5 mg/m/sup 3/ poses a serious occupational health concern for a future oil shale industry. Research recommendations are presented based on the potential for reducing the estimated uncertainties in the risks. 173 refs., 36 tabs.

  9. Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

    PubMed

    Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

    2016-03-01

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. PMID:24782478

  10. Connecticut's new comprehensive and universal early childhood health assessment form.

    PubMed

    Crowley, Angela A; Whitney, Grace-Ann C

    2005-10-01

    Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's health status and for program administrators who wish to collect data across groups of children. This article describes how the passage of new legislation in Connecticut establishing a statewide prekindergarten program presented the opportunity to develop a comprehensive early childhood health form for all early childhood programs, which promotes children's access to health services and coordination of care among health care professionals, early childhood providers, and families. PMID:16179077

  11. Community Health Needs Assessment: Potential for Population Health Improvement.

    PubMed

    Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

    2016-06-01

    Derived from various health care policies and initiatives, the concept of population health has been newly adopted by health care and medicine. In particular, it has been suggested that the Patient Protection and Affordable Care Act provision that requires nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address health priorities has the potential to improve population health. A mixed methods study design was used to examine the potential for population health improvements to occur through the Internal Revenue Service (IRS)-mandated nonprofit hospital CHNA and planning processes. Methods involved a 2-phased approach composed of (1) content analysis of 95 CHNA/implementation strategies reports and (2) interviews with key informants, consultants, and community stakeholders involved in CHNA and planning processes. Although this is a great opportunity for the nonprofit hospital assessment and planning processes to influence population health outcomes, the findings from the first 3-year assessment and planning cycle (2011-2013) suggest this is unlikely. As nonprofit hospitals begin the second 3-year assessment and planning cycle, this article offers recommendations to increase the potential for nonprofit hospitals to improve population health. These recommendations include clarifying the purpose of IRS CHNA regulations, engaging community stakeholders in collaborative assessment and planning, understanding disease etiology and identifying and addressing broader determinants of health, adopting a public health assessment and planning model, and emphasizing population health improvement. (Population Health Management 2016;19:178-186). PMID:26440370

  12. Health and environmental effects document for oil shale - 1982

    SciTech Connect

    Not Available

    1982-12-01

    The second year effort to analyze the potential human health and environmental risks of a hypothetical one million barrels-per-day industry has been completed as an aid in the formulation and management of a program of environmental research. Based on the sulfur surrogate model for premature deaths from air pollution, a significant benefit in human health (e.g. a factor of 20) results if low sulfur oil shale is used to displace imported foreign crude currently being refined. The largest uncertainties for expected fatalities are in the public sector from air pollutants although the occupational sector is estimated to have 60% more expected fatalities than the public sector. Occupational safety and illness have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Pneumoconiosis from the dust environment is the worker disease resulting in the greatest number of fatalities, followed by chronic bronchitis, internal cancer, and skin cancers, respectively. Research recommendations are presented for reducing the uncertainties in the risks analyzed to fill data gaps to estimate other risks.

  13. Health and environmental effects document for oil shale - 1982

    SciTech Connect

    Not Available

    1982-12-31

    The second year effort to analyze the potential human health and environmental risks of a hypothetical one million barrels-per-day industry has been completed as an aid in the formulation and management of a program of environmental research. Based on the sulfur surrogate model for premature deaths from air pollution, a significant benefit in human health (e.g. a factor of 20) results if low sulfur oil shale is used to displace imported foreign crude currently being refined. The largest uncertainties for expected fatalities are in the public sector from air pollutants although the occupational sector is estimated to have 60% more expected fatalities than the public sector. Occupational safety and illness have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Pneumoconiosis from the dust environment is the worker disease resulting in the greatest number of fatalities, followed by chronic bronchitis, internal cancer, and skin cancers, respectively. Research recommendations are presented for reducing the uncertainties in the risks analyzed to fill data gaps to estimate other risks.

  14. Assessing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Cuff, Patricia A.

    2014-01-01

    "Assessing Health Professional Education" is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and…

  15. CONSUMER ASSESSMENT OF HEALTH PLANS SURVEY (CAHPS)

    EPA Science Inventory

    This 5-year project has been used for consumers to identify the best health care plans and services for their needs. The goals of the Consumer Assessment of Health Plans (CAHPS?) are to (1) develop and test questionnaires that assess health plans and services, (2) produce easily ...

  16. Document Selection and Relevance Assessments during a Research Project.

    ERIC Educational Resources Information Center

    White, Marilyn Domas; Wang, Peiling

    User's information needs and the tasks they face change over the stages of a research project. In previous research by Peiling Wang, a cognitive model of users' document selection behavior for their research projects was developed. This study looks at the general applicability of Wang's model to subsequent decision-making about items selected…

  17. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

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

  18. Documenting Student Competence through Effective Performance Assessment: Employability Skills. Workshop Summary.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Agricultural Curriculum Materials Service.

    This report contains 26 performance assessments for documenting student employability skills. Each performance assessment consists of the following: a competency; a terminal performance objective (outcome); competency builders and pupil performance objectives (criteria for documenting mastery of the objective); applied academic competencies;…

  19. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Rules and Regulations Assessments § 1220.314... assessment to a Qualified State Soybean Board or the United Soybean Board is required to give to the producer... producer. (6) Date. (7) State in which soybeans were grown. (b)...

  20. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Rules and Regulations Assessments § 1220.314... assessment to a Qualified State Soybean Board or the United Soybean Board is required to give to the producer... producer. (6) Date. (7) State in which soybeans were grown. (b)...

  1. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Rules and Regulations Assessments § 1220.314... assessment to a Qualified State Soybean Board or the United Soybean Board is required to give to the producer... producer. (6) Date. (7) State in which soybeans were grown. (b)...

  2. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Rules and Regulations Assessments § 1220.314... assessment to a Qualified State Soybean Board or the United Soybean Board is required to give to the producer... producer. (6) Date. (7) State in which soybeans were grown. (b)...

  3. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Rules and Regulations Assessments § 1220.314... assessment to a Qualified State Soybean Board or the United Soybean Board is required to give to the producer... producer. (6) Date. (7) State in which soybeans were grown. (b)...

  4. 78 FR 14510 - Notice of Availability of a Treatment Evaluation Document and an Environmental Assessment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... as soil and nursery stock are shipped outside the infested area. The Animal and Plant Health... Animal and Plant Health Inspection Service Notice of Availability of a Treatment Evaluation Document and... Plant Health Inspection Service, USDA. ACTION: Notice of availability and request for comments....

  5. 9 CFR 98.35 - Declaration, health certificate, and other documents for animal semen.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Declaration, health certificate, and other documents for animal semen. 98.35 Section 98.35 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS IMPORTATION...

  6. 75 FR 20606 - Guidance for Industry on Tobacco Health Document Submission; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Tobacco Health Document Submission; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug... (74 FR 68629), FDA announced the availability of a draft guidance entitled ``Tobacco Health...

  7. Health insurance and outcomes: comprehensive assessment of health system outputs.

    PubMed

    Perkins, N A

    1991-01-01

    Outcomes analysis in health care has historically meant the examination of clinical results of inpatient hospitalization. In response to climbing health care and health insurance costs, the organization of health care providers, the location of service delivery and reimbursement mechanisms have changed. As the health care industry changes, so too must the definition of outcomes. This article presents a conceptual framework for the analysis of health outcomes as health industry outputs, with an emphasis on the ways in which such outputs are being assessed and improved. PMID:10116955

  8. An Analysis of Community Health Nurses Documentation: The Best Approach to Computerization

    PubMed Central

    Chalmers, M.

    1988-01-01

    The study explored and analyzed the actual patient-related documentation performed by a sample of community health nurses working in voluntary home health agencies. The outcome of the study was a system flow chart of that documentation and included: common components of the documentation, where in the existing systems they are recorded, when they are recorded by the nurse and why they are used by the nurses and administrative personnel in the agencies. The flow chart is suitable for use as a prototype for the development of a computer software package for the computerization of the patient-related documentation by community health nurses. General System and communication theories were used as a framework for this study. A thorough analysis of the documenation resulted in a complete and exhaustive explication of the documentation by community health nurses, as well as the identification of what parts of that documentation lend themselves most readily to computerization and what areas, if any, may not readily adapt to computerization.

  9. Automated Geospatial Watershed Assessment (AGWA) Documentation Version 2.0

    EPA Science Inventory

    The Automated Geospatial Watershed Assessment Http://www.epa.gov/nerlesd1/landsci/agwa/introduction.htm and www.tucson.ars.ag.gov/agwa) tool is a GIS interface jointly developed by the U.S. Environmental Protection Agency, USDA-Agricultural Research Service, University of Arizon...

  10. Sulfur Oxides Risk and Exposure Assessment Planning Document

    EPA Science Inventory

    In conducting risk/exposure assessments for the Sulfur Oxides NAAQS review, EPA will first develop a draft Scope and Methods Plan which will describe the proposed scope of the quantitative and qualitative analyses to be performed and the tools/methods that may be employed

  11. Documenting Reading Achievement and Growth for Students Taking Alternate Assessments

    ERIC Educational Resources Information Center

    Tindal, Gerald; Nese, Joseph F. T.; Farley, Dan; Saven, Jessica L.; Elliott, Stephen N.

    2016-01-01

    Students with disabilities have been included in state accountability systems for more than a decade; however, only in the past few years have alternate assessments of alternate achievement standards (AA-AAS) become stable enough to allow examination of these students' achievement growth. Using data from Oregon's AA-AAS in Reading during the…

  12. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs. PMID:27027459

  13. Alabama Allied Health Needs Assessment Study.

    ERIC Educational Resources Information Center

    Morris, Libby V.

    This study assessed the supply of and demand for allied health professionals in Alabama, focusing on the relationship between supply and demand in various workplace settings in the context of Alabama's demographics, current educational programs, and projected changes in health care. The health care professions included in the study were all fields…

  14. The West Virginia Health Education Assessment Project

    ERIC Educational Resources Information Center

    Tompkins, Nancy O'Hara; Kamal, Khalid M.; Chapman, Don

    2005-01-01

    Well-designed school health education should provide students with the knowledge and skills to prevent the health risk behaviors most responsible for the major causes of morbidity and mortality. This paper reports the methodology and findings of a West Virginia statewide health education assessment initiative and describes how the findings are…

  15. Impact of a Care Directives Activity Tab in the Electronic Health Record on Documentation of Advance Care Planning

    PubMed Central

    Turley, Marianne; Wang, Susan; Meng, Di; Kanter, Michael; Garrido, Terhilda

    2016-01-01

    Context: To ensure patient-centered end-of-life care, advance care planning (ACP) must be documented in the medical record and readily retrieved across care settings. Objective: To describe use of the Care Directives Activity tab (CDA), a single-location feature in the electronic health record for collecting and viewing ACP documentation in inpatient and ambulatory care settings, and to assess its association with ACP documentation rates. Design: Retrospective pre- and postimplementation analysis in 2012 and 2013 at Kaiser Permanente Southern California among 113,309 patients aged 65 years and older with ACP opportunities during outpatient or inpatient encounters. Main Outcome Measures: Providers’ CDA use rates and documentation rates of advance directives and physician orders for life-sustaining treatments stratified by CDA use. Results: Documentation rates of advance directives and physician orders for life-sustaining treatments among patients with outpatient and inpatient encounters were 3.5 to 9.6 percentage points higher for patients with CDA use vs those without it. The greatest differences were for orders for life-sustaining treatments among patients with inpatient encounters and for advance directives among patients with outpatient encounters; both were 9.6 percentage points higher among those with CDA use than those without it. All differences were significant after controlling for yearly variation (p < 0.001). Conclusion: Statistically significant differences in documentation rates between patients with and without CDA use suggest the potential of a standardized location in the electronic health record to improve ACP documentation. Further research is required to understand effects of CDA use on retrieval of preferences and end-of-life care. PMID:27057820

  16. Health Effects Assessment for Hexahydro-1,3,5-Trinitro-1,3,5-Triazine (Rdx)

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  17. Safety assessment document for the dynamic test complex (Building 836)

    SciTech Connect

    Odell, B.N.; Pfeifer, H.E.

    1981-11-24

    A safety assessment was performed to determine if potential accidents at the 836 Complex at Site 300 could present undue hazards to the general public, personnel at Site 300, or have an adverse effect on the environment. The credible accidents that might have an effect on these facilities or have off-site consequences were considered. These were earthquake, extreme wind (including missiles), lightning, flood, criticality, high explosive (H) detonation that disperses uranium and beryllium, spontaneous oxidation of plutonium, explosions due to finely divided particles, and a fire.

  18. Digital imaging technology assessment: Digital document storage project

    NASA Technical Reports Server (NTRS)

    1989-01-01

    An ongoing technical assessment and requirements definition project is examining the potential role of digital imaging technology at NASA's STI facility. The focus is on the basic components of imaging technology in today's marketplace as well as the components anticipated in the near future. Presented is a requirement specification for a prototype project, an initial examination of current image processing at the STI facility, and an initial summary of image processing projects at other sites. Operational imaging systems incorporate scanners, optical storage, high resolution monitors, processing nodes, magnetic storage, jukeboxes, specialized boards, optical character recognition gear, pixel addressable printers, communications, and complex software processes.

  19. Environment, safety and health progress assessment manual. Volume 1

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES&H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ``more focused, concentrating on ES&H management, ES&H corrective actions, self-assessment programs, and root-cause related issues.`` In July 1991, the Secretary approved the initiation of ES&H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES&H areas. This manual documents the processes to be used to perform the ES&H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy.

  20. Findings from ATSDR's Health Assessments.

    ERIC Educational Resources Information Center

    Susten, Allan S.

    1992-01-01

    Summarizes findings from the Agency for Toxic Substances and Disease Registry concerning the evaluation of data about hazardous substance release into the environment. Identifies the hazardous substances, exposure, health effects, and public health impact from 951 facilities identified on the National Priorities List (NPL) by the Environmental…

  1. HEALTH ASSESSMENT DOCUMENT FOR VINYLIDENE CHLORIDE. FINAL REPORT

    EPA Science Inventory

    Vinylidene chloride is a highly reactive, flammable, clear colorless liquid. In the absence of chemical inhibitors, it can produce violently explosive, complex peroxides. The estimated, ambient air level of vinylidene chloride in urban-suburban areas of the United States is 20 mi...

  2. Health Assessment Document for Ethylene Oxide (External Review Draft)

    EPA Science Inventory

    The largest single use of ethylene oxide is an intermediate in the synthesis of ethylene glycol. However, small amounts of this epoxide are used as a sterilant or pesticide in commodities, pharmaceuticals, medical devices, tobacco, and other items, representing a considerable pot...

  3. Health assessment document for hydrogen sulfide: review draft

    SciTech Connect

    Ammann, H.M.; Bradow, F.; Fennell, D.; Griffin, R.; Kearney, B.

    1986-08-01

    Hydrogen sulfide is a highly toxic gas which is immediately lethal in concentrations greater than 2000 ppm. The toxic end-point is due to anoxia to brain and heart tissues which results from its interaction with the celluar enzyme cytochrome oxidase. Inhibition of the enzyme halts oxidative metabolism which is the primary energy source for cells. A second toxic end-point is the irritative effect of hydrogen sulfide on mucous membranes, particularly edema at sublethal doses (250 to 500 ppm) in which sufficient exposure occurs before conciousness is lost. Recovered victims of exposure report neurologic symptoms such as headache, fatigue, irritability, vertigo, and loss of libido. Long-term effects are similar to those caused by anoxia due to other toxic agents like CO, and probably are not due to specific H/sub 2/S effects. H/sub 2/S is not a cumulative poison. No mutagenic, carcinogenic, reproductive, or teratogenic effects have been reported in the literature.

  4. Framework for Assessing Health Risk of Environmental Exposure to Children (External Review Draft)

    EPA Science Inventory

    The draft document, Framework For Assessing Health Risks of Environmental Exposure to Children, can serve as a resource on children's health risk assessment and it addresses the need to provide a comprehensive and consistent framework for considering children in risk asses...

  5. Listening for Competence through Documentation: Assessing Children with Language Delays Using Digital Video

    ERIC Educational Resources Information Center

    Suarez, Stephanie Cox; Daniels, Karen J.

    2009-01-01

    This case study uses documentation as a tool for formative assessment to interpret the learning of twin boys with significantly delayed language skills. Reggio-inspired documentation (the act of collecting, interpreting, and reflecting on traces of learning from video, images, and observation notes) focused on the unfolding of the boys' nonverbal…

  6. Airborne infection control in India: Baseline assessment of health facilities

    PubMed Central

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  7. SPATIAL ALLOCATION FACTOR PROCEDURES FOR THE 1980 NAPAP (NATIONAL ACID PRECIPITATION ASSESSMENT PROGRAM) EMISSIONS INVENTORY DOCUMENTATION

    EPA Science Inventory

    The report documents the development of spatial allocation factors to apportion National Acid Precipitation Assessment Program (NAPAP) area source emissions from counties to individual grid cells for input to the Regional Acid Deposition Models (RADM) and Regional Oxidant Models ...

  8. Assessment of health risks of policies

    SciTech Connect

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana; and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  9. Advanced Photon Source experimental beamline Safety Assessment Document: Addendum to the Advanced Photon Source Accelerator Systems Safety Assessment Document (APS-3.2.2.1.0)

    SciTech Connect

    1995-01-01

    This Safety Assessment Document (SAD) addresses commissioning and operation of the experimental beamlines at the Advanced Photon Source (APS). Purpose of this document is to identify and describe the hazards associated with commissioning and operation of these beamlines and to document the measures taken to minimize these hazards and mitigate the hazard consequences. The potential hazards associated with the commissioning and operation of the APS facility have been identified and analyzed. Physical and administrative controls mitigate identified hazards. No hazard exists in this facility that has not been previously encountered and successfully mitigated in other accelerator and synchrotron radiation research facilities. This document is an updated version of the APS Preliminary Safety Analysis Report (PSAR). During the review of the PSAR in February 1990, the APS was determined to be a Low Hazard Facility. On June 14, 1993, the Acting Director of the Office of Energy Research endorsed the designation of the APS as a Low Hazard Facility, and this Safety Assessment Document supports that designation.

  10. A scalable climate health justice assessment model

    PubMed Central

    McDonald, Yolanda J.; Grineski, Sara E.; Collins, Timothy W.; Kim, Young-An

    2014-01-01

    This paper introduces a scalable “climate health justice” model for assessing and projecting incidence, treatment costs, and sociospatial disparities for diseases with well-documented climate change linkages. The model is designed to employ low-cost secondary data, and it is rooted in a perspective that merges normative environmental justice concerns with theoretical grounding in health inequalities. Since the model employs International Classification of Diseases, Ninth Revision Clinical Modification (ICD-9-CM) disease codes, it is transferable to other contexts, appropriate for use across spatial scales, and suitable for comparative analyses. We demonstrate the utility of the model through analysis of 2008–2010 hospitalization discharge data at state and county levels in Texas (USA). We identified several disease categories (i.e., cardiovascular, gastrointestinal, heat-related, and respiratory) associated with climate change, and then selected corresponding ICD-9 codes with the highest hospitalization counts for further analyses. Selected diseases include ischemic heart disease, diarrhea, heat exhaustion/cramps/stroke/syncope, and asthma. Cardiovascular disease ranked first among the general categories of diseases for age-adjusted hospital admission rate (5286.37 per 100,000). In terms of specific selected diseases (per 100,000 population), asthma ranked first (517.51), followed by ischemic heart disease (195.20), diarrhea (75.35), and heat exhaustion/cramps/stroke/syncope (7.81). Charges associated with the selected diseases over the 3-year period amounted to US$5.6 billion. Blacks were disproportionately burdened by the selected diseases in comparison to non-Hispanic whites, while Hispanics were not. Spatial distributions of the selected disease rates revealed geographic zones of disproportionate risk. Based upon a downscaled regional climate-change projection model, we estimate a >5% increase in the incidence and treatment costs of asthma attributable to

  11. Safety assessment document for the Dynamic Test Complex B854

    SciTech Connect

    Odell, B.N.; Pfeifer, H.E.

    1981-12-11

    A safety assessment was performed to determine if potential accidents at the 854 Complex at Site 300 could present undue hazards to the general public, personnel at Site 300, or have an adverse effect on the environment. The credible accidents that might have an effect on these facilities or have off-site consequences were considered. These were earthquake, extreme wind (including missiles), lightning, flood, criticality, high explosive (HE) detonation that disperses uranium and beryllium, spontaneous oxidation of plutonium, explosions due to finely divided particles, and a fire. Seismic and extreme wind (including missiles) analyses indicate that the buildings are basically sound. The lightning protection system is in the process of being upgraded to meet AMCR 385-100. These buildings are located high above the dry creek bed so that a flood is improbable. The probability of high explosive detonation involving plutonium is very remote since the radioactive materials are encased and plutonium and HE are not permitted concurrently in the same area at Site 300. (The exception to this policy is that explosive actuating devices are sometimes located in assemblies containing fissile materials. However, an accidental actuation will not affect the safe containment of the plutonium within the assembly.) There is a remote possibility of an HE explosion involving uranium and beryllium since these are permitted in the same area.The possibility of a criticality accident is very remote since the fissile materials are doubly encased in stout metal containers. All operations involving these materials are independently reviewed and inspected by the Criticality Safety Office. It was determined that a fire was unlikely due to the low fire loading and the absence of ignition sources. It was also determined that the consequences of any accidents were reduced by the remote location of these facilities, their design, and by administrative controls.

  12. Comparison of Select Health Outcomes by Deployment Health Assessment Completion.

    PubMed

    Luse, Tina M; Slosek, Jean; Rennix, Christopher

    2016-02-01

    The Department of Defense (DoD) requires service members to complete regular health assessments for identification of deployment-related physical/behavioral issues and environmental/occupational exposures. Compliance among active duty Department of the Navy personnel varies; however, and the impact of incomplete assessments on generalizability of results is unclear. This study examines the differences between Navy and Marine Corps service members who completed both the Post-Deployment Health Assessment and Post-Deployment Health Reassessment (n = 9,452) as compared to service members who never attempted either form (n = 5,603) in fiscal year 2010. Deployment rosters, assessments, and clinical data were analyzed to determine certified assessment completion rates and incidence of certain health conditions in these populations. Only 38.9% of applicable personnel met the completion and certification criteria for the required assessments. Service members who did not complete the forms were distinctly different demographically and at increased risk for psychotropic drug use, post-traumatic stress disorder diagnosis, and traumatic brain injury diagnosis following deployment. The prevailing assumption that the risk of adverse health effects on operational forces can be estimated using the population that completed the required assessments is incorrect, and the true operational impact and medical burden of these conditions may be underestimated. PMID:26837080

  13. Tools Used to Evaluate Written Medicine and Health Information: Document and User Perspectives

    ERIC Educational Resources Information Center

    Luk, Alice; Aslani, Parisa

    2011-01-01

    This study aims to identify and review tools used to evaluate consumer-oriented written medicine (WMI) and health (WHI) information from a document and user perspective. Articles that met the following inclusion criteria were reviewed: studies evaluating readability, presentation, suitability, quality of WMI/WHI. A total of 152 articles were…

  14. Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

    ERIC Educational Resources Information Center

    Jensen, Tracey A.

    2013-01-01

    Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

  15. 48 CFR 801.602-78 - Processing solicitations and contract documents for legal or technical review-Veterans Health...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Scarce medical specialist and health-care resource solicitations, quotations, and proposed contracts (i.e... and contract documents for legal or technical review-Veterans Health Administration field facilities... solicitations and contract documents for legal or technical review—Veterans Health Administration...

  16. 48 CFR 801.602-78 - Processing solicitations and contract documents for legal or technical review-Veterans Health...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Scarce medical specialist and health-care resource solicitations, quotations, and proposed contracts (i.e... and contract documents for legal or technical review-Veterans Health Administration field facilities... solicitations and contract documents for legal or technical review—Veterans Health Administration...

  17. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and public health and safety documentation regarding any gaming place, facility, or location where... environmental and public health and safety documentation regarding any gaming place, facility, or location where gaming will occur? A tribe shall provide Indian lands or environmental and public health and...

  18. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... and public health and safety documentation regarding any gaming place, facility, or location where... environmental and public health and safety documentation regarding any gaming place, facility, or location where gaming will occur? A tribe shall provide Indian lands or environmental and public health and...

  19. 48 CFR 801.602-78 - Processing solicitations and contract documents for legal or technical review-Veterans Health...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and contract documents for legal or technical review-Veterans Health Administration field facilities... solicitations and contract documents for legal or technical review—Veterans Health Administration field...) Scarce medical specialist and health-care resource solicitations, quotations, and proposed contracts...

  20. Underground Test Area Subproject Phase I Data Analysis Task. Volume VIII - Risk Assessment Documentation Package

    SciTech Connect

    1996-12-01

    Volume VIII of the documentation for the Phase I Data Analysis Task performed in support of the current Regional Flow Model, Transport Model, and Risk Assessment for the Nevada Test Site Underground Test Area Subproject contains the risk assessment documentation. Because of the size and complexity of the model area, a considerable quantity of data was collected and analyzed in support of the modeling efforts. The data analysis task was consequently broken into eight subtasks, and descriptions of each subtask's activities are contained in one of the eight volumes that comprise the Phase I Data Analysis Documentation.

  1. Nurses' Contribution to Health Information Technology of Iran's 2025 Health Map: A Review of the Document.

    PubMed

    Sadoughi, Farahnaz; Azadi, Tania; Azadi, Tannaz

    2016-01-01

    Implementation of eHealth strategy in Iran has a history less than 17 years. Iran's eHealth strategy is developed in 2011 and is called "Iran' 2025 Health Map: Health Information Technology". Considering the important role of nurses in providing healthcare services as well as in future long term plans such as sustainable development, it is of high value to pay attention to nurses' contribution in developing eHealth strategies. Thus the purpose of this study was to investigate nurses' contribution to health information technology of Iran's 2025 health map. This study was a qualitative study conducted in 2015 through reviewing the "Iran' 2025 Health Map: Health Information Technology" official report. The strategy published in three volumes and in Persian language was downloaded through the official website of the office of Statistics and Information Technology of Iranian Ministry of Health and Medical Education (MOHME). Two main themes were identified in the report indicating areas which nurses' roles were clearly stated. The findings revealed that nurses' contribution is not clearly stated in the strategy. However, there are a few areas highlighting nurses' involvement such as "determining beneficiary groups" and "information dissemination". It is suggested that more attention needs to be paid in contribution of nurses in further actions to revise the Iran's eHealth strategy. PMID:27332183

  2. Integrating Sexual Minority Health Issues into a Health Assessment Class.

    PubMed

    Bosse, Jordon D; Nesteby, J Aleah; Randall, Carla E

    2015-01-01

    The health needs of the lesbian, gay, bisexual, and transgender (LGBT) population are traditionally overlooked by the health care community and are rendered invisible by most nursing school curricula. Initial contact with a nurse during a health history and assessment can have an impact on whether the person will feel comfortable disclosing his or her identity, returning for services, or following plans of care. Because the first interaction with a nurse can be critical, the health assessment course is an appropriate place in the curriculum to discuss the needs of the LGBT community. This article includes a discussion of unique health risks to the LGBT population, benefits, and challenges of incorporating these issues into the classroom and recommendations for including the care of this population into a health assessment nursing course. Specific communication techniques are provided that may be helpful during history taking and physical examination with a patient who is LGBT. Guidance regarding physical examination of the transgender patient is also included. These suggestions will be helpful to nurse faculty who teach health assessment, nursing students, educators who design and implement professional development and continuing education for established nurses, preceptors in the clinical setting, and any nurse who is unfamiliar with the needs and concerns specific to the LGBT population. PMID:26653044

  3. Health Risk Assessments for Alumina Refineries

    PubMed Central

    Coffey, Patrick S.

    2014-01-01

    Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10−6. Conclusions: The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries. PMID:24806721

  4. Health at the Intersections of Precarious Documentation Status and Gender-Based Partner Violence.

    PubMed

    Parson, Nia; Escobar, Rebecca; Merced, Mariam; Trautwein, Anna

    2016-01-01

    This article is based on qualitative research investigating Spanish-speaking immigrant women's experiences of gender-based intimate partner violence (GBPV) and help seeking in New Jersey (2006-2008). Methods included interviews with these women, health care and social service providers, and community members. This article reveals that as many immigrant women live at the intersections of structural, normalized, and gender-based partner violence, integrated social service responses emerge as key health care responses to GBPV. The health impacts of undocumented and precariously documented migration and GBPV demand policy interventions and dedication of resources to address the multi-faceted needs of this population. PMID:25148835

  5. Office for prevention and health services assessment

    NASA Astrophysics Data System (ADS)

    Wright, James A.

    1994-12-01

    The Air Force Surgeon General has established the Office for Prevention and Health Care ASsessment (OPHSA) to become the center of excellence for preventive services and health care assessment in the U.S. Air Force and the Department of Defense. OPHSA using the principles of total quality management and integrated teams will evaluate, compare, and modify preventive services delivery guidelines to preserve the fighting force by preventing illness and injuries in military populations. OPHSA will evaluate and formulate health care delivery guidelines to improve health care access and delivery to military patient populations. OPHSA will develop data to determine the health status and health needs to beneficiary populations so medical managers can deliver medical care in the most cost effective manner. OPHSA is located at Brooks Air Force Base in San Antonio, Texas. OPHSA will have thirty seven active duty military, civil service, and contract employees and should be fully functional by the end of 1995.

  6. An Assessment of Environmental Health Needs

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

  7. Content Assessment of Selected College Health Textbooks.

    ERIC Educational Resources Information Center

    Huetteman, Julie Doidge

    Six college health textbooks published between 1980 and 1987 were analyzed to determine the extent of coverage of 10 selected content areas from "Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention." Content areas assessed included: motor vehicle accidents, alcohol and drug misuse, teenage pregnancy, sexually…

  8. [Approaches for assessing forest ecosystem health].

    PubMed

    Chen, Gao; Deng, Hongbing; Wang, Qingli; Dai, Limin; Hao, Zhanqing

    2003-06-01

    Assessment and indicator system become the key issues in the research on ecosystem health in 21st century. Assessing forest ecosystem health gradually attach much attention because it is an important component of terrestrial ecosystem. The definition, measurement, evaluation and its management had been discussed broadly, and some theories, assessing methods and frameworks had been proposed, which provides a new concept and a serial research approaches for dealing with the crisis of terrestrial ecosystems, even the environment problems in the world. Now, the common operational models for assessing forest ecosystem health do not exist owing to the manifold limitations. This paper discussed forest ecosystem health problem, and brought forward three preconditions for assessing forest ecosystem health: 1) a clear conceptual framework; 2) adequate data sets; 3) proper research and analysis techniques. The issues of three preconditions were discussed, and the possible approaches for the assessing research on forest ecosystem health, e.g., long-term studies and environment monitoring, space-for-time substation studies, e.g., history approaches, economics valuation and others were expariated. PMID:12974013

  9. [Health research and health technology assessment in Chile].

    PubMed

    Espinoza, Manuel Antonio; Cabieses, Báltica; Paraje, Guillermo

    2014-01-01

    Health research is considered an essential element for the improvement of population health and it has been recommended that a share of the national health budget should be allocated to develop this field. Chile has undertaken efforts in the last decades in order to improve the governmental structure created to promote the development of health research, which has increased human resources and funding opportunities. On the other hand, the sustained economic growth of Chile in the last decades suggests that the health expenditure will maintain its increasing trend in the following years. This additional funding could be used to improve coverage of current activities performed in the health system, but also to address the incorporation of new strategies. More recently, health technology assessment (HTA) has been proposed as a process to support decisions about allocation of resources based on scientific evidence. This paper examines the relationship between the development of health research and the HTA process. First, it presents a brief diagnosis of the situation of health research in Chile. Second, it reviews the conceptual basis and the methods that account for the relationship between a HTA process and the development of health research. In particular, it emphasizes the relevance of identifying information gaps where funding additional research can be considered a good use of public resources. Finally, it discusses the challenges and possible courses of action that Chile could take in order to guarantee the continuous improvement of an articulated structure for health research and HTA. PMID:24861179

  10. Cornerstone Documents, Milestones, and Policies: Shaping the Direction of Public Health Nursing 1890-1950.

    PubMed

    Kub, Joan; Kulbok, Pamela A; Glick, Doris

    2015-01-01

    The interplay of policy, milestone events, and cornerstone documents was critical in the evolution of the specialty of public health nursing (PHN) from 1890-1950. Using our contemporary lens, this article examines PHN development from an historical perspective, including events and milestones driving growth in the early 20th century. Some of the challenges faced by our founding public health nursing leadership are not unlike challenges we face today. In 1950, Ruth Hubbard, a former leader in the National Organization of Public Health Nurses and Director of the Visiting Nurse Society of Philadelphia, spoke of the value of examining the past to forge a new future. This article calls for contemporary public health nurses to act upon the lessons learned from the past, to strengthen the renewed focus on prevention, to develop policies that impact population health, and to foster a vision that will guide us into the future. PMID:26882422

  11. Environment, Safety and Health Progress Assessment of the Hanford Site

    SciTech Connect

    Not Available

    1992-05-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Hanford Site, in Richland, Washington. The assessment, which was conducted from May 11 through May 22, 1992, included a selective-review of the ES&H management systems and programs of the responsible DOE Headquarters Program Offices the DOE Richland Field Office, and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the Hanford Site ES&H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES&H problems and requirements. They are not intended to be comprehensive compliance assessments of ES&H activities. The point of reference for assessing programs at the Hanford Site was, for the most part, the Tiger Team Assessment of the Hanford Site, which was conducted from May 21 through July 18, 1990. A summary of issues and progress in the areas of environment, safety and health, and management is included.

  12. The Prenatal Assessment of Fetal Health

    PubMed Central

    Parboosingh, J.; Mousseau, J.; Deacon, J.

    1979-01-01

    This article reviews the objectives, indications and methods currently used to assess fetal health in pregnancies at risk of fetoplacental dysfunction. The graphic display of clinical data encourages the physician to recognize deviations from the norm and assists in the selection of patients for assessment by the more sophisticated tests of fetoplacental function. PMID:21297709

  13. HEALTH ASSESSMENT OF 1,3-BUTADIENE

    EPA Science Inventory

    This assessment was conducted to review the new information that has become available since EPA's 1985 health assessment of 1,3-butadiene.

    1,3-Butadiene is a gas used commercially in the production of styrene-butadiene rubber, plastics, and thermoplastic resins. The major...

  14. Smart Sensors Assess Structural Health

    NASA Technical Reports Server (NTRS)

    2010-01-01

    NASA frequently inspects launch vehicles, fuel tanks, and other components for structural damage. To perform quick evaluation and monitoring, the Agency pursues the development of structural health monitoring systems. In 2001, Acellent Technologies Inc., of Sunnyvale, California, received Small Business Innovation Research (SBIR) funding from Marshall Space Flight Center to develop a hybrid Stanford Multi-Actuator Receiver Transduction (SMART) Layer for aerospace vehicles and structures. As a result, Acellent expanded the technology's capability and now sells it to aerospace and automotive companies; construction, energy, and utility companies; and the defense, space, transportation, and energy industries for structural condition monitoring, damage detection, crack growth monitoring, and other applications.

  15. Ten years of democracy in South Africa: documenting transformation in reproductive health policy and status.

    PubMed

    Cooper, Diane; Morroni, Chelsea; Orner, Phyllis; Moodley, Jennifer; Harries, Jane; Cullingworth, Lee; Hoffman, Margaret

    2004-11-01

    The advent of democracy in South Africa in 1994 created a unique opportunity for new lows and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS. PMID:15626198

  16. Health assessment of exposure to developmental toxicants

    SciTech Connect

    Kimmel, C.A.

    1987-07-01

    In 1984, the U.S. EPA published proposed Guidelines for the Health Assessment of Suspect Developmental Toxicants. The assessment of data from studies on developmental effects of chemical exposure and the estimation of risk for humans is a difficult process. Although structure/activity relationships and data from short-term tests are often used in the risk-assessment process for assessing carcinogens, these are not useful as the first step in developmental toxicity risk assessment. Human epidemiological data are used, if available, but often the only available evidence is from animal studies. Therefore, the guidelines focus on the evaluation of data from routine animal testing studies.

  17. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual.

  18. Assessing the adequacy of the HL7/LOINC Document Ontology Role axis.

    PubMed

    Rajamani, Sripriya; Chen, Elizabeth S; Akre, Mari E; Wang, Yan; Melton, Genevieve B

    2015-05-01

    The healthcare landscape is changing, driven by innovative care models and the emergence of new roles that are inter-professional in nature. Currently, the HL7/LOINC Document Ontology (DO) aids the use and exchange of clinical documents using a multi-axis structure of document attributes for Kind of Document, Setting, Role, Subject Matter Domain, and Type of Service. In this study, the adequacy of the Role axis for representing the type of author documenting care was assessed. Experts used a master list of 220 values created from seven resources and established mapping guidelines. Baseline certification, licensure, and didactic training were identified as key parameters that define roles and hence often need to be pre-coordinated. DO was inadequate in representing 82% of roles, and this gap was primarily due to lack of granularity in DO. Next steps include refinement of the proposed schema for the Role axis and dissemination within the larger standards community. PMID:25352569

  19. Compilation of Quality Assurance Documentation for Analyses Performed for the Resumption of Transient Testing Environmental Assessment

    SciTech Connect

    Annette L. Schafer; A. Jeffrey Sondrup

    2013-11-01

    This is a companion document to the analyses performed in support of the environmental assessment for the Resumption of Transient Fuels and Materials Testing. It is provided to allow transparency of the supporting calculations. It provides computer code input and output. The basis for the calculations is documented separately in INL (2013) and is referenced, as appropriate. Spreadsheets used to manipulate the code output are not provided.

  20. Assessment of documentation requirements under DOE 5481. 1, Safety Analysis and Review System (SARS)

    SciTech Connect

    Browne, E.T.

    1981-03-01

    This report assesses the requirements of DOE Order 5481.1, Safety Analysis and Review System for DOE Operations (SARS) in regard to maintaining SARS documentation. Under SARS, all pertinent details of the entire safety analysis and review process for each DOE operation are to be traceable from the initial identification of a hazard. This report is intended to provide assistance in identifying the points in the SARS cycle at which documentation is required, what type of documentation is most appropriate, and where it ultimately should be maintained.

  1. Final Action Plan to Tiger Team. Environmental, safety and health assessment

    SciTech Connect

    Not Available

    1992-02-28

    This document presents planned actions, and their associated costs, for addressing the findings in the Environmental, Safety and Health Tiger Team Assessment of the Sandia National Laboratories, Albuquerque, May 1991, hereafter called the Assessment. This Final Action Plan should be read in conjunction with the Assessment to ensure full understanding of the findings addressed herein. The Assessment presented 353 findings in four general categories: (1)Environmental (82 findings); (2) Safety and Health (243 findings); (3) Management and Organization (18 findings); and (4) Self-Assessment (10 findings). Additionally, 436 noncompliance items with Occupational Safety and Health Administration (OSHA) standards were addressed during and immediately after the Tiger Team visit.

  2. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES §...

  3. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

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

    PubMed

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

    2013-01-01

    Protection of working mothers: operational guide document. The aim of this operational guide document is to protect the health of working mothers and their babies during pregnancy, puerperium and breastfeeding. The project was developed by a technical working group which included professionals in the pertinent fields from the Workplace Prevention and Safety Services of the local Vasta-2 Area of the Marche Regional Health Service:physicians, health assistants, and nurses. It is considered to be a useful tool for risk assessment at the workplace aimed at professionals who are involved, with various duties and responsibilities, in the health care of the working mother. This paper consists of two functionally related sections, "Table of risks" and "Technical specifications". In the "Table of Risks" section, the occupational hazards for women during pregnancy or postpartum were analyzed with the highest possible degree of care. To this end the technical group provided, for each occupational hazard, its own operational suggestions, in relation to legislation, current scientific knowledge and Guidelines of other Italian Regions. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) participated in the final draft of the entire document. The second section, "Technical Specifications", illustrates the main tasks and any risks involved in the 34 manufacturing sectors most prevalent in this area. This operational guide document is intended to be the beginning of a common strategy in public health to achieve a wider field of action in promotion and information aimed at protecting the reproductive health of working mothers. PMID:24228309

  5. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  6. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES...

  7. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  8. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES...

  9. Human health and wellbeing in environmental impact assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects

    SciTech Connect

    Harris, Patrick J.; Harris, Elizabeth; Thompson, Susan; Harris-Roxas, Ben; Kemp, Lynn

    2009-09-15

    Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs in New South Wales, Australia. Results showed that health and wellbeing impacts were not considered explicitly. They were, however, included indirectly in the identification of traditional public health exposures associated with the physical environment and to a lesser extent the inclusion of social and economic impacts. However, no health data was used to inform any of the assessments, there was no reference to causal pathways between exposures or determinants and physical or mental health effects, and there was no inclusion of the differential distribution of exposures or health impacts on different populations. The results add conceptually and practically to the long standing integration debate, showing that health is in a position to add value to the EIA process as an explicit part of standard environmental, social and economic considerations. However, to overcome the consistently documented barriers to integrating health in EIA, capacity must be developed amongst EIA professionals, led by the health sector, to progress health related knowledge and tools.

  10. Mental health assessment of rape offenders

    PubMed Central

    Sarkar, Jaydip

    2013-01-01

    There is an urgent need for development of methods of assessment and management of sex offenders (rapists, child sex offenders, other sexual offenders, and murderers) to mount a society-wide battle against the scourge of sexual offences in India. This paper provides an overview of theories, models, and assessment methods of rapists. It draws upon literature from psychiatry, psychology, criminology, probation, and ethics to provide a framework for understanding reasons behind rape, how mental health issues are implicated, what mental health professionals can do to contribute to crime management, and why this is ethically right and proper. PMID:24082243

  11. Interim response action, basin F liquid incineration project. Draft final human health assessment. Volume 2. Appendices

    SciTech Connect

    1993-09-01

    The multipathway human health risk assessment based on the SQI emission rate measured during the trial burn of basin F liquid indicates that the maximum level of human health risk associated with operation of this incinerator will not exceed the benchmark risk levels defined in the final decision document (Woodward-Clyde, 1990).

  12. HEALTH EFFECTS ASSESSMENT FOR 2,3,7,8-TETRACHLORODIBENZO-P-DIOXIN (1984)

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  13. Interim response action, basin F liquid incineration project. Draft final human health assessment. Volume 1

    SciTech Connect

    1993-09-02

    The multipathway human health risk assessment based on the SQ1 emission rates measured during the trial burn of basin F liquid indicates that the maximum level of human health risk associated with operation of this incinerator will not exceed the benchmark risk levels defined in the final decision document (Woodward-Clyde, 1990).

  14. Principles for social impact assessment: A critical comparison between the international and US documents

    SciTech Connect

    Vanclay, Frank . E-mail: Frank.Vanclay@utas.edu.au

    2006-01-15

    The 'International Principles for Social Impact Assessment' and the 'Principles and Guidelines for Social Impact Assessment in the USA', both developed under the auspices of the International Association for Impact Assessment and published in 2003, are compared. Major differences in the definition and approach to social impact assessment (SIA) are identified. The US Principles and Guidelines is shown to be positivist/technocratic while the International Principles is identified as being democratic, participatory and constructivist. Deficiencies in both documents are identified. The field of SIA is changing to go beyond the prevention of negative impacts, to include issues of building social capital, capacity building, good governance, community engagement and social inclusion.

  15. A pilot study on the evaluation of medical student documentation: assessment of SOAP notes

    PubMed Central

    2016-01-01

    Purpose: The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records. Methods: We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP) notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP)-encounter with a SP complaining rhinorrhea and warring about meningitis. Results: Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient’s symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7%) for diagnosis and treatment (52.6%). Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively. Conclusion: Our results showed that third-year medical students’ SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students’ signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed. PMID:26996436

  16. Lawrence Livermore National Laboratory Emergency Response Capability Baseline Needs Assessment Requirement Document

    SciTech Connect

    Sharry, J A

    2009-12-30

    This revision of the LLNL Fire Protection Baseline Needs Assessment (BNA) was prepared by John A. Sharry, LLNL Fire Marshal and LLNL Division Leader for Fire Protection and reviewed by Martin Gresho, Sandia/CA Fire Marshal. The document follows and expands upon the format and contents of the DOE Model Fire Protection Baseline Capabilities Assessment document contained on the DOE Fire Protection Web Site, but only address emergency response. The original LLNL BNA was created on April 23, 1997 as a means of collecting all requirements concerning emergency response capabilities at LLNL (including response to emergencies at Sandia/CA) into one BNA document. The original BNA documented the basis for emergency response, emergency personnel staffing, and emergency response equipment over the years. The BNA has been updated and reissued five times since in 1998, 1999, 2000, 2002, and 2004. A significant format change was performed in the 2004 update of the BNA in that it was 'zero based.' Starting with the requirement documents, the 2004 BNA evaluated the requirements, and determined minimum needs without regard to previous evaluations. This 2010 update maintains the same basic format and requirements as the 2004 BNA. In this 2010 BNA, as in the previous BNA, the document has been intentionally divided into two separate documents - the needs assessment (1) and the compliance assessment (2). The needs assessment will be referred to as the BNA and the compliance assessment will be referred to as the BNA Compliance Assessment. The primary driver for separation is that the needs assessment identifies the detailed applicable regulations (primarily NFPA Standards) for emergency response capabilities based on the hazards present at LLNL and Sandia/CA and the geographical location of the facilities. The needs assessment also identifies areas where the modification of the requirements in the applicable NFPA standards is appropriate, due to the improved fire protection provided, the

  17. An assessment of fiscal space for health in Bhutan.

    PubMed

    Sharma, Jayendra

    2016-07-01

    Several factors are expected to put a strain on health financing in Bhutan. In a predominantly public-financed healthcare, ensuring that the health system gains sufficient fiscal space to ensure the sustainability of its financing is a critical policy concern. This fiscal space assessment bases its analysis on national surveys and statistics, international databases and review of official documents and reports. Assuming that the government health spending will continue to respond in the same way to growth as in the period 2002-2012, Bhutan can expect to see a robust increase in government investments in health. If elasticity of health expenditure with respect to GDP does not change significantly, projections indicate that per-capita government spending for health could more than double in the period 2012 to 2019. This increase from Ngultrum 2632 in 2012 to Ngultrum 6724 in 2019 could correspond to government health spending from 2.65% of GDP to 3.98% of GDP in the respective years. The country, however, needs to closely monitor and ensure that government investment in healthcare keeps pace with the growth of the national economy. Along with this, supplementary resources for healthcare could be explored through earmarked taxes and by generating efficiency gains. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25982663

  18. Shift work, health, the working time regulations and health assessments.

    PubMed

    Nicholson, P J; D'Auria, D A

    1999-04-01

    Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value. PMID:10451593

  19. Documentation assessment, Project C-018H, 200-E area effluent treatment facility

    SciTech Connect

    Peres, M.W.; Connor, M.D.; Mertelendy, J.I.

    1994-12-21

    Project C-018H is one of the fourteen subprojects to the Hanford Environmental Compliance (HEC) Project. Project C-018H provides treatment and disposal for the 242-A Evaporator and PUREX plant process condensate waste streams. This project used the Integrated Management Team (IMT) approach proposed by RL. The IMT approach included all affected organizations on the project team to coordinate and execute all required project tasks, while striving to integrate and satisfy all technical, operational, functional, and organizational objectives. The HEC Projects were initiated in 1989. Project C-018H began in early 1990, with completion of construction currently targeted for mid-1995. This assessment was performed to evaluate the effectiveness of the management control on design documents and quality assurance records developed and submitted for processing, use, and retention for the Project. The assessment focused primarily on the overall adequacy and quality of the design documentation currently being submitted to the project document control function.

  20. Practitioner Expectations and Experiences with the Certificate IV in Training and Assessment (TAA40104): Support Document

    ERIC Educational Resources Information Center

    Clayton, Berwyn; Meyers, Dave; Bateman, Andrea; Bluer, Robert

    2010-01-01

    This document supports the report "Practitioner Expectations and Experiences with the Certificate IV in Training and Assessment (TAA40104)". The first section outlines the methodology used to undertake the research and covers the design of the research, sample details, data collection processes and the strategy for data analysis and reporting. The…

  1. ECOLOGICAL ASSESSMENT OF HAZARDOUS WASTE SITES: A FIELD AND LABORATORY REFERENCE DOCUMENT

    EPA Science Inventory

    This document has the following purposes: 1) to discuss the scientific basis for assessing adverse ecological effects at hazardous waste sites (HWSs), and 2) to present methods for evaluating the on-site and off-site ecological effects of HWSs. The methods are intended for implem...

  2. Essential Communication and Documentation Skills. Module: Final Assessment and Action Planning.

    ERIC Educational Resources Information Center

    Medina, Muriel; And Others

    This module is the 10th of 10 in the Essential Communication and Documentation Skills curriculum. It develops final assessment and action planning, workplace literacy skills identified as being directly related to the job of the direct care worker. The curriculum is designed to improve the competence of New York State Division for Youth direct…

  3. Making Learning Visible in Kindergarten Classrooms: Pedagogical Documentation as a Formative Assessment Technique

    ERIC Educational Resources Information Center

    Buldu, Mehmet

    2010-01-01

    This study investigated interactions between pedagogical documentation--a formative assessment technique and instructional intervention designed to increase student learning by recording children's experiences--and kindergarten children, families and teachers in the UAE. The study sample comprised six teachers in six kindergarten classrooms, 141…

  4. Evaluation and Assessment in Mathematics Education. Science and Technology Education Document Series No. 32.

    ERIC Educational Resources Information Center

    Robitaille, David F.

    This document contains 15 papers selected from 47 papers presented at a theme group of the Sixth International Congress on Mathematical Education. The papers included have been divided into four groups. The first group consists of a survey paper, which discusses the history of assessment and evaluation. The second section consists of six papers…

  5. Health technology assessment and thyroid surgery.

    PubMed

    Lucchini, R; Sanguinetti, A; Monacelli, M; Triola, R; Avenia, S; Conti, C; Santoprete, S; Avenia, N

    2013-01-01

    The growth of technological innovation, the request for assistance, the rising patient's expectations and the interest of the industry have led to a rise in the cost of health care systems. In this context the role of the National Health System is not to delay the development or adoption of new technologies, but rather to drive the development selecting priorities and promoting its use. Health Technology Assessment (HTA) is a multidisciplinary and multidimensional approach for analyzing the medical-clinical, social, organizational, economic, ethical and legal implications of a technology (devices, drugs, procedures) through the assessment of multiple parameters such as effectiveness, safety, costs of the social and organizational impact. A health technology assessment is a comprehensive, systematic evaluation of the prerequisites for estimating the consequences of using health technology. Main characteristic of HTA is that the problem is tackled using an approach focused on four main elements: - technology; - patient; - organization; - economy. The authors have applied the HTA method for the analysis of the ultrasonic focus dissector on thyroid surgery. They compared the cost of the surgical procedure using the ultrasonic dissector and without it in a case study of 440 patients who underwent thyroidectomy. PMID:24091174

  6. Who Has Used Internal Company Documents for Biomedical and Public Health Research and Where Did They Find Them?

    PubMed Central

    Wieland, L. Susan; Rutkow, Lainie; Vedula, S. Swaroop; Kaufmann, Christopher N.; Rosman, Lori M.; Twose, Claire; Mahendraratnam, Nirosha; Dickersin, Kay

    2014-01-01

    Objective To describe the sources of internal company documents used in public health and healthcare research. Methods We searched PubMed and Embase for articles using internal company documents to address a research question about a health-related topic. Our primary interest was where authors obtained internal company documents for their research. We also extracted information on type of company, type of research question, type of internal documents, and funding source. Results Our searches identified 9,305 citations of which 357 were eligible. Scanning of reference lists and consultation with colleagues identified 4 additional articles, resulting in 361 included articles. Most articles examined internal tobacco company documents (325/361; 90%). Articles using documents from pharmaceutical companies (20/361; 6%) were the next most common. Tobacco articles used documents from repositories; pharmaceutical documents were from a range of sources. Most included articles relied upon internal company documents obtained through litigation (350/361; 97%). The research questions posed were primarily about company strategies to promote or position the company and its products (326/361; 90%). Most articles (346/361; 96%) used information from miscellaneous documents such as memos or letters, or from unspecified types of documents. When explicit information about study funding was provided (290/361 articles), the most common source was the US-based National Cancer Institute. We developed an alternative and more sensitive search targeted at identifying additional research articles using internal pharmaceutical company documents, but the search retrieved an impractical number of citations for review. Conclusions Internal company documents provide an excellent source of information on health topics (e.g., corporate behavior, study data) exemplified by articles based on tobacco industry documents. Pharmaceutical and other industry documents appear to have been less used for

  7. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

    In this age of educational accountability, there is an increasing emphasis on assessment and institutional effectiveness, not only in the academic arena but also in other aspects of community college operation, such as fiscal health and stability, revenue generation, resource allocation, facilities, workforce development, and community enrichment…

  8. HEALTH EFFECTS ASSESSMENT SUMMARY TABLES (HEAST)

    EPA Science Inventory

    The Annual Health Effects Summary Tables (HEAST) are for use at both Superfund and RCRA sites. It is maintained by the Environmental Protection Agencys Office of Superfund Remediation and Technology Innovation and provides a comprehensive listing of provisional risk assessment in...

  9. Watershed Health Assessment Tools Investigating Fisheries

    EPA Science Inventory

    WHATIF is software that integrates a number of calculators, tools, and models for assessing the health of watersheds and streams with an emphasis on fish communities. The tool set consists of hydrologic and stream geometry calculators, a fish assemblage predictor, a fish habitat ...

  10. [The electronic health record: computerised provider order entry and the electronic instruction document as new functionalities].

    PubMed

    Derikx, Joep P M; Erdkamp, Frans L G; Hoofwijk, A G M

    2013-01-01

    An electronic health record (EHR) should provide 4 key functionalities: (a) documenting patient data; (b) facilitating computerised provider order entry; (c) displaying the results of diagnostic research; and (d) providing support for healthcare providers in the clinical decision-making process.- Computerised provider order entry into the EHR enables the electronic receipt and transfer of orders to ancillary departments, which can take the place of handwritten orders.- By classifying the computer provider order entries according to disorders, digital care pathways can be created. Such care pathways could result in faster and improved diagnostics.- Communicating by means of an electronic instruction document that is linked to a computerised provider order entry facilitates the provision of healthcare in a safer, more efficient and auditable manner.- The implementation of a full-scale EHR has been delayed as a result of economic, technical and legal barriers, as well as some resistance by physicians. PMID:23965237

  11. Health Education and Physical Education (Healthy, Active Living). Grades 5 and 9. Assessment Annotations for the Curriculum Frameworks.

    ERIC Educational Resources Information Center

    Missouri State Dept. of Elementary and Secondary Education, Jefferson City.

    This document provides supplemental assessment information to "Missouri's Framework for Curriculum Development in Health Education and Physical Education (Healthy, Active Living) K-12." The assessment annotations found in the third column of this document are intended to provide information for administrators, curriculum directors, and teachers…

  12. Public health assessment--Russian Federation, 1992.

    PubMed

    1992-02-14

    On December 25, 1991, the Russian Federation became an independent republic, and on January 2, 1992, restrictions on retail prices of most commodities were removed. From January 16 through February 6, a multidisciplinary team from the U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the needs for humanitarian and technical assistance, focusing on three regions in the southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included observations of health facilities, vaccine- and drug-storage centers, and disease-control programs; review of health data at central, regional, and district epidemiology stations; and collection of food-price and income data through interviews with administrative authorities and surveys of markets and private homes. This report summarizes findings from the assessment. PMID:1734228

  13. Health impact assessment: assessing opportunities and barriers to intersectoral health improvement in an expanded European Union.

    PubMed

    Lock, Karen; McKee, Martin

    2005-05-01

    On 1 May 2004 the European Union (EU) underwent unprecedented enlargement, from 15 to 25 countries, increasing its population by 20% to over 450 million. Although EU law has limited specific competence in the area of health, its influence on other policy sectors such as agriculture, trade, and employment has wide ranging implications for health. Yet with the exception of provisions on communicable disease control and food safety, public health considerations have played little part in negotiations on EU accession. This paper argues for an intersectoral public health approach in the expanded EU. It reviews the legal basis for assessing the health impacts of policy in the EU and, using health impact assessment as a case study, it examines how well the new member states may be prepared to tackle intersectoral public health action within the constraints imposed by EU policy. PMID:15831682

  14. Thai health technology assessment guideline development.

    PubMed

    Teerawattananon, Yot; Chaikledkaew, Usa

    2008-06-01

    Health Technology Assessment (HTA) is a comprehensive form of policy research that provides information on the consequences of the application of health technology. It is used primarily to guide health care resource allocation decisions. In Thailand, there is increasing impetus to use HTA information to allow more explicit and transparent health care priority setting. A previous study indicated that serious attention needed to be given to the quality of reporting and the use of information in the analyses. These problems could be reduced by setting up standard guidelines for conducting HTA to stimulate the provision of standardized, reliable and good quality information for policy makers. Nevertheless, Thailand has not yet set up such guidelines. This may lead to low quality evaluations. Therefore, the objective of this article was to describe the rationale for guideline development, supporting principles, guideline development process, sources of information, and future challenges for HTA. PMID:19253483

  15. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study

    PubMed Central

    Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Background Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Method Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. Results The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees’ presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. Conclusion This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are

  16. Infection Control Protocol for Student Clinical Experiences. A Protocol Document for Health Occupations Education Programs in Missouri.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    Developed especially for high school health occupations education programs in Missouri, this guide uses U.S. Occupational Safety and Health Administration (OSHA) rules as a base for guidelines for student participation in health care. The document informs administrators and teachers about special circumstances that must be considered in the…

  17. Lake ecosystem health assessment: indicators and methods.

    PubMed

    Xu, F L; Tao, S; Dawson, R W; Li, P G; Cao, J

    2001-09-01

    A set of ecological indicators including structural, functional, and system-level aspects were proposed for a lake ecosystem health assessment, according to the structural, functional, and system-level responses of lake ecosystems to chemical stresses including acidification, eutrophication and copper, oil and pesticide contamination. The structural indicators included phytoplankton cell size and biomass, zooplankton body size and biomass, species diversity, macro- and micro-zooplankton biomass, the zooplankton phytoplankton ratio, and the macrozooplankton microzooplankton ratio. The functional indicators encompassed the algal C assimilation ratio, resource use efficiency, community production, gross production/respiration (i.e. P/R) ratio, gross production standing crop biomass (i.e. P/B) ratio, and standing crop biomass unit energy flow (i.e. B/E) ratio. The ecosystem-level indicators conisisted of ecological buffer capacities, energy, and structural energy. Based on these indicators, a direct measurement method (DMM) and an ecological modeling method (EMM) for lake ecosystem health assessment were developed. The DMM procedures were designed to: (1) identify key indicators; (2) measure directly or calculate indirectly the selected indicators; and, (3) assess ecosystem health on the basis of the indicator values. The EMM procedures were designed to: (1) determine the structure and complexity of the ecological model according to the lake's ecosystem structure; (2) establish an ecological model by designing a conceptual diagram, establishing model equations, and estimating model pararmeters; (3) compare the simulated values of important state variables and process rates with actual observations; (4) calculate ecosystem health indicators using the ecological model; and, (5) assess lake ecosystem health according to the values of the ecological indicators. The results of a case study demonstrated that both methods provided similar results which corresponded with the

  18. Every document and picture tells a story: using internal corporate document reviews, semiotics, and content analysis to assess tobacco advertising

    PubMed Central

    Anderson, S J; Dewhirst, T; Ling, P M

    2006-01-01

    In this article we present communication theory as a conceptual framework for conducting documents research on tobacco advertising strategies, and we discuss two methods for analysing advertisements: semiotics and content analysis. We provide concrete examples of how we have used tobacco industry documents archives and tobacco advertisement collections iteratively in our research to yield a synergistic analysis of these two complementary data sources. Tobacco promotion researchers should consider adopting these theoretical and methodological approaches. PMID:16728758

  19. Untapped potential of health impact assessment.

    PubMed

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-04-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

  20. Untapped potential of health impact assessment

    PubMed Central

    Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-01-01

    Abstract The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to “green economy” and “institutional framework” strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century’s sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

  1. Use of regulatory documents for assessing the contamination of soils with heavy metals

    NASA Astrophysics Data System (ADS)

    Nesterova, O. V.; Tregubova, V. G.; Semal, V. A.

    2014-11-01

    The chronological review and analysis of the existing regulatory documents relevant to the assessment of soil contamination with heavy metals have been presented. Attention has been given to the incorrect use of the term "total heavy metal content" and the method of its determination in a 5 M nitric acid solution recommended by some regulatory documents. The maximum permissible concentrations (MPCs) and tentatively permissible concentrations (TPCTPCs) for the total heavy metal contents are based on the above method; therefore, the conventional methods of determining the true total contents of heavy metals overestimate the degree of contamination. To avoid confusion, it has been proposed to call the content of a heavy metal in a 5 M nitric acid solution the "pseudototal" content and to compare the experimental results with the MPC or TPCTPC values only if the methods recommended by the regulatory documents were used.

  2. Crew Health Care System (CHeCS) Design Research, Documentations, and Evaluations

    NASA Technical Reports Server (NTRS)

    CLement, Bethany M.

    2011-01-01

    The Crew Health Care System (CHeCS) is a group within the Space Life Science Directorate (SLSD) that focuses on the overall health of astronauts by reinforcing the three divisions - the Environmental Maintenance System (EMS), the Countermeasures System (CMS), and the Health Maintenance System (HMS). This internship provided opportunity to gain knowledge, experience, and skills in CHeCS engineering and operations tasks. Various and differing tasks allowed for occasions to work independently, network to get things done, and show leadership abilities. Specific exercises included reviewing hardware certification, operations, and documentation within the ongoing Med Kit Redesign (MKR) project, and learning, writing, and working various common pieces of paperwork used in the engineering and design process. Another project focused on the distribution of various pieces of hardware to off-site research facilities with an interest in space flight health care. The main focus of this internship, though, was on a broad and encompassing understanding of the engineering process as time was spent looking at each individual step in a variety of settings and tasks.

  3. Assessing Consumer Health Vocabulary Familiarity: An Exploratory Study

    PubMed Central

    Keselman, Alla; Tse, Tony; Crowell, Jon; Browne, Allen; Ngo, Long

    2007-01-01

    of such a model include readability formulas tailored to the consumer health domain and tools to “translate” professional medical documents into text that is more accessible to consumers. The study also highlights the usefulness of distinguishing between surface-level term familiarity and deeper concept understanding and presents one method for assessing familiarity at each level. PMID:17478414

  4. Metric-based no-reference quality assessment of heterogeneous document images

    NASA Astrophysics Data System (ADS)

    Nayef, Nibal; Ogier, Jean-Marc

    2015-01-01

    No-reference image quality assessment (NR-IQA) aims at computing an image quality score that best correlates with either human perceived image quality or an objective quality measure, without any prior knowledge of reference images. Although learning-based NR-IQA methods have achieved the best state-of-the-art results so far, those methods perform well only on the datasets on which they were trained. The datasets usually contain homogeneous documents, whereas in reality, document images come from different sources. It is unrealistic to collect training samples of images from every possible capturing device and every document type. Hence, we argue that a metric-based IQA method is more suitable for heterogeneous documents. We propose a NR-IQA method with the objective quality measure of OCR accuracy. The method combines distortion-specific quality metrics. The final quality score is calculated taking into account the proportions of, and the dependency among different distortions. Experimental results show that the method achieves competitive results with learning-based NR-IQA methods on standard datasets, and performs better on heterogeneous documents.

  5. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  6. Teaching health assessment in the virtual classroom.

    PubMed

    Lashley, Mary

    2005-08-01

    Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online. PMID:16130340

  7. 76 FR 31363 - Solicitation for a Cooperative Agreement: Document-Tools in Assessing Inmates' Risks & Needs: The...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF JUSTICE National Institute of Corrections Solicitation for a Cooperative Agreement: Document--Tools in Assessing Inmates' Risks & Needs: The Assessment Interview AGENCY: National Institute of Corrections,...

  8. The P15--A Multinational Assessment Battery for Collecting Data on Health Indicators Relevant to Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Perry, J.; Linehan, C.; Kerr, M.; Salvador-Carulla, L.; Zeilinger, E.; Weber, G.; Walsh, P.; Van Schrojenstein Lantman-De-Valk, H.; Haveman, M.; Azema, B.; Buono, S.; Cara, A. C.; Germanavicius, A.; Van Hove, G.; Maatta, T.; Berger, D. M.; Tossebro, J.

    2010-01-01

    Background: Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a…

  9. Environment, safety and health progress assessment of the Pantex Plant

    SciTech Connect

    Not Available

    1993-03-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES H) Progress Assessment of the Pantex Plant, in Amarillo, Texas, conducted from March 15 through March 26, 1993. The ES H Progress Assessments are part of DOE's continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the Pantex Plant ES H Progress Assessment is to provide the Secretary of Energy and senior DOE management with concise independent information on the following: (1) change in culture and attitude related to ES H activities; (2) progress and effectiveness of the ES H corrective actions resulting from previous Tiger Team Assessments; (3) adequacy and effectiveness of the ES H self-assessment programs of the DOE line organizations and the site management and operating contractor; and (4) effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES H problems and new ES H initiatives.

  10. [Consensus Document. Update on latex exposure and use of gloves in Italian health care settings].

    PubMed

    Crippa, Michela; Balbiani, Lara; Baruffini, Adriana; Belleri, L; Draicchio, F; Feltrin, G; Larese, Francesca; Maggio, G M; Marcer, G; Micheloni, G P; Montomoli, Loretta; Moscato, Gianna; Previdi, M; Sartorelli, P; Sossai, D; Spatari, Giovanna; Zanetti, Caterina

    2008-01-01

    This consensus document was prepared by an Italian working group including occupational health professionals involved for many years in the management of glove- and latex-related problems in health care settings. The aim of this document was to address the most significant technical, epidemiological, clinical, environmental and prevention problems related to the use of gloves and latex. The group's recommendations are based on scientific evidence and practical experience but they cannot be considered as final. These topics need to be periodically revised. The following points should be taken into account: glove quality seems to have improved considerably but the information on glove features provided by the manufacturers is often still inaccurate or incomplete; the regulations in force provide that the manufacturers perform tests to supply evidence for the quality of the products but they do not indicate which analytical method should be used and they do not require that the results be reported in the technical data sheets. Thus the manufacturers have only to declare that their products are "in accordance with the rules"; therefore, purchasers should require the manufacturing companies to supply detailed information and verify their reliability. Moreover, the rules should be adapted to higher quality standards; occupational physicians must be involved for the correct choice and purchase of protective gloves; the use of gloves (in particular latex gloves) and latex devices in health care settings should be based on specific criteria: procedures must be available stating which kind of gloves are suitable for specific tasks. When exposure to latex cannot be avoided it is necessary to choose products that have good biocompatibility (e.g., powder free-gloves with low allergen content); once and for all latex powdered gloves should no longer be commercially available! labels for latex devices (including gloves) should report the extractable latex allergen content. Limit

  11. Risk assessment and toxicology databases for health effects assessment

    SciTech Connect

    Lu, P.Y.; Wassom, J.S.

    1990-12-31

    Scientific and technological developments bring unprecedented stress to our environment. Society has to predict the results of potential health risks from technologically based actions that may have serious, far-reaching consequences. The potential for error in making such predictions or assessment is great and multiplies with the increasing size and complexity of the problem being studied. Because of this, the availability and use of reliable data is the key to any successful forecasting effort. Scientific research and development generate new data and information. Much of the scientific data being produced daily is stored in computers for subsequent analysis. This situation provides both an invaluable resource and an enormous challenge. With large amounts of government funds being devoted to health and environmental research programs and with maintenance of our living environment at stake, we must make maximum use of the resulting data to forecast and avert catastrophic effects. Along with the readily available. The most efficient means of obtaining the data necessary for assessing the health effects of chemicals is to utilize applications include the toxicology databases and information files developed at ORNL. To make most efficient use of the data/information that has already been prepared, attention and resources should be directed toward projects that meticulously evaluate the available data/information and create specialized peer-reviewed value-added databases. Such projects include the National Library of Medicine`s Hazardous Substances Data Bank, and the U.S. Air Force Installation Restoration Toxicology Guide. These and similar value-added toxicology databases were developed at ORNL and are being maintained and updated. These databases and supporting information files, as well as some data evaluation techniques are discussed in this paper with special focus on how they are used to assess potential health effects of environmental agents. 19 refs., 5 tabs.

  12. Using rangeland health assessment to inform successional management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...

  13. [Design of a semantic framework for contextualized retrieval of scientific documents in the health domain].

    PubMed

    Santos Gago, J M; Álvarez Sabucedo, L M; Fernández Iglesias, M J; Míguez Pérez, R; Alonso Roris, V M; Mikic Fonte, F

    2012-11-01

    Personalized healthcare requires recombining heterogeneous publicly available data with a patient's or group of patient's profile. A well-known problem in state-of-the-art information management is the overwhelming amount of information available. Besides, state-of-the-art solutions do not take advantage of modern semantic processing to adequately transform data into knowledge. This issue is especially relevant in the health domain, as key processes depend dramatically on the access to high quality, complete, up-to-date, and relevant content (e.g. diagnostics, risk assessment, public health interventions, etc.). This proposal aims to provide novel information management and retrieval solutions in the domain of health sciences to address the situation discussed above. More specifically, we introduce semantic reasoning to retrieve the most relevant knowledge available according to the health profile of a given person. For this, we developed a semantic model to represent health profiles of people and to characterize existing sources of relevant information in order to crawl them to populate a semantic repository with content references and properties. We outline the tools needed to query the knowledge base using the semantic profiles of individuals to get the most relevant content. The proposed solution, discussed here as a proof-of-concept, aims to contribute to the realm of personal health and evidence-based medicine technologies. The tools developed could also be used to take advantage of existing knowledge to facilitate a systematic review of reports, studies and analysis that may be relevant to the health conditions of single patients or patient profiles. PMID:23568399

  14. NASA-STD-7009 Guidance Document for Human Health and Performance Models and Simulations

    NASA Technical Reports Server (NTRS)

    Walton, Marlei; Mulugeta, Lealem; Nelson, Emily S.; Myers, Jerry G.

    2014-01-01

    Rigorous verification, validation, and credibility (VVC) processes are imperative to ensure that models and simulations (MS) are sufficiently reliable to address issues within their intended scope. The NASA standard for MS, NASA-STD-7009 (7009) [1] was a resultant outcome of the Columbia Accident Investigation Board (CAIB) to ensure MS are developed, applied, and interpreted appropriately for making decisions that may impact crew or mission safety. Because the 7009 focus is engineering systems, a NASA-STD-7009 Guidance Document is being developed to augment the 7009 and provide information, tools, and techniques applicable to the probabilistic and deterministic biological MS more prevalent in human health and performance (HHP) and space biomedical research and operations.

  15. Lessons Learned from Implementation of Voice Recognition for Documentation in the Military Electronic Health Record System

    PubMed Central

    Hoyt, Robert; Yoshihashi, Ann

    2010-01-01

    This study evaluated the implementation of voice recognition (VR) for documenting outpatient encounters in the electronic health record (EHR) system at a military hospital and its 12 outlying clinics. Seventy-five clinicians volunteered to use VR, and 64 (85 percent) responded to an online questionnaire post implementation to identify variables related to VR continuance or discontinuance. The variables investigated were user characteristics, training experience, logistics, and VR utility. Forty-four respondents (69 percent) continued to use VR and overall felt that the software was accurate, was faster than typing, improved note quality, and permitted closing a patient encounter the same day. The discontinuation rate of 31 percent was related to location at an outlying clinic and perceptions of inadequacy of training, decreased productivity due to VR inaccuracies, and no improvement in note quality. Lessons learned can impact future deployment of VR in other military and civilian healthcare facilities. PMID:20697464

  16. The Documentation of Health Problems in Relation to Prescribed Medication in People with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

    2009-01-01

    Background: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. Method: Persons with PIMD with an…

  17. [Forest health ecological risk assessment in China].

    PubMed

    Xiao, Fengjin; Ouyang, Hua; Cheng, Shulan; Zhang, Qiang

    2004-02-01

    Forest health ecological risk assessment is an important factor in forest resources management. In this paper, we selected forest fire, forest disease-pest disasters and acid rain as main risk sources, described the risk resources by probability, intensity and distributing, and mapped each risk source. The endpoints were the damages that the risk acceptor might and these damages might cause ecosystems' organization and function changing under the uncertainty risk sources. Endpoints of forest might compose of productivity descent, reducing biodiversity, forest degrading, forest ecological function declining, furthermore, forest disappearing. We described exposure in terms of intensity, space, and time. In the exposure and hazard analysis, we used fragile index to show frangibility or resistibility (resistibility is reverse to frangibility), and analyzed the damages by different risk sources. Risk assessment and management was the integrated phase of the research. Because of the spatial heterogeneity of risk sources, all risk index were overlaid in the China map by GIS, which divided the region into 30 ecological risk sub-zones (provinces), according to risk index of each risk sub-zone, and the forest in China was divided into six levels of risk zones. In every level of risk zones, we also put forward the countermeasures for forest health ecological risk management. The result of assessment could provide scientific basis for forest management. PMID:15146655

  18. Photogrammetry and geographic information systems for quick assessment, documentation and analysis of earthquakes

    NASA Astrophysics Data System (ADS)

    Altan, O.; Toz, G.; Kulur, S.; Seker, D.; Volz, S.; Fritsch, D.; Sester, M.

    After a catastrophe like an earthquake, one on the most important problems is to provide shelter and housing for the homeless. To this end, it is necessary to decide if a building is still habitable, or if it is has to be renovated or even torn down. A prerequisite for such decisions is the detailed knowledge about the status of the building. Earlier earthquakes revealed problems in the processes of documenting and analysing the building damage, as they demanded much effort in terms of time and manpower. The main difficulties appeared to be because of the analogue damage assessments which created a great variety of unstructured information that had to be put in a line to allow further analysis. Apart from that, documentation of damage effects was not detailed and could only be carried out on the spot of a disaster. The aim of this study is to make an improvement, using combination of Geographic Information Systems (GIS) as a management and data analysis tool and photogrammetry as a documentation method. Photogrammetric data acquisition is achieved using a CCD camera and the digital photogrammetric software package PICTRAN by Technet. The information system part is the GIS package ArcView by ESRI. The combination of rapid data acquisition and GIS offers a quick assessment of the situation and the possibility of its objective and holistic analysis. This is the prerequisite for a quick initiation of appropriate measures to help people.

  19. Health Impact Assessment of Urban Waterway Decisions

    PubMed Central

    Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B.J.; Daniell, William; Erdmann, Jared; Garrison, Valerie

    2014-01-01

    Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a “health lens”. This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond. PMID:25547399

  20. INTELLIGENCE AND TRANSPARENCY IN HEALTH TECHNOLOGY ASSESSMENT.

    PubMed

    Richardson, Henry S

    2016-01-01

    Current thinking about the methodology of health technology assessment (HTA) seems to be dominated by two fundamental tensions: [1] between maintaining a tight focus on quality-adjusted life-years and broadening its concern out to pay attention to a broader range of factors, and [2] between thinking of the evaluative dimensions that matter as being objectively important factors or as ones that are ultimately of merely subjective importance. In this study, I will argue that health is a tremendously important all-purpose means to enjoying basic human capabilities, but a mere means, and not an end. The ends to which health is a means are manifold, requiring all those engaged in policy making to exercise intelligence in a continuing effort to identify them and to think through how they interrelate. Retreating to the subjective here would be at odds with the basic idea of HTA, which is to focus on certain objectively describable dimensions of what matters about health and to collect empirical evidence rigorously bearing on what produces improvements along those dimensions. To proceed intelligently in doing HTA, it is important to stay open to reframing and refashioning the ends we take to apply to that arena. The only way for that to happen, as an exercise of public, democratic policy making, is for the difficult value questions that arise when ends clash not to be buried in subjective preference information, but to be front-and-center in the analysis. PMID:26956573

  1. Assessing Hmong farmers' safety and health.

    PubMed

    de Castro, A B; Krenz, Jennifer; Neitzel, Richard L

    2014-05-01

    This pilot project investigated agricultural-related safety and health issues among Hmong refugees working on family-operated farms. Novel approaches, namely participatory rural appraisal and photovoice, were used to conduct a qualitative occupational hazard assessment with a group of Hmong farmers in Washington State. These two methods were useful in gathering participants' own perspectives about priority concerns. Several identified problems were related to musculoskeletal disorders, handling and operating heavy machinery, heat and cold stress, respiratory exposures, pest management, and socioeconomic and language concerns. Findings from this study provide insight into the work-related challenges that Hmong refugee farmers encounter and can serve as a basis for occupational health professionals to develop interventions to assist this underserved group. PMID:24806037

  2. Assessing Hmong Farmers’ Safety and Health

    PubMed Central

    de Castro, A. B.; Krenz, Jennifer; Neitzel, Richard L.

    2014-01-01

    This pilot project investigated agricultural-related safety and health issues among Hmong refugees working on family-operated farms. Novel approaches, namely participatory rural appraisal and photovoice, were used to conduct a qualitative occupational hazard assessment with a group of Hmong farmers in Washington State. These two methods were useful in gathering participants’ own perspectives about priority concerns. Several identified problems were related to musculoskeletal disorders, handling and operating heavy machinery, heat and cold stress, respiratory exposures, pest management, and socioeconomic and language concerns. Findings from this study provide insight into the work-related challenges that Hmong refugee farmers encounter and can serve as a basis for occupational health professionals to develop interventions to assist this underserved group. PMID:24806037

  3. Predictors of Self-Assessed Health among Elderly Post Hospitalization.

    ERIC Educational Resources Information Center

    Lurie, Elinore; And Others

    Self-assessment of health incorporates both objective and subjective elements into a general state with implications for health-related behavior. To examine the predictors of self-assessed health in an elderly, post-hospitalization population, 73 adults, 65 years of age or older, were asked to assess the status of the condition for which they were…

  4. Assessing Psychological Health: The Contribution of Psychological Strengths

    ERIC Educational Resources Information Center

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

    Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale…

  5. Environmental, health and safety assessment of photovoltaics

    NASA Technical Reports Server (NTRS)

    Rose, E. C.

    1983-01-01

    The environmental, health, and safety (E, H and S) concerns associated with the fabrication, deployment, and decommissioning of photovoltaic (PV) systems in terrestial applications are identified and assessed. Discussion is limited to crystalline silicon technologies. The primary E, H, and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.

  6. The Willow Hill Community Health Assessment: Assessing the Needs of Children in a Former Slave Community.

    PubMed

    Alfonso, Moya L; Jackson, Gayle; Jackson, Alvin; Hardy, DeShannon; Gupta, Akrati

    2015-10-01

    The overall purpose of this community needs assessment was to explore the perceptions of health and educational needs among youth residing in a rural Georgia community, document existing assets that could be utilized to meet those needs, and to identify socioeconomic barriers and facilitators in health education. A sequential mixed method design was used. Intercept surveys were conducted followed by individual, key informant interviews and a focus group. Survey data was entered into an Excel spreadsheet and SPSS for analysis and descriptive statistics including means and frequencies were calculated. For qualitative interviews, full transcripts were created from audio-recordings and uploaded into NVivo for content analysis. Several health issues were highlighted by the Willow Hill/Portal Georgia community members, including teachers, parents, youth and Willow Hill Heritage and Renaissance Center board members. Some of the health issues identified by youth in the community were low levels of physical activity, obesity, diabetes, lack of healthy food choices, and access to health care services. Including the issues identified by youth, the parents, teachers and board members identified additional health issues in the community such as asthma, hygiene and lack of dental and eye care facilities. Overall, there is a need for better infrastructure and awareness among community members. Utilizing identified assets, including active community leaders, involved faith-based organizations, commitment of community members, presence of land resources, and commitment to physical activity and sports, could modify the current community landscape. PMID:26264907

  7. Mobile technology for mental health assessment

    PubMed Central

    Areàn, Patricia A.; Hoa Ly, Kien; Andersson, Gerhard

    2016-01-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making. PMID:27489456

  8. Mobile technology for mental health assessment.

    PubMed

    Areàn, Patricia A; Hoa Ly, Kien; Andersson, Gerhard

    2016-06-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making. PMID:27489456

  9. Spent Fuel Working Group report on inventory and storage of the Department`s spent nuclear fuel and other reactor irradiated nuclear materials and their environmental, safety and health vulnerabilities. Volume 2, Working Group Assessment Team reports; Vulnerability development forms; Working group documents

    SciTech Connect

    Not Available

    1993-11-01

    The Secretary of Energy`s memorandum of August 19, 1993, established an initiative for a Department-wide assessment of the vulnerabilities of stored spent nuclear fuel and other reactor irradiated nuclear materials. A Project Plan to accomplish this study was issued on September 20, 1993 by US Department of Energy, Office of Environment, Health and Safety (EH) which established responsibilities for personnel essential to the study. The DOE Spent Fuel Working Group, which was formed for this purpose and produced the Project Plan, will manage the assessment and produce a report for the Secretary by November 20, 1993. This report was prepared by the Working Group Assessment Team assigned to the Hanford Site facilities. Results contained in this report will be reviewed, along with similar reports from all other selected DOE storage sites, by a working group review panel which will assemble the final summary report to the Secretary on spent nuclear fuel storage inventory and vulnerability.

  10. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2013)

    EPA Science Inventory

    EPA is announcing the availability of the First External Review Draft of the Integrated Science Assessment for Oxides of Nitrogen – Health Criteria for public comment and independent peer review. This draft document provides EPA’s evaluation and synthesis of the most polic...

  11. 2008 Final Report: Integrated Science Assessment for Oxides of Nitrogen – Health Criteria

    EPA Science Inventory

    Cover of the NOx ISA 2008 Report The Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria document represent...

  12. 78 FR 31454 - Community Health Needs Assessments for Charitable Hospitals; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 1 and 53 RIN 1545-BL30 Community Health Needs Assessments for Charitable Hospitals; Correction Correction In proposed rule document 2013-12013, appearing on pages...

  13. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (Second External Review Draft, 2008)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation...

  14. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (First External Review Draft)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluatio...

  15. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2007)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and eva...

  16. 2008 Final Report: Integrated Science Assessment for Oxides of Nitrogen – Health Criteria

    EPA Science Inventory

    Cover of the NOx ISA 2008 Report The Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria document represent...

  17. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (Second External Review Draft)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluati...

  18. 78 FR 17201 - Pesticide Chemicals; Registration Review; Draft Human Health and Ecological Risk Assessments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ...This notice announces the availability of EPA's draft human health and ecological risk assessments for the registration review of ancymidol, fosthiazate, lactofen, polybutene resins, quizalofop, and soap salts and opens a public comment period on these documents. Registration review is EPA's periodic review of pesticide registrations to ensure that each pesticide continues to satisfy the......

  19. Quality and Quantity of Information in Summary Basis of Decision Documents Issued by Health Canada

    PubMed Central

    Habibi, Roojin; Lexchin, Joel

    2014-01-01

    Background Health Canada’s Summary Basis of Decision (SBD) documents outline the clinical trial information that was considered in approving a new drug. We examined the ability of SBDs to inform clinician decision-making. We asked if SBDs answered three questions that clinicians might have prior to prescribing a new drug: 1) Do the characteristics of patients enrolled in trials match those of patients in their practice? 2) What are the details concerning the drug’s risks and benefits? 3) What are the basic characteristics of trials? Methods 14 items of clinical trial information were identified from all SBDs published on or before April 2012. Each item received a score of 2 (present), 1 (unclear) or 0 (absent). The unit of analysis was the individual SBD, and an overall SBD score was derived based on the sum of points for each item. Scores were expressed as a percentage of the maximum possible points, and then classified into five descriptive categories based on that score. Additionally, three overall ‘component’ scores were tallied for each SBD: “patient characteristics”, “benefit/risk information” and “basic trial characteristics”. Results 161 documents, spanning 456 trials, were analyzed. The majority (126/161) were rated as having information sometimes present (score of >33 to 66%). No SBDs had either no information on any item, or 100% of the information. Items in the patient characteristics component scored poorest (mean component score of 40.4%), while items corresponding to basic trial information were most frequently provided (mean component score of 71%). Conclusion The significant omissions in the level of clinical trial information in SBDs provide little to aid clinicians in their decision-making. Clinicians’ preferred source of information is scientific knowledge, but in Canada, access to such information is limited. Consequently, we believe that clinicians are being denied crucial tools for decision-making. PMID:24651766

  20. Effects of moderate beer consumption on health and disease: A consensus document.

    PubMed

    de Gaetano, G; Costanzo, S; Di Castelnuovo, A; Badimon, L; Bejko, D; Alkerwi, A; Chiva-Blanch, G; Estruch, R; La Vecchia, C; Panico, S; Pounis, G; Sofi, F; Stranges, S; Trevisan, M; Ursini, F; Cerletti, C; Donati, M B; Iacoviello, L

    2016-06-01

    A large evidence-based review on the effects of a moderate consumption of beer on human health has been conducted by an international panel of experts who reached a full consensus on the present document. Low-moderate (up to 1 drink per day in women, up to 2 in men), non-bingeing beer consumption, reduces the risk of cardiovascular disease. This effect is similar to that of wine, at comparable alcohol amounts. Epidemiological studies suggest that moderate consumption of either beer or wine may confer greater cardiovascular protection than spirits. Although specific data on beer are not conclusive, observational studies seem to indicate that low-moderate alcohol consumption is associated with a reduced risk of developing neurodegenerative disease. There is no evidence that beer drinking is different from other types of alcoholic beverages in respect to risk for some cancers. Evidence consistently suggests a J-shaped relationship between alcohol consumption (including beer) and all-cause mortality, with lower risk for moderate alcohol consumers than for abstainers or heavy drinkers. Unless they are at high risk for alcohol-related cancers or alcohol dependency, there is no reason to discourage healthy adults who are already regular light-moderate beer consumers from continuing. Consumption of beer, at any dosage, is not recommended for children, adolescents, pregnant women, individuals at risk to develop alcoholism, those with cardiomyopathy, cardiac arrhythmias, depression, liver and pancreatic diseases, or anyone engaged in actions that require concentration, skill or coordination. In conclusion, although heavy and excessive beer consumption exerts deleterious effects on the human body, with increased disease risks on many organs and is associated to significant social problems such as addiction, accidents, violence and crime, data reported in this document show evidence for no harm of moderate beer consumption for major chronic conditions and some benefit against

  1. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    PubMed

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  2. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners

    PubMed Central

    Springer, Andrew E.; Evans, Alexandra E.

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  3. Psychiatric workforce needs and recommendations for the community mental health system: a state needs assessment.

    PubMed

    Walker, Elizabeth Reisinger; Berry, Frank W; Citron, Tod; Fitzgerald, Judy; Rapaport, Mark H; Stephens, Bryan; Druss, Benjamin G

    2015-02-01

    Similar to other states, Georgia is facing workforce challenges within its community mental health system. These issues may be exacerbated as implementation of the Affordable Care Act expands demand for behavioral health services. Georgia's Department of Behavioral Health and Developmental Disabilities commissioned a needs assessment to examine the shortage of prescribing providers (psychiatrists, advanced practice registered nurses, and physician assistants) in the state's public mental health system. A unique partnership of key stakeholders developed and conducted the mixed-methods needs assessment at six of Georgia's 27 community mental health centers serving more than 40,000 patients annually. The assessment documented challenges in recruiting and retaining psychiatrists and workforce shortages for all prescriber groups. The authors describe opportunities for optimizing the psychiatric workforce and training the next generation of community psychiatrists. PMID:25642608

  4. Implementing Routine Health Literacy Assessment in Hospital and Primary Care Patients

    PubMed Central

    Cawthon, Courtney; Mion, Lorraine C.; Willens, David E.; Roumie, Christianne L.; Kripalani, Sunil

    2014-01-01

    Background Patients with inadequate health literacy often have poorer health outcomes and increased utilization and costs, compared to those with adequate health literacy skills. The Institute of Medicine has recommended that health literacy assessment be incorporated into health care information systems, which would facilitate large-scale studies of the effects of health literacy, as well as evaluation of system interventions to improve care by addressing health literacy. As part of the Health Literacy Screening (HEALS) study, a brief health literacy screen (BHLS) was incorporated into the electronic health record (EHR) at a large academic medical center. Methods Changes were implemented to the nursing intake documentation across all adult hospital units, the emergency department, and three primary care practices. The change involved replacing previous education screening items with the BHLS. Implementation was based on a quality improvement framework, with a focus on acceptability, adoption, appropriateness, feasibility, fidelity and sustainability. Support was gained from nursing leadership, education and training was provided, a documentation change was rolled out, feedback was obtained, and uptake of the new health literacy screening items was monitored. Results Between November 2010 and April 2012, there were 55,611 adult inpatient admissions, and from November 2010 to September 2011, 23,186 adult patients made 39,595 clinic visits to the three primary care practices. The completion (uptake) rate in the hospital for November 2010 through April 2012 was 91.8%. For outpatient clinics, the completion rate between November 2010 and October 2011 was 66.6%. Conclusions Although challenges exist, it is feasible to incorporate health literacy screening into clinical assessment and EHR documentation. Next steps are to evaluate the association of health literacy with processes and outcomes of care across inpatient and outpatient populations. PMID:24716329

  5. Health hazards of fire fighters: exposure assessment.

    PubMed Central

    Brandt-Rauf, P W; Fallon, L F; Tarantini, T; Idema, C; Andrews, L

    1988-01-01

    There is growing concern over the detrimental health effects to firefighters produced by exposure to combustion byproducts of burning materials. To assess the types and levels of exposure encountered by firefighters during their routine occupational duties, members of the Buffalo Fire Department were monitored during firefighting activities with personal, portable, ambient environmental sampling devices. The results indicate that firefighters are frequently exposed to significant concentrations of hazardous materials including carbon monoxide, benzene, sulphur dioxide, hydrogen cyanide, aldehydes, hydrogen chloride, dichlorofluoromethane, and particulates. Furthermore, in many cases of the worst exposure to these materials respiratory protective equipment was not used owing to the visual impression of low smoke intensity, and thus these levels represent actual direct exposure of the firefighters. Many of these materials have been implicated in the production of cardiovascular, respiratory, or neoplastic diseases, which may provide an explanation for the alleged increased risk for these illnesses among firefighters. PMID:3179235

  6. Assessing clinical competency in the health sciences

    NASA Astrophysics Data System (ADS)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p < .05 and for the HD case r = .700, p < .01. The SPs scored students higher than the other raters. Students' self-assessments were most closely aligned with the investigator. Effects were apparent due to case. Content validity was gathered in the process of developing cases and patient scenarios that were used in this study. Construct validity was obtained from the survey results analyzed from the experts and students. Future studies should examine the effect of rater training upon the reliability. Criterion or predictive validity could be further studied by comparing students' performances on the ISPE with other independent estimates

  7. GLOBAL CHANGE RESEARCH NEWS #5: HEALTH SECTOR ASSESSMENT

    EPA Science Inventory

    The Health Sector Assessment is one of the three levels of the assessment process that is intended to answer four questions: (1) What is the current status of the nation's health, and what are current stresses on our health? (2) How might climate change affect the country's healt...

  8. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

    Lybeck, Nancy; Coble, Jamie B.; Tawfik, Magdy; Bond, Leonard J.

    2012-05-18

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of an NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of an NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures

  9. Creation of an Accurate Algorithm to Detect Snellen Best Documented Visual Acuity from Ophthalmology Electronic Health Record Notes

    PubMed Central

    French, Dustin D; Gill, Manjot; Mitchell, Christopher; Jackson, Kathryn; Kho, Abel; Bryar, Paul J

    2016-01-01

    Background Visual acuity is the primary measure used in ophthalmology to determine how well a patient can see. Visual acuity for a single eye may be recorded in multiple ways for a single patient visit (eg, Snellen vs. Jäger units vs. font print size), and be recorded for either distance or near vision. Capturing the best documented visual acuity (BDVA) of each eye in an individual patient visit is an important step for making electronic ophthalmology clinical notes useful in research. Objective Currently, there is limited methodology for capturing BDVA in an efficient and accurate manner from electronic health record (EHR) notes. We developed an algorithm to detect BDVA for right and left eyes from defined fields within electronic ophthalmology clinical notes. Methods We designed an algorithm to detect the BDVA from defined fields within 295,218 ophthalmology clinical notes with visual acuity data present. About 5668 unique responses were identified and an algorithm was developed to map all of the unique responses to a structured list of Snellen visual acuities. Results Visual acuity was captured from a total of 295,218 ophthalmology clinical notes during the study dates. The algorithm identified all visual acuities in the defined visual acuity section for each eye and returned a single BDVA for each eye. A clinician chart review of 100 random patient notes showed a 99% accuracy detecting BDVA from these records and 1% observed error. Conclusions Our algorithm successfully captures best documented Snellen distance visual acuity from ophthalmology clinical notes and transforms a variety of inputs into a structured Snellen equivalent list. Our work, to the best of our knowledge, represents the first attempt at capturing visual acuity accurately from large numbers of electronic ophthalmology notes. Use of this algorithm can benefit research groups interested in assessing visual acuity for patient centered outcome. All codes used for this study are currently

  10. High level waste storage tank farms/242-A evaporator standards/requirements identification document phase 1 assessment report

    SciTech Connect

    Biebesheimer, E., Westinghouse Hanford Co.

    1996-09-30

    This document, the Standards/Requirements Identification Document (S/RID) Phase I Assessment Report for the subject facility, represents the results of an Administrative Assessment to determine whether S/RID requirements are fully addressed by existing policies, plans or procedures. It contains; compliance status, remedial actions, and an implementing manuals report linking S/RID elements to requirement source to implementing manual and section.

  11. Assessing the Strengths of Mental Health Consumers: A Systematic Review

    ERIC Educational Resources Information Center

    Bird, Victoria J.; Le Boutillier, Clair; Leamy, Mary; Larsen, John; Oades, Lindsay G.; Williams, Julie; Slade, Mike

    2012-01-01

    Strengths assessments focus on the individual's talents, abilities, resources, and strengths. No systematic review of strengths assessments for use within mental health populations has been published. The aims of this study were to describe and evaluate strengths assessments for use within mental health services. A systematic review identified 12…

  12. Health Impact Assessment as a Student Service Learning Experience

    ERIC Educational Resources Information Center

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

    Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

  13. From Documenting to Eliminating Disparities in Mental Health Care for Latinos

    ERIC Educational Resources Information Center

    Lopez, Steven R.; Barrio, Concepcion; Kopelowicz, Alex; Vega, William A.

    2012-01-01

    The U.S. Surgeon General's report "Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General" (U.S. Department of Health and Human Services, 2001) identified significant disparities in mental health care for Latinos and recommended directions for future research and mental health services. We update…

  14. Using Community Health Assessment to Teach and Explore Health Status Disparities

    ERIC Educational Resources Information Center

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  15. Association of Medical Directors of Information Systems consensus on inpatient electronic health record documentation.

    PubMed

    Shoolin, J; Ozeran, L; Hamann, C; Bria, W

    2013-01-01

    In 2013, electronic documentation of clinical care stands at a crossroads. The benefits of creating digital notes are at risk of being overwhelmed by the inclusion of easily importable detail. Providers are the primary authors of encounters with patients. We must document clearly our understanding of patients and our communication with them and our colleagues. We want to document efficiently to meet without exceeding documentation guidelines. We copy and paste documentation, because it not only simplifies the documentation process generally, but also supports meeting coding and regulatory requirements specifically. Since the primary goal of our profession is to spend as much time as possible listening to, understanding and helping patients, clinicians need information technology to make electronic documentation easier, not harder. At the same time, there should be reasonable restrictions on the use of copy and paste to limit the growing challenge of 'note bloat'. We must find the right balance between ease of use and thoughtless documentation. The guiding principles in this document may be used to launch an interdisciplinary dialogue that promotes useful and necessary documentation that best facilitates efficient information capture and effective display. PMID:23874365

  16. Association of Medical Directors of Information Systems Consensus on Inpatient Electronic Health Record Documentation

    PubMed Central

    Shoolin, J.; Ozeran, L.; Hamann, C.; Bria II, W.

    2013-01-01

    In 2013, electronic documentation of clinical care stands at a crossroads. The benefits of creating digital notes are at risk of being overwhelmed by the inclusion of easily importable detail. Providers are the primary authors of encounters with patients. We must document clearly our understanding of patients and our communication with them and our colleagues. We want to document efficiently to meet without exceeding documentation guidelines. We copy and paste documentation, because it not only simplifies the documentation process generally, but also supports meeting coding and regulatory requirements specifically. Since the primary goal of our profession is to spend as much time as possible listening to, understanding and helping patients, clinicians need information technology to make electronic documentation easier, not harder. At the same time, there should be reasonable restrictions on the use of copy and paste to limit the growing challenge of ‘note bloat’. We must find the right balance between ease of use and thoughtless documentation. The guiding principles in this document may be used to launch an interdisciplinary dialogue that promotes useful and necessary documentation that best facilitates efficient information capture and effective display. PMID:23874365

  17. Rangeland health assessment - The key to understanding and assessing rangeland soil health in the Northern Great Plains

    Technology Transfer Automated Retrieval System (TEKTRAN)

    As the science related to soil and rangeland health evolves, so do their protocols and assessment methodologies. Rangeland health assessments consist of evaluating how well ecological processes such as the water cycle, energy flow and nutrient cycling are functioning at a site. Soil health is the ca...

  18. Risk management measures for chemicals in consumer products: documentation, assessment, and communication across the supply chain.

    PubMed

    Bruinen de Bruin, Yuri; Hakkinen, Pertti Bert; Lahaniatis, Majlinda; Papameletiou, Demosthenes; Del Pozo, Carlos; Reina, Vittorio; Van Engelen, Jacqueline; Heinemeyer, Gerhard; Viso, Anne Catherine; Rodriguez, Carlos; Jantunen, Matti

    2007-12-01

    This paper analyzes the way risk management measures (RMMs) for consumer products have been used to date in authority and industry risk assessments. A working concept for consumer product RMMs is developed, aimed at controlling, limiting or avoiding exposures, and helping to insure the safe use (or handling) of a substance as part of a consumer product. Particular focus is placed on new requirements introduced by REACH (registration, evaluation, and authorization of chemicals). A RMMs categorization approach is also developed, dividing consumer product RMMs into those that are product integrated and those that are communicated to consumers. For each of these categories, RMMs for normal use, accidental use or misuse need to be distinguished. The level of detail for documenting, assessing and communicating RMMs across supply chains can vary, depending on the type of the assessment (tiered approach). Information on RMMs was collected from published sources to demonstrate that a taxonomical approach using standard descriptors for RMMs libraries is needed for effective information exchange across supply chains. PMID:17609687

  19. Comprehensive health assessment for newly arrived refugee children in Australia.

    PubMed

    Davidson, N; Skull, S; Chaney, G; Frydenberg, A; Jones, Cheryl; Isaacs, D; Kelly, P; Lampropoulos, B; Raman, S; Silove, D; Buttery, J; Smith, M; Steel, Z; Burgner, D

    2004-01-01

    Providing appropriate and responsive care to refugees from diverse backgrounds and with unique health needs is challenging. Refugee children may present with a wide range of conditions, which may be unfamiliar to health professionals in developed countries. Additionally, refugees may experience unfamiliarity with the Australian health system and distrust of authority figures and/or medical practitioners. This article provides an overview of the priority areas in health and health management for paediatric refugee patients for paediatricians as well as other relevant health care providers caring for this group. Specific issues covered include general health assessment, infectious diseases, immunization, growth and nutrition, oral health, development and disability, mental health and child protection. Comprehensive health assessment can assist in identifying children at risk of poor health and to provide them with timely and effective care, advocacy and appropriate referral. PMID:15367154

  20. 77 FR 44613 - Notice of Availability of the External Review Draft of Framework for Human Health Risk Assessment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ...The U.S. Environmental Protection Agency (EPA) Office of the Science Advisor (OSA) announces a 60-day public comment period for the external review draft of ``A Framework for Human Health Risk Assessment to Inform Decision Making.'' This document was developed as part of an agencywide program by the EPA Risk Assessment Forum. The EPA is releasing this draft document solely for the purpose of......

  1. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and public health and safety documentation regarding any gaming place, facility, or location where gaming will occur? 559.7 Section 559.7 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GAMING LICENSES AND BACKGROUND INVESTIGATIONS FOR KEY EMPLOYEES AND PRIMARY MANAGEMENT...

  2. Assessing Conscientious Personality in Primary Care: An Opportunity for Prevention and Health Promotion

    PubMed Central

    Israel, Salomon; Moffitt, Terrie E.

    2014-01-01

    The articles in this special section bolster the already strong evidence base that personality differences in the trait of conscientiousness predict health. What is now needed is a research agenda for translating documented risk associations between low conscientiousness and poor health into policies and interventions that improve health outcomes for individuals and populations. In this commentary, we highlight 1 such avenue: introducing brief personality assessment into primary care practice. We provide examples of how conscientiousness assessment may help health care professionals get to know their patients better and potentially serve as a guide for more personalized care. We also raise key considerations for implementation research aimed at examining the feasibility and utility of integrating conscientiousness assessment into primary care settings. PMID:24773110

  3. Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework

    PubMed Central

    Seitio-Kgokgwe, Onalenna; Gauld, Robin DC; Hill, Philip C; Barnett, Pauline

    2014-01-01

    Background: Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods: This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40) and senior officers from stakeholder organizations (N= 14), and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results: The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion: While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this

  4. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Mobile Health (mHealth) Technology

    PubMed Central

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-01-01

    Background Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. Methods We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents’ use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). Data Analysis We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 & R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. Results A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Conclusion Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention

  5. A new approach to criteria for health risk assessment

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-15

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.

  6. Health Risk Assessment for Area 514 RCRA Closure

    SciTech Connect

    Gallegos, G M; Hall, L C

    2005-05-26

    Lawrence Livermore National Laboratory (LLNL) is a USDOE research and development institution for science and technology applied to national security. The specific area that is the subject of this document, Area 514, was the location of active LLNL waste treatment facilities until November 2003, and the operations there were authorized under interim status. The site is being closed pursuant to the requirements of the Resource Conservation Recovery Act. The DTSC-approved ''Closure Plan for Area 514 Treatment and Storage Facility, LLNL 2004'', states clean closure concentrations for certain organic compounds, metals and metalloids. if all soil samples contained measured concentrations less than these levels, it was agreed that the site would meet the requirements for clean closure. However, if the samples had measured concentrations greater than the clean closure levels, a more detailed risk assessment could be prepared to evaluate the potential effects of the actual measured levels. Soil samples collected from 33 locations in Area 514 were analyzed for 37 constituents of potential concern, as identified by the Closure Plan. Many of these compounds and elements were not detected. However, 10 metals or metalloids were present at levels above the clean closure requirements, and 19 organic compounds were identified as contaminants of potential concern. Following the guidance in the Closure Plan, a health risk assessment is presented in this document to demonstrate the low level of potential health effects from the remaining constituents and to support clean closure of the site. Three types of hypothetical receptors were identified: an intrusive construction worker conducting trenching in the area, a bystander worker in a nearby building, and a future resident. Of the worker receptors, the intrusive construction worker was found to have the greater overall chronic exposure, with a theoretical calculated carcinogenic risk of 4 x 10{sup -8}, a chronic hazard index of 8 x

  7. U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

    SciTech Connect

    Blaylock, B.P.; Legg, J.; Travis, C.C.; Simek, M.A.; Sutherland, J.; Scofield, P.A.

    1995-06-01

    This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

  8. An integrated framework for health and ecological risk assessment

    SciTech Connect

    Suter, Glenn W. . E-mail: suter.glenn@epa.gov; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

    2005-09-01

    The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species.

  9. Using a social justice and health framework to assess European climate change adaptation strategies.

    PubMed

    Boeckmann, Melanie; Zeeb, Hajo

    2014-12-01

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents. PMID:25464133

  10. Using a Social Justice and Health Framework to Assess European Climate Change Adaptation Strategies

    PubMed Central

    Boeckmann, Melanie; Zeeb, Hajo

    2014-01-01

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents. PMID:25464133

  11. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  12. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  13. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  14. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  15. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  16. Environmental, health, and safety assessment of photovoltaics

    SciTech Connect

    Rose, E.C.

    1983-10-15

    Potential enviornmental, health, and safety (E,H and S) concerns associated with all phases of the photovoltaic (PV) energy system life cycle are identified and assessed. E,H and S concerns affecting the achievement of National PV Program goals or the viability of specific PV technologies are emphasized. The report is limited to near-term manufacturing process alternatives for crystalline silicon PV materials, addresses flat-plate and concentrator collector designs, and reviews system deployment in grid-connected, roof-mounted, residential and ground-mounted central-station applications. The PV life-cycle phases examined include silicon refinement and manufacture of PV collectors, system deployment, and decommissioning. The primary E,H and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.

  17. Environment, safety and health progress assessment of the Fernald Environmental Management Project (FEMP)

    SciTech Connect

    Not Available

    1991-11-01

    This report documents the results of the Environment, Safety, and Health (ES&H) Progress Assessment of the Fernald Environmental Management Project (FEMP), Fernald, Ohio, conducted from October 15 through October 25, 1991. The Secretary of Energy directed that small, focused, ES&H Progress Assessments be performed as part of the continuing effort to institutionalize line management accountability and the self-assessment process in the areas of ES&H. The FEMP assessment is the pilot assessment for this new program. The objectives for the FEMP ES&H Progress Assessment were to assess: (1) how the FEMP has progressed since the 1989 Tiger Assessment; (2) how effectively the FEMP has corrected specific deficiencies and associated root causes identified by that team; and (3) whether the current organization, resources, and systems are sufficient to proactively manage ES&H issues.

  18. Rangeland health attributes and indicators for qualitative assessment

    USGS Publications Warehouse

    Pyke, David A.; Herrick, J.E.; Pellant, Mike

    2002-01-01

    Panels of experts from the Society for Range Management and the National Research Council proposed that status of rangeland ecosystems could be ascertained by evaluating an ecological site's potential to conserve soil resources and by a series of indicators for ecosystem processes and site stability. Using these recommendations as a starting point, we developed a rapid, qualitative method for assessing a moment-in-time status of rangelands. Evaluators rate 17 indicators to assess 3 ecosystem attributes (soil and site stability, hydrologic function, and biotic integrity) for a given location. Indicators include rills, water flow patterns, pedestals and terracettes, bare ground, gullies, wind scour and depositional areas, litter movement, soil resistance to erosion, soil surface loss or degradation, plant composition relative to infiltration, soil compaction, plant functional/structural groups, plant mortality, litter amount, annual production, invasive plants, and reproductive capability. In this paper, we detail the development and evolution of the technique and introduce a modified ecological reference worksheet that documents the expected presence and amount of each indicator on the ecological site. In addition, we review the intended applications for this technique and clarify the differences between assessment and monitoring that lead us to recommend this technique be used for moment-in-time assessments and not be used for temporal monitoring of rangeland status. Lastly, we propose a mechanism for adapting and modifying this technique to reflect improvements in understanding of ecosystem processes. We support the need for quantitative measures for monitoring rangeland health and propose some measures that we believe may address some of the 17 indicators.

  19. Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

    PubMed

    Mittelmark, M B

    2001-09-01

    The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for. PMID:11509463

  20. Outcomes Assessment Planning: An Overview with Applications in Health Sciences.

    ERIC Educational Resources Information Center

    Trent, Ava M.

    2002-01-01

    Provides a brief overview of the process of outcomes assessment and examples of its application in professional health science education. Provides a background for other articles in this issue describing ongoing activities in outcomes assessment in veterinary education and for programs considering developing a plan. Focuses on health professions…

  1. Urban Ecosystem Health Assessment: Perspectives and Chinese Practice

    PubMed Central

    Su, Meirong; Zhang, Yan; Liu, Gengyuan; Xu, Linyu; Zhang, Lixiao; Yang, Zhifeng

    2013-01-01

    The concept of ecosystem health is a way to assess the holistic operations and development potential of urban ecosystems. Accelerated by the practical need for integrated ecosystem management, assessment of urban ecosystem health has been greatly developed and extensively applied in urban planning and management. Development is aimed at comprehensively evaluating the performance of urban ecosystems, identifying the limiting factors, and providing suggestions for urban regulation. The time has come for reviewing and establishing an instructional framework for urban ecosystem health assessment to shed light on certain essential issues of urban ecosystem health. Based on literature reviews and series of practice, a holistic framework of urban ecosystem health assessment is proposed. The framework covers the essential elements of urban ecosystem health and integrates three dimensions: theoretical foundation, assessment method, and practical application. Concrete assessment methods are also established, focusing on both external performance and internal metabolic processes. The practice of urban ecosystem health assessment in China is illustrated to briefly demonstrate the application of the established framework and methods. Some prospects are discussed for urban ecosystem health assessment and its application in urban planning and management. PMID:24201094

  2. Urban ecosystem health assessment: perspectives and Chinese practice.

    PubMed

    Su, Meirong; Zhang, Yan; Liu, Gengyuan; Xu, Linyu; Zhang, Lixiao; Yang, Zhifeng

    2013-11-01

    The concept of ecosystem health is a way to assess the holistic operations and development potential of urban ecosystems. Accelerated by the practical need for integrated ecosystem management, assessment of urban ecosystem health has been greatly developed and extensively applied in urban planning and management. Development is aimed at comprehensively evaluating the performance of urban ecosystems, identifying the limiting factors, and providing suggestions for urban regulation. The time has come for reviewing and establishing an instructional framework for urban ecosystem health assessment to shed light on certain essential issues of urban ecosystem health. Based on literature reviews and series of practice, a holistic framework of urban ecosystem health assessment is proposed. The framework covers the essential elements of urban ecosystem health and integrates three dimensions: theoretical foundation, assessment method, and practical application. Concrete assessment methods are also established, focusing on both external performance and internal metabolic processes. The practice of urban ecosystem health assessment in China is illustrated to briefly demonstrate the application of the established framework and methods. Some prospects are discussed for urban ecosystem health assessment and its application in urban planning and management. PMID:24201094

  3. The Development of a Secondary School Health Assessment Model

    ERIC Educational Resources Information Center

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

    The objective of this research was to: 1) involved a survey of information relating to secondary school health, 2) involved the construction of a model of health assessment and a handbook for using the model in secondary school, 3) develop an assessment model for secondary school. The research included 3 phases. (1) involved a survey of…

  4. Biomarkers: Dynamic "Tools" for Health and Safety Risk Assessment

    EPA Science Inventory

    Today informational flow from biomarkers contributes importantly to various types of health effects research, risk assessment and risk management decisions that impact, or have the potential to impact, public health and safety. Therefore, dependent upon the nature of the health r...

  5. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Development of Health Risk Assessment Guidance AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services...

  6. Mental Snapshots: Creating an Organized Plan for Health Assessment.

    PubMed

    Fosbrook, Susan Curro

    2015-01-01

    Beginning nursing students enter a rapidly moving and changing health care climate. Multiple stimulations can frighten and overwhelm the student's ability to find order of essential patient information. Students need to know how to collect, process, and manage important health data accurately and efficiently in the clinical setting. An integrative method for teaching nursing students to walk into the patient's room and construct a patterned sequence of focused assessments assists students in creating an organized plan for health assessment. The Mental Snapshots Method includes three components for health assessment: (a) sequential assessment steps of the patient; (b) color-coded visual images of the patient representing a bodily condition; and (c) focused assessment questions of primary health complaint(s) with a plan for nursing care. This mental snapshots strategy employs an information processing model of sensory, memory, and motor functioning, which enable students to maintain patient quality and safety. PMID:26428347

  7. Environmental health impact assessment of National Aluminum Company, Orissa

    PubMed Central

    Patil, Rajan R.

    2011-01-01

    Environmental Health Impact Assessment of industries is an important tool help decision-makers make choices about alternatives and improvements to prevent disease/injury and to actively promote health around industrial sites. A rapid environmental health hazard and vulnerability assessment of National Aluminum Company was undertaken in the villages in the vicinity plant in Angul region of Orissa. Aluminum smelter plant was known to discharge hundreds of tones of fluoride in to the environment contaminating the ecosystem around the plant. The present Environmental health impact assessment was carried out in 2005-06 at the request of officials from Government of Orissa. The findings showed adverse effects on human, veterinary and ecological health. Human health effects manifestations included dental and skeletal fluorosis. Veternary health effects were manifested through skeletal fluorosis. Ecological adverse effects were manifested by damage to paddy fields and crop yield. PMID:22223954

  8. Environmental health impact assessment of National Aluminum Company, Orissa.

    PubMed

    Patil, Rajan R

    2011-05-01

    Environmental Health Impact Assessment of industries is an important tool help decision-makers make choices about alternatives and improvements to prevent disease/injury and to actively promote health around industrial sites. A rapid environmental health hazard and vulnerability assessment of National Aluminum Company was undertaken in the villages in the vicinity plant in Angul region of Orissa. Aluminum smelter plant was known to discharge hundreds of tones of fluoride in to the environment contaminating the ecosystem around the plant. The present Environmental health impact assessment was carried out in 2005-06 at the request of officials from Government of Orissa. The findings showed adverse effects on human, veterinary and ecological health. Human health effects manifestations included dental and skeletal fluorosis. Veternary health effects were manifested through skeletal fluorosis. Ecological adverse effects were manifested by damage to paddy fields and crop yield. PMID:22223954

  9. A quality assessment framework for natural hazard event documentations: application to trans-basin flood reports in Germany

    NASA Astrophysics Data System (ADS)

    Uhlemann, S.; Thieken, A. H.; Merz, B.

    2013-02-01

    Written sources that aim at documenting and analysing a particular natural hazard event in the recent past are published at vast majority as grey literature (e.g. as technical reports) and therefore outside of the scholarly publication routes. In consequence, the application of event specific documentations in natural hazard research has been constrained by barriers in accessibility and concerns of credibility towards these sources and by limited awareness of their content and its usefulness for research questions. In this study we address the concerns of credibility for the first time and present a quality assessment framework for written sources from a user's perspective, i.e. we assess the documents' fitness for use to enhance the understanding of trans-basin floods in Germany in the period 1952-2002. The framework is designed to be generally applicable for any natural hazard event documentation and assesses the quality of a document addressing accessibility as well as representational, contextual, and intrinsic dimensions of quality. We introduce an ordinal scaling scheme to grade the quality in the single quality dimensions and the Pedigree score which serves as a measure for the overall document quality. We present results of an application of the framework to a set of 133 event specific documentations relevant for understanding trans-basin floods in Germany. Our results show that the majority of flood event specific reports are of a good quality, i.e. they are well enough drafted, largely accurate and objective, and contain a substantial amount of information on the sources, pathways and receptors/consequences of the floods. The validation of our results against assessments of two independent peers confirms the objectivity and transparency of the quality assessment framework. Using an example flood event that occurred in October/November 1998 we demonstrate how the information from multiple reports can be synthesised under consideration of their quality.

  10. A quality assessment framework for natural hazard event documentation: application to trans-basin flood reports in Germany

    NASA Astrophysics Data System (ADS)

    Uhlemann, S.; Thieken, A. H.; Merz, B.

    2014-02-01

    Written sources that aim at documenting and analysing a particular natural hazard event in the recent past are published at vast majority as grey literature (e.g. as technical reports) and therefore outside of the scholarly publication routes. In consequence, the application of event-specific documentation in natural hazard research has been constrained by barriers in accessibility, concerns of credibility towards these sources and by limited awareness of their content and its usefulness for research questions. In this study we address the concerns of credibility for the first time and present a quality assessment framework for written sources from a user's perspective, i.e. we assess the documents' fitness for use to enhance the understanding of trans-basin floods in Germany in the period 1952-2002. The framework is designed to be generally applicable for any natural hazard event documentation and assesses the quality of a document, addressing accessibility as well as representational, contextual, and intrinsic dimensions of quality. We introduce an ordinal scaling scheme to grade the quality in the individual quality dimensions and the Pedigree score which serves as a measure for the overall document quality. We present results of an application of the framework to a set of 133 cases of event-specific documentation relevant for understanding trans-basin floods in Germany. Our results show that the majority of flood event-specific reports are of good quality, i.e. they are well enough drafted, largely accurate and objective, and contain a substantial amount of information on the sources, pathways and receptors/consequences of the floods. The validation of our results against assessments of two independent peers confirms the objectivity and transparency of the quality assessment framework. Using an example flood event that occurred in October/November 1998 we demonstrate how the information from multiple reports can be synthesised.

  11. Assessing health risks of synthetic vitreous fibers: an integrative approach.

    PubMed

    McClellan, R O

    1994-12-01

    This paper reviews a tiered approach to acquiring information from multiple experimental systems to understand and assess the potential human health risks of exposure to airborne synthetic fibers. The approach is grounded in the now widely accepted research-risk assessment-risk management paradigm. It involves the acquisition of information that will provide mechanistic linkages within the exposure-dose-response paradigm. It advocates the use of the inhalation route of exposure for developing relevant information for assessing human health risks and calls attention to serious problems encountered using nonphysiologic routes of administration to assess human health risks. PMID:7724844

  12. The Tennessee Department of Health WORKshops on Use of Secondary Data for Community Health Assessment, 2012

    PubMed Central

    Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B.

    2014-01-01

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community’s health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county public health departments as trusted leaders in providing population data and engaging community stakeholders in assessments. The Tennessee Department of Health’s Division of Policy, Planning, and Assessment conducted regional 2-day training workshops to explain and guide completion of computer spreadsheets on 12 health topics. Participants from 93 counties extracted data from multiple and diverse sources to quantify county demographics, health status, and resources and wrote problem statements based on the data examined. The workshops included additional staff development through integration of short lessons on data analysis, epidemiology, and social-behavior theory. Participants reported in post-workshop surveys higher degrees of comfort in interpreting data and writing about their findings on county health issues, and they shared their findings with health, hospital, school, and government leaders (including county health council members) in their counties. Completion of the assessments enabled counties and the Tennessee Department of Health to address performance-improvement goals and assist counties in preparing to meet public health accreditation prerequisites. The methods developed for using secondary data for community health assessment are Tennessee’s first-phase response to counties’ request for a statewide structure for conducting such assessments. PMID:24384302

  13. Primary Care and Public Health Activities in Select US Health Centers: Documenting Successes, Barriers, and Lessons Learned

    PubMed Central

    Shi, Leiyu; Chowdhury, Joya; Sripipatana, Alek; Zhu, Jinsheng; Sharma, Ravi; Hayashi, A. Seiji; Daly, Charles A.; Tomoyasu, Naomi; Nair, Suma; Ngo-Metzger, Quyen

    2012-01-01

    Objectives. We examined primary care and public health activities among federally funded health centers, to better understand their successes, the barriers encountered, and the lessons learned. Methods. We used qualitative and quantitative methods to collect data from 9 health centers, stratified by administrative division, urban–rural location, and race/ethnicity of patients served. Descriptive data on patient and institutional characteristics came from the Uniform Data System, which collects data from all health centers annually. We administered questionnaires and conducted phone interviews with key informants. Results. Health centers performed well on primary care coordination and community orientation scales and reported conducting many essential public health activities. We identified specific needs for integrating primary care and public health: (1) more funding for collaborations and for addressing the social determinants of health, (2) strong leadership to champion collaborations, (3) trust building among partners, with shared missions and clear expectations of responsibilities, and (4) alignment and standardization of data collection, analysis, and exchange. Conclusions. Lessons learned from health centers should inform strategies to better integrate public health with primary care. PMID:22690975

  14. Health and impact assessment: Are we seeing closer integration?

    SciTech Connect

    Morgan, Richard K.

    2011-07-15

    Health has always had a place in wider impact assessment activities, from the earliest days of the National Environmental Policy Act in the United States. However, early thinking tended to focus on health protection and environmental health issues, especially in relation to the effects of pollution. The adoption of wider models of health was reflected in impact assessment circles from the early 1990s, with particular emphasis on an integrated approach to impact assessment, especially at the project level, which would see health impact assessment benefiting from working with other forms of impact assessment, such as social and ecological. Yet twenty years later, integration still seems a distant prospect in many countries. In this paper I examine the case for integrating health considerations within the wider IA process, discuss some of the problems that have historically restricted progress towards this end, and explore the degree to which impact assessment practitioners have been successful in seeking to improve the consideration of health in IA. In New Zealand, project-level impact assessment is based on an integrated model under the Resource Management Act. In addition, HIA was recognised in the early 1990s as a valuable addition to the toolkit for project assessment. Since then policy-level HIA has grown supported by extensive capacity building. If health is being integrated into wider impact assessment, it should be happening in New Zealand where so many enabling conditions are met. Three major project proposals from New Zealand are examined, to characterise the broad trends in HIA development in New Zealand in the last ten years and to assess the degree to which health concerns are being reflected in wider impact assessments. The findings are discussed in the context of the issues outlined in the early part of the paper.

  15. How Accessible Was Information about H1N1 Flu? Literacy Assessments of CDC Guidance Documents for Different Audiences

    PubMed Central

    Lagassé, Lisa P.; Rimal, Rajiv N.; Smith, Katherine C.; Storey, J. Douglas; Rhoades, Elizabeth; Barnett, Daniel J.; Omer, Saad B.; Links, Jonathan

    2011-01-01

    We assessed the literacy level and readability of online communications about H1N1/09 influenza issued by the Centers for Disease Control and Prevention (CDC) during the first month of outbreak. Documents were classified as targeting one of six audiences ranging in technical expertise. Flesch-Kincaid (FK) measure assessed literacy level for each group of documents. ANOVA models tested for differences in FK scores across target audiences and over time. Readability was assessed for documents targeting non-technical audiences using the Suitability Assessment of Materials (SAM). Overall, there was a main-effect by audience, F(5, 82) = 29.72, P<.001, but FK scores did not vary over time, F(2, 82) = .34, P>.05. A time-by-audience interaction was significant, F(10, 82) = 2.11, P<.05. Documents targeting non-technical audiences were found to be text-heavy and densely-formatted. The vocabulary and writing style were found to adequately reflect audience needs. The reading level of CDC guidance documents about H1N1/09 influenza varied appropriately according to the intended audience; sub-optimal formatting and layout may have rendered some text difficult to comprehend. PMID:22039401

  16. Documenting the health consequences of endemic warfare in three pastoralist communities of northern Kenya: a conceptual framework.

    PubMed

    Pike, Ivy L; Straight, Bilinda; Oesterle, Matthias; Hilton, Charles; Lanyasunya, Adamson

    2010-01-01

    Violent conflict represents the third most important source of mortality around the world, yet violence-related mortality remains profoundly undercounted (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). As a step toward documenting the consequences of even the "smallest wars" we offer a conceptual framework for a recently initiated project that comparatively examines the direct and indirect consequences of intercommunity violence among Pokot, Samburu, and Turkana herding communities of Northern Kenya. While a substantial body of work has accumulated on the social responses to this violence very little is known about the differential impacts on community health. Based on our cumulative ethnographic experience in the area, we offer a conceptual framework that merges a context-sensitive ethnographic approach with a comparative epidemiological one centered on documenting the lived experience of violence and inequality. In this paper, we provide evidence for the importance of a contextualized approach detailing how social environments that include chronic episodes of violence produce variations in health. We do so by presenting the results of previous work to highlight what is known and follow this by identifying what remains to be understood about how violence, inequality, and health interact in these communities. While much is known about the importance of access to livestock herds for health, nutrition, and child growth in this difficult physical environment, far less is known about how the social responses to violence interact with access to herds to create new patterns of nutrition and health. With respect to pastoralists, additional areas that remain only nominally understood include age-specific mortality patterns, reproductive health, and psychosocial/mental health, topics that we view as central to the current study. In sum, we suggest that health offers one of the most useful tools for examining the costs of violence by creating opportunities for advocacy. PMID

  17. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    PubMed Central

    Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

    2016-01-01

    Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  18. Functional health pattern assessment: a seasonal migrant farmworker community.

    PubMed

    Decker, S D; Knight, L

    1990-01-01

    A broad-based needs assessment of a migrant farmworker community was conducted using the community functional health pattern tool (Gikow & Kucharski, 1987) and Porter's (1987) factor-isolating theory of population group diagnosis. Data analysis revealed numerous health needs in all 10 functional health patterns and an urgent need for accessible primary prevention programs. A mobile outreach program to the migrant camps was seen as the most effective way to provide education, screening, and health care. PMID:2401903

  19. Intranet-based safety documentation in management of major hazards and occupational health and safety.

    PubMed

    Leino, Antti

    2002-01-01

    In the European Union, Council Directive 96/82/EC requires operators producing, using, or handling significant amounts of dangerous substances to improve their safety management systems in order to better manage the major accident potentials deriving from human error. A new safety management system for the Viikinmäki wastewater treatment plant in Helsinki, Finland, was implemented in this study. The system was designed to comply with both the new safety liabilities and the requirements of OHSAS 18001 (British Standards Institute, 1999). During the implementation phase experiences were gathered from the development processes in this small organisation. The complete documentation was placed in the intranet of the plant. Hyperlinks between documents were created to ensure convenience of use. Documentation was made accessible for all workers from every workstation. PMID:12189104

  20. A Review of Data Quality Assessment Methods for Public Health Information Systems

    PubMed Central

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-01-01

    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

  1. Health Information: What Can Mobile Phone Assessments Add?

    PubMed Central

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients’ health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures. In this pilot study, two randomly selected groups of patients provided information about their pain for one week postoperatively. One group responded via cell phones, and the other, a control group, responded using paper-based questionnaires. The mobile phone system was found to provide a fast and safe basis for reporting pain postoperatively in real time. The results indicate that on days 3 and 4 the mobile phone group reported significantly higher levels of pain than the control group, and the cholecystectomy patients reported significantly more pain at movement on days 3 and 4 than the hysterectomy patients. The mobile phone approach is an adaptation to modern technology and the mobility of individuals. This technology is user friendly and requires minimal support. However, as the sample size was small (n = 37), further studies are needed before additional conclusions can be drawn. PMID:23209453

  2. Radiological/Health physics program assessement at Rocky Flats, the process

    SciTech Connect

    Psomas, P.O.

    1996-06-01

    The Department of Energy, Rocky Flats Office, Safety and Health Group, Health Physics Team (HPT) is responsible for oversight of the Radiation Protection and Health Physics Program (RPHP) of the Integrating Management Contractor (IMC), Kaiser-Hill (K-H) operations at the Rocky Flats Environmental Technology Site (RFETS). As of 1 January 1996 the Rocky Flats Plant employed 300 DOE and 4,300 contractor personnel (K-H and their subcontractors). WSI is a subcontractor and provides plant security. To accomplish the RPHP program oversight HPT personnel developed a systematic methodology for performing a functional RPHP Assessment. The initial process included development of a flow diagram identifying all programmatic elements and assessment criteria documents. Formulation of plans for conducting interviews and performance of assessments constituted the second major effort. The generation of assessment reports was the final step, based on the results of this process. This assessment will be a 6 person-year effort, over the next three years. This process is the most comprehensive assessment of any Radiation Protection and Health Physics (RPHP) Program ever performed at Rocky Flats. The results of these efforts will establish a baseline for future RPHP Program assessments at RFETS. This methodology has been well-received by contractor personnel and creates no Privacy Act violations or other misunderstandings.

  3. Current Assessment and Classification of Suicidal Phenomena using the FDA 2012 Draft Guidance Document on Suicide Assessment: A Critical Review

    PubMed Central

    Giddens, Jennifer M.; Sheehan, Kathy Harnett

    2014-01-01

    Objective: Standard international classification criteria require that classification categories be comprehensive to avoid type II error. Categories should be mutually exclusive and definitions should be clear and unambiguous (to avoid type I and type II errors). In addition, the classification system should be robust enough to last over time and provide comparability between data collections. This article was designed to evaluate the extent to which the classification system contained in the United States Food and Drug Administration 2012 Draft Guidance for the prospective assessment and classification of suicidal ideation and behavior in clinical trials meets these criteria. Method: A critical review is used to assess the extent to which the proposed categories contained in the Food and Drug Administration 2012 Draft Guidance are comprehensive, unambiguous, and robust. Assumptions that underlie the classification system are also explored. Results: The Food and Drug Administration classification system contained in the 2012 Draft Guidance does not capture the full range of suicidal ideation and behavior (type II error). Definitions, moreover, are frequently ambiguous (susceptible to multiple interpretations), and the potential for misclassification (type I and type II errors) is compounded by frequent mismatches in category titles and definitions. These issues have the potential to compromise data comparability within clinical trial sites, across sites, and over time. Conclusion: These problems need to be remedied because of the potential for flawed data output and consequent threats to public health, to research on the safety of medications, and to the search for effective medication treatments for suicidality. PMID:25520889

  4. US Department of Energy Environment, Safety and Health Progress Assessment of the Nevada Test Site

    SciTech Connect

    Not Available

    1992-08-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety, and Health (ES&H) Progress Assessment of the Nevada Test Site (NTS), Nye County, Nevada. The assessment, which was conducted from July 20 through August 4, 1992, included a selective review of the ES&H management systems and progress of the responsible DOE Headquarters Program Offices; the DOE Nevada Field Office (NV); and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. This report presents a summary of issues and progress in the areas of environment, safety and health, and management.

  5. Mental Health Computing in the 1980s: I. General Information Systems and Clinical Documentation.

    ERIC Educational Resources Information Center

    Hedlund, James L.; And Others

    1985-01-01

    This is the first of a two-part state-of-the-art review concerning current trends in mental health computing. It deals principally with general mental health information systems, the emerging role of microcomputers and general applications software, computerizing medical records, and computer support for quality assurance programs. (Author)

  6. 9 CFR 98.35 - Declaration, health certificate, and other documents for animal semen.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the United States in accordance with subpart C of 9 CFR part 98. (e) The certificate accompanying... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Declaration, health certificate, and... HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS...

  7. [Summary and conclusions of the document "Population, reproductive health, and poverty"].

    PubMed

    1998-12-01

    This paper briefly examines the impact on reproductive health of social inequalities and poverty in Latin America and the Caribbean. The need to improve the quality of health services and to develop appropriate programs that promote reproductive rights is emphasized. PMID:12321988

  8. Using an Experience Documentation Opportunity to Certify Advanced-Level Health Education Specialists

    ERIC Educational Resources Information Center

    Wilson, Kelly L.; Dennis, Dixie L.; Gambescia, Stephen F.; Chen, W. William; Lysoby, Linda

    2012-01-01

    The worldwide burden of diseases, environmental threats, and injuries help establish the global context and need for credentialing in health education and promotion. To ensure effective practice by certified or credentialed individuals, it is critical that the global health education and promotion workforce identify, agree on, and establish core…

  9. Public health crises: the development of a consensus document on their management in Spain.

    PubMed

    Rodrigo, T; Caylà, Ja

    2011-01-01

    Several public health crises in Europe have led to sustained outbreaks, political problems, or have generated social alarm. For this reason, a nationwide study was conducted in Spain with the objective to determine which public health events provoke the most frequent crises, to reach a consensus regarding the appropriate actions to be taken when responding to public health crises, and to provide recommendations for their management. The events which had most frequently provoked crises between 1999 and 2004 were identified. A consensus was obtained by public health experts from the 17 Autonomous Regions of Spain and the National Epidemiological Centre using the RAND/UCLA method which combines the Nominal Groups and Delphi techniques. Legionellosis, foodborne diseases, severe acute respiratory syndrome (SARS), bovine spongiform encephalopathy (BSE), bioterrorism, meningococcal meningitis, tuberculosis, heat waves, and influenza epidemics were found to be cause for most public health crises. In Spain, 75% of the crises identified by senior public health experts from the Autonomous Regions involved infectious diseases. Factors triggering a crisis included the type of disease, social alarm, population affected, and the course of action taken by public institutions and reporting in the media. There was consensus that correct information, qualified personnel, availability of standardised protocols for investigation and control, information distribution, and setting up of ‘crisis offices’ were actions with a positive effect regarding crisis resolution. Appropriate management of outbreaks or other situations being perceived as a risk to health can mitigate or even contain the generation of public health crises. PMID:21507319

  10. Defining and Assessing Public Health Functions: A Global Analysis.

    PubMed

    Martin-Moreno, Jose M; Harris, Meggan; Jakubowski, Elke; Kluge, Hans

    2016-01-01

    Given the broad scope and intersectoral nature of public health structures and practices, there are inherent difficulties in defining which services fall under the public health remit and in assessing their capacity and performance. The aim of this study is to analyze how public health functions and practice have been defined and operationalized in different countries and regions around the world, with a specific focus on assessment tools that have been developed to evaluate the performance of essential public health functions, services, and operations. Our review has identified nearly 100 countries that have carried out assessments, using diverse analytical and methodological approaches. The assessment processes have evolved quite differently according to administrative arrangements and resource availability, but some key contextual factors emerge that seem to favor policy-oriented follow-up. These include local ownership of the assessment process, policymakers' commitment to reform, and expert technical advice for implementation. PMID:26789385

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

    SciTech Connect

    Pennock, Michael; Ura, Karma

    2011-01-15

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

  12. Assessing Student Learning Outcomes and Documenting Success through a Capstone Course

    ERIC Educational Resources Information Center

    Sum, Paul E.; Light, Steven Andrew

    2010-01-01

    Colleges and universities are increasingly intentional about meeting well-articulated and consistent general education goals and documenting substantive learning outcomes. Institutional imperatives to document the successful teaching of essential knowledge and skill sets frequently fall to faculty and departments, posing new challenges in an…

  13. Basins 4.0 Climate Assessment Tool (Cat): Supporting Documentation and User Manual (External Review Draft)

    EPA Science Inventory

    EPA has released of the draft document solely for the purpose of pre-dissemination peer review under applicable Information Quality Guidelines (IQGs). This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agenc...

  14. Plain Language in Environmental Policy Documents: An Assessment of Reader Comprehension and Perceptions

    ERIC Educational Resources Information Center

    Jones, Natasha; McDavid, Justin; Derthick, Katie; Dowell, Randy; Spyridakis, Jan

    2012-01-01

    Several government agencies are seeking quality improvement in environmental policy documents by asking for the implementation of Plain Language (PL) guidelines. Our mixed-methods research examines whether the application of certain PL guidelines affects the comprehension and perceptions of readers of environmental policy documents. Results show…

  15. Using Collaborative Assessment to Examine the Relationship between Self-Reported Beliefs and the Documentable Practices of Preschool Teachers

    ERIC Educational Resources Information Center

    McMullen, Mary Benson; Elicker, James; Goetze, Giselle; Huang, Hsin-Hui; Lee, Sun-Mi; Mathers, Carrie; Wen, Xiaoli; Yang, Heayoung

    2006-01-01

    A team of researchers used a collaborative assessment protocol to compare the self-reported teaching beliefs of a convenience sample of preschool teachers (N = 57) to their documentable practices (i.e., practices that could be observed, recorded, and categorized using a deductive strategy). Data were examined from survey instruments, detailed…

  16. Occupational Competency Profile for Health Occupations Education Program: Health Agency Assessment. Information Series: Report No. 10.

    ERIC Educational Resources Information Center

    Walters, Norma J.

    This assessment instrument is intended to provide health occupations teachers and state departments of education with information needed to revise and improve the curriculum used in training prospective health occupations teachers and in updating certification requirements for practicing health care professionals. The profile lists the…

  17. Career Education for Mental Health Workers. Health Assessment. Human Service Instructional Series. Module No. 6.

    ERIC Educational Resources Information Center

    Redcay, Madeleine C.

    This module on health assessment is one of a set of six developed to prepare human services workers for the changing mental health service delivery system. A total of seven objectives are included to help students utilize knowledge of physical factors which may influence health and behavior in order to recognize signs and symptoms which indicate…

  18. A health literacy assessment of the epilepsy.com website.

    PubMed

    Elliott, John O; Shneker, Bassel F

    2009-07-01

    Current healthcare guidelines identify low health literacy as a major barrier to optimal health communication. Health literacy is defined as the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions. An estimated 90 million people in the U.S. have marginal health literacy. The Institute of Medicine and the U.S. Department of Education recommend that health related information be written at the 6th-8th grade level to address low health literacy. Epidemiological studies demonstrate that persons with epilepsy have significantly lower educational attainment and lower incomes placing them at risk for low health literacy and limited Internet access. While Internet users tend to have higher educational attainment, previous research indicates even good readers prefer simpler rather than more complex medical information. Health educational content that could be printed and given to patients addresses an important need in clinical epilepsy care. Previous reviews of health websites found they exceed recommended readability levels. Two online programs were used to assess the reading level of 1327 web pages on the www.epilepsy.com website using established readability formulas. Based on the Flesch Reading Ease assessment, only 3% of epilepsy.com web pages are written for a 6th grade reading level or below. If 8th grade level or below is used as the standard, only 15% are adequate. Recommendations and examples are provided for improving the readability of epilepsy-specific health education content. PMID:19419887

  19. Assessing public health emergency preparedness: concepts, tools, and challenges.

    PubMed

    Nelson, Christopher; Lurie, Nicole; Wasserman, Jeffrey

    2007-01-01

    Policymakers are increasingly seeking to determine whether the federal government's recent investments in public health preparedness have left the public health system better prepared to respond to large-scale public health emergencies. Yet, there remain questions about how to define "public health emergency preparedness," how much preparedness is enough, and how preparedness can be measured and assessed. This chapter identifies the key challenges associated with measuring public health preparedness and reviews approaches currently in use. We also identify some emerging measurement techniques that might help address some of these challenges. PMID:17129174

  20. Expenditures for Public Health: Assessing Historical and Prospective Trends

    PubMed Central

    Kinner, Kyle

    2009-01-01

    We integrated publicly available fiscal and budgetary data to assess historical and prospective trends in public health system funding at the federal, state, and local levels in relation to the recommended objectives outlined in the Institute of Medicine's definitive 2002 report. Although historical growth rates for public health expenditures at all levels were competitive with other major funding objects (requested or funded budget items), outlays for health care services and medical research dwarfed public health spending in absolute amounts. Competition for scarce discretionary resources, competing policy priorities, and protracted fiscal pressures will make it difficult for public health systems to achieve the recommended objectives. PMID:19696394

  1. The consideration of health in strategic environmental assessment (SEA)

    SciTech Connect

    Fischer, Thomas B; Matuzzi, Marco; Nowacki, Julia

    2010-04-15

    Following the requirements of the European Directive 2001/42/EC on strategic environmental assessment (SEA) and the Protocol on Strategic Environmental Assessment (Kiev, 2003) to the Convention on Environmental Impact Assessment in a Transboundary Context (Espoo, 1991), health is one of the aspects to be considered in SEA. In this paper, results of an evaluation of eight SEAs from Austria, the Czech Republic, Germany, the Netherlands and the United Kingdom (England and Wales) regarding the consideration of health are presented. This includes SEAs for five spatial plans, as well as one SEA for each, a transport, a waste management and an economic development plan. It is found that while all SEAs cover important physical and natural aspects that are related to health, social and behavioural aspects are considered to a much smaller extent. Based on the results, facilitating factors and barriers for health inclusive SEA are identified. Overall, good baseline data can be seen as an important starting point for effective health inclusive SEA, while an effective monitoring system is crucial for effective implementation of the measures and recommendations brought forward in health inclusive SEA. Crucially, health authorities/health experts need to engage more with SEA, as this provides a key platform for cross sectoral dialogue on a range of issues. SEA presents the health sector with an opportunity to influence the policy and decision-making process to improve people's health and well-being.

  2. Metrics for assessing improvements in primary health care.

    PubMed

    Stange, Kurt C; Etz, Rebecca S; Gullett, Heidi; Sweeney, Sarah A; Miller, William L; Jaén, Carlos Roberto; Crabtree, Benjamin F; Nutting, Paul A; Glasgow, Russell E

    2014-01-01

    Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences. PMID:24641561

  3. ASSESSING BIOACCUMULATION FOR DERIVING NATIONAL HUMAN HEALTH WATER QUALITY CRITERIA

    EPA Science Inventory

    The United States Environmental Protection Agency is revising its methodology for deriving national ambient water quality criteria (AWQC) to protect human health. A component of this guidance involves assessing the potential for chemical bioaccumulation in commonly consumed fish ...

  4. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accept requests to perform health assessments for a particular facility or release from any person or...: Assistant Administrator, Agency for Toxic Substances and Disease Registry, 1600 Clifton Road NE.,...

  5. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... accept requests to perform health assessments for a particular facility or release from any person or...: Assistant Administrator, Agency for Toxic Substances and Disease Registry, 1600 Clifton Road NE.,...

  6. FRAMEWORK FOR THE INTEGRATION OF HEALTH AND ECOLOIGCAL RISK ASSESSMENT

    EPA Science Inventory

    The World Health Organization's International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency have developed a collaborative partnership to foster integration; of assessment approa...

  7. Assessing herbal products with health claims.

    PubMed

    Lapenna, Silvia; Gemen, Raymond; Wollgast, Jan; Worth, Andrew; Maragkoudakis, Petros; Caldeira, Sandra

    2015-01-01

    Herbs, herbal extracts, or phytochemicals are broadly used as foods, drugs, and as traditional medicines. These are well regulated in Europe, with thorough controls on both safety and efficacy or validity of health claims. However, the distinction between medicines and foods with health claims is not always clear. In addition, there are several cases of herbal products that claim benefits that are not scientifically demonstrated. This review details the European Union (EU) legislative framework that regulates the approval and marketing of herbal products bearing health claims as well as the scientific evidence that is needed to support such claims. To illustrate the latter, we focus on phytoecdysteroid (PE)-containing preparations, generally sold to sportsmen and bodybuilders. We review the limited published scientific evidence that supports claims for these products in humans. In addition, we model the in silico binding between different PEs and human nuclear receptors and discuss the implications of these putative bindings in terms of the mechanism of action of this family of compounds. We call for additional research to validate the safety and health-promoting properties of PEs and other herbal compounds, for the benefit of all consumers. PMID:24915414

  8. US Policy approaches for assessing soil health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is worldwide recognition for a more holistic vision of soil health and tools to guide soil conservation policy, management and restoration. To meet this need, U.S. conservation programs in the US Food, Conservation, and Energy Act of 2008 (the farm bill), including the Conservation Stewardship...

  9. Assessment of Health Knowledge in College Women.

    ERIC Educational Resources Information Center

    Richmond, Gail; And Others

    1991-01-01

    The level of accurate health knowledge that young adult women possess regarding selected information dealing with nutrition; disease; and over-the-counter, prescription, and social drugs is discussed. Sections include the introduction, methods, results, discussion, and implications for biology teachers. (KR)

  10. Health needs assessment in primary care: the evolution of a practical public health approach.

    PubMed

    Kilduff, A; McKeown, K; Crowther, A

    1998-05-01

    The purpose of the paper is to place health needs assessment in its primary care context. This is a dynamic context where changes in policies, staff roles and patient expectations have all to be considered. Given this complexity and the variations between practices, it is necessary to help primary health care teams (PHCTs) to understand their stage of development and how this will directly affect any health needs assessment. The technical and methodological aspects of health needs assessment have been explored and described by others, and that work will not be duplicated here. This paper reviews the health needs assessment (HNA) work of the Ribblesdale Total Purchasing Project (RTPP) and then sets this review against the political, organisational, professional and practical pressures that currently confront primary care. Out of this analysis emerges a diagnostic and development tool which links together, and emphasises the intimate relationships between, five stages of development needed for effective primary care-oriented health needs assessment work. The emphasis is on understanding the place of health needs assessment within the general processes and systems of the primary health care team. The paper concludes by suggesting ways in which public health practitioners and specialists might approach the task of supporting and influencing the evolution of the recently proposed Primary Care Groups and Primary Care Trusts. The overall intention of the article is to stimulate debate and action. PMID:9629025

  11. Overall Assessment of the Speaker's Experience of Stuttering (OASES): Documenting Multiple Outcomes in Stuttering Treatment

    ERIC Educational Resources Information Center

    Yaruss, J. Scott; Quesal, Robert W.

    2006-01-01

    This paper describes a new instrument for evaluating the experience of the stuttering disorder from the perspective of individuals who stutter. Based on the World Health Organization's "International Classification of Functioning, Disability, and Health" [World Health Organization (2001). "The International Classification of Functioning,…

  12. The Adequacy of ICNP Version 1.0 as a Representational Model for Electronic Nursing Assessment Documentation

    PubMed Central

    Dykes, Patricia C.; Kim, Hyeon-eui; Goldsmith, Denise M.; Choi, Jeeyae; Esumi, Kumiko; Goldberg, Howard S.

    2009-01-01

    Objectives The purpose of this study was to evaluate the adequacy of the International Classification of Nursing Practice 1 (ICPN) Version 1.0 as a representational model for nursing assessment documentation. Design and Measurements To identify representational requirements of nursing assessments, the authors mapped key concepts and semantic relations extracted from standardized and local nursing admission assessment documentation forms/templates and inpatient admission assessment records to the ICNP. Next, they expanded the list of ICNP semantic relations with those obtained from the admission assessment forms/templates. The expanded ICNP semantic relations were then validated against the semantic relations identified from an additional set of admission assessment records and a set of 300 randomly selected North American Nursing Diagnosis Association defining characteristic phrases. The concept coverage of the ICNP was evaluated by mapping the concepts extracted from these sources to the ICNP concepts. The UMLS Methathesaurus was then used to map concepts without exact matches to other American Nursing Association (ANA) recognized terminologies. Results The authors found that along with the 30 existing ICNP semantic relations, an additional 17 are required for the ICNP to function as a representational model for nursing assessment documentation. Eight hundred and five unique assessment concepts were extracted from all sources. Forty-three percent of these unique assessment concepts had exact matches in the ICNP. An additional 20% had matches in the ICNP classified as narrower, broader, or “other.” Of the concepts without exact matches in the ICNP, 81% had exact matches found in other ANA recognized terminologies. Conclusions The broad concept coverage and the logic-based structure of the ICNP make it a flexible and robust standard. The ICNP provides a framework from which to capture and reuse atomic level data to facilitate evidence-based practice. PMID

  13. Documenting the health insurance needs of cancer patients and providing scarce resolutions.

    PubMed

    Wiatrek, Dawn Elise; Morra, Marion; Shaw, Beverly; Sharpe, Katherine; George, Roshini; Battaglia-Seiler, Mandi; Fellers, Melissa

    2013-06-01

    The American Cancer Society's Health Insurance Assistance Service provides callers to its National Cancer Information Center with detailed knowledge to help them access or maintain health insurance coverage for which they might be eligible. Demographic data from April 2009 to June 2011 show that 76 % were uninsured and between the ages of 40-60; 65 % were Caucasian, 17 % African American, and 12% Hispanic; and monthly incomes were $1,999 or less. Current trends indicate that callers are similar to those identified in various health care reform publications: callers are unable to afford co-pays; facilities are requesting cash upfront; callers report loss of coverage, less adequate or less affordable coverage from employers; large out-of-pocket expense or high deductibles are needed; and modification of the CDC's Breast and Cervical Screening Program's eligibility guidelines create challenges. Six lessons that have been learned while initiating and managing this program are presented. PMID:23371058

  14. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    PubMed

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed. PMID:26438747

  15. Transforming Student Health Services through Purpose-Driven Assessment Techniques

    ERIC Educational Resources Information Center

    Knoll, Dorothy; Meiers, Chris; Honeck, Sara

    2006-01-01

    The University of Kansas Medical Center did a comprehensive review of the services provided in the Student Health Center (SHC). Using purpose-driven assessment techniques, areas needing improvement were identified. The results of the survey were presented to students and, with student support, student health fees were increased to fund desired…

  16. Health Effects Assessment for Benzo[a]pyrene

    EPA Science Inventory

    This final report represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related g...

  17. Low Cost Needs Assessment for a Rural Mental Health Center.

    ERIC Educational Resources Information Center

    MacDevitt, Margaret; MacDevitt, John

    1987-01-01

    Conducted an inexpensive mental health needs assessment of 520 households in a rural community using volunteer university students as telephone interviewers. Respondents considered situational stressors such as unemployment, financial strain, and alcohol and drug abuse to be community's most pressing mental health problems and believed that…

  18. Development of Guidelines for Health Impact Assessment in Southern Italy.

    PubMed

    Bert, Fabrizio; Gualano, Maria Rosaria; Di Stanislao, Francesco; Siliquini, Roberta; Tozzi, Quinto; Pizzuti, Renato; Rizzo, Liliana; Scondotto, Salvatore; Bux, Francesco

    2016-01-01

    Health impact assessment (HIA) is a multidisciplinary method aimed at assessing the health effects of policies, plans, and projects using quantitative, qualitative, and participatory techniques. In many European countries, such as in Italy, there is a lack of implementation of HIA procedures and it would be necessary to develop instruments and protocols in order to improve the specific skills of professionals involved in the assessment process. This article aims to describe the development and implementation of HIA guidelines, promoted by the Italian National Agency for Regional Health Services (AGENAS), in 4 Southern Italian regions. Public health search engine and institutional Web sites were consulted to collect international data existing in this field. Monthly workshops were then organized with regional representatives to discuss the scientific literature and to identify the guidelines' contents: source of data, stakeholders, screening- and scoping-phase checklist tools, priority areas, monitoring, and reporting plans. Four regions (Calabria, Campania, Puglia, and Sicilia) took part in the project. This article describes the methodology of development and implementation of HIA guidelines in the Italian context. The tools created to collect data and assess health consequences (such as screening and scoping grids) are reported. This project represents the first structured initiative proposed and supported by the Ministry of Health aiming to introduce HIA in Italy. HIA should be considered a priority in the public health agenda, as a fundamental instrument in helping decision makers to make choices about alternatives to prevent disease/injury and to actively promote health. PMID:26125232

  19. Views of Mental Health: A First Step in Needs Assessment.

    ERIC Educational Resources Information Center

    Ronald, Linda; And Others

    Mental health professionals and the general public have generally held differing attitudes toward mental illness. As part of a needs assessment survey, 102 persons (20 service providers, 20 referral persons, and 62 potential consumers) were interviewed concerning their views of mental health problems and services. Respondents first listed examples…

  20. TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    Humans are exposed to a variety of environmental toxicants, and this together with a large number of interacting factors can contribute to an individual's risk for health. To understand the toxic mechanisms and/or modes of action for human health risk assessment, molecular charac...

  1. A programme for Health Impact Assessment in Brighton and Hove.

    PubMed

    Scanlon, Thomas J; Lawrence, Lydie; Blair-Stevens, Terry; Nichols, Sarah

    2006-01-01

    HIA is based on the theory of health determinants, which recognizes that well-being is determined by a wide range of economic, social and environmental factors, by heredity and medical intervention. The intended HIA procedure represents a new approach to the evaluation of all local authority policies in order to assess their potential health impacts and to improve the quality of governmental decisions, through recommendations to enhance predicted positive health impacts and minimize negative ones. PMID:17191538

  2. A semantic approach for digital long-term preservation of electronic health documents.

    PubMed

    Kiefer, Stephan; Schäfer, Michael; Rauch, Jochen

    2012-01-01

    Long-term preservation of electronic patient health information is a key issue for life-long electronic health records, however, it is poorly implemented in healthcare institutions and little attention is given to problems like obsolescence of formats and EHR applications or changing regulations, which jeopardize reusability of information after decades of preservation. We present in this paper an ontology driven approach to digital preservation and related metadata management which seems to be superior to conventional concepts of the digital library world. PMID:22874193

  3. Profile: the National Documentation Centre for Family Planning of India's National Institute of Health and Family Welfare.

    PubMed

    1991-12-01

    In 1974, the National Documentation Centre for Family Planning was founded at India's National Institute of Health and Family Welfare with funds from the government and the UN Population Fund (UNFPA) to provide reliable population information to policy makers, planners, administrators for program development as well as to academics, researchers, students, and social workers engaged in population issues. Data collected from states and districts by the Ministry of Health and Family Welfare are disseminated through publications. The Centre receives documents from other Indian research entities and from foreign bodies. The existing collection consists of 40,000 books and monographs, 10,000 periodicals and journals, 450 current journals, 2000 institutional publications, 1000 annual reports, and 5000 fugitive material items. A data base containing this collected material has the purpose of generating various publications, and full copies of originals are provided at request. WHO designated the Centre a resource center for primary health care information. It is a linchpin of the Asia-Pacific POPIN network. Requests are frequent for information on family welfare program management. Dissemination includes information packages, annotated bibliographies, synthesized information, case studies, and field experience reports. The staff includes subject specialists, communication experts, and software and management specialists. 54 health and family welfare training centers have been involved in information activities since 1985. Exchange of information with population research centers has started by means of computer networking. Local area networks are developed with science libraries of major cities. DELNET (Delhi Library Network) launched a resource-sharing effort of health and family planning libraries. The creation of a National Population Information Database is also planned by the establishment of POPIN-India. PMID:12286547

  4. An Assessment of Environmental Health Needs for Manned Spacecraft

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. Environmental monitoring coupled with other measures including active and passive controls and the implementation of environmental standards (SMACs, SWEGs, microbial and acoustics limits) are used to ensure environmental health in manned spacecraft. NASA scientists and engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. Environmental monitoring data confirms the health of ECLS systems, in addition to contributing to the management of the health of human systems. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in knowledge and technology, required to address those risks, were identified for various types of Exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of this assessment and findings are presented in this paper.

  5. Assessing the risks of trace gases that can modify the stratosphere. Volume 6. Technical support documentation production projections

    SciTech Connect

    Hoffman, J.S.

    1987-12-01

    This document is one of a series that examines the human health, environmental, and atmospheric risks associated with a decrease in stratospheric ozone. This volume includes reports on: Probabilistic projections of chlorofluorocarbon consumption; Scenarios of chlorofluorocarbon use: 1985-2075; Product uses and market trends for potential ozone depleting substance 1985-2000; and An analytic method for constructing scenarios from a subjective joint possibility distribution.

  6. Compounding conservatisms: EPA's health risk assessment methods

    SciTech Connect

    Stackelberg, K. von; Burmaster, D.E. )

    1993-03-01

    Superfund conjures up images of hazardous waste sites, which EPA is spending billions of dollars to remediate. One of the law's most worrisome effects is that it drains enormous economic resources without returning commensurate benefits. In a Sept. 1, 1991, front page article in The New York Times, experts argued that most health dangers at Superfund sites could be eliminated for a fraction of the billions that will be spent cleaning up the 1,200 high-priority sites across the country. Even EPA has suggested that the Superfund program may receive disproportionate resources, compared with other public health programs, such as radon in houses, the diminishing ozone layer and occupational diseases. Public opinion polls over the last decade consistently have mirrored the public's vast fear of hazardous waste sites, a fear as great as that held for nuclear power plants. Fear notwithstanding, the high cost of chosen remedies at given sites may have less to do with public health goals than with the method EPA uses to translate them into acceptable contaminant concentrations in soil, groundwater and other environmental media.

  7. Documenting nursing and health care history in the mid-Atlantic region.

    PubMed

    Weinberg, D M

    1993-01-01

    The records of health care institutions can be of great value to library patrons. Yet, librarians rarely provide these unique resources because records must be collected, arranged, and described before they can be useful to patrons. The University of Pennsylvania's Center for the Study of the History of Nursing conducted a survey of health care agencies in the mid-Atlantic region to locate records created by area health care institutions. The goals of this project were to develop a database of primary source materials, to place organizational records with enduring value at suitable repositories, and to assist in the development of in-house archival programs at agencies keeping records. In-house programs provide health care institutions with a systematic way to preserve their records for administrative, legal, fiscal, and research use. Such programs also facilitate access to information, reduce cost through records management, and promote an institution through preservation and use of its historical records. The survey demonstrated that record keeping is not coordinated in most institutions, and that institutional awareness of the organization or content of records is minimal. PMID:8428186

  8. 75 FR 2145 - Draft Guidance for Industry on Tobacco Health Document Submission; Availability; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... Register of December 28, 2009 (74 FR 68629). The notice announced the availability of a draft guidance...., Rockville, MD 20850-3229, 240-276-1717, May.Nelson@fda.hhs.gov . SUPPLEMENTARY INFORMATION: In FR Doc. E9... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Tobacco Health...

  9. Legacy of Health: Documentary Photographs of the Panama Canal Construction. Teaching with Documents.

    ERIC Educational Resources Information Center

    Schamel, Wynell; Potter, Lee Ann; West, Jean M., Ed.

    2000-01-01

    Provides information on the health issues during the construction of the Panama Canal, focusing on issues such as the identification of mosquitoes as carriers of yellow fever and malaria and the role of Colonel William Crawford Gorgas in the battle against mosquito-born disease. Includes teaching activities. (CMK)

  10. Partnership at the Forefront of Change: Documenting the Transformation of Child and Youth Mental Health Services in Quebec

    PubMed Central

    Nadeau, Lucie; Jaimes, Annie; Rousseau, Cécile; Papazian-Zohrabian, Garine; Germain, Kateri; Broadhurst, Joanna; Battaglini, Alex; Measham, Toby

    2012-01-01

    Objective: The Quebec Plan d’action en santé mentale (PASM) (Mental Health Action Plan) reform, a major transformation of the province’s mental health care system, has put primary care rather than hospital-based care at the forefront of mental health service delivery. This study documents perceptions of changes in child and youth mental health (CYMH) services following the reform, as well as facilitators and obstacles to collaboration and partnership in CYMH services, and the specific challenges related to collaboration and partnership when servicing multi-ethnic populations. Methods: This qualitative participatory research study collected data using semi-structured individual interviews, focus groups and participant observation in community-based health and social service institutions. Thematic analysis was performed. Results: The reform process encountered challenges in building a common culture of care within and between institutions, while collaboration and partnership evolved in a positive direction throughout the study. Study results highlighted the importance of fostering communication at all levels. Collaboration and partnership was facilitated by opportunities for clinical discussions, dialogue on models of care, harmonizing administrative and clinical priorities, and involving key actors and structures. The results revealed difficulties in implementing multidisciplinary work and in negotiating partners’ responsibilities. Quality of partnership and collaboration appeared particularly crucial in providing optimal care to vulnerable families, including migrants. Conclusion: The PASM reform involved a major and challenging transformation in CYMH services. Continuous dialogue through time and leadership sharing appeared promising to foster this transformation. PMID:22548105

  11. Integration of site-specific health information: Agency for Toxic Substances and Disease Registry health assessments

    SciTech Connect

    Lesperance, A.M.; Siegel, M.R.

    1990-12-01

    The Agency for Toxic Substances and Disease Registry is required to conduct a health assessment of any site that is listed on or proposed for the US Environmental Protection Agency's National Priorities List. Sixteen US Department of Energy (DOE) sites currently fall into this category. Health assessments contain a qualitative description of impacts to public health and the environment from hazardous waste sites, as well as recommendations for actions to mitigate or eliminate risk. Because these recommendations may have major impacts on compliance activities at DOE facilities, the health assessments are an important source of information for the monitoring activities of DOE's Office of Environmental Compliance (OEC). This report provides an overview of the activities involved in preparing the health assessment, its role in environmental management, and its key elements.

  12. Evaluation of a mHealth Data Quality Intervention to Improve Documentation of Pregnancy Outcomes by Health Surveillance Assistants in Malawi: A Cluster Randomized Trial

    PubMed Central

    Joos, Olga; Silva, Romesh; Amouzou, Agbessi; Moulton, Lawrence H.; Perin, Jamie; Bryce, Jennifer; Mullany, Luke C.

    2016-01-01

    Background While community health workers are being recognized as an integral work force with growing responsibilities, increased demands can potentially affect motivation and performance. The ubiquity of mobile phones, even in hard-to-reach communities, has facilitated the pursuit of novel approaches to support community health workers beyond traditional modes of supervision, job aids, in-service training, and material compensation. We tested whether supportive short message services (SMS) could improve reporting of pregnancies and pregnancy outcomes among community health workers (Health Surveillance Assistants, or HSAs) in Malawi. Methods and Findings We designed a set of one-way SMS that were sent to HSAs on a regular basis during a 12-month period. We tested the effectiveness of the cluster-randomized intervention in improving the complete documentation of a pregnancy. We defined complete documentation as a pregnancy for which a specific outcome was recorded. HSAs in the treatment group received motivational and data quality SMS. HSAs in the control group received only motivational SMS. During baseline and intervention periods, we matched reported pregnancies to reported outcomes to determine if reporting of matched pregnancies differed between groups and by period. The trial is registered as ISCTRN24785657. Conclusions Study results show that the mHealth intervention improved the documentation of matched pregnancies in both the treatment (OR 1.31, 95% CI: 1.10–1.55, p<0.01) and control (OR 1.46, 95% CI: 1.11–1.91, p = 0.01) groups relative to the baseline period, despite differences in SMS content between groups. The results should be interpreted with caution given that the study was underpowered. We did not find a statistically significant difference in matched pregnancy documentation between groups during the intervention period (OR 0.94, 95% CI: 0.63–1.38, p = 0.74). mHealth applications have the potential to improve the tracking and data quality of

  13. Environmental assessment of the relocation of Neutron Tube Target Loading Operations. Final document

    SciTech Connect

    1995-12-11

    Neutron Tube Target Loading (NTTL) is an operation that involves the transferring (i.e. loading) of radioactive tritium gas onto metal target disks under an inert nitrogen atmosphere using a glovebox operation. The relocation of NTTL operations from the Pinellas Plant to the Los Alamos National Laboratory (LANL) in Los Alamos, New Mexico, was addressed in the Non-nuclear Consolidation Environmental Assessment (EA) of June 1993. This EA analyzes a Proposed Action to relocate the NTTL operations at LANL from Building 209 at TA-21 to Building 450 at TA-16. The Proposed Action would require the remodeling of Building 450 and some modifications to Buildings 205 and 205A, collectively referred to as the Weapons Engineering Tritium Facility (WETF) in TA-16. The construction of a change room addition would also be required to connect Building 450 and the WETF to take advantage of existing tritium control and confinement systems. Other construction activities and site modifications would include a new electrical substation, a new mechanical and electrical room, minor demolition work, two additional transportable buildings and a new parking area. An alternative to the Proposed Action includes keeping the NTTL operations at TA-21 (No Action). Alternatives considered but dismissed include the construction of a new NTTL laboratory at LANL, and the renovation of an alternative facility to Building 450 for conducting NTTL operations. None of the alternatives would enable the DOE to meet its mission responsibilities at LANL in a timely manner. The principle environmental issues associated with the Proposed Action include a minor amount of air emissions associated with construction activities and tritium operations and a small quantity of construction and low-level radioactive wastes. Human health and cumulative effects are expected to be negligible. On-site transportation of tritium between TA-21 and TA-16 to support NTTL operations would be eliminated.

  14. WATERSHED HEALTH ASSESSMENT TOOLS-INVESTIGATING FISHERIES (WHAT-IF): A MODELING TOOLKIT FOR WATERSHED AND FISHERIES MANAGEMENT

    EPA Science Inventory

    The Watershed Health Assessment Tools-Investigating Fisheries (WHAT-IF) is a decision-analysis modeling toolkit for personal computers that supports watershed and fisheries management. The WHAT-IF toolkit includes a relational database, help-system functions and documentation, a...

  15. Health Impact Assessment (HIA) and EnviroAtlas: Integrating Ecosystem Services into the Decision-Making Process-Guide

    EPA Science Inventory

    This document was created to highlight the many ways that the U.S. EPA EnviroAtlas suite of ecosystem services tools can be used to aid in the Health Impact Assessment (HIA) process. Ecosystems provide numerous services and benefits to individuals, communities, businesses, and ot...

  16. 76 FR 39399 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... AGENCY Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Notice of Availability... availability of EPA's preliminary human health risk assessment for the registration review of chlorpyrifos and... comprehensive preliminary human health risk assessment for all chlorpyrifos uses. After reviewing...

  17. [Health technology assessment agencies in the xxi century].

    PubMed

    Argimon, Josep Maria

    2015-11-01

    The origins of the health technology assessment (HTA) agencies date back to the 70s in the United States; in the European context, the current Agency for Quality and Health Assessment of Catalonia was among the pioneers in 1991. Epidemiological, social, technological and economic changes of recent years have led to the incorporation, by the agencies, of new functions, activities and projects that can offer better services (information and knowledge) to the various players in the healthcare system (patients, professionals, providers, insurers and policy-makers) in order to increase healthcare quality and preserve the sustainability of the health system. PMID:26711062

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

    PubMed Central

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

    2014-01-01

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

  19. Assessment of the health impacts of climate change in Kiribati.

    PubMed

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

    2014-05-01

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

  20. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  1. The effectiveness of an abuse assessment protocol in public health prenatal clinics.

    PubMed Central

    Wiist, W H; McFarlane, J

    1999-01-01

    OBJECTIVES: This study evaluated whether incorporation of an abuse assessment protocol into the routine procedures of the prenatal clinics of a large urban public health department led to increased referral for and assessment, identification, and documentation of abuse. METHODS: Evaluation was conducted at 3 matched prenatal clinics serving a total of 12,000 maternity patients per year. Two clinics used the abuse protocol and 1 did not. An audit was performed at the clinics on a randomly selected sample of 540 maternity patient charts for the 15 months before the protocol was initiated and of 540 records for the 15 months after the protocol was introduced. Ninety-six percent of the patients represented in the sample were Latina. RESULTS: At the clinics using the protocol, abuse assessment increased from 0 to 88%. Detection of abuse increased from 0.8% to 7%. There were no changes at the comparison clinic. CONCLUSIONS: Incorporation of an abuse assessment protocol into the routine procedures of public health department prenatal clinics increases the assessment, identification, and documentation of and referral for abuse among pregnant women. An abuse protocol should be a routine part of maternity care. PMID:10432909

  2. Assessing the social and physical determinants of circumpolar population health

    PubMed Central

    Driscoll, David L.; Dotterrer, Bruce; Brown, Richard A.

    2013-01-01

    Introduction Systematic reviews of the social and physical determinants of health provide metrics for evaluation of programs to mitigate health disparities. Previous meta-analyses of the population health literature have identified several proximate social and physical determinants of population health in the circumpolar north including addiction, environmental exposures, diet/nutrition and global climate change. Proximate health determinants are most amenable to early detection and modification or mitigation through disease prevention or health promotion interventions. Design There is a need for research to replicate these findings based on the latest science. This presentation describes a study applying Dahlgren and Whitehead's (1991) socio-ecological model of health determinants to identify the proximate social and physical determinants of health in the circumpolar north. Methods The study consisted of a systematic review of recent studies that link determinants of health with the leading causes of mortality and morbidity in Alaska. Our search strategy employed a keyword search using the Circumpolar Health Bibliographic Database (CHBD) and 4 databases within the Web of Knowledge (WoK) data gateway. Keywords included various terms for the arctic, all relevant nations and territories within the region, as well as leading health outcomes. Results Studies meeting the following inclusion criteria were reviewed: original research within a circumpolar population, published in English during 2011, and involving a rigorous demonstration of a link between a social determinant and selected health outcomes. Conclusions Study conclusions includes a list of determinants identified, their associated outcomes and the study designs implemented to assess that association. PMID:23986893

  3. National Public Health Performance Standards assessment: first steps in strengthening North Dakota's public health system.

    PubMed

    Baird, John R; Carlson, Kelly J

    2005-01-01

    North Dakota, as a rural state with a decentralized public health system, has found the National Public Health Performance Standards Program useful in assessing performance of the state's public health system. The local instrument was used for local public health systems and on Native American reservations. A description of the process as well as aggregated results of the local performance assessment is presented. An importance ranking scale was combined with the performance scores to identify priority areas. Priority needs were specifically identified for developing community health profiles, working more closely with community partnerships, and increasing emphasis on health education activities. The process was a good opportunity for bringing partners together in local public health systems and for developing interest in using the more complete strategic planning tools in Mobilizing for Action through Planning and Partnerships. PMID:16103817

  4. Health technology assessment: an evidence-based medicine perspective.

    PubMed

    Glasziou, Paul

    2012-01-01

    A challenge of health technology assessment is integrating the information from different disciplines. This talk focuses on the evidence-based medicine perspective and challenges 3 assumptions of health technology assessment: assumptions about effectiveness, assumptions about coverage by health technology assessment, and assumptions about costs being immutable. Challenging these assumptions has several implications. First is the need for better evidence on effects: both low-volume, high-cost technologies and low-cost, high-volume technologies that are ineffective drains on health care systems' resources. Second, cheap but effective technologies should be better promoted, as they can displace high-cost technologies. Finally, for effective but expensive technologies, we should work to lower the price and/or costs. PMID:22040831

  5. Assessment of health impacts in electricity generation and use

    SciTech Connect

    Morris, S.C.

    1995-11-01

    This paper describes the health effects of concern associated with electricity generation, information from which health effects can be estimated, and how the boundaries of analysis are determined. It also describes advances, new approaches, and trends in the risk assessment process. It discusses the application of these advances to comparative risk studies. Trends in the risk assessment process include more explicit characterization of quantitative uncertainty, the broader application and acceptance of Monte Carlo analysis and other numerical methods to the propagation of uncertainties through the analysis, greater realism in risk assessment, and the application of greatly increased computational capabilities.

  6. Health technology assessment: Off-site sterilization

    PubMed Central

    Dehnavieh, Reza; Mirshekari, Nadia; Ghasemi, Sara; Goudarzi, Reza; Haghdoost, AliAkbar; Mehrolhassani, Mohammad Hossain; Moshkani, Zahra; Noori Hekmat, Somayeh

    2016-01-01

    Background: Every year millions of dollars are expended to equip and maintain the hospital sterilization centers, and our country is not an exception of this matter. According to this, it is important to use more effective technologies and methods in health system in order to reach more effectiveness and saving in costs. This study was conducted with the aim of evaluating the technology of regional sterilization centers. Methods: This study was done in four steps. At the first step, safety and effectiveness of technology was studied via systematic study of evidence. The next step was done to evaluate the economical aspect of off-site sterilization technology using gathered data from systematic review of the texts which were related to the technology and costs of off-site and in-site hospital sterilization. Third step was conducted to collect experiences of using technology in some selected hospitals around the world. And in the last step different aspects of acceptance and use of this technology in Iran were evaluated. Results: Review of the selected articles indicated that efficacy and effectiveness of this technology is Confirmed. The results also showed that using this method is not economical in Iran. Conclusion: According to the revealed evidences and also cost analysis, due to shortage of necessary substructures and economical aspect, installing the off-site sterilization health technology in hospitals is not possible currently. But this method can be used to provide sterilization services for clinics and outpatients centers. PMID:27390714

  7. Community Health Risk Assessment of Primary Aluminum Smelter Emissions

    PubMed Central

    Larivière, Claude

    2014-01-01

    Objective: Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. Methods: We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted. Results: On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. Conclusions: It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data. PMID:24806724

  8. Assessment in health psychology: Introduction to the special issue.

    PubMed

    Butt, Zeeshan

    2016-09-01

    For the past 27 years, has been committed to publishing empirical research relevant to clinical assessment of basic and applied cognition, personality, interpersonal behavior, psychopathology, forensics, and biological psychology. There is growing interest in the use of patient-centered outcomes in medical/surgical care and for measuring health care performance. Patient-centered outcome measures complement traditional clinical outcomes of morbidity and mortality, capturing the patient's perspective regarding their health and its treatment. In this issue, we highlight 11 articles that address different aspects of such work. The articles in this special issue represent both the depth and breadth of the opportunities that exist for psychological assessment in the health setting. While there are countless patient-centered measures currently in use to measure health and health outcomes, the evidence base for their use can be quite variable (Butt, 2016). The hope is that future issues of will highlight more work in this area. (PsycINFO Database Record PMID:27536998

  9. Assessing human health risk in the USDA forest service

    SciTech Connect

    Hamel, D.R.

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  10. Lack of data drives uncertainty in PCB health risk assessments.

    PubMed

    Cogliano, Vincent James

    2016-02-01

    Health risk assessments generally involve many extrapolations: for example, from animals to humans or from high doses to lower doses. Health risk assessments for PCBs involve all the usual uncertainties, plus additional uncertainties due to the nature of PCBs as a dynamic, complex mixture. Environmental processes alter PCB mixtures after release into the environment, so that people are exposed to mixtures that might not resemble the mixtures where there are toxicity data. This paper discusses the evolution of understanding in assessments of the cancer and noncancer effects of PCBs. It identifies where a lack of data in the past contributed to significant uncertainty and where new data subsequently altered the prevailing understanding of the toxicity of PCB mixtures, either qualitatively or quantitatively. Finally, the paper identifies some uncertainties remaining for current PCB health assessments, particularly those that result from a lack of data on exposure through nursing or on effects from inhalation of PCBs. PMID:26347413

  11. Public health assessment for Richardson Flat Tailings, Park City, Summit County, Utah, Region 8. Cerclis No. UTD980952840. Addendum. Preliminary report

    SciTech Connect

    Not Available

    1994-03-03

    The document is an addendum to the preliminary public health assessment prepared for the Richardson Flat Tailings site by the Agency for Toxic Substances and Disease Registry (ATSDR) in July 1990 (PB90-260092). ATSDR's Health Activities Recommendation Panel (HARP) has evaluated the data and information developed in the Richardson Flat Tailings Public Health Assessment. The panel determined that, because of the apparent lack of past and present public health hazards and community health concerns, no follow-up health activities are indicated at this time.

  12. Environment, safety and health progress assessment manual. Volume 2, Appendices

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES&H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ``more focused, concentrating on ES&H management, ES&H corrective actions, self-assessment programs, and root-cause related issues.`` In July 1991, the Secretary approved the initiation of ES&H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES&H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual.

  13. Summaries and Technical Documentation for Performance Changes in Citizenship and Social Studies Assessments, 1969-76.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

    This report summarizes changes in student performance in the areas of citizenship and social studies, as measured by the National Assessment of Educational Progress. An initial assessment of citizenship was conducted in 1969-70, and an initial assessment of social studies was conducted in 1971-72. Both areas were reassessed in 1975-76. Because…

  14. Future Follow Through Documentation and Research: The Assessment of Academic/Cognitive Abilities of Black Children.

    ERIC Educational Resources Information Center

    Miller-Jones, Dalton

    Offering guidelines for future Follow Through program design, documentation, and evaluation, this paper examines the bases of criticisms of standardized tests, describes learning characteristics of black children, and briefly enunciates a system for Follow Through evaluation efforts. Discussion of standardized tests addresses the following…

  15. Assessment challenges in competency-based education: A case study in health professions education.

    PubMed

    Fitzgerald, James T; Burkhardt, John C; Kasten, Steven J; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Tsai, Antonius; Vasquez, John A; Gruppen, Larry D

    2016-05-01

    There is a growing demand for health sciences faculty with formal training in education. Addressing this need, the University of Michigan Medical School created a Master in Health Professions Education (UM-MHPE). The UM-MHPE is a competency-based education (CBE) program targeting professionals. The program is individualized and adaptive to the learner's situation using personal mentoring. Critical to CBE is an assessment process that accurately and reliably determines a learner's competence in educational domains. The program's assessment method has two principal components: an independent assessment committee and a learner repository. Learners submit evidence of competence that is evaluated by three independent assessors. The assessments are presented to an Assessment Committee who determines whether the submission provides evidence of competence. The learner receives feedback on the submission and, if needed, the actions needed to reach competency. During the program's first year, six learners presented 10 submissions for review. Assessing learners in a competency-based program has created challenges; setting standards that are not readily quantifiable is difficult. However, we argue it is a more genuine form of assessment and that this process could be adapted for use within most competency-based formats. While our approach is demanding, we document practical learning outcomes that assess competence. PMID:26052881

  16. NASA Occupational Health Program FY98 Self-Assessment

    NASA Technical Reports Server (NTRS)

    Brisbin, Steven G.

    1999-01-01

    The NASA Functional Management Review process requires that each NASA Center conduct self-assessments of each functional area. Self-Assessments were completed in June 1998 and results were presented during this conference session. During FY 97 NASA Occupational Health Assessment Team activities, a decision was made to refine the NASA Self-Assessment Process. NASA Centers were involved in the ISO registration process at that time and wanted to use the management systems approach to evaluate their occupational health programs. This approach appeared to be more consistent with NASA's management philosophy and would likely confer status needed by Senior Agency Management for the program. During FY 98 the Agency Occupational Health Program Office developed a revised self-assessment methodology based on the Occupational Health and Safety Management System developed by the American Industrial Hygiene Association. This process was distributed to NASA Centers in March 1998 and completed in June 1998. The Center Self Assessment data will provide an essential baseline on the status of OHP management processes at NASA Centers. That baseline will be presented to Enterprise Associate Administrators and DASHO on September 22, 1998 and used as a basis for discussion during FY 99 visits to NASA Centers. The process surfaced several key management system elements warranting further support from the Lead Center. Input and feedback from NASA Centers will be essential to defining and refining future self assessment efforts.

  17. Editorial: Lead Risk Assessment and Health Effects

    PubMed Central

    Mielke, Howard W.

    2016-01-01

    In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  18. Editorial: Lead Risk Assessment and Health Effects.

    PubMed

    Mielke, Howard W

    2016-01-01

    In 1980, Clair C. Patterson stated: "Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century". We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson's statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  19. The "SMART Travel Health" Mobile Application Assessment.

    PubMed

    Gallos, Parisis; Mantas, John

    2015-01-01

    An empirical study was conducted to evaluate the users' perception on a pilot mobile application ("SMART Travel Health"), their attitude towards use, and their intention to use it. A theoretical model was constructed based on TAM and other related works. The population was 88 travellers who used the pilot application. Data analysis was performed using partial least squares path modeling. Results highlight the very strong significant effect of perceived ease of use to perceived usefulness, the strong significant effect of perceived usefulness to attitude towards use, as well as, the significant effect of perceived ease of use to attitude towards using the application. Also, the strong significant effect of attitude towards use to behavioral intention to use is presenting the positive perception of the population about this mobile application. PMID:26153000

  20. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    PubMed

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network. PMID:27222729

  1. [Health situation of the armies in the Crimean war and a document related to this].

    PubMed

    Dağlar, Oya

    2004-01-01

    Although the Crimean War seems to be a war between the Ottoman and Russian with the support of England an France, in reality, it was a power struggle between the biggest European countries. The cooperation between England - Ottoman Empire and France in the Crimean War meanly determined the result of the war. The Crimean War should not only be evaluated in militarian and political aspect, but also from other perspectives. One of the most important problems for the allied armies in Istanbul and Crimea was related to the health concepts. During the two years long war, problems were the freezing cold and contagious diseases before the Russian soldiers. And thypus, scorbut, cholera and malaria prepears the dead of a large number of soldiers. Although the allied armies won the battle but all the sides fighting in the was lost many people due to contagious diseases. According to the resources, the contagious diseases such as, thypus, cholera and malaria led to the deads of more than ten times of the people who were in the battle field. Thats why, The European armies understood the importance of the treatment diseases in the war and gave importance to the development of military medical services and form this point, the Crimean War became the begining of an important development in military health concept. PMID:15487045

  2. Some Insights on Grassland Health Assessment Based on Remote Sensing

    PubMed Central

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  3. Some insights on grassland health assessment based on remote sensing.

    PubMed

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  4. AIR QUALITY CRITERIA DOCUMENT(S) FOR LEAD

    EPA Science Inventory

    This collection of documents intend to assess the latest scientific information on the health and environmental fate and effects of lead to provide scientific bases for periodic review and possible revision of the National Ambient Air Quality Standards (NAAQS) for lead.

  5. Assessing and responding to infant mental health needs.

    PubMed

    Cousins, Judy

    2013-09-01

    Early recognition of mental health problems in maltreated infants, coupled with tailored support to aid recovery, has the potential to offer significant benefits to a population whose needs have perhaps remained hidden in the past. All forms of maltreatment may adversely affect infant mental health, but perhaps none more so than emotional neglect. Universal contact with families with young children makes health visitors ideally placed to provide early support to this vulnerable group, but such practice requires considerable knowledge and understanding. This paper examines how emotional neglect can impact on an infant's mental health and explores how health visitors can assess and respond effectively to this key health need. Throughout, the term 'infant' is used to describe children from birth to age three. PMID:24133942

  6. Health of North American forests: Stress and risk assessment

    SciTech Connect

    Smith, W.H. )

    1990-01-01

    The 1980s will be remembered by forest professionals as a decade of intense and widespread societal concern for the vitality and integrity of forest systems. Daily reports of tropical deforestation and temperate forest decline have heightened social consciousness of forest health. It is therefore appropriate, as we enter the 1990s, to assess the health of our forests and propose new initiatives in this critically important area. Making generalizations about the health of North American forests is difficult because of the extraordinary diversity of forests, management regimes, and stress factors. This overview article summarizes forest health fundamentals, significant health risks, and priorities in future forest health management for temperate forests of the United States.

  7. 42 CFR 90.4 - Contents of requests for health assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Contents of requests for health assessments. 90.4 Section 90.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  8. Health risk assessment of irradiated topaz

    SciTech Connect

    Nelson, J.W.; Baum, J.W. )

    1993-01-01

    Irradiated topaz gemstones are currently processed for color improvement by subjecting clear stones to neutron or high-energy electron irradiations, which leads to activation of trace elements in the stones. Assessment of the risk to consumers required the identification and quantification of the resultant radionuclides and the attendant exposure. Representative stones from Brazil, India, Nigeria, Sri Lanka were irradiated and analyzed for gamma ray and beta particle emissions, using sodium iodide and germanium spectrometers; and Geiger-Muller, plastic and liquid scintillation, autoradiography, and thermoluminescent-dosimetry measurement techniques. Based on these studies and other information derived from published literature, dose and related risk estimates were made for typical user conditions. New criteria and methods for routine assays for acceptable release, based on gross beta and gross photon emissions from the stones, were also developed.

  9. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for Ensuring Quality Implementation of Health Promotion Programs

    PubMed Central

    Taylor, Catherine R.; DiPietro, Natalie A.

    2012-01-01

    Objective. To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. Methods. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Results. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. Conclusion. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists’ contributions to public health. PMID:22412211

  10. Indochinese refugee health assessment and treatment.

    PubMed

    Sutherland, J E; Avant, R F; Franz, W B; Monzon, C M; Stark, N M

    1983-01-01

    Many Southeast Asian refugees have resettled in the United States. This report reviews data from 426 refugees who underwent comprehensive examination and treatment at the Mayo Clinic. Health problems identified were primarily selected contagious illnesses and stress syndromes with functional complaints. Counseling was necessary in 17 percent of adults for psychosomatic problems or psychiatric disorders. When family-planning issues were applicable and addressed, 80 percent of women chose some method of contraception. The prevalence rate of intestinal parasites was 82 percent, and pathogens necessitated persistent treatment and follow-up. Tuberculosis skin-sensitivity testing was positive in 54 percent; the risk of active disease warrants prophylactic treatment until age 35 years. Hepatitis antigen was positive in 13 percent; precautions should be taken for potentially exposed professionals. Hematologic genetic disorders were very common and accounted for most of the 25 percent incidence of microcytosis. Physicians should become aware of cultural attitudes and treatment acceptance among Indochinese patients and should carefully investigate for infectious diseases. PMID:6848638

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

    PubMed Central

    2010-01-01

    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. PMID:20515478

  12. E-health readiness assessment: promoting "hope" in the health-care institutions of Pakistan.

    PubMed

    Khoja, Shariq; Scott, Richard; Gilani, Salman

    2008-01-01

    e-Health readiness refers to the preparedness of health-care institutions to implement programmes that involve use of Information and Communication Technology (ICT) in provision and management of health services. Level of readiness depends on a number of factors that lead to success or failure of e-health programmes, and thus increase or decrease hope of achieving the desired results. This report presents results from in-depth interviews conducted during a larger study and presents views of managers and health-care providers from various institutions in Pakistan about the usefulness of e-health readiness assessment tools. Participants emphasized the need for implementing e-health programmes in the country, while appreciating the need for readiness assessment tools, and the way these tools could avoid failures related to implementation of e-health programmes. Participants also linked e-health readiness with the process of change management, essential for sustainable implementation of e-health programmes in the health-care institutions of developing countries. PMID:18549033

  13. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  14. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    ERIC Educational Resources Information Center

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  15. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    ERIC Educational Resources Information Center

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

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

    PubMed

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

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. PMID:27021760

  17. Health assessment in the Framingham Offspring Study: a research proposal.

    PubMed

    Berkeley, J L; Israel, I; Stokes, J

    1987-01-01

    This paper proposes that a broader health assessment be made in the Framingham Offspring/Spouse Study than is undertaken in the Framingham Study. The Offspring Study is composed of the children (and their spouses) of the members of the original Framingham Study cohort. The Offspring population has a broader age range and an average age that is approximately 30 years younger than the original parent cohort. Therefore, mortality and morbidity measures, which were used as indices of health status for the parent cohort and which focus on the negative "sickness" component of health, are less appropriate for use in this relatively healthy population. Thus, we propose a broader conceptual framework of health that emphasizes the positive "wellness" side of the health continuum. The essential components of the comprehensive health index we describe include global health perceptions, measures of physical, mental, and social functioning across valued social roles, the ability to withstand stress as mediated by the coping process and social resources, and the assessment of genetic, behavioral, and physiological risk factors. One purpose of the proposal is to stimulate discussion in the hope of achieving general agreement regarding a shared conceptual frame of reference that would guide the development and testing of a reliable and valid health status instrument. PMID:3597695

  18. Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testing

    PubMed Central

    Yost, Kathleen J.; Webster, Kimberly; Baker, David W.; Choi, Seung W.; Bode, Rita K.; Hahn, Elizabeth A.

    2009-01-01

    Objective Current health literacy measures are too long, imprecise, or have questionable equivalence of English and Spanish versions. The purpose of this paper is to describe the development and pilot testing of a new bilingual computer-based health literacy assessment tool. Methods We analyzed literacy data from three large studies. Using a working definition of health literacy, we developed new prose, document and quantitative items in English and Spanish. Items were pilot tested on 97 English- and 134 Spanish-speaking participants to assess item difficulty. Results Items covered topics relevant to primary care patients and providers. English- and Spanish-speaking participants understood the tasks involved in answering each type of question. The English Talking Touchscreen was easy to use and the English and Spanish items provided good coverage of the difficulty continuum. Conclusion Qualitative and quantitative results provided useful information on computer acceptability and initial item difficulty. After the items have been administered on the Talking Touchscreen (la Pantalla Parlanchina) to 600 English-speaking (and 600 Spanish-speaking) primary care patients, we will develop a computer adaptive test. Practice Implications This health literacy tool will enable clinicians and researchers to more precisely the level at which low health literacy adversely affects health and healthcare utilization. PMID:19386462

  19. Health impact assessment needs in south-east Asian countries.

    PubMed Central

    Caussy, Deoraj; Kumar, Priti; Than Sein, U.

    2003-01-01

    A situation analysis was undertaken to assess impediments to health impact assessment (HIA) in the South-East Asia Region of WHO (SEARO). The countries of the region were assessed on the policy framework and procedures for HIA, existing infrastructure required to support HIA, the capacity for undertaking HIA, and the potential for intersectoral collaboration. The findings show that environmental impact assessment (EIA) is being used implicitly as a substitute for HIA, which is not explicitly or routinely conducted in virtually all countries of the Region. Therefore, policy, infrastructure, capacity, and intersectoral collaboration need strengthening for the routine implementation of HIA. PMID:12894329

  20. Palau assessment for a continuing health care professional development program.

    PubMed

    Chen, Tai-Ho; Dever, Gregory; Kuartei, Stevenson; Maskarinec, Gregory G

    2007-03-01

    In 2003, the University of Hawai'i Department of Family Medicine and Community Health entered a 4-year cooperative agreement with the U.S. Health Resources and Services Administration to establish the "Pacific Association for Clinical Training" (PACT). PACT's goal is to develop effective distance education methods to improve the education and skills of health care professionals in the U.S.-Affiliated Pacific Island nations. To determine the situation existing in 2004, one of PACT's first projects was to perform site visits to each jurisdiction, conducting needs assessments through interviews with key health care professionals, hospital administrators and government officials. This article highlights findings of PACT's Palau assessment. Meant to establish a baseline for future reference, all data were collected in 2004-2005 and have not been updated. PMID:19772140

  1. Uncertainties associated with assessing the public health risk from Legionella

    PubMed Central

    Whiley, Harriet; Keegan, Alexandra; Fallowfield, Howard; Ross, Kirstin

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose, and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practices for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practices. PMID:25309526

  2. BASINS 4.0 CLIMATE ASSESSMENT TOOL (CAT): SUPPORTING DOCUMENTATION AND USER'S MANUAL (FINAL REPORT)

    EPA Science Inventory

    The U.S. Environmental Protection Agency’s Global Change Research Program (GCRP) is an assessment-oriented program within the Office of Research and Development that focuses on assessing how potential changes in climate and other global environmental stressors may impact water qu...

  3. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    PubMed Central

    Tawfik-Shukor, Ali R; Klazinga, Niek S; Arah, Onyebuchi A

    2007-01-01

    Background Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. Methods We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. Results Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans) does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. Conclusion To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed, before even attempting any

  4. Health technology assessment in Iran: challenges and views

    PubMed Central

    Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

    2014-01-01

    Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

  5. The Swedish Council on Technology Assessment in Health Care.

    PubMed

    Bloom, B S; Banta, H D; Gross, P F; Peña-Mohr, J; Sisk, J E; Stocking, B

    1989-01-01

    During its first year of operation (1988) the Swedish Council on Technology Assessment in Health Care focused on nine areas. Additional activities will be added as need requires and resources permit. Also, preparations for 1989 projects have begun. The nine areas include: identification of technologies needing assessment, including international comparisons; review and synthesis of the value of preoperative routines; review and synthesis of the value of gastroscopy for diagnosing stomach pain; assessment of different treatment methods for back pain; assessment of the value of vascular surgery for vascular spasms in the legs; organization of a strategy conference concerning medical technology assessment in Sweden; creation of a strategy that addresses an international review of medical technology, future technologies in health care, waiting lists for medical care--the importance of medical technology, resource utilization and organizational and educational aspects of introducing new technology in health care, and costs and medical technology; translation of foreign assessment studies, with comments; national and international cooperation. SCTA has discussed the need for assessing specific technology such as bone marrow transplantation and surgical treatment of epilepsy. SCTA's Scientific Advisory Committee has additionally considered the following subjects for future projects: medical, social, and economic consequences of alternative technologies screening for prostate, colorectal, breast, and cervical cancer; costs, indications, and medical benefit of surgery for varicose vains; and modern urology technologies, particularly those related to prostate care. PMID:10292538

  6. Practice and documentation of performance of colonoscopy in a central Canadian health region

    PubMed Central

    Singh, Harminder; Kaita, Lisa; Taylor, Gerry; Nugent, Zoann; Bernstein, Charles

    2014-01-01

    OBJECTIVE: To evaluate the reporting and performance of colonoscopy in a large urban centre. METHODS: Colonoscopies performed between January and April 2008 in community hospitals and academic centres in the Winnipeg Regional Health Authority (Manitoba) were identified from hospital discharge databases and retrospective review of a random sample of identified charts. Information regarding reporting of colonoscopies (including bowel preparation, photodocumentation of cecum/ileum, size, site, characteristics and method of polyp removal), colonoscopy completion rates and follow-up recommendations was extracted. Colonoscopy completion rates were compared among different groups of physicians. RESULTS: A total of 797 colonoscopies were evaluated. Several deficiencies in reporting were identified. For example, bowel preparation quality was reported in only 20%, the agent used for bowel preparation was recorded in 50%, photodocumentation of colonoscopy completion in 6% and polyp appearance (ie, pedunculated or not) in 34%, and polyp size in 66%. Although the overall colonoscopy completion rate was 92%, there was a significant difference among physicians with varying medical specialty training and volume of procedures performed. Recommendations for follow-up procedures (barium enema, computed tomography colonography or repeat colonoscopy) were recorded for a minority of individuals with reported poor bowel preparation or incomplete colonoscopy. CONCLUSIONS: The present study found many deficiencies in reporting of colonoscopy in typical, city-wide clinical practices. Colonoscopy completion rates varied among different physician specialties. There is an urgent need to adopt standardized colonoscopy reporting systems in everyday practice and to provide feedback to physicians regarding deficiencies so they can be rectified. PMID:24729991

  7. Environment, safety and health progress assessment of the Lawrence Livermore National Laboratory

    SciTech Connect

    Not Available

    1992-11-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES H) Progress Assessment of the Lawrence Livermore National Laboratory (LLNL) in Livermore, California. The onsite assessment, which was conducted from November 9 through November 20, 1992, included a selective review of the ES H management systems and programs with principal focus on the Office of the Assistant Secretary for Defense Programs (DP); San Francisco Field Office (SF), including the Livermore Site Office (LSO); and the site contractor, the University of California. The purpose of the LLNL ES H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES H issues and requirements. The assessment was not a comprehensive compliance assessment of ES H activities. The point of reference for assessing programs at LLNL was, for the most part, the Tiger Team Assessment of LLNL, which was conducted from February 26 through April 5, 1990. The LLNL Progress Assessment was conducted by a team of 12 professionals from various DOE offices and their support contractors, with expertise in the areas of management, environment, safety, and health. The Progress Assessment Team concluded that LLNL management recognizes the importance that the Secretary of Energy places on ES H excellence and has responded with improvements in all ES H areas. Progress has been made in addressing the deficiencies identified in the 1990 Tiger Team Assessment. Although much remains to be done and concerns were noted in several areas, these concerns do not diminish the significance of the progress made since the 1990 Tiger Team Assessment.

  8. Environment, safety and health progress assessment of the Lawrence Livermore National Laboratory

    SciTech Connect

    Not Available

    1992-11-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Lawrence Livermore National Laboratory (LLNL) in Livermore, California. The onsite assessment, which was conducted from November 9 through November 20, 1992, included a selective review of the ES&H management systems and programs with principal focus on the Office of the Assistant Secretary for Defense Programs (DP); San Francisco Field Office (SF), including the Livermore Site Office (LSO); and the site contractor, the University of California. The purpose of the LLNL ES&H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES&H issues and requirements. The assessment was not a comprehensive compliance assessment of ES&H activities. The point of reference for assessing programs at LLNL was, for the most part, the Tiger Team Assessment of LLNL, which was conducted from February 26 through April 5, 1990. The LLNL Progress Assessment was conducted by a team of 12 professionals from various DOE offices and their support contractors, with expertise in the areas of management, environment, safety, and health. The Progress Assessment Team concluded that LLNL management recognizes the importance that the Secretary of Energy places on ES&H excellence and has responded with improvements in all ES&H areas. Progress has been made in addressing the deficiencies identified in the 1990 Tiger Team Assessment. Although much remains to be done and concerns were noted in several areas, these concerns do not diminish the significance of the progress made since the 1990 Tiger Team Assessment.

  9. Probabilistic assessment of acute health symptoms related to pesticide use under intensified Nepalese agriculture.

    PubMed

    Atreya, Kishor

    2008-06-01

    Agriculture intensification has pushed farmers to use pesticides for maintaining agricultural productivity and to increase income. However, pesticide use has a significant negative impact on farmers' health. In Nepal, uses of pesticides have been already documented in agriculturally intensified areas, however, little is known on health impacts. Weekly interviews were conducted during 2005 to assess the emerging pesticide problems, estimate the magnitude of pesticide-related acute illness, and identify associated risk factors. The study showed that very few farmers have adopted safety gear during pesticide spraying. The safety measures regression shows that warm temperature and drinking habits significantly reduced adoption of safety gear, whereas, integrated pest management (IPM) training and farm experience increased its adoption. The dose-response analyses showed that use of insecticides or fungicides, spray duration and mixing pesticides significantly affect farmer's health, which could be reduced either by educating farmers, increasing the use of safety gear, or reducing mixtures applications. PMID:18569147

  10. Health technology assessment. Evaluation of biomedical innovative technologies.

    PubMed

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival. PMID:20659860

  11. Health Risk Assessment of Irradiated Topaz

    NASA Astrophysics Data System (ADS)

    Nelson, Kevin Lyle

    1991-06-01

    Radiation-produced blue topaz, indistinguishable from natural blue topaz, is produced by several different techniques. Published information on radionuclides present, activity levels, equipment necessary to detect activated nuclides and dosimetric assessment is lacking. Using a 60 megawatt nuclear reactor, fifty-one samples of colorless topaz from Nigeria, Sri Lanka, India and Brazil were irradiated with thermal and fast neutron fluences ranging from 1.8 times 10 13 to 9.2 times 1018 neutrons cm^{-2}. Seventeen MeV electrons produced by a linear accelerator were also used to irradiate 36 colorless topaz from the same countries. Gamma ray or positron-emitting nuclides were identified using calibrated well-type NaI or germanium detectors. For germanium detectors having relative efficiencies of approximately 20 percent, an analysis time of one hour or more was needed. Geiger Mueller (G-M) detectors, scintillators (plastic and liquid), gas flow proportional counters, a ZnS detector and autoradiography techniques were used to measure charged particle activity. Isotopes produced from neutron activation included 182Ta, ^ {59}Fe, 46Sc, 51Cr, 54Mn, 124Sb, ^{32 }P, 77As, ^ {183}Ta, 77Ge, 72Ga, and ^{24 }Na. Possible nuclides produced from 17 MeV electron treatment include ^{68 }Ga, 64Cu, ^ {49}Cr, and 18F. Positive identification of the electron activated nuclides was not possible because of the short half-lives involved (<1 day). Of the possible pure beta emitters activated during neutron bombardment, 32P and 35S are the most likely to be produced. The identification of 32P was made using a three point beta absorption analysis with a G-M detector. Skin and breast cancer risk estimates were calculated for various sized topaz containing NRC exempt concentration levels. When compared to a negligible individual risk level (NIRL) of 10^{-7}, the risk of an irradiated topaz in contact with the skin or three inches from breast tissue was a small fraction of the NIRL. At a risk

  12. Recommended Toxicity Equivalence Factors (TEFs) for Human Health Risk Assessments of 2,3,7,8-Tetrachlorodibenzo-p-dioxin and Dioxin-Like Compounds

    EPA Science Inventory

    The Risk Assessment Forum (RAF) Human Health TEFs document describes EPA’s updated approach for evaluating the human health risks from exposures to environmental media containing dioxin-like compounds. It recommends the use of consensus TEF values for 2,3,7,8-tetrachlorodibenzo-...

  13. Mental Health Screening and Assessment of Detained Youth.

    PubMed

    Soulier, Matthew; McBride, Anne

    2016-01-01

    The effective rehabilitation of detained youth begins with optimal screening of their mental health needs as they enter the juvenile delinquency system. The Massachusetts Youth Screening Instrument-Version 2 is the most used and empirically proven tool to screen juveniles. Juvenile facilities should consider the use of screening instruments like the Massachusetts Youth Screening Instrument-Version 2 as close to intake as feasible. Mental health professionals working in these systems of care will then need adequate resources to assess the mental health needs according to a biopsychosocial model of these youth. PMID:26593116

  14. Pohnpei, FSM case study in a global health project documents its local food resources and successfully promotes local food for health.

    PubMed

    Englberger, L; Kuhnlein, H V; Lorens, A; Pedrus, P; Albert, K; Currie, J; Pretrick, M; Jim, R; Kaufer, L

    2010-04-01

    This paper presents a summary of Pohnpei, Federated States Micronesia's involvement in a global health study focused on documenting traditional food systems in different parts of the world and providing evidence that local resources are critical for food security, nutrition and health. The Pohnpei study was based in Mand Community, Madolenihmw. The study found that there was a great diversity of foods locally available (381 food items documented), but these were underused. Overweight, obesity, diabetes, and vitamin A deficiency were identified as serious problems. Interventions included community meetings, school activities, and agriculture workshops, cooking classes, charcoal oven development, weight loss and planting competitions, poster campaigns and other relevant mass media. Significant dietary improvements were achieved following the intervention efforts, as well as positive changes in attitude towards local food including: decrease in average daily rice consumption from 846 g/person in 2005 to 544 g/person in 2007 (p = 0.0002); increase in provitamin A carotenoid intake from 227 microg/person in 2005 to 475 microg/person in 2007 (p = 0.02); increased frequency of consumption of local banana (53%), giant swamp taro (476%), local vegetables (130%); and increased dietary diversity (4.8 local food groups consumed in 2005 to 5.5 in 2007). Another positive outcome in Pohnpei was the popularization of the slogan "Let's Go Local." PMID:20968245

  15. Assessing Quality across Health Care Subsystems in Mexico

    PubMed Central

    Puig, Andrea; Pagán, José A.; Wong, Rebeca

    2012-01-01

    Recent healthcare reform efforts in Mexico have focused on the need to improve the efficiency and equity of a fragmented healthcare system. In light of these reform initiatives, there is a need to assess whether healthcare subsystems are effective at providing high-quality healthcare to all Mexicans. Nationally representative household survey data from the 2006 Encuesta Nacional de Salud y Nutrición (National Health and Nutrition Survey) were used to assess perceived healthcare quality across different subsystems. Using a sample of 7234 survey respondents, we found evidence of substantial heterogeneity in healthcare quality assessments across healthcare subsystems favoring private providers over social security institutions. These differences across subsystems remained even after adjusting for socioeconomic, demographic, and health factors. Our analysis suggests that improvements in efficiency and equity can be achieved by assessing the factors that contribute to heterogeneity in quality across subsystems. PMID:19305224

  16. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    NASA Technical Reports Server (NTRS)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

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

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

    SciTech Connect

    Harris-Roxas, Ben Harris, Elizabeth

    2011-07-15

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

  18. Reporting heterogeneity in self-assessed health among elderly Europeans

    PubMed Central

    2012-01-01

    Introduction Self-assessed health (SAH) is a frequently used measure of individuals’ health status. It is also prone to reporting heterogeneity. To control for reporting heterogeneity objective measures of true health need to be included in an analysis. The topic becomes even more complex for cross-country comparisons, as many key variables tend to vary strongly across countries, influenced by cultural and institutional differences. This study aims at exploring the key drivers for reporting heterogeneity in SAH in an international context. To this end, country specific effects are accounted for and the objective health measure is concretized, distinguishing effects of mental and physical health conditions. Methods We use panel data from the SHARE-project which provides a rich dataset on the elderly European population. To obtain distinct indicators for physical and mental health conditions two indices are constructed. Finally, to identify potential reporting heterogeneity in SAH a generalized ordered probit model is estimated. Results We find evidence that in addition to health behaviour, health care utilization, mental and physical health condition as well as country characteristics affect reporting behaviour. We conclude that observed and unobserved heterogeneity play an important role when analysing SAH and have to be taken into account. PMID:23036352

  19. A framework for assessing e-health preparedness.

    PubMed

    Wickramasinghe, Nilmini S; Fadlalla, Adam M A; Geisler, Elie; Schaffer, Jonathan L

    2005-01-01

    Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative. PMID:18048213

  20. Large area crop inventory experiment crop assessment subsystem software requirements document

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The functional data processing requirements are described for the Crop Assessment Subsystem of the Large Area Crop Inventory Experiment. These requirements are used as a guide for software development and implementation.

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

    SciTech Connect

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-07-15

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

  2. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    ERIC Educational Resources Information Center

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  3. [Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas].

    PubMed

    Roca Saumell, Carme; Soriano-Arandes, Antoni; Solsona Díaz, Lluís; Gascón Brustenga, Joaquim

    2015-05-01

    Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health. PMID:25704793

  4. Holistic health assessment tool for patients on maintenance hemodialysis.

    PubMed

    Singhania, P R; Mandalika, S

    2012-07-01

    The recent emphasis on assessment of the psychological status, availability of newer and better methods of interpreting the anthropometric measurements of renal patients on dialysis therapy prompted the authors to develop the "Holistic Health Assessment Tool for dialysis patients (HHAT-D)." A total of 30 subjects (25-65 years), enrolled from dialysis centers in Mumbai were administered the HHAT-D tool to assess anthropometric, biochemical, functional, and psychological status (knowledge, needs, that coping strategies) along with dietary intake. The results showed that majority of the patients (73.3%) were mild to moderately malnourished. A highly significant negative correlation of anthropometric measurements (BMI, lean body mass, mid arm circumference, arm muscle area, bicep skin fold thickness, % usual body weight, and % standard body weight) with the HHAT-D scores (P<0.01) confirmed the validity of the tool in assessing the degree of malnutrition. The poor health status of the patients was further confirmed by the average (40%) to poor (36.6%) flexibility status and poor dietary nutrient intake. Moderate (36.6%) to high (60%) coping effectiveness was recorded in the patients as assessed using the "coping effectiveness inventory." A high degree of interitem correlation (Cronbach's coefficient alpha-test value 0.836) also proved the reliability of the HHAT-D tool. Thus, the HHAT-D was found to be a specific and reliable tool for assessment of holistic health status of patients on maintenance hemodialysis to improve quality of life and facilitate faster recovery. PMID:23162270

  5. Best practices for assessing ocean health in multiple contexts using tailorable frameworks.

    PubMed

    Lowndes, Julia S Stewart; Pacheco, Erich J; Best, Benjamin D; Scarborough, Courtney; Longo, Catherine; Katona, Steven K; Halpern, Benjamin S

    2015-01-01

    Marine policy is increasingly calling for maintaining or restoring healthy oceans while human activities continue to intensify. Thus, successful prioritization and management of competing objectives requires a comprehensive assessment of the current state of the ocean. Unfortunately, assessment frameworks to define and quantify current ocean state are often site-specific, limited to a few ocean components, and difficult to reproduce in different geographies or even through time, limiting spatial or temporal comparisons as well as the potential for shared learning. Ideally, frameworks should be tailorable to accommodate use in disparate locations and contexts, removing the need to develop frameworks de novo and allowing efforts to focus on the assessments themselves to advise action. Here, we present some of our experiences using the Ocean Health Index (OHI) framework, a tailorable and repeatable approach that measures health of coupled human-ocean ecosystems in different contexts by accommodating differences in local environmental characteristics, cultural priorities, and information availability and quality. Since its development in 2012, eleven assessments using the OHI framework have been completed at global, national, and regional scales, four of which have been led by independent academic or government groups. We have found the following to be best practices for conducting assessments: Incorporate key characteristics and priorities into the assessment framework design before gathering information; Strategically define spatial boundaries to balance information availability and decision-making scales; Maintain the key characteristics and priorities of the assessment framework regardless of information limitations; and Document and share the assessment process, methods, and tools. These best practices are relevant to most ecosystem assessment processes, but also provide tangible guidance for assessments using the OHI framework. These recommendations also promote

  6. Best practices for assessing ocean health in multiple contexts using tailorable frameworks

    PubMed Central

    Pacheco, Erich J.; Best, Benjamin D.; Scarborough, Courtney; Longo, Catherine; Katona, Steven K.; Halpern, Benjamin S.

    2015-01-01

    Marine policy is increasingly calling for maintaining or restoring healthy oceans while human activities continue to intensify. Thus, successful prioritization and management of competing objectives requires a comprehensive assessment of the current state of the ocean. Unfortunately, assessment frameworks to define and quantify current ocean state are often site-specific, limited to a few ocean components, and difficult to reproduce in different geographies or even through time, limiting spatial or temporal comparisons as well as the potential for shared learning. Ideally, frameworks should be tailorable to accommodate use in disparate locations and contexts, removing the need to develop frameworks de novo and allowing efforts to focus on the assessments themselves to advise action. Here, we present some of our experiences using the Ocean Health Index (OHI) framework, a tailorable and repeatable approach that measures health of coupled human-ocean ecosystems in different contexts by accommodating differences in local environmental characteristics, cultural priorities, and information availability and quality. Since its development in 2012, eleven assessments using the OHI framework have been completed at global, national, and regional scales, four of which have been led by independent academic or government groups. We have found the following to be best practices for conducting assessments: Incorporate key characteristics and priorities into the assessment framework design before gathering information; Strategically define spatial boundaries to balance information availability and decision-making scales; Maintain the key characteristics and priorities of the assessment framework regardless of information limitations; and Document and share the assessment process, methods, and tools. These best practices are relevant to most ecosystem assessment processes, but also provide tangible guidance for assessments using the OHI framework. These recommendations also promote

  7. Assessing Students with Serious Mental Health and Behavioral Problems: Clinical Assessment for Educators.

    ERIC Educational Resources Information Center

    Hansen, Jo-Ida C.; Conlon, Amy L.

    The current intervention trend for many of the mental health and behavioral problems faced by today's youth is an integrative approach that involves the community, families, and schools. Clinical assessment for serious mental health and behavioral problems can be an important component in the development of school-based screening programs. The…

  8. Documenting and Assessing Dolphin Calls and Ambient and Anthropogenic Noise Levels via PAM and a SPL Meter.

    PubMed

    Dudzinski, Kathleen M; Melillo-Sweeting, Kelly; Gregg, Justin D

    2016-01-01

    Song Meter SM2M marine recorders were deployed to document dolphin calls and ambient and anthropogenic noise. Recordings from Bimini were split into 2-h segments; no segment was without dolphin calls. At Dolphin Encounters, average noise levels ranged from 110 to 125 dB; the highest source level was 147.98 dB re 1 μPa at 1 m. Average ambient-noise levels documented at 4 sites in Guam were below 118 dB re 1 μPa at 1 m. These data were compared with values from a custom-built sound pressure level (SPL) meter and confirm that the SM2M recorder is a useful tool for assessing animal calls and ambient and anthropogenic noise levels. PMID:26610966

  9. Use of Community Assessments for Public Health Emergency Response (CASPERs) to Rapidly Assess Public Health Issues — United States, 2003–2012

    PubMed Central

    Bayleyegn, Tesfaye M.; Schnall, Amy H.; Ballou, Shimere G.; Zane, David F.; Burrer, Sherry L.; Noe, Rebecca S.; Wolkin, Amy F.

    2015-01-01

    Introduction Community Assessment for Public Health Emergency Response (CASPER) is an epidemiologic technique designed to provide quick, inexpensive, accurate, and reliable household-based public health information about a community’s emergency response needs. The Health Studies Branch at the Centers for Disease Control and Prevention (CDC) provides in-field assistance and technical support to state, local, tribal, and territorial (SLTT) health departments in conducting CASPERs during a disaster response and in non-emergency settings. Data from CASPERs conducted from 2003 through 2012 were reviewed to describe uses of CASPER, ascertain strengths of the CASPER methodology, and highlight significant findings. Methods Through an assessment of the CDC’s CASPER metadatabase, all CASPERs that involved CDC support performed in US states and territories from 2003 through 2012 were reviewed and compared descriptively for differences in geographic distribution, sampling methodology, mapping tool, assessment settings, and result and action taken by decision makers. Results For the study period, 53 CASPERs were conducted in 13 states and one US territory. Among the 53 CASPERS, 38 (71.6%) used the traditional 2-stage cluster sampling methodology, 10 (18.8%) used a 3-stage cluster sampling, and two (3.7%) used a simple random sampling methodology. Among the CASPERs, 37 (69.9%) were conducted in response to specific natural or human-induced disasters, including 14 (37.8%) for hurricanes. The remaining 16 (30.1%) CASPERS were conducted in non-disaster settings to assess household preparedness levels or potential effects of a proposed plan or program. The most common recommendations resulting from a disaster-related CASPER were to educate the community on available resources (27; 72.9%) and provide services (18; 48.6%) such as debris removals and refills of medications. In preparedness CASPERs, the most common recommendations were to educate the community in disaster

  10. Lawrence Livermore National Laboratory RCRA (Resource Conservation and Recovery Act) Part B health risk assessment

    SciTech Connect

    Not Available

    1989-12-01

    The Lawrence Livermore National Laboratory (LLNL) operates several hazardous waste storage and treatment units including a hazardous waste incinerator for managing wastes generated by research programs. Research programs conducted at LLNL generate nonradioactive, radioactive, hazardous, and mixed wastes. LLNL operates several hazardous waste storage and treatment units including a hazardous waste incinerator. Because numerous storage and treatment operations are used to manage these wastes, it was necessary to conduct this health risk assessment. This document presents the results of a detailed evaluation of the hazardous and radioactive waste incinerator and associated waste feed tank. 200 refs., 5 figs., 53 tabs.

  11. LLNL (Lawrence Livermore National Laboratory) RCRA Part B incinerator health risk assessment

    SciTech Connect

    Not Available

    1989-12-01

    The Lawrence Livermore National Laboratory (LLNL) operates several hazardous waste storage and treatment units including a hazardous waste incinerator for managing wastes generated by research programs. Research programs conducted at LLNL generate nonradioactive, radioactive, hazardous, and mixed wastes. LLNL operates several hazardous waste storage and treatment units including a hazardous waste incinerator. Because numerous storage and treatment operations are used to manage these wastes, it was necessary to conduct this health risk assessment. This document presents the results of a detailed evaluation of the hazardous and radioactive waste incinerator and associated waste feed tank. This volume contains only appendices. 200 refs., 5 figs., 53 tabs.

  12. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    PubMed

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. PMID:26774008

  13. A new air quality perception scale for global assessment of air pollution health effects.

    PubMed

    Deguen, Séverine; Ségala, Claire; Pédrono, Gaëlle; Mesbah, Mounir

    2012-12-01

    Despite improvements in air quality in developed countries, air pollution remains a major public health issue. To fully assess the health impact, we must consider that air pollution exposure has both physical and psychological effects; this latter dimension, less documented, is more difficult to measure and subjective indicators constitute an appropriate alternative. In this context, this work presents the methodological development of a new scale to measure the perception of air quality, useful as an exposure or risk appraisal metric in public health contexts. On the basis of the responses from 2,522 subjects in eight French cities, psychometric methods are used to construct the scale from 22 items that assess risk perception (anxiety about health and quality of life) and the extent to which air pollution is a nuisance (sensorial perception and symptoms). The scale is robust, reproducible, and discriminates between subpopulations more susceptible to poor air pollution perception. The individual risk factors of poor air pollution perception are coherent with those findings in the risk perception literature. Perception of air pollution by the general public is a key issue in the development of comprehensive risk assessment studies as well as in air pollution risk management and policy. This study offers a useful new tool to measure such efforts and to help set priorities for air quality improvements in combination with air quality measurements. PMID:22852801

  14. The American College Health Association National College Health Assessment (ACHA-NCHA), Spring 2003 Reference Group Report

    ERIC Educational Resources Information Center

    Journal of American College Health, 2005

    2005-01-01

    Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey instrument developed by the American College Health Association (ACHA) in 1998 to assist institutions of higher…

  15. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    PubMed

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. PMID:27015612

  16. Radar remote sensing for crop classification and canopy condition assessment: Ground-data documentation

    NASA Technical Reports Server (NTRS)

    Ulaby, F. T. (Principal Investigator); Jung, B.; Gillespie, K.; Hemmat, M.; Aslam, A.; Brunfeldt, D.; Dobson, M. C.

    1983-01-01

    A vegetation and soil-moisture experiment was conducted in order to examine the microwave emission and backscattering from vegetation canopies and soils. The data-acquisition methodology used in conjunction with the mobile radar scatterometer (MRS) systems is described and associated ground-truth data are documented. Test fields were located in the Kansas River floodplain north of Lawrence, Kansas. Ten fields each of wheat, corn, and soybeans were monitored over the greater part of their growing seasons. The tabulated data summarize measurements made by the sensor systems and represent target characteristics. Target parameters describing the vegetation and soil characteristics include plant moisture, density, height, and growth stage, as well as soil moisture and soil-bulk density. Complete listings of pertinent crop-canopy and soil measurements are given.

  17. Assessing Health Literacy in Deaf American Sign Language Users.

    PubMed

    McKee, Michael M; Paasche-Orlow, Michael K; Winters, Paul C; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, health care messages, and health care communication, which, when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version (ASL-NVS). We found that 48% of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research. PMID:26513036

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

    PubMed

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

    2015-01-01

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated. PMID:26377091

  19. PILOT VOLUNTEER TRAINING FOR WETLAND MONITORING AND HEALTH ASSESSMENT

    EPA Science Inventory

    Massachusetts Bays Estuary Program expressed a need to better assess and monitor the health of their saltmarshes. By training citizen volunteers in the methodologies of saltmarsh bioassessment, Mass Bays saw the additional opportunity to engage the public in their estuary protec...

  20. 78 FR 20523 - Community Health Needs Assessments for Charitable Hospitals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... rulemaking in the Federal Register (REG-130266-11; 77 FR 38148) (``2012 proposed regulations'') that contains... Internal Revenue Service 26 CFR Parts 1 and 53 RIN 1545-BL30 Community Health Needs Assessments for Charitable Hospitals AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed...

  1. An Assessment of Nursing Attitudes toward Computers in Health Care.

    ERIC Educational Resources Information Center

    Carl, David L.; And Others

    The attitudes and perceptions of practicing nurses, student nurses, and nurse educators toward computerization of health care were assessed using questionnaires sent to two general hospitals and five nursing education programs. The sample consisted of 83 first-year nursing students, 84 second-year nursing students, 52 practicing nurses, and 26…

  2. A 21st Century Roadmap for Human Health Risk Assessment

    EPA Science Inventory

    For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, t...

  3. Child Health Assessment; Part I: A Literature Review.

    ERIC Educational Resources Information Center

    Barnard, Kathryn E., Ed.; Douglas, Helen Bee, Ed.

    Presented are 13 papers describing the Seattle Project and reviewing the literature relevant to the project's purpose of developing and testing an assessment format to enable nurses to better identify health and developmental problems in children. Six papers pertaining to predictor variables cover the areas of prenatal and perinatal factors,…

  4. Environmental Epigenetics: Potential Application in Human Health Risk Assessment

    EPA Science Inventory

    Although previous studies have shown a significant involvement of epigenetic dysregulation in human diseases, the applicability of epigenetic data in the current human health risk assessment paradigm is unclear. The goals of this study are to compare the relative sensitivities of...

  5. INCORPORATING HUMAN INTERINDIVIDUAL BIOTRANSFORMATION VARIANCE IN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

  6. POLLUTION AND ECOSYSTEM HEALTH - ASSESSING ECOLOGICAL CONDITION OF COASTAL ECOSYSTEMS

    EPA Science Inventory

    Summers, Kevin. 2004. Pollution and Ecosystem Health - Assessing Ecological Condition of Coastal Ecosystems. Presented at the White Water to Blue Water (WW2BW) Miami Conference, 21-26 March 2004, Miami, FL. 1 p. (ERL,GB R973).

    Throughout the coastal regions and Large Mari...

  7. Mental Health Assessment of Infants in Foster Care

    ERIC Educational Resources Information Center

    Silver, Judith; Dicker, Sheryl

    2007-01-01

    Infants placed in foster care are at high risk for emotional and behavioral problems. Assessment of their mental health must account for their often-adverse life experiences prior to placement and the involvement of multiple systems that shape their lives in lieu of parents' authority. This article presents practice guidelines for infant mental…

  8. Damage Assessment and Digital 2D-3D Documentation of PetraTreasury

    NASA Astrophysics Data System (ADS)

    Bala'awi, Fadi; Alshawabkeh, Yahya; Alawneh, Firas; Masri, Eyed al

    The treasury is the icon monument of the world heritage site of ancient Petra city. Unfortunately, this important part of the world's cultural heritage is gradually being diminished due to weathering and erosion problems. This give rise to the need to have a comprehensive study and full documentation of the monument in order to evaluate its status. In this research a comprehensive approach utilizing 2D-3D documentation of the structure using laser scanner and photogrammetry is carried parallel with a laboratory analysis and a correlation study of the salt content and the surface weathering forms. In addition, the research extends to evaluate a set of chemical and physical properties of the case study monument. Studies of stone texture and spatial distribution of soluble salts were carried out at the monument in order to explain the mechanism of the weathering problem. Then a series of field work investigations and laboratory work were undertaken to study the effect of relative humidity, temperature, and wind are the main factors in the salt damage process. The 3D modelling provides accurate geometric and radiometric properties of the damage shape. In order to support the visual quality of 3D surface details and cracks, a hybrid approach combining data from the laser scanner and the digital imagery was developed. Based on the findings, salt damage appears to be one of the main problems at this monument. Although, the total soluble salt content are quite low, but the salts contamination is all over the tested samples in all seasons, with higher concentrations at deep intervals. The thermodynamic calculations carried out by this research have also shown that salt damage could be minimised by controlling the surrounding relative humidity conditions. This measure is undoubtedly the most challenging of all, and its application, if deemed feasible, should be carried out in parallel with other conservation measures.

  9. Soil Health Assessment Approaches and the Cornell Framework

    NASA Astrophysics Data System (ADS)

    van Es, Harold

    2016-04-01

    Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

  10. Environment, safety and health compliance assessment, Feed Materials Production Center, Fernald, Ohio

    SciTech Connect

    Not Available

    1989-09-01

    The Secretary of Energy established independent Tiger Teams to conduct environment, safety, and health (ES H) compliance assessments at US Department of Energy (DOE) facilities. This report presents the assessment of the Feed Materials Production Center (FMPC) at Fernald, Ohio. The purpose of the assessment at FMPC is to provide the Secretary with information regarding current ES H compliance status, specific ES H noncompliance items, evaluation of the adequacy of the ES H organizations and resources (DOE and contractor), and root causes for noncompliance items. Areas reviewed included performance under Federal, state, and local agreements and permits; compliance with Federal, state and DOE orders and requirements; adequacy of operations and other site activities, such as training, procedures, document control, quality assurance, and emergency preparedness; and management and staff, including resources, planning, and interactions with outside agencies.

  11. Tiger Team environment, safety, and health assessment of the Oak Ridge National Laboratory

    SciTech Connect

    Not Available

    1990-11-01

    This report documents the results of the US Department of Energy's (DOE's) Tiger Team Assessment of Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, conducted from October 22 and November 30, 1990. The assessment was conducted by a tam comprised of environment, safety, and health (ES H) professional from the Department, its contractors, and consultants. The purpose of the ORNL Tiger Team Assessment is to provide the Secretary of Energy with concise information on: current ES H compliance status at the site and the vulnerabilities associated with that compliance status; root causes for noncompliance; and adequacy of DOE and site contractor ES H management programs. This information will assist DOE in determining patterns and trends in ES H compliance and probable root causes, and will provide guidance for management to take needed corrective actions.

  12. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions. PMID:2278245

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

    SciTech Connect

    Simpson, Sarah . E-mail: sarah.simpson@unsw.edu.au; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-10-15

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

  14. Assessing Organizational Readiness for a Participatory Occupational Health/Health Promotion Intervention in Skilled Nursing Facilities.

    PubMed

    Zhang, Yuan; Flum, Marian; West, Cheryl; Punnett, Laura

    2015-09-01

    The long-term care sector is characterized by high morbidity and employee turnover, along with associated costs. Effective health protection and health promotion are important to improve physical and psychosocial well-being of caregivers. Assessment of organizational readiness for change is an essential precursor to the successful implementation of workplace programs addressing work climate, structure of tasks and relationships, and other issues that may be perceived as challenging by some within the institution. This study qualitatively assessed readiness of five skilled nursing facilities for a participatory occupational health/health promotion intervention. Selection criteria were developed to screen for program feasibility and ability to conduct prospective evaluations, and information was collected from managers and employees (interviews and focus groups). Three centers were selected for the program, and the first year of formative evaluation and intervention experience was then reviewed to evaluate and modify our selection criteria after the fact. Lessons learned include adding assessment of communication and the structure of problem solving to our selection criteria, improving methods to assess management support in a concrete (potentially nonverbal) form, and obtaining a stated financial commitment and resources to enable the team to function. Assessment of organizational readiness for change is challenging, although necessary to implement effective and sustainable health promotion programs in specific organizations. PMID:25715335

  15. Private Sector Initiative Program. Documentation and Assessment of CETA Title VII Implementation. Final Report.

    ERIC Educational Resources Information Center

    Smith, Thomas J.

    The development and performance, through 1981, of Private Industry Councils (PICs) in 16 study sites are described and assessed in this report. (PICs were set up under Title VII of the Comprehensive Employment and Training Act (CETA) to serve as a hub for attracting increased private sector involvement in employment and training activities for the…

  16. Tank 241-AY-102 Leak Assessment Supporting Documentation: Miscellaneous Reports, Letters, Memoranda, And Data

    SciTech Connect

    Engeman, J. K.; Girardot, C. L.; Harlow, D. G.; Rosenkrance, C. L.

    2012-12-20

    This report contains reference materials cited in RPP-ASMT -53793, Tank 241-AY-102 Leak Assessment Report, that were obtained from the National Archives Federal Records Repository in Seattle, Washington, or from other sources including the Hanford Site's Integrated Data Management System database (IDMS).

  17. Modular Engine Noise Component Prediction System (MCP) Technical Description and Assessment Document

    NASA Technical Reports Server (NTRS)

    Herkes, William H.; Reed, David H.

    2005-01-01

    This report describes an empirical prediction procedure for turbofan engine noise. The procedure generates predicted noise levels for several noise components, including inlet- and aft-radiated fan noise, and jet-mixing noise. This report discusses the noise source mechanisms, the development of the prediction procedures, and the assessment of the accuracy of these predictions. Finally, some recommendations for future work are presented.

  18. English Language Assessment in the Colleges of Applied Sciences in Oman: Thematic Document Analysis

    ERIC Educational Resources Information Center

    Al Hajri, Fatma

    2014-01-01

    Proficiency in English language and how it is measured have become central issues in higher education research as the English language is increasingly used as a medium of instruction and a criterion for admission to education. This study evaluated the English language assessment in the foundation Programme at the Colleges of Applied sciences in…

  19. National Assessments for Student Teachers: Documenting Teaching Readiness to the Tipping Point

    ERIC Educational Resources Information Center

    Margolis, Jason; Doring, Anne

    2013-01-01

    To evaluate the impact of the emergent national teacher performance assessment (TPA) on student teachers, this study examined a pilot implementation at one university in Washington State during Spring 2011. The qualitative research focused on the lived experience of those directly affected by TPA implementation: student teachers, mentor teachers,…

  20. Technical Assistance Document for Assessment and Evaluation of Preschool Children Who Are Culturally and Linguistically Diverse.

    ERIC Educational Resources Information Center

    Flores, Jeff; Lopez, Eric J.; De Leon, Jozi

    This manual presents New Mexico state guidelines for the assessment and evaluation of preschool children who are culturally and linguistically diverse, and focuses on the principles of parent participation and nondiscriminatory evaluation as defined in the Individuals with Disabilities Education Act and the New Mexico Administrative Codes. A…

  1. AREA SOURCE DOCUMENTATION FOR THE 1985 NATIONAL ACID PRECIPITATION ASSESSMENT PROGRAM INVENTORY

    EPA Science Inventory

    The report provides, to states and other participants and users of the 1985 National Acid Precipitation Assessment Program Emissions Inventory, a general understanding of the estimating procedures that will be used by NAPAP and EPA's Office of Air Quality Planning and Standards t...

  2. An evaluation of EU legislation concerning risk assessment and preventive measures in occupational safety and health.

    PubMed

    Niskanen, Toivo; Naumanen, Paula; Hirvonen, Maria L

    2012-09-01

    The European Council Directive 89/391/EC of 12 June 1989 is concerned with the introduction of measures to encourage improvements in the occupational safety and health. For example, it deals with risk assessment and preventive measures. The Finnish legislation enacts the risk assessment and prevention measures in a similar way as the EU Directive 89/391/EC. The aim of this study was to examine: 1) the implementation of risk assessment process as a part of OSH management, and 2) the effectiveness of the OSH legislation concerned with risk assessment. The quantitative method involved an online questionnaire. The respondents were employers (N = 1478), workers (N = 1416) and occupational care (OHC) professionals' units (N = 469). Three quarters of the employer respondents and two thirds of the workers and OHC service providers felt that the EU legislative provisions have promoted the engagement of the management. According to the study, improvement is needed in ensuring the cooperation between employers and workers. The combined variables of Risk Assessment Process revealed positive impacts both on Cooperation and Management Measures and on the Concrete Preventive Measures among the employers and the workers. The combined variables of Use of Documents of Risk Assessments highlighted positive impacts on both the Exploiting of Results of Risk Assessments in Planning and Management and on the Exploiting of Results of Risk Assessment in Cooperation and Technology. PMID:22233692

  3. Health Impact Assessment, Physical Activity and Federal Lands Trail Policy

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard L.

    2016-01-01

    Objectives The objectives of this paper are to describe the application of Health Impact Assessment (HIA) to inform trail decisions affecting a rural, under-resourced community and propose the routine integration of HIAs to enhance NEPA environmental assessments and environmental impact statements for trail decisions on federal lands. Methods Screening, scoping, assessment, recommendations, reporting, monitoring and evaluation are being used to examine the health impact of trail location and design. Results HIA recommendations are being integrated into the public lands National Environmental Protection Act process for planning access to a new segment of the Continental Divide National Scenic Trail. Potential users from a nearby rural New Mexico community and a region of almost one million may benefit from this HIA-informed planning. Conclusions HIA can be integrated into the policy and decision-making process for trails on public lands.

  4. Health-related quality of life assessment in clinical practice.

    PubMed

    Meers, C; Singer, M A

    1996-01-01

    Assessment of biochemical responses to therapy is routine in the management of patients with end stage renal disease (ESRD). Assessment of health-related quality of life (HRQOL), however, is less common. Previous research indicates that HRQOL is a meaningful indicator that should be integrated into clinical practice. HRQOL is longitudinally evaluated in in-centre hemodialysis patients using the RAND 36-item Health Survey 1.0. Caregivers incorporate scores from this instrument into their assessment of patient functioning and well-being. HRQOL scores can be utilized to evaluate responses to changes in therapy, and to direct clinical decision-making, adding an important dimension to holistic, quality care for ESRD patients. PMID:8900807

  5. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine.

    PubMed

    Steuten, Lotte M G

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved "upstream" so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bridges between oral health and systems medicine since what happens in oral health affects systems pathophysiology, and vice versa. This article offers a synthesis of the latest trends and approaches in early phase HTA, with a view to near future applications in oral health, systems medicine, and biomarker-guided precision medicine. In brief, this review underscores that demonstrating health outcomes of biomarkers and next-generation diagnostics is particularly challenging because they do not always influence long-term outcomes directly, but rather impact subsequent care processes. Biomarker testing costs are typically less of a barrier to uptake in practice than the biomarker's impact on longer term health outcomes. As a single biomarker or next-generation diagnostic in oral health can inform decisions about numerous downstream diagnosis-treatment combinations, early stage "upstream" HTA is crucial in prioritizing the most valuable diagnostic applications to pursue first. For the vast array of oral health biomarkers currently developed, early HTA is necessary to timely and iteratively assess their comparative effectiveness and anticipate the inevitable questions about value for money from regulators and payers. PMID:26760958

  6. Finding Qualitative Research Evidence for Health Technology Assessment.

    PubMed

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. PMID:27117960

  7. Assessing the privacy policies in mobile personal health records.

    PubMed

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs. PMID:25571104

  8. Particulate matter in urban areas: health-based economic assessment.

    PubMed

    El-Fadel, M; Massoud, M

    2000-08-10

    The interest in the association between human health and air pollution has grown substantially in recent years. Based on epidemiological studies in several countries, there is conclusive evidence of a link between particulate air pollution and adverse health effects. Considering that particulate matter may be the most serious pollutant in urban areas and that pollution-related illness results in financial and non-financial welfare losses, the main objective of this study is to assess the economic benefits of reducing particulate air pollution in Lebanese urban areas. Accordingly, the extent and value of health benefits due to decreasing levels of particulate in the air are predicted. Health impacts are expressed in both physical and monetary terms for saved statistical lives, and productivity due to different types of morbidity endpoints. Finally, the study concludes with a range of policy options available to mitigate particulate air pollution in urban areas. PMID:10989923

  9. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    SciTech Connect

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  10. Quantitative estimation in Health Impact Assessment: Opportunities and challenges

    SciTech Connect

    Bhatia, Rajiv; Seto, Edmund

    2011-04-15

    Health Impact Assessment (HIA) considers multiple effects on health of policies, programs, plans and projects and thus requires the use of diverse analytic tools and sources of evidence. Quantitative estimation has desirable properties for the purpose of HIA but adequate tools for quantification exist currently for a limited number of health impacts and decision settings; furthermore, quantitative estimation generates thorny questions about the precision of estimates and the validity of methodological assumptions. In the United States, HIA has only recently emerged as an independent practice apart from integrated EIA, and this article aims to synthesize the experience with quantitative health effects estimation within that practice. We use examples identified through a scan of available identified instances of quantitative estimation in the U.S. practice experience to illustrate methods applied in different policy settings along with their strengths and limitations. We then discuss opportunity areas and practical considerations for the use of quantitative estimation in HIA.

  11. The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self-Assessed Health.

    PubMed

    Darden, Michael; Gilleskie, Donna

    2016-08-01

    An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25981179

  12. Document Monitor

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The charters of Freedom Monitoring System will periodically assess the physical condition of the U.S. Constitution, Declaration of Independence and Bill of Rights. Although protected in helium filled glass cases, the documents are subject to damage from light vibration and humidity. The photometer is a CCD detector used as the electronic film for the camera system's scanning camera which mechanically scans the document line by line and acquires a series of images, each representing a one square inch portion of the document. Perkin-Elmer Corporation's photometer is capable of detecting changes in contrast, shape or other indicators of degradation with 5 to 10 times the sensitivity of the human eye. A Vicom image processing computer receives the data from the photometer stores it and manipulates it, allowing comparison of electronic images over time to detect changes.

  13. Assessment of effectiveness of geologic isolation systems. CIRMIS data system. Volume 1. Initialization, operation, and documentation

    SciTech Connect

    Friedrichs, D.R.

    1980-01-01

    The Assessment of Effectiveness of Geologic Isolation Systems (AEGIS) Program is developing and applying the methodology for assessing the far-field, long-term post-closure safety of deep geologic nuclear waste repositories. AEGIS is being performed by Pacific Northwest Laboratory (PNL) under contract with the Office of Nuclear Waste Isolation (ONWI) for the Department of Energy (DOE). One task within AEGIS is the development of methodology for analysis of the consequences (water pathway) from loss of repository containment as defined by various release scenarios. The various input parameters required in the analysis are compiled in data systems. The data are organized and prepared by various input subroutines for use by the hydrologic and transport codes. The hydrologic models simulate the groundwater flow systems and provide water flow directions, rates, and velocities as inputs to the transport models. Outputs from the transport models are basically graphs of radionuclide concentration in the groundwater plotted against time. After dilution in the receiving surface-water body (e.g., lake, river, bay), these data are the input source terms for the dose models, if dose assessments are required. The dose models calculate radiation dose to individuals and populations. CIRMIS (Comprehensive Information Retrieval and Model Input Sequence) Data System, a storage and retrieval system for model input and output data, including graphical interpretation and display is described. This is the first of four volumes of the description of the CIRMIS Data System.

  14. Can Migration Health Assessments Become a Mechanism for Global Public Health Good?

    PubMed Central

    Wickramage, Kolitha; Mosca, Davide

    2014-01-01

    Migrant health assessments (HAs) consist of a medical examination to assess a migrant’s health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and migrant HA processors at the country level are needed to shift these from being limited as an instrument of determining non-admissibility for purposes of visa issuance, to a process that may enhance public health. The importance of providing appropriate care and follow-up of migrants who “fail” their HA and the need for global efforts to enable data-collection and research on HAs are also highlighted. PMID:25342234

  15. Wound emergencies: the importance of assessment, documentation, and early treatment using a wound electronic medical record.

    PubMed

    Golinko, Michael S; Clark, Sunday; Rennert, Robert; Flattau, Anna; Boulton, Andrew J M; Brem, Harold

    2009-05-01

    Chronic wounds such as diabetic foot ulcers, venous ulcers, and pressure ulcers are a major source of morbidity and mortality. To describe wound characteristics associated with a wound emergency, the Wound Electronic Medical Records (WEMR) of 200 consecutive admissions (139 patients, average number of admissions 1.4) to a dedicated inpatient wound healing unit over a period of 5 months were retrospectively reviewed. Patient mean age was 62 +/- 16 years, 59% were men, 27% had a foot ulcer and diabetes mellitus, and 29% had venous ulcers. Presenting signs and symptoms included wound pain, cellulitis, nonpurulent drainage, and undermining, but few presented with classic local clinical signs of infection. Treatment consisted of sharp debridement with deep tissue culture and pathology from the wound base and/or systemic antibiotics. Twenty-percent (20%) of patients had pathology-confirmed and 38% had pathology- or radiology-confirmed osteomyelitis on admission, supporting that new or increasing wound pain, cellulitis, and/or nonpurulent drainage or presence of significant undermining may be indicative of an invasive infection and that patients presenting with these signs and symptoms require an immediate treatment plan and consideration of hospital admission. Use of an objective documentation system such as the WEMR may help alert clinicians to subtle wound changes that require aggressive treatment; thereby, avoiding emergency room visits and hospital admissions. Future research is needed utilizing the WEMR across multiple medical centers to further define criteria for a chronic wound emergency. PMID:19471049

  16. Interview: Health technology assessment in Asia: an emerging trend.

    PubMed

    Yang, Bong-min

    2012-05-01

    Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research. PMID:24237405

  17. Assessing Health Literacy in Deaf American Sign Language Users

    PubMed Central

    McKee, Michael M.; Paasche-Orlow, Michael; Winters, Paul C.; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, healthcare messages, and health care communication, which when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version of the NVS (ASL-NVS). Forty-eight percent of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research. PMID:26513036

  18. A workshop on developing risk assessment methods for medical use of radioactive material. Volume 2: Supporting documents

    SciTech Connect

    Tortorelli, J.P.

    1995-08-01

    A workshop was held at the Idaho National Engineering Laboratory, August 16--18, 1994 on the topic of risk assessment on medical devices that use radioactive isotopes. Its purpose was to review past efforts to develop a risk assessment methodology to evaluate these devices, and to develop a program plan and a scoping document for future methodology development. This report contains presentation material and a transcript of the workshop. Participants included experts in the fields of radiation oncology, medical physics, risk assessment, human-error analysis, and human factors. Staff from the US Nuclear Regulatory Commission (NRC) associated with the regulation of medical uses of radioactive materials and with research into risk-assessment methods participated in the workshop. The workshop participants concurred in NRC`s intended use of risk assessment as an important technology in the development of regulations for the medical use of radioactive material and encouraged the NRC to proceed rapidly with a pilot study. Specific recommendations are included in the executive summary and the body of this report.

  19. Primary health care assessment tools: a literature review and metasynthesis.

    PubMed

    Fracolli, Lislaine Aparecida; Gomes, Maria Fernanda Pereira; Nabão, Fabiana Rodrigues Zequini; Santos, Mariana Souza; Cappellini, Verusca Kelly; de Almeida, Ana Cláudia Correa

    2014-12-01

    This study comprises a systematic review and metasynthesis of qualitative literature on national and international databases to identify the main tools used to assess Primary Health Care (PHC). A total of 3,048 results were returned for literature written in Portuguese, Spanish and English published between 1979 and 2013. Thirty-three articles/studies were selected after thorough reading and analysis. Eight of these studies addressed the use of one or more of the following validated PHC assessment tools: the WHO Primary Care Assessment Tool (PCET); the ADHD Questionnaire for Primary Care Providers (AQ-PCP); the General Practice Assessment Questionnaire (GPAQ), PACOTAPS (primary health care software); and the PCAT (Primary Care Assessment Tool). The study showed that the majority of these tools were used internationally. The PCAT and EUROPEP were used in Brazil and the most commonly used tool in this country was the PCAT. The results show that the use of research tools to assess PHC may assist in the creation of new proposals to improve family healthcare and that PCAT is the most adequate tool for this purpose. PMID:25388193

  20. Health-care technology assessment: a clinical perspective.

    PubMed

    Chantler, Cyril

    2004-01-01

    Health technology assessment needs to relate to contemporary questions which concern public health-care systems: how to keep people healthy, how to focus on the needs of those with chronic disabilities and integrate care between the hospital and the community, how to encourage and audit effective teamwork, and how to establish a consensus about what is effective and affordable. Clinicians have an ethical responsibility to practice efficiently and economically, for profligacy in the care of one patient may mean that another is treated inadequately. For similar reasons, clinicians need to play a full role in the management of services. Advice from health technology assessment is vital and needs to be accurate, relevant, timely, clear, and accessible. As well as being concerned about what works, we need also to eliminate from practice what does not. Regular audit and appraisal of practice against the evidence base should be useful in this respect. Alternative approaches to management, such as the provision of care as opposed to aggressive treatments, need to be evaluated, and health technology assessment needs to consider how services are delivered, not just specific treatments. PMID:15176183