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Sample records for health integrating radiative

  1. RADIATION INTEGRATOR

    DOEpatents

    Glass, F.M.; Wilson, H.N.

    1959-02-17

    Radiation detecting and measuring systems, particularly a compact, integrating, background monitor, are discussed. One of the principal features of the system is the use of an electrometer tube where the input of the tube is directly connected to an electrode of the radiation detector and a capacitor is coupled to the tube input. When a predetermined quantity of radiation has been integrated, a trigger signal is fed to a recorder and a charge is delivered to the capacitor to render the tube inoperative. The capacitor is then recharged for the next period of operation. With this arrangement there is a substantial reduction in lead lengths and the principal components may be enclosed and hermetically sealed to insure low leakage.

  2. Association between sperm DNA integrity and seminal plasma antioxidant levels in health workers occupationally exposed to ionizing radiation

    SciTech Connect

    Kumar, Dayanidhi; Salian, Sujith Raj; Kalthur, Guruprasad; Uppangala, Shubhashree; Kumari, Sandhya; Challapalli, Srinivas; Chandraguthi, Shrinidhi Gururajarao; Jain, Navya; Krishnamurthy, Hanumanthappa; Kumar, Pratap; Adiga, Satish Kumar

    2014-07-15

    There is a paucity of data regarding the association between occupational radiation exposure and risk to human fertility. Recently, we provided the first evidence on altered sperm functional characteristics, DNA damage and hypermethylation in radiation health workers. However, there is no report elucidating the association between seminal plasma antioxidants and sperm chromatin integrity in occupationally exposed subjects. Here, we assessed the seminal plasma antioxidants and lipid peroxidation level in 83 men who were occupationally exposed to ionizing radiation and then correlated with the sperm chromatin integrity. Flow cytometry based sperm chromatin integrity assay revealed a significant decline in αt value in the exposed group in comparison to the non-exposed group (P<0.0001). Similarly, both total and reduced glutathione levels and total antioxidant capacity in the seminal plasma were significantly higher in exposed group than the non-exposed group (P<0.01, 0.001 and 0.0001, respectively). However, superoxide dismutase level and malondialdehyde level, which is an indicator of lipid peroxidation in the seminal plasma, did not differ significantly between two groups. The total antioxidant capacity (TAC) and GSH level exhibited a positive correlation with sperm DNA integrity in exposed subjects. To conclude, this study distinctly shows that altered sperm chromatin integrity in radiation health workers is associated with increase in seminal plasma antioxidant level. Further, the increased seminal plasma GSH and TAC could be an adaptive measure to tackle the oxidative stress to protect genetic and functional sperm deformities in radiation health workers. - Highlights: • Seminal plasma antioxidants were measured in men occupationally exposed to radiation. • Sperm chromatin integrity was significantly affected in the exposed group. • Glutathione and total antioxidant capacity was significantly higher in exposed group. • Sperm DNA damage in exposed subjects

  3. Healthful radiation

    SciTech Connect

    Agard, E.T.

    1997-01-01

    This title of this article sounds paradoxical to most people because the general public is not fully aware of the many benefits radiation has brought to people`s healthcare. Radiation has provided the most effective means of noninvasive diagnosis of many diseases, thus reducing the need for exploratory surgery, at significantly reduced risks. Furthermore, radiotherapy has been effective in treating many diseases without surgical removal of the diseased part. The breast is one excellent example of the benefits of radiation in both diagnosis and treatment with preservation. Yet the public still regards radiation as mysterious and dangerous, while trained experts regard it as beneficial with manageable risks. This article suggests ways of presenting this material to the public in a manner that is interesting and informative. 11 refs.

  4. Healthful radiation.

    PubMed

    Agard, E T

    1997-01-01

    This title of this article sounds paradoxical to most people because the general public is not fully aware of the many benefits radiation has brought to people's healthcare. Radiation has provided the most effective means of noninvasive diagnosis of many diseases, thus reducing the need for exploratory surgery, at significantly reduced risks. Furthermore, radiotherapy has been effective in treating many diseases without surgical removal of the diseased part. The breast is one excellent example of the benefits of radiation in both diagnosis and treatment with preservation. Yet the public still regards radiation as mysterious and dangerous, while trained experts regard it as beneficial with manageable risks. This article suggests ways of presenting this material to the public in a manner that is interesting and informative. PMID:8972833

  5. Clues to Coral Reef Health: Integrating Radiative Transfer Modeling and Hyperspectral Data

    NASA Technical Reports Server (NTRS)

    Guild, Liane; Ganapol, Barry; Kramer, Philip; Armstrong, Roy; Gleason, Art; Torres, Juan; Johnson, Lee; Garfield, Toby; Peterson, David L. (Technical Monitor)

    2002-01-01

    An important contribution to coral reef research is to improve spectral distinction between various health states of coral species in areas subject to harmful anthropogenic activity and climate change. New insights into radiative transfer properties of corals under healthy and stressed conditions can advance understandings of ecological processes on reefs and allow better assessments of the impacts of large-scale bleaching and disease events, Our objective was to examine the spectral and spatial properties of hyperspectral sensors that may be used to remotely sense changes in reef community health. We compare in situ reef environment spectra (healthy coral, stressed coral, dead coral, algae, and sand) with airborne hyperspectral data to identify important spectral characteristics and indices. Additionally, spectral measurements over a range of water depths, relief, and bottom types are compared to help quantify bottom-water column influences. In situ spectra were collected in July and August 2002 at the Long Rock site in the Andros Island, Bahamas coastal zone coral reef. Our primary emphasis was on Acropora palmata (or elkhorn coral), a major reef building coral, which is prevalent in the study area, but is suffering from white band disease. A. palmata is currently being, proposed as an endangered species because its populations have severely declined in many areas of the Caribbean. In addition to the A. palmata biotope, we have collected spectra of at least seven other coral biotopes that exist within the study area, each with different coral community composition, density of corals, relief, and size of corals. Coral spectral reflectance was then input into a radiative transfer model, CORALMOD (CM1), which is based on a leaf radiative transfer model. In CM1, input coral reflectance measurements produce modeled reflectance through an inversion at each visible wavelength to provide the absorption spectrum. Initially, we imposed a scattering baseline that is the

  6. Clues to Coral Reef Health: Integrating Radiative Transfer Modeling and Hyperspectral Data

    NASA Astrophysics Data System (ADS)

    Guild, L.; Ganapol, B.; Kramer, P.; Armstrong, R.; Gleason, A.; Torres, J.; Johnson, L.; Garfield, N.

    2002-12-01

    An important contribution to coral reef research is to improve spectral distinction between various health states of coral species in areas subject to harmful anthropogenic activity and climate change. New insights into radiative transfer properties of corals under healthy and stressed conditions can advance understandings of ecological processes on reefs and allow better assessments of the impacts of large-scale bleaching and disease events. Our objective is to examine the spectral and spatial properties of hyperspectral sensors that may be used to remotely sense changes in reef community health. We compare in situ reef environment spectra (healthy coral, stressed coral, dead coral, algae, and sand) with airborne hyperspectral data to identify important spectral characteristics and indices. Additionally, spectral measurements over a range of water depths, relief, and bottom types are compared to help quantify bottom-water column influences. In situ spectra was collected in July and August 2002 at the Long Rock site in the Andros Island, Bahamas coastal zone coral reef. Our primary emphasis is on Acropora palmata (or elkhorn coral), a major reef building coral, which is prevalent in the study area, but is suffering from white band disease. A. palmata is currently being proposed as an endangered species because its populations have severely declined in many areas of the Caribbean. In addition to the A. palmata biotope, we have collected spectra of at least seven other coral biotopes that exist within the study area, each with different coral community composition, density of corals, relief, and size of corals. Coral spectral reflectance is input into a radiative transfer model, CORALMOD (CM1), which is based on a leaf radiative transfer model. In CM1, input coral reflectance measurements produce modeled reflectance through an inversion at each visible wavelength to provide the absorption spectrum. Initially, we have imposed a scattering baseline that is the same

  7. Radiation and health*

    PubMed Central

    Lindell, B.

    1987-01-01

    Radiation has been a source of fascination and concern ever since Wilhelm Konrad Röntgen discovered X-rays on 8 November 1895. Over the years, health workers as well as the public have been concerned about medical uses of X-rays, the presence of radon in buildings, radioactive waste from nuclear power stations, fallout from nuclear test explosions, radioactive consumer products, microwave ovens, and many other sources of radiation. Most recently, the tragic accident at the Chernobyl nuclear power station in the USSR, and the subsequent contamination over most of Europe, has again wakened interest and concern and also reminded us about a number of misconceptions about radiation. This article describes the essentials about radiation (especially ionizing radiation) and its health effects. PMID:3496982

  8. Integrative radiation systems biology.

    PubMed

    Unger, Kristian

    2014-01-01

    Maximisation of the ratio of normal tissue preservation and tumour cell reduction is the main concept of radiotherapy alone or combined with chemo-, immuno- or biologically targeted therapy. The foremost parameter influencing this ratio is radiation sensitivity and its modulation towards a more efficient killing of tumour cells and a better preservation of normal tissue at the same time is the overall aim of modern therapy schemas. Nevertheless, this requires a deep understanding of the molecular mechanisms of radiation sensitivity in order to identify its key players as potential therapeutic targets. Moreover, the success of conventional approaches that tried to statistically associate altered radiation sensitivity with any molecular phenotype such as gene expression proofed to be somewhat limited since the number of clinically used targets is rather sparse. However, currently a paradigm shift is taking place from pure frequentistic association analysis to the rather holistic systems biology approach that seeks to mathematically model the system to be investigated and to allow the prediction of an altered phenotype as the function of one single or a signature of biomarkers. Integrative systems biology also considers the data from different molecular levels such as the genome, transcriptome or proteome in order to partially or fully comprehend the causal chain of molecular mechanisms. An example for the application of this concept currently carried out at the Clinical Cooperation Group "Personalized Radiotherapy in Head and Neck Cancer" of the Helmholtz-Zentrum München and the LMU Munich is described. This review article strives for providing a compact overview on the state of the art of systems biology, its actual challenges, potential applications, chances and limitations in radiation oncology research working towards improved personalised therapy concepts using this relatively new methodology. PMID:24411063

  9. Environmental integrity, racism, health.

    PubMed

    Westra, L

    1996-05-17

    Environmental degradation seriously affects human health. Thus, a close relationship exists between the protection of ecosystem integrity and wilderness on one hand, and human health on the other. However, there is an overarching, holistic perspective in laws and regulations--as well as morality--to to maintain a healthy relationship between the two. Problem areas focused on in this paper are: (a) climate change and global warming; (b) food production; and (c) global equity. This paper argues for the principle of integrity, which provides an holistic perspective, suggested as a better approach than that of current regulations to mitigate against associated threats to human health. PMID:8693347

  10. Integrated structural health monitoring.

    SciTech Connect

    Farrar, C. R.

    2001-01-01

    Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the authors opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.

  11. Integrated structural health monitoring

    NASA Astrophysics Data System (ADS)

    Farrar, Charles R.; Sohn, Hoon; Fugate, Michael L.; Czarnecki, Jerry J.

    2001-07-01

    Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the author's opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.

  12. Radiation health research, 1986 - 1990

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A collection of 225 abstracts of radiation research sponsored by NASA during the period 1986 through 1990 is reported. Each abstract was categorized within one of four discipline areas: physics, biology, risk assessment, and microgravity. Topic areas within each discipline were assigned as follows: Physics - atomic physics, nuclear science, space radiation, radiation transport and shielding, and instrumentation; Biology - molecular biology, cellular radiation biology, tissue, organs and organisms, radioprotectants, and plants; Risk assessment - radiation health and epidemiology, space flight radiation health physics, inter- and intraspecies extrapolation, and radiation limits and standards; and Microgravity. When applicable subareas were assigned for selected topic areas. Keywords and author indices are provided.

  13. Real Time Radiation Exposure And Health Risks

    NASA Technical Reports Server (NTRS)

    Hu, Shaowen; Barzilla, Janet E.; Semones, Edward J.

    2015-01-01

    Radiation from solar particle events (SPEs) poses a serious threat to future manned missions outside of low Earth orbit (LEO). Accurate characterization of the radiation environment in the inner heliosphere and timely monitoring the health risks to crew are essential steps to ensure the safety of future Mars missions. In this project we plan to develop an approach that can use the particle data from multiple satellites and perform near real-time simulations of radiation exposure and health risks for various exposure scenarios. Time-course profiles of dose rates will be calculated with HZETRN and PDOSE from the energy spectrum and compositions of the particles archived from satellites, and will be validated from recent radiation exposure measurements in space. Real-time estimation of radiation risks will be investigated using ARRBOD. This cross discipline integrated approach can improve risk mitigation by providing critical information for risk assessment and medical guidance to crew during SPEs.

  14. Integral Radiator and Storage Tank

    NASA Technical Reports Server (NTRS)

    Burke, Kenneth A.; Miller, John R.; Jakupca, Ian; Sargi,Scott

    2007-01-01

    A simplified, lightweight system for dissipating heat of a regenerative fuel- cell system would include a heat pipe with its evaporator end placed at the heat source and its condenser end integrated into the wall of the regenerative fuel cell system gas-storage tanks. The tank walls act as heat-radiating surfaces for cooling the regenerative fuel cell system. The system was conceived for use in outer space, where radiation is the only physical mechanism available for transferring heat to the environment. The system could also be adapted for use on propellant tanks or other large-surface-area structures to convert them to space heat-radiating structures. Typically for a regenerative fuel cell system, the radiator is separate from the gas-storage tanks. By using each tank s surface as a heat-radiating surface, the need for a separate, potentially massive radiator structure is eliminated. In addition to the mass savings, overall volume is reduced because a more compact packaging scheme is possible. The underlying tank wall structure provides ample support for heat pipes that help to distribute the heat over the entire tank surface. The heat pipes are attached to the outer surface of each gas-storage tank by use of a high-thermal conductance, carbon-fiber composite-material wrap. Through proper choice of the composite layup, it is possible to exploit the high longitudinal conductivity of the carbon fibers (greater than the thermal conductivity of copper) to minimize the unevenness of the temperature distribution over the tank surface, thereby helping to maximize the overall heat-transfer efficiency. In a prototype of the system, the heat pipe and the composite wrap contribute an average mass of 340 g/sq m of radiator area. Lightweight space radiator panels have a mass of about 3,000 g/sq m of radiator area, so this technique saves almost 90 percent of the mass of separate radiator panels. In tests, the modified surface of the tank was found to have an emissivity of 0

  15. Nonlinearity of radiation health effects.

    PubMed Central

    Pollycove, M

    1998-01-01

    The prime concern of radiation protection policy since 1959 has been to protect DNA from damage. In 1994 the United Nations Scientific Community on the Effects of Atomic Radiation focused on biosystem response to radiation with its report Adaptive Responses to Radiation of Cells and Organisms. The 1995 National Council on Radiation Protection and Measurements report Principles and Application of Collective Dose in Radiation Protection states that because no human data provides direct support for the linear nonthreshold hypothesis (LNT), confidence in LNT is based on the biophysical concept that the passage of a single charged particle could cause damage to DNA that would result in cancer. Several statistically significant epidemiologic studies contradict the validity of this concept by showing risk decrements, i.e., hormesis, of cancer mortality and mortality from all causes in populations exposed to low-dose radiation. Unrepaired low-dose radiation damage to DNA is negligible compared to metabolic damage. The DNA damage-control biosystem is physiologically operative on both metabolic and radiation damage and effected predominantly by free radicals. The DNA damage-control biosystem is suppressed by high dose and stimulated by low-dose radiation. The hormetic effect of low-dose radiation may be explained by its increase of biosystem efficiency. Improved DNA damage control reduces persistent mis- or unrepaired DNA damage i.e., the number of mutations that accumulate during a lifetime. This progressive accumulation of gene mutations in stem cells is associated with decreasing DNA damage control, aging, and malignancy. Recognition of the positive health effects produced by adaptive responses to low-dose radiation would result in a realistic assessment of the environmental risk of radiation. Images Figure 1 Figure 3 Figure 5 Figure 6 Figure 8 Figure 10 PMID:9539031

  16. [Health in Andean regional integration].

    PubMed

    Agudelo, Carlos A

    2007-01-01

    Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of experiences in health has shown that integration depends on the countries' respective strengths and to a major extent on national political processes. PMID:17625652

  17. Space radiation health program plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The Space Radiation Health Program intends to establish the scientific basis for the radiation protection of humans engaged in the exploration of space, with particular emphasis on the establishment of a firm knowledge base to support cancer risk assessment for future planetary exploration. This document sets forth the technical and management components involved in the implementation of the Space Radiation Health Program, which is a major part of the Life Sciences Division (LSD) effort in the Office of Space Science and Applications (OSSA) at the National Aeronautics and Space Administration (NASA). For the purpose of implementing this program, the Life Sciences Division supports scientific research into the fundamental mechanisms of radiation effects on living systems and the interaction of radiation with cells, tissues, and organs, and the development of instruments and processes for measuring radiation and its effects. The Life Sciences Division supports researchers at universities, NASA field centers, non-profit research institutes and national laboratories; establishes interagency agreements for cooperative use and development of facilities; and conducts a space-based research program using available and future spaceflight vehicles.

  18. The NASA Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Schimmerling, Walter

    1991-01-01

    The Space Radiation Health Program (SRHP) is defined in terms of motivation and methodology with specific reference given to the impacts of HZE particles and solar energetic particles. The biological hazards are mentioned that can be associated with the two particle types and ionizing radiation in general. The lack of data on the impact of such radiation and effective shielding countermeasures is identified as the primary motivation for worst-case assumptions. However, the resulting shielding designs can potentially overestimate the thickness by a factor of 10 and add unnecessarily to vehicle take-off mass. A space-based validation system is proposed to complement ground-based investigations of the effects of ionizing radiation in interplanetary space. The Lifesat satellite is proposed as a part of the SRHP effort to determine the requirements for protection and future shielding specifications.

  19. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  20. Allied health: integral to transforming health.

    PubMed

    Lizarondo, Lucylynn; Turnbull, Catherine; Kroon, Tracey; Grimmer, Karen; Bell, Alison; Kumar, Saravana; McEvoy, Maureen; Milanese, Steve; Russell, Mary; Sheppard, Lorraine; Walters, Julie; Wiles, Louise

    2016-04-01

    Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the 'maximum value for spend' of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to

  1. [Health effects of ultraviolet radiation].

    PubMed

    Ohnaka, T

    1993-01-01

    Exposure to ultraviolet radiation (UVR) occurs from both natural and artificial sources. The main natural source is the sun. On the other hand, artificial UVR sources are widely used in industry and also used in hospitals, laboratories, etc. because of their germicidal properties. They are even used for cosmetic purposes. UVR can be classified into three regions according to its wavelength: as UVA (320-400nm), UVB (320-280nm) and UVC (280-200nm). The UVC has the greatest health effect on humans among the three. The sun radiates a wide range of spectrum of electromagnetic radiation including the UVR, however the radiation below 290 nm in wavelength does not reach the surface of the earth for effective absorption by the stratospheric ozone layer. As a result, UVR from a natural source consists of only UVA and a part of UVB. On the other hand, artificial UVR sources include UVC region and have serious effects on the human body, especially on the skin and eyes. The health effects of UVR on humans can be beneficial or detrimental, depending on the amount and form of UVR, as well as on the skin type of the individual exposed. It has been acknowledged that a long period of UVR deficiency may have harmful effects on the human body, such as the development of vitamin D deficiency and rickets in children due to a disturbance in the phosphorus and calcium metabolism. Appropriate measures to increase the amount of exposure to UVR, especially to UVB radiation by the use of sun bathing, the exposure to artificial UVR sources, etc. have shown to prevent disease states caused by UVR deficiency. The harmful effects of UVR consist of erythema, sunburn, photodamage (photoaging), photocarcinogenesis, damage to the eyes, alteration of the immune system of the skin, and chemical hypersensitivity. Skin cancer is commonly produced by UVR. In this review, various states of UV from solar radiation and the degree of exposure to UVR are introduced. The benefits and harmful health effects of

  2. Solar radiation and human health

    NASA Astrophysics Data System (ADS)

    Juzeniene, Asta; Brekke, Pål; Dahlback, Arne; Andersson-Engels, Stefan; Reichrath, Jörg; Moan, Kristin; Holick, Michael F.; Grant, William B.; Moan, Johan

    2011-06-01

    The Sun has played a major role in the development of life on Earth. In Western culture, people are warned against Sun exposure because of its adverse effects: erythema, photoimmunosuppression, photoageing, photocarcinogenesis, cataracts and photokeratitis. However, Sun exposure is also beneficial, since moderate doses give beneficial physiological effects: vitamin D synthesis, reduction of blood pressure and mental health. Shortage of Sun exposure may be even more dangerous to human health than excessive exposure. Avoiding Sun exposure leads to vitamin D deficiency which is associated not only with rickets and osteomalacia, but also with increased risk of cardiovascular disease, multiple sclerosis, rheumatoid arthritis, diabetes, influenza, many types of cancer and adverse pregnancy outcomes. Solar radiation induces nitric oxide release in tissue and immediate pigment darkening which certainly play important roles, although these are still unknown. Action spectra relevant for health are described. We will also review what is known about spectral and intensity variations of terrestrial solar radiation as well as its penetration through the atmosphere and into human skin and tissue.

  3. National Center for Complementary and Integrative Health

    MedlinePlus

    ... About NCCIH NCCIH At a Glance Mission and Vision Organizational Structure Director's ... Integrative Health Health All Health Topics from A-Z Research-based info from acupuncture to zinc. Complementary, Alternative, ...

  4. The NASA Space Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Schimmerling, W.; Sulzman, F. M.

    1994-01-01

    The NASA Space Radiation Health Program is a part of the Life Sciences Division in the Office of Space Science and Applications (OSSA). The goal of the Space Radiation Health Program is development of scientific bases for assuring adequate radiation protection in space. A proposed research program will determine long-term health risks from exposure to cosmic rays and other radiation. Ground-based animal models will be used to predict risk of exposures at varying levels from various sources and the safe levels for manned space flight.

  5. Space radiation health research, 1991-1992

    SciTech Connect

    Jablin, M.H.; Brooks, C.; Ferraro, G.; Dickson, K.J.; Powers, J.V.; Wallace-Robinson, J.; Zafren, B.

    1993-10-01

    The present volume is a collection of 227 abstracts of radiation research sponsored by the NASA Space Radiation Health Program for the period 1991-1992. Each abstract has been categorized within one of three discipline areas: Physics, Biology and Risk Assessment. Topic areas within each discipline have been assigned as follows: Physics - Atomic Physics, Theory, Cosmic Ray and Astrophysics, Experimental, Environments and Environmental Models, Solar Activity and Prediction, Experiments, Radiation Transport and Shielding, Theory and Model Development, Experimental Studies, and Instrumentation. Biology - Biology, Molecular Biology, Cellular Radiation Biology, Transformation, Mutation, Lethality, Survival, DNA Damage and Repair, Tissue, Organs, and Organisms, In Vivo/In Vitro Systems, Carcinogenesis and Life Shortening, Cataractogenesis, Genetics/Developmental, Radioprotectants, Plants, and Other Effects. Risk Assessment - Risk Assessment, Radiation Health and Epidemiology, Space Flight Radiation Health Physics, Inter- and Intraspecies Extrapolation and Radiation Limits and Standards. Section I contains refereed journals; Section II contains reports/meetings. Keywords and author indices are provided.

  6. Integrated Solar Concentrator and Shielded Radiator

    NASA Technical Reports Server (NTRS)

    Clark, David Larry

    2010-01-01

    A shielded radiator is integrated within a solar concentrator for applications that require protection from high ambient temperatures with little convective heat transfer. This innovation uses a reflective surface to deflect ambient thermal radiation, shielding the radiator. The interior of the shield is also reflective to provide a view factor to deep space. A key feature of the shield is the parabolic shape that focuses incoming solar radiation to a line above the radiator along the length of the trough. This keeps the solar energy from adding to the radiator load. By placing solar cells along this focal line, the concentration of solar energy reduces the number and mass of required cells. By shielding the radiator, the effective reject temperature is much lower, allowing lower radiator temperatures. This is particularly important for lower-temperature processes, like habitat heat rejection and fuel cell operations where a high radiator temperature is not feasible. Adding the solar cells in the focal line uses the concentrating effect of the shield to advantage to accomplish two processes with a single device. This shield can be a deployable, lightweight Mylar structure for compact transport.

  7. Integrator Circuitry for Single Channel Radiation Detector

    NASA Technical Reports Server (NTRS)

    Holland, Samuel D. (Inventor); Delaune, Paul B. (Inventor); Turner, Kathryn M. (Inventor)

    2008-01-01

    Input circuitry is provided for a high voltage operated radiation detector to receive pulses from the detector having a rise time in the range of from about one nanosecond to about ten nanoseconds. An integrator circuit, which utilizes current feedback, receives the incoming charge from the radiation detector and creates voltage by integrating across a small capacitor. The integrator utilizes an amplifier which closely follows the voltage across the capacitor to produce an integrator output pulse with a peak value which may be used to determine the energy which produced the pulse. The pulse width of the output is stretched to approximately 50 to 300 nanoseconds for use by subsequent circuits which may then use amplifiers with lower slew rates.

  8. INTEGRATING ECOLOGY, HUMAN HEALTH AND SOCIOECONOMICS

    EPA Science Inventory

    This research involves collaboration with other ORD Labs and Centers, as well as external collaborators, to foster integration of assessment approaches used to evaluate human health and ecological risks and to demonstrate integrated environmental socioeconomic approaches. Part...

  9. Health systems, communicable diseases and integration.

    PubMed

    Shigayeva, Altynay; Atun, Rifat; McKee, Martin; Coker, Richard

    2010-11-01

    The HIV/AIDS, tuberculosis and malaria pandemics pose substantial challenges globally and to health systems in the countries they affect. This demands an institutional approach that can integrate disease control programmes within health and social care systems. Whilst integration is intuitively appealing, evidence of its benefits remains uncertain and evaluation is beset by lack of a common understanding of what it involves. The aim of this paper is to better define integration in health systems relevant to communicable disease control. We conducted a critical review of published literature on concepts, definitions, and analytical and methodological approaches to integration as applied to health system responses to communicable disease. We found that integration is understood and pursued in many ways in different health systems. We identified a variety of typologies that relate to three fundamental questions associated with integration: (1) why is integration a goal (that is, what are the driving forces for integration); (2) what structures and/or functions at different levels of health system are affected by integration (or the lack of); and (3) how does integration influence interactions between health system components or stakeholders. The frameworks identified were evaluated in terms of these questions, as well as the extent to which they took account of health system characteristics, the wider contextual environment in which health systems sit, and the roles of key stakeholders. We did not find any one framework that explicitly addressed all of these three questions and therefore propose an analytical framework to help address these questions, building upon existing frameworks and extending our conceptualization of the 'how' of integration to identify a continuum of interactions that extends from no interactions, to partial integration that includes linkage and coordination, and ultimately to integration. We hope that our framework may provide a basis for

  10. Integration of video and radiation analysis data

    SciTech Connect

    Menlove, H.O.; Howell, J.A.; Rodriguez, C.A.; Eccleston, G.W.; Beddingfield, D.; Smith, J.E.; Baumgart, C.W.

    1994-08-01

    We have introduced a new method to integrate spatial (digital video) and time (radiation monitoring) information. This technology is based on pattern recognition by neural networks, provides significant capability to analyze complex data, and has the ability to learn and adapt to changing situations. This technique could significantly reduce the frequency of inspection visits to key facilities without a loss of safeguards effectiveness.

  11. Health Effects of UV Radiation

    MedlinePlus

    ... menu Learn the Issues Air Chemicals and Toxics Climate Change Emergencies Greener Living Health and Safety Land and Cleanup Pesticides Waste Water Science & Technology Air Climate Change Ecosystems Health Land, Waste and Cleanup Pesticides Substances ...

  12. Ultraviolet Radiation: Human Exposure and Health Risks.

    ERIC Educational Resources Information Center

    Tenkate, Thomas D.

    1998-01-01

    Provides an overview of human exposure to ultraviolet radiation and associated health effects as well as risk estimates for acute and chronic conditions resulting from such exposure. Demonstrates substantial reductions in health risk that can be achieved through preventive actions. Also includes a risk assessment model for skin cancer. Contains 36…

  13. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.

    2014-01-01

    The radiation environment in space poses significant challenges to human health and is a major concern for long duration manned space missions. Outside the Earth's protective magnetosphere, astronauts are exposed to higher levels of galactic cosmic rays, whose physical characteristics are distinct from terrestrial sources of radiation such as x-rays and gamma-rays. Galactic cosmic rays consist of high energy and high mass nuclei as well as high energy protons; they impart unique biological damage as they traverse through tissue with impacts on human health that are largely unknown. The major health issues of concern are the risks of radiation carcinogenesis, acute and late decrements to the central nervous system, degenerative tissue effects such as cardiovascular disease, as well as possible acute radiation syndromes due to an unshielded exposure to a large solar particle event. The NASA Human Research Program's Space Radiation Program Element is focused on characterization and mitigation of these space radiation health risks along with understanding these risks in context of the other biological stressors found in the space environment. In this overview, we will provide a description of these health risks and the Element's research strategies to understand and mitigate these risks.

  14. Integrating reproductive health: myth and ideology.

    PubMed Central

    Lush, L.; Cleland, J.; Walt, G.; Mayhew, S.

    1999-01-01

    Since 1994, integrating human immunodeficiency virus/sexually transmitted disease (HIV/STD) services with primary health care, as part of reproductive health, has been advocated to address two major public health problems: to control the spread of HIV; and to improve women's reproductive health. However, integration is unlikely to succeed because primary health care and the political context within which this approach is taking place are unsuited to the task. In this paper, a historical comparison is made between the health systems of Ghana, Kenya and Zambia and that of South Africa, to examine progress on integration of HIV/STD services since 1994. Our findings indicate that primary health care in Ghana, Kenya and Zambia has been used mainly by women and children and that integration has meant adding new activities to these services. For the vertical programmes which support these services, integration implies enhanced collaboration rather than merged responsibility. This compromise between comprehensive rhetoric and selective reality has resulted in little change to existing structures and processes; problems with integration have been exacerbated by the activities of external donors. By comparison, in South Africa integration has been achieved through political commitment to primary health care rather than expanding vertical programmes (top-down management systems). The rhetoric of integration has been widely used in reproductive health despite lack of evidence for its feasibility, as a result of the convergence of four agendas: improving family planning quality; the need to improve women's health; the rapid spread of HIV; and conceptual shifts in primary health care. International reproductive health actors, however, have taken little account of political, financial and managerial constraints to implementation in low-income countries. PMID:10534902

  15. An integrated radiation physics computer code system.

    NASA Technical Reports Server (NTRS)

    Steyn, J. J.; Harris, D. W.

    1972-01-01

    An integrated computer code system for the semi-automatic and rapid analysis of experimental and analytic problems in gamma photon and fast neutron radiation physics is presented. Such problems as the design of optimum radiation shields and radioisotope power source configurations may be studied. The system codes allow for the unfolding of complex neutron and gamma photon experimental spectra. Monte Carlo and analytic techniques are used for the theoretical prediction of radiation transport. The system includes a multichannel pulse-height analyzer scintillation and semiconductor spectrometer coupled to an on-line digital computer with appropriate peripheral equipment. The system is geometry generalized as well as self-contained with respect to material nuclear cross sections and the determination of the spectrometer response functions. Input data may be either analytic or experimental.

  16. Space radiation health research, 1991-1992

    NASA Technical Reports Server (NTRS)

    Jablin, M. H. (Compiler); Brooks, C. (Compiler); Ferraro, G. (Compiler); Dickson, K. J. (Compiler); Powers, J. V. (Compiler); Wallace-Robinson, J. (Compiler); Zafren, B. (Compiler)

    1993-01-01

    The present volume is a collection of 227 abstracts of radiation research sponsored by the NASA Space Radiation Health Program for the period 1991-1992. Each abstract has been categorized within one of three discipline areas: Physics, Biology and Risk Assessment. Topic areas within each discipline have been assigned as follows: Physics - Atomic Physics, Theory, Cosmic Ray and Astrophysics, Experimental, Environments and Environmental Models, Solar Activity and Prediction, Experiments, Radiation Transport and Shielding, Theory and Model Development, Experimental Studies, and Instrumentation. Biology - Biology, Molecular Biology, Cellular Radiation Biology, Transformation, Mutation, Lethality, Survival, DNA Damage and Repair, Tissue, Organs, and Organisms, In Vivo/In Vitro Systems, Carcinogenesis and Life Shortening, Cataractogenesis, Genetics/Developmental, Radioprotectants, Plants, and Other Effects. Risk Assessment - Risk Assessment, Radiation Health and Epidemiology, Space Flight Radiation Health Physics, Inter- and Intraspecies Extrapolation and Radiation Limits and Standards. Section I contains refereed journals; Section II contains reports/meetings. Keywords and author indices are provided. A collection of abstracts spanning the period 1986-1990 was previously issued as NASA Technical Memorandum 4270.

  17. Health systems integration: state of the evidence

    PubMed Central

    Armitage, Gail D.; Suter, Esther; Oelke, Nelly D.; Adair, Carol E.

    2009-01-01

    Introduction Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration. PMID:19590762

  18. Biological countermeasures in space radiation health.

    PubMed

    Kennedy, Ann R; Todd, Paul

    2003-06-01

    Exposure to the types of ionizing radiation encountered during space travel may cause a number of health-related problems, but the primary concern is related to the increased risk of cancer induction in astronauts. The major types of radiation considered to be of importance during space travel are protons and particles of high atomic number and high energy (HZE particles). It is now clear that biological countermeasures can be used to prevent or reduce the levels of biological consequences resulting from exposure to protons or HZE particles, including the induction of cancer, immunosuppression and neurological defects caused by these types of ionizing radiation. Research related to the dietary additions of agents to minimize the risks of developing health-related problems which can result from exposure to space radiations is reviewed. PMID:12959130

  19. Biological countermeasures in space radiation health

    NASA Technical Reports Server (NTRS)

    Kennedy, Ann R.; Todd, Paul

    2003-01-01

    Exposure to the types of ionizing radiation encountered during space travel may cause a number of health-related problems, but the primary concern is related to the increased risk of cancer induction in astronauts. The major types of radiation considered to be of importance during space travel are protons and particles of high atomic number and high energy (HZE particles). It is now clear that biological countermeasures can be used to prevent or reduce the levels of biological consequences resulting from exposure to protons or HZE particles, including the induction of cancer, immunosuppression and neurological defects caused by these types of ionizing radiation. Research related to the dietary additions of agents to minimize the risks of developing health-related problems which can result from exposure to space radiations is reviewed.

  20. INTERCONNECTIONS BETWEEN HUMAN HEALTH AND ECOLOGICAL INTEGRITY

    EPA Science Inventory

    Interconnections between Human Health and Ecological Integrity emanates from a June 2000 Pellston Workshop in Snowbird, Utah, USA. Jointly sponsored by the Society of Environmental Toxicology and Chemistry (SETAC) and the Society of Toxicology (SOT), the workshop was motivated by...

  1. Benefits of radiation processing to public health

    NASA Astrophysics Data System (ADS)

    Kampelmacher, E. H.

    The problem of foodborne diseases, in which especially food of animals origin and the infected animal is involved, is reviewed. Salmonella and Campylobacter contamination of meat and poultry may today, together with parasites in meat and fish be considered as an increasing public health problem. Control and prevention measures, especially including radiation processing is summarized and with regard to specific micro-organisms and parasites and to various food commodities suitable for irradiation purposes. The possibilities of this new processing technique for reduction and probably elimination of pathogens and parasites are discussed and recommendations are given for practical application of radiation in order to eliminate health risks eliminating from contaminated food.

  2. Integration of video and radiation analysis data

    SciTech Connect

    Menlove, H.O.; Howell, J.A.; Rodriguez, C.A.; Eccleston, G.W.; Beddingfield, D.; Smith, J.E.; Baumgart, C.W.

    1995-12-31

    For the past several years, the integration of containment and surveillance (C/S) with nondestructive assay (NDA) sensors for monitoring the movement of nuclear material has focused on the hardware and communications protocols in the transmission network. Little progress has been made in methods to utilize the combined C/S and NDA data for safeguards and to reduce the inspector time spent in nuclear facilities. One of the fundamental problems in the integration of the combined data is that the two methods operate in different dimensions. The C/S video data is spatial in nature; whereas, the NDA sensors provide radiation levels versus time data. The authors have introduced a new method to integrate spatial (digital video) with time (radiation monitoring) information. This technology is based on pattern recognition by neural networks, provides significant capability to analyze complex data, and has the ability to learn and adapt to changing situations. This technique has the potential of significantly reducing the frequency of inspection visits to key facilities without a loss of safeguards effectiveness.

  3. Progress in radiation immune thermionic integrated circuits

    SciTech Connect

    Lynn, D.K.; McCormick, J.B.

    1985-08-01

    This report describes the results of a program directed at evaluating the thermionic integrated circuit (TIC) technology for applicability to military systems. Previous programs under the sponsorship of the Department of Energy, Office of Basic Energy Sciences, have developed an initial TIC technology base and demonstrated operation in high-temperature and high-radiation environments. The program described in this report has two parts: (1) a technical portion in which experiments and analyses were conducted to refine perceptions of near-term as well as ultimate performance levels of the TIC technology and (2) an applications portion in which the technical conclusions were to be evaluated against potential military applications. This report draws several conclusions that strongly suggest that (1) useful radiation-hard/high-temperature operable integrated circuits can be developed using the TIC technology; (2) because of their ability to survive and operate in hostile environments, a variety of potential military applications have been projected for this technology; and (3) based on the above two conclusions, an aggressive TIC development program should be initiated to provide the designers of future systems with integrated circuits and devices with the unique features of the TICs.

  4. Has radiation protection become a health hazard?

    SciTech Connect

    Rockwell, T.

    1996-12-31

    Scientists and engineers have a responsibility to speak out when their findings and recommendations lead to public harm. This can happen in several ways. One is when the media misinterpret or sensationalize a scientific fact misleading the public and creating unwarranted fear. Another is when regulations or public policy decision are purportedly based on scientific data but are, in fact, scientifically invalid. Fear of radiation has been far more detrimental to health than radiation itself. The author knows of no deaths to the public from accidental release of radiation, but the consequences of fear have been deadly.

  5. Radiation, chemicals, and occupational health research

    SciTech Connect

    Turner, J.E.

    1984-01-01

    Radiation protection and its interplay with physical research programs are described. Differences and similarities between problems in health protection for chemicals and for radiation are discussed. The importance of dosimetry in radiation work and its relevance to chemicals are cited. A collaborative program between physical and biological scientists on the toxicity of metals is briefly described. It serves as an example of new research directed toward the development of fundamental concepts and principles as a basis for understanding and controlling occupational and population exposures to chemicals. 12 references, 4 figures.

  6. Space Radiation and its Associated Health Consequences

    NASA Technical Reports Server (NTRS)

    Wu, Honglu

    2007-01-01

    During space travel, astronauts are exposed to energetic particles of a complex composition and energy distribution. For the same amount of absorbed dose, these particles can be much more effective than X- or gamma rays in the induction of biological effects, including cell inactivation, genetic mutations, cataracts, and cancer induction. Several of the biological consequences of space radiation exposure have already been observed in astronauts. This presentation will introduce the space radiation environment and discuss its associated health risks. Accurate assessment of the radiation risks and development of respective countermeasures are essential for the success of future exploration missions to the Moon and Mars.

  7. Radiation effects on power integrated circuits

    SciTech Connect

    Darwish, M.N.; Dolly, M.C.; Goodwin, C.A.; Titus, J.L

    1988-12-01

    A study was initiated to investigate the effects of gamma (total ionizing dose), prompt gamma (gamma dot), and neutron radiation on commercially available power integrated circuits (PIC's). A Dielectric Isolated (DI) Bipolar-CMOS-DMOS (BCDMOS) technology developed at AT and T Bell Laboratories was selected for this characterization. Total ionizing dose testing resulted in device failure at 30 krads (Si). Gamma dot testing (30 ns pulsewidth) resulted in device failure due to transient upset of the CMOS logic at 1.0 E+09 rads(Si)/s. Neutron testing resulted in severe degradation in performance, but devices remained functional after receiving a fluence of 2.0 E+14 n/cm/sup 2/. Also, an attempt was made to harden the BCDMOS technology to gamma radiation. Devices from eight processing splits were characterized to determine if specific process changes would improve their performance.

  8. Integrating homoeopathy in health systems.

    PubMed Central

    Poitevin, B.

    1999-01-01

    Homoeopathy is a therapy which involves many components and three main agents: the patient, with his or her condition and personal characteristics; the medication used, with its composition and manufacturing procedure; and the physician, with his or her approach to treatment and concepts of health. The development of research and evaluation structures, combined with a critical education in the discipline, would help to improve practices and define homoeopathy's potential role in relation to the other therapies, both conventional and unconventional, used in Western health systems. PMID:10083716

  9. Integrating Children's Mental Health into Primary Care.

    PubMed

    Wissow, Lawrence S; van Ginneken, Nadja; Chandna, Jaya; Rahman, Atif

    2016-02-01

    Children's mental health problems are among global health advocates' highest priorities. Nearly three-quarters of adult disorders have their onset or origins during childhood, becoming progressively harder to treat over time. Integrating mental health with primary care and other more widely available health services has the potential to increase treatment access during childhood, but requires re-design of currently-available evidence-based practices to fit the context of primary care and place a greater emphasis on promoting positive mental health. While some of this re-design has yet to be accomplished, several components are currently well-defined and show promise of effectiveness and practicality. PMID:26613691

  10. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  11. Potential health effects of space radiation

    NASA Technical Reports Server (NTRS)

    Yang, Chui-Hsu; Craise, Laurie M.

    1993-01-01

    Crewmembers on missions to the Moon or Mars will be exposed to radiation belts, galactic cosmic rays, and possibly solar particle events. The potential health hazards due to these space radiations must be considered carefully to ensure the success of space exploration. Because there is no human radioepidemiological data for acute and late effects of high-LET (Linear-Energy-Transfer) radiation, the biological risks of energetic charged particles have to be estimated from experimental results on animals and cultured cells. Experimental data obtained to date indicate that charged particle radiation can be much more effective than photons in causing chromosome aberrations, cell killing, mutation, and tumor induction. The relative biological effectiveness (RBE) varies with biological endpoints and depends on the LET of heavy ions. Most lesions induced by low-LET radiation can be repaired in mammalian cells. Energetic heavy ions, however, can produce large complex DNA damages, which may lead to large deletions and are irreparable. For high-LET radiation, therefore, there are less or no dose rate effects. Physical shielding may not be effective in minimizing the biological effects on energetic heavy ions, since fragments of the primary particles can be effective in causing biological effects. At present the uncertainty of biological effects of heavy particles is still very large. With further understanding of the biological effects of space radiation, the career doses can be kept at acceptable levels so that the space radiation environment need not be a barrier to the exploitation of the promise of space.

  12. Medical Physicists and Health Physicists: Radiation Occupations

    ERIC Educational Resources Information Center

    LaPointe, Jeffrey

    2011-01-01

    Physics is the study of matter and energy and the ways in which the two interact. Some physicists use their expertise in physics to focus on radiation. These specialists, called medical physicists and health physicists, work to help people or protect the environment. Medical physicists work with physicians, assisting patients who need imaging…

  13. An Integrated Approach for Gear Health Prognostics

    NASA Technical Reports Server (NTRS)

    He, David; Bechhoefer, Eric; Dempsey, Paula; Ma, Jinghua

    2012-01-01

    In this paper, an integrated approach for gear health prognostics using particle filters is presented. The presented method effectively addresses the issues in applying particle filters to gear health prognostics by integrating several new components into a particle filter: (1) data mining based techniques to effectively define the degradation state transition and measurement functions using a one-dimensional health index obtained by whitening transform; (2) an unbiased l-step ahead RUL estimator updated with measurement errors. The feasibility of the presented prognostics method is validated using data from a spiral bevel gear case study.

  14. Integrating oral health into the interdisciplinary health sciences curriculum.

    PubMed

    Dolce, Maria C; Aghazadeh-Sanai, Nona; Mohammed, Shan; Fulmer, Terry T

    2014-10-01

    Oral health inequities for older adults warrant new models of interprofessional education and collaborative practice. The Innovations in Interprofessional Oral Health: Technology, Instruction, Practice and Service curricular model at Bouvé College of Health Sciences aims to transform health professions education and primary care practice to meet global and local oral health challenges. Innovations in simulation and experiential learning help to advance interprofessional education and integrate oral health care as an essential component of comprehensive primary health care. The Program of All-Inclusive Care for the Elderly clinic is an exemplary model of patient-centeredness and interprofessional collaborative practice for addressing unmet oral health needs of its patient population. PMID:25201545

  15. Integrative Metabolic Signatures for Hepatic Radiation Injury

    PubMed Central

    Su, Gang; Meng, Fan; Liu, Laibin; Mohney, Robert; Kulkarni, Shilpa; Guha, Chandan

    2015-01-01

    Background Radiation-induced liver disease (RILD) is a dose-limiting factor in curative radiation therapy (RT) for liver cancers, making early detection of radiation-associated liver injury absolutely essential for medical intervention. A metabolomic approach was used to determine metabolic signatures that could serve as biomarkers for early detection of RILD in mice. Methods Anesthetized C57BL/6 mice received 0, 10 or 50 Gy Whole Liver Irradiation (WLI) and were contrasted to mice, which received 10 Gy whole body irradiation (WBI). Liver and plasma samples were collected at 24 hours after irradiation. The samples were processed using Gas Chromatography/Mass Spectrometry and Liquid Chromatography/Mass Spectrometry. Results Twenty four hours after WLI, 407 metabolites were detected in liver samples while 347 metabolites were detected in plasma. Plasma metabolites associated with 50 Gy WLI included several amino acids, purine and pyrimidine metabolites, microbial metabolites, and most prominently bradykinin and 3-indoxyl-sulfate. Liver metabolites associated with 50 Gy WLI included pentose phosphate, purine, and pyrimidine metabolites in liver. Plasma biomarkers in common between WLI and WBI were enriched in microbial metabolites such as 3 indoxyl sulfate, indole-3-lactic acid, phenyllactic acid, pipecolic acid, hippuric acid, and markers of DNA damage such as 2-deoxyuridine. Metabolites associated with tryptophan and indoles may reflect radiation-induced gut microbiome effects. Predominant liver biomarkers in common between WBI and WLI were amino acids, sugars, TCA metabolites (fumarate), fatty acids (lineolate, n-hexadecanoic acid) and DNA damage markers (uridine). Conclusions We identified a set of metabolomic markers that may prove useful as plasma biomarkers of RILD and WBI. Pathway analysis also suggested that the unique metabolic changes observed after liver irradiation was an integrative response of the intestine, liver and kidney. PMID:26046990

  16. Fundamentals of health physics for the radiation-protection officer

    SciTech Connect

    Murphy, B.L.; Traub, R.J.; Gilchrist, R.L.; Mann, J.C.; Munson, L.H.; Carbaugh, E.H.; Baer, J.L.

    1983-03-01

    The contents of this book on health physics include chapters on properties of radioactive materials, radiation instrumentation, radiation protection programs, radiation survey programs, internal exposure, external exposure, decontamination, selection and design of radiation facilities, transportation of radioactive materials, radioactive waste management, radiation accidents and emergency preparedness, training, record keeping, quality assurance, and appraisal of radiation protection programs. (ACR)

  17. Health Knowledge Effects: An Integrated Community Health Promotion Platform.

    PubMed

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu

    2016-03-01

    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform. PMID:26657621

  18. Capitated contracting of integrated health provider organizations.

    PubMed

    Bazzoli, G J; Dynan, L; Burns, L R

    This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on health plan risk contracting with health providers. PMID:10711318

  19. Exposure to UV radiation and human health

    NASA Astrophysics Data System (ADS)

    Kimlin, Michael G.

    2005-08-01

    This paper will overview the significant issues facing researchers in relating the impact of exposure to sunlight and human health. Exposure to solar ultraviolet radiation is the major causative factor in most sun-related skin and eye disorders, however, very little is known quantitatively about human UV exposures. Interestingly, human exposure to sunlight also has a nutritional impact, namely the development of pre-Vitamin D, which is an important nutrient in bone health. New research suggest that low vitamin D status may be a causative factor in the development of selective types of cancer and autoimminue diseases, as well as a contributing factor in bone health. The 'health duality' aspect of sunlight exposure is an interesting and controversial topic that is a research focus of Kimlin's research group.

  20. Integral -tracking extreme radiation across the Universe

    NASA Astrophysics Data System (ADS)

    2002-10-01

    . Galactic black holes also give off gamma rays, and with such awesome power that you can detect them almost halfway across the known Universe. As well as making the most accurate studies of these objects to date, Integral will also investigate the mysterious blasts of gamma rays that explode across the Universe about once a day, the gamma-ray bursts. They can last just a few seconds and can come from any direction in space. The origin of gamma-ray bursts has remained unexplained for years, from their first observation in the late 1960s. Today, many scientists think that gamma ray bursts could be linked to the death throes of the very first stars. Alternatively, they could be generated by colliding neutron stars, or could be caused by the explosion of supermassive stars at the end of their lives, the hypernovae. Integral's instruments will study gamma-ray bursts with the highest accuracy ever and may discover something about their origins. Integral’s instruments Integral has four instruments to give the spacecraft maximum versatility in its task of studying the gamma-ray Universe. Designed to complement each other, their combined observations will allow scientists to get a very complete and accurate picture of each celestial target at different wavelengths. The first two are dedicated gamma-ray instruments. Imager on Board the Integral Satellite (IBIS) is the sharpest-resolution gamma-ray camera ever built. Spectrometer on Integral (SPI) will measure the energy of gamma rays with exceptional accuracy. In particular, it will be more sensitive to fainter radiation than any previous gamma-ray spectrometer. The other two instruments are designed to provide complementary scientific data about Integral’s targets. The Joint European X-Ray Monitor (JEM-X) will make observations simultaneously with the main gamma-ray instruments and will provide images at X-ray wavelengths. The Optical Monitoring Camera (OMC) will do the same but at visible-light wavelengths. The total weight of

  1. Integrating mental health into primary health care in Iraq

    PubMed Central

    2011-01-01

    The Ministry of Health in Iraq is undertaking a systematic programme to integrate mental health into primary care in order to increase population access to mental health care. This paper reports the evaluation of the delivery of a ten day interactive training programme to 20% of primary care centres across Iraq. The multistage evaluation included a pre- and post-test questionnaire to assess knowledge, attitudes and practice in health workers drawn from 143 health centres, a course evaluation questionnaire and, in a random sample of 41 clinics, direct observation of health workers skills and exit interviews of patients, comparing health workers who had received the training programme with those from the same clinics who had not received the training. Three hundred andseventeen health workersparticipated in the training, which achieved an improvement in test scores from 42.3% to 59%. Trained health workers were observed by research psychiatrists to have a higher level of excellent skills than the untrained health workers, and patient exit interviews also reported better skills in the trained rather than untrained health workers. The two week course has thus been able to achieve significant change, not only in knowledge, but also in subsequent demonstration of trained practitioners practical skills in the workplace. Furthermore, it has been possible to implement the course and the evaluation despite a complex conflict situation. PMID:22479291

  2. Integrated natural radiation exposure studies in stable Yugoslav rural communities.

    PubMed

    Zunic, Z S; McLaughlin, J P; Walsh, C; Birovljev, A; Simopoulos, S E; Jakupi, B; Gordanic, V; Demajo, M; Trotti, F; Falk, R; Vanmarcke, H; Paridaens, J; Fujimoto, K

    2001-05-14

    The results of field investigations of natural radiation exposures of the general population in two stable rural communities in Yugoslavia are presented. The principal emphasis was on exposures to contemporary indoor radon, but measurements of external penetrating radiation absorbed dose rates in air were carried out in the majority of cases. In addition, in a limited number of dwellings, measurements of thoron gas concentrations were made. By means of making a series of sequential 3-month radon measurements, both seasonal variations and annual average radon levels in the dwellings were determined. Using passive alpha track detectors, individual radon and thoron indoor concentrations as high as 9591 Bq m(-3) and 709 Bq m(-3), respectively, were detected while absorbed dose rates in air in the dwellings as high as 430 nGy h(-1) were recorded. On the basis of these different types of measurements, assessments could be made of the integrated natural radiation exposures being received by the populations. In addition to contemporary radon measurements, retrospective radon exposure assessments in most of the dwellings were made on the basis of measurements of 210Po concentrations in both surface (glass) traps and in volume (porous materials) traps. A description is given of the sampling strategies and protocols used in this field work. It is shown that at least one stable rural community receiving high natural radiation exposures, has been clearly identified and plans for future health investigations of the population there are outlined. PMID:11379920

  3. [Information systems in health and health indicators: an integrating perspective].

    PubMed

    Canela-Soler, Jaume; Elvira-Martínez, David; Labordena-Barceló, María Jesús; Loyola-Elizondo, Enrique

    2010-02-01

    Health Information Systems (HIS) are the core support to decision-making in health organizations. Within HIS, health indicators (HI) reflect, numerically, events measured in the health-illness continuum. The integrated health information system is intended to standardize, integrate and organize all the information available in health information systems through an accessible and secure repository, and to conveniently distribute information for decision-making. To standardize information it is necessary to define standards and semantic information to enable us to identify concepts and relate them uniquely to each other. The definition of a catalog of entities (DEA) with concepts, attributes and domains will enable the configuration of the information system, so there will be a catalog of entities (concepts of information and domains). Based on operational systems, analytical systems enabling management and strategy in the management of organizations will be built. The maximum level of analysis is the Balanced Score Card (BSC), which is established as the strategic tool for managers. It is necessary for the organization an integrated information system to plan, manage, evaluate and therefore provide managers with a decision tool for strategic and tactical decision-making in short and medium term. PMID:20211346

  4. Investigation of Integrated Vehicle Health Management Approaches

    NASA Technical Reports Server (NTRS)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  5. Integrating health and environmental impact analysis.

    PubMed

    Reis, S; Morris, G; Fleming, L E; Beck, S; Taylor, T; White, M; Depledge, M H; Steinle, S; Sabel, C E; Cowie, H; Hurley, F; Dick, J McP; Smith, R I; Austen, M

    2015-10-01

    Scientific investigations have progressively refined our understanding of the influence of the environment on human health, and the many adverse impacts that human activities exert on the environment, from the local to the planetary level. Nonetheless, throughout the modern public health era, health has been pursued as though our lives and lifestyles are disconnected from ecosystems and their component organisms. The inadequacy of the societal and public health response to obesity, health inequities, and especially global environmental and climate change now calls for an ecological approach which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose a new conceptual model, the ecosystems-enriched Drivers, Pressures, State, Exposure, Effects, Actions or 'eDPSEEA' model, to address this shortcoming. The model recognizes convergence between the concept of ecosystems services which provides a human health and well-being slant to the value of ecosystems while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession. It will require outreach to political and other stakeholders including a currently largely disengaged general public. The need for an effective and robust science-policy interface has

  6. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  7. Health Impacts from Acute Radiation Exposure

    SciTech Connect

    Strom, Daniel J.

    2003-09-30

    Absorbed doses above1-2 Gy (100-200 rads) received over a period of a day or less lead to one or another of the acute radiation syndromes. These are the hematopoietic syndrome, the gastrointestinal (GI) syndrome, the cerebrovascular (CV) syndrome, the pulmonary syndrome, or the cutaneous syndrome. The dose that will kill about 50% of the exposed people within 60 days with minimal medical care, LD50-60, is around 4.5 Gy (450 rads) of low-LET radiation measured free in air. The GI syndrome may not be fatal with supportive medical care and growth factors below about 10 Gy (1000 rads), but above this is likely to be fatal. Pulmonary and cutaneous syndromes may or may not be fatal, depending on many factors. The CV syndrome is invariably fatal. Lower acute doses, or protracted doses delivered over days or weeks, may lead to many other health outcomes than death. These include loss of pregnancy, cataract, impaired fertility or temporary or permanent sterility, hair loss, skin ulceration, local tissue necrosis, developmental abnormalities including mental and growth retardation in persons irradiated as children or fetuses, radiation dermatitis, and other symptoms listed in Table 2 on page 12. Children of parents irradiated prior to conception may experience heritable ill-health, that is, genetic changes from their parents. These effects are less strongly expressed than previously thought. Populations irradiated to high doses at high dose rates have increased risk of cancer incidence and mortality, taken as about 10-20% incidence and perhaps 5-10% mortality per sievert of effective dose of any radiation or per gray of whole-body absorbed dose low-LET radiation. Cancer risks for non-uniform irradiation will be less.

  8. Integrated Theory of Health Behavior Change

    PubMed Central

    RYAN, POLLY

    2009-01-01

    An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care. PMID:19395894

  9. Method for analyzing radiation sensitivity of integrated circuits

    NASA Technical Reports Server (NTRS)

    Gauthier, M. K.; Stanley, A. G. (Inventor)

    1979-01-01

    A method for analyzing the radiation sensitivity of an integrated circuit is described to determine the components. The application of a narrow radiation beam to portions of the circuit is considered. The circuit is operated under normal bias conditions during the application of radiation in a dosage that is likely to cause malfunction of at least some transistors, while the circuit is monitored for failure of the irradiated transistor. When a radiation sensitive transistor is found, then the radiation beam is further narrowed and, using a fresh integrated circuit, a very narrow beam is applied to different parts of the transistor, such as its junctions, to locate the points of greatest sensitivity.

  10. Emerging Radiation Health-Risk Mitigation Technologies

    SciTech Connect

    Wilson, J.W.; Cucinotta, F.A.; Schimmerling, W.

    2004-02-04

    Past space missions beyond the confines of the Earth's protective magnetic field have been of short duration and protection from the effects of solar particle events was of primary concern. The extension of operational infrastructure beyond low-Earth orbit to enable routine access to more interesting regions of space will require protection from the hazards of the accumulated exposures of Galactic Cosmic Rays (GCR). There are significant challenges in providing protection from the long-duration exposure to GCR: the human risks to the exposures are highly uncertain and safety requirements places unreasonable demands in supplying sufficient shielding materials in the design. A vigorous approach to future radiation health-risk mitigation requires a triage of techniques (using biological and technical factors) and reduction of the uncertainty in radiation risk models. The present paper discusses the triage of factors for risk mitigation with associated materials issues and engineering design methods.

  11. Outcome mapping for health system integration

    PubMed Central

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  12. Outcome mapping for health system integration.

    PubMed

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  13. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  14. The Russian radiation legacy: its integrated impact and lessons.

    PubMed Central

    Goldman, M

    1997-01-01

    Information about the consequences of human exposure to radiation in the former Soviet Union has recently become available. These data add new insights and provide possible answers to several important questions regarding radiation and its impact on occupational and public health. The 1986 Chernobyl accident initiated a major and early increase in childhood thyroid cancer that resulted from ingestion of iodine-131 (131I) by young children living in the most heavily contaminated areas of Belarus, Ukraine, and Russia. No significant additional cancer or other adverse medical effects have yet been reported in the affected populations and among clean-up workers. Major psychological stress independent of radiation dose has been observed in those people thought to be exposed. During the early days of the atomic energy program in the former Soviet Union, some unfortunate events occurred. The country's first atomic test in Semipalatinsk in 1949 exposed over 25,000 people downwind from the blast to significant doses of fission products, especially 131I. During the late 1940s and the early 1950s nuclear material production facilities were developed near Chelyabinsk in the South Ural Mountains, which resulted in major releases into the environment and significant overexposures for thousands of workers and nearby populations. Chronic radiation sickness was observed early in exposed workers, and increases in leukemia and other cancers were also reported. The series of plutonium inhalation-related lung cancers and fatalities among workers exposed in that first decade appears to be unique. Long-term consequences of chronic radiation sickness and four decades of follow-up are being described for the first time. Villagers downstream from the plant consumed high levels of 137Cs and 90Sr and, it is reported, manifested increases in leukemia from internal and external exposures. Although the 40-year databases for retrospective dosimetry epidemiology studies are just beginning to be

  15. The Russian radiation legacy: its integrated impact and lessons.

    PubMed

    Goldman, M

    1997-12-01

    Information about the consequences of human exposure to radiation in the former Soviet Union has recently become available. These data add new insights and provide possible answers to several important questions regarding radiation and its impact on occupational and public health. The 1986 Chernobyl accident initiated a major and early increase in childhood thyroid cancer that resulted from ingestion of iodine-131 (131I) by young children living in the most heavily contaminated areas of Belarus, Ukraine, and Russia. No significant additional cancer or other adverse medical effects have yet been reported in the affected populations and among clean-up workers. Major psychological stress independent of radiation dose has been observed in those people thought to be exposed. During the early days of the atomic energy program in the former Soviet Union, some unfortunate events occurred. The country's first atomic test in Semipalatinsk in 1949 exposed over 25,000 people downwind from the blast to significant doses of fission products, especially 131I. During the late 1940s and the early 1950s nuclear material production facilities were developed near Chelyabinsk in the South Ural Mountains, which resulted in major releases into the environment and significant overexposures for thousands of workers and nearby populations. Chronic radiation sickness was observed early in exposed workers, and increases in leukemia and other cancers were also reported. The series of plutonium inhalation-related lung cancers and fatalities among workers exposed in that first decade appears to be unique. Long-term consequences of chronic radiation sickness and four decades of follow-up are being described for the first time. Villagers downstream from the plant consumed high levels of 137Cs and 90Sr and, it is reported, manifested increases in leukemia from internal and external exposures. Although the 40-year databases for retrospective dosimetry epidemiology studies are just beginning to be

  16. Health Partners of Western Ohio: Integrated Care Case Study.

    PubMed

    Taflinger, Kimberly; West, Elizabeth; Sunderhaus, Janis; Hilton, Irene V

    2016-03-01

    Health centers are unique health care delivery organizations in which multiple disciplines, such as primary care, dental, behavioral health, pharmacy, podiatry, optometry and alternative medicine, are often located at the same site. Because of this characteristic, many health centers have developed systems of integrated care. This paper describes the characteristics of health centers and highlights the integrated health care delivery system of one early adopter health center, Health Partners of Western Ohio. PMID:27044240

  17. Integrating Electronic Health Record Competencies into Undergraduate Health Informatics Education.

    PubMed

    Borycki, Elizabeth M; Griffith, Janessa; Kushniruk, Andre W

    2016-01-01

    In this paper we report on our findings arising from a qualitative, interview study of students' experiences in an undergraduate health informatics program. Our findings suggest that electronic health record competencies need to be integrated into an undergraduate curriculum. Participants suggested that there is a need to educate students about the use of the EHR, followed by best practices around interface design, workflow, and implementation with this work culminating in students spearheading the design of the technology as part of their educational program of study. PMID:27577461

  18. Making Technology Ready: Integrated Systems Health Management

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

    This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

  19. Radiation safety for health care workers in the bronchoscopy suite.

    PubMed

    Jain, P; Fleming, P; Mehta, A C

    1999-03-01

    Increased use of fluoroscopy during flexible bronchoscopy has raised concerns about radiation safety of health care workers in the bronchoscopy suite. We review the potential health risks associated with occupational radiation exposure, the monitoring devices available, and discuss the measures to reduce radiation exposure during flexible bronchoscopy. PMID:10205715

  20. Challenges of Systematic Reviewing Integrative Health Care

    PubMed Central

    Coulter, Ian D.; Khorsan, Raheleh; Crawford, Cindy; Hsiao, An-Fu

    2013-01-01

    This article is based on an extensive review of integrative medicine (IM) and integrative health care (IHC). Since there is no general agreement of what constitutes IM/IHC, several major problems were identified that make the review of work in this field problematic. In applying the systematic review methodology, we found that many of those captured articles that used the term integrative medicine were in actuality referring to adjunctive, complementary, or supplemental medicine. The objective of this study was to apply a sensitivity analysis to demonstrate how the results of a systematic review of IM and IHC will differ according to what inclusion criteria is used based on the definition of IM/IHC. By analyzing 4 different scenarios, the authors show that, due to unclear usage of these terms, results vary dramatically, exposing an inconsistent literature base for this field. PMID:23843689

  1. Integrated Vehicle Health Management (IVHM) Activities at Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Fox, Jack

    2000-01-01

    Integrated Vehicle Health Management (IVHM) goals are to develop and integrate the technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce the costs of operations.

  2. Securing health sensing using integrated circuit metric.

    PubMed

    Tahir, Ruhma; Tahir, Hasan; McDonald-Maier, Klaus

    2015-01-01

    Convergence of technologies from several domains of computing and healthcare have aided in the creation of devices that can help health professionals in monitoring their patients remotely. An increase in networked healthcare devices has resulted in incidents related to data theft, medical identity theft and insurance fraud. In this paper, we discuss the design and implementation of a secure lightweight wearable health sensing system. The proposed system is based on an emerging security technology called Integrated Circuit Metric (ICMetric) that extracts the inherent features of a device to generate a unique device identification. In this paper, we provide details of how the physical characteristics of a health sensor can be used for the generation of hardware "fingerprints". The obtained fingerprints are used to deliver security services like authentication, confidentiality, secure admission and symmetric key generation. The generated symmetric key is used to securely communicate the health records and data of the patient. Based on experimental results and the security analysis of the proposed scheme, it is apparent that the proposed system enables high levels of security for health monitoring in resource optimized manner. PMID:26492250

  3. Securing Health Sensing Using Integrated Circuit Metric

    PubMed Central

    Tahir, Ruhma; Tahir, Hasan; McDonald-Maier, Klaus

    2015-01-01

    Convergence of technologies from several domains of computing and healthcare have aided in the creation of devices that can help health professionals in monitoring their patients remotely. An increase in networked healthcare devices has resulted in incidents related to data theft, medical identity theft and insurance fraud. In this paper, we discuss the design and implementation of a secure lightweight wearable health sensing system. The proposed system is based on an emerging security technology called Integrated Circuit Metric (ICMetric) that extracts the inherent features of a device to generate a unique device identification. In this paper, we provide details of how the physical characteristics of a health sensor can be used for the generation of hardware “fingerprints”. The obtained fingerprints are used to deliver security services like authentication, confidentiality, secure admission and symmetric key generation. The generated symmetric key is used to securely communicate the health records and data of the patient. Based on experimental results and the security analysis of the proposed scheme, it is apparent that the proposed system enables high levels of security for health monitoring in resource optimized manner. PMID:26492250

  4. Impaired skin integrity related to radiation therapy

    SciTech Connect

    Ratliff, C.

    1990-09-01

    Skin reactions associated with radiation therapy require frequent nursing assessment and intervention. Preventive interventions and early management can minimize the severity of the skin reaction. With the understanding of the pathogenesis of radiation skin reactions, the ET nurse can determine who is at risk and then implement preventive measures. Because radiation treatment is fractionated, skin reactions do not usually occur until midway through the course of therapy and will subside within a few weeks after completion of radiation. Many patients and their families still fear that radiation causes severe burns. Teaching and anticipatory guidance by the ET nurse is needed to assist patients and their families to overcome this fear, and to educate them on preventive skin care regimens.

  5. Integrating Behavioral Health into Primary Care.

    PubMed

    McGough, Peter M; Bauer, Amy M; Collins, Laura; Dugdale, David C

    2016-04-01

    Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81-87). PMID:26348355

  6. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  7. Integrating Behavioral Health into Primary Care

    PubMed Central

    Bauer, Amy M.; Collins, Laura; Dugdale, David C.

    2016-01-01

    Abstract Depression is one of the more common diagnoses encountered in primary care, and primary care in turn provides the majority of care for patients with depression. Many approaches have been tried in efforts to improve the outcomes of depression management. This article outlines the partnership between the University of Washington (UW) Neighborhood Clinics and the UW Department of Psychiatry in implementing a collaborative care approach to integrating the management of anxiety and depression in the ambulatory primary care setting. This program was built on the chronic care model, which utilizes a team approach to caring for the patient. In addition to the patient and the primary care provider (PCP), the team included a medical social worker (MSW) as care manager and a psychiatrist as team consultant. The MSW would manage a registry of patients with depression at a clinic with several PCPs, contacting the patients on a regular basis to assess their status, and consulting with the psychiatrist on a weekly basis to discuss patients who were not achieving the goals of care. Any recommendation (eg, a change in medication dose or class) made by the psychiatrist was communicated to the PCP, who in turn would work with the patient on the new recommendation. This collaborative care approach resulted in a significant improvement in the number of patients who achieved care plan goals. The authors believe this is an effective method for health systems to integrate mental health services into primary care. (Population Health Management 2016;19:81–87) PMID:26348355

  8. Radiation hydrodynamics integrated in the PLUTO code

    NASA Astrophysics Data System (ADS)

    Kolb, Stefan M.; Stute, Matthias; Kley, Wilhelm; Mignone, Andrea

    2013-11-01

    Aims: The transport of energy through radiation is very important in many astrophysical phenomena. In dynamical problems the time-dependent equations of radiation hydrodynamics have to be solved. We present a newly developed radiation-hydrodynamics module specifically designed for the versatile magnetohydrodynamic (MHD) code PLUTO. Methods: The solver is based on the flux-limited diffusion approximation in the two-temperature approach. All equations are solved in the co-moving frame in the frequency-independent (gray) approximation. The hydrodynamics is solved by the different Godunov schemes implemented in PLUTO, and for the radiation transport we use a fully implicit scheme. The resulting system of linear equations is solved either using the successive over-relaxation (SOR) method (for testing purposes) or using matrix solvers that are available in the PETSc library. We state in detail the methodology and describe several test cases to verify the correctness of our implementation. The solver works in standard coordinate systems, such as Cartesian, cylindrical, and spherical, and also for non-equidistant grids. Results: We present a new radiation-hydrodynamics solver coupled to the MHD-code PLUTO that is a modern, versatile, and efficient new module for treating complex radiation hydrodynamical problems in astrophysics. As test cases, either purely radiative situations, or full radiation-hydrodynamical setups (including radiative shocks and convection in accretion disks) were successfully studied. The new module scales very well on parallel computers using MPI. For problems in star or planet formation, we added the possibility of irradiation by a central source.

  9. Ultraviolet radiation and health: friend and foe.

    PubMed

    Lucas, Robyn M; Ponsonby, Anne-Louise

    While excessive exposure to ultraviolet radiation (UVR) is a significant cause of disease burden in Australia and the Western Pacific region, there are well documented beneficial as well as adverse effects of UVR exposure. Ambient UVR levels do not translate directly to personal UVR dose and thus to biological effect - each person's sun-exposure behaviour and pigmentation also play a role. Exposure in childhood may be more important than exposure in adulthood for both beneficial and adverse effects. Stratospheric ozone depletion increases ambient UVR in the UVB wavelength, possibly the most important wavelength for both beneficial and deleterious health effects. There is ongoing research examining the effects of UVR exposure on immune function, including an examination of the possible role of lack of UVR exposure in the aetiology of multiple sclerosis and type 1 diabetes mellitus. PMID:12463975

  10. Rocket Testing and Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

    Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.

  11. Rethinking global health research: towards integrative expertise

    PubMed Central

    MacLachlan, Malcolm

    2009-01-01

    The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries. PMID:19643021

  12. Community-oriented integrated mental health services

    PubMed Central

    Morris, David

    2014-01-01

    Unprecedented levels of cost containment in NHS and social care organisations – together with integration as a policy priority – make this a key moment for fresh ways of thinking about how to commission and provide community-based integrated services that meet the challenge of local accountability and citizen participation. This is nowhere more important than in mental health. Primary care with its local orientation is properly at the heart of this agenda, but there is a need for new forms of leadership for collaboration in the sector. In this context, the contribution of general practitioner (GP) networks is likely to be fundamental. This paper is a brief discussion of some of the issues associated with GP networks and mental health, set in the context of a round table discussion with three sets of participants at a 2014 London Journal of Primary Care/Royal College of General Practitioners conference. The conference provided a forum for capturing a diversity of experience and knowledge and for turning this into a force for critical transformation. This paper describes a contribution to the day. PMID:25949738

  13. Integration: the firm and the health care sector.

    PubMed

    Laugesen, Miriam J; France, George

    2014-07-01

    Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations. PMID:24759287

  14. Radiation-hardened transistor and integrated circuit

    DOEpatents

    Ma, Kwok K.

    2007-11-20

    A composite transistor is disclosed for use in radiation hardening a CMOS IC formed on an SOI or bulk semiconductor substrate. The composite transistor has a circuit transistor and a blocking transistor connected in series with a common gate connection. A body terminal of the blocking transistor is connected only to a source terminal thereof, and to no other connection point. The blocking transistor acts to prevent a single-event transient (SET) occurring in the circuit transistor from being coupled outside the composite transistor. Similarly, when a SET occurs in the blocking transistor, the circuit transistor prevents the SET from being coupled outside the composite transistor. N-type and P-type composite transistors can be used for each and every transistor in the CMOS IC to radiation harden the IC, and can be used to form inverters and transmission gates which are the building blocks of CMOS ICs.

  15. Integrating Wireless Networking for Radiation Detection

    NASA Astrophysics Data System (ADS)

    Board, Jeremy; Barzilov, Alexander; Womble, Phillip; Paschal, Jon

    2006-10-01

    As wireless networking becomes more available, new applications are being developed for this technology. Our group has been studying the advantages of wireless networks of radiation detectors. With the prevalence of the IEEE 802.11 standard (``WiFi''), we have developed a wireless detector unit which is comprised of a 5 cm x 5 cm NaI(Tl) detector, amplifier and data acquisition electronics, and a WiFi transceiver. A server may communicate with the detector unit using a TCP/IP network connected to a WiFi access point. Special software on the server will perform radioactive isotope determination and estimate dose-rates. We are developing an enhanced version of the software which utilizes the receiver signal strength index (RSSI) to estimate source strengths and to create maps of radiation intensity.

  16. Health monitoring techniques using integrated sensors

    NASA Astrophysics Data System (ADS)

    Pfleiderer, Klaus; Stoessel, Rainer; Busse, Gerhard

    2003-08-01

    Advanced high performance materials and components such as CFRP, GFRP and Smart Structures require improved testing techniques. The first part of our contribution deals with nonlinear vibrometry as a defect selective non-destructive testing method. This method uses higher harmonics (which are generated only at defects) to locate the defect by scanning across the surface of the sample with a laser interferometer. For input coupling of the elastic wave both an external (like ultrasound welding converters) or internal (integrated piezo actuators) excitation source can be used. The external detection tools are a microphone or a scanning laser vibrometer. With this technique, we characterized Smart Structures made of aerospace materials and composites with embedded piezoelectric actuators. The next part is about health monitoring techniques and diagnostics where integrated elements are used for excitation and detection. Thus, we monitored the transfer function over a large frequency spectrum and especially its changes caused e.g. by defects. Changes in the properties of structures by fatigue, impacts, and thermoplasticity have been successfully observed. Also the changes in reinforced plastics under tensile stress have been monitored. The results were correlated with destructive measurements. For health monitoring we also present the impedance analysis of embedded piezo ceramic sensors. A defect causes changes in the modal response of the hole structure and that effect can be detected using the phase angle of the electric impedance of the piezo element. Additionally some types of defects cause a non-linear behavior of the structure which was verified by extracting higher harmonics as a reaction to sinusoidal single frequency excitation.

  17. Health physics/radiation protection enrollments and degrees, 1987

    SciTech Connect

    Not Available

    1988-06-01

    The ''Health Physics/Radiation Protection Enrollments and Degrees Survey, 1987'' included 59 institutions with programs offering a major in health physics or an option within another major with equivalent course work which will prepare the graduate to take a major role in conducting, coordinating, directing, or planning a program for the evaluation and control of radiation hazards, i.e., programs which prepare graduates to perform as health physicists. This report discusses the results of this survey.

  18. 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

  19. Frequency Integrated Radiation Models for Absorbing and Scattering Media

    NASA Technical Reports Server (NTRS)

    Ripoll, J. F.; Wray, A. A.

    2004-01-01

    The objective of this work is to contribute to the simplification of existing radiation models used in complex emitting, absorbing, scattering media. The application in view is the computation of flows occurring in such complex media, such as certain stellar interiors or combusting gases. In these problems, especially when scattering is present, the complexity of the radiative transfer leads to a high numerical cost, which is often avoided by simply neglecting it. The complexity lies partly in the strong dependence of the spectral coefficients on frequency. Models are then needed to capture the effects of the radiation when one cannot afford to directly solve for it. In this work, the frequency dependence will be modeled and integrated out in order retain only the average effects. A frequency-integrated radiative transfer equation (RTE) will be derived.

  20. Integrating the Healthcare Enterprise in Radiation Oncology Plug and Play-The Future of Radiation Oncology?

    SciTech Connect

    Abdel-Wahab, May; Rengan, Ramesh; Curran, Bruce; Swerdloff, Stuart; Miettinen, Mika; Field, Colin; Ranjitkar, Sunita; Palta, Jatinder; Tripuraneni, Prabhakar

    2010-02-01

    Purpose: To describe the processes and benefits of the integrating healthcare enterprises in radiation oncology (IHE-RO). Methods: The IHE-RO process includes five basic steps. The first step is to identify common interoperability issues encountered in radiation treatment planning and the delivery process. IHE-RO committees partner with vendors to develop solutions (integration profiles) to interoperability problems. The broad application of these integration profiles across a variety of vender platforms is tested annually at the Connectathon event. Demonstration of the seamless integration and transfer of patient data to the potential users are then presented by vendors at the public demonstration event. Users can then integrate these profiles into requests for proposals and vendor contracts by institutions. Results: Incorporation of completed integration profiles into requests for proposals can be done when purchasing new equipment. Vendors can publish IHE integration statements to document the integration profiles supported by their products. As a result, users can reference integration profiles in requests for proposals, simplifying the systems acquisition process. These IHE-RO solutions are now available in many of the commercial radiation oncology-related treatment planning, delivery, and information systems. They are also implemented at cancer care sites around the world. Conclusions: IHE-RO serves an important purpose for the radiation oncology community at large.

  1. NASA Space Radiation Program Integrative Risk Model Toolkit

    NASA Technical Reports Server (NTRS)

    Kim, Myung-Hee Y.; Hu, Shaowen; Plante, Ianik; Ponomarev, Artem L.; Sandridge, Chris

    2015-01-01

    NASA Space Radiation Program Element scientists have been actively involved in development of an integrative risk models toolkit that includes models for acute radiation risk and organ dose projection (ARRBOD), NASA space radiation cancer risk projection (NSCR), hemocyte dose estimation (HemoDose), GCR event-based risk model code (GERMcode), and relativistic ion tracks (RITRACKS), NASA radiation track image (NASARTI), and the On-Line Tool for the Assessment of Radiation in Space (OLTARIS). This session will introduce the components of the risk toolkit with opportunity for hands on demonstrations. The brief descriptions of each tools are: ARRBOD for Organ dose projection and acute radiation risk calculation from exposure to solar particle event; NSCR for Projection of cancer risk from exposure to space radiation; HemoDose for retrospective dose estimation by using multi-type blood cell counts; GERMcode for basic physical and biophysical properties for an ion beam, and biophysical and radiobiological properties for a beam transport to the target in the NASA Space Radiation Laboratory beam line; RITRACKS for simulation of heavy ion and delta-ray track structure, radiation chemistry, DNA structure and DNA damage at the molecular scale; NASARTI for modeling of the effects of space radiation on human cells and tissue by incorporating a physical model of tracks, cell nucleus, and DNA damage foci with image segmentation for the automated count; and OLTARIS, an integrated tool set utilizing HZETRN (High Charge and Energy Transport) intended to help scientists and engineers study the effects of space radiation on shielding materials, electronics, and biological systems.

  2. AN ENERGY SYSTEMS PERPECTIVE OF ECOLOGICAL INTEGRITY AND ECOSYSTEM HEALTH

    EPA Science Inventory

    The integrity and health of society's life-supporting ecosystems establishes a fundamental constraint on economic growth and development. Energy Systems Theory provides a theoretical basis for defining, measuring and interpreting the concepts of ecological integrity and ecosystem...

  3. Analysis of integrated video and radiation data

    SciTech Connect

    Howell, J.A.; Menlove, H.O.; Rodriguez, C.A.; Beddingfield, D.; Vasil, A.

    1995-07-01

    We have developed prototype software for a facility-monitoring application that will detect anomalous activity in a nuclear facility. The software, which forms the basis of a simple model, automatically reviews and analyzes integrated safeguards data from continuous unattended monitoring systems. This technology, based on pattern recognition by neural networks, provides significant capability to analyze complex data and has the ability to learn and adapt to changing situations. It is well suited for large automated facilities, reactors, spent-fuel storage facilities, reprocessing plants, and nuclear material storage vaults.

  4. Elements of an integrated health monitoring framework

    NASA Astrophysics Data System (ADS)

    Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda

    2003-07-01

    Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integrated health monitoring analysis framework.

  5. Integrated Systems Health Management for Space Exploration

    NASA Technical Reports Server (NTRS)

    Uckun, Serdar

    2005-01-01

    Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

  6. Technology Maturation of Integrated System Health Management

    NASA Astrophysics Data System (ADS)

    Feather, Martin S.; Uckun, Serdar; Hicks, Kenneth A.

    2008-01-01

    Despite two decades of significant investments in R&D of Integrated System Health Management (ISHM), mission-critical applications of it in aerospace are few and far between. ISHM is subject to the general difficulty of transitioning technologies out of R&D labs and into practical applications. New and unproven methods such as ISHM introduce multiple mission risks (technology, schedule, cost), and may require a transition to unconventional and as-yet-unproven operations concepts in order to be effective. Laboratory and flight demonstrations are necessary but insufficient to adequately reduce those risks. What is needed is a solid business case before a new technology can be considered for fleetwide deployment. To address these problems, we recently applied a technology maturation assessment process developed at NASA's Jet Propulsion Laboratory to study the challenges of ISHM technology maturation. This application resulted in identification of the technologies (and technology maturation activities) that would result in the greatest risk reduction per investment dollar. Our approach and its results are described herein.

  7. Enhanced Composites Integrity Through Structural Health Monitoring

    NASA Astrophysics Data System (ADS)

    Giurgiutiu, Victor; Soutis, Constantinos

    2012-10-01

    This paper discusses the topic of how the integrity of safety-critical structural composites can be enhanced by the use of structural health monitoring (SHM) techniques. The paper starts with a presentation of how the certification of flight-critical composite structures can be achieved within the framework of civil aviation safety authority requirements. Typical composites damage mechanisms, which make this process substantially different from that for metallic materials are discussed. The opportunities presented by the use of SHM techniques in future civil aircraft developments are explained. The paper then focuses on active SHM with piezoelectric wafer active sensors (PWAS). After reviewing the PWAS-based SHM options, the paper follows with a discussion of the specifics of guided wave propagation in composites and PWAS-tuning effects. The paper presents a number of experimental results for damage detection in simple flat unidirectional and quasi-isotropic composite specimens. Calibrated through holes of increasing diameter and impact damage of various energies and velocities are considered. The paper ends with conclusions and suggestions for further work.

  8. [What are the economic advantages of Integrated Health Care?].

    PubMed

    Henke, K-D

    2006-01-01

    Integrated Health Care and Managed Health Care are both tools to implement broader responsibilities of health care providers for the economic efforts of their activities. While Managed Care is quite common in the United States of America, experiences with such systems are sparse in Europe and Germany. With Integrated Health Care, new types of markets will emerge: not only a market for health care services, but also for insurance contracts, and for provision of care. The paper discusses different incentives arising from different health care systems. PMID:16598562

  9. The Effects of Space Radiation on Linear Integrated Circuit

    NASA Technical Reports Server (NTRS)

    Johnston, A.

    2000-01-01

    Permanent and transient effects are discussed that are induced in linear integrated circuits by space radiation. Recent developments include enhanced damage at low dose rate, increased damage from protons due to displacement effects, and transients in digital comparators that can cause circuit malfunctions.

  10. Occupational health effects of nonionizing radiation

    SciTech Connect

    Yost, M.G. )

    1992-07-01

    Nonionizing radiation includes electromagnetic energy distributed as near-ultraviolet and visible light, infrared radiation, microwaves, radio frequencies, and very low frequency and extremely low frequency alternating electric and magnetic fields, and almost every member of modern society is exposed to it in some form. Usually the intensity of exposure is low in the general population but can be greatly increased in the workplace. The forms of nonionizing radiation are described and their physical characteristics, occupational sources, biologic effects, and exposure criteria are delineated.90 references.

  11. Workplace mental health: developing an integrated intervention approach

    PubMed Central

    2014-01-01

    Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

  12. Facilitating culturally integrated behaviors among allied health students.

    PubMed

    Barrett, Katherine

    2002-01-01

    This article offers a perspective on why culturally integrated behaviors are important for allied health education and suggestions of methods to facilitate such behaviors. Literature and theory are used to support cultural integration in allied health curricula. Examples of learning experiences from students in cross-cultural environments and reflections on those experiences further elucidate facilitation methods. PMID:12041003

  13. Evaluating integrated health care: a model for measurement

    PubMed Central

    Ahgren, Bengt; Axelsson, Runo

    2005-01-01

    Abstract Purpose In the development of integrated care, there is an increasing need for knowledge about the actual degree of integration between different providers of health services. The purpose of this article is to describe the conceptualisation and validation of a practical model for measurement, which can be used by managers to implement and sustain integrated care. Theory The model is based on a continuum of integration, extending from full segregation through intermediate forms of linkage, coordination and cooperation to full integration. Methods The continuum was operationalised into a ratio scale of functional clinical integration. This scale was used in an explorative study of a local health authority in Sweden. Data on integration were collected in self-assessment forms together with estimated ranks of optimum integration between the different units of the health authority. The data were processed with statistical methods and the results were discussed with the managers concerned. Results Judging from this explorative study, it seems that the model of measurement collects reliable and valid data of functional clinical integration in local health care. The model was also regarded as a useful instrument for managers of integrated care. Discussion One of the main advantages with the model is that it includes optimum ranks of integration beside actual ranks. The optimum integration rank between two units is depending on the needs of both differentiation and integration. PMID:16773158

  14. 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...

  15. [Cervical cancer: integral care to the woman in health services].

    PubMed

    Soares, Marilu Correa; Mishima, Silvana Martins; da Silva, Renata Cunha; Ribeiro, Caroline Vargas; Meincke, Sonia Maria Könzgen; Corrêa, Ana Cândida Lopes

    2011-09-01

    This study aims to understand how the health services of the Brazilian Public Health System (BPHS) are organized to give an integral care to the woman with cervical cancer. This is a descriptive, qualitative research with 20 women. Semistructured interviews were coupled with participant observation in data collection. The thematic analysis revealed the theme: "The search for care: access to BPHS and use of health services in the search for integral care". In the use of health services, women have exposed their views on the received care, and on the potentialities and limits of integrality in this context. The conclusion is that the effectivation of health actions that aim at the integrality of care for women requires courage and the promotion of a dialogue between social actors as a way to build a health awareness that allows an ethical commitment pointing towards the necessary changes in care. PMID:22165396

  16. Integrating Work and Family: Women's Health Outcomes.

    ERIC Educational Resources Information Center

    Killien, Marcia

    An exploratory study examined the relationship between individual, family, and work variables and working mothers' health. The study also investigated the relationship between health management strategies and health. A cross-sectional survey design was used to gather data from 85 women who were married, employed 20 hours a week or more, and had…

  17. [European health systems and the integration problem of modern societies].

    PubMed

    Lüschen, G

    2000-04-01

    With reference to the national health systems in Germany and the UK we must acknowledge that it was in particular Bismarck's Reform, originally directed toward a solidarity among the socially weak, which entailed in its development a marked redistribution via progressive health fees and standardized health services. In view of Alfred Marshall's original expectations this has resulted in a specific integration of the socially weak and with some difference for nationally tax-financed and social security financed health systems to a genuine contribution towards integration of modern society. An open research question is whether as a consequence of solidarity and integration through health systems there is a decline of social inequality for health. Equally open is the question as to the socio-structural and economic consequences the expansion of modern health systems has. PMID:10838787

  18. Integrated Crew Health Care System for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2007-01-01

    Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.

  19. Consumer Health Informatics--integrating patients, providers, and professionals online.

    PubMed

    Klein-Fedyshin, Michele S

    2002-01-01

    Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care. PMID:12238015

  20. Health physics fundamentals, radiation protection, and radioactive waste treatment. Volume ten

    SciTech Connect

    Not Available

    1986-01-01

    Topics include health physics fundamentals (is radiation dangerous, what is health physics, federal regulations, presence of radiation, sources of radiation, types of radiation), radiation protection (amounts of radiation, radiation measurement, individual radiation exposure measurements, reducing the effects of radiation), and radioactive waste treatment (what are radioactive wastes, gaseous radioactive waste, liquid radioactive waste, solid radioactive waste, methods of rad-waste treatment, PWR and BWR radwaste treatment.

  1. Integration of Basic Sciences in Health's Courses

    ERIC Educational Resources Information Center

    Azzalis, L. A.; Giavarotti, L.; Sato, S. N.; Barros, N. M. T.; Junqueira, V. B. C.; Fonseca, F. L. A.

    2012-01-01

    Concepts from disciplines such as Biochemistry, Genetics, Cellular and Molecular Biology are essential to the understanding and treatment of an elevated number of illnesses, but often they are studied separately, with no integration between them. This article proposes a model for basic sciences integration based on problem-based learning (PBL) and…

  2. The need for integration in health sciences sets the future direction for public health education.

    PubMed

    Li, L M; Tang, J L; Lv, J; Jiang, Y; Griffiths, S M

    2011-01-01

    Since the foundation of the People's Republic of China in 1949, there has been remarkable developments in public health in the country. These achievements are primarily attributed to the public health services and patriotic public health campaigns, although the contribution of high-technology medical applications is also recognized. However, along with the recent socio-economic developments and scientific and technological progress, medical disciplines have become more and more specialized, and clinical and preventive medicine have become further separated from each other. Conventional Chinese wisdom says 'when long divided they must unite, when long united they must divide'. At the onset of the new round of reforms of health care in China, it seems important to revisit the discussions on the urgency for integration of health sciences in medicine in China. Several issues and viewpoints on integrating medicine are discussed in this paper. The biopsychosocial model for health calls for broad integration. Primary care development in China requires integration in education and practice, and in treatment and prevention. Control of chronic diseases requires integrated and united action. Integration of traditional Chinese medicine with Western medicine requires creativity. The integration perspective should be instilled in the minds of medical students. Integration also entails integrated practice. After all, integration entails integrated education and practice in public health education. Changing the current public health education system still has a long way to go. True integration requires integration of concepts, policies, resources and measures, as well as changes in the organization of health care including public health, prevention and treatment. This needs to be a systematic process. Finally, success of integration relies on social mobilization, advocacy, promotion and attention of the entire society. PMID:21168177

  3. Radiation Testing and Evaluation Issues for Modern Integrated Circuits

    NASA Technical Reports Server (NTRS)

    LaBel, Kenneth A.; Cohn, Lew M.

    2005-01-01

    Abstract. Changes in modern integrated circuit (IC) technologies have modified the way we approach and conduct radiation tolerance and testing of electronics. These changes include scaling of geometries, new materials, new packaging technologies, and overall speed and device complexity challenges. In this short course section, we will identify and discuss these issues as they impact radiation testing, modeling, and effects mitigation of modern integrated circuits. The focus will be on CMOS-based technologies, however, other high performance technologies will be discussed where appropriate. The effects of concern will be: Single-Event Effects (SEE) and steady state total ionizing dose (TID) IC response. However, due to the growing use of opto-electronics in space systems issues concerning displacement damage testing will also be considered. This short course section is not intended to provide detailed "how-to-test" information, but simply provide a snapshot of current challenges and some of the approaches being considered.

  4. Sensor Technology for Integrated Vehicle Health Management of Aerospace Vehicles

    NASA Technical Reports Server (NTRS)

    Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.

    2002-01-01

    NASA is focusing considerable efforts on technology development for Integrated Vehicle Health Management systems. The research in this area is targeted toward increasing aerospace vehicle safety and reliability, while reducing vehicle operating and maintenance costs. Onboard, real-time sensing technologies that can provide detailed information on structural integrity are central to such a health management system. This paper describes a number of sensor technologies currently under development for integrated vehicle health management. The capabilities, current limitations, and future research needs of these technologies are addressed.

  5. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing.

    ERIC Educational Resources Information Center

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.

    1999-01-01

    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  6. Radiation health for a Mars mission

    NASA Technical Reports Server (NTRS)

    Robbins, Donald E.

    1992-01-01

    Uncertainties in risk assessments for exposure of a Mars mission crew to space radiation place limitations on mission design and operation. Large shielding penalties are imposed in order to obtain acceptable safety margins. Galactic cosmic rays (GCR) and solar particle events (SPE) are the major concern. A warning system and 'safe-haven' are needed to protect the crew from large SPE which produce lethal doses. A model developed at NASA Johnson Space Center (JSC) to describe solar modulation of GCR intensities reduces that uncertainty to less than 10 percent. Radiation transport models used to design spacecraft shielding have large uncertainties in nuclear fragmentation cross sections for GCR which interact with spacecraft materials. Planned space measurements of linear energy transfer (LET) spectra behind various shielding thicknesses will reduce uncertainties in dose-versus-shielding thickness relationships to 5-10 percent. The largest remaining uncertainty is in biological effects of space radiation. Data on effects of energetic ions in human are nonexistent. Experimental research on effects in animals and cell is needed to allow extrapolation to the risk of carcinogenesis in humans.

  7. Radiation damage in MOS integrated circuits, Part 1

    NASA Technical Reports Server (NTRS)

    Danchenko, V.

    1971-01-01

    Complementary and p-channel MOS integrated circuits made by four commercial manufacturers were investigated for sensitivity to radiation environment. The circuits were irradiated with 1.5 MeV electrons. The results are given for electrons and for the Co-60 gamma radiation equivalent. The data are presented in terms of shifts in the threshold potentials and changes in transconductances and leakages. Gate biases of -10V, +10V and zero volts were applied to individual MOS units during irradiation. It was found that, in most of circuits of complementary MOS technologies, noticable changes due to radiation appear first as increased leakage in n-channel MOSFETs somewhat before a total integrated dose 10 to the 12th power electrons/sg cm is reached. The inability of p-channel MOSFETs to turn on sets in at about 10 to the 13th power electrons/sq cm. Of the circuits tested, an RCA A-series circuit was the most radiation resistant sample.

  8. Community matters - why outbreak responses need to integrate health promotion.

    PubMed

    Kickbusch, Ilona; Reddy, K Srikanth

    2016-03-01

    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks. PMID:26518038

  9. HERMES: a health care workstation integration architecture.

    PubMed

    van Mulligen, E M; Timmers, T; Brand, J; Cornet, R; van den Heuvel, F; Kalshoven, M; van Bemmel, J H

    1994-01-01

    An architecture is described that facilitates integration of existing databases and applications without modifying them. By means of this architecture, data from different sources dispersed in a network can be combined and directly used in existing applications or applications that have been developed specially for integration. This feature of combining data from different sources into one workstation is viewed as the enabling technology on which computer-based patient records can be built. The abstraction of computer-, network- and application-specific details is completely dealt with by the integration architecture. This integration architecture has been developed with extendibility and flexibility in mind, and allows for a growth-path towards application of the open system paradigm in medicine. PMID:8125638

  10. Why integrated health networks have failed.

    PubMed

    Friedman, L; Goes, J

    2001-01-01

    Over the last two decades, hospitals, physicians, and nursing homes have rushed to merge or partner with one another, cheered on by consultants, academics, and experts who claimed that such networking was imperative for these organizations to survive in an increasingly competitive environment. In the 1990s, however, reports of the major difficulties encountered by the merged entities began to dampen the industry's enthusiasm for integration, causing some to even question the value of the integration "revolution." This article will review the primary rationale behind integration and will assess its success to date. Based on field reports and the available evidence, the authors conclude that IHNS have not delivered on their promise. While each network should be considered in its unique market and contextual situation, the enormous financial, human, and clinical resources devoted to integration have not borne much fruit. Evidence of quantifiable, sustained financial or clinical value is scant. PMID:11436240

  11. Integrating Social Theory Into Public Health Practice

    PubMed Central

    Potvin, Louise; Gendron, Sylvie; Bilodeau, Angèle; Chabot, Patrick

    2005-01-01

    The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114

  12. Does cultural integration explain a mental health advantage for adolescents?

    PubMed Central

    Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

    2012-01-01

    Background A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. Methods A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a ‘total difficulties score’ and by classification as a ‘probable clinical case’. Results A total of 6643 pupils in first and second years of secondary school (ages 11–13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005–06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Conclusions Cultural integration was associated with better mental health, independent of the mental health advantage

  13. 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

  14. Promoting Access Through Integrated Mental Health Care Education.

    PubMed

    Kverno, Karan

    2016-01-01

    Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students. PMID:27347257

  15. Promoting Access Through Integrated Mental Health Care Education

    PubMed Central

    Kverno, Karan

    2016-01-01

    Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students. PMID:27347257

  16. 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...

  17. Introductory Chemical Education of Health Professionals: An Integrated Clinical Approach.

    ERIC Educational Resources Information Center

    Farina, Joseph; Frechette, Michael

    1979-01-01

    Reports the development of an integrated clinical approach to introductory chemistry education at the undergraduate level for students majoring in nursing and the allied health professions at the University of Lowell. (BT)

  18. Health protection: Toxic agent and radiation control.

    PubMed Central

    1983-01-01

    It is estimated that of the four million chemical compounds which have been synthesized or isolated from natural materials, more than 55,000 are produced commercially. Approximately 1,000 new compounds are introduced annually; pesticide formulations alone contain about 1,500 active chemical ingredients. Diagnostic x-rays are used extensively in medicine and dentistry. Over 2,000 chemicals are suspected carcinogens in laboratory animals--epidemiologic evidence suggests that 26 of these chemicals and/or industrial processes are carcinogenic in humans. More than 20 agents are known to be associated with birth defects in humans; 47 atmospheric contaminants have been identified in animal studies as recognized carcinogens and 128 as mutagens; and, of the 765 contaminants identified in drinking water, 12 were recognized carcinogens, 31 suspected carcinogens, and 59 mutagens. Radiation has known carcinogenic and genetic effects at significant levels of exposure. Problems with toxic agents and radiation sources occur not only in industry, but also in medical and dental care (x-rays and drugs), agriculture (pesticides and herbicides), Government activities (biological and chemical agents), consumer products (incorrect use of consumer products which contain toxic substances), and natural sources (fungal products). PMID:6414020

  19. One Client, One Team: Health system integration for leaders.

    PubMed

    Daub, Stacey; Goldhar, Jodeme; Purbhoo, Dipti

    2016-07-01

    This article examines the implementation of the strategy and Integrated Client Care Program, a multi-level health system strategy to break down the barriers in a solid health system and a program to integrate care for populations with the most complex needs. Specific reference is made to two specialized programs, older adults with complex care needs and a palliative care program whose goal is to meet the needs of patients and their families in a community setting. PMID:27365383

  20. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration. PMID:27326804

  1. Integrating Occupational Safety and Health into TAFE Courses: Policy Guidelines.

    ERIC Educational Resources Information Center

    Hill, Graham L.; Mageean, Pauline

    Intended to help administrators, curriculum developers, and teachers integrate occupational health and safety into Australian vocational courses on bricklaying, metal fabrication, and horticulture, this document suggests specific policies and provides further amplification concerning three general policies for that integration. The three general…

  2. Social Integration and the Mental Health of Black Adolescents

    ERIC Educational Resources Information Center

    Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.

    2014-01-01

    The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…

  3. Counselors and Physicians Providing Mental Health Services: An Integrated Approach

    ERIC Educational Resources Information Center

    Enochs, Wendy K; Young, Mark; Choate, Robert O.

    2006-01-01

    The authors argue that there is a clear link between mental and physical health issues. A wellness-based approach to integrated health care, such as the one described in this article, may allow older clients to be empowered to make lifestyle changes that can improve the quality of their lives and reduce physical illness.

  4. Integrating Complementary and Alternative Medicine into the Health Education Curriculum.

    ERIC Educational Resources Information Center

    Patterson, Sheila M.; Graf, Helen M.

    2000-01-01

    Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals,…

  5. Software for the occupational health and safety integrated management system

    SciTech Connect

    Vătăsescu, Mihaela

    2015-03-10

    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety.

  6. Lights, Camera, Action: Integrating Popular Film in the Health Classroom

    ERIC Educational Resources Information Center

    Diez, Keri S.; Pleban, Francis T.; Wood, Ralph J.

    2005-01-01

    This article discusses the benefits as well as the important considerations that should be taken into account in integrating popular films in health education classes. Use of popular films in the classroom, termed "cinema education," is becoming increasingly popular in teaching health education. As a matter of convenience, popular films are easy…

  7. Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

    ERIC Educational Resources Information Center

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

    Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

  8. Integrating Occupational Health and Safety into TAFE Courses: Curriculum Topics.

    ERIC Educational Resources Information Center

    Hall, Bob; Mageean, Pauline

    This guide is designed to help technical and further education (TAFE) curriculum writers in Australia integrate safety education into vocational education courses. It provides a general overview of occupational health and safety from the perspective of TAFE trade training and a brief summary of the major health and safety issues that might be…

  9. Social Integration and Mental Health of the Aged.

    ERIC Educational Resources Information Center

    Deimling, Gary T.; Harel Zev

    Social support has been found to be positively related to well being in elderly individuals. To examine the effects of social integration (social resources, social interaction, and perceived adequacy of resources), and health, age, marital status, and socioeconomic status (SES) on mental health among urban elderly individuals, 1,727 persons from…

  10. Social integration and the mental health of Black adolescents

    PubMed Central

    Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra Howard

    2014-01-01

    The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim’s Social Integration Theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative psychosocial well-being indicators. Results showed that adolescents’ integration into family and school were related to better mental health. Additionally, commitment to religious involvement positively influenced mental health. Although the direct effect of religious involvement was inversely related to mental health, mediation analyses revealed a positive influence through religious commitment. Findings suggest a greater emphasis on all three social contexts when designing strategies to improve the mental health of Black adolescents. PMID:24815855

  11. Monolithic Integrated Radiation Sensor Using Stimulated Luminescence From Alumina

    NASA Technical Reports Server (NTRS)

    McKeever, S. W. S.; Yukihara, E. G.; Stoebe, T. G.; Chen, T.-C.

    2005-01-01

    The project goal was to design and test a monolithic integrated device for radiation sensing, using optically stimulated luminescence (OSL) from Al2O3:C. The device would consist of GaN/InGaN-based components epitaxially grown on each side of a A12O3:C substrate. Radiation energy stored in the substrate would be stimulated by visible emission from a GaN light-emitting diode (LED) grown on one side of the device, and the OSL emission from the substrate (in the blue region of the spectrum) would be detected by the InGaN pi-n diode grown on the other side of the substrate. The primary application of the device would be in space radiation environments. Thus, two major research thrusts were launched during this project. Firstly, research at Oklahoma State University (Dr. Stephen W.S. McKeever and Dr. E.G. Yukihara) concentrated on characterization of the OSL properties of Al2O3:C in radiation fields typical of those experienced in low-Earth orbit. Secondly, research at the University of Washington (Co-Is, Dr. T.G. Stoebe and Dr. T. Chen) focused of device development and GaN/InGaN epitaxial growth. While progress in each line of research has been substantial, the ultimate goal (that of producing a working prototype device) has not yet been reached. We detail the research progress and identify outstanding issues in this paper.

  12. Integrated Systems Health Management (ISHM) Toolkit

    NASA Technical Reports Server (NTRS)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

    2013-01-01

    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  13. Pinnacle Health / Zynx Health / Siemens Medical Solutions A Study of Integration of Evidence Based Nursing Content

    PubMed Central

    Matter, Sheri; Brown, Cindy; Button, Patricia S.; Kennedy, Rosemary

    2006-01-01

    In 2005, Pinnacle Health System, Zynx Health, and Siemens Medical Solutions developed a partnership to conduct a study to explore the opportunities and challenges associated with the integration of evidence-based knowledge within the EHR with the goal of creating repeatable methodologies for integrating nursing knowledge within the EHR. The two-phase study involved access to referential evidence-based content, as well as integration of customized evidence-based plans of care within the documentation applications of the EHR.

  14. Integration of mental health into primary care in Kenya.

    PubMed

    Jenkins, Rachel; Kiima, David; Njenga, Frank; Okonji, Marx; Kingora, James; Kathuku, Dammas; Lock, Sarah

    2010-06-01

    Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes. PMID:20671901

  15. Radiation-induced transmission loss of integrated optic waveguide devices

    NASA Astrophysics Data System (ADS)

    Henschel, Henning; Koehn, Otmar; Schmidt, Hans U.

    1993-04-01

    The radiation sensitivity of different integrated optic (IO) devices was compared under standardized test conditions. We investigated four relatively simple device types made by four different manufacturers. The waveguide materials were proton exchanged LiTaO3, LiNbO3:Ti, Tl-diffused glass, and Ag-diffused glass, respectively. In order to standardize the irradiation parameters we followed the 'Procedure for Measuring Radiation-Induced Attenuation in Optical Fibers and Optical Cables' proposed by the NATO NETG as close as possible. In detail we made pulsed irradiations with dose values of about 500 rad*, 104 rad, and 105 rad, as well as continuous irradiations at a 60Co source with a dose rate of 1300 rad*/min up to a total dose of 104 rad. Device temperatures were about 22 degree(s)C, -50 degree(s)C, and +80 degree(s)C.

  16. [Integral estimation of genetic effects of ionizing radiation].

    PubMed

    Shevchenko, V A

    1997-01-01

    A system of criteria (direct, indirect, extrapolational, integral, populational, evolutional) has been proposed to estimate the consequences of irradiation of flora, fauna and human population. This system makes it possible to obtain the most comprehensive estimate of genetic effects from exposure of live organisms to ionizing radiations. An attempt has been made to use extrapolational approaches for assessing the genetic risk on the basis of the results of cytogenetic examination of the human population in a number of regions exposed to the action of ionizing radiations as a result of the Chernobyl accident, in connection with the activity of the chemical plant Mayak in the Chelyabinsk region, nuclear explosions at the Semipalatinsk nuclear test site, the accident at the Three Mile Island nuclear power plant in the U.S.A. PMID:9599614

  17. 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.

  18. Radiation and Health Technology Laboratory Capabilities

    SciTech Connect

    Goles, Ronald W.; Johnson, Michelle Lynn; Piper, Roman K.; Peters, Jerry D.; Murphy, Mark K.; Mercado, Mike S.; Bihl, Donald E.; Lynch, Timothy P.

    2003-07-15

    The Radiological Standards and Calibrations Laboratory, a part of Pacific Northwest National Laboratory (PNNL)(a) performs calibrations and upholds reference standards necessary to maintain traceability to national standards. The facility supports U.S. Department of Energy (DOE) programs at the Hanford Site, programs sponsored by DOE Headquarters and other federal agencies, radiological protection programs at other DOE and commercial nuclear sites and research and characterization programs sponsored through the commercial sector. The laboratory is located in the 318 Building of the Hanford Site's 300 Area. The facility contains five major exposure rooms and several laboratories used for exposure work preparation, low-activity instrument calibrations, instrument performance evaluations, instrument maintenance, instrument design and fabrication work, thermoluminescent and radiochromic Dosimetry, and calibration of measurement and test equipment (M&TE). The major exposure facilities are a low-scatter room used for neutron and photon exposures, a source well room used for high-volume instrument calibration work, an x-ray facility used for energy response studies, a high-exposure facility used for high-rate photon calibration work, a beta standards laboratory used for beta energy response studies and beta reference calibrations and M&TE laboratories. Calibrations are routinely performed for personnel dosimeters, health physics instrumentation, photon and neutron transfer standards alpha, beta, and gamma field sources used throughout the Hanford Site, and a wide variety of M&TE. This report describes the standards and calibrations laboratory.

  19. Radiation and Health Technology Laboratory Capabilities

    SciTech Connect

    Bihl, Donald E.; Lynch, Timothy P.; Murphy, Mark K.; Myers, Lynette E.; Piper, Roman K.; Rolph, James T.

    2005-07-09

    The Radiological Standards and Calibrations Laboratory, a part of Pacific Northwest National Laboratory (PNNL)(a) performs calibrations and upholds reference standards necessary to maintain traceability to national standards. The facility supports U.S. Department of Energy (DOE) programs at the Hanford Site, programs sponsored by DOE Headquarters and other federal agencies, radiological protection programs at other DOE and commercial nuclear sites and research and characterization programs sponsored through the commercial sector. The laboratory is located in the 318 Building of the Hanford Site's 300 Area. The facility contains five major exposure rooms and several laboratories used for exposure work preparation, low-activity instrument calibrations, instrument performance evaluations, instrument maintenance, instrument design and fabrication work, thermoluminescent and radiochromic Dosimetry, and calibration of measurement and test equipment (M&TE). The major exposure facilities are a low-scatter room used for neutron and photon exposures, a source well room used for high-volume instrument calibration work, an x-ray facility used for energy response studies, a high-exposure facility used for high-rate photon calibration work, a beta standards laboratory used for beta energy response studies and beta reference calibrations and M&TE laboratories. Calibrations are routinely performed for personnel dosimeters, health physics instrumentation, photon and neutron transfer standards alpha, beta, and gamma field sources used throughout the Hanford Site, and a wide variety of M&TE. This report describes the standards and calibrations laboratory.

  20. 76 FR 52329 - Advisory Board on Radiation and Worker Health: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... October 6, 1972, that the Advisory Board on Radiation and Worker Health, Department of Health and Human.... Theodore Katz, Designated Federal Officer, Advisory Board on Radiation and Worker Health, Department...

  1. 76 FR 16776 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice... Assistant Secretary for Health, Office of the Surgeon General of the United States Public Health Service... for the Advisory Group on Prevention, Health Promotion, and Integrative and Public ] Health...

  2. Integrated health of the girl child.

    PubMed

    Ghosh, S

    1995-01-01

    This article discusses factors that affect the well-being and health of female children in India: sex ratio, literacy, food intake, morbidity, mortality, early marriage, maternal mortality, nutrition, prenatal care and delivery, family planning responsibilities, and access to health services. India has recognized within its Constitution and other government documents and programs equality for women, but practices lag behind principles. A National Action Plan was formulated for the period 1991-2000 for the girl child. Women themselves must change their attitudes about themselves and their female children. Several pilot programs have demonstrated the potential to empower girls to be outspoken, vocal, and enthusiastic. Girls in India are disadvantaged even before their birth. Patriarchal norms reinforce the view of girls as a bad investment. Women are blamed for not bearing a son, despite the evidence that males carry the deciding gender-specific chromosome. Tamil Nadu districts are known for their female infanticide. The declining sex ratio is attributed to the higher death rate among females younger than 35 years. Females until recently had a lower life expectancy than males. Sex ratios vary between states. The only state with a positive female sex ratio is Kerala. Males outnumber females by almost 10% in most of the northern and eastern states. Illiteracy among women is high in about 100 districts. Female school enrollment is 50% less than male enrollment. Females suffer from higher rates of malnutrition, morbidity, and death. Girls' adolescent growth spurt is delayed until 18 years. Maternal mortality accounts for the largest proportion of deaths among women of reproductive age. The most common reason for abortion is "too many children." Lower socioeconomic status is associated with lower nutrition. Women do not have control over their fertility. Women are limited in their access to reproductive health care. PMID:12158016

  3. 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.

  4. Integration of priority population, health and nutrition interventions into health systems: systematic review

    PubMed Central

    2011-01-01

    Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction) and secondary (improved population coverage, access to health services, efficiency, and quality) using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health outcomes, quality of care

  5. Toward the integration of education and mental health in schools.

    PubMed

    Atkins, Marc S; Hoagwood, Kimberly E; Kutash, Krista; Seidman, Edward

    2010-03-01

    Education and mental health integration will be advanced when the goal of mental health includes effective schooling and the goal of effective schools includes the healthy functioning of students. To build a solid foundation for this reciprocal agenda, especially within the zeitgeist of recent educational reforms, a change in the fundamental framework within which school mental health is conceptualized is needed. This change involves acknowledging a new set of priorities, which include: the use of naturalistic resources within schools to implement and sustain effective supports for students' learning and emotional/behavioral health; inclusion of integrated models to enhance learning and promote health; attention to improving outcomes for all students, including those with serious emotional/behavioral needs; and strengthening the active involvement of parents. A strong research agenda to support these new priorities is essential. PMID:20309623

  6. Knowledge integration, teamwork and performance in health care.

    PubMed

    Körner, Mirjam; Lippenberger, Corinna; Becker, Sonja; Reichler, Lars; Müller, Christian; Zimmermann, Linda; Rundel, Manfred; Baumeister, Harald

    2016-04-11

    Purpose - Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. Design/methodology/approach - The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. Findings - The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. Practical/implications - In practice, the results of the study provide a valuable starting point for team development interventions. Originality/value - This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance. PMID:27052623

  7. The Radiation Problem and Its Solution from a Health Communication Perspective

    PubMed Central

    2016-01-01

    This paper observes both foreign and national discussions on preexisting radiation communication and attempts to find out what it takes to ensure that discussion concerning radiation leads to participation of and trust-building with members of society while considering cultural aspects. When analyzing Korean studies on health risk communication concerning radiation which utilize the frame of foreign literature, Korean studies can be categorized into one of the following themes: different risk perceptions between experts and the general public, discussion on the effects of the framing of radiation messages and media coverage, and research discussing the social implications of the dangers of radiation and the need for effective communication. These study results can be better explained when integrated with Korean social cultural dimensions. The “boiling pot effect” towards risk issues, egalitarian perceptions, escalation of ideological opposition and biased reasoning, and so on are especially major influences. Communication addressing radiological risks must foremost be open and able to mitigate distrust, must give the general public a chance to judge for themselves to prevent stigmatization, and, through the use of media and public education, must make efforts to prevent the proliferation of needless anxiety. Using literature research, this paper discusses possible ways to improve the effect of future health risk communication concerning radiation. PMID:26908994

  8. The Radiation Problem and Its Solution from a Health Communication Perspective.

    PubMed

    Kim, Yungwook

    2016-02-01

    This paper observes both foreign and national discussions on preexisting radiation communication and attempts to find out what it takes to ensure that discussion concerning radiation leads to participation of and trust-building with members of society while considering cultural aspects. When analyzing Korean studies on health risk communication concerning radiation which utilize the frame of foreign literature, Korean studies can be categorized into one of the following themes: different risk perceptions between experts and the general public, discussion on the effects of the framing of radiation messages and media coverage, and research discussing the social implications of the dangers of radiation and the need for effective communication. These study results can be better explained when integrated with Korean social cultural dimensions. The "boiling pot effect" towards risk issues, egalitarian perceptions, escalation of ideological opposition and biased reasoning, and so on are especially major influences. Communication addressing radiological risks must foremost be open and able to mitigate distrust, must give the general public a chance to judge for themselves to prevent stigmatization, and, through the use of media and public education, must make efforts to prevent the proliferation of needless anxiety. Using literature research, this paper discusses possible ways to improve the effect of future health risk communication concerning radiation. PMID:26908994

  9. The effect of low dose ionizing radiation on homeostasis and functional integrity in an organotypic human skin model.

    PubMed

    von Neubeck, Claere; Geniza, Matthew J; Kauer, Paula M; Robinson, R Joe; Chrisler, William B; Sowa, Marianne B

    2015-05-01

    Outside the protection of Earth's atmosphere, astronauts are exposed to low doses of high linear energy transfer (LET) radiation. Future NASA plans for deep space missions or a permanent settlement on the moon are limited by the health risks associated with space radiation exposures. There is a paucity of direct epidemiological data for low dose exposures to space radiation-relevant high LET ions. Health risk models are used to estimate the risk for such exposures, though these models are based on high dose experiments. There is increasing evidence, however, that low and high dose exposures result in different signaling events at the molecular level, and may involve different response mechanisms. Further, despite their low abundance, high LET particles have been identified as the major contributor to health risk during manned space flight. The human skin is exposed in every external radiation scenario, making it an ideal epithelial tissue model in which to study radiation induced effects. Here, we exposed an in vitro three dimensional (3-D) human organotypic skin tissue model to low doses of high LET oxygen (O), silicon (Si) and iron (Fe) ions. We measured proliferation and differentiation profiles in the skin tissue and examined the integrity of the skin's barrier function. We discuss the role of secondary particles in changing the proportion of cells receiving a radiation dose, emphasizing the possible impact on radiation-induced health issues in astronauts. PMID:25839759

  10. The effect of low dose ionizing radiation on homeostasis and functional integrity in an organotypic human skin model

    SciTech Connect

    von Neubeck, Claere; Geniza, Matthew; Kauer, Paula M.; Robinson, Joseph E.; Chrisler, William B.; Sowa, Marianne B.

    2015-05-01

    Outside the protection of earth’s atmosphere, astronauts are exposed to low doses of high linear energy transfer (LET) radiation. Future NASA plans for deep space missions or a permanent settlement on the moon are limited by the health risks associated with space radiation exposures. There is a paucity of direct epidemiological data for low dose exposures to space radiation-relevant high LET ions. Health risk models are used to estimate the risk for such exposures, though these models are based on high dose experiments. There is increasing evidence, however, that low and high dose exposures result in different signaling events at the molecular level, and may involve different response mechanisms. Further, despite their low abundance, high LET particles have been identified as the major contributor to health risk during manned space flight. The human skin is exposed in every external radiation scenario, making it an ideal epithelial tissue model in which to study radiation induced effects. Here, we exposed an in vitro three dimensional (3-D) human organotypic skin tissue model to low doses of high LET oxygen (O), silicon (Si) and iron (Fe) ions. We measured proliferation and differentiation profiles in the skin tissue and examined the integrity of the skin’s barrier function. We discuss the role of secondary particles in changing the proportion of cells receiving a radiation dose, emphasizing the possible impact on radiation-induced health issues in astronauts.

  11. Employer-driven consumerism: integrating health into the business model.

    PubMed

    Thompson, Michael; Checkley, Joseph

    2006-01-01

    Consumer-driven health care is a misnomer. Notwithstanding the enormous role the individual consumer has to play in reshaping the U.S. health care delivery system, this article will focus on the employer as the key driver of change and innovation in the consumerism revolution. American Standard provides a case study of how one major employer has evaluated health care in the context of its business and aggressively integrated consumerism and health into the core of its business. Other companies will appropriately execute consumerism strategies in a fashion consistent with their own needs, culture, resources and populations. However, the principles supporting those strategies will be very much consistent. PMID:16827541

  12. Managing the physics of the economics of integrated health care.

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  13. Biological detection of low radiation doses with integrated photothermal assay

    NASA Astrophysics Data System (ADS)

    Zharov, Vladimir P.; Viegas, Mark; Soderberg, Lee S. F.

    2005-04-01

    The goal of this paper was to evaluate the diagnostic value of integrated photothermal (PT) assay with additional fluorescent and photoacoustic (PA) modules to assess both the "safety limit" of exposure to ionizing γ-radiation and optimal therapeutic doses for cancer treatment. With this assay, the influences of γ irradiation on cancer cells (pancreatic-AR42J and hepatocytes-hepG2) and healthy cells (mouse lymphocytes and erythrocytes) was examined as a function of exposure dose (0.6-5 Gy) and time after irradiation, in vitro and in vivo. Independent verification of data obtained with conventional assays revealed that integrated PT assay allowed us to detect the different stages of radiation impact, including changes in cell metabolism at low dose, or stages related to cell death (apoptosis and necrosis) at high doses with a threshold sensitivity of at least three orders of magnitude better than existing assays. Also, PT assay was capable of quantitatively differentiating the biological action of γ irradiation alone and in combination with drug and nicotine impact. Finally, we demonstrated on an animal model that IPT assay has the potential for use in routine rapid evaluation of biological consequences of low-dose exposure a few days after irradiation.

  14. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    PubMed Central

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  15. Data integration reveals key homeostatic mechanisms following low dose radiation exposure

    SciTech Connect

    Tilton, Susan C.; Matzke, Melissa M.; Sowa, Marianne B.; Stenoien, David L.; Weber, Thomas J.; Morgan, William F.; Waters, Katrina M.

    2015-05-15

    The goal of this study was to define pathways regulated by low dose radiation to understand how biological systems respond to subtle perturbations in their environment and prioritize pathways for human health assessment. Using an in vitro 3-D human full thickness skin model, we have examined the temporal response of dermal and epidermal layers to 10 cGy X-ray using transcriptomic, proteomic, phosphoproteomic and metabolomic platforms. Bioinformatics analysis of each dataset independently revealed potential signaling mechanisms affected by low dose radiation, and integrating data shed additional insight into the mechanisms regulating low dose responses in human tissue. We examined direct interactions among datasets (top down approach) and defined several hubs as significant regulators, including transcription factors (YY1, MYC and CREB1), kinases (CDK2, PLK1) and a protease (MMP2). These data indicate a shift in response across time — with an increase in DNA repair, tissue remodeling and repression of cell proliferation acutely (24–72 h). Pathway-based integration (bottom up approach) identified common molecular and pathway responses to low dose radiation, including oxidative stress, nitric oxide signaling and transcriptional regulation through the SP1 factor that would not have been identified by the individual data sets. Significant regulation of key downstream metabolites of nitrative stress was measured within these pathways. Among the features identified in our study, the regulation of MMP2 and SP1 was experimentally validated. Our results demonstrate the advantage of data integration to broadly define the pathways and networks that represent the mechanisms by which complex biological systems respond to perturbation. - Highlights: • Low dose ionizing radiation altered homeostasis in 3D skin tissue model. • Global gene/protein/metabolite data integrated using complementary statistical approaches • Time and location-specific change in matrix regulation

  16. From Neurodegeneration to Brain Health: An Integrated Approach.

    PubMed

    Petersen, Robert B; Lissemore, Frances M; Appleby, Brian; Aggarwal, Neelum; Boyatzis, Richard; Casadesus, Gemma; Cummings, Jeff; Jack, Anthony; Perry, George; Safar, Jiri; Sajatovic, Martha; Surewicz, Witold K; Wang, Yanming; Whitehouse, Peter; Lerner, Alan

    2015-01-01

    The term "brain health" integrates general health and well-being with cognitive fitness, in the context of an environment that includes the spectrum of positive and negative factors affecting the individual. Brain health incorporates the effects of neurodegeneration in an ecological sense and the effects of environment and health practices on brain function. It also provides a framework for understanding and maximizing cognitive function across the lifespan. Despite decades of research into the pathogenesis of neurodegenerative disorders, our understanding of how to treat them is relatively rudimentary. Unidimensional approaches, such as medication monotherapies, have generally produced negative results in treatment trials. New integrative paradigms that cut across the molecular and cellular level to the individual and societal level may provide new approaches to understand and treat these disorders. This report on proceedings of a multi-disciplinary conference held in Cleveland, Ohio, in October 2013 summarizes research progress in understanding neurodegenerative disorders in a brain health context. A new "brain health" paradigm is essential to finally understand neurodegenerative disorders such as Alzheimer's disease and overcome the relative stand-still in therapeutics research that has characterized the last decade. The authors summarize progress in these emerging areas with the aim of producing new integrated scientific models for understanding brain health, potentially modifying disease course and advancing care for individuals and families affected by neurodegenerative conditions. PMID:25720413

  17. 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

  18. Synergy for health equity: integrating health promotion and social determinants of health approaches in and beyond the Americas.

    PubMed

    Jackson, Suzanne F; Birn, Anne-Emanuelle; Fawcett, Stephen B; Poland, Blake; Schultz, Jerry A

    2013-12-01

    Health promotion and social determinants of health approaches, when integrated, can better contribute to understanding and addressing health inequities. Yet, they have typically been pursued as two solitudes. This paper presents the key elements, principles, actions, and potential synergies of these complementary frameworks for addressing health equity. The value-added of integrating these two approaches is illustrated by three examples drawn from the authors' experiences in the Americas: at the community level, through a community-based coalition for reducing chronic disease disparities among minorities in an urban center in the United States; at the national level, through healthy-settings interventions in Canada; and at the Regional level, through health cooperation based on social justice values in Latin America. Challenges to integrating health promotion and social determinants of health approaches in the Americas are also discussed. PMID:24569978

  19. Ultraviolet radiation and health: from hazard identification to effective prevention.

    PubMed

    Yamaguchi, N; Kinjo, Y; Akiba, S; Watanabe, S

    1999-12-01

    The increased exposure to ultraviolet (UV) radiation due to ozone depletion is one of the most serious global health problems. The UV exposure is known to cause skin carcinoma, cataract and deteriorated immune function, but for countries like Japan, the magnitude of health effects of UV radiation is yet to be elucidated. The International Workshop on the Health Effects of Ultraviolet Radiation was held in Tokyo, Japan, on February 17-19, 1999, in attempts to visualize the size of this problem and to identify better solutions. Through this workshop, several lines of scientific evidence were provided, which clearly show that the risk of cataract and skin cancer among people living in Japan increases with the increasing level of sun exposure. We must seek, therefore, the extent to which the UV exposure of given intensity causes adverse health effects in Japanese population. Through the workshop, the importance of preventive measure was confirmed. The scientific basis of prevention is, of course, the knowledge of dose-response relationship and the current exposure status in Japanese population. It is hoped that the communications between researchers in Japan and other countries are strengthened through this workshop. PMID:10709343

  20. Long-term effects of radiation exposure on health.

    PubMed

    Kamiya, Kenji; Ozasa, Kotaro; Akiba, Suminori; Niwa, Ohstura; Kodama, Kazunori; Takamura, Noboru; Zaharieva, Elena K; Kimura, Yuko; Wakeford, Richard

    2015-08-01

    Late-onset effects of exposure to ionising radiation on the human body have been identified by long-term, large-scale epidemiological studies. The cohort study of Japanese survivors of the atomic bombings of Hiroshima and Nagasaki (the Life Span Study) is thought to be the most reliable source of information about these health effects because of the size of the cohort, the exposure of a general population of both sexes and all ages, and the wide range of individually assessed doses. For this reason, the Life Span Study has become fundamental to risk assessment in the radiation protection system of the International Commission on Radiological Protection and other authorities. Radiation exposure increases the risk of cancer throughout life, so continued follow-up of survivors is essential. Overall, survivors have a clear radiation-related excess risk of cancer, and people exposed as children have a higher risk of radiation-induced cancer than those exposed at older ages. At high doses, and possibly at low doses, radiation might increase the risk of cardiovascular disease and some other non-cancer diseases. Hereditary effects in the children of atomic bomb survivors have not been detected. The dose-response relation for cancer at low doses is assumed, for purposes of radiological protection, to be linear without a threshold, but has not been shown definitively. This outstanding issue is not only a problem when dealing appropriately with potential health effects of nuclear accidents, such as at Fukushima and Chernobyl, but is of growing concern in occupational and medical exposure. Therefore, the appropriate dose-response relation for effects of low doses of radiation needs to be established. PMID:26251392

  1. An integrated view of gamma radiation effects on marine fauna: from molecules to ecosystems.

    PubMed

    Won, Eun-Ji; Dahms, Hans-U; Kumar, K Suresh; Shin, Kyung-Hoon; Lee, Jae-Seong

    2015-11-01

    Accidental release of nuclides into the ocean is causing health risks to marine organisms and humans. All life forms are susceptible to gamma radiation with a high variation, depending on various physical factors such as dose, mode, and time of exposure and various biological factors such as species, vitality, age, and gender. Differences in sensitivity of gamma radiation are also associated with different efficiencies of mechanisms related to protection and repair systems. Gamma radiation may also affect various other integration levels: from gene, protein, cells and organs, population, and communities, disturbing the energy flow of food webs that will ultimately affect the structure and functioning of ecosystems. Depending on exposure levels, gamma radiation induces damages on growth and reproduction in various organisms such as zooplankton, benthos, and fish in aquatic ecosystems. In this paper, harmful effects of gamma-irradiated aquatic organisms are described and the potential of marine copepods in assessing the risk of gamma radiation is discussed with respect to physiological adverse effects that even affect the ecosystem level. PMID:25382502

  2. Integrating mental health parity for homebound older adults under the medicare home health care benefit.

    PubMed

    Davitt, Joan K; Gellis, Zvi D

    2011-04-01

    Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults. PMID:21462061

  3. Implications for management in integrated health systems.

    PubMed

    Ross, A

    1987-01-01

    Leadership formulas cannot be tacked to an office wall for use. Leadership encompasses artistry and is a fluctuating, high tech, high touch activity. It must operate with fluidity and flexibility. Leaders must translate ethical issues in day-by-day operations by knowing the difference between right and wrong. The lines between the two are not always clear, but it is essential for the leader to clarify the issues in order for the team to function with the best interest of both the patient and the organization in mind. Executives operating within complex organizational structures need to focus carefully on these ethical and value systems, and it is the responsibility of educators to prepare students to understand these value issues. Once value systems are understood, it is easier to deal with organizational confrontation and control issues. The health system is changing, and educators and practitioners are also changing. A prescription for success includes a strong element of self-assessment that links personal and professional behavior to leadership. Leadership is the awareness of how one can positively affect the organization's change process and is the means that the individual uses to determine its direction and course. Leaders simply work harder at doing what they do best and by so doing, motivate others as well to achieve high levels of success and performance. If there is one characteristic that contributes most to the development of a leader both on campus and off, it is the commitment to a lifelong process of learning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10283131

  4. The Importance Of Integrating Narrative Into Health Care Decision Making.

    PubMed

    Dohan, Daniel; Garrett, Sarah B; Rendle, Katharine A; Halley, Meghan; Abramson, Corey

    2016-04-01

    When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice. PMID:27044974

  5. National Institutes of Health Funding in Radiation Oncology: A Snapshot

    SciTech Connect

    Steinberg, Michael; McBride, William H.; Vlashi, Erina; Pajonk, Frank

    2013-06-01

    Currently, pay lines for National Institutes of Health (NIH) grants are at a historical low. In this climate of fierce competition, knowledge about the funding situation in a small field like radiation oncology becomes very important for career planning and recruitment of faculty. Unfortunately, these data cannot be easily extracted from the NIH's database because it does not discriminate between radiology and radiation oncology departments. At the start of fiscal year 2013 we extracted records for 952 individual grants, which were active at the time of analysis from the NIH database. Proposals originating from radiation oncology departments were identified manually. Descriptive statistics were generated using the JMP statistical software package. Our analysis identified 197 grants in radiation oncology. These proposals came from 134 individual investigators in 43 academic institutions. The majority of the grants (118) were awarded to principal investigators at the full professor level, and 122 principal investigators held a PhD degree. In 79% of the grants, the research topic fell into the field of biology, 13% in the field of medical physics. Only 7.6% of the proposals were clinical investigations. Our data suggest that the field of radiation oncology is underfunded by the NIH and that the current level of support does not match the relevance of radiation oncology for cancer patients or the potential of its academic work force.

  6. Understanding and integrating mindfulness into psychiatric mental health nursing practice.

    PubMed

    Tusaie, Kathleen; Edds, Kelly

    2009-10-01

    The practice of mindfulness is increasingly being integrated into Western clinical practice within the context of psychotherapy and stress management. Although it is based in ancient Buddhist philosophy, there remains confusion about the definition, antecedents, processes, and outcomes of mindfulness practice. This article reviews the literature on mindfulness, with a focus upon a clearer definition and understanding of the processes and integration into psychiatric mental health nursing practice. PMID:19766927

  7. HYGEIAnet: the integrated regional health information network of Crete.

    PubMed

    Orphanoudakis, Stelios

    2004-01-01

    The healthcare environment is currently changing and the health sector is being transformed to meet new challenges and to benefit from new opportunities. Priorities for the 21st century ought to be set based on emerging dominant trends in healthcare, including the shift towards shared or integrated care, in which an individual's healthcare is the responsibility of a team of professionals across all levels of the healthcare system hierarchy. In addition to the requirement for efficient and secure access to the Integrated Electronic Health Record (I-EHR) of a citizen, this necessitates the development and deployment of Regional Health Information Networks (RHINs), synchronous and asynchronous collaboration services, and novel eHealth and mHealth services, facilitated by intelligent sensors, monitoring devices, hand-held or wearable technologies, the Internet and wireless broadband communications. These further require the adoption of an open Reference Architecture and the creation of a scalable Health Information Infrastructure (HII).This paper discusses the challenges encountered in developing and deploying HYGEIAnet, the Regional Health Information Network of Crete, as well as relevant benefits for citizens and health professionals. Furthermore, HYGEIAnet systems and services are presented, with emphasis on the development of the HII and the implementation of the I-EHR service for providing secure, role-based access to validated content by authorized and authenticated users. PMID:15718565

  8. Disease Prevention and Health Promotion: How Integrative Medicine Fits.

    PubMed

    Ali, Ather; Katz, David L

    2015-11-01

    As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels of prevention, acknowledging the relative deficiency of research on the effectiveness of practice-based integrative care. One goal of integrative medicine is to make the widest array of appropriate options available to patients, ultimately blurring the boundaries between conventional and complementary medicine. Both disciplines should be subject to rigorous scientific inquiry so that interventions that are efficacious and effective are systematically distinguished from those that are not. Furthermore, principles of preventive medicine can be infused into prevalent practices in complementary and integrative medicine, promoting public health in the context of more responsible practices. The case is made that an integrative preventive approach involves the responsible use of science with responsiveness to the needs of patients that persist when conclusive data are exhausted, providing a framework to make clinical decisions among integrative therapies. PMID:26477898

  9. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  10. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  11. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  12. Thyroid cancer radioiodine therapy: health service performance and radiation safety.

    PubMed

    Vogiatzi, S; Liossis, A; Lamprinakou, M

    2015-07-01

    Greek Atomic Energy Commission collected data related to radioiodine I-131 therapy (RAIT) delivery to differentiated thyroid carcinoma patients, for the period 2003-13, corresponding to 100 % of hospitals at national level. Radiation safety and health service performance outcome indicators were assessed. The numbers of hospitals and nuclear medicine (NM) therapy wards, as well as RAIT annual frequencies, have increased. Geographical inhomogeneous distribution of existing infrastructure is recorded. In some cases, the observed inefficient use of NM therapy wards seems to be due to lack of human resources (e.g. nurses). Regular assessment of appropriate key indicators could serve as a useful tool for radiation safety monitoring and health service performance improvement. PMID:25809109

  13. Manifestations of integrated public health policy in Dutch municipalities.

    PubMed

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. PMID:25500994

  14. Tackling community integration in mental health home visit integration in Finland.

    PubMed

    Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

    2016-09-01

    Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge. PMID:25950446

  15. Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

    PubMed Central

    Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K

    2012-01-01

    Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the

  16. The new Australian Primary Health Networks: how will they integrate public health and primary care?

    PubMed

    Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne

    2016-01-01

    On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166

  17. Integrated health care in California's managed care capital.

    PubMed

    Terry, D

    1994-01-01

    Sacramento, California's capital, represents the nation's most competitive managed care marketplace. The Sutter Health organization represents a significant force in this marketplace and surrounding regions of Northern California. Sutter has created an integrated regional health care network capable of delivering a full continuum of care through appropriate community-based facilities, a variety of physician relationships, and both owned and aligned managed care structures. The overall Sutter Health strategy that incorporates facilities, physician partnerships, and patient care financing is described. The article identifies six key lessons learned during this period of growth. PMID:10138791

  18. Evaluating landscape health: Integrating societal goals and biophysical process

    USGS Publications Warehouse

    Rapport, D.J.; Gaudet, C.; Karr, J.R.; Baron, J. S.; Bohlen, C.; Jackson, W.; Jones, B.; Naiman, R.J.; Norton, B.; Pollock, M. M.

    1998-01-01

    Evaluating landscape change requires the integration of the social and natural sciences. The social sciences contribute to articulating societal values that govern landscape change, while the natural sciences contribute to understanding the biophysical processes that are influenced by human activity and result in ecological change. Building upon Aldo Leopold's criteria for landscape health, the roles of societal values and biophysical processes in shaping the landscape are explored. A framework is developed for indicators of landscape health and integrity. Indicators of integrity are useful in measuring biological condition relative to the condition in landscapes largely unaffected by human activity, while indicators of health are useful in evaluating changes in highly modified landscapes. Integrating societal goals and biophysical processes requires identification of ecological services to be sustained within a given landscape. It also requires the proper choice of temporal and spatial scales. Societal values are based upon inter-generational concerns at regional scales (e.g. soil and ground water quality). Assessing the health and integrity of the environment at the landscape scale over a period of decades best integrates societal values with underlying biophysical processes. These principles are illustrated in two contrasting case studies: (1) the South Platte River study demonstrates the role of complex biophysical processes acting at a distance; and (2) the Kissimmee River study illustrates the critical importance of social, cultural and economic concerns in the design of remedial action plans. In both studies, however, interactions between the social and the biophysical governed the landscape outcomes. The legacy of evolution and the legacy of culture requires integration for the purpose of effectively coping with environmental change.

  19. Semen Abnormalities, Sperm DNA Damage and Global Hypermethylation in Health Workers Occupationally Exposed to Ionizing Radiation

    PubMed Central

    Kumar, Dayanidhi; Salian, Sujith Raj; Kalthur, Guruprasad; Uppangala, Shubhashree; Kumari, Sandhya; Challapalli, Srinivas; Chandraguthi, Srinidhi Gururajarao; Krishnamurthy, Hanumanthappa; Jain, Navya; Kumar, Pratap; Adiga, Satish Kumar

    2013-01-01

    Background Cytogenetic studies have demonstrated that low levels of chronic radiation exposure can potentially increase the frequency of chromosomal aberrations and aneuploidy in somatic cells. Epidemiological studies have shown that health workers occupationally exposed to ionizing radiation bear an increased risk of hematological malignancies. Objectives To find the influence of occupational radiation exposure on semen characteristics, including genetic and epigenetic integrity of spermatozoa in a chronically exposed population. Methods This cross sectional study included 134 male volunteers of which 83 were occupationally exposed to ionizing radiation and 51 were non-exposed control subjects. Semen characteristics, sperm DNA fragmentation, aneuploidy and incidence of global hypermethylation in the spermatozoa were determined and compared between the non-exposed and the exposed group. Results Direct comparison of the semen characteristics between the non-exposed and the exposed population revealed significant differences in motility characteristics, viability, and morphological abnormalities (P<0.05–0.0001). Although, the level of sperm DNA fragmentation was significantly higher in the exposed group as compared to the non-exposed group (P<0.05–0.0001), the incidence of sperm aneuploidy was not statistically different between the two groups. However, a significant number of hypermethylated spermatozoa were observed in the exposed group in comparison to non-exposed group (P<0.05). Conclusions We provide the first evidence on the detrimental effects of occupational radiation exposure on functional, genetic and epigenetic integrity of sperm in health workers. However, further studies are required to confirm the potential detrimental effects of ionizing radiation in these subjects. PMID:23922858

  20. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... relating to health effects of radiation exposure. 1.17 Section 1.17 Pensions, Bonuses, and Veterans' Relief... health effects of radiation exposure. (a) From time to time, the Secretary shall publish evaluations of scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in...

  1. Integrating Health Belief Model and Technology Acceptance Model: An Investigation of Health-Related Internet Use

    PubMed Central

    2015-01-01

    perceived usefulness of the Internet and attitude toward Internet use for health purposes for women who were health conscious and who perceived their health to be at risk. Conclusions The integrated model proposed and tested in this study shows that the HBM, when combined with the TAM, is able to predict Internet use for health purposes. For women who subjectively evaluate their health as vulnerable to diseases and are concerned about their health, cognition beliefs in and positive affective feelings about the Internet come into play in determining the use of health-related Internet use. Furthermore, this study shows that engaging in health-related Internet use is a proactive behavior rather than a reactive behavior, suggesting that TAM dimensions have a significant mediating role in Internet health management. PMID:25700481

  2. Mental health policy and integrated care: global perspectives.

    PubMed

    Zolnierek, C D

    2008-09-01

    Although omitted from the World Health Organization's eight Millennium Development Goals, mental illness ranks fourth of the 10 leading causes of disability in the world and is expected to approach second place by 2020. Scarce resources challenge responses to mental health needs. Effective approaches must consider existing healthcare delivery networks, nurses as care providers, as well as social, cultural, political and historical contexts. This paper reviews policy development and care approaches to address mental health needs around the world. Challenges, successes and further needs are discussed. Selected articles were reviewed to represent varied approaches to address mental health needs in countries with diverse resources and infrastructures. Integrated systems offer one model for addressing mental health needs along with physical health needs within a population. While potentially an efficient strategy, caution is advised to ensure services are integrated and not merely added on top of an already overburdened system. As the largest group of healthcare professionals worldwide, nurses play a key role in the delivery of mental health services. Nurses have an opportunity, if not a responsibility, to collaborate across borders sharing education and innovative approaches to care delivery. PMID:18768008

  3. Integrating GDM management in public health: Pakistan perspective.

    PubMed

    Riaz, Musarrat; Basit, Abdul

    2016-09-01

    Pakistan is a developing country with diverse social, economic and cultural dimensions along with limited resources. Non communicable diseases (NCDS) including diabetes are highly prevalent compromising the already challenged health care system. Gestational diabetes mellitus (GDM) with its associated maternal and foetal complications is increasing with rapidly changing lifestyle pattern. Since Pakistan has limited resources and other health issues compete strongly with gestational diabetes initiatives, the most feasible strategy will be the horizontal integration. This will work with the existing primary health care system integrating NCD control programmes with Maternal and Child health (MCH) programmes. Utilizing the existing health care system is the only implementable cost effective strategy. Antenatal screening and treatment of GDM alone is not sufficient but Post-partum screening (PPS) of women with GDM is an important strategy for prevention of diabetes as the conversion rates of GDM to type 2 diabetes are high. Furthermore, instead of perceiving GDM as a temporary reversible clinical entity, it should be considered as a trans-generational prevention of diabetes that needs to be addressed as a public health issue in order to improve maternal and foetal health. PMID:27582139

  4. How to enhance integrated care towards the personal health paradigm?

    PubMed

    Blobel, Bernd G M E; Pharow, Peter; Norgall, Thomas

    2007-01-01

    For improving quality and efficiency of health delivery under the well-known burdens, the health service paradigm has to change from organization-centered over process-controlled to personal health. The growing complexity of highly distributed and fully integrated healthcare settings can only be managed through an advanced architectural approach, which has to include all dimensions of personal health. Here, ICT, medicine, biomedical engineering, bioinformatics and genomics, legal and administrative aspects, terminology and ontology have to be mentioned. The Generic Component Model allows for different domains' concept representation and aggregation. Framework, requirements, methodology and process design possibilities for such a future-proof and meanwhile practically demonstrated approach are discussed in detail. The deployment of the Generic Component Model and the concept representation to biomedical engineering aspects of eHealth are touched upon as essential issues. PMID:17911701

  5. [A federal project of Integrated Health Care in cardiology].

    PubMed

    Beyrle, B

    2006-01-01

    This paper reports in detail on a project of Integrated Health Care in cardiology at the federal level in Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data. PMID:16598581

  6. Integrating Health and Vocational Psychology: HIV and Employment

    ERIC Educational Resources Information Center

    Werth, James L., Jr.; Borges, Nicole J.; McNally, Christopher J.; Maguire, Colleen P.; Britton, Paula J.

    2008-01-01

    This article introduces the Major Contribution on integrating health and vocational psychology, using persons with HIV who have work-related concerns as an example. The authors describe the demographics associated with HIV disease and new treatments that have allowed people with HIV to remain healthy and continue working, or consider returning to…

  7. Integrated Care in College Health: A Case Study

    ERIC Educational Resources Information Center

    Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris

    2008-01-01

    This case study describes 1 international student's treatment experience with an integrated health program on a college campus. This program uses a multidisciplinary, mind-body approach, which incorporates individual counseling, primary care, psychiatric consultation, a mindfulness-based cognitive therapy class, and a meditation group.

  8. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    PubMed Central

    Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael

    2014-01-01

    Background A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Conclusion Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients. PMID:24648834

  9. Radiation is not always harmful to human health

    SciTech Connect

    Thomas, R.G.

    1995-12-31

    The U.S. populace seems to associate the word radiation synonymously with the word doom. There is good reason for this as the media, special-interest groups, our regulatory agencies, and the ever-present litigious atmosphere exude doom whenever radiation is mentioned. The organizations that establish our radiation guidelines are also at fault as they continue to set levels that are coincident with the mood of the populace. Some of the most extensive epidemiological studies of the effects of ionizing radiation in humans have failed to conclude that there are health effects below whole-body equivalent radiation doses of 0.2 Gy (20 rads). This has been demonstrated in the study of survivors of the bombings in Japan; in the cases of radium dial painters (luminizers) studied in the United States, this value is 10 Gy (1000 rads). The luminizer data comprise the major portion of the discussion in this paper, but it must be emphasized that agency support for this program was severed in 1993, and these valuable data records currently lie unavailable for scientific use.

  10. [Social constructionism in primary health care: an integrative review].

    PubMed

    Cadoná, Eliane; Scarparo, Helena

    2015-09-01

    This study sets out to analyze scientific articles in order to investigate how researchers in the area of Social Constructionism define "health" in Primary Health Care. An integrative review of the literature was conducted along with a decision to concentrate on those works with narrative experiences and research studies. The database researched was the Brazilian Virtual Health Library, with experiences in the scope of Primary Health Care. The effectiveness of this step resulted in 12 articles. Data were analyzed and discussed based on the perspectives of social constructionism, which generated two central themes. They were: citizenship exercises - promoting health in collective spaces; health practices - overcoming the dichotomies and absolute truths. This study revealed the relevance of the notion of shared responsibility on meanings of health contained in the texts analyzed. The researchers claim that it is possible to expand health practices into collective action to facilitate ongoing dialogue between health users and workers. However, the dominance of biomedical discourse is criticized by the researchers, because that paradigm still promotes practices of care focused on illness. PMID:26331504

  11. Labor markets and health: an integrated life course perspective.

    PubMed

    Amick, Benjamin C; McLeod, Christopher B; Bültmann, Ute

    2016-07-01

    Current work and health research is fragmented, focusing on jobs, exposures, specific worker groups, work organization, or employment contracts. An emphasis on the labor market in framing the work and health relationship conceptualizes work not only as an exposure that increases or lessens health risk but also as a life course experience that is dependent on place and time. The intention is to illustrate how the labor markets and health framework coupled with a life course perspective extends other epidemiological approaches to work and health to identify new research questions. Taking the changing nature of work and labor markets into account, this paper updates the labor markets and health framework. It then reviews, defines, and integrates key life course concepts. A model is developed that guides the understanding of how labor markets and health trajectories emerge from the consideration of the working life course in a social context. The application leads to new research questions investigating characteristics of labor markets and health trajectories that may lead to positive health outcomes over the life course. PMID:27158797

  12. System Integration and Network Planning in the Academic Health Center

    PubMed Central

    Testa, Marcia A.; Spackman, Thomas J.

    1985-01-01

    The transfer of information within the academic health center is complicated by the complex nature of the institution's multi-dimensional role. The diverse functions of patient care, administration, education and research result in a complex web of information exchange which requires an integrated approach to system management. System integration involves a thorough assessment of “end user” needs in terms of hardware and software as well as specification of the communications network architecture. The network will consist of a series of end user nodes which capture, process, archive and display information. This paper will consider some requirements of these nodes, also called intelligent workstations, relating to their management and integration into a total health care network.

  13. Integrating funds for health and social care: an evidence review

    PubMed Central

    Goddard, Maria; Weatherly, Helen; Chalkley, Martin

    2015-01-01

    Objectives Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice. Methods We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice. We searched eight electronic databases and relevant websites, and checked reference lists of reviews and empirical studies. We extracted data on the types of funding integration used by schemes, their benefits and costs (including unintended effects), and the barriers to implementation. We interpreted our findings with reference to our framework. Results The review included 38 schemes from eight countries. Most of the randomized evidence came from Australia, with nonrandomized comparative evidence available from Australia, Canada, England, Sweden and the US. None of the comparative evidence isolated the effect of integrated funding; instead, studies assessed the effects of ‘integrated financing plus integrated care’ (i.e. ‘integration’) relative to usual care. Most schemes (24/38) assessed health outcomes, of which over half found no significant impact on health. The impact of integration on secondary care costs or use was assessed in 34 schemes. In 11 schemes, integration had no significant effect on secondary care costs or utilisation. Only three schemes reported significantly lower secondary care use compared with usual care. In the remaining 19 schemes, the evidence was mixed or unclear. Some schemes achieved short-term reductions in delayed discharges, but there was anecdotal evidence of

  14. Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery.

    PubMed

    Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

    2015-12-01

    A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. PMID:26489924

  15. 75 FR 38099 - Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... Public Health AGENCY: Department of Health and Human Services, Office of the Secretary, Office of Public... March 23, 2010. The Advisory Group on Prevention, Health Promotion, and Integrative and Public Health... Prevention, Health Promotion, and Integrative and Public Health, as directed by Executive Order 13544....

  16. Integration of Health Protection and Health Promotion: Rationale, Indicators, and Metrics

    PubMed Central

    Sorensen, Glorian; McLellan, Deborah; Dennerlein, Jack T.; Pronk, Nicolaas P.; Allen, Jennifer D.; Boden, Leslie I.; Okechukwu, Cassandra A.; Hashimoto, Dean; Stoddard, Anne; Wagner, Gregory R

    2014-01-01

    Objective To offer a definition of an “integrated” approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. Methods Guided by the question, “How will we know it when we see it?” we reviewed relevant literature to identify available definitions and metrics, and used a modified-Delphi process to review and refine indicators and measures of integrated approaches. Results A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers and workers. Conclusions A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process. PMID:24284762

  17. Integrated Theory of Health Behavior Change: background and intervention development.

    PubMed

    Ryan, Polly

    2009-01-01

    An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care. PMID:19395894

  18. Four Decades of Population Health Data: The Integrated Health Interview Series as an Epidemiologic Resource

    PubMed Central

    Johnson, Pamela Jo; Blewett, Lynn A.; Ruggles, Steven; Davern, Michael E.; King, Miriam L.

    2008-01-01

    The National Health Interview Survey (NHIS) is a primary source of information on the changing health of the U.S. population over the past four decades. The full potential of NHIS data for analyzing long-term change, however, has rarely been exploited. Time series analysis is complicated by several factors: large numbers of data files and voluminous documentation; complexity of file structures; and changing sample designs, questionnaires, and variable-coding schemes. We describe a major data integration project that will simplify cross-temporal analysis of population health data available in the NHIS. The Integrated Health Interview Series (IHIS) is a Web-based system that provides an integrated set of data and documentation based on the NHIS public use files from 1969 to the present. The Integrated Health Interview Series enhances the value of NHIS data for researchers by allowing them to make consistent comparisons across four decades of dramatic changes in health status, health behavior, and healthcare. PMID:18854709

  19. Contribution of modern medical imaging technology to radiation health effects in exposed populations

    SciTech Connect

    Fabrikant, J.I,

    1980-11-01

    The introduction of technically-advanced imaging systems in medicine carries with it potential health hazards, particularly from ionizing and nonionizing radiation exposure of human populations. This paper will discuss what we know and what we do not know about the health effects of low-level radiation, how the risks of radiation-induced health effects may be estimated, the sources of the scientific data, the dose-response models used, the uncertainties which limit precision of estimation of excess health risks from low-level radiation, and what the implications might be for radiation protection in medicine and public health policy.

  20. Organisational culture matters for system integration in health care.

    PubMed

    Munir, Samina K; Kay, Stephen

    2003-01-01

    This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the 'Actual Usefulness' of the system and the 'Organisational Culture'. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated. PMID:14728220

  1. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

    Daniels, James

    2014-01-01

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

  2. Telematics and smart cards in integrated health information system.

    PubMed

    Sicurello, F; Nicolosi, A

    1997-01-01

    Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole

  3. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

    McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

    2013-01-01

    In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  4. Research on information fusion for engineering system integrated health management

    NASA Astrophysics Data System (ADS)

    Gao, Zhanbao; Li, Xingshan; Sun, Cong; Liu, Qi

    2006-11-01

    Integrated Health Management technology is the emerging paradigm in system supervision and maintenance area, and it is the key to achieving true condition-based maintenance. But this task is complicated by the extremely large amount of the data available, the existence of uncertainties, and interactive engineering system operational conditions. Therefore, it is reasonable to research the health information fusion technology to achieve better performance and a higher level of autonomy for IHM system. This paper analyses the requirements of the information fusion in an IHM system, describes the fusion application areas, proposes the Health Sensing Unit (HSU) concept, and designs the distributed hierarchical fusion architecture. Using the confidence distance matrix as the measure of HSU's performance, this paper proposes a fusion algorithm to fuse multiple HSUs' output, and figure out the system health index according to the maximum likelihood principle. The simulation result yields conclusive evidence that fusion can be very valuable in the IHM technology for the system supervision and maintenance.

  5. Integrating risk adjustment and enrollee premiums in health plan payment.

    PubMed

    McGuire, Thomas G; Glazer, Jacob; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D; Zuvekas, Samuel H

    2013-12-01

    In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  6. A sustainable behavioral health program integrated with public health primary care.

    PubMed

    Mims, Susan

    2006-01-01

    The need for behavioral healthcare for the poor and indigent is well documented in rural North Carolina, and integrated behavioral healthcare--that is, mental health screening and treatment offered as part of primary care services--has proven a very effective and efficient method to improve patients' health. In 2000, the Buncombe County Health Center (BCHC) began a grant-funded program treating depressed patients in its public health clinics and school health programs. The Health Center used the opportunity to send a team to the Management Academy for Public Health to learn business principles that could be applied to the challenge of sustaining this program as part of its ongoing public health service delivery for the county. Using their business plan from the Management Academy, the BCHC sought funding from various stakeholders, and, through their support, was able to institute a fully integrated behavioral health program in 2004. The BCHC has now joined forces with other partners in the state to address statewide policy changes in support of such programs. These efforts are an example of how a community health center can apply entrepreneurial thinking and strategic business planning to improve healthcare and effect wide-ranging change. PMID:16912608

  7. Integration of health systems and priority health interventions: a case study of the integration of HIV and TB control programmes into the general health system in Vietnam.

    PubMed

    Conseil, Alexandra; Mounier-Jack, Sandra; Coker, Richard

    2010-11-01

    This case study on Vietnam aims to generate empirical evidence on the relative merits of integration of two priority health interventions, HIV/AIDS and tuberculosis (TB), into six functions of the wider health system: stewardship and governance, service delivery, demand generation, monitoring and evaluation, planning, and financing. Selective documentary reviews and 25 qualitative, semi-structured interviews were conducted in early 2009 in Hanoi, Hai Duong province, Chih Linh district and Hoang Tien commune with informants from international, national and sub-national agencies steering or managing the HIV/AIDS and TB programmes and from health facilities providing HIV/AIDS and TB services. Data collected were collated and evaluated against 25 elements of integration. Each element of integration was ultimately classified as being 'fully/predominantly integrated', 'partially integrated', 'not or predominantly not integrated'. The results showed that none of the six programme functions was fully integrated into the general health care system as a whole. They were established either in parallel, notably at higher administrative levels, or were partially integrated. The study findings also revealed that little integration across all functional levels has occurred between the two programmes. Generally international agencies and sub-national domestic stakeholders supported more integration between vertical programmes (HIV and TB) and the general health systems, while national bodies responsible for HIV and TB favoured reinforcing a more vertical and thus less integrated approach. In the absence of shared assumptions and goals, this polarization of views may result in sub-optimal effectiveness and efficiency of each of the disease programmes as well as of HIV/TB interventions. PMID:20966106

  8. [Electrosmog, cellular phones, sunbeds etc. -- adverse health effects from radiation? Health aspects of non-ionizing radiation].

    PubMed

    Bernhardt, J H

    2005-01-01

    This review supplies a survey of the three physical influences, i. e. UV radiation, high-frequency electromagnetic fields of radio telephone systems and other wireless radio applications as well as low-frequency fields of electric power supply. The exposure to UV radiation must be considered to be by far the highest health risk. The annual rate of about 2000 deaths from skin cancer in Germany, mainly caused by extensive exposure to solar UV radiation, demands protective measures. Teaching reasonable behaviour is the supreme issue. Recommended protective measures in the order of their effectiveness are protection by adaptation of behaviour, by clothes, sun hats and sunglasses as well as by sun creams. Children are the most important target group. With regard to UV tanning appliances it is recommended not to use artificial UV radiation for cosmetic purposes because of the related health risks. For the assessment of health impairments caused by exposure to electromagnetic fields, direct field reactions due to induced electric body currents, reactions on the surface of the body or heating effects should be separated from indirect field reactions (e. g. electric shocks and burns) due to contact currents or interference with electronic body aids and implants. Risk assessment has led to recommendations of threshold values which-in agreement with international research results-exclude all impairments of health caused by direct field reactions scientifically proven to date. Contrary to public concerns, which are mostly related to base transmitters of radio telephone systems, exposure due to handheld radio telephones (cellular phones) should rather be considered from the viewpoint of precautionary health protection, since it is more likely that their use can lead to high exposure of the user. Due to the protective measures provided so far and observance of the threshold values based on scientific results, exposures do not lead to health impairments-not even in children

  9. Approaches to integrated monitoring for environmental health impact assessment

    PubMed Central

    2012-01-01

    Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions. PMID:23171406

  10. Approaches to integrated monitoring for environmental health impact assessment.

    PubMed

    Liu, Hai-Ying; Bartonova, Alena; Pascal, Mathilde; Smolders, Roel; Skjetne, Erik; Dusinska, Maria

    2012-01-01

    Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as 'a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain'. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions. PMID:23171406

  11. Rapid radiation dose assessment for radiological public health emergencies: roles of NIAID and BARDA.

    PubMed

    Grace, Marcy B; Moyer, Brian R; Prasher, Joanna; Cliffer, Kenneth D; Ramakrishnan, Narayani; Kaminski, Joseph; Coleman, C Norman; Manning, Ronald G; Maidment, Bert W; Hatchett, Richard

    2010-02-01

    A large-scale radiological incident would result in an immediate critical need to assess the radiation doses received by thousands of individuals to allow for prompt triage and appropriate medical treatment. Measuring absorbed doses of ionizing radiation will require a system architecture or a system of platforms that contains diverse, integrated diagnostic and dosimetric tools that are accurate and precise. For large-scale incidents, rapidity and ease of screening are essential. The National Institute of Allergy and Infectious Diseases of the National Institutes of Health is the focal point within the Department of Health and Human Services (HHS) for basic research and development of medical countermeasures for radiation injuries. The Biomedical Advanced Research and Development Authority within the HHS Office of the Assistant Secretary for Preparedness and Response coordinates and administers programs for the advanced development and acquisition of emergency medical countermeasures for the Strategic National Stockpile. Using a combination of funding mechanisms, including funds authorized by the Project BioShield Act of 2004 and those authorized by the Pandemic and All-Hazards Preparedness Act of 2006, HHS is enhancing the nation's preparedness by supporting the radiation dose assessment capabilities that will ensure effective and appropriate use of medical countermeasures in the aftermath of a radiological or nuclear incident. PMID:20065680

  12. Integrating Windblown Dust Forecasts with Public Safety and Health Systems

    NASA Astrophysics Data System (ADS)

    Sprigg, W. A.

    2014-12-01

    Experiments in real-time prediction of desert dust emissions and downstream plume concentrations (~ 3.5 km near-surface spatial resolution) succeed to the point of challenging public safety and public health services to beta test a dust storm warning and advisory system in lowering risks of highway and airline accidents and illnesses such as asthma and valley fever. Key beta test components are: high-resolution models of dust emission, entrainment and diffusion, integrated with synoptic weather observations and forecasts; satellite-based detection and monitoring of soil properties on the ground and elevated above; high space and time resolution for health surveillance and transportation advisories.

  13. Integrating comparative effectiveness research programs into predictive health: a unique role for academic health centers.

    PubMed

    Rask, Kimberly J; Brigham, Kenneth L; Johns, Michael M E

    2011-06-01

    The growing burden of chronic disease, an aging population, and rising health care costs threaten the sustainability of our current model for health care delivery. At the same time, innovations in predictive health offer a pathway to reduce disease burden by preventing and mitigating the development of disease. Academic health centers are uniquely positioned to evaluate the comparative effectiveness of predictive and personalized health interventions, given institutional core competencies in innovative knowledge development. The authors describe Emory University's commitment to integrating comparative effectiveness research (CER) into predictive health programs through the creation and concurrent evaluation of its Center for Health Discovery and Well Being (hereafter, "the Center"). Established in 2008, the Center is a clinical laboratory for testing the validity and utility of a health-focused rather than disease-focused care setting. The Center provides preventive health services based on the current evidence base, evaluates the effectiveness of its care delivery model, involves trainees in both the delivery and evaluation of its services, and collects structured physical, social, and emotional health data on all participants over time. Concurrent evaluation allows the prospective exploration of the complex interactions among health determinants as well as the comparative effectiveness of novel biomarkers in predicting health. Central to the Center is a cohort study of randomly selected university employees. The authors describe how the Center has fostered a foundation for CER through the structured recruitment of study cohorts, standardized interventions, and scheduled data collection strategies that support pilot studies by faculty and trainees. PMID:21512361

  14. Health impacts of ultraviolet radiation in urban ecosystems: a review

    NASA Astrophysics Data System (ADS)

    Heisler, Gordon M.

    2005-08-01

    This paper explores the literature on ultraviolet irradiance (UV) in urban ecosystems with respect to the likely effects on human health. The focus was the question of whether the health effects of UV radiation should be included in planning of landscape elements such as trees and shading structures. In examining the literature, special attention was given to seeking information on the question of whether it is important that shade be provided for elementary school play areas, and if so, how should it be accomplished? Before such practical questions could be dealt with, it became obvious that answers to several pertinent secondary questions had to be sought. Foremost of these was, what are the negative and positive health effects of UV exposure? Recent epidemiological findings of apparent benefits of sunlight because of vitamin-D photosynthesis and resulting anti-cancer effects make this highly relevant. Another basic question is that of trends in ozone depletion, which leads to interesting questions of long-term trends, short-term extremes, and urban influences on UV irradiance. A host of these and other pertinent questions, such as, "What is the relationship between climate of a location and dress," i.e., "How much exposure will people receive during time spent outdoors?" require much more study. Judging from current knowledge of typical spectra of solar radiation in tree shade and the difference between the action spectra for vitamin D synthesis and erythema in human skin, exposure to solar radiation in tree shade for a short period of time can be somewhat more beneficial for vitamin D synthesis and regulation than detrimental in producing sunburn.

  15. Data Integration Reveals Key Homeostatic Mechanisms Following Low Dose Radiation Exposure

    SciTech Connect

    Tilton, Susan C.; Matzke, Melissa M.; Sowa, Marianne B.; Stenoien, David L.; Weber, Thomas J.; Morgan, William F.; Waters, Katrina M.

    2015-05-01

    The goal of this study was to define pathways regulated by low dose radiation to understand how biological systems respond to subtle perturbations in their environment and prioritize pathways for human health assessment. Using an in vitro 3-D human full thickness skin model, we have examined the temporal response of dermal and epidermal layers to 10 cGy X-ray using transcriptomic, proteomic, phosphoproteomic and metabolomic platforms. Bioinformatics analysis of each dataset independently revealed potential signaling mechanisms affected by low dose radiation, and integrating data shed additional insight into the mechanisms regulating low dose responses in human tissue. We examined direct interactions among datasets (top down approach) and defined several hubs as significant regulators, including transcription factors (YY1, MYC and CREB1), kinases (CDK2, PLK1) and a protease (MMP2). These data indicate a shift in response across time - with an increase in DNA repair, tissue remodeling and repression of cell proliferation acutely (24 – 72 hr). Pathway-based integration (bottom up approach) identified common molecular and pathway responses to low dose radiation, including oxidative stress, nitric oxide signaling and transcriptional regulation through the SP1 factor that would not have been identified by the individual data sets. Significant regulation of key downstream metabolites of nitrative stress were measured within these pathways. Among the features identified in our study, the regulation of MMP2 and SP1 were experimentally validated. Our results demonstrate the advantage of data integration to broadly define the pathways and networks that represent the mechanisms by which complex biological systems respond to perturbation.

  16. Providing primary health care through integrated microfinance and health services in Latin America.

    PubMed

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  17. Combined Exposure to Simulated Microgravity and Acute or Chronic Radiation Reduces Neuronal Network Integrity and Survival

    PubMed Central

    Quintens, Roel; Samari, Nada; de Saint-Georges, Louis; van Oostveldt, Patrick; Baatout, Sarah; Benotmane, Mohammed Abderrafi

    2016-01-01

    During orbital or interplanetary space flights, astronauts are exposed to cosmic radiations and microgravity. However, most earth-based studies on the potential health risks of space conditions have investigated the effects of these two conditions separately. This study aimed at assessing the combined effect of radiation exposure and microgravity on neuronal morphology and survival in vitro. In particular, we investigated the effects of simulated microgravity after acute (X-rays) or during chronic (Californium-252) exposure to ionizing radiation using mouse mature neuron cultures. Acute exposure to low (0.1 Gy) doses of X-rays caused a delay in neurite outgrowth and a reduction in soma size, while only the high dose impaired neuronal survival. Of interest, the strongest effect on neuronal morphology and survival was evident in cells exposed to microgravity and in particular in cells exposed to both microgravity and radiation. Removal of neurons from simulated microgravity for a period of 24 h was not sufficient to recover neurite length, whereas the soma size showed a clear re-adaptation to normal ground conditions. Genome-wide gene expression analysis confirmed a modulation of genes involved in neurite extension, cell survival and synaptic communication, suggesting that these changes might be responsible for the observed morphological effects. In general, the observed synergistic changes in neuronal network integrity and cell survival induced by simulated space conditions might help to better evaluate the astronaut's health risks and underline the importance of investigating the central nervous system and long-term cognition during and after a space flight. PMID:27203085

  18. Combined Exposure to Simulated Microgravity and Acute or Chronic Radiation Reduces Neuronal Network Integrity and Survival.

    PubMed

    Pani, Giuseppe; Verslegers, Mieke; Quintens, Roel; Samari, Nada; de Saint-Georges, Louis; van Oostveldt, Patrick; Baatout, Sarah; Benotmane, Mohammed Abderrafi

    2016-01-01

    During orbital or interplanetary space flights, astronauts are exposed to cosmic radiations and microgravity. However, most earth-based studies on the potential health risks of space conditions have investigated the effects of these two conditions separately. This study aimed at assessing the combined effect of radiation exposure and microgravity on neuronal morphology and survival in vitro. In particular, we investigated the effects of simulated microgravity after acute (X-rays) or during chronic (Californium-252) exposure to ionizing radiation using mouse mature neuron cultures. Acute exposure to low (0.1 Gy) doses of X-rays caused a delay in neurite outgrowth and a reduction in soma size, while only the high dose impaired neuronal survival. Of interest, the strongest effect on neuronal morphology and survival was evident in cells exposed to microgravity and in particular in cells exposed to both microgravity and radiation. Removal of neurons from simulated microgravity for a period of 24 h was not sufficient to recover neurite length, whereas the soma size showed a clear re-adaptation to normal ground conditions. Genome-wide gene expression analysis confirmed a modulation of genes involved in neurite extension, cell survival and synaptic communication, suggesting that these changes might be responsible for the observed morphological effects. In general, the observed synergistic changes in neuronal network integrity and cell survival induced by simulated space conditions might help to better evaluate the astronaut's health risks and underline the importance of investigating the central nervous system and long-term cognition during and after a space flight. PMID:27203085

  19. Integration services to enable regional shared electronic health records.

    PubMed

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency. PMID:21893763

  20. Health-related aspects of integrated pest management.

    PubMed Central

    Smith, R F; Calvert, D J

    1976-01-01

    Basic concepts and philosophy of integrated pest management are presented in order to dispel several misconceptions and to provide the necessary background information for discussion of its relationship to the health-related effects of pesticide use. Implications for human health of current pesticide practices in Central America are examined to illustrate major problems associated with the injudicious use of insecticides, i.e., human pesticide poisonings, development of insect resistance, and persistence in the environment. Mitigation of these problems would ideally be achieved through the efforts and cooperation of a multidisciplinary team of scientists and technical people in the medical and agricultural sciences. The dilemma associated with the development of integrated pest control systems in developing countries is discussed. The FAO/UNEP Global Programme was reviewed. PMID:976225

  1. A method for optimizing integrated system health management

    NASA Astrophysics Data System (ADS)

    Jambor, Bruno; Rouch, Robin L.; Eger, George W.; Black, Stephen T.

    1996-03-01

    The cost of operating the existing fleet of launch vehicles, both expendable and reusable, is too high. The high cost is attributable to two primary sources: people-intensive checkout procedures and delayed launches. This latter has cost impacts on both launch procedures and other launch operations through ripple-down effects. Without significant changes in how the launch vehicle community does business, the next generation of vehicles shall be burdened by the same high costs. By integrating system health management into the next generation, Reusable Launch Vehicle (RLV) operations costs can be reduced. A method for optimizing Integrated System Health Management (ISHM) is being developed under a cooperative agreement between NASA and Lockheed Martin Corporation (LMC). This paper describes the work currently underway at LMC. ISHM shall be implemented on the prototype vehicle X-33 in order to demonstrate its usefulness for RLV.

  2. Integrated Approaches to Address the Social Determinants of Health for Reducing Health Inequity

    PubMed Central

    Mitlin, Diana; Mulholland, Catherine; Hardoy, Ana; Stern, Ruth

    2007-01-01

    The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the multidimensional nature of poverty and the connections between health and social conditions and present an opportunity to move beyond narrow sectoral interventions and to develop comprehensive social responses and participatory processes that address the root causes of health inequity. Considering the complexity and magnitude of health, poverty, and environmental issues in cities, it is clear that improvements in health and health equity demand not only changes in the physical and social environment of cities, but also an integrated approach that takes into account the wider socioeconomic and contextual factors affecting health. Integrated or multilevel approaches should address not only the immediate, but also the underlying and particularly the fundamental causes at societal level of related health issues. The political and legal organization of the policy-making process has been identified as a major determinant of urban and global health, as a result of the role it plays in creating possibilities for participation, empowerment, and its influence on the content of public policies and the distribution of scarce resources. This paper argues that it is essential to adopt a long-term multisectoral approach to address the social determinants of health in urban settings. For comprehensive approaches to address the social determinants of health effectively and at multiple levels, they need explicitly to tackle issues of participation, governance, and the politics of power, decision making, and empowerment. PMID:17393340

  3. Pesticides and public health: integrated methods of mosquito management.

    PubMed Central

    Rose, R. I.

    2001-01-01

    Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control. PMID:11266290

  4. Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Johnson, A. Steve; Badhwar, Gautam D.; Golightly, Michael J.; Hardy, Alva C.; Konradi, Andrei; Yang, Tracy Chui-Hsu

    1993-01-01

    The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.

  5. 76 FR 77235 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... whether there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a...

  6. 78 FR 19268 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-29

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such...

  7. 78 FR 732 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such...

  8. 77 FR 61756 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such...

  9. 78 FR 53147 - Advisory Board on Radiation and Worker Health: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Advisory Board on Radiation and Worker...-463) of October 6, 1972, that the Advisory Board on Radiation and Worker Health, Department of Health... Information Contact: Mr. Theodore Katz, Designated Federal Officer, Advisory Board on Radiation and...

  10. Integrated Experimental and Computational Approach to Understand the Effects of Heavy Ion Radiation on Skin Homeostasis.

    SciTech Connect

    von Neubeck, Claere; Shankaran, Harish; Geniza, Matthew; Kauer, Paula M.; Robinson, Robert J.; Chrisler, William B.; Sowa, Marianne B.

    2013-08-08

    The effects of low dose high linear energy transfer (LET) radiation on human health are of concern for both space and clinical exposures. As epidemiological data for such radiation exposures are scarce for making relevant predictions, we need to understand the mechanism of response especially in normal tissues. Our objective here is to understand the effects of heavy ion radiation on tissue homeostasis in a realistic model system. Towards this end, we exposed an in vitro three dimensional skin equivalent to low fluences of Neon (Ne) ions (300 MeV/u), and determined the differentiation profile as a function of time following exposure using immunohistochemistry. We found that Ne ion exposures resulted in transient increases in the tissue regions expressing the differentiation markers keratin 10, and filaggrin, and more subtle time-dependent effects on the number of basal cells in the epidermis. We analyzed the data using a mathematical model of the skin equivalent, to quantify the effect of radiation on cell proliferation and differentiation. The agent-based mathematical model for the epidermal layer treats the epidermis as a collection of heterogeneous cell types with different proliferation/differentiation properties. We obtained model parameters from the literature where available, and calibrated the unknown parameters to match the observed properties in unirradiated skin. We then used the model to rigorously examine alternate hypotheses regarding the effects of high LET radiation on the tissue. Our analysis indicates that Ne ion exposures induce rapid, but transient, changes in cell division, differentiation and proliferation. We have validated the modeling results by histology and quantitative reverse transcription polymerase chain reaction (qRT-PCR). The integrated approach presented here can be used as a general framework to understand the responses of multicellular systems, and can be adapted to other epithelial tissues.

  11. Developing Multipurpose Reproductive Health Technologies: An Integrated Strategy

    PubMed Central

    Harrison, P. F.; Hemmerling, A.; Romano, J.; Whaley, K. J.; Young Holt, B.

    2013-01-01

    Women worldwide confront two frequently concurrent reproductive health challenges: the need for contraception and for protection from sexually transmitted infections, importantly HIV/AIDS. While conception and infection share the same anatomical site and mode of transmission, there are no reproductive health technologies to date that simultaneously address that reality. Relevant available technologies are either contraceptive or anti-infective, are limited in number, and require different modes of administration and management. These “single-indication” technologies do not therefore fully respond to what is a substantial reproductive health need intimately linked to pivotal events in many women's lives. This paper reviews an integrated attempt to develop multipurpose prevention technologies—“MPTs”—products explicitly designed to simultaneously address the need for both contraception and protection from sexually transmitted infections. It describes an innovative and iterative MPT product development strategy with the following components: identifying different needs for such technologies and global variations in reproductive health priorities, defining “Target Product Profiles” as the framework for a research and development “roadmap,” collating an integrated MPT pipeline and characterizing significant pipeline gaps, exploring anticipated regulatory requirements, prioritizing candidates for problem-solving and resource investments, and implementing an ancillary advocacy agenda to support this breadth of effort. PMID:23533733

  12. Integrating new graduate nurses in home health care.

    PubMed

    Meadows, Carl A

    2009-10-01

    In 2005, the home health nursing sector of a large Canadian health authority was on its way toward changing a hiring prerequisite of acute care (medical or surgical) experience for entry to practice into home care nursing. At that time, home healthcare services in Canada and the United States were generally requiring acute care experience as prerequisites for working in home health. However, much of the research beginning as early as early 2000 challenged this perspective and universities and colleges offering baccalaureate degrees in nursing began including home health content in their curricula. The findings from research add to the ongoing critique of this acute care requirement and support the concept that acute care and home care are different practice areas with distinct competencies. This article discusses the contextual background that influenced the undertaking of our research, the relevant research literature, our research findings, model for integration, and evaluation of our pilot and lessons learned. The successes seen as a result of New Graduate integration are now being utilized by other home care nursing offices as a result of this work. PMID:19820662

  13. [Juvenile obesity with a focus on health promotion: integrative review].

    PubMed

    Luna, Izaildo Tavares; Moreira, Rosa Aparecida Nogueira; da Silva, Kelanne Lima; Caetano, Joselany Afio; Pinheiro, Patrícia Neyva da Costa; Rebouças, Cristiana Brasil de Almeida

    2011-06-01

    This integrative review summarizes nursing researches that contribute to study juvenile obesity with a focus on health promotion. 20 articles were identified in a bibliographical survey that followed the criteria: date, language, and the descriptors: nursing, adolescent, obesity and health promotion. The Pediatric Nursing Journal published seven of these papers (35%). Indexed papers were published in the last ten years in Portuguese and English. Results showed the construction of scientific knowledge in nursing that developed health promotion strategies in cases of juvenile obesity, thus contributing to the development of the profession. Showing the cumulative risk that juvenile obesity presents of turning subjects into obese adults is a precious resource to plan nursing actions for this population, and for these actions to achieve effective results. PMID:21988003

  14. [Practices that integrate mental health with public health: matricial support and interconsultation].

    PubMed

    Silveira, Elaine Rosner

    2012-09-01

    This article is an offshoot of my doctoral thesis defended at the Federal University of Rio Grande do Sul. It seeks to approach the historical dissociation between mental health and broader public health as well as practices that work towards the integration of the two. It examines the scientific background that fosters this dissociation and also national and international health-related documents that stress the need for integration. Based on Rose, I analyzed the documents and interviews with health professionals on the practices of Matricial Support and Interconsultation formulated by the Ministry of Health and by the Porto Alegre/ Rio Grande do Sul Municipal Health Department, which seek to relate mental health with Primary Healthcare. These documents and health practices propose new subjectivations to the professionals. They emphasize the interdisciplinarity and the non-hierarchization of services and knowledge, and are in line with the form of contemporary social organization, which suggests taking horizontal and democratic decisions, rather than decisions imposed by a vertical authority typical of the patriarchal and biomedical model. PMID:22996888

  15. Effects upon health of occupational exposure to microwave radiation (radar)

    SciTech Connect

    Robinette, C.D.; Silverman, C.; Jablon, S.

    1980-07-01

    The effects of occupational experience with microwave radiation (radar) on the health of US enlisted Naval personnel were studied in cohorts of approximately 20,000 men with maximum opportunity for exposure (electronic equipment repair) and 20,000 with minimum potential for exposure (equipment operation) who served during the Korean War period. Potential exposure was assessed in terms of occupational duties, length of time in occupation and power of equipment at the time of exposure. Actual exposure to members of each cohort could not be established. Mortality by cause of death, hospitalization during military service, later hospitalization in Veterans Administration (VA) facilities, and VA disability compensation were the health indexes studied, largely through the use of automated record systems. No adverse effects were detected in these indexes that could be attributed to potential microwave radiation exposures during the period 1950-1954. Functional and behavioral changes and ill-defined conditions, such as have been reported as microwave effects, could not be investigated in this study but subgroups of the living study population can be identified for expanded follow-up.

  16. Integration of a Mobile-Integrated Therapy with Electronic Health Records: Lessons Learned

    PubMed Central

    Peeples, Malinda M.; Iyer, Anand K.; Cohen, Joshua L.

    2013-01-01

    Background: Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient–provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. Methods: In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Results: Findings from the diverse stakeholder group of a MIT–EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Conclusions: Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. PMID:23759392

  17. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    PubMed

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains. PMID:22563727

  18. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Paris, Deidre; Trevino, Luis C.; Watson, Michael D.

    2005-01-01

    Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented

  19. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    PubMed Central

    Polanco, Nuria Toro; Zabalegui, Iñaki Berraondo; Irazusta, Itziar Pérez; Solinís, Roberto Nuño; Del Río Cámara, Mario

    2015-01-01

    Introduction This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework. Results The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes. PMID:26150764

  20. Integrated approach for managing health risks at work--the role of occupational health nurses.

    PubMed

    Marinescu, Luiza G

    2007-02-01

    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management. PMID:17323873

  1. Integrated Environmental Health Impact Assessment for Risk Governance Purposes; Across What Do We Integrate?

    PubMed Central

    Lebret, Erik

    2015-01-01

    Integrated Environmental Health Impact Assessment (IEHIA) can be considered as an element in the third phase of environmental risk management. Its focus is on providing inclusive descriptions of multiple impacts from multiple stressors in such a way that they can be evaluated against the potential societal benefits of the causes of the stressors. This paper emphasises some differences and difficulties in the integration across professional paradigms and scientific fields, across stakeholder perspectives and differences in impact indicators that emanate from these different fields and paradigms. PMID:26703709

  2. The forgotten spirit: integration of spirituality in health care.

    PubMed

    Mattison, Debra

    2006-02-01

    Health care technology has witnessed incredible advances and increasingly effective treatments for physical and psychological disorders, but the spiritual component of care is an intervention resource that often goes unseen, unaddressed, and underused for patients facing multiple challenges. State-of-the-art services must take a perspective that expands beyond a focus on the biological and psychological needs of patients to also integrate practice skills to address spiritual needs. Spirituality can provide valuable interventions to help maintain hope and stability in times of turbulence. If health care providers are to offer holistic care to patients, we must create an environment in which spirituality is competently explored and addressed. What do health care providers have to lose by integrating the spiritual, dimension into care delivery and accessing a powerful intervention that can make a positive difference to patients? How might patients benefit and what might we learn by asking a few simple, but profound, spiritual questions? What gives your life meaning? What is your greatest hope? What do you fear? What comforts or encourages you most? As you consider how spirituality fits into and benefits your practice you might find meaning in Viktor Frankl's words, "No cure that fails to engage our spirit can make us well". PMID:16499171

  3. Integrated medication management in mHealth applications.

    PubMed

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service. PMID:24825709

  4. Biological Effects of Sunlight, Ultraviolet Radiation, Visible Light, Infrared Radiation and Vitamin D for Health.

    PubMed

    Holick, Michael F

    2016-03-01

    Humans evolved in sunlight and had depended on sunlight for its life giving properties that was appreciated by our early ancestors. However, for more than 40 years the lay press and various medical and dermatology associations have denounced sun exposure because of its association with increased risk for skin cancer. The goal of this review is to put into perspective the many health benefits that have been associated with exposure to sunlight, ultraviolet A (UVA) ultraviolet B (UVB), visible and infrared radiation. PMID:26977036

  5. Telematic integration of health data: a practicable contribution.

    PubMed

    Guerriero, Lorenzo; Ferdeghini, Ezio M; Viola, Silvia R; Porro, Ivan; Testi, Angela; Bedini, Remo

    2011-09-01

    The patients' clinical and healthcare data should virtually be available everywhere, both to provide a more efficient and effective medical approach to their pathologies, as well as to make public healthcare decision makers able to verify the efficacy and efficiency of the adopted healthcare processes. Unfortunately, customised solutions adopted by many local Health Information Systems in Italy make it difficult to share the stored data outside their own environment. In the last years, worldwide initiatives have aimed to overcome such sharing limitation. An important issue during the passage towards standardised, integrated information systems is the possible loss of previously collected data. The herein presented project realises a suitable architecture able to guarantee reliable, automatic, user-transparent storing and retrieval of information from both modern and legacy systems. The technical and management solutions provided by the project avoid data loss and overlapping, and allow data integration and organisation suitable for data-mining and data-warehousing analysis. PMID:21848451

  6. Improving Quality of Emergency Care Through Integration of Mental Health.

    PubMed

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput. PMID:26711094

  7. The Integration of Behavioral Health Interventions in Children’s Health Care: Services, Science, and Suggestions

    PubMed Central

    Kolko, David J.; Perrin, Ellen C.

    2014-01-01

    Objective Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This paper examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. Method This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices (EBP), and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers are provided to enhance the capacity of the practice to deliver behavioral health care. Results There is moderate empirical support for the feasibility, acceptability, and clinical utility of these interventions for treating internalizing and externalizing behavior problems. Practical strategies to extend this work and addressing methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Discussion Pediatric primary care has become an important venue for providing mental health services to children and adolescents due, in part, to its many desirable features (e.g., no stigma, local setting, familiar providers). Further adaptation of existing delivery models may promote the delivery of effective integrated interventions with primary care providers as partners designed to address mental health problems in pediatric healthcare. PMID:24588366

  8. Integrative Medicine Selects Best Practice from Public Health and Biomedicine

    PubMed Central

    Ryan, Terence J

    2013-01-01

    The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803

  9. Opportunities for Launch Site Integrated System Health Engineering and Management

    NASA Technical Reports Server (NTRS)

    Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

    2005-01-01

    The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

  10. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

  11. The strategic role of health informatics in integrated delivery systems.

    PubMed

    Currie, G A

    1998-01-01

    Having accurate measures and high-quality health information is critically important for all providers today. Integrated delivery systems are faced with increasing demands for numerous redundant, sometimes conflicting, performance measurement and reporting data from managed care customers, regulators, and accreditors. When implemented independently within each organizational subunit, these measurement systems are costly and difficult to manage. Centralization of all measurement services can maximize the productivity of the costly resources required to deliver them and can achieve efficiencies, cost savings, and a better balance between internal and external resources while collecting information that is of a higher quality for managerial and clinical decision making. PMID:10185721

  12. [Criteria catalogue for Integrated Health Care in cardiology].

    PubMed

    Frantz, E

    2006-01-01

    This paper comprises criteria for projects of Integrated Health Care in cardiology. With these criteria, projects can be assessed for their congruence with essentials that have been assigned by the German Cardiac Society, the Association of German Hospital Cardiologists and the Association of German Practice Cardiologists. The main purpose is to ensure that evidence-based medicine is the basis for the contracts and that all valid guidelines have been observed when services have been agreed. Possibly this paper may be the basis to award an approval to projects that meet all the criteria. This paper is no model contract. PMID:16598573

  13. Integrated controls and health monitoring for chemical transfer propulsion

    NASA Technical Reports Server (NTRS)

    Millis, Marc G.; Binder, Michael P.

    1990-01-01

    NASA is reviewing various propulsion technologies for exploring space. The requirements are examined for one enabling propulsion technology: Integrated Controls and Health Monitoring (ICHM) for Chemical Transfer Propulsion (CTP). Functional requirements for a CTP-ICHM system are proposed from tentative mission scenarios, vehicle configurations, CTP specifications, and technical feasibility. These CTP-ICHM requirements go beyond traditional reliable operation and emergency shutoff control to include: (1) enhanced mission flexibility; (2) continuously variable throttling; (3) tank-head start control; (4) automated prestart and post-shutoff engine check; (5) monitoring of space exposure degradation; and (6) product evolution flexibility. Technology development plans are also discussed.

  14. Integration of theory and practice in learning mental health nursing.

    PubMed

    Munnukka, T; Pukuri, T; Linnainmaa, P; Kilkku, N

    2002-02-01

    This article describes an action research project that aimed at a better integration of theory and practice in the education of mental health nursing students. Two partners, an institute of nursing and health care and a university hospital, collaborated to develop a new educational programme for mental health nursing. The blocks of theoretical studies were implemented simultaneously with practical training, and the theory content was taught by nursing teachers as well as by nurse practitioners who worked on the teaching wards. In addition, the students had their own personal nurse-preceptors on the wards. The nurse managers were responsible for the educational level of the teaching wards and the director of nursing planned the teaching arrangements together with the nursing teachers. In all, the project involved over 50 different actors and several researchers. The results are encouraging: all the participants - students, preceptors, nurse managers and nursing teachers - found the project rewarding and they want to continue to develop and improve the level of teaching and learning in mental health nursing education. All the participants grew and developed professionally during the project. PMID:11896851

  15. Maritime health in Spain: integrated services are the key.

    PubMed

    Canals, M L; Gómez, F; Herrador, J

    2001-01-01

    The maritime occupational health services in Spain are overviewed, and their coordination for seafarers and fishermen within the integrated governmental "Maritime Health Programme", which as from 1984 has been supervised by the Labour and Social Affairs Ministry. The institution in charge is the "Instituto Social de la Marina" (ISM) in Madrid (Mariners' Social Institute) established in 1919, which has organised a network of specialised health institutions in ports. They provide medical assistance on board ships and coastal preventive services for maritime workers. There is the Radio Medical Advice Centre in Madrid, local centres in ports, centres abroad, hospital ships and a repatriation centre. All of them are connected in a centralised database net of shared medical records in a confidential computerised system. Another institution is "Sanidad Exterior" which is related to vaccinations and hygienic problems in harbours. There is also a non profit national scientific medical organisation, the Spanish Society of Maritime Medicine (SEMM) established in 1989, and another society of Naval Medicine founded in 1995. There are also groups of specialists in underwater medicine and health problems of divers. A separate article is published on the SEMM and its activities. PMID:11817826

  16. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    NASA Astrophysics Data System (ADS)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  17. The Montana Model: Integrated Primary Care and Behavioral Health in a Family Practice Residency Program

    ERIC Educational Resources Information Center

    Oakley, Claire; Moore, Douglas; Burford, Duncan; Fahrenwald, Roxanne; Woodward, Kathryn

    2005-01-01

    To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while…

  18. From Foucault to Freire through Facebook: Toward an Integrated Theory of mHealth

    ERIC Educational Resources Information Center

    Bull, Sheana; Ezeanochie, Nnamdi

    2016-01-01

    Objective: To document the integration of social science theory in literature on mHealth (mobile health) and consider opportunities for integration of classic theory, health communication theory, and social networking to generate a relevant theory for mHealth program design. Method: A secondary review of research syntheses and meta-analyses…

  19. An Integrated Radiation Transport Particle-in-Cell Method

    NASA Astrophysics Data System (ADS)

    Lee, H. J.; Verboncoeur, J. P.; Smith, H. B.; Parker, G. J.; Birdsall, C. K.

    2000-10-01

    The study of radiation transport is important to understand the basic physics and to calculate the efficiency in a lamp discharge or laser induced plasma. Many models neglect radiation transport effects in evolving the steady state. In this study, we established a basic model to calculate radiation transport, including the effects of nonuniform ground state density and atomic collisions in one dimensional cylindrical and planar geometries. We coupled radiation transport with the self-consistent kinetic particle-in-cell codes, XPDP1 and XPDC1[1]. We treat electrons and ions with a particle-in-cell method, and the neutral ground and excited states with a fluid model to calculate radiation transport and atomic collisions. The steady state result of this model compares well with the solution of Holstein equation[2]. [1] J. P. Verboncoeur, M. V. Alves, V. Vahedi, and C. K. Birdsall, Journal of Computational Physics 104, 321 (1993). [2] T. Holstein, Phys. Rev. 72, 1213 (1947).

  20. Extending functionality of and demonstrating integrated surveillance for public health within a prototype regional health information exchange.

    PubMed

    Painter, Ian S; Hills, Rebecca A; Lober, William B; Randels, Kelly M; Sibley, Jim; Webster, Eric

    2008-01-01

    At the HIMSS 2008 conference we demonstrated how multi-jurisdictional public health surveillance and monitoring processes could be supported and expedited through integration with a prototype health information exchange. PMID:18999244

  1. The integration of mental and behavioral health into disaster preparedness, response, and recovery.

    PubMed

    Pfefferbaum, Betty; Flynn, Brian W; Schonfeld, David; Brown, Lisa M; Jacobs, Gerard A; Dodgen, Daniel; Donato, Darrin; Kaul, Rachel E; Stone, Brook; Norwood, Ann E; Reissman, Dori B; Herrmann, Jack; Hobfoll, Stevan E; Jones, Russell T; Ruzek, Josef I; Ursano, Robert J; Taylor, Robert J; Lindley, David

    2012-03-01

    The close interplay between mental health and physical health makes it critical to integrate mental and behavioral health considerations into all aspects of public health and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioral health into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioral health as part of a unified public health and medical response to disasters. Integration of mental and behavioral health into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice. PMID:22490938

  2. 77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health, Office of the Secretary,...

  3. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service,...

  4. Expanding physician education in health care fraud and program integrity.

    PubMed

    Agrawal, Shantanu; Tarzy, Bruce; Hunt, Lauren; Taitsman, Julie; Budetti, Peter

    2013-08-01

    Program integrity (PI) spans the entire spectrum of improper payments from fraud to abuse, errors, and waste in the health care system. Few physicians will perpetrate fraud or abuse during their careers, but nearly all will contribute to the remaining spectrum of improper payments, making preventive education in this area vital. Despite the enormous impact that PI issues have on government-sponsored and private insurance programs, physicians receive little formal education in this area. Physicians' lack of awareness of PI issues not only makes them more likely to submit inappropriate claims, generate orders that other providers and suppliers will use to submit inappropriate claims, and document improperly in the medical record but also more likely to become victims of fraud schemes themselves.In this article, the authors provide an overview of the current state of PI issues in general, and fraud in particular, as well as a description of the state of formal education for practicing physicians, residents, and fellows. Building on the lessons from pilot programs conducted by the Centers for Medicare and Medicaid Services and partner organizations, the authors then propose a model PI education curriculum to be implemented nationwide for physicians at all levels. They recommend that various stakeholder organizations take part in the development and implementation process to ensure that all perspectives are included. Educating physicians is an essential step in establishing a broader culture of compliance and improved integrity in the health care system, extending beyond Medicare and Medicaid. PMID:23807100

  5. Scientific integrity: critical issues in environmental health research

    PubMed Central

    Merlo, Domenico Franco; Vahakangas, Kirsi; Knudsen, Lisbeth E

    2008-01-01

    Environmental health research is a relatively new scientific area with much interdisciplinary collaboration. Regardless of which human population is included in field studies (e.g., general population, working population, children, elderly, vulnerable sub-groups, etc.) their conduct must guarantee well acknowledged ethical principles. These principles, along with codes of conduct, are aimed at protecting study participants from research-related undesired effects and guarantee research integrity. A central role is attributed to the need for informing potential participants (i.e., recruited subjects who may be enrolled in a study), obtaining their written informed consent to participate, and making them aware of their right to refuse to participate at any time and for any reason. Data protection is also required and communication of study findings must respect participant's willingness to know or not know. This is specifically relevant for studies including biological markers and/or storing biological samples that might be analysed years later to tackle research objectives that were specified and communicated to participants at the time of recruitment or that may be formulated after consent was obtained. Integrity is central to environmental health research searching for causal relations. It requires open communication and trust and any violation (i.e., research misconduct, including fabrication or falsification of data, plagiarism, conflicting interests, etc.) may endanger the societal trust in the research community as well as jeopardize participation rates in field projects. PMID:18541075

  6. Integrated System Health Management: Foundational Concepts, Approach, and Implementation

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2009-01-01

    A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

  7. Sustainable watersheds: integrating ecosystem services and public health.

    PubMed

    Jordan, Stephen J; Benson, William H

    2015-01-01

    Sustainable management of aquatic ecosystems is a worldwide priority; the integrity of these systems depends, in turn, on the integrity of the watersheds (catchments) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health, and socioeconomic values in the context of water quality, water quantity, landscapes, the condition of watersheds, and the connectivity of waters, from headwaters to estuaries and the coastal ocean. These assessments will be a foundation for what we have termed "watershed epidemiology," through which the connections between ecosystems and human health can be explored over broad spatial and temporal scales. Understanding and communicating these relationships should lead to greater awareness of the roles watersheds play in human well-being, and hence to better management and stewardship of water resources. The U.S. Environmental Protection Agency is developing the research, models, and planning tools to support operational national assessments of watershed sustainability, building upon ongoing assessments of aquatic resources in streams, rivers, lakes, wetlands and estuaries. PMID:25987844

  8. Sustainable Watersheds: Integrating Ecosystem Services and Public Health

    PubMed Central

    Jordan, Stephen J; Benson, William H

    2015-01-01

    Sustainable management of aquatic ecosystems is a worldwide priority; the integrity of these systems depends, in turn, on the integrity of the watersheds (catchments) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health, and socioeconomic values in the context of water quality, water quantity, landscapes, the condition of watersheds, and the connectivity of waters, from headwaters to estuaries and the coastal ocean. These assessments will be a foundation for what we have termed “watershed epidemiology,” through which the connections between ecosystems and human health can be explored over broad spatial and temporal scales. Understanding and communicating these relationships should lead to greater awareness of the roles watersheds play in human well-being, and hence to better management and stewardship of water resources. The U.S. Environmental Protection Agency is developing the research, models, and planning tools to support operational national assessments of watershed sustainability, building upon ongoing assessments of aquatic resources in streams, rivers, lakes, wetlands and estuaries. PMID:25987844

  9. Fractional integration and radiative transfer in a multifractal atmosphere

    SciTech Connect

    Naud, C.; Schertzer, D.; Lovejoy, S.

    1996-04-01

    Recently, Cess et al. (1995) and Ramathan et al. (1995) cited observations which exhibit an anomalous absorption of cloudy skies in comparison with the value predicted by usual models and which thus introduce large uncertainties for climatic change assessments. These observation raise questions concerning the way general circulation models have been tuned for decades, relying on classical methods, of both radiative transfer and dynamical modeling. The observations also tend to demonstrate that homogeneous models are simply not relevant in relating the highly variable properties of clouds and radiation fields. However smoothed, the intensity of cloud`s multi-scattered radiation fields reflect this extreme variability.

  10. An Integrated Health Monitoring System for Fission Surface Power

    NASA Astrophysics Data System (ADS)

    Hashemian, H. M.; Shumaker, B. D.; McCulley, J. R.; Morton, G. W.

    Based on such criteria as safety and mission success, programmatic risk, affordability, and extensibility/flexibility, the National Aeronautics and Space Administration (NASA) has chosen fission surface power (FSP) as the primary energy source for building a sustained human presence on the Moon, exploring Mars, and extremely long-duration space missions. The current benchmark FSP system has a mission life of at least 8 years during which time there is no opportunity for repair, sensor calibrations, or periodic maintenance tasks that are normally performed on terrestrial-based nuclear power plants during scheduled outages. Current technology relies heavily on real-time human interaction, monitoring and control. However; due to the long communication times between the Earth and Moon, or Mars, real-time human control is not possible, resulting in a critical need to develop autonomous health monitoring technology for FSP systems.This paper describes the design and development of an autonomous health monitoring system that will (1) provide on-line calibration monitoring, (2) reduce uncertainties in sensor measurements, and (3) provide sensor validation and fault detection capabilities for the control systems of various FSP subsystems. The health monitoring system design integrates a number of signal processing algorithms and techniques such as cross-calibration, empirical modeling using neural networks, and physical modeling under a modular signal processing platform that will enable robust sensor and system monitoring without the need for human interaction. Prototypes of the health monitoring system have been tested and validated on data acquired from preliminary subsystem testing of NASA's FSP Technology Demonstration Unit (TDU) as well as simulated laboratory data. Results from this testing have demonstrated the utility and benefits that such autonomous health monitoring systems can provide to FSP subsystems and other potential applications within NASA such as launch

  11. Progress Monitoring in an Integrated Health Care System: Tracking Behavioral Health Vital Signs.

    PubMed

    Steinfeld, Bradley; Franklin, Allie; Mercer, Brian; Fraynt, Rebecca; Simon, Greg

    2016-05-01

    Progress monitoring implementation in an integrated health care system is a complex process that must address factors such as measurement, technology, delivery system care processes, patient needs and provider requirements. This article will describe how one organization faced these challenges by identifying the key decision points (choice of measure, process for completing rating scale, interface with electronic medical record and clinician engagement) critical to implementation. Qualitative and quantitative data will be presented describing customer and stakeholder satisfaction with the mental health progress monitoring tool (MHPMT) as well as organizational performance with key measurement targets. PMID:25840521

  12. Sequential circuit design for radiation hardened multiple voltage integrated circuits

    DOEpatents

    Clark, Lawrence T.; McIver, III, John K.

    2009-11-24

    The present invention includes a radiation hardened sequential circuit, such as a bistable circuit, flip-flop or other suitable design that presents substantial immunity to ionizing radiation while simultaneously maintaining a low operating voltage. In one embodiment, the circuit includes a plurality of logic elements that operate on relatively low voltage, and a master and slave latches each having storage elements that operate on a relatively high voltage.

  13. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Walker, Mark; Wilkins, Kim; Johnson, Robert; Sass, Jared; Youney, Justin

    2014-01-01

    An intelligent autonomous control capability has been developed and is currently being validated in ground cryogenic fluid management operations. The capability embodies a physical architecture consistent with typical launch infrastructure and control systems, augmented by a higher level autonomous control (AC) system enabled to make knowledge-based decisions. The AC system is supported by an integrated system health management (ISHM) capability that detects anomalies, diagnoses causes, determines effects, and could predict future anomalies. AC is implemented using the concept of programmed sequences that could be considered to be building blocks of more generic mission plans. A sequence is a series of steps, and each executes actions once conditions for the step are met (e.g. desired temperatures or fluid state are achieved). For autonomous capability, conditions must consider also health management outcomes, as they will determine whether or not an action is executed, or how an action may be executed, or if an alternative action is executed instead. Aside from health, higher level objectives can also drive how a mission is carried out. The capability was developed using the G2 software environment (www.gensym.com) augmented by a NASA Toolkit that significantly shortens time to deployment. G2 is a commercial product to develop intelligent applications. It is fully object oriented. The core of the capability is a Domain Model of the system where all elements of the system are represented as objects (sensors, instruments, components, pipes, etc.). Reasoning and decision making can be done with all elements in the domain model. The toolkit also enables implementation of failure modes and effects analysis (FMEA), which are represented as root cause trees. FMEA's are programmed graphically, they are reusable, as they address generic FMEA referring to classes of subsystems or objects and their functional relationships. User interfaces for integrated awareness by

  14. Integrating traditional indigenous medicine and western biomedicine into health systems: a review of Nicaraguan health policies and miskitu health services.

    PubMed

    Carrie, Heather; Mackey, Tim K; Laird, Sloane N

    2015-01-01

    Throughout the world, indigenous peoples have advocated for the right to retain their cultural beliefs and traditional medicine practices. In 2007, the more than 370 million people representing 5000 distinct groups throughout the world received global recognition with the adoption of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). UNDRIP Article 24 affirms the rights of indigenous peoples to their traditional medicines and health practices, and to all social and health services. Although not a legally binding agreement, UNDRIP encourages nation states to comply and implement measures to support and uphold its provisions. Within the context of indigenous health and human rights, Nicaragua serves as a unique case study for examining implementation of UNDRIP Article 24 provisions due to the changes in the Nicaraguan Constitution that strive for the overarching goal of affirming an equal right to health for all Nicaraguans and supporting the integration of traditional medicine and biomedicine at a national and regional level. To explore this subject further, we conducted a review of the policy impact of UNDRIP on health services accessible to the Miskitu indigenous peoples of the North Atlantic Autonomous Region (RAAN). We found that although measures to create therapeutic cooperation are woven into Nicaraguan health plans at the national and regional level, in practice, the delivery of integrated health services has been implemented with varying results. Our review suggests that the method of policy implementation and efforts to foster intercultural collaborative approaches involving respectful community engagement are important factors when attempting to assess the effectiveness of UNDRIP implementation into national health policy and promoting traditional medicine access. In response, more study and close monitoring of legislation that acts to implement or align with UNDRIP Article 24 is necessary to ensure adequate promotion and access

  15. An integrated FBG sensing system for bridge health monitoring

    NASA Astrophysics Data System (ADS)

    Sun, Ru-Jiao; Sun, Zhi; Dan, Dan-Hui; Sun, Li-Min

    2006-03-01

    Thanking to its distinguishing advantages including wavelength multiplexing capability, miniature size, high sensitivity, immunity from electro-magnetic interference and etc, the fiber Bragg grating (FBG) sensing technologies are regarded as a competent candidate for the bridge long-term health monitoring. According to the shifted Bragg wavelength of the light reflected by a fiber grating, the FBG sensors can accurately measure various physical properties such as strain, temperature, displacement, acceleration and corrosion. One special advantage of the FBG sensing technology is that only one demodulation device is required to acquire various physical properties simultaneously. Compared with the bridge health monitoring system using conventional sensors, this advantage makes the quasi-distributed sensing possible and data transmission more convenient because many FBG sensors can be connected in series by a single fiber. In this paper, an integrated FBG sensing system is presented for monitoring the physical state of a real bridge, the main-navigation channel cable-stayed bridge of the Donghai Bridge. The strain variation of two selected sections in the construction stage and during the load trial test are continuously monitored. The results of this study will supply a good guidance for the use of FBG sensors on the health monitoring of real bridges. Finally, the paper present the design and fabrication of an accelerometer based on the FBG technology for structure vibration monitoring.

  16. Implementing personalisation in integrated mental health teams in England.

    PubMed

    Hamilton, Sarah; Manthorpe, Jill; Szymczynska, Paulina; Clewett, Naomi; Larsen, John; Pinfold, Vanessa; Tew, Jerry

    2015-01-01

    This article explores how role boundaries and professional priorities in integrated mental health teams have impacted on the implementation of personalised approaches to social care support. We focus on the use of personal budgets to meet mental health-related social care needs as a key mechanism for personalised care. Drawing on 28 qualitative interviews with mental health practitioners from three local authorities in England undertaken in 2013, we report nurses', social workers', and occupational therapists' attitudes towards, and engagement with, personal budgets. Professional boundaries and competing priorities heavily influenced the extent to which personal budgets were perceived as a legitimate part of their roles. Across different professional groups, a sense emerged that personal budgets should be somebody else's job. A focus on attention to treatment, stability, and risk management often resulted in low prioritisation of personal budgets and led practitioners to avoid recommending them or to exclude service users from the process as a way to save time. Implications of the dominant medical model and the protection of traditional professional roles for the implementation of new, person-centred models of practice are discussed. PMID:26171867

  17. Integrating cultural humility into health care professional education and training.

    PubMed

    Chang, E-shien; Simon, Melissa; Dong, XinQi

    2012-05-01

    As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article proposes to move forward by integrating the concept of cultural humility into current trainings, in which we believe, is vital in complementing the current model, and better prepare future professionals to address health challenges with culturally appropriate care. Based on the works of Chinese philosophers, cultural values and the contemporary Chinese immigrants' experience, we hereby present the QIAN (Humbleness) curriculum: the importance of self-Questioning and critique, bi-directional cultural Immersion, mutually Active-listening, and the flexibility of Negotiation. The principles of the QIAN curriculum reside not only between the patient and the healthcare professional dyad, but also elicit the necessary support of family, health care system as well as the community at large. The QIAN curriculum could improve practice and enhance the exploration, comprehension and appreciation of the cultural orientations between healthcare professionals and patients which ultimately could improve patient satisfaction, patient-healthcare professional relationship, medical adherence and the reduction of health disparities. QIAN model is highly adaptable to other cultural and ethnic groups in multicultural societies around the globe. Incorporating its framework into the current medical education may enhance cross-cultural clinical encounters. PMID:21161680

  18. Developmental Origins of Health and Disease: Integrating Environmental Influences.

    PubMed

    Heindel, Jerrold J; Balbus, John; Birnbaum, Linda; Brune-Drisse, Marie Noel; Grandjean, Philippe; Gray, Kimberly; Landrigan, Philip J; Sly, Peter D; Suk, William; Cory Slechta, Deborah; Thompson, Claudia; Hanson, Mark

    2015-10-01

    There are now robust data supporting the Developmental Origins of Health and Disease (DOHaD) paradigm. This includes human and animal data focusing on nutrition or environmental chemicals during development. However, the term DOHaD has not been generally accepted as the official term to be used when one is concerned with understanding the pathophysiological basis for how environmental influences acting during early development influence the risk of later noncommunicable diseases. Similarly, there is no global research or public health program built around the DOHaD paradigm that encompasses all aspects of environment. To better inform the global health efforts aimed at addressing the growing epidemic of chronic noncommunicable diseases of environmental origin, we propose a two-pronged approach: first, to make it clear that the current concept of DOHaD comprehensively includes a range of environmental factors and their relevance to disease occurrence not just throughout the life span but potentially across several generations; and second, to initiate the discussion of how adoption of DOHaD can promote a more realistic, accurate, and integrative approach to understanding environmental disruption of developmental programming and better inform clinical and policy interventions. PMID:26241070

  19. Computerization of Mental Health Integration Complexity Scores at Intermountain Healthcare

    PubMed Central

    Oniki, Thomas A.; Rodrigues, Drayton; Rahman, Noman; Patur, Saritha; Briot, Pascal; Taylor, David P.; Wilcox, Adam B.; Reiss-Brennan, Brenda; Cannon, Wayne H.

    2014-01-01

    Intermountain Healthcare’s Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient’s mental health complexity as “mild,” “medium,” or “high” based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring. Informatics and MHI personnel collaboratively and iteratively refined the criteria to make them adequately explicit and reflective of MHI objectives. When tested on retrospective data of 540 patients, the clinician agreed with the computer’s conclusion in 52.8% of the cases (285/540). We considered the analysis sufficiently successful to begin piloting the computerized score in prospective clinical care. So far in the pilot, clinicians have agreed with the computer in 70.6% of the cases (24/34). PMID:25954401

  20. Mobile health platform for pressure ulcer monitoring with electronic health record integration.

    PubMed

    Rodrigues, Joel J P C; Pedro, Luís M C C; Vardasca, Tomé; de la Torre-Díez, Isabel; Martins, Henrique M G

    2013-12-01

    Pressure ulcers frequently occur in patients with limited mobility, for example, people with advanced age and patients wearing casts or prostheses. Mobile information communication technologies can help implement ulcer care protocols and the monitoring of patients with high risk, thus preventing or improving these conditions. This article presents a mobile pressure ulcer monitoring platform (mULCER), which helps control a patient's ulcer status during all stages of treatment. Beside its stand-alone version, it can be integrated with electronic health record systems as mULCER synchronizes ulcer data with any electronic health record system using HL7 standards. It serves as a tool to integrate nursing care among hospital departments and institutions. mULCER was experimented with in different mobile devices such as LG Optimus One P500, Samsung Galaxy Tab, HTC Magic, Samsung Galaxy S, and Samsung Galaxy i5700, taking into account the user's experience of different screen sizes and processing characteristics. PMID:24255053

  1. A decade of integration and collaboration: the development of integrated health care in Sweden 2000–2010

    PubMed Central

    Ahgren, Bengt; Axelsson, Runo

    2011-01-01

    Introduction The recent history of integrated health care in Sweden is explored in this article, focusing on the first decade of the 2000s. In addition, there are some reflections about successes and setbacks in this development and challenges for the next decade. Description of policy and practice The first efforts to integrate health care in Sweden appeared in the beginning of the 1990s. The focus was on integration of intra-organisational processes, aiming at a more cost-effective health care provision. Partly as a reaction to the increasing economism at that time, there was also a growing interest in quality improvement. Out of this work emerged the ‘chains of care’, integrating all health care providers involved in the care of specific patient groups. During the 2000s, many county councils have also introduced inter-organisational systems of ‘local health care’. There has also been increasing collaboration between health professionals and other professional groups in different health and welfare services. Discussion and conclusion Local health care meant that the chains of care and other forms of integration and collaboration became embedded in a more integrative context. At the same time, however, policy makers have promoted free patient choice in primary health care and also mergers of hospitals and clinical departments. These policies tend to fragment the provision of health care and have an adverse effect on the development of integrated care. As a counterbalance, more efforts should be put into evaluation of integrated health care, in order to replace political convictions with evidence concerning the benefits of such health care provision. PMID:21677844

  2. Managing the health of the elite athlete: a new integrated performance health management and coaching model.

    PubMed

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

    2014-04-01

    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

  3. Managing the health of the elite athlete: a new integrated performance health management and coaching model

    PubMed Central

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

    2014-01-01

    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

  4. Ionizing and Nonionizing Radiation Protection. Module SH-35. Safety and Health.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This student module on ionizing and nonionizing radiation protection is one of 50 modules concerned with job safety and health. This module describes various types of ionizing and nonionizing radiation, and the situations in the workplace where potential hazards from radiation may exist. Following the introduction, 13 objectives (each keyed to a…

  5. Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

    PubMed Central

    2010-01-01

    Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen) 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines) to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme initiated a reform programme

  6. The effect of integrated health management model on the health of older adults with diabetes in a randomized controlled trial.

    PubMed

    Chao, Jianqian; Yang, Liang; Xu, Hui; Yu, Qing; Jiang, Lili; Zong, Mengmeng

    2015-01-01

    The objective of this study was to evaluate the effect of integrated health management model on the health of older adults with diabetes. The 100 older adults with diabetes who gave informed consent were randomly allocated 1:1 into management and control groups. The integrated health management model was applied in the former while the latter was only given usual care. This model included the following components: health record establishment, health evaluation and health management (such as: diet advice, psychological aspects of health, education/skills training on health self-management, regular blood glucose monitoring, long-term diabetes drug monitoring, etc.). After 18 months, differences in three categories of variables (subjective grading items, objective measurement health indices and health service utilization) between the two groups before and after the intervention were assessed with t-test, χ(2)-test and mixed model analysis. The management group demonstrated improvement on the following variables: health knowledge score, self-evaluated psychological conditions, overall self-evaluated health conditions, diet score, physical activity duration per week, regular blood sugar monitoring, waist-to-hip ratio, diastolic blood pressure and fasting blood sugar, the days of hospital admissions in the preceding 6 months. Mixed model analysis showed that gender, age, self-evaluated health status, self-evaluated psychological status, education level and resident status were important factors affecting health indices. This study demonstrated that integrated health management model was effectiveness in improving the health of older adults with diabetes. PMID:25456892

  7. Smart Sensors' Role in Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Perotti, Jose M.; Mata, Carlos

    2005-01-01

    During the last decade, there has been a major effort in the aerospace industry to reduce the cost per pond of payload and become competitive in the international market. Competition from Europe, Japan, and China has reduced this cost to almost a third from 1990 to 2000. This cost has leveled in recent years to an average price of around $12,000/pound of payload. One of NASA's goals is to promote the development of technologies to reduce this cost by a factor of 10 or more Exploration of space, specially manned exploration missions, involves very complex launch and flight vehicles, associated ground support systems, and extensive human support during all phases of the mission. When considering the Space Shuttle Program, we can see that vehicle and ground support systems' processing, operation, and maintenance represent a large percentage of the program cost and time. Reducing operating, processing and maintenance costs will greatly reduce the cost of Exploration programs. The Integrated System Health Management (ISHM) concept is one of the technologies that will help reduce these operating, processing and maintenance costs. ISHM is an integrated health monitoring system applicable to both flight and ground systems. It automatically and autonomously acquires information from sensors and actuators and processes that information using the ISHM-embedded knowledge. As a result, it establishes the health of the system based on the acquired information and its prior knowledge. When this concept is fully implemented, ISHM systems shall be able to perform failure prediction and remediation before actual hard failures occurs, preventing its costly consequences. Data sources, sensors, and their associated data acquisition systems, constitute the foundation of the system. A smart sensing architecture is required to support the acquisition of reliable, high quality data, required by the ISHM. A thorough definition of the smart sensor architectures, their embedded diagnostic

  8. Intelligent Integrated Health Management for a System of Systems

    NASA Technical Reports Server (NTRS)

    Smith, Harvey; Schmalzel, John; Figueroa, Fernando

    2008-01-01

    An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and

  9. Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

    PubMed

    Mansoori, Bahar; Erhard, Karen K; Sunshine, Jeffrey L

    2012-02-01

    The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. PMID:22212425

  10. Managing the transition to integrated health care organizations.

    PubMed

    Griffith, J R

    1996-01-01

    Today's successful community hospitals should and will evolve into integrated health care organizations (IHCOs) that will share several common characteristics. IHCOs will have a community--not a membership--orientation, and this will be a distinguishing characteristic and a source of market appeal. The transition to IHCO will be a slow one, and to prosper, the IHCO will have to accommodate both price-oriented markets and traditional ones. Successful IHCOs will expand technical skills and capabilities to control costs and quality. New strategic competencies will have to be developed, and to do this, emerging IHCOs will improve the ability of managers to support decisions and sell them both to the buyers and the public at large. Excellent patient care will rest upon better trained, advised, and informed management teams. Making the change to an IHCO will take time and money, but organizations that make steady progress are likely to succeed. PMID:10156172

  11. Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

    SciTech Connect

    Jhaveri, Pavan M.; Sun Zhuyi; Ballas, Leslie; Followill, David S.; Hoffman, Karen E.; Jiang Jing; Smith, Benjamin D.

    2012-09-01

    Purpose: Integrated urology-radiation oncology (RO) practices have been advocated as a means to improve community-based prostate cancer care by joining urologic and radiation care in a single-practice environment. However, little is known regarding the scope and actual physical integration of such practices. We sought to characterize the emergence of such practices in Texas, their extent of physical integration, and their potential effect on patient travel times for radiation therapy. Methods and Materials: A telephone survey identified integrated urology-RO practices, defined as practices owned by urologists that offer RO services. Geographic information software was used to determine the proximity of integrated urology-RO clinic sites with respect to the state's population. We calculated patient travel time and distance from each integrated urology-RO clinic offering urologic services to the RO treatment facility owned by the integrated practice and to the nearest nonintegrated (independent) RO facility. We compared these times and distances using the Wilcoxon-Mann-Whitney test. Results: Of 229 urology practices identified, 12 (5%) offered integrated RO services, and 182 (28%) of 640 Texas urologists worked in such practices. Approximately 53% of the state population resides within 10 miles of an integrated urology-RO clinic site. Patients with a diagnosis of prostate cancer at an integrated urology-RO clinic site travel a mean of 19.7 miles (26.1 min) from the clinic to reach the RO facility owned by the integrated urology-RO practice vs 5.9 miles (9.2 min) to reach the nearest nonintegrated RO facility (P<.001). Conclusions: Integrated urology-RO practices are common in Texas and are generally clustered in urban areas. In most integrated practices, the urology clinics and the integrated RO facilities are not at the same location, and driving times and distances from the clinic to the integrated RO facility exceed those from the clinic to the nearest

  12. Systems integrity in health and aging - an animal model approach

    PubMed Central

    2013-01-01

    Human lifespan is positively correlated with childhood intelligence, as measured by psychometric (IQ) tests. The strength of this correlation is similar to the negative effect that smoking has on the life course. This result suggests that people who perform well on psychometric tests in childhood may remain healthier and live longer. The correlation, however, is debated: is it caused exclusively by social-environmental factors or could it also have a biological component? Biological traits of systems integrity that might result in correlations between brain function and lifespan have been suggested but are not well-established, and it is questioned what useful knowledge can come from understanding such mechanisms. In a recent study, we found a positive correlation between brain function and longevity in honey bees. Honey bees are highly social, but relevant social-environmental factors that contribute to cognition-survival correlations in humans are largely absent from insect colonies. Our results, therefore, suggest a biological explanation for the correlation in the bee. Here, we argue that individual differences in stress handling (coping) mechanisms, which both affect the bees’ performance in tests of brain function and their survival could be a trait of systems integrity. Individual differences in coping are much studied in vertebrates, and several species provide attractive models. Here, we discuss how pigs are an interesting model for studying behavioural, physiological and molecular mechanisms that are recruited during stress and that can drive correlations between health, cognition and longevity traits. By revealing biological factors that make individuals susceptible to stress, it might be possible to alleviate health and longevity disparities in people. PMID:24472488

  13. Systems integrity in health and aging - an animal model approach.

    PubMed

    Oostindjer, Marije; Amdam, Gro V

    2013-01-01

    Human lifespan is positively correlated with childhood intelligence, as measured by psychometric (IQ) tests. The strength of this correlation is similar to the negative effect that smoking has on the life course. This result suggests that people who perform well on psychometric tests in childhood may remain healthier and live longer. The correlation, however, is debated: is it caused exclusively by social-environmental factors or could it also have a biological component? Biological traits of systems integrity that might result in correlations between brain function and lifespan have been suggested but are not well-established, and it is questioned what useful knowledge can come from understanding such mechanisms. In a recent study, we found a positive correlation between brain function and longevity in honey bees. Honey bees are highly social, but relevant social-environmental factors that contribute to cognition-survival correlations in humans are largely absent from insect colonies. Our results, therefore, suggest a biological explanation for the correlation in the bee. Here, we argue that individual differences in stress handling (coping) mechanisms, which both affect the bees' performance in tests of brain function and their survival could be a trait of systems integrity. Individual differences in coping are much studied in vertebrates, and several species provide attractive models. Here, we discuss how pigs are an interesting model for studying behavioural, physiological and molecular mechanisms that are recruited during stress and that can drive correlations between health, cognition and longevity traits. By revealing biological factors that make individuals susceptible to stress, it might be possible to alleviate health and longevity disparities in people. PMID:24472488

  14. Considerations for Integration of Counseling and Health Services on College and University Campuses

    ERIC Educational Resources Information Center

    Journal of American College Health, 2010

    2010-01-01

    While the majority of college and university campuses have discrete mental health and medical services, the integration of the two areas has been subject of increased discussion among student health and counseling professionals. The push to integrate counseling and health services is motivated by a variety of reasons: a philosophical desire to…

  15. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration

    PubMed Central

    Mayhew, Susannah H.; Ploubidis, George B.; Sloggett, Andy; Church, Kathryn; Obure, Carol D.; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E.; Watts, Charlotte; Vassall, Anna

    2016-01-01

    Background The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of ‘integrated service delivery’ and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Methods and Findings Data were drawn from the Integra Initiative’s client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008–2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients—i.e. “functional integration”. Conclusions These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its ‘impact’ on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments. PMID:26800517

  16. Integrated Care and Connected Health Approaches Leveraging Personalised Health through Big Data Analytics.

    PubMed

    Maglaveras, Nicos; Kilintzis, Vassilis; Koutkias, Vassilis; Chouvarda, Ioanna

    2016-01-01

    Integrated care and connected health are two fast evolving concepts that have the potential to leverage personalised health. From the one side, the restructuring of care models and implementation of new systems and integrated care programs providing coaching and advanced intervention possibilities, enable medical decision support and personalized healthcare services. From the other side, the connected health ecosystem builds the means to follow and support citizens via personal health systems in their everyday activities and, thus, give rise to an unprecedented wealth of data. These approaches are leading to the deluge of complex data, as well as in new types of interactions with and among users of the healthcare ecosystem. The main challenges refer to the data layer, the information layer, and the output of information processing and analytics. In all the above mentioned layers, the primary concern is the quality both in data and information, thus, increasing the need for filtering mechanisms. Especially in the data layer, the big biodata management and analytics ecosystem is evolving, telemonitoring is a step forward for data quality leverage, with numerous challenges still left to address, partly due to the large number of micro-nano sensors and technologies available today, as well as the heterogeneity in the users' background and data sources. This leads to new R&D pathways as it concerns biomedical information processing and management, as well as to the design of new intelligent decision support systems (DSS) and interventions for patients. In this paper, we illustrate these issues through exemplar research targeting chronic patients, illustrating the current status and trends in PHS within the integrated care and connected care world. PMID:27225565

  17. Integrated System Health Management (ISHM) Technology Demonstration Project Final Report

    NASA Technical Reports Server (NTRS)

    Mackey, Ryan; Iverson, David; Pisanich, Greg; Toberman, Mike; Hicks, Ken

    2006-01-01

    Integrated System Health Management (ISHM) is an essential capability that will be required to enable upcoming explorations mission systems such as the Crew Exploration Vehicle (CEV) and Crew Launch Vehicle (CLV), as well as NASA aeronautics missions. However, the lack of flight experience and available test platforms have held back the infusion by NASA Ames Research Center (ARC) and the Jet Propulsion Laboratory (JPL) of ISHM technologies into future space and aeronautical missions. To address this problem, a pioneer project was conceived to use a high-performance aircraft as a low-cost proxy to develop, mature, and verify the effectiveness of candidate ISHM technologies. Given the similarities between spacecraft and aircraft, an F/A-18 currently stationed at Dryden Flight Research Center (DFRC) was chosen as a suitable host platform for the test bed. This report describes how the test bed was conceived, how the technologies were integrated on to the aircraft, and how these technologies were matured during the project. It also describes the lessons learned during the project and a forward path for continued work.

  18. Integrated Vehicle Health Management (IVHM) for Aerospace Systems

    NASA Technical Reports Server (NTRS)

    Baroth, Edmund C.; Pallix, Joan

    2006-01-01

    To achieve NASA's ambitious Integrated Space Transportation Program objectives, aerospace systems will implement a variety of new concept in health management. System level integration of IVHM technologies for real-time control and system maintenance will have significant impact on system safety and lifecycle costs. IVHM technologies will enhance the safety and success of complex missions despite component failures, degraded performance, operator errors, and environment uncertainty. IVHM also has the potential to reduce, or even eliminate many of the costly inspections and operations activities required by current and future aerospace systems. This presentation will describe the array of NASA programs participating in the development of IVHM technologies for NASA missions. Future vehicle systems will use models of the system, its environment, and other intelligent agents with which they may interact. IVHM will be incorporated into future mission planners, reasoning engines, and adaptive control systems that can recommend or execute commands enabling the system to respond intelligently in real time. In the past, software errors and/or faulty sensors have been identified as significant contributors to mission failures. This presentation will also address the development and utilization of highly dependable sohare and sensor technologies, which are key components to ensure the reliability of IVHM systems.

  19. CADe system integrated within the electronic health record.

    PubMed

    Vállez, Noelia; Bueno, Gloria; Déniz, Óscar; Fernández, María del Milagro; Pastor, Carlos; Rienda, Miguel Ángel; Esteve, Pablo; Arias, María

    2013-01-01

    The latest technological advances and information support systems for clinics and hospitals produce a wide range of possibilities in the storage and retrieval of an ever-growing amount of clinical information as well as in detection and diagnosis. In this work, an Electronic Health Record (EHR) combined with a Computer Aided Detection (CADe) system for breast cancer diagnosis has been implemented. Our objective is to provide to radiologists a comprehensive working environment that facilitates the integration, the image visualization, and the use of aided tools within the EHR. For this reason, a development methodology based on hardware and software system features in addition to system requirements must be present during the whole development process. This will lead to a complete environment for displaying, editing, and reporting results not only for the patient information but also for their medical images in standardised formats such as DICOM and DICOM-SR. As a result, we obtain a CADe system which helps in detecting breast cancer using mammograms and is completely integrated into an EHR. PMID:24151586

  20. CADe System Integrated within the Electronic Health Record

    PubMed Central

    Vállez, Noelia; Déniz, Óscar; Fernández, María del Milagro; Pastor, Carlos; Rienda, Miguel Ángel; Esteve, Pablo; Arias, María

    2013-01-01

    The latest technological advances and information support systems for clinics and hospitals produce a wide range of possibilities in the storage and retrieval of an ever-growing amount of clinical information as well as in detection and diagnosis. In this work, an Electronic Health Record (EHR) combined with a Computer Aided Detection (CADe) system for breast cancer diagnosis has been implemented. Our objective is to provide to radiologists a comprehensive working environment that facilitates the integration, the image visualization, and the use of aided tools within the EHR. For this reason, a development methodology based on hardware and software system features in addition to system requirements must be present during the whole development process. This will lead to a complete environment for displaying, editing, and reporting results not only for the patient information but also for their medical images in standardised formats such as DICOM and DICOM-SR. As a result, we obtain a CADe system which helps in detecting breast cancer using mammograms and is completely integrated into an EHR. PMID:24151586

  1. Integrating big data and actionable health coaching to optimize wellness.

    PubMed

    Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D

    2015-01-01

    The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory. PMID:25575752

  2. Integration of Radiation-Hard Magnetic Random Access Memory with CMOS ICs

    SciTech Connect

    Cerjan, C.J.; Sigmon, T.W.

    2000-02-15

    The research undertaken in this LDRD-funded project addressed the joint development of magnetic material-based nonvolatile, radiation-hard memory cells with Sandia National Laboratory. Specifically, the goal of this project was to demonstrate the intrinsic radiation-hardness of Giant Magneto-Resistive (GMR) materials by depositing representative alloy combinations upon radiation-hardened silicon-based integrated circuits. All of the stated goals of the project were achieved successfully. The necessary films were successfully deposited upon typical integrated circuits; the materials retained their magnetic field response at the highest radiation doses; and a patterning approach was developed that did not degrade the as-fabricated properties of the underlying circuitry. These results establish the feasibility of building radiation-hard magnetic memory cells.

  3. The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans.

    PubMed

    Huang, Susan; Fong, Susana; Duong, Thomas; Quach, Thu

    2016-06-01

    The Affordable Care Act has greatly expanded health care coverage and recognizes mental health as a major priority. However, individuals suffering from mental health disorders still face layered barriers to receiving health care, especially Asian Americans. Integration of behavioral health services within primary care is a viable way of addressing underutilization of mental health services. This paper provides insight into a comprehensive care approach integrating behavioral health services into primary care to address underutilization of mental health services in the Asian American population. True integration of behavioral health services into primary care will require financial support and payment reform to address multi-disciplinary care needs and optimize care coordination, as well as training and workforce development early in medical and mental health training programs to develop the skills that aid prevention, early identification, and intervention. Funding research on evidence-based practice oriented to the Asian American population needs to continue. PMID:27188196

  4. Integrating collaborative place-based health promotion coalitions into existing health system structures: the experience from one Australian health coalition

    PubMed Central

    Kendall, Elizabeth

    2015-01-01

    Background Increasingly, place-based collaborative partnerships are being implemented to develop the capacity of communities to build supportive environments and improve population health outcomes. These place-based initiatives require cooperative and coordinated responses that can exist within social systems and integrate multiple responses. However, the dynamic interplay between co-existing systems and new ways of working makes implementation outcomes unpredictable. Method We interviewed eight programme leaders, three programme teams and two advisory groups to explore the capacity of one social system to implement and normalise a collaborative integrated place-based health promotion initiative in the Logan and Beaudesert area in South East Queensland, Australia. The construct of capacity as defined in the General Theory of Implementation was used to develop a coding framework. Data were then placed into conceptually coherent groupings according to this framework until all data could be accounted for. Results Four themes defined capacity for implementation of a collaborative and integrated response; namely, the ability to (1) traverse a nested and contradictory social landscape, (2) be a responsive and ‘good’ community partner, (3) establish the scaffolding required to work ‘in place’; and (4) build a shared meaning and engender trust. Overall, we found that the capacity of the system to embed a place-based health promotion initiative was severely limited by the absence of these features. Conclusion Conflict, disruption and constant change within the context into which the place-based collaborative partnership was being implemented meant that existing relationships were constantly undermined and the capacity of the partners to develop trust-based coherent partnerships was constantly diminished. To enhance the likelihood that collaborative and integrated place-based health promotion initiatives will become established ways of working, an agreed, meaningful

  5. Fast evaluation of Sommerfeld integrals for EM scattering and radiation by three-dimensional buried objects

    SciTech Connect

    Cui, T.J.; Chew, W.C.

    1999-03-01

    This paper presents a fast method for electromagnetic scattering and radiation problems pertinent to three-dimensional (3-D) buried objects. In this approach, a new symmetrical form of the Green`s function is derived, which can reduce the number of Sommerfeld integrals involved in the buried objects problem. The integration along steepest descent paths and leading-order approximations are introduced to evaluate these Sommerfeld integrals, which can greatly accelerate the computation. Based on the fast evaluation of Sommerfeld integrals, the radiation of an arbitrarily oriented electric dipole buried in a half space is first analyzed and computed. Then, the scattering by buried dielectric objects and conducting objects is considered using the method of moments (MOM). Numerical results show that the fast method can save tremendous CPU time in radiation and scattering problems involving buried objects.

  6. Microbes in Beach Sands: Integrating Environment, Ecology and Public Health

    PubMed Central

    Whitman, Richard; Harwood, Valerie J.; Edge, Thomas A.; Nevers, Meredith; Byappanahalli, Muruleedhara; Vijayavel, Kannappan; Brandão, João; Sadowsky, Michael J.; Alm, Elizabeth Wheeler; Crowe, Allan; Ferguson, Donna; Ge, Zhongfu; Halliday, Elizabeth; Kinzelman, Julie; Kleinheinz, Greg; Przybyla-Kelly, Kasia; Staley, Christopher; Staley, Zachery; Solo-Gabriele, Helena M.

    2014-01-01

    SUMMARY Beach sand is a habitat that supports many microbes, including viruses, bacteria, fungi and protozoa (micropsammon). The apparently inhospitable conditions of beach sand environments belie the thriving communities found there. Physical factors, such as water availability and protection from insolation; biological factors, such as competition, predation, and biofilm formation; and nutrient availability all contribute to the characteristics of the micropsammon. Sand microbial communities include autochthonous species/phylotypes indigenous to the environment. Allochthonous microbes, including fecal indicator bacteria (FIB) and waterborne pathogens, are deposited via waves, runoff, air, or animals. The fate of these microbes ranges from death, to transient persistence and/or replication, to establishment of thriving populations (naturalization) and integration in the autochthonous community. Transport of the micropsammon within the habitat occurs both horizontally across the beach, and vertically from the sand surface and ground water table, as well as at various scales including interstitial flow within sand pores, sediment transport for particle-associated microbes, and the large-scale processes of wave action and terrestrial runoff. The concept of beach sand as a microbial habitat and reservoir of FIB and pathogens has begun to influence our thinking about human health effects associated with sand exposure and recreational water use. A variety of pathogens have been reported from beach sands, and recent epidemiology studies have found some evidence of health risks associated with sand exposure. Persistent or replicating populations of FIB and enteric pathogens have consequences for watershed/beach management strategies and regulatory standards for safe beaches. This review summarizes our understanding of the community structure, ecology, fate, transport, and public health implications of microbes in beach sand. It concludes with recommendations for future

  7. Microbes in Beach Sands: Integrating Environment, Ecology and Public Health.

    PubMed

    Whitman, Richard; Harwood, Valerie J; Edge, Thomas A; Nevers, Meredith; Byappanahalli, Muruleedhara; Vijayavel, Kannappan; Brandão, João; Sadowsky, Michael J; Alm, Elizabeth Wheeler; Crowe, Allan; Ferguson, Donna; Ge, Zhongfu; Halliday, Elizabeth; Kinzelman, Julie; Kleinheinz, Greg; Przybyla-Kelly, Kasia; Staley, Christopher; Staley, Zachery; Solo-Gabriele, Helena M

    2014-09-01

    Beach sand is a habitat that supports many microbes, including viruses, bacteria, fungi and protozoa (micropsammon). The apparently inhospitable conditions of beach sand environments belie the thriving communities found there. Physical factors, such as water availability and protection from insolation; biological factors, such as competition, predation, and biofilm formation; and nutrient availability all contribute to the characteristics of the micropsammon. Sand microbial communities include autochthonous species/phylotypes indigenous to the environment. Allochthonous microbes, including fecal indicator bacteria (FIB) and waterborne pathogens, are deposited via waves, runoff, air, or animals. The fate of these microbes ranges from death, to transient persistence and/or replication, to establishment of thriving populations (naturalization) and integration in the autochthonous community. Transport of the micropsammon within the habitat occurs both horizontally across the beach, and vertically from the sand surface and ground water table, as well as at various scales including interstitial flow within sand pores, sediment transport for particle-associated microbes, and the large-scale processes of wave action and terrestrial runoff. The concept of beach sand as a microbial habitat and reservoir of FIB and pathogens has begun to influence our thinking about human health effects associated with sand exposure and recreational water use. A variety of pathogens have been reported from beach sands, and recent epidemiology studies have found some evidence of health risks associated with sand exposure. Persistent or replicating populations of FIB and enteric pathogens have consequences for watershed/beach management strategies and regulatory standards for safe beaches. This review summarizes our understanding of the community structure, ecology, fate, transport, and public health implications of microbes in beach sand. It concludes with recommendations for future work in

  8. An Assessment of Integrated Health Management (IHM) Frameworks

    SciTech Connect

    N. Lybeck; M. Tawfik; L. Bond; J. Coble

    2012-05-01

    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 nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. 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 a 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 a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  9. Radiation and Its Health Effects. AIO Red Paper #19.

    ERIC Educational Resources Information Center

    Duda, Terrie

    Radiation has been a serious concern to individuals for over 100 years. A process by which an atomic nucleus emits particles to reach a more stable energy state, radiation harms living cells (usually by inhalation and absorption into the lungs) by causing abnormal cell function and structure. Man is constantly exposed to background radiation, both…

  10. Integrating Human Immunodeficiency Virus and Reproductive, Maternal and Child, and Tuberculosis Health Services Within National Health Systems.

    PubMed

    Joseph Davey, Dvora; Myer, Landon; Bukusi, Elizabeth; Ramogola-Masire, Doreen; Kilembe, William; Klausner, Jeffrey D

    2016-06-01

    Joint United Nations Programme on HIV/AIDS (UNAIDS) established 90-90-90 HIV treatment targets for 2020 including the following: 90 % of HIV-infected people know their HIV status, 90 % of HIV-infected people who know their status are on treatment, and 90 % of people on HIV treatment have a suppressed viral load. Integration of HIV and other programs into the national health system provides an important pathway to reach those targets. We examine the case for integrating HIV and other health services to ensure sustainability and improve health outcomes within national health systems. In this non-systematic review, we examined recent studies on integrating HIV, tuberculosis (TB), maternal-child health (MCH), and sexually transmitted infection (STI) programs. Existing evidence is limited about the effectiveness of integration of HIV and other services. Most studies found that service integration increased uptake of services, but evidence is mixed about the effect on health outcomes or quality of health services. More rigorous studies of different strategies to promote integration over a wider range of services and settings are needed. Research on how best to maximize benefits, including sustainability, of integrated services is necessary to help inform international and national policy. We recommend additional interventions to test how best to integrate HIV and MCH services, HIV and TB services, HIV testing and treatment, and STI testing and treatment. PMID:27221628

  11. A Support Database System for Integrated System Health Management (ISHM)

    NASA Technical Reports Server (NTRS)

    Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

    2007-01-01

    The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between

  12. 'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

    PubMed

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

  13. ‘Trust and teamwork matter’: Community health workers' experiences in integrated service delivery in India

    PubMed Central

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

  14. INTEGRATED SACHS-WOLFE EFFECT FOR GRAVITATIONAL RADIATION

    SciTech Connect

    Laguna, Pablo; Larson, Shane L.; Spergel, David; Yunes, Nicolas

    2010-05-20

    Gravitational waves (GWs) are messengers carrying valuable information about their sources. For sources at cosmological distances, the waves will also contain the imprint left by the intervening matter. The situation is in close analogy with cosmic microwave photons, for which the large-scale structures the photons traverse contribute to the observed temperature anisotropies, in a process known as the integrated Sachs-Wolfe effect. We derive the GW counterpart of this effect for waves propagating on a Friedman-Robertson-Walker background with scalar perturbations. We find that the phase, frequency, and amplitude of the GWs experience Sachs-Wolfe-type integrated effects, in addition to the magnification effects on the amplitude from gravitational lensing. We show that for supermassive black hole binaries, the integrated effects could account for measurable changes on the frequency, chirp mass, and luminosity distance of the binary, thus unveiling the presence of inhomogeneities, and potentially dark energy, in the universe.

  15. [Mental health and work: integrated technical actions between services for preventive hygiene and worksite safety and mental health centers].

    PubMed

    Bosco, M G; Salerno, S; Valcella, F

    1999-01-01

    We analyzed occupational and mental health activities in an occupational health service and in a mental health service using the Method of Organizational Congruences (MOC). No technical actions in either services were dedicated to mental health at work although this is prescribed by the Italian law (833/76) and has a demand among the local shared users identified in this study. We propose integrated technical action for mental health in public health services to address the risk of stress, burnout and mobbing in the workplace. Attention is drawn to the need for further research on health services in the field of organization and mental well-being. PMID:10703191

  16. ASA conference on radiation and health: Health effects of electric and magnetic fields: Statistical support for research strategies. Final report

    SciTech Connect

    Not Available

    1990-05-01

    This report is a collection of papers documenting presentations made at the VIII ASA (American Statistical Association) Conference on Radiation and Health entitled Health Effects of Electric and Magnetic Fields: Statistical Support for Research Strategies. Individual papers are abstracted and indexed for the database.

  17. Analysis of outcomes in radiation oncology: An integrated computational platform

    PubMed Central

    Liu, Dezhi; Ajlouni, Munther; Jin, Jian-Yue; Ryu, Samuel; Siddiqui, Farzan; Patel, Anushka; Movsas, Benjamin; Chetty, Indrin J.

    2009-01-01

    Radiotherapy research and outcome analyses are essential for evaluating new methods of radiation delivery and for assessing the benefits of a given technology on locoregional control and overall survival. In this article, a computational platform is presented to facilitate radiotherapy research and outcome studies in radiation oncology. This computational platform consists of (1) an infrastructural database that stores patient diagnosis, IMRT treatment details, and follow-up information, (2) an interface tool that is used to import and export IMRT plans in DICOM RT and AAPM/RTOG formats from a wide range of planning systems to facilitate reproducible research, (3) a graphical data analysis and programming tool that visualizes all aspects of an IMRT plan including dose, contour, and image data to aid the analysis of treatment plans, and (4) a software package that calculates radiobiological models to evaluate IMRT treatment plans. Given the limited number of general-purpose computational environments for radiotherapy research and outcome studies, this computational platform represents a powerful and convenient tool that is well suited for analyzing dose distributions biologically and correlating them with the delivered radiation dose distributions and other patient-related clinical factors. In addition the database is web-based and accessible by multiple users, facilitating its convenient application and use. PMID:19544785

  18. Integration and scaling of UV-B radiation effects on plants: from DNA to leaf.

    PubMed

    Suchar, Vasile Alexandru; Robberecht, Ronald

    2015-07-01

    A process-based model integrating the effects of UV-B radiation through epidermis, cellular DNA, and its consequences to the leaf expansion was developed from key parameters in the published literature. Enhanced UV-B radiation-induced DNA damage significantly delayed cell division, resulting in significant reductions in leaf growth and development. Ambient UV-B radiation-induced DNA damage significantly reduced the leaf growth of species with high relative epidermal absorbance at longer wavelengths and average/low pyrimidine cyclobutane dimers (CPD) photorepair rates. Leaf expansion was highly dependent on the number of CPD present in the DNA, as a result of UV-B radiation dose, quantitative and qualitative absorptive properties of epidermal pigments, and repair mechanisms. Formation of pyrimidine-pyrimidone (6-4) photoproducts (6-4PP) has no effect on the leaf expansion. Repair mechanisms could not solely prevent the UV-B radiation interference with the cell division. Avoidance or effective shielding by increased or modified qualitative epidermal absorptance was required. Sustained increased UV-B radiation levels are more detrimental than short, high doses of UV-B radiation. The combination of low temperature and increased UV-B radiation was more significant in the level of UV-B radiation-induced damage than UV-B radiation alone. Slow-growing leaves were more affected by increased UV-B radiation than fast-growing leaves. PMID:26257869

  19. Integration and scaling of UV-B radiation effects on plants: from DNA to leaf

    PubMed Central

    Suchar, Vasile Alexandru; Robberecht, Ronald

    2015-01-01

    A process-based model integrating the effects of UV-B radiation through epidermis, cellular DNA, and its consequences to the leaf expansion was developed from key parameters in the published literature. Enhanced UV-B radiation-induced DNA damage significantly delayed cell division, resulting in significant reductions in leaf growth and development. Ambient UV-B radiation-induced DNA damage significantly reduced the leaf growth of species with high relative epidermal absorbance at longer wavelengths and average/low pyrimidine cyclobutane dimers (CPD) photorepair rates. Leaf expansion was highly dependent on the number of CPD present in the DNA, as a result of UV-B radiation dose, quantitative and qualitative absorptive properties of epidermal pigments, and repair mechanisms. Formation of pyrimidine-pyrimidone (6-4) photoproducts (6-4PP) has no effect on the leaf expansion. Repair mechanisms could not solely prevent the UV-B radiation interference with the cell division. Avoidance or effective shielding by increased or modified qualitative epidermal absorptance was required. Sustained increased UV-B radiation levels are more detrimental than short, high doses of UV-B radiation. The combination of low temperature and increased UV-B radiation was more significant in the level of UV-B radiation-induced damage than UV-B radiation alone. Slow-growing leaves were more affected by increased UV-B radiation than fast-growing leaves. PMID:26257869

  20. Health effects of radiation and other health problems in the aftermath of nuclear accidents, with an emphasis on Fukushima.

    PubMed

    Hasegawa, Arifumi; Tanigawa, Koichi; Ohtsuru, Akira; Yabe, Hirooki; Maeda, Masaharu; Shigemura, Jun; Ohira, Tetsuya; Tominaga, Takako; Akashi, Makoto; Hirohashi, Nobuyuki; Ishikawa, Tetsuo; Kamiya, Kenji; Shibuya, Kenji; Yamashita, Shunichi; Chhem, Rethy K

    2015-08-01

    437 nuclear power plants are in operation at present around the world to meet increasing energy demands. Unfortunately, five major nuclear accidents have occurred in the past--ie, at Kyshtym (Russia [then USSR], 1957), Windscale Piles (UK, 1957), Three Mile Island (USA, 1979), Chernobyl (Ukraine [then USSR], 1986), and Fukushima (Japan, 2011). The effects of these accidents on individuals and societies are diverse and enduring. Accumulated evidence about radiation health effects on atomic bomb survivors and other radiation-exposed people has formed the basis for national and international regulations about radiation protection. However, past experiences suggest that common issues were not necessarily physical health problems directly attributable to radiation exposure, but rather psychological and social effects. Additionally, evacuation and long-term displacement created severe health-care problems for the most vulnerable people, such as hospital inpatients and elderly people. PMID:26251393

  1. Opportunities for and constraints to integration of health services in Poland*

    PubMed Central

    Sobczak, Alicja

    2002-01-01

    Abstract At the beginning of the article the typologies, expected outcomes and forces aiming at health care integration are discussed. Integration is recognised as a multidimensional concept. The suggested typologies of integration are based on structural configurations, co-ordination mechanisms (including clinical co-ordination), and driving forces. A review of the Polish experience in integration/disintegration of health care systems is the main part of the article. Creation of integrated health care management units (ZOZs) in the beginning of the 1970s serves as an example of structural vertical integration missing co-ordination mechanisms. ZOZs as huge, costly and inflexible organisations became subjects of public criticism and discredited the idea of health care integration. At the end of the 1980s and in the decade of the 1990s, management of public health care was decentralised, the majority of ZOZs dismantled, and many health care public providers got the status of independent entities. The private sector developed rapidly. Sickness funds, which in 1999 replaced the previous state system, introduced “quasi-market” conditions where health providers have to compete for contracts. Some providers developed strategies of vertical and horizontal integration to get a competitive advantage. Consolidation of private ambulatory clinics, the idea of “integrated care” as a “contracting package”, development of primary health care and ambulatory specialist clinics in hospitals are the examples of such strategies. The new health policy declared in 2002 has recognised integration as a priority. It stresses the development of payment mechanisms and information base (Register of Health Services – RUM) that promote integration. The Ministry of Health is involved directly in integrated emergency system designing. It seems that after years of disintegration and deregulation the need for effective integration has become obvious. PMID:16896398

  2. 78 FR 38346 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of...

  3. 78 FR 62635 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of...

  4. 77 FR 15761 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of...

  5. USING ENERGY SYSTEMS THEORY TO DEFINE, MEASURE AND INTERPRET ECOLOGICAL INTEGRITY AND ECOSYSTEM HEALTH

    EPA Science Inventory

    Energy systems theory provides a theoretical basis for defining, measuring, and interpreting the concepts of ecological integrity and ecosystem health. Ecological integrity is defined as an emergent property of ecosystems operating at maximum power that can be quantified using va...

  6. Fall 2015 NASA Internship, and Space Radiation Health Project

    NASA Technical Reports Server (NTRS)

    Patience, Luke

    2015-01-01

    This fall, I was fortunate enough to have been able to participate in an internship at NASA's Lyndon B. Johnson Space Center. I was placed into the Human Health & Performance Directorate, where I was specifically tasked to work with Dr. Zarana Patel, researching the impacts of cosmic level radiation on human cells. Using different laboratory techniques, we were able to examine the cells to see if any damage had been done due to radiation exposure, and if so, how much damage was done. Cell culture samples were exposed at different doses, and fixed at different time points so that we could accumulate a large pool of quantifiable data. After examining quantifiable results relative to the impacts of space radiation on the human body at the cellular and chromosomal level, researchers can defer to different areas of the space program that have to do with astronaut safety, and research and development (extravehicular mobility unit construction, vehicle design and construction, etc.). This experience has been very eye-opening, and I was able to learn quite a bit. I learned some new laboratory techniques, and I did my best to try and learn new ways to balance such a hectic work and school schedule. I also learned some very intimate thing about working at NASA; I learned that far more people want to watch you succeed, rather than watch you fail, and I also learned that this is a place that is alive with innovators and explorers - people who have a sole purpose of exploring space for the betterment of humanity, and not for any other reason. It's truly inspiring. All of these experiences during my internship have impacted me in a really profound way, so much that my educational and career goals are completely different than when I started. I started out as a biotechnology major, and I discovered recently toward the end of the internship, that I don't want to work in a lab, nor was I as enthralled by biological life sciences as a believed myself to be. Taking that all into

  7. A tunable integrated system to simulate colder stellar radiation

    NASA Astrophysics Data System (ADS)

    Erculiani, Marco S.; Claudi, Riccardo; Barbisan, Diego; Giro, Enrico; Bonato, Matteo; Cocola, Lorenzo; Farisato, Giancarlo; Meneghini, Metteo; Poletto, Luca; Salasnich, Bernardo; Trivellin, Nicola

    2015-09-01

    In the last years, a lot of extrasolar planets have been discovered in any direction of the Galaxy. More interesting, some of them have been found in the habitable zone of their host stars. A large diversity of spectral type, from early types (A) to colder ones (M), is covered by the planetary system host stars. A lot of efforts are done in order to find habitable planets around M stars and indeed some habitable super earths were found. In this framework, "Atmosphere in a Test Tube", a project started at Astronomical observatory of Padua, simulates planetary environmental condition in order to understand how and how much the behavior of photosynthetic bacteria in different planetary/star scenarios can modify the planet atmosphere. The particular case of an habitable planet orbiting a M dwarf star is under study for the time being. The irradiation of an M star, due to its lower surface temperature is very different in quality and quantity by the irradiation of a star like our Sun. We would like to describe the study of feasibility of a new kind of tunable led stellarlight simulator capable to recreate the radiation spectrum of M type stars (but with the potential to be expanded even to F, G, K star spectra types) incident on the planet. The radiation source is a multiple LED matrix cooled by means of air fan technology. In order to endow it with modularity this device will be composed by a mosaic of circuit boards arranged in a pie-chart shape, on the surface of which will be welded the LEDs. This concept is a smart way in order to replace blown out pieces instead of changing the entire platform as well as implement the device with new modules suitable to reproduce other type of stars. The device can be driven by a PC to raise or lower the intensity of both each LED and the lamp, in order to simulate as close as possible a portion of the star spectrum. The wavelength intervals overlap the limits of photosynthetic pigment absorption range (280-850 nm), while the

  8. 77 FR 52335 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the health of members...

  9. 76 FR 47590 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the health of members of this...

  10. 75 FR 66769 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the health of members of this...

  11. 76 FR 5814 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the health of members of this...

  12. Electrical integrity of oxides in a radiation field

    SciTech Connect

    Zinkle, S.J.; Kinoshita, C.

    1996-04-01

    In the absence of an applied electric field, irradiation generally produces a decrease in the permanent (beam-off) electrical conductivity of ceramic insulators. However, in the past 6 years several research groups have reported a phenomenon known as radiation induced electrical degradation (RIED), which produces significant permanent increases in the electrical conductivity of ceramic insulators irradiated with an applied electric field. RIED has been reported to occur at temperatures between 420 and 800 K with applied electric fields as low as 20 V/mm.

  13. Report on policy and activities concerning public awareness of health effects of low-level radiation

    SciTech Connect

    1986-11-01

    In the summer of 1986, the Executive Committee authorized a study limited to determining policy and practices relevant to dissemination of information to the public on radiation health effects in three federal agencies. This report summarizes findings on two broad questions related to the communication issue: What, if any, are the policies under which federal agencies operate in disseminating information on health effects of radiation and what are the current programs and activities designed to provide the public information on health effects of radiation.

  14. Nepal: integrating traditional and modern health services in the remote area of Bashkharka.

    PubMed

    Sharma, A; Ross, J

    1990-01-01

    Within a framework of Primary Health Care (PHC) and Health Promotion (HP), the focus of this paper is on integrating traditional and modern health care in the remote area of Bashkharka, Nepal. The relevance to integrated health care of factors such as geography, ethnicity, religion, national infrastructure and international development agencies are discussed. Issues concerning the relationship between the theory and practice of PHC and HP are raised. PMID:2081655

  15. Hollow shaft integrated health monitoring system for railroad wheels

    NASA Astrophysics Data System (ADS)

    Frankenstein, B.; Hentschel, D.; Pridoehl, E.; Schubert, F.

    2005-05-01

    The economic efficiency and competitiveness of environment-friendly rail transportation depends on safety, availability and maintenance of single highly loaded structure components. Until now these components have been changed in fixed maintenance intervals irrespective of any usage related conditions. With the knowledge and evaluation of the component conditions, life cycle costs can be reduced by means of optimized maintenance and/or "fit for purpose" design. For example, rail-bound vehicle wheel sets are among the most highly stressed travelling gear components of the bogie. if such a component fails, a serious accident may occur. For this reason, a health monitoring system based on the interpretation of ultrasonic sound signatures has been developed. First, the ultrasonic waves generated by an artificial defect on the outer wheel tread of a railroad wheel towards an acoustic sensor, placed inside the hollow shaft of the railroad axis were simulated with a EFIT (Elastodynamic Finite Integration Technique). The results achieved proved that relevant signals can be found in a frequency range up to 300 kHz. Based on this a diagnostic unit was designed and built for application under rotation conditions, which consists of a piezo-electric sensor, primary electronics, an analog-to-digital converter, a digital signal processor, a trigger unit, and a telemetric transmitter. This diagnostic unit was integrated in the hollow shaft of a railroad wheel axis, a component of a special laboratory test rig. Algorithms which allow for the rotation-synchronized processing of acoustic signals were implemented into the rotating diagnostic unit. After successfully completing a campaign for this test rig, a second test was performed inside the wheel/railroad simulation test rig of the Deutsche Bahn AG under railroad-like conditions. The data generated inside the hollow shaft of the railroad wheel axis by the diagnostic unit were telemetrically transmitted to an industrial computer

  16. Integrating service user participation in mental health care: what will it take?

    PubMed Central

    Lawn, Sharon

    2015-01-01

    Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective. PMID:25759608

  17. Integrating Health Care for the Most Vulnerable: Bridging the Differences in Organizational Cultures Between US Hospitals and Community Health Centers.

    PubMed

    Ko, Michelle; Murphy, Julia; Bindman, Andrew B

    2015-11-01

    Policymakers have increasingly promoted health services integration to improve quality and efficiency. The US health care safety net, which comprises providers of health care to uninsured, Medicaid, and other vulnerable patients, remains a largely fragmented collection of providers. We interviewed leadership from safety net hospitals and community health centers in 5 US cities (Boston, MA; Denver, CO; Los Angeles, CA; Minneapolis, MN; and San Francisco, CA) throughout 2013 on their experiences with service integration. We identify conflicts in organizational mission, identity, and consumer orientation that have fostered reluctance to enter into collaborative arrangements. We describe how smaller scale initiatives, such as capitated model for targeted populations, health information exchange, and quality improvements led by health plans, can help bridge cultural differences to lay the groundwork for developing integrated care programs. PMID:26509286

  18. Integrating Health Care for the Most Vulnerable: Bridging the Differences in Organizational Cultures Between US Hospitals and Community Health Centers

    PubMed Central

    Murphy, Julia; Bindman, Andrew B.

    2015-01-01

    Policymakers have increasingly promoted health services integration to improve quality and efficiency. The US health care safety net, which comprises providers of health care to uninsured, Medicaid, and other vulnerable patients, remains a largely fragmented collection of providers. We interviewed leadership from safety net hospitals and community health centers in 5 US cities (Boston, MA; Denver, CO; Los Angeles, CA; Minneapolis, MN; and San Francisco, CA) throughout 2013 on their experiences with service integration. We identify conflicts in organizational mission, identity, and consumer orientation that have fostered reluctance to enter into collaborative arrangements. We describe how smaller scale initiatives, such as capitated model for targeted populations, health information exchange, and quality improvements led by health plans, can help bridge cultural differences to lay the groundwork for developing integrated care programs. PMID:26509286

  19. Radiation-induced health effects on atmospheric flight crew members: clues for a radiation-related risk analysis

    NASA Astrophysics Data System (ADS)

    De Angelis, G.; Caldora, M.; Santaquilani, M.; Scipione, R.; Verdecchia, A.

    There are few human data on low-dose-rate-radiation exposure and the consequent acute and late effects. This fact makes it difficult to assess health risks due to radiation in the space environment, especially for long-term missions. Epidemiological data on civilian flight personnel cohorts can provide information on effects due to the low-dose and low-dose rate mixed high- and low-LET radiation environment in the earth's atmosphere.The physical characteristics of the radiation environment of the atmosphere make the results of the studies of commercial flight personel relevant to the studies of activities in space.The cooperative international effort now in progress to investigate dose reconstructions will contribute to our understanding of radiation risks for space exploration.

  20. The integrated project: a promising promotional strategy for primary health care.

    PubMed

    Daniel, C; Mora, B

    1985-10-01

    The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain

  1. Mental health service users' experiences of mental health care: an integrative literature review.

    PubMed

    Newman, D; O'Reilly, P; Lee, S H; Kennedy, C

    2015-04-01

    A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person-centred practice. The authors completed an in-depth search of the literature to answer the question: What are service users' experiences of the mental health service? Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care. The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support. This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider-service user relationship to facilitate true service-user engagement in their care. The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host (Academic Search Complete, MEDLINE, CINAHL Plus

  2. An integral equation formulation for predicting radiation patterns of a space shuttle annular slot antenna

    NASA Technical Reports Server (NTRS)

    Jones, J. E.; Richmond, J. H.

    1974-01-01

    An integral equation formulation is applied to predict pitch- and roll-plane radiation patterns of a thin VHF/UHF (very high frequency/ultra high frequency) annular slot communications antenna operating at several locations in the nose region of the space shuttle orbiter. Digital computer programs used to compute radiation patterns are given and the use of the programs is illustrated. Experimental verification of computed patterns is given from measurements made on 1/35-scale models of the orbiter.

  3. Testing and Qualifying Linear Integrated Circuits for Radiation Degradation in Space

    NASA Technical Reports Server (NTRS)

    Johnston, Allan H.; Rax, Bernard G.

    2006-01-01

    This paper discusses mechanisms and circuit-related factors that affect the degradation of linear integrated circuits from radiation in space. For some circuits there is sufficient degradation to affect performance at total dose levels below 4 krad(Si) because the circuit design techniques require higher gain for the pnp transistors that are the most sensitive to radiation. Qualification methods are recommended that include displacement damage as well as ionization damage.

  4. Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts

    PubMed Central

    Gee, Gilbert C.; Payne-Sturges, Devon C.

    2004-01-01

    Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure–disease paradigm has long suggested that differential “vulnerability” may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards. PMID:15579407

  5. Propulsion Integrated Vehicle Health Management Technology Experiment (PITEX) Conducted

    NASA Technical Reports Server (NTRS)

    Maul, William A.; Chicatelli, Amy K.; Fulton, Christopher E.

    2004-01-01

    The Propulsion Integrated Vehicle Health Management (IVHM) Technology Experiment (PITEX) is a continuing NASA effort being conducted cooperatively by the NASA Glenn Research Center, the NASA Ames Research Center, and the NASA Kennedy Space Center. It was a key element of a Space Launch Initiative risk-reduction task performed by the Northrop Grumman Corporation in El Segundo, California. PITEX's main objectives are the continued maturation of diagnostic technologies that are relevant to second generation reusable launch vehicle (RLV) subsystems and the assessment of the real-time performance of the PITEX diagnostic solution. The PITEX effort has considerable legacy in the NASA IVHM Technology Experiment for X-vehicles (NITEX) that was selected to fly on the X-34 subscale RLV that was being developed by Orbital Sciences Corporation. NITEX, funded through the Future-X Program Office, was to advance the technology-readiness level of selected IVHM technologies within a flight environment and to begin the transition of these technologies from experimental status into RLV baseline designs. The experiment was to perform realtime fault detection and isolation and suggest potential recovery actions for the X-34 main propulsion system (MPS) during all mission phases by using a combination of system-level analysis and detailed diagnostic algorithms.

  6. POTENTIAL HUMAN STUDY POPULATIONS FOR NON-IONIZING (RADIO FREQUENCY) RADIATION HEALTH EFFECTS

    EPA Science Inventory

    This research project was initiated to identify potential human populations for future epidemiological studies of the health effects of radio frequency radiation. Through a literature search and contacts with various groups and organizations, numerous occupations and applications...

  7. Sustainability in Primary Care and Mental Health Integration Projects in Veterans Health Administration

    PubMed Central

    Ford, James H.; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn

    2015-01-01

    Objective To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Data Sources Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. Study Design One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Principal Findings Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Conclusions Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change. PMID:23011071

  8. Radiation-hardened CMOS integrated circuit development for space nuclear power applications

    NASA Astrophysics Data System (ADS)

    Gover, J. E.; Gregory, B. L.

    Examination of the types of systems required for space nuclear power applications suggests a need for microelectronics technology that can function during and after exposure to radiation levels exceeding 1 x 10 to the 16th neutrons/sq cm and gamma ray doses in excess of 1 x 10 to the 7th rad(Si). Radiation-hardened Complimentary Metal Oxide Silicon and Silicon Nitride Oxide Silicon (SNOS) ICs presently in development at Sandia National Laboratories' Center for Radiation-Hardened Microelectronics satisfy these radiation requirements. Future integrated circuit development will further advance the radiation hardness capabilities while extending the IC technology to 32-bit enhanced microprocessors and 1-Mbyte SNOS EEPROM memories.

  9. Directional radiation of Babinet-inverted optical nanoantenna integrated with plasmonic waveguide

    PubMed Central

    Kim, Jineun; Roh, Young-Geun; Cheon, Sangmo; Jeong Kim, Un; Hwang, Sung Woo; Park, Yeonsang; Lee, Chang-Won

    2015-01-01

    We present a Babinet-inverted optical nanoantenna integrated with a plasmonic waveguide. Using an integrated nanoantenna, we can couple the plasmon guide mode in a metal-insulator-metal (MIM) structure into the resonant antenna feed directly. The resonantly excited feed slot then radiates to free space and generates a magnetic dipole-like far-field pattern. The coupling efficiency of the integrated nanoantenna is calculated as being approximately 19% using a three-dimensional finite-difference time-domain (3D FDTD) simulation. By adding an auxiliary groove structure along with the feed, the radiation direction can be controlled similar to an optical Yagi-Uda antenna. We also determine, both theoretically and experimentally, that groove depth plays a significant role to function groove structure as a reflector or a director. The demonstrated Babinet-inverted optical nanoantenna integrated with a plasmonic waveguide can be used as a “plasmonic via” in plasmonic nanocircuits. PMID:26135115

  10. Directional radiation of Babinet-inverted optical nanoantenna integrated with plasmonic waveguide

    NASA Astrophysics Data System (ADS)

    Kim, Jineun; Roh, Young-Geun; Cheon, Sangmo; Jeong Kim, Un; Hwang, Sung Woo; Park, Yeonsang; Lee, Chang-Won

    2015-07-01

    We present a Babinet-inverted optical nanoantenna integrated with a plasmonic waveguide. Using an integrated nanoantenna, we can couple the plasmon guide mode in a metal-insulator-metal (MIM) structure into the resonant antenna feed directly. The resonantly excited feed slot then radiates to free space and generates a magnetic dipole-like far-field pattern. The coupling efficiency of the integrated nanoantenna is calculated as being approximately 19% using a three-dimensional finite-difference time-domain (3D FDTD) simulation. By adding an auxiliary groove structure along with the feed, the radiation direction can be controlled similar to an optical Yagi-Uda antenna. We also determine, both theoretically and experimentally, that groove depth plays a significant role to function groove structure as a reflector or a director. The demonstrated Babinet-inverted optical nanoantenna integrated with a plasmonic waveguide can be used as a “plasmonic via” in plasmonic nanocircuits.

  11. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

    PubMed Central

    H., Hildebrandt; C., Hermann; R., Knittel; M., Richter-Reichhelm; A., Siegel; W., Witzenrath

    2010-01-01

    Introduction Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal. Description of integrated care case Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg). Discussion and (preliminary) conclusion The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether—and to what extent—cost reduction may be attributed to a real population health gain. PMID:20689772

  12. Integrated Environment and Safety and Health Management System (ISMS) Implementation Project Plan

    SciTech Connect

    MITCHELL, R.L.

    2000-01-10

    The Integrated Environment, Safety and Health Management System (ISMS) Implementation Project Plan serves as the project document to guide the Fluor Hanford, Inc (FHI) and Major Subcontractor (MSC) participants through the steps necessary to complete the integration of environment, safety, and health into management and work practices at all levels.

  13. BEIR-III report and its implications for radiation protection and public health policy

    SciTech Connect

    Fabrikant, J.I.

    1980-03-01

    A general background is given of the implications the BEIR-III Report may have on societal decision-making in the regulation of activities concerned with the health effects of low-level radiation. The scientific basis for establishing appropriate radiation protection guides are discussed. (ACR)

  14. Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation?

    PubMed

    Seong, Ki Moon; Seo, Songwon; Lee, Dalnim; Kim, Min-Jeong; Lee, Seung-Sook; Park, Sunhoo; Jin, Young Woo

    2016-02-01

    Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation. PMID:26908982

  15. Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation?

    PubMed Central

    2016-01-01

    Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation. PMID:26908982

  16. Non-Targeted Effects Induced by Ionizing Radiation: Mechanisms and Potential Impact on Radiation Induced Health Effects

    SciTech Connect

    Morgan, William F.; Sowa, Marianne B.

    2015-01-01

    Not-targeted effects represent a paradigm shift from the "DNA centric" view that ionizing radiation only elicits biological effects and subsequent health consequences as a result of an energy deposition event in the cell nucleus. While this is likely true at higher radiation doses (> 1Gy), at low doses (< 100mGy) non-targeted effects associated with radiation exposure might play a significant role. Here definitions of non-targeted effects are presented, the potential mechanisms for the communication of signals and signaling networks from irradiated cells/tissues are proposed, and the various effects of this intra- and intercellular signaling are described. We conclude with speculation on how these observations might lead to and impact long-term human health outcomes.

  17. Radiation exposure and adverse health effects of interventional cardiology staff.

    PubMed

    Kesavachandran, Chandrasekharan Nair; Haamann, Frank; Nienhaus, Albert

    2013-01-01

    To the best of our knowledge, this chapter constitutes the first systematic review of radiation exposure to eyes, thyroid, and hands for Interventional Cardiology (IC) staff. We have concluded from our review that these anatomical locations are likely to be exposed to radiation as a result of the limited use of personal protective equipment (PPE) among IC staff as shown in Fig. 8. Our review also reveals that, with the exception of three eye exposure cases, the annual radiation dose to eyes, thyroid, and hands among IC staff was within recommended levels and limits. The As Low As Reasonably Achievable (ALARA) limit was not achieved in three cases for fingers/hands and four cases for eyes. However, an increased incidence of cataracts were reported for IC staff, and this gives rise to the concern that low-dose or unnoticed exposures may increase the risk of developing cataracts among cardiology staff. Clearly, the formation of cataracts among IC staff may be an issue and should be studied in more depth. Our review also disclosed that the two groups who receive excessive radiation doses (i.e., exceed the recommended limit) are physicians-in-training and junior staff physicians who work in cardiac catheterization laboratories. In particular, more attention should be given to assessing the effects of radiation exposure among IC staff who work in the Asia Pacific countries, because our review indicates that the number of IC procedures performed by IC staff in these countries is higher than for other continents. There is a huge demand for procedures conducted by IC staff in the Asia-Pacific area, for both treating patients and consulting with specialists. Our review also disclosed that recommended limits for per-procedure radiation doses are needed for IC staff. We recommend that such limits be established by the appropriate national and international agencies that are responsible for occupational radiation exposure. Although our review indicates that the current

  18. The SDGs Will Require Integrated Agriculture, Nutrition, and Health at the Community Level.

    PubMed

    Canavan, Chelsey R; Graybill, Lauren; Fawzi, Wafaie; Kinabo, Joyce

    2016-03-01

    Child malnutrition is an urgent and complex issue and requires integrated approaches across agriculture, nutrition, and health. This issue has gained prominence at the global level. While national-level efforts are underway in many countries, there is little information on how to integrate at the community level. Here, we offer a community-based approach using cadres of agricultural and community health workers, drawing on qualitative work we have conducted in Tanzania. Agriculture is an important driver of nutritional and health outcomes, and improving child health will require practical solutions for integration that can add to the evidence base. PMID:26769040

  19. Developing a multivariate electronic medical record integration model for primary health care.

    PubMed

    Lau, Francis; Price, Morgan; Lesperance, Mary

    2013-01-01

    This paper describes the development of a multivariate electronic medical record (EMR) integration model for the primary health care setting. Our working hypothesis is that an integrated EMR is associated with high quality primary health care. Our assumption is that EMR integration should be viewed as a form of complex intervention with multiple interacting components that can impact the quality of care. Depending on how well the EMR is integrated in the practice setting, one can expect a corresponding change in the quality of care as measured through a set of primary health care quality indicators. To test the face validity of this model, a Delphi study is being planned where health care providers and information technology professionals involved with EMR adoption are polled for their feedback. This model has the potential to quantify and explain the factors that influence successful EMR integration to improve primary health care. PMID:23388317

  20. Advancing human health risk assessment: integrating recent advisory committee recommendations.

    PubMed

    Dourson, Michael; Becker, Richard A; Haber, Lynne T; Pottenger, Lynn H; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A

    2013-07-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose-response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose-response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  1. Advancing human health risk assessment: Integrating recent advisory committee recommendations

    PubMed Central

    Becker, Richard A.; Haber, Lynne T.; Pottenger, Lynn H.; Bredfeldt, Tiffany; Fenner-Crisp, Penelope A.

    2013-01-01

    Over the last dozen years, many national and international expert groups have considered specific improvements to risk assessment. Many of their stated recommendations are mutually supportive, but others appear conflicting, at least in an initial assessment. This review identifies areas of consensus and difference and recommends a practical, biology-centric course forward, which includes: (1) incorporating a clear problem formulation at the outset of the assessment with a level of complexity that is appropriate for informing the relevant risk management decision; (2) using toxicokinetics and toxicodynamic information to develop Chemical Specific Adjustment Factors (CSAF); (3) using mode of action (MOA) information and an understanding of the relevant biology as the key, central organizing principle for the risk assessment; (4) integrating MOA information into dose–response assessments using existing guidelines for non-cancer and cancer assessments; (5) using a tiered, iterative approach developed by the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) as a scientifically robust, fit-for-purpose approach for risk assessment of combined exposures (chemical mixtures); and (6) applying all of this knowledge to enable interpretation of human biomonitoring data in a risk context. While scientifically based defaults will remain important and useful when data on CSAF or MOA to refine an assessment are absent or insufficient, assessments should always strive to use these data. The use of available 21st century knowledge of biological processes, clinical findings, chemical interactions, and dose–response at the molecular, cellular, organ and organism levels will minimize the need for extrapolation and reliance on default approaches. PMID:23844697

  2. Enhancing interprofessional education: integrating public health and social work perspectives.

    PubMed

    Addy, Cheryl L; Browne, Teri; Blake, Elizabeth W; Bailey, Jennifer

    2015-03-01

    National stakeholders in health system improvement and patient safety including accreditation bodies have requested health professional educational programs to include multiple interprofessional experiences through didactic and experiential opportunities. Clinical and population health faculty at the University of South Carolina redesigned and expanded an introductory interprofessional course to include more than 500 students from public health, social work, medicine, pharmacy, and nursing. Students participated in 3 live class meetings and completed required online coursework to explore concepts related to social determinants of health and health disparities, health system improvement, patient safety, cultural competency, and ethics to address interprofessional education core competencies. Course modifications and expanded student enrollment improved understanding of key health concepts and appreciation of interprofessional collaboration. PMID:25706002

  3. A Population Health Model for Integrated Assessment Models

    SciTech Connect

    Pitcher, Hugh M.; Ebi, Kristie L.; Brenkert, Antoinette L.

    2008-05-01

    This paper presents the initial results of a project to develop a population health model so we can extend the scenarios included in the IPCC's Special Report on Emissions Scenarios to include population health status.

  4. Integrating mental health services into primary HIV care for women: the Whole Life project.

    PubMed Central

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, implementation strategies, effects of the service integration, and lessons learned. Funded by the Health Resources and Services Administration (HRSA) as a Special Program of National Significance (SPNS), Whole Life efforts have been sustained beyond the demonstration funding period as a result of the changes brought about in organizational structures, service delivery, and the providers' conceptualization of health for HIV-infected women. PMID:15147649

  5. Connecting Body and Mind: A Resource Guide to Integrated Health Care in Texas and the United States

    ERIC Educational Resources Information Center

    Lopez, Molly; Coleman-Beattie, Brenda; Jahnke, Lauren; Sanchez, Katherine

    2008-01-01

    There is a call across the country and in Texas to improve health care systems through integrated care. Integrated health care is the systematic coordination of physical and behavioral health services. The idea is that physical and behavioral health problems often occur at the same time and that integrating services will provide the best results…

  6. Medical provider attitudes about behavioral health consultants in integrated primary care: a preliminary study.

    PubMed

    Torrence, Nicole D; Mueller, Anne E; Ilem, Allison A; Renn, Brenna N; DeSantis, Brian; Segal, Daniel L

    2014-12-01

    Integrated behavioral health increases service utilization and treatment success, particularly with high-risk populations. This study assessed medical personnel's attitudes and perceptions of behavioral health clinicians (BHCs) in primary care using a brief self-report measure. A 6-item survey was given to medical providers (n = 45) from a health care system that includes integrated behavioral health services. Survey items assessed providers' attitudes and perceptions about BHCs. Attitudes about behavioral health were largely favorable. For all items, 73.3% to 100% of participants endorsed strongly agree or agree. Chi-square analyses revealed that those who interacted more frequently with BHCs were more comfortable discussing behavioral health issues with their patients, χ²(6, n = 45) = 13.43, p < .05, and that physicians believe that BHCs help patients effectively address their behavioral health problems, χ²(2, n = 45) = 6.36, p < .05. Age, gender, and health center in which the providers worked were not significantly related to any survey items. Medical providers surveyed believe that BHCs are valuable members of integrated health care, improving their abilities to provide care and to address their patients' physical and behavioral health problems. Although these preliminary results are promising, the setting surveyed has well-integrated behavioral health care services and thus might not be representative of other settings without such integration. Future studies should address medical providers' opinions of BHCs in a variety of settings with larger samples. PMID:25329753

  7. Perceived Control, Communication, and Health: An Integrative Review.

    ERIC Educational Resources Information Center

    Brenders, David A.

    Perceived control has become an important construct for health care research. Since the processes and outcomes of health and illness are constantly mediated and affected by communication, the relationship between a person's belief in his/her personal control of events and health care interactions is an important component of the theory and…

  8. Hardware Specific Integration Strategy for Impedance-Based Structural Health Monitoring of Aerospace Systems

    NASA Technical Reports Server (NTRS)

    Owen, Robert B.; Gyekenyesi, Andrew L.; Inman, Daniel J.; Ha, Dong S.

    2011-01-01

    The Integrated Vehicle Health Management (IVHM) Project, sponsored by NASA's Aeronautics Research Mission Directorate, is conducting research to advance the state of highly integrated and complex flight-critical health management technologies and systems. An effective IVHM system requires Structural Health Monitoring (SHM). The impedance method is one such SHM technique for detection and monitoring complex structures for damage. This position paper on the impedance method presents the current state of the art, future directions, applications and possible flight test demonstrations.

  9. Ethnic Variation in Oral Health and Social Integration among Older Rural Adults

    PubMed Central

    Arcury, Thomas A.; Chen, Haiying; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Bell, Ronny A.; Quandt, Sara A.

    2011-01-01

    This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, white) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size. Minority elders have poorer oral health than do white older adults. Most rural elders have substantial social engagement and social networks. Better oral health (greater number of teeth) is directly associated with social engagement, while the relationship of oral health to social network size is complex. The association of oral health with social engagement does not differ by ethnicity. Poorer oral health is associated with less social integration among African American, American Indian and white elders. More research on the ways oral health affects the lives of older adults is warranted. PMID:23788829

  10. The Health Care Strengthening Act: The next level of integrated care in Germany.

    PubMed

    Milstein, Ricarda; Blankart, Carl Rudolf

    2016-05-01

    The lack of integration of health-care sectors and specialist groups is widely accepted as a necessity to effectively address the most urgent challenges in modern health care systems. Germany follows a more decentralized approach that allows for many degrees of freedom. With its latest bill, the German government has introduced several measures to explicitly foster the integration of health-care services. This article presents the historic development of integrated care services and offers insights into the construction of integrated care programs in the German health-care system. The measures of integrated care within the Health Care Strengthening Act are presented and discussed in detail from the perspective of the provider, the payer, and the political arena. In addition, the effects of the new act are assessed using scenario technique based on an analysis of the effects of previously implemented health policy reforms. Germany now has a flourishing integrated care scene with many integrated care programs being able to contain costs and improve quality. Although it will be still a long journey for Germany to reach the coordination of care standards set by leading countries such as the United Kingdom, New Zealand or Switzerland, international health policy makers may deliberately and selectively adopt elements of the German approach such as the extensive freedom of contract, the strong patient-focus by allowing for very need-driven and regional solutions, or the substantial start-up funding allowing for more unproven and progressive endeavors to further improve their own health systems. PMID:27103332

  11. INTEGRAL/SPI Limits on Electron-Positron Annihilation Radiation from the Galactic Plane

    NASA Technical Reports Server (NTRS)

    Teegarden, B. J.; Watanabe, K.; Jean, P.; Knoedlseder, J.; Lonjou, V.; Roques, J. P.; Skinner, G. K.; vonBallmoos, P.; Weidenspointner, G.; Bazzano, A.

    2005-01-01

    The center of our Galaxy is a known strong source of electron-positron 511- keV annihilation radiation. Thus far, however, there have been no reliable detections of annihilation radiation outside of the central radian of our Galaxy. One of the primary objectives of the INTEGRAL (INTErnational Gamma-RAy Astrophysics Laboratory) mission, launched in Oct. 2002, is the detailed study of this radiation. The Spectrometer on INTEGRAL (SPI) is a high resolution coded-aperture gamma-ray telescope with an unprecedented combination of sensitivity, angular resolution and energy resolution. We report results from the first 10 months of observation. During this period a significant fraction of the observing time was spent in or near the Galactic Plane. No positive annihilation flux was detected outside of the central region (|l| greater than 40 degrees) of our Galaxy. In this paper we describe the observations and data analysis methods and give limits on the 511-keV flux.

  12. Modular, thermal bus-to-radiator integral heat exchanger design for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe; Ewert, Michael

    1990-01-01

    The baseline concept is introduced for the 'integral heat exchanger' (IHX) which is the interface of the two-phase thermal bus with the heat-rejecting radiator panels. A direct bus-to-radiator heat-pipe integral connection replaces the present interface hardware to reduce the weight and complexity of the heat-exchange mechanism. The IHX is presented in detail and compared to the baseline system assuming certain values for heat rejection, mass per unit width, condenser capacity, contact conductance, and assembly mass. The spreadsheet comparison can be used to examine a variety of parameters such as radiator length and configuration. The IHX is shown to permit the reduction of panel size and system mass in response to better conductance and packaging efficiency. The IHX is found to be a suitable heat-rejection system for the Space Station Freedom because it uses present technology and eliminates the interface mechanisms.

  13. Strategies for integrating mental health into schools via a multitiered system of support.

    PubMed

    Stephan, Sharon Hoover; Sugai, George; Lever, Nancy; Connors, Elizabeth

    2015-04-01

    To fully realize the potential of mental health supports in academic settings, it is essential to consider how to effectively integrate the mental health and education systems and their respective resources, staffing, and structures. Historically, school mental health services have not effectively spanned a full continuum of care from mental health promotion to treatment, and several implementation and service challenges have evolved. After an overview of these challenges, best practices and strategies for school and community partners are reviewed to systematically integrate mental health interventions within a school's multitiered system of student support. PMID:25773320

  14. The economic costs of radiation-induced health effects: Estimation and simulation

    SciTech Connect

    Nieves, L.A.; Tawil, J.J.

    1988-08-01

    This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.

  15. Academic Integrity and Plagiarism: A Review of the Influences and Risk Situations for Health Students

    ERIC Educational Resources Information Center

    Jiang, Hai; Emmerton, Lynne; McKauge, Leigh

    2013-01-01

    Health professions are increasingly focusing on the development of integrity and professionalism in students of Health disciplines. While it is expected that Health students will develop, and commit to, the highest standards of conduct as undergraduates, and henceforth through their careers, the pressures of assessment and external commitments may…

  16. Integrated Health and Physical Education Program to Reduce Media Use and Increase Physical Activity in Youth

    ERIC Educational Resources Information Center

    Clocksin, Brian D.; Wattson, Doris L.; Williams, Daniel P.; Randsell, Lynda

    2009-01-01

    The purpose of this project was to compare an integrated health and physical education curriculum, focused on reducing media use and on increasing physical activity in middle school adolescents, to traditional and nonintegrated health and physical education curricula. Two middle schools' health and physical education classes were assigned to an…

  17. The impact of radiation hardened by design (RHBD) techniques on the performance of readout integrated circuits in radiation environments

    NASA Astrophysics Data System (ADS)

    Hubbs, John E.; Gramer, Mark E.; Maestas-Jepson, Diana; Dole, Gary A.; Hahn, Allan

    2008-08-01

    The tolerance of a hybrid array (HA) to total ionizing dose (TID) radiation continues to be a major performance consideration for space based imaging systems. In an effort to improve TID performance, HA manufacturers have begun to utilize circuit design techniques to enhance the TID tolerance of readout integrated circuits (ROICs). This paper will report on the radiometric and TID radiation characterizations of a HA that utilizes radiation-hardened-by-design (RHBD) techniques. This paper will not describe the design techniques used. Instead, characterization data are presented that demonstrate a HA TID tolerance of over 25 units of total ionizing dose (UTID). This result is compared with the performance of devices with ROICs processed at commercial foundries that do not make use of RHBD techniques. The HA described in this paper represents a state-of-the-art device; the ROIC was designed to be low noise, high gain, and radiation tolerant. While design techniques were utilized to enhance its TID hardness, no special fabrication processes were used.

  18. Telehealth and Occupational Therapy: Integral to the Triple Aim of Health Care Reform.

    PubMed

    Cason, Jana

    2015-01-01

    Programs and concepts included in the Patient Protection and Affordable Care Act of 2010 are expected to transform health care in the United States from a volume-based health system to a value-based health system with increased emphasis on prevention and health promotion. The Triple Aim, a framework set forth by the Institute for Healthcare Improvement, focuses on improving the health care experience, the health of populations, and the affordability of care. This article describes telehealth as an integral component in achieving the Triple Aim of health care and discusses implications for occupational therapy practitioners. PMID:26122676

  19. Integrated health promotion strategies: a contribution to tackling current and future health challenges.

    PubMed

    Jackson, Suzanne F; Perkins, Fran; Khandor, Erika; Cordwell, Lauren; Hamann, Stephen; Buasai, Supakorn

    2006-12-01

    This paper was presented as a technical background paper at the WHO sixth Global Conference on Health Promotion in Bangkok Thailand, August 2005. It describes what we know about the effectiveness of four of the Ottawa Charter health promotion strategies from eight reviews that have been conducted since 1999. The six lessons are that (i) the investment in building healthy public policy is a key strategy; (ii) supportive environments need to be created at the individual, social and structural levels; (iii) the effectiveness of strengthening community action is unclear and more research and evidence is required; (iv) personal skills development must be combined with other strategies to be effective; (v) interventions employing multiple strategies and actions at multiple levels are most effective; (vi) certain actions are central to effectiveness, such as intersectoral action and interorganizational partnerships at all levels, community engagement and participation in planning and decision-making, creating healthy settings (particularly focusing on schools, communities, workplaces and municipalities), political commitment, funding and infrastructure and awareness of the socio-environmental context. In addition, four case studies at the international, national, regional and local levels are described as illustrations of combinations of the key points described earlier. The paper concludes that the four Ottawa Charter strategies have been effective in addressing many of the issues faced in the late 20th century and that these strategies have relevance for the 21st century if they are integrated with one another and with the other actions described in this paper. PMID:17307960

  20. Health effects of low level radiation: carcinogenesis, teratogenesis, and mutagenesis

    SciTech Connect

    Ritenour, E.R.

    1986-04-01

    The carcinogenic effects of radiation have been demonstrated at high dose levels. At low dose levels, such as those encountered in medical diagnosis, the magnitude of the effect is more difficult to quantify. Three reasons for this difficulty are (1) the effects in human populations are small compared with the natural incidence of cancer in the populations; (2) it is difficult to transfer results obtained in animal studies to the human experience; and (3) the effects of latency period and plateau increase the complexity of population studies. In spite of these difficulties, epidemiologic studies of human populations exposed to low levels of radiation still play a valuable role in the determination of radiation carcinogenecity. They serve to provide upper estimates of risk and to rule out the appearance of new effects that may be masked by the effects of high doses. While there is evidence for mutagenic effects of radiation in experimental animals, no conclusive human data exist at the present. It is not possible to rule out the presence of genetic effects of radiation in humans, however, because many problems exist with regard to the epidemiologic detection of small effects when the natural incidence is relatively large. In animals, subtle effects (eg, a decrease in the probability of survival from egg to adult) may occur with greater frequency than more dramatic disorders in irradiated populations. However, these types of genetic abnormalities are difficult to quantitate. Current risk estimates are based primarily upon data pertaining to dominant mutations in rodents. Some specific locus studies also permit identification of recessive mutation rates. The embryo and fetus are considered to be at greater risk for adverse effects of radiation than is the adult.

  1. Impact of late radiation effects on cancer survivor children: an integrative review.

    PubMed

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-03-01

    We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: "neoplasias/neoplasms" AND "radioterapia/radiotherapy" AND "radiação/radiation". After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: "Late endocrine effects" and "Late non-endocrine effects". Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses. PMID:26313432

  2. Systems Modeling to Implement Integrated System Health Management Capability

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge F.; Walker, Mark; Morris, Jonathan; Smith, Harvey; Schmalzel, John

    2007-01-01

    ISHM capability includes: detection of anomalies, diagnosis of causes of anomalies, prediction of future anomalies, and user interfaces that enable integrated awareness (past, present, and future) by users. This is achieved by focused management of data, information and knowledge (DIaK) that will likely be distributed across networks. Management of DIaK implies storage, sharing (timely availability), maintaining, evolving, and processing. Processing of DIaK encapsulates strategies, methodologies, algorithms, etc. focused on achieving high ISHM Functional Capability Level (FCL). High FCL means a high degree of success in detecting anomalies, diagnosing causes, predicting future anomalies, and enabling health integrated awareness by the user. A model that enables ISHM capability, and hence, DIaK management, is denominated the ISHM Model of the System (IMS). We describe aspects of the IMS that focus on processing of DIaK. Strategies, methodologies, and algorithms require proper context. We describe an approach to define and use contexts, implementation in an object-oriented software environment (G2), and validation using actual test data from a methane thruster test program at NASA SSC. Context is linked to existence of relationships among elements of a system. For example, the context to use a strategy to detect leak is to identify closed subsystems (e.g. bounded by closed valves and by tanks) that include pressure sensors, and check if the pressure is changing. We call these subsystems Pressurizable Subsystems. If pressure changes are detected, then all members of the closed subsystem become suspect of leakage. In this case, the context is defined by identifying a subsystem that is suitable for applying a strategy. Contexts are defined in many ways. Often, a context is defined by relationships of function (e.g. liquid flow, maintaining pressure, etc.), form (e.g. part of the same component, connected to other components, etc.), or space (e.g. physically close

  3. The Internet. Building knowledge & offering integrated solutions to health care.

    PubMed

    Russo, H E

    2000-07-01

    Technology is changing the way we do things, including how the health care community provides information and services to the public. Disparate populations, once separated by distance and time, will experience dramatic changes as they become part of a global community. Fundamental changes will continue to occur in the way health information is received, utilized, exchanged and stored. This article explores access to the Internet as well as applications of interactive health technology and the emerging issues surrounding technology use. PMID:11010439

  4. Human health benefits and burdens of a pharmaceutical treatment: Discussion of a conceptual integrated approach.

    PubMed

    Debaveye, Sam; De Soete, Wouter; De Meester, Steven; Vandijck, Dominique; Heirman, Bert; Kavanagh, Shane; Dewulf, Jo

    2016-01-01

    The effects of a pharmaceutical treatment have until now been evaluated by the field of Health Economics on the patient health benefits, expressed in Quality-Adjusted Life Years (QALYs) versus the monetary costs. However, there is also a Human Health burden associated with this process, resulting from emissions that originate from the pharmaceutical production processes, Use Phase and End of Life (EoL) disposal of the medicine. This Human Health burden is evaluated by the research field of Life Cycle Assessment (LCA) and expressed in Disability-Adjusted Life Years (DALYs), a metric similar to the QALY. The need for a new framework presents itself in which both the positive and negative health effects of a pharmaceutical treatment are integrated into a net Human Health effect. To do so, this article reviews the methodologies of both Health Economics and the area of protection Human Health of the LCA methodology and proposes a conceptual framework on which to base an integration of both health effects. Methodological issues such as the inclusion of future costs and benefits, discounting and age weighting are discussed. It is suggested to use the structure of an LCA as a backbone to cover all methodological challenges involved in the integration. The possibility of monetizing both Human Health benefits and burdens is explored. The suggested approach covers the main methodological aspects that should be considered in an integrated assessment of the health effects of a pharmaceutical treatment. PMID:26544901

  5. The NOAA Integrated Surface Irradiance Study (ISIS) - A new surface radiation monitoring program

    SciTech Connect

    Hicks, B.B.; DeLuisi, J.J.

    1996-12-01

    This paper describes a new radiation monitoring program, the Integrated Surface Irradiance Study (ISIS), that builds upon and takes over from earlier NOAA networks monitoring components of solar radiation [both the visible component (SOLRAD) and the shortwave component that causes sunburn, UV-B] across the continental United States. ISIS is implemented in two levels. Level 1 addresses incoming radiation only, and level 2 addresses the surface radiation balance. Level 2 also constitutes the SURFRAD (Surface Radiation) program of the NOAA Office of Global Programs, specifically intended to provide radiation data to support large-scale hydrologic studies that will be conducted under the Global Energy and Water Cycle Experiment. Eventually, it is planned for level 2 sites to monitor all components of the surface energy balance. Both levels of ISIS will eventually measure both visible and UV radiation components. At present, there are nine sites that are considered to be at ISIS level 1 standard and an additional four level 2 SURFRAD sites. A 10th level 1 site will be in operation soon. Plans call for an increase in the number of sites of both kinds, up to about 15 ISIS sites, of which 6 will be at the SURFRAD level. 20 refs., 2 figs., 1 tab.

  6. Integrative therapies in hospice and home health: introduction and adoption.

    PubMed

    Johnson, Esther L; O'Brien, Deborah

    2009-02-01

    Integrative therapies comprise a variety of nonpharmacologic methods that provide pain and symptom management. These therapies are increasingly gaining acceptance in the healthcare community as complementary to traditional treatments for pain. This article details the introduction, scope, and challenges healthcare organizations face when incorporating integrative therapies into their care plans. PMID:19212218

  7. All Health Is Global Health, All Medicine Is Social Medicine: Integrating the Social Sciences Into the Preclinical Curriculum.

    PubMed

    Kasper, Jennifer; Greene, Jeremy A; Farmer, Paul E; Jones, David S

    2016-05-01

    As physicians work to achieve optimal health outcomes for their patients, they often struggle to address the issues that arise outside the clinic. Social, economic, and political factors influence patients' burden of disease, access to treatment, and health outcomes. This challenge has motivated recent calls for increased attention to the social determinants of health. At the same time, advocates have called for increased attention to global health. Each year, more U.S. medical students participate in global health experiences. Yet, the global health training that is available varies widely. The discipline of social medicine, which attends to the social determinants of disease, social meanings of disease, and social responses to disease, offers a solution to both challenges. The analyses and techniques of social medicine provide an invaluable toolkit for providing health care in the United States and abroad.In 2007, Harvard Medical School implemented a new course, required for all first-year students, that teaches social medicine in a way that integrates global health. In this article, the authors argue for the importance of including social medicine and global health in the preclinical curriculum; describe Harvard Medical School's innovative, integrated approach to teaching these disciplines, which can be used at other medical schools; and explore the barriers that educators may face in implementing such a curriculum, including resistance from students. Such a course can equip medical students with the knowledge and tools that they will need to address complex health problems in the United States and abroad. PMID:26703416

  8. Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity

    PubMed Central

    Hendriks, Anna-Marie; Gubbels, Jessica S.; De Vries, Nanne K.; Seidell, Jaap C.; Kremers, Stef P. J.; Jansen, Maria W. J.

    2012-01-01

    Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated public health policies is intersectoral collaboration. Since the development of integrated policies is still in its early stages, this study aimed to answer the following research question: “What interventions can promote intersectoral collaboration and the development of integrated health policies for the prevention of childhood obesity?” Data were collected through a literature search and observations of and interviews with stakeholders. Based on a theoretical framework, we categorized potential interventions that could optimize an integrated approach regarding children's physical activity and diet. The intervention categories included education, persuasion, incentivization, coercion, training, restriction, environmental restructuring, modeling, and enablement. PMID:22792120

  9. Evaluation of health care delivery integration: the case of the Russian Federation.

    PubMed

    Sheiman, Igor; Shevski, Vladimir

    2014-04-01

    Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care. It then presents a summary of service integration problems in Russia and the results of a large survey of physicians concerning the attributes of integration. It is argued that characteristics of the national service delivery model don't ensure integration. The Semashko model is not an equivalent to the integrated model. Big organizational forms of service provision, like polyclinics and integrated hospital-polyclinics, don't have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration/fragmentation, regulation of integration activities, enhancing the role of PHC providers, economic incentives. PMID:24461718

  10. Curriculum: Integrating Health and Safety Into Engineering Curricula.

    ERIC Educational Resources Information Center

    Talty, John T.

    1985-01-01

    National Institute for Occupational Safety and Health instituted a project in 1980 to encourage engineering educators to focus on occupational safety and health issues in engineering curricula. Progress to date is outlined, considering specific results in curriculum development, engineering society interaction, and formation of a teaching…

  11. Crossing the divide: primary care and mental health integration.

    PubMed

    Upshur, Carole C

    2005-03-01

    This paper describes the views of primary care providers about treating depression among adult Medicaid patients and their experiences with managed behavioral health care. It also shows the outcomes of an intervention project that provides a care manager to facilitate connections among PCPs, patients, and behavioral health providers. Despite widespread initiatives to improve depression management in primary care and to manage behavioral health services, it appears that links between the two systems and the use of evidence-based approaches to managing patients are rare. A pilot project to initiate practice redesign, the use of a care manager to assist in patient support, and compliance with both medical and behavioral health treatment has been shown to improve communication and results in positive patient outcomes. Managed behavioral health care can result in incentive structures that create gaps between primary care and behavioral health systems. This project illustrates an initiative co-sponsored by the Massachusetts behavioral health program designed to strengthen links between behavioral health and primary care, and increase rates and effectiveness of depression treatment. PMID:15844853

  12. Incorporating Integrative Health Services in Social Work Education

    ERIC Educational Resources Information Center

    Gant, Larry; Benn, Rita; Gioia, Deborah; Seabury, Brett

    2009-01-01

    More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are…

  13. INTEGRATING AIR QUALITY DATA TO INFORM HUMAN HEALTH DECISIONS

    EPA Science Inventory

    The August 1-2, 2005 EPA-NIEHS workshop is addressing the linkages between air quality and human health. My presentation will discuss the strengths and limitations of various databases for relating air quality to health impacts. Specifically, the need for fusing ground-based, s...

  14. Health Promotion Dissemination and Systems Thinking: Towards an Integrative Model

    ERIC Educational Resources Information Center

    Best, Allan; Moor, Gregg; Holmes, Bev; Clark, Pamela I.; Bruce, Ted; Leischow, Scott; Buchholz, Kaye; Krajnak, Judith

    2003-01-01

    Objective:: To help close the gap between health promotion research and practice by using systems thinking. Methods: We review 3 national US tobacco control initiatives and a project (ISIS) that has introduced systems thinking to tobacco control, speculating on ways in which systems thinking may add value to health promotion dissemination and…

  15. Developing IntegRATE: a fast and frugal patient-reported measure of integration in health care delivery

    PubMed Central

    Elwyn, Glyn; Thompson, Rachel; John, Roshen; Grande, Stuart W

    2015-01-01

    Background Efforts have been made to measure integration in health care delivery, but few existing instruments have adopted a patient perspective, and none is sufficiently generic and brief for administration at scale. We sought to develop a brief and generic patient-reported measure of integration in health care delivery. Methods Drawing on both existing conceptualisations of integrated care and research on patients’ perspectives, we chose to focus on four distinct domains of integration: information sharing, consistent advice, mutual respect and role clarity. We formulated candidate items and conducted cognitive interviews with end users to further develop and refine the items. We then pilot-tested the measure. Results Four rounds of cognitive interviews were conducted (n = 14) and resulted in a four-item measure that was both relevant and understandable to end users. The pilot administration of the measure (n = 15) further confirmed the relevance and interpretability of items and demonstrated that the measure could be completed in less than one minute. Conclusions This new measure, IntegRATE, represents a patient-reported measure of integration in health care delivery that is conducive to use in both routine performance monitoring and research. The psychometric properties of the measure will be assessed in the next stage of development. PMID:26034467

  16. Association between Social Integration and Health among Internal Migrants in ZhongShan, China

    PubMed Central

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Shi, Jingrong; Han, Siqi; Song, Xiaolei; Xu, Yong; Ling, Li

    2016-01-01

    Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants’ health statuses with varying years of residence, and explored the associations between the migrants’ social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3–6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health

  17. Association between Social Integration and Health among Internal Migrants in ZhongShan, China.

    PubMed

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Shi, Jingrong; Han, Siqi; Song, Xiaolei; Xu, Yong; Ling, Li

    2016-01-01

    Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3-6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health

  18. Policy actions to achieve integrated community-based mental health services.

    PubMed

    DeSilva, Mary; Samele, Chiara; Saxena, Shekhar; Patel, Vikram; Darzi, Ara

    2014-09-01

    Globally, the majority of people with mental health problems do not receive evidence-based interventions that can transform their lives. We describe six mental health policy actions adopted at the World Innovation Summit for Health in 2013. For each policy action, we offer real-world examples of mental health innovations that governments and health care providers can implement to move toward universal health coverage for mental health. The six policy actions are empowering people with mental health problems and their families, building a diverse mental health workforce, developing collaborative and multidisciplinary mental health teams, using technology to increase access to mental health care, identifying and treating mental health problems early, and reducing premature mortality in people with mental health problems. Challenges to implementing these policy actions include the lack of recognition of mental health as a global health priority and the resulting lack of investment in mental health, the difficulties of integrating mental health into primary care health services because of a scarcity of human and financial resources, and the lack of evidence on the effectiveness and costs of taking innovations to a national scale. PMID:25201664

  19. 75 FR 35496 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  20. 77 FR 43090 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  1. 78 FR 44954 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  2. 78 FR 21370 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  3. 77 FR 62240 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  4. 75 FR 81277 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  5. 76 FR 16787 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  6. 78 FR 732 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  7. 75 FR 11186 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such radiation doses may have endangered the...

  8. Introduction to integrative primary care: the health-oriented clinic.

    PubMed

    Fortney, Luke; Rakel, Dave; Rindfleisch, J Adam; Mallory, Jill

    2010-03-01

    Integrative medicine is healing-oriented medicine that accounts for the whole person (body, mind, and spirit), including all aspects of lifestyle. Integrative medicine emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. This article describes ways to bring the integrative perspective into primary care practice. Several approaches are described, including some that are routinely used in the authors' practice. Changes in practice philosophy that can (1) help inform primary care redesign, (2) facilitate the creation of patient-centered medical homes, (3) strengthen provider-patient relationships, and (4) enhance patient satisfaction are also provided. PMID:20188994

  9. SEM analysis of ionizing radiation effects in linear integrated circuits. [Scanning Electron Microscope

    NASA Technical Reports Server (NTRS)

    Stanley, A. G.; Gauthier, M. K.

    1977-01-01

    A successful diagnostic technique was developed using a scanning electron microscope (SEM) as a precision tool to determine ionization effects in integrated circuits. Previous SEM methods radiated the entire semiconductor chip or major areas. The large area exposure methods do not reveal the exact components which are sensitive to radiation. To locate these sensitive components a new method was developed, which consisted in successively irradiating selected components on the device chip with equal doses of electrons /10 to the 6th rad (Si)/, while the whole device was subjected to representative bias conditions. A suitable device parameter was measured in situ after each successive irradiation with the beam off.

  10. Shuttle active thermal control system development testing. Volume 5: Integrated radiator/expendable cooling system tests

    NASA Technical Reports Server (NTRS)

    Scheps, P. B.

    1974-01-01

    Tests were conducted to gather data on a space shuttle active control system (ATCS) incorporating both radiators and an expendable cooling device to provide vehicle heat removal. Two systems were tested and design information was provided for both nominal and limit conditions. The tests verified the concept that an integrated radiator/expendable cooling system can adequately maintain desired water quantities while responding to variations in heat loads and environments. In addition, the need for duct heating was demonstrated, while exhaust nozzle heating was also shown to be unnecessary.

  11. Efficient application of the spectrally integrated Voigt function to radiative transfer spectroscopy

    NASA Astrophysics Data System (ADS)

    Abrarov, Sanjar

    We present a new application of the spectrally integrated Voigt function (SIVF) to the radiative transfer spectroscopy that enables computation of the spectral radiance and radiance at reduced spectral resolution. Applying a technique based on the Fourier expansion of the exponential multiplier we obtain the series approximations providing high-accuracy and rapid SIVF computation. In contrast to traditional line-by-line (LBL) radiative transfer models, the proposed SIVF algorithm prevents underestimation in the absorption coefficients and, therefore, preserves the radiant energy. LBL sample computations utilizing SIVF algorithm show the advantages of the proposed methodology in terms of the accuracy and computational speed.

  12. Application of the spectrally integrated Voigt function to line-by-line radiative transfer modelling

    NASA Astrophysics Data System (ADS)

    Quine, B. M.; Abrarov, S. M.

    2013-09-01

    We show that a new approach based on the spectrally integrated Voigt function (SIVF) enables the computation of line-by-line (LBL) radiative transfer at reduced spectral resolution without loss of accuracy. The algorithm provides rapid and accurate computation of area under the Voigt function in a way that preserves spectral radiance and, consequently, radiant intensity. The error analysis we provide shows the high-accuracy of the proposed SIVF approximations. A comparison of the performance of the method with that of the traditional LBL approach is presented. Motivations for the use and advantage of the SIVF as a replacement for conventional line function computations in radiative transfer are discussed.

  13. An integrated approach to health services and manpower development: the experience of Poland.

    PubMed

    Kostrzewski, J

    1980-03-01

    After World War II, a new socio-economic policy stimulated development of industry and the socio-economic reconstruction of Poland. One of the main objectives of the new social policy was to develop the national health service so that it was available to the whole population. The most important decisions made for the health services and health manpower development in Poland were the following: 1945 -- Ministry of Health appointed as superior body responsible for organization and administration of national health services; 1951 -- Medical and Pharmaceutical Faculties become Medical Academies under the administration of the Minister of Health. Medical schools for nurses, midwives, sanitary instructors, and allied health personnel placed under supervision of the Ministry of Health; 1954 -- Sanitary epidemiological services organized and State Sanitary Inspection Act passed; 1956 -- Industrial health service organized; 1960 -- Minister of Health and Social Welfare appointed and charged with the administration of social welfare as well as rehabilitation and employment of invalids; 1971 -- Medical care and medical aid made available free of charge for the entire population, including the rural population previously not covered by health insurance system. In the years 1946--1960, a tendency towards vertical centralization prevailed in the organization and administration of the health services. Subsequently, decentralization has dominated, with a tendency to integrate health services with the social services, especially at the provincial and county levels and, more recently, in the form of the Integrated Health Service Institutions at the local level. PMID:10297735

  14. Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects

    PubMed Central

    Angus, Lynnell; Ewen, Shaun; Coombe, Leanne

    2016-01-01

    The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public health This approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH

  15. Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects.

    PubMed

    Angus, Lynnell; Ewen, Shaun; Coombe, Leanne

    2016-04-26

    The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public healthThis approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH

  16. INTEGRATION OF HUMAN HEALTH AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    The WHO International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency (USEPA) have developed a collaborative partnership to foster integration of assessment approaches to evaluate ...

  17. Complementary, Alternative, or Integrative Health: What's In a Name?

    MedlinePlus

    ... healthy behaviors. Integrative Approaches for Pain Management for Military Personnel and Veterans Chronic pain is a common problem among active-duty military personnel and veterans. NCCIH, the U.S. Department of Veterans ...

  18. 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

  19. Integrating Primary Care and Behavioral Health: A Nurse Practitioner’s Perspective

    PubMed Central

    Thai, Le; Saw, Anne

    2016-01-01

    Health equity for individuals with serious mental illness (SMI) requires collaborative partnerships between primary care and behavioral health organizations. This paper presents the experiences and perspectives of a nurse practitioner in a large-scale pilot program to integrate primary care and behavioral health between an FQHC and a community mental health center, both serving predominantly Asian immigrant populations. This paper discusses lessons learned through program implementation and provides insights on developing a truly integrated system involving equal and full cooperation across disciplines to provide quality and holistic care for patients with SMI. Implications for clinical practice and policy are discussed. PMID:26900384

  20. Progress in the development of integrated mental health care in Scotland.

    PubMed

    Woods, Kevin; McCollam, Allyson

    2002-01-01

    The development of integrated care through the promotion of 'partnership working' is a key policy objective of the Scottish Executive, the administration responsible for health services in Scotland. This paper considers the extent to which this goal is being achieved in mental health services, particularly those for people with severe and enduring mental illness. Distinguishing between the horizontal and vertical integration of services, exploratory research was conducted to assess progress towards this objective by examining how far a range of functional activities in Primary Care Trusts (PCTs) and their constituent Local Health Care Co-operatives (LHCCs) were themselves becoming increasingly integrated. All PCTs in Scotland were surveyed by postal questionnaire, and followed up by detailed telephone interviews. Six LHCC areas were selected for detailed case study analysis. A Reference Group was used to discuss and review emerging themes from the fieldwork. The report suggests that faster progress is being made in the horizontal integration of services between health and social care organisations than is the case for vertical integration between primary health care and specialist mental health care services; and that there are significant gaps in the extent to which functional activities within Trusts are changing to support the development of integrated care. A number of models are briefly considered, including the idea of 'intermediate care' that might speed the process of integration. PMID:16896397

  1. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant

    PubMed Central

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-01-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. PMID:25413928

  2. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant.

    PubMed

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-05-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. PMID:25413928

  3. Environment, safety, and health information technology systems integration.

    SciTech Connect

    Hendrickson, David A.; Bayer, Gregory W.

    2006-02-01

    The ES&H Information Systems department, motivated by the numerous isolated information technology systems under its control, undertook a significant integration effort. This effort was planned and executed over the course of several years and parts of it still continue today. The effect was to help move the ES&H Information Systems department toward integration with the corporate Information Solutions and Services center.

  4. Sustainability science: an integrated approach for health-programme planning.

    PubMed

    Gruen, Russell L; Elliott, Julian H; Nolan, Monica L; Lawton, Paul D; Parkhill, Anne; McLaren, Cameron J; Lavis, John N

    2008-11-01

    Planning for programme sustainability is a key contributor to health and development, especially in low-income and middle-income countries. A consensus evidence-based operational framework would facilitate policy and research advances in understanding, measuring, and improving programme sustainability. We did a systematic review of both conceptual frameworks and empirical studies about health-programme sustainability. On the basis of the review, we propose that sustainable health programmes are regarded as complex systems that encompass programmes, health problems targeted by programmes, and programmes' drivers or key stakeholders, all of which interact dynamically within any given context. We show the usefulness of this approach with case studies drawn from the authors' experience. PMID:18984192

  5. Integrating Health Information Technology to Achieve Seamless Care Transitions.

    PubMed

    Marcotte, Leah; Kirtane, Janhavi; Lynn, Joanne; McKethan, Aaron

    2015-12-01

    Improving care transitions, or "handoffs" as patients migrate from one care setting to another, is a priority across stakeholder groups and health-care settings and additionally is included in national health-care goals set forth in the National Quality Strategy. Although many demonstrations of improved care transitions have succeeded, particularly for hospital discharges, ensuring consistent, high-quality, and safe transitions of care remains challenging. This paper highlights the potential for health information technology to become an increasing part of effective transitional care interventions, with the potential to reduce the resource burden currently associated with effective care transitions, the ability to spread improved practices to larger numbers of patients and providers efficiently and at scale, and, as health technology interoperability increases, the potential to facilitate critical information flow and feedback loops to clinicians, patients, and caregivers across disparate information systems and care settings. PMID:24522208

  6. A systematic, integrated behavioral health response to disaster.

    PubMed

    Fojt, Diane F; Cohen, Martin D; Wagner, Janet

    2008-01-01

    The behavioral health aspects of disaster have not historically been addressed as a priority in emergency preparedness planning. The overwhelming evidence of significant to severe psychological consequences of disaster has remained in the shadows compared to the more widely televised dramatic physical destruction and trauma. However, the aftermath of September 11, as well as 2005's Hurricane Katrina and 2008's Hurricane Ike disasters reminded the country that the psychological footprint of disaster easily dwarfs the more visual physical footprint. Disaster behavioral health is now recognized as a major public health concern and a national issue that deserves a logical, systematic, proactive approach within the structure of the National Incident Management System (NIMS) and Incident Command Structure (ICS; Fojt, Cohen, Wagner 2008). With increased commitment, collaboration, and organization we can better utilize our qualified yet limited behavioral health resources, meeting the predictable needs of future disasters' survivors, communities, and responders. PMID:19112934

  7. An integrated health care standard for the management and prevention of obesity in The Netherlands.

    PubMed

    Seidell, J C; Halberstadt, J; Noordam, H; Niemer, S

    2012-04-01

    The Partnership Overweight Netherlands (PON) is a collaboration between 18 partners, which are national organizations of health care providers, health insurance companies and patient organizations. The PON published an integrated health care standard for obesity in November 2010. The integrated health care standard for obesity involves strategies for diagnosis and early detection of high-risk individuals as well as appropriate combined lifestyle interventions for those who are overweight and obese and, when appropriate, additional medical therapies. The PON works towards a standard that transcends traditional boundaries of conventional health care systems and health care professions but, instead, focuses on competences of groups of health professionals who organize care from a patient-oriented perspective. PMID:22399546

  8. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities.

    PubMed

    Mercuri, Mathew; Rehani, Madan M; Einstein, Andrew J

    2012-10-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency's Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray-based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the US, currently lags behind x-ray-based procedures with respect to reporting of radiation dosimetric information. This article discusses qualitative differences between nuclear medicine and x-ray-based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying, monitoring, and reporting strategies used in x-ray-based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists, and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  9. Murder by radiation poisoning: implications for public health.

    PubMed

    Miller, Charles W; Whitcomb, Robert C; Ansari, Armin; McCurley, Carol; Nemhauser, Jeffrey B; Jones, Robert

    2012-06-01

    On November 23, 2006, former Russian military intelligence officer Alexander Litvinenko died in a London hospital. Authorities determined he was deliberately poisoned with the radionuclide Polonium-210 (210Po). Police subsequently discovered that those involved in this crime had--apparently inadvertently--spread 210Po over many locations in London. The United Kingdom Health Protection Agency (HPA) contacted many persons who might have been exposed to 210Po and provided voluntary urine testing. Some of those identified as potentially exposed were U.S. citizens, whom the HPA requested that the Centers for Disease Control and Prevention (CDC) assist in contacting. CDC also provided health care professionals and state and local public health officials with guidance as to how they might respond should a Litvinenko-like incident occur in the U.S. This guidance has resulted in the identification of a number of lessons that can be useful to public health and medical authorities in planning for radiological incidents. Eight such lessons are discussed in this article. PMID:22708201

  10. A health examination system integrated with clinical decision support system.

    PubMed

    Kuo, Kuan-Liang; Fuh, Chiou-Shann

    2010-10-01

    Health examinations play a key role in preventive medicine. We propose a health examination system named Health Examination Automatic Logic System (HEALS) to assist clinical workers in improving the total quality of health examinations. Quality of automated inference is confirmed by the zero inference error where during 6 months and 14,773 cases. Automated inference time is less than one second per case in contrast to 2 to 5 min for physicians. The most significant result of efficiency evaluation is that 3,494 of 4,356 (80.2%) cases take less than 3 min per case for producing a report summary. In the evaluation of effectiveness, novice physicians got 18% improvement in making decisions with the assistance of our system. We conclude that a health examination system with a clinical decision system can greatly reduce the mundane burden on clinical workers and markedly improve the quality and efficiency of health examination tasks. PMID:20703626

  11. Radon in the Workplace: the Occupational Safety and Health Administration (OSHA) Ionizing Radiation Standard.

    PubMed

    Lewis, Robert K

    2016-10-01

    On 29 December 1970, the Occupational Safety and Health Act of 1970 established the Occupational Safety and Health Administration (OSHA). This article on OSHA, Title 29, Part 1910.1096 Ionizing Radiation standard was written to increase awareness of the employer, the workforce, state and federal governments, and those in the radon industry who perform radon testing and radon mitigation of the existence of these regulations, particularly the radon relevant aspect of the regulations. This review paper was also written to try to explain what can sometimes be complicated regulations. As the author works within the Radon Division of the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection, the exclusive focus of the article is on radon. The 1910.1096 standard obviously covers many other aspects of radiation and radiation safety in the work place. PMID:27575350

  12. Integrating Neglected Tropical Disease and Immunization Programs: The Experiences of the Tanzanian Ministry of Health

    PubMed Central

    Mwingira, Upendo John; Means, Arianna Rubin; Chikawe, Maria; Kilembe, Bernard; Lyimo, Dafrossa; Crowley, Kathryn; Rusibamayila, Neema; Nshala, Andreas; Mphuru, Alex

    2016-01-01

    Global health practitioners are increasingly advocating for the integration of community-based health-care platforms as a strategy for increasing the coverage of programs, encouraging program efficiency, and promoting universal health-care goals. To leverage the strengths of compatible programs and avoid geographic and temporal duplications in efforts, the Tanzanian Ministry of Health and Social Welfare coordinated immunization and neglected tropical disease programs for the first time in 2014. Specifically, a measles and rubella supplementary vaccine campaign, mass drug administration (MDA) of ivermectin and albendazole, and Vitamin A were provisionally integrated into a shared community-based delivery platform. Over 21 million people were targeted by the integrated campaign, with the immunization program and MDA program reaching 97% and 93% of targeted individuals, respectively. The purpose of this short report is to share the Tanzanian experience of launching and managing this integrated campaign with key stakeholders. PMID:27246449

  13. Vehicle Integrated Propulsion Research for the Study of Health Management Capabilities

    NASA Technical Reports Server (NTRS)

    Lekki, John D.; Simon, Donald L.; Hunter, Gary W.; Woike, Mary; Tokars, Roger P.

    2012-01-01

    Presentation on vehicle integrated propulsion research results and planning. This research emphasizes the testing of advanced health management sensors and diagnostics in an aircraft engine that is operated through multiple baseline and fault conditions.

  14. Integrating Neglected Tropical Disease and Immunization Programs: The Experiences of the Tanzanian Ministry of Health.

    PubMed

    Mwingira, Upendo John; Means, Arianna Rubin; Chikawe, Maria; Kilembe, Bernard; Lyimo, Dafrossa; Crowley, Kathryn; Rusibamayila, Neema; Nshala, Andreas; Mphuru, Alex

    2016-09-01

    Global health practitioners are increasingly advocating for the integration of community-based health-care platforms as a strategy for increasing the coverage of programs, encouraging program efficiency, and promoting universal health-care goals. To leverage the strengths of compatible programs and avoid geographic and temporal duplications in efforts, the Tanzanian Ministry of Health and Social Welfare coordinated immunization and neglected tropical disease programs for the first time in 2014. Specifically, a measles and rubella supplementary vaccine campaign, mass drug administration (MDA) of ivermectin and albendazole, and Vitamin A were provisionally integrated into a shared community-based delivery platform. Over 21 million people were targeted by the integrated campaign, with the immunization program and MDA program reaching 97% and 93% of targeted individuals, respectively. The purpose of this short report is to share the Tanzanian experience of launching and managing this integrated campaign with key stakeholders. PMID:27246449

  15. WATER QUALITY AND OYSTER HEALTH (CRASSOSTREA VIRGINICA): AN INTEGRATED APPROACH TO DETERMINING HABITAT RESTORATION POTENTIAL

    EPA Science Inventory

    Volety, Aswani K., S. Gregory Tolley and James T. Winstead. 2001. Water Quality and Oyster Health (Crassostrea virginica): An Integrated Approach to Determining Habitat Restoration Potential (Abstract). Presented at the 5th International Conference on Shellfish Restoration, 18-21...

  16. The Integrated Medical Model: A Decision Support Tool for In-flight Crew Health Care

    NASA Technical Reports Server (NTRS)

    Butler, Doug

    2009-01-01

    This viewgraph presentation reviews the development of an Integrated Medical Model (IMM) decision support tool for in-flight crew health care safety. Clinical methods, resources, and case scenarios are also addressed.

  17. A different approach to evaluating health effects from radiation exposure

    SciTech Connect

    Bond, V.P.; Sondhaus, C.A.; Feinendegen, L.E.

    1988-01-01

    Absorbed dose D is shown to be a composite variable, the product of the fraction of cells hit (I/sub H/) and the mean /open quotes/dose/close quotes/ (hit size) /ovr z/ to those cells. D is suitable for use with high level (HLE) to radiation and its resulting acute organ effects because, since I/sub H/ = 1.0, D approximates closely enough the mean energy density in the cell as well as in the organ. However, with low-level exposure (LLE) to radiation and its consequent probability of cancer induction from a single cell, stochastic delivery of energy to cells results in a wide distribution of hit sizes z, and the expected mean value, /ovr z/, is constant with exposure. Thus, with LLE, only I/sub H/ varies with D so that the apparent proportionality between /open quotes/dose/close quotes/ and the fraction of cells transformed is misleading. This proportionality therefore does not mean that any (cell) dose, no matter how small, can be lethal. Rather, it means that, in the exposure of a population of individual organisms consisting of the constituent relevant cells, there is a small probabililty of particle-cell interactions which transfer energy. The probability of a cell transforming and initiating a cancer can only be greater than zero if the hit size (/open quotes/dose of energy/close quotes/) to the cell is large enough. Otherwise stated, if the /open quotes/dose/close quotes/ is defined at the proper level of biological organization, namely, the cell and not the organ, only a large dose z to that cell is effective. The above precepts are utilized to develop a drastically different approach to evaluation oif risk from LLE, that holds promise of obviating any requirement for the components of the present system: absorbed organ dose, LET, a standard radiation, REB(Q), dose equivalent and rem. 12 refs., 11 figs.

  18. Choosing populations to study the health effects of low-dose ionizing radiation.

    PubMed Central

    Dreyer, N A; Loughlin, J E; Friedlander, E R; Clapp, R W; Fahey, F H

    1981-01-01

    In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public. PMID:7294269

  19. Level of radiation dose in university hospital noninsured private health screening programs in Korea

    PubMed Central

    2016-01-01

    Objectives The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. Methods Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. Results Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography–computed tomography was the most critical factor in determining the level of effective dose. Conclusions It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure. PMID:27032387

  20. Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

    PubMed

    Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

    1999-08-01

    Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed. PMID:10539425

  1. [Regional integration, population health needs, and human resources for health systems and services: an approach to the concept of health care gap].

    PubMed

    Schweiger, Arturo Luis Francisco; Alvarez, Daniela Teresita

    2007-01-01

    The existence of gaps between the population's health needs and the human resources available for meeting them, as well as limitations in the methods to estimate such needs, constitute key factors to be tackled in the development and integration of health systems in Latin America. This aim of this study was to conduct an initial literature review on the tools and procedures used to estimate and plan human resources allocation in health and to use this review as the basis for identifying the advantages, limitations, and complementary characteristics of these tools, subsequently proposing the need for more in-depth studies on their applicability for designing regional health policies. The article then presents the concept of global public health goods, the generation and use of which results in a strategic alternative for improving both health systems integration in the region and quality of life for the population covered by such services. PMID:17625647

  2. Mobile phone health risk policy in Germany: the role of the federal government and the Federal Office for Radiation Protection.

    PubMed

    Schweikardt, Christoph; Gross, Dominik

    2012-01-01

    In order to establish a regulatory framework for a given technology important to society, the government must make decisions in the face of existing unknowingness. In the last decade, health risks originating from electromagnetic fields of mobile telecommunication transmitting stations and devices have become a regulation policy issue in Germany. This article investigates the role of the government and the Federal Office for Radiation Protection in regard to policy-making by analysing publications and Federal Parliament reports, hearings and debates. The government and Federal Parliament perceived the research situation in 2001 as insufficient in the absence of hard evidence for health impairment. Against this background, the government struck a compromise with mobile telecommunication network operators, who did not want to integrate stricter limit values for transmission stations as precautionary measures. The network operators' voluntary self-commitment included financing half the budget of the German Mobile Telecommunication Research Programme (2002-2008) under the lead management of the Federal Office for Radiation Protection, which concluded that it was not required to change the position taken in 2001. The results of this programme provided the basis to continue the agreement of that year. With regard to health issues and all the other interests involved, this agreement was an acceptable and remarkably stable compromise. PMID:21923562

  3. Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

    PubMed

    Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

    2016-03-01

    Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. PMID:26169927

  4. Toward an Integrated Public Health Approach for Epilepsy in the 21st Century

    PubMed Central

    Kobau, Rosemarie; Whittemore, Vicky H.; Mann, Marie Y.; Johnson, Jennifer G.; Hutter, Joseph D.; Jones, Wanda K.

    2014-01-01

    Epilepsy, a complex spectrum of disorders, merits enhanced public health action. In 2012, the Institute of Medicine (IOM) released a seminal report on the public health dimensions of the epilepsies, recommending actions in 7 domains. The report urged a more integrated and coordinated national approach for care centering on the whole patient, including heightened attention to comorbidities and quality of life; more timely referral and access to treatments; and improved community resources, education, stakeholder collaboration, and public communication. The US Department of Health and Human Services responded to this report by accelerating and integrating ongoing initiatives and beginning new ones. This article summarizes recent federally supported activities promoting an integrated public health approach for epilepsy, highlighting progress in response to the landmark 2012 IOM report and identifying opportunities for continued public health action. PMID:25167091

  5. Combined exposure to simulated microgravity and acute or chronic radiation reduces neuronal network integrity and cell survival

    NASA Astrophysics Data System (ADS)

    Benotmane, Rafi

    During orbital or interplanetary space flights, astronauts are exposed to cosmic radiations and microgravity. This study aimed at assessing the effect of these combined conditions on neuronal network density, cell morphology and survival, using well-connected mouse cortical neuron cultures. To this end, neurons were exposed to acute low and high doses of low LET (X-rays) radiation or to chronic low dose-rate of high LET neutron irradiation (Californium-252), under the simulated microgravity generated by the Random Positioning Machine (RPM, Dutch space). High content image analysis of cortical neurons positive for the neuronal marker βIII-tubulin unveiled a reduced neuronal network integrity and connectivity, and an altered cell morphology after exposure to acute/chronic radiation or to simulated microgravity. Additionally, in both conditions, a defect in DNA-repair efficiency was revealed by an increased number of γH2AX-positive foci, as well as an increased number of Annexin V-positive apoptotic neurons. Of interest, when combining both simulated space conditions, we noted a synergistic effect on neuronal network density, neuronal morphology, cell survival and DNA repair. Furthermore, these observations are in agreement with preliminary gene expression data, revealing modulations in cytoskeletal and apoptosis-related genes after exposure to simulated microgravity. In conclusion, the observed in vitro changes in neuronal network integrity and cell survival induced by space simulated conditions provide us with mechanistic understanding to evaluate health risks and the development of countermeasures to prevent neurological disorders in astronauts over long-term space travels. Acknowledgements: This work is supported partly by the EU-FP7 projects CEREBRAD (n° 295552)

  6. Impact of late radiation effects on cancer survivor children: an integrative review

    PubMed Central

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-01-01

    ABSTRACT We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: “neoplasias/neoplasms” AND “radioterapia/radiotherapy” AND “radiação/radiation”. After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: “Late endocrine effects” and “Late non-endocrine effects”. Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses. PMID:26313432

  7. Radiation exposure assessment for portsmouth naval shipyard health studies.

    PubMed

    Daniels, R D; Taulbee, T D; Chen, P

    2004-01-01

    Occupational radiation exposures of 13,475 civilian nuclear shipyard workers were investigated as part of a retrospective mortality study. Estimates of annual, cumulative and collective doses were tabulated for future dose-response analysis. Record sets were assembled and amended through range checks, examination of distributions and inspection. Methods were developed to adjust for administrative overestimates and dose from previous employment. Uncertainties from doses below the recording threshold were estimated. Low-dose protracted radiation exposures from submarine overhaul and repair predominated. Cumulative doses are best approximated by a hybrid log-normal distribution with arithmetic mean and median values of 20.59 and 3.24 mSv, respectively. The distribution is highly skewed with more than half the workers having cumulative doses <10 mSv and >95% having doses <100 mSv. The maximum cumulative dose is estimated at 649.39 mSv from 15 person-years of exposure. The collective dose was 277.42 person-Sv with 96.8% attributed to employment at Portsmouth Naval Shipyard. PMID:15266069

  8. [More Health in Urban Districts: The Integration of Health Promotion in Urban Development].

    PubMed

    Reimann, B; Böhme, C

    2015-09-01

    Poverty represents a considerable health risk. As social- and health-related disadvantages are spatially concentrated, municipalities must take up the task of forging a stronger link between urban district development and health promotion than has thus far been the case. Moreover, they must put health promotion as part of urban district development as an item on the agenda. The present contribution illustrates in which ways health promotion in disadvantaged urban districts and its scientific monitoring and evaluation can be successful. PMID:23757098

  9. Nuclear Energy and Health: And the Benefits of Low-Dose Radiation Hormesis

    PubMed Central

    Cuttler, Jerry M.; Pollycove, Myron

    2009-01-01

    Energy needs worldwide are expected to increase for the foreseeable future, but fuel supplies are limited. Nuclear reactors could supply much of the energy demand in a safe, sustainable manner were it not for fear of potential releases of radioactivity. Such releases would likely deliver a low dose or dose rate of radiation, within the range of naturally occurring radiation, to which life is already accustomed. The key areas of concern are discussed. Studies of actual health effects, especially thyroid cancers, following exposures are assessed. Radiation hormesis is explained, pointing out that beneficial effects are expected following a low dose or dose rate because protective responses against stresses are stimulated. The notions that no amount of radiation is small enough to be harmless and that a nuclear accident could kill hundreds of thousands are challenged in light of experience: more than a century with radiation and six decades with reactors. If nuclear energy is to play a significant role in meeting future needs, regulatory authorities must examine the scientific evidence and communicate the real health effects of nuclear radiation. Negative images and implications of health risks derived by unscientific extrapolations of harmful effects of high doses must be dispelled. PMID:19343116

  10. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

    PubMed Central

    2014-01-01

    Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion

  11. A management system integrating radiation protection and safety supporting safety culture in the hospital.

    PubMed

    Almén, A; Lundh, C

    2015-04-01

    Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system. The main experience from developing a management system is that it is possible to create a vast number of common policies and routines for the whole hospital, resulting in a cost-efficient system. One of the key benefits is the involvement of management at all levels, including the hospital director. Furthermore, a transparent system will involve staff throughout the organisation as well. A management system supports a common view on what should be done, who should do it and how the activities are reviewed. An integrated management system for radiation protection and safety includes key elements supporting a safety culture. PMID:25429027

  12. Radiation induced currents in MRI RF coils: application to linac/MRI integration

    PubMed Central

    Burke, B; Fallone, B G; Rathee, S

    2010-01-01

    The integration of medical linear accelerators (linac) with magnetic resonance imaging (MRI) systems is advancing the current state of image-guided radiotherapy. The MRI in these integrated units will provide real-time, accurate tumor locations for radiotherapy treatment, thus decreasing geometric margins around tumors and reducing normal tissue damage. In the real-time operation of these integrated systems, the radiofrequency (RF) coils of MRI will be irradiated with radiation pulses from the linac. The effect of pulsed radiation on MRI radio frequency (RF) coils is not known and must be studied. The instantaneous radiation induced current (RIC) in two different MRI RF coils were measured and presented. The frequency spectra of the induced currents were calculated. Some basic characterization of the RIC was also done: isolation of the RF coil component responsible for RIC, dependence of RIC on dose rate, and effect of wax buildup placed on coil on RIC. Both the time and frequency characteristics of the RIC were seen to vary with the MRI RF coil used. The copper windings of the RF coils were isolated as the main source of RIC. A linear dependence on dose rate was seen. The RIC was decreased with wax buildup, suggesting an electronic disequilibrium as the cause of RIC. This study shows a measurable RIC present in MRI RF coils. This unwanted current could be possibly detrimental to the signal to noise ratio in MRI and produce image artifacts. PMID:20071754

  13. Integrated Cloud-Aerosol-Radiation Product using CERES, MODIS, CALIPSO and CloudSat Data

    NASA Technical Reports Server (NTRS)

    Sun-Mack, Sunny; Minnis, Patrick; Chen, Yan; Gibson, Sharon; Yi, Yuhong; Trepte, Qing; Wielicki, Bruce; Kato, Seiji; Winker, Dave

    2007-01-01

    This paper documents the development of the first integrated data set of global vertical profiles of clouds, aerosols, and radiation using the combined NASA A-Train data from the Aqua Clouds and Earth's Radiant Energy System (CERES) and Moderate Resolution Imaging Spectroradiometer (MODIS), Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO), and CloudSat. As part of this effort, cloud data from the CALIPSO lidar and the CloudSat radar are merged with the integrated column cloud properties from the CERES-MODIS analyses. The active and passive datasets are compared to determine commonalities and differences in order to facilitate the development of a 3- dimensional cloud and aerosol dataset that will then be integrated into the CERES broadband radiance footprint. Preliminary results from the comparisons for April 2007 reveal that the CERES-MODIS global cloud amounts are, on average, 0.14 less and 0.15 greater than those from CALIPSO and CloudSat, respectively. These new data will provide unprecedented ability to test and improve global cloud and aerosol models, to investigate aerosol direct and indirect radiative forcing, and to validate the accuracy of global aerosol, cloud, and radiation data sets especially in polar regions and for multi-layered cloud conditions.

  14. Thermal management in MoS2 based integrated device using near-field radiation

    NASA Astrophysics Data System (ADS)

    Peng, Jiebin; Zhang, Gang; Li, Baowen

    2015-09-01

    Recently, wafer-scale growth of monolayer MoS2 films with spatial homogeneity is realized on SiO2 substrate. Together with the latest reported high mobility, MoS2 based integrated electronic devices are expected to be fabricated in the near future. Owing to the low lattice thermal conductivity in monolayer MoS2, and the increased transistor density accompanied with the increased power density, heat dissipation will become a crucial issue for these integrated devices. In this letter, using the formalism of fluctuation electrodynamics, we explored the near-field radiative heat transfer from a monolayer MoS2 to graphene. We demonstrate that in resonance, the maximum heat transfer via near-field radiation between MoS2 and graphene can be ten times higher than the in-plane lattice thermal conduction for MoS2 sheet. Therefore, an efficient thermal management strategy for MoS2 integrated device is proposed: Graphene sheet is brought into close proximity, 10-20 nm from MoS2 device; heat energy transfer from MoS2 to graphene via near-field radiation; this amount of heat energy then be conducted to contact due to ultra-high lattice thermal conductivity of graphene. Our work sheds light for developing cooling strategy for nano devices constructing with low thermal conductivity materials.

  15. Thermal management in MoS{sub 2} based integrated device using near-field radiation

    SciTech Connect

    Peng, Jiebin; Zhang, Gang; Li, Baowen

    2015-09-28

    Recently, wafer-scale growth of monolayer MoS{sub 2} films with spatial homogeneity is realized on SiO{sub 2} substrate. Together with the latest reported high mobility, MoS{sub 2} based integrated electronic devices are expected to be fabricated in the near future. Owing to the low lattice thermal conductivity in monolayer MoS{sub 2}, and the increased transistor density accompanied with the increased power density, heat dissipation will become a crucial issue for these integrated devices. In this letter, using the formalism of fluctuation electrodynamics, we explored the near-field radiative heat transfer from a monolayer MoS{sub 2} to graphene. We demonstrate that in resonance, the maximum heat transfer via near-field radiation between MoS{sub 2} and graphene can be ten times higher than the in-plane lattice thermal conduction for MoS{sub 2} sheet. Therefore, an efficient thermal management strategy for MoS{sub 2} integrated device is proposed: Graphene sheet is brought into close proximity, 10–20 nm from MoS{sub 2} device; heat energy transfer from MoS{sub 2} to graphene via near-field radiation; this amount of heat energy then be conducted to contact due to ultra-high lattice thermal conductivity of graphene. Our work sheds light for developing cooling strategy for nano devices constructing with low thermal conductivity materials.

  16. Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region

    PubMed Central

    Fluet, Norman R.; Reis, Michael D.; Stern, Charles H.; Thompson, Alexander W.; Jolly, Gillian A.

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process. PMID:27034543

  17. Integrated Knowledge Translation in Mental Health: Family Help as an Example

    PubMed Central

    McGrath, Patrick J.; Lingley-Pottie, Patricia; Emberly, Debbie Johnson; Thurston, Cathy; McLean, Cathy

    2009-01-01

    Objective To describe and provide an example of integrated knowledge translation. Methods We review the elements of integrated knowledge translation and describe the Family Help Program, a distance treatment program for child mental health as an example of integrated knowledge translation. Results Family Help, a distance treatment program for child mental health, was developed with a grant from the Canadian Institutes of Health Research (CIHR). One of the requirements of the grant was involvement of community partners. This partnership resulted in a form of integrated knowledge translation (KT). To be successful, integrated KT requires the engagement of all partners and maintenance of mutual respect. The grant met its objectives and several distance treatments for child mental health were developed and evaluated. Integrated KT was effective in supporting the transfer of this research project into clinical practice and Family Help is now employed in several collaborating health districts. Conclusion Integrated KT in the early phases of research has significant advantages when the purpose is inclusion of key stakeholders’ (e.g. decision makers and consumers) knowledge to yield an effective product and facilitate uptake into clinical practice. PMID:19270846

  18. Health effects in women exposed to low levels of ionizing radiation

    SciTech Connect

    Fabrikant, J.I.

    1982-06-01

    There are three delayed health effects of radiation which appear at the present time to have importance to women in radiation protection. These are: (1) the probability of cancer-induction at low doses and low-dose rates; (2) the consideration of those cancers in women, notably the breast and the thyroid, attributable to radiation exposure; and (3) the probability of induction of developmental abnormalities in the newborn following low-dose exposure in utero. The bases for the concern over these effects are discussed. (ACR)

  19. [General practitioners: practices and integration of mental health care in Québec].

    PubMed

    Imboua, Armelle; Fleury, Marie-Josée

    2009-01-01

    This article examines the socio-demographic profile of general practitioners (GPs), their role in the management of (transient/moderate, severe/chronic) mental health disorders in different areas (urban, semi-urban, and rural) of Quebec as well as if their clinical practice and collaboration are oriented towards integration of mental health services. This crosswise study is based on 398 GPs representative of all Quebec GPs who answered a questionnaire. The study shows that GPs play a central role in mental health. According to territories, they have different socio-demographic and practice profiles. The types of territory and the degree of severity of mental health illnesses influence the propensity of GPs to integrate mental health care. Finally, GPs practiced mostly in silo, but they support greater integration of mental health services. The authors conclude that to improve mental health services integration, more proactive incentives should be favoured by political elites, adapted to the severity of the case and environments (urban, semi-urban or rural). However, the shortage of resources that is particularly striking in rural areas as well as inadequate mechanisms for clinical decision, reduce inter-relations and seriously limit the integration of healthcare. PMID:19475194

  20. Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care

    PubMed Central

    Detmer, Don; Bloomrosen, Meryl; Raymond, Brian; Tang, Paul

    2008-01-01

    Background Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable. Discussion While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders. Summary Integrated PHRs promote active, ongoing

  1. The Cleveland Health Network: a new integrated delivery system.

    PubMed

    Roman, L K

    1997-01-01

    CHN and its subsidiary CHN MCO have significantly impacted the Cleveland market place in the two years since their inception. CHN will continue to expand geographically with hospital and physician partners who are committed to providing quality care in the most cost-effective manner. Medical management will continue to be the central focus and over-riding success of the CHN MCO, making this organization extremely attractive to the payer market. The integrated CHN and its medical management focus could become a model for other integrated delivery systems. As the market place continues to experience an increase in managed care and more consolidation of healthcare providers (and in some cases, mergers with payers), more integrated delivery systems will emerge. Senior- and mid-level administrators and managers with operational responsibilities need to take into consideration how their patient access systems will need to be modified to meet the demands of managed care through the formation of integrated delivery systems. How patients access the systems is of critical importance in ensuring financial success, ease of access for the patient, and tracking of appropriate medical care. PMID:10166776

  2. Examining Acceptance of an Integrated Personal Health Record (PHR)

    ERIC Educational Resources Information Center

    Morton, Alicia A.

    2011-01-01

    Objective: The purpose of this project was to examine the practice question, "What are the factors influencing acceptance of integrated PHRs for self-care management among the Howard University Hospital (HUH) Diabetes Treatment Clinic (DTC) patients?" These factors include a) demographic characteristics, b) computer access/use/experience,…

  3. Adapting needs assessment methodologies to build integrated health pathways for people in the criminal justice system.

    PubMed

    de Viggiani, N

    2012-09-01

    Criminal justice health services should be underpinned with good public health evidence about the population's health needs. Health needs assessment methodologies can provide valuable intelligence for commissioners to evaluate the quality of services and innovate according to need. However, health needs assessment can be limited if it takes a conventional epidemiological approach, focussing on individuals' healthcare needs in criminal justice settings. Techniques used to measure health and social need could be more widely applied and appropriately employed in the planning of health and social care services, especially if the intention is to be effective in reducing social exclusion and tackling health inequalities. Assessment tools are available that capture individual, social and environmental risk factors and determinants predisposing people to health and criminogenic risks. Good evidence gathering can mean that public health practitioners not only improve health, reduce inequalities and tackle social exclusion, but contribute to reducing re-offending. This paper suggests a new approach to assessment that integrates the full range of assessment methodologies available to practitioners. An integrated approach may be the way to enhance and enrich the public health function in providing evidence to improve the quality of local public services. PMID:22770740

  4. The Boston Safe Shops model: an integrated approach to community environmental and occupational health.

    PubMed

    Roelofs, Cora; Shoemaker, Paul; Skogstrom, Tiffany; Acevedo, Persio; Kendrick, Jumaane; Nguyen, Nancie

    2010-04-01

    Small, immigrant-owned businesses, such as auto repair shops and nail salons, often face barriers to environmental and occupational health compliance and may be a source of neighborhood pollution complaints. The Boston Public Health Commission established the Safe Shops Project to improve safety and environmental practices in such businesses using a community partnership model that incorporates enforcement inspection findings, worker training, technical assistance, and referral to health care and business resources. This integrated technical assistance approach has led to improved occupational health and environmental conditions, adoption of pollution prevention technologies, novel problem-solving, and dozens of health screenings and insurance referrals for workers and their neighbors. PMID:20147670

  5. Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides - Health Criteria

    EPA Science Inventory

    EPA has announced a draft development plan for the next Integrated Science Assessment (ISA) for the health effects of nitrogen oxides (NOX) which will serve as the scientific basis for review of the primary (health-based) National Ambient Air Quality Standard for nitrogen dioxide...

  6. Integrating Health and Sustainability: The Higher Education Sector as a Timely Catalyst

    ERIC Educational Resources Information Center

    Orme, J.; Dooris, M.

    2010-01-01

    Higher education is an influential sector with enormous potential to impact positively on health and sustainability. The purpose of this paper was to explore its emergent role as a key setting for promoting health and sustainability and for addressing their challenges in an integrated and coherent way. Acknowledging both the relative narrowness of…

  7. Creating an Early Childhood Mental Health System: A Success Story Focused on Community and Integration

    ERIC Educational Resources Information Center

    Walker, Pamela

    2006-01-01

    This article describes how a rural community in Colorado developed the infrastructure to provide a family-centered, culturally competent array of early childhood mental health services that are integrated into existing community-based programs. The Early Childhood Health/Education Outreach (ECHO) and Family Center Early Childhood Council's…

  8. Educating Masters of Public Health Students on Tobacco Control and Prevention: An Integrated Curriculum Approach

    ERIC Educational Resources Information Center

    Lowe, John; Aquilino, Mary; Abramsohn, Erin

    2007-01-01

    Objectives: Comprehensive training in the area of tobacco control and prevention has not been available to public health students receiving professional degrees. This study describes findings of a project designed to develop and evaluate an integrated approach to the education of Masters of Public Health (MPH) students at the University of Iowa…

  9. Integrity in Health Care Institutions. Humane Environments for Teaching, Inquiry, and Healing.

    ERIC Educational Resources Information Center

    Bulger, Ruth Ellen, Ed.; Reiser, Stanley Joel, Ed.

    This book of essays focuses on the diminution of trust resulting from a perceived diminution in individual and institutional integrity as they relate to our university-based health educational and care programs. Following an introduction titled "Covenant, Leadership, and Value Formation in Academic Health Centers" (Roger J. Bulger), the first…

  10. Internet Continuing Education for Health Care Professionals: An Integrative Review

    ERIC Educational Resources Information Center

    Cobb, Susan Copley

    2004-01-01

    Introduction: The objective was to review key articles and research studies on practices, preferences, and evaluation of on-line continuing education used by health care professionals. Methods: Data sources included searches of the "MEDLINE," "CINAHL," and "ERIC" databases (January 1990 to June 2004) and manual searches of the "Journal of…

  11. The low risk and high return of integrative health services.

    PubMed

    Russo, Ruthann; Diener, Ian; Stitcher, Michael

    2015-11-01

    Supplemental treatments and practices such as yoga, acupuncture, guided imagery, and meditation can benefit not only patients in their recovery but also hospitals and health systems financially and operationally. Benefits include: > Savings in sedation costs for patients who use guided imagery during procedures > Increased revenue due to measurably increased patient satisfaction > Decreased length of stay. PMID:26685445

  12. Michigan health system launches integrated campaign using patient testimonials.

    PubMed

    2006-01-01

    Spectrum Health System in Michigan recently launched The Right Decision campaign, which totes the system's heart center and cancer facilities. The effort is underway with aggressive print ads, television and radio spots, and Web site promotion. The 1,000-bed, acute-care system hopes to raise awareness of the heart and cancer centers through real-life patient testimonials. PMID:16813347

  13. Social Factors in Creating an Integrated Capability for Health System Modeling and Simulation

    NASA Astrophysics Data System (ADS)

    Maglio, Paul P.; Cefkin, Melissa; Haas, Peter J.; Selinger, Pat

    The health system is a complex system of systems - changes in agriculture, transportation, economics, family life, medical practices, and many other things can have a profound influence on health and health costs. Yet today, policy-level investment decisions are frequently made by modeling individual systems in isolation. We describe two sets of issues that we face in trying to develop a platform, method, and service for integrating expert models from different domains to support health policy and investment decisions. The first set of questions concerns how to develop accurate social and behavioral health models and integrate them with engineering models of transportation, clinic operations, and so forth. The second set of questions concerns the design of an environment that will encourage and facilitate collaboration between the health modelers themselves, who come from a wide variety of disciplines.

  14. [Radiation-related health effects of major nuclear events].

    PubMed

    Orgiazzi, Jacques

    2015-01-01

    Three major nuclear events, the Hirosima and Nagasaki bombings and the Chernobyl and Fukushima catastrophes, have been selected to Illustrate the health consequences, observed or anticipated, of irradation of populations. Differences in doses and modalities of irradiation, with the combination of clinical epidemiology and dose estimates, recently revisited, allow for more accurate dose-effect relationship models of the risks. However, extrapolation to the low-doses (< 0.1 Gy) or very low-doses of these models obtained with doses ≥ 0.2 Gy remains hazardous. PMID:25842445

  15. Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

    PubMed

    Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

    2011-11-01

    In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development. PMID:22262276

  16. Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

    PubMed

    Ellis, Horace; Alexander, Vinette

    2016-06-01

    There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in

  17. EMAS position statement: The ten point guide to the integral management of menopausal health.

    PubMed

    Neves-E-Castro, Manuel; Birkhauser, Martin; Samsioe, Goran; Lambrinoudaki, Irene; Palacios, Santiago; Borrego, Rafael Sanchez; Llaneza, Placido; Ceausu, Iuliana; Depypere, Herman; Erel, C Tamer; Pérez-López, Faustino R; Schenck-Gustafsson, Karin; van der Schouw, Yvonne T; Simoncini, Tommaso; Tremollieres, Florence; Rees, Margaret

    2015-05-01

    With increased longevity and more women becoming centenarians, management of the menopause and postreproductive health is of growing importance as it has the potential to help promote health over several decades. Women have individual needs and the approach needs to be personalised. The position statement provides a short integral guide for all those involved in menopausal health. It covers diagnosis, screening for diseases in later life, treatment and follow-up. PMID:25757366

  18. An integrated circuit/microsystem/nano-enhanced four species radiation sensor for inexpensive fissionable material detection

    NASA Astrophysics Data System (ADS)

    Waguespack, Randy Paul

    2011-12-01

    Small scale radiation detectors sensitive to alpha, beta, electromagnetic, neutron radiation are needed to combat the threat of nuclear terrorism and maintain national security. There are many types of radiation detectors on the market, and the type of detector chosen is usually determined by the type of particle to be detected. In the case of fissionable material, an ideal detector needs to detect all four types of radiation, which is not the focus of many detectors. For fissionable materials, the two main types of radiation that must be detected are gamma rays and neutrons. Our detector uses a glass or quartz scintillator doped with 10B nanoparticles to detect all four types of radiation particles. Boron-10 has a thermal neutron cross section of 3,840 barns. The interaction between the neutron and boron results in a secondary charge particle in the form of an alpha particle to be emitted, which is detectable by the scintillator. Radiation impinging on the scintillator matrix produces varying optical pulses dependent on the energy of the particles. The optical pulses are then detected by a photomultiplier (PM) tube, creating a current proportional to the energy of the particle. Current pulses from the PM tube are differentiated by on-chip pulse height spectroscopy, allowing for source discrimination. The pulse height circuitry has been fabricated with discrete circuits and designed into an integrated circuit package. The ability to replace traditional PM tubes with a smaller, less expensive photomultiplier will further reduce the size of the device and enhance the cost effectiveness and portability of the detector.

  19. Facilitating Virtual Health Management Using Medical Device Integration.

    PubMed

    Zaleski, John R

    2015-01-01

    Data from connected medical devices (CMDS) provides an objective and rich source of information to augment patient care management and clinical decision making. A principal reason is measurements of patient properties made through bedside CMDs are not typically subject to errors associated with misinterpretation, incorrect recording, and incorrect time stamping. Furthermore, data from CMDs can be collected regularly, ensuring a dense and robust data record on a given patient. The ability to remotely manage and monitor patients is greatly facilitated by access to data, as measurements represent an objective source of information that facilitate clinical decision making. In my recent book, Connected Medical Devices: Integrating Patient Care Data in Healthcare System, I discuss the topic of medical device integration (MDI) in relation to implementing CMDs in healthcare settings as a guide to assist hospitals in this undertaking. The following discussion about MDI are the opening paragraphs from this text, followed by a discussion of MDI architectures. PMID:26571635

  20. Achieving revenue integrity in hospitals and health systems.

    PubMed

    Schoen, Marianne; Najera, Michael

    2012-09-01

    The Bellevue Hospital sought to improve its performance in three areas-days in accounts receivable (A/R), denials, and charge capture-to enhance revenue integrity. Results included the following: A 30-percent reduction in days in A/R. A nearly 200 percent increase in bad debt collections. A more than $1.6 million reduction in denials write-offs. An improvement in net revenue of more than $1 million. PMID:22978037