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Sample records for acceptable health risk

  1. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults

    PubMed Central

    Yang, Chih-Hsiang; Maher, Jaclyn P.; Conroy, David E.

    2015-01-01

    Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October–November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction. PMID:26844135

  2. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults.

    PubMed

    Yang, Chih-Hsiang; Maher, Jaclyn P; Conroy, David E

    2015-01-01

    Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October-November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction. PMID:26844135

  3. Approaches to acceptable risk

    SciTech Connect

    Whipple, C.

    1997-04-30

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.

  4. Acceptability of human risk.

    PubMed Central

    Kasperson, R E

    1983-01-01

    This paper has three objectives: to explore the nature of the problem implicit in the term "risk acceptability," to examine the possible contributions of scientific information to risk standard-setting, and to argue that societal response is best guided by considerations of process rather than formal methods of analysis. Most technological risks are not accepted but are imposed. There is also little reason to expect consensus among individuals on their tolerance of risk. Moreover, debates about risk levels are often at base debates over the adequacy of the institutions which manage the risks. Scientific information can contribute three broad types of analyses to risk-setting deliberations: contextual analysis, equity assessment, and public preference analysis. More effective risk-setting decisions will involve attention to the process used, particularly in regard to the requirements of procedural justice and democratic responsibility. PMID:6418541

  5. PCB contaminated dust on indoor surfaces--health risks and acceptable surface concentrations in residential and occupational settings.

    PubMed

    Kuusisto, Sari; Lindroos, Outi; Rantio, Tiina; Priha, Eero; Tuhkanen, Tuula

    2007-04-01

    Polychlorinated biphenyls (PCBs) have been used in diverse purposes such as indoor paints. Removal of these paints with dust creating techniques, like sandblasting, will result in contamination of building surfaces with PCB-containing dust. Objectives of this study was to analyze the PCB concentrations on surfaces after sandblasting with silica using wipe samples and estimate the resulting health risks and further calculate the risk based acceptable PCB surface concentrations that do not cause incremental lifetime cancer risk higher that 10(-5) or does not cause immunosupression effects in residential use or in occupational settings. Both deterministic and probabilistic approaches were used. The total PCB concentrations on surfaces ranged from 10 to 1100 microg/m(2). Estimated cancer risk was 1.2 x 10(-4) for childhood exposure, 1.3 x 10(-5) for adult residents and 1.5 x 10(-5) for occupational exposure. Probabilistic risk assessment revealed that point estimates were quite reasonable and located between 45th and 79th percentiles on probabilistic distribution of risk. The noncancer risks were calculated as hazard quotients (HQ) which ranged from 3.3 to 35 depending on the exposure scenario. Acceptable surface concentrations based on noncancer effects that are protective for 95% of exposed population were 7 microg/m(2) for residential use, 65 microg/m(2) for residential use if only adults will be exposed and 140 microg/m(2) for occupational use. Preliminary cleanup experiment revealed that when contaminated dust was carefully removed with industrial vacuum cleaner and further washed with terpene containing liquid the surface concentration dropped below the acceptable levels calculated in this study. PMID:17166563

  6. Risk comparisons, conflict, and risk acceptability claims.

    PubMed

    Johnson, Branden B

    2004-02-01

    Despite many claims for and against the use of risk comparisons in risk communication, few empirical studies have explored their effect. Even fewer have examined the public's relative preferences among different kinds of risk comparisons. Two studies, published in this journal in 1990 and 2003, used seven measures of "acceptability" to examine public reaction to 14 examples of risk comparisons, as used by a hypothetical factory manager to explain risks of his ethylene oxide plant. This study examined the effect on preferences of scenarios involving low or high conflict between the factory manager and residents of the hypothetical town (as had the 2003 study), and inclusion of a claim that the comparison demonstrated the risks' acceptability. It also tested the Finucane et al. (2000) affect hypothesis that information emphasizing low risks-as in these risk comparisons-would raise benefits estimates without changing risk estimates. Using similar but revised scenarios, risk comparison examples (10 instead of 14), and evaluation measures, an opportunity sample of 303 New Jersey residents rated the comparisons, and the risks and benefits of the factory. On average, all comparisons received positive ratings on all evaluation measures in all conditions. Direct and indirect measures showed that the conflict manipulation worked; overall, No-Conflict and Conflict scenarios evoked scores that were not significantly different. The attachment to each risk comparison of a risk acceptability claim ("So our factory's risks should be acceptable to you.") did not worsen ratings relative to conditions lacking this claim. Readers who did or did not see this claim were equally likely to infer an attempt to persuade them to accept the risk from the comparison. As in the 2003 article, there was great individual variability in inferred rankings of the risk comparisons. However, exposure to the risk comparisons did not reduce risk estimates significantly (while raising benefit estimates

  7. Risk: assessment, acceptability and management

    SciTech Connect

    Not Available

    1981-01-01

    Risk assessment, particularly of risks to the public health resulting from government and industry decisions, is discussed. Cost/benefit analysis as applied to such situations as human deaths and the contracting of cancer by humans is discussed. The role of government regulations and standards is discussed.

  8. Can mHealth Improve Risk Assessment in Underserved Populations? Acceptability of a Breast Health Questionnaire App in Ethnically Diverse, Older, Low-Income Women

    PubMed Central

    Bravo, Carolina; O’Donoghue, Cristina; Kaplan, Celia P.; Luce, Judith; Ozanne, Elissa

    2014-01-01

    Background Use of mobile health (mHealth) tools has expanded rapidly but little research has been done on its acceptability by low-income, diverse, older patient populations. Objective To assess the attitudes of a diverse group of underserved women on the acceptability and usability of mHealth tools in a clinical setting using a breast health questionnaire application (app) at a public hospital mammography clinic. Methods Semi-structured interviews were conducted in a breast-imaging center of an urban safety net institution from July-August 2012. Interviews included pre- and post-questions. Women completed the Athena breast health questionnaire app on an iPad and were asked about their experience and ways to improve the tool. Results Fifteen women age 45–79 years from diverse ethnic and educational backgrounds were interviewed. The majority of women, 11 of 15, preferred the Athena app over a paper version and all the women thought the app was easy to use. Two Spanish-speaking Latinas preferred paper; and two women, with limited mobile phone use, did not have a preference. Many women indicated that it would be necessary to have staff available for instruction and assistance if the app were to be implemented. Conclusions mHealth tools are an acceptable, if not preferred, method of collecting health information for diverse, older, low-income women. Further studies are required to evaluate the reliability and accuracy of data collection using mHealth tools in underserved populations. mHealth tools should be explored as a novel way to engage diverse populations to improve clinical care and bridge gaps in health disparities. PMID:25705576

  9. Science and Safety: 'Acceptable' Risk

    ERIC Educational Resources Information Center

    Science News, 1976

    1976-01-01

    Stresses ways to answer questions related to widespread publicity - are nuclear reactors safe, will dangerous research in genetic manipulation be banned? - with emphasis on true meaning of safety as related to risks. (EB)

  10. Approaches to acceptable risk: a critical guide

    SciTech Connect

    Fischhoff, B.; Lichtenstein, S.; Slovic, P.; Keeney, R.; Derby, S.

    1980-12-01

    Acceptable-risk decisions are an essential step in the management of technological hazards. In many situations, they constitute the weak (or missing) link in the management process. The absence of an adequate decision-making methodology often produces indecision, inconsistency, and dissatisfaction. The result is neither good for hazard management nor good for society. This report offers a critical analysis of the viability of various approaches as guides to acceptable-risk decisions. This report seeks to define acceptable-risk decisions and to examine some frequently proposed, but inappropriate, solutions. 255 refs., 22 figs., 25 tabs.

  11. Development of quantitative risk acceptance criteria

    SciTech Connect

    Griesmeyer, J. M.; Okrent, D.

    1981-01-01

    Some of the major considerations for effective management of risk are discussed, with particular emphasis on risks due to nuclear power plant operations. Although there are impacts associated with the rest of the fuel cycle, they are not addressed here. Several previously published proposals for quantitative risk criteria are reviewed. They range from a simple acceptance criterion on individual risk of death to a quantitative risk management framework. The final section discussed some of the problems in the establishment of a framework for the quantitative management of risk.

  12. Health risks.

    PubMed

    Longstreth, J; de Gruijl, F R; Kripke, M L; Abseck, S; Arnold, F; Slaper, H I; Velders, G; Takizawa, Y; van der Leun, J C

    1998-10-01

    The health risks associated with ozone depletion will principally be those due to increased ultraviolet B (UV-B) radiation in the environment, i.e., increased damage to the eyes, the immune system, and the skin. Some new risks may also be introduced with the increased use of alternatives to the ozone-depleting substances (ODSs). Quantitative risk estimates are available for some of the UV-B-associated effects, e.g., cataract and skin cancer; however, the data are insufficient to develop similar estimates for effects such as immunosuppression and the toxicity of alternatives. Ocular damage from UV exposures includes effects on the cornea, lens, iris, and associated epithelial and conjunctival tissues. The most common acute ocular effect of environmental ultraviolet radiation (UVR) is photokeratitis. Also known as snowblindness in skiers, this condition also occurs in other outdoor recreationists. Chronic eye conditions likely to increase with ozone depletion include cataract, squamous cell carcinoma, ocular melanoma, and a variety of corneal/conjunctival effects, e.g., pterygium and pinguecula. Suppression of local (at the site of UV exposure) and systemic (at a distant, unexposed site) immune responses to a variety of antigens has been demonstrated in both humans and animals exposed to UV-B. In experiments with animals these effects have been shown to worsen the course/outcome of some infectious diseases and cancers. There is reasonably good evidence that such immunosuppression plays a role in human carcinogenesis; however, the implications of such immunosuppression for human infectious diseases are still unknown. In light-skinned populations, exposure to solar UVR appears to be the most important environmental risk factor for basal and squamous cell carcinomas and cutaneous melanoma. Originally it was believed that total accumulated exposure to UVR was the most important environmental factor in determining risk for these tumors. Recent information now suggests

  13. Acceptance of Swedish e-health services

    PubMed Central

    Jung, Mary-Louise; Loria, Karla

    2010-01-01

    Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

  14. Defining "Acceptable Risk" for Earthquakes Worldwide

    NASA Astrophysics Data System (ADS)

    Tucker, B.

    2001-05-01

    The greatest and most rapidly growing earthquake risk for mortality is in developing countries. Further, earthquake risk management actions of the last 50 years have reduced the average lethality of earthquakes in earthquake-threatened industrialized countries. (This is separate from the trend of the increasing fiscal cost of earthquakes there.) Despite these clear trends, every new earthquake in developing countries is described in the media as a "wake up" call, announcing the risk these countries face. GeoHazards International (GHI) works at both the community and the policy levels to try to reduce earthquake risk. GHI reduces death and injury by helping vulnerable communities recognize their risk and the methods to manage it, by raising awareness of its risk, building local institutions to manage that risk, and strengthening schools to protect and train the community's future generations. At the policy level, GHI, in collaboration with research partners, is examining whether "acceptance" of these large risks by people in these countries and by international aid and development organizations explains the lack of activity in reducing these risks. The goal of this pilot project - The Global Earthquake Safety Initiative (GESI) - is to develop and evaluate a means of measuring the risk and the effectiveness of risk mitigation actions in the world's largest, most vulnerable cities: in short, to develop an earthquake risk index. One application of this index is to compare the risk and the risk mitigation effort of "comparable" cities. By this means, Lima, for example, can compare the risk of its citizens dying due to earthquakes with the risk of citizens in Santiago and Guayaquil. The authorities of Delhi and Islamabad can compare the relative risk from earthquakes of their school children. This index can be used to measure the effectiveness of alternate mitigation projects, to set goals for mitigation projects, and to plot progress meeting those goals. The preliminary

  15. Willingness to accept risk in the treatment of rheumatic disease.

    PubMed Central

    O'Brien, B J; Elswood, J; Calin, A

    1990-01-01

    STUDY OBJECTIVE--The aim was to assess patients willingness to accept mortal risk in the drug treatment of chronic rheumatic disease. DESIGN--A non-random sample of consecutive patients were interviewed with a standardised survey instrument. SETTING--The study took place in the Royal National Hospital for Rheumatic Diseases, Bath, UK. PATIENTS--100 consecutive in- and out-patients aged 65 or less were interviewed, 50 with rheumatoid arthritis and 50 with ankylosing spondylitis. Mean age was 48 years with mean disease duration of 14 years. The rheumatoid arthritis group was mainly female (84%), v 26% in the ankylosing spondylitis group. MEASUREMENTS AND MAIN RESULTS--Risk preferences were elicited using the method of standard gamble in the context of a hypothetical new drug. Patients indicated the maximum percentage probability of mortality they regarded as acceptable to achieve four different levels of benefit: total cure (20.7%), relief of pain (16.9%), relief of stiffness (13.1%), return to normal functioning (14.5%). Rheumatoid arthritis patients displayed a higher (p less than 0.05) willingness to accept risk than ankylosing spondylitis patients for all gambles except relief of stiffness. Analysis of variance indicated that willingness to accept risk decreases with the duration of disease and increases with reductions in self assessed health status. CONCLUSIONS--Evaluative methods such as standard gamble can elicit useful risk-benefit preference data from patients to assist those who manage clinical risks. PMID:2273365

  16. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable flight risk. 415.35 Section 415... Launch Range § 415.35 Acceptable flight risk. (a) Flight risk through orbital insertion or impact. Acceptable flight risk through orbital insertion for an orbital launch vehicle, and through impact for...

  17. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable flight risk. 415.35 Section 415... Launch Range § 415.35 Acceptable flight risk. (a) Flight risk through orbital insertion or impact. Acceptable flight risk through orbital insertion for an orbital launch vehicle, and through impact for...

  18. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable flight risk. 415.35 Section 415... Launch Range § 415.35 Acceptable flight risk. (a) Flight risk through orbital insertion or impact. Acceptable flight risk through orbital insertion for an orbital launch vehicle, and through impact for...

  19. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... explosive debris. (b) Hazard identification and risk assessment. To demonstrate compliance with paragraph (a... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Acceptable flight risk. 415.35 Section 415... Launch Range § 415.35 Acceptable flight risk. (a) Flight risk through orbital insertion or...

  20. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... explosive debris. (b) Hazard identification and risk assessment. To demonstrate compliance with paragraph (a... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Acceptable flight risk. 415.35 Section 415... Launch Range § 415.35 Acceptable flight risk. (a) Flight risk through orbital insertion or...

  1. Social acceptability of phytoremediation: The role of risk and values.

    PubMed

    Weir, Ellen; Doty, Sharon

    2016-10-01

    A former gas production site that was converted to a public park was chosen as the research location for the present study. Some of the contaminants at the site have been remediated; however, much of the soil is still contaminated with polycyclic aromatic hydrocarbons (PAHs). PAHs are toxic pollutants that have been shown to have numerous negative health effects. The primary form of remediation at the site has been capping, which is usually considered a temporary remediation strategy since it does not remove contaminants from the site but simply covers them, and this requires repeated re-capping efforts. Endophyte-assisted phytoremediation using willow shrubs is an alternative remediation strategy that could improve soil quality and permanently reduce contaminant levels in the soil. The goal of the present study was to explore the social acceptability of utilizing phytoremediation strategies. Surveys were used to explore public perceptions of the park and of using phytoremediation to clean up existing contamination. Results indicated a high level of social acceptability of phytoremediation at the park. Additionally, ecocentrism was shown to be a significant predictor of phytoremediation acceptability. Risk and anthropocentrism were not significant predictors of acceptability. Results suggest that messages intended to encourage the use and acceptability of phytoremediation should focus on the environmental benefits of phytoremediation. PMID:27167719

  2. Safety analysis, risk assessment, and risk acceptance criteria

    SciTech Connect

    Jamali, K.; Stack, D.W.; Sullivan, L.H.; Sanzo, D.L.

    1997-08-01

    This paper discusses a number of topics that relate safety analysis as documented in the Department of Energy (DOE) safety analysis reports (SARs), probabilistic risk assessments (PRA) as characterized primarily in the context of the techniques that have assumed some level of formality in commercial nuclear power plant applications, and risk acceptance criteria as an outgrowth of PRA applications. DOE SARs of interest are those that are prepared for DOE facilities under DOE Order 5480.23 and the implementing guidance in DOE STD-3009-94. It must be noted that the primary area of application for DOE STD-3009 is existing DOE facilities and that certain modifications of the STD-3009 approach are necessary in SARs for new facilities. Moreover, it is the hazard analysis (HA) and accident analysis (AA) portions of these SARs that are relevant to the present discussions. Although PRAs can be qualitative in nature, PRA as used in this paper refers more generally to all quantitative risk assessments and their underlying methods. HA as used in this paper refers more generally to all qualitative risk assessments and their underlying methods that have been in use in hazardous facilities other than nuclear power plants. This discussion includes both quantitative and qualitative risk assessment methods. PRA has been used, improved, developed, and refined since the Reactor Safety Study (WASH-1400) was published in 1975 by the Nuclear Regulatory Commission (NRC). Much debate has ensued since WASH-1400 on exactly what the role of PRA should be in plant design, reactor licensing, `ensuring` plant and process safety, and a large number of other decisions that must be made for potentially hazardous activities. Of particular interest in this area is whether the risks quantified using PRA should be compared with numerical risk acceptance criteria (RACs) to determine whether a facility is `safe.` Use of RACs requires quantitative estimates of consequence frequency and magnitude.

  3. Replacing fish meal by food waste to produce lower trophic level fish containing acceptable levels of polycyclic aromatic hydrocarbons: Health risk assessments.

    PubMed

    Cheng, Zhang; Mo, Wing-Yin; Lam, Cheung-Lung; Choi, Wai-Ming; Wong, Ming-Hung

    2015-08-01

    This study aimed at using different types of food wastes (mainly containing cereal [food waste A] and meat meal [food waste B]) as major sources of protein to replace the fish meal used in fish feeds to produce quality fish. The traditional fish farming model used to culture low trophic level fish included: bighead, (Hypophthalmichthys nobilis), grass carp, (Ctenopharyngodon idellus), and mud carp, (Cirrhinus molitorella) of omnivorous chain. The results indicated that grass carp and bighead carp fed with food waste feeds were relatively free of PAHs. The results of health risk assessment showed that the fish fed with food waste feeds were safe for consumption from the PAHs perspective. PMID:25880597

  4. Rapid HIV Testing Is Highly Acceptable and Preferred among High-Risk Gay And Bisexual Men after Implementation in Sydney Sexual Health Clinics

    PubMed Central

    Conway, Damian P.; Guy, Rebecca; Davies, Stephen C; Couldwell, Deborah L.; McNulty, Anna; Smith, Don E.; Keen, Phillip; Cunningham, Philip; Holt, Martin

    2015-01-01

    Background Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia. We assessed the acceptability of RHT and its associations among gay, bisexual and other men who have sex with men (GBM) after implementation of RHT in Sydney sexual health clinics. Methods GBM were invited to complete an acceptability questionnaire before and after provision of the result of finger-prick blood RHT, comparing their experience of RHT with conventional HIV testing (CHT) involving venipuncture. Logistic regression was used to assess associations between patient characteristics and the preference for RHT over CHT next time they tested for HIV. Results Of 1061 GBM who received non-reactive RHT results, 59% found RHT less stressful than CHT and 34% reported no difference, and 61% found RHT more comfortable than CHT and 26% reported no difference. Nearly all men were satisfied with RHT result delivery (99%) and the RHT process overall (99%). Most men (79%) preferred RHT for their next HIV test and this preference was stronger in men who were aged 35-44 years (adjusted odds ratio [AOR] 2.49, p<0.01), reported they would test more often if RHT was available (AOR 1.66, p=0.01), found returning for results annoying (AOR 1.67, p=0.01), and found RHT less stressful (AOR 2.37, p<0.01) and more comfortable (AOR 1.62, p=0.02) than CHT. Men concerned about the reliability of RHT were less than half as likely to prefer RHT for their next HIV test (AOR 0.44, p<0.01). Conclusions Most GBM preferred RHT to CHT next time and this preference was associated with finding RHT more convenient, more comfortable and less stressful than CHT. These findings suggest that in a clinic setting RHT should be considered to improve the patient experience and may potentially increase uptake and frequency of HIV testing. PMID:25898140

  5. Replacing fish meal by food waste in feed pellets to culture lower trophic level fish containing acceptable levels of organochlorine pesticides: health risk assessments.

    PubMed

    Cheng, Zhang; Mo, Wing-Yin; Man, Yu-Bon; Nie, Xiang-Ping; Li, Kai-Bing; Wong, Ming-Hung

    2014-12-01

    The present study used food waste (collected from local hotels and restaurants) feed pellets in polyculture of low-trophic level fish [bighead (Aristichtys nobilis), grass carp (Ctenopharyngodon idellus), and mud carp (Cirrhina molitorella)] aiming at producing safe and quality products for local consumption. The results indicated that grass carp (hexachlorocyclohexanes (HCHs) <0.03; dichlorodiphenyltrichloroethanes (DDTs) 1.42-3.34 ng/g ww) and bighead carp (HCHs<0.03; DDTs 1.55-2.56 ng/g ww) fed with food waste feed pellets were relatively free of organochlorine pesticides (OCPs). The experimental ponds (water and sediment) were relatively free of OCPs, lowering the possibility of biomagnification of OCPs in the food chains within the ponds. The raw concentrations of OCPs extracted from the fish were not in the bioavailable form, which would ultimately reach bloodstream and exert adverse effects on human body. Health risk assessments based on digestible concentrations are commonly regarded as a more accurate method. The results of health risk assessments based on raw and digestible concentrations showed that the fish fed with food waste feed pellets were safe for consumption from the OCP perspective. PMID:25080070

  6. Launch Risk Acceptability Considering Uncertainty in Risk Estimates

    NASA Astrophysics Data System (ADS)

    Collins, J. D.; Carbon, S. L.

    2010-09-01

    Quantification of launch risk is difficult and uncertain due to the assumptions made in the modeling process and the difficulty in developing the supporting data. This means that estimates of the risks are uncertain and the decision maker must decide on the acceptability of the launch under uncertainty. This paper describes the process to quantify the uncertainty and, in the process, describes the separate roles of aleatory and epistemic uncertainty in obtaining the point estimate of the casualty expectation and, ultimately, the distribution of the uncertainty in the computed casualty expectation. Tables are included of the significant sources and the nature of the contributing uncertainties. In addition, general procedures and an example are also included to describe the computational procedure. The second part of the paper discusses how the quantified uncertainty should be applied to the decision-making process. This discussion describes the procedure proposed and adopted by the Risk Committee of the Range Commander’s Council Range Safety Group which will be published in RCC 321-10 [1].

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

    PubMed Central

    2015-01-01

    Background Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes. Objective This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use. Methods Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed. Results Perceived health risk (β=.135, t 1999=2.676) and health consciousness (β=.447, t 1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (β=.025, t 1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (β=.029, t 1999=3.609). These results suggest the central role of

  8. Acceptance of health information technology in health professionals: an application of the revised technology acceptance model.

    PubMed

    Ketikidis, Panayiotis; Dimitrovski, Tomislav; Lazuras, Lambros; Bath, Peter A

    2012-06-01

    The response of health professionals to the use of health information technology (HIT) is an important research topic that can partly explain the success or failure of any HIT application. The present study applied a modified version of the revised technology acceptance model (TAM) to assess the relevant beliefs and acceptance of HIT systems in a sample of health professionals (n = 133). Structured anonymous questionnaires were used and a cross-sectional design was employed. The main outcome measure was the intention to use HIT systems. ANOVA was employed to examine differences in TAM-related variables between nurses and medical doctors, and no significant differences were found. Multiple linear regression analysis was used to assess the predictors of HIT usage intentions. The findings showed that perceived ease of use, but not usefulness, relevance and subjective norms directly predicted HIT usage intentions. The present findings suggest that a modification of the original TAM approach is needed to better understand health professionals' support and endorsement of HIT. Perceived ease of use, relevance of HIT to the medical and nursing professions, as well as social influences, should be tapped by information campaigns aiming to enhance support for HIT in healthcare settings. PMID:22733680

  9. Launch Risk Acceptability: The Public Speaks

    NASA Technical Reports Server (NTRS)

    Haber, Jerold M.; Lamoreaux, Richard W.

    2008-01-01

    The perspective of those assuming risk has become increasingly important to launch agencies. The IAASS white paper "An ICAO for Space?" proposed four ultimate goals of any international regulatory framework. The first of these was to "Ensure that citizens of all nations are equally protected from "unreasonable levels" of risk from overflight by missiles, launch vehicles and returning spacecraft". A key component of this concept is the issue of what is an "unreasonable level" of risk from the perspective of those assuming the risk.

  10. Comparative research on NIMBY risk acceptability between Chinese and Japanese college students.

    PubMed

    Wu, Yunqing; Zhai, Guofang; Li, Shasha; Ren, Chongqiang; Tsuchida, Shoji

    2014-10-01

    Along with the progressive acceleration of urbanization, the need to identify potentially troublesome "Not In My Back Yard" (NIMBY) facilities in the city is inevitable. To resolve NIMBY conflict, it is important to know people's NIMBY risk acceptability for these facilities. A questionnaire survey was used among Chinese and Japanese college students to identify NIMBY risk acceptability. LISREL was used to construct a structural equation model to analyze the difference in NIMBY risk acceptability between the Chinese and Japanese college students. Factors that may affect NIMBY risk acceptability were analyzed: "perceiving utility," "perceiving risk," "trust in government," "reasonable compensation," and "procedural justice." The findings show that Japanese students' concerns were greater than Chinese students' concerns. Perceiving utility and perceiving risk were the most important factors that affect people's NIMBY risk acceptability, followed by procedural justice, trust in government, and reasonable compensation. There is a difference between the different cultural backgrounds in confronting the risk: Chinese students focus more on the reputation and value of real estate, while Japanese students pay more attention to environmental pollution and damage to health. Furthermore, cultural influences play a role in students' risk perception. To improve the risk acceptability for NIMBY facilities and provide a basis for resolving NIMBY conflicts, it is necessary to ensure the benefits of the NIMBY facility while reducing environmental pollution. The findings of this study may be of interest for policy makers and practitioners to devise future NIMBY strategies. PMID:25004852

  11. Workaholism, Health, and Self-Acceptance

    ERIC Educational Resources Information Center

    Chamberlin, Christine M.; Zhang, Naijian

    2009-01-01

    This study examined the relationships between workaholism, perceived parental workaholism, self-acceptance, psychological well-being, and physical symptoms among 347 college students. Statistically significant relationships were found between college students' perceived parental workaholism and their own workaholism. Also, relationships between…

  12. Values, perceived risks and benefits, and acceptability of nuclear energy.

    PubMed

    de Groot, Judith I M; Steg, Linda; Poortinga, Wouter

    2013-02-01

    We examined how personal values and perceptions of risks and benefits are associated with the acceptability of nuclear energy (NE). A theoretical model is tested in which beliefs about the risks and benefits of NE mediate the relationship between values and acceptability. The results showed that egoistic values are positively related to the perceived benefits and acceptability of NE. In contrast, altruistic and biospheric values were positively related to the perceived risks of NE. Although it has been argued that NE may help to combat climate change through lower CO(2) emissions, these environmental benefits were not acknowledged by people with strong biospheric values. Furthermore, results confirmed that the more risks respondents perceived, the less they were inclined to accept NE. In contrast, the more a person believed that NE has beneficial consequences, the more acceptable NE was. Finally, as expected, perceived risks and benefits were found to partly mediate the relationship between personal values and acceptability. We discuss the theoretical and practical implications of these findings. PMID:22642255

  13. Pesticides and health risks.

    PubMed

    Gilden, Robyn C; Huffling, Katie; Sattler, Barbara

    2010-01-01

    Pesticides are a category of chemicals formulated to kill or repel a pest or halt its reproduction. In this article we review the toxicological and epidemiological literature; describe common potential pesticide exposures; and focus on the associated health risks to fetal development. Clinical implications are reviewed, and recommendations are made regarding the integration of this environmental health concern into nursing education, practice, research, and policy/advocacy work. Recommendations for pesticide elimination and reduction in health care settings are included. PMID:20409108

  14. PARALLELS OF RADIATION- AND FINANCIAL-RISK MANAGEMENT ON PUBLIC ACCEPTANCE

    SciTech Connect

    Hogue, M.

    2010-01-04

    The financial collapse of 2007 provides an opportunity for a cross-discipline comparison of risk assessments. Flaws in financial risk assessments bear part of the blame for the financial collapse. There may be a potential for similar flaws to be made in radiological risk assessments. Risk assessments in finance and health physics are discussed in the context of a broader view of the risk management environment. Flawed risk assessments can adversely influence public acceptance of radiological technologies, so the importance of quality is magnified.

  15. Parallels of radiation and financial risk management: impacts on public acceptance.

    PubMed

    Hogue, Mark

    2011-02-01

    The financial collapse of 2007 provides an opportunity for a cross-discipline comparison of risk assessments. Flaws in financial risk assessments bear part of the blame for the financial collapse. There may be a potential for similar flaws to be made in radiological risk assessments. Risk assessments in finance and health physics are discussed in the context of a broader view of the risk management environment. Flawed risk assessments can adversely influence public acceptance of radiological technologies, so the importance of quality is magnified. PMID:21399429

  16. End-To-End Risk Assesment: From Genes and Protein to Acceptable Radiation Risks for Mars Exploration

    NASA Astrophysics Data System (ADS)

    Cucinotta, Francis A.; Schimmerling, Walter

    2000-07-01

    The human exploration of Mars will impose unavoidable health risks from galactic cosmic rays (GCR) and possibly solar particle events (SPE). It is the goal of NASA's Space Radiation Health Program to develop the capability to predict health risks with significant accuracy to ensure that risks are well below acceptable levels and to allow for mitigation approaches to be effective at reasonable costs. End-to-End risk assessment is the approach being followed to understand proton and heavy ion damage at the molecular, cellular, and tissue levels in order to predict the probability of the major health risk including cancer, neurological disorders, hereditary effects, cataracts, and acute radiation sickness and to develop countermeasures for mitigating risks.

  17. End-To-End Risk Assesment: From Genes and Protein to Acceptable Radiation Risks for Mars Exploration

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.; Schimmerling, Walter

    2000-01-01

    The human exploration of Mars will impose unavoidable health risks from galactic cosmic rays (GCR) and possibly solar particle events (SPE). It is the goal of NASA's Space Radiation Health Program to develop the capability to predict health risks with significant accuracy to ensure that risks are well below acceptable levels and to allow for mitigation approaches to be effective at reasonable costs. End-to-End risk assessment is the approach being followed to understand proton and heavy ion damage at the molecular, cellular, and tissue levels in order to predict the probability of the major health risk including cancer, neurological disorders, hereditary effects, cataracts, and acute radiation sickness and to develop countermeasures for mitigating risks.

  18. Use and Acceptance of Social Media among Health Educators

    ERIC Educational Resources Information Center

    Hanson, Carl; West, Joshua; Neiger, Brad; Thackeray, Rosemary; Barnes, Michael; McIntyre, Emily

    2011-01-01

    Background: As social media use grows in popularity, health educators are challenged to think differently about how to communicate with audiences. Purpose: The purpose of this study was to explore social media use and factors that determine acceptance of social media use among health educators. Methods: A random sample of Certified Health…

  19. Risk perception, risk evaluation and human values: cognitive bases of acceptability of a radioactive waste repository

    SciTech Connect

    Earle, T.C.; Lindell, M.K.; Rankin, W.L.

    1981-07-01

    Public acceptance of radioactive waste management alternatives depends in part on public perception of the associated risks. Three aspects of those perceived risks were explored in this study: (1) synthetic measures of risk perception based on judgments of probability and consequences; (2) acceptability of hypothetical radioactive waste policies, and (3) effects of human values on risk perception. Both the work on synthetic measures of risk perception and on the acceptability of hypothetical policies included investigations of three categories of risk: (1) Short-term public risk (affecting persons living when the wastes are created), (2) Long-term public risk (affecting persons living after the time the wastes were created), and (3) Occupational risk (affecting persons working with the radioactive wastes). The human values work related to public risk perception in general, across categories of persons affected. Respondents were selected according to a purposive sampling strategy.

  20. Acceptability of risk from radiation: Application to human space flight

    SciTech Connect

    1997-04-30

    This one of NASA`s sponsored activities of the NCRP. In 1983, NASA asked NCRP to examine radiation risks in space and to make recommendations about career radiation limits for astronauts (with cancer considered as the principal risk). In conjunction with that effort, NCRP was asked to convene this symposium; objective is to examine the technical, strategic, and philosophical issues pertaining to acceptable risk and radiation in space. Nine papers are included together with panel discussions and a summary. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  1. Risk Perception and the Public Acceptance of Drones.

    PubMed

    Clothier, Reece A; Greer, Dominique A; Greer, Duncan G; Mehta, Amisha M

    2015-06-01

    Unmanned aircraft, or drones, are a rapidly emerging sector of the aviation industry. There has been limited substantive research, however, into the public perception and acceptance of drones. This article presents the results from two surveys of the Australian public designed to investigate (1) whether the public perceive drones to be riskier than existing manned aviation, (2) whether the terminology used to describe the technology influences public perception, and (3) what the broader concerns are that may influence public acceptance of the technology. We find that the Australian public currently hold a relatively neutral attitude toward drones. Respondents did not consider the technology to be overly unsafe, risky, beneficial, or threatening. Drones are largely viewed as being of comparable risk to that of existing manned aviation. Furthermore, terminology had a minimal effect on the perception of the risks or acceptability of the technology. The neutral response is likely due to a lack of knowledge about the technology, which was also identified as the most prevalent public concern as opposed to the risks associated with its use. Privacy, military use, and misuse (e.g., terrorism) were also significant public concerns. The results suggest that society is yet to form an opinion of drones. As public knowledge increases, the current position is likely to change. Industry communication and media coverage will likely influence the ultimate position adopted by the public, which can be difficult to change once established. PMID:25689883

  2. When Failure Means Success: Accepting Risk in Aerospace Development

    NASA Technical Reports Server (NTRS)

    Dumbacher, Daniel L.; Singer, Christopher E.

    2009-01-01

    Over the last three decades, NASA has been diligent in qualifying systems for human space flight. As the Agency transitions from operating the Space Shuttle, its employees must learn to accept higher risk levels to generate the data needed to certify its next human space flight system. The Marshall Center s Engineering workforce is developing the Ares I crew launch vehicle and designing the Ares V cargo launch vehicle for safety, reliability, and cost-effective operations. This presentation will provide a risk retrospective, using first-hand examples from the Delta Clipper-Experimental Advanced (DC-XA) and the X-33 single-stage-to-orbit flight demonstrators, while looking ahead to the upcoming Ares I-X uncrewed test flight. The DC-XA was successfully flown twice in 26 hours, setting a new turnaround-time record. Later, one of its 3 landing gears did not deploy, it tipped over, and was destroyed. During structural testing, the X-33 s advanced composite tanks were unable to withstand the forces to which it was subjected and the project was later cancelled. These are examples of successful failures, as the data generated are captured in databases used by vehicle designers today. More recently, the Ares I-X flight readiness review process was streamlined in keeping with the mission's objectives, since human lives are not at stake, which reflects the beginning of a cultural change. Failures are acceptable during testing, as they provide the lessons that actually lead to mission success. These and other examples will stimulate the discussion of when to accept risk in aerospace projects.

  3. Plastics and health risks.

    PubMed

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics. PMID:20070188

  4. Children at health risks.

    PubMed

    Sekar, H R

    1992-01-01

    In India, 69% of the children of the working class die, most of whom are child laborers. Economic pressure forces parents to make their children work. Employers want child workers because they can manipulate them and pay them low wages, thereby ensuring their viability. The caste system induces social inequality, inheritance invokes cultural inequality, and patriarchal socialization is responsible for gender inequality, all of which perpetuates exploitation of children by employers. In Sivakasi, an estimated 125,000 children make up the child labor force, comprising 30% of the entire labor force. 75% are from the lowest castes. 90% of child workers are girls because they are more obedient and accept even lower wages than boys, and girls need to save for their dowry. Girls often suffer verbal and physical abuse. Like their parents who were also child workers, child workers are illiterate and work long hours. A small rich elite in Sivakasi controls most of the trading and industrial capital, educational institutions, and voluntary organizations. Employers' agents give parents a loan and use their children's labor as security. Each day, they bring child workers to Sivakasi in factory buses from villages to work at least 12 hour days. They work under hazardous conditions, e.g., working with toxic chemicals. Coughing, sore throat, dizziness, methemoglobinemia, and anemia are common effects of ingestion or inhalation of chlorate dust. Inhalation of sulphur dust causes respiratory infections, eye infections, and chronic lung diseases (e.g., asthma). Fires and explosions are common risks for working children. Factory management seldom undertake fire prevention measures. An extensive survey of the problem of child labor is needed in Sivakasi before systematic planning to protect children could be done. Overall development, especially agricultural development, is needed. Parents, employers, enforcement authorities, trade unions, and social groups need to be sensitized to the

  5. The First Rotavirus Vaccine and the Politics of Acceptable Risk

    PubMed Central

    Schwartz, Jason L

    2012-01-01

    Context Vaccination in the United States is a frequent source of controversy, with critics alleging failures by public health officials to adequately identify, monitor, and respond to risks associated with vaccines. In response to these charges, the case of RotaShield, a vaccine withdrawn in 1999 following confirmation of a serious adverse event associated with its use, is regularly invoked as evidence of the effectiveness of current vaccine safety activities. Methods This article examines the history of RotaShield, with particular attention paid to decision making regarding its use in the United States and internationally. I reviewed and analyzed federal advisory committee meeting transcripts, international conference reports, government and scientific publications, media coverage, and other primary and secondary source materials. I also conducted six semistructured interviews with former senior officials and advisory committee members at the U.S. Centers for Disease Control and Prevention who participated in decisions regarding the vaccine. Findings Decision making regarding RotaShield, including the ultimate withdrawal of its recommendation for use, was shaped significantly by government health officials’ concern for preserving public confidence in overall U.S. vaccination efforts amid several unrelated vaccine risk controversies ongoing at that time. This attention to public perception and external pressures occurred in tandem with the evaluation of the quantitative evidence regarding the magnitude and severity of the risk associated with the vaccine. The decisions made in the United States resulted in foreseen but unintended consequences for international use of the vaccine, including in nations where the profile of risks and potential benefits was dramatically different. Conclusions As enthusiasm for evidence-based decision making grows throughout medicine and public health, greater explicit attention should be directed to the processes by which decision

  6. Space Reactor Launch Safety-An Acceptably Low Risk

    NASA Astrophysics Data System (ADS)

    Weitzberg, Abraham; Wright, Steven

    2008-01-01

    Results from previous space reactor and radioisotope power source risk assessments were combined to provide a scoping assessment of the possible risks from the launch of a reactor power system for use on the surface of the moon or Mars. It is assumed that future reactor power system launches would be subject to the same rigorous safety analysis and launch approval process as past nuclear payload launches. Using the same methodology that has gained approval of past launches, it was determined that the mission risk would be 0.029 person-rem worldwide which translates to 1.5*10-5 latent health effects. It is seen that the only significant sources of radiological risks from a non-operating reactor are possible inadvertent criticality accidents and the consequences of such events have been shown to be extremely low. Passive means such as spectral shift poisons or high reactor core length/diameter ratios have been shown to be able to reduce or eliminate the possibility of the more credible criticality accidents, such as flooding or sand burial. This paper advances the premise that, for design purposes, future space reactor surface-power designs should primarily address the credible accidents and not the hypothetical accidents. For launch accidents and other safety assessments, a probabilistic risk assessment approach will have to be used to assess the safety impact of all types of accidents, including the hypothetical accidents. With this approach, the design of the system will not be burdened with design features that are based on hypothetical criticality accidents having negligible risk. Moreover, there is little chance of convincingly demonstrating that these design features can substantially reduce or eliminated the risk associated with hypothetical criticality accidents.

  7. Space Reactor Launch Safety--An Acceptably Low Risk

    SciTech Connect

    Weitzberg, Abraham; Wright, Steven

    2008-01-21

    Results from previous space reactor and radioisotope power source risk assessments were combined to provide a scoping assessment of the possible risks from the launch of a reactor power system for use on the surface of the moon or Mars. It is assumed that future reactor power system launches would be subject to the same rigorous safety analysis and launch approval process as past nuclear payload launches. Using the same methodology that has gained approval of past launches, it was determined that the mission risk would be 0.029 person-rem worldwide which translates to 1.5*10{sup -5} latent health effects. It is seen that the only significant sources of radiological risks from a non-operating reactor are possible inadvertent criticality accidents and the consequences of such events have been shown to be extremely low. Passive means such as spectral shift poisons or high reactor core length/diameter ratios have been shown to be able to reduce or eliminate the possibility of the more credible criticality accidents, such as flooding or sand burial. This paper advances the premise that, for design purposes, future space reactor surface-power designs should primarily address the credible accidents and not the hypothetical accidents. For launch accidents and other safety assessments, a probabilistic risk assessment approach will have to be used to assess the safety impact of all types of accidents, including the hypothetical accidents. With this approach, the design of the system will not be burdened with design features that are based on hypothetical criticality accidents having negligible risk. Moreover, there is little chance of convincingly demonstrating that these design features can substantially reduce or eliminated the risk associated with hypothetical criticality accidents.

  8. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  9. Health Risks of Nuclear Power.

    ERIC Educational Resources Information Center

    Cohen, Bernard L.

    1978-01-01

    Deals with the wastes generated in nuclear power plants and the health risks involved as compared to those of wastes generated by coal-fired plants. Concludes that the risks of nuclear power plants are many times smaller than the risks from alternative energy resources. (GA)

  10. Health risks in perspective: Judging health risks of energy technologies

    SciTech Connect

    Rowe, M.D.

    1992-09-18

    Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

  11. Health Risk of Radon

    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. 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

  13. Peer Acceptance in the School Class and Subjective Health Complaints: A Multilevel Approach

    ERIC Educational Resources Information Center

    Almquist, Ylva B.; Modin, Bitte; Augustine, Lilly

    2013-01-01

    Background: Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even…

  14. Acceptability and Trust of Community Health Workers Offering Maternal and Newborn Health Education in Rural Uganda

    ERIC Educational Resources Information Center

    Singh, Debra; Cumming, Robert; Negin, Joel

    2015-01-01

    When trusted, Community Health Workers (CHWs) can contribute to improving maternal and newborn health outcomes in low- and middle-income countries through education. Issues of acceptability of CHWs by communities were explored through experiences gained in a qualitative study that is part of a cluster randomized trial in East Uganda. Initially,…

  15. The Mutable Nature of Risk and Acceptability: A Hybrid Risk Governance Framework.

    PubMed

    Wong, Catherine Mei Ling

    2015-11-01

    This article focuses on the fluid nature of risk problems and the challenges it presents to establishing acceptability in risk governance. It introduces an actor-network theory (ANT) perspective as a way to deal with the mutable nature of risk controversies and the configuration of stakeholders. To translate this into a practicable framework, the article proposes a hybrid risk governance framework that combines ANT with integrative risk governance, deliberative democracy, and responsive regulation. This addresses a number of the limitations in existing risk governance models, including: (1) the lack of more substantive public participation throughout the lifecycle of a project; (2) hijacking of deliberative forums by particular groups; and (3) the treatment of risk problems and their associated stakeholders as immutable entities. The framework constitutes a five-stage process of co-selection, co-design, co-planning, and co-regulation to facilitate the co-production of collective interests and knowledge, build capacities, and strengthen accountability in the process. The aims of this article are twofold: conceptually, it introduces a framework of risk governance that accounts for the mutable nature of risk problems and configuration of stakeholders. In practice, this article offers risk managers and practitioners of risk governance a set of procedures with which to operationalize this conceptual approach to risk and stakeholder engagement. PMID:26094547

  16. Health Security and Risk Aversion.

    PubMed

    Herington, Jonathan

    2016-09-01

    Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. PMID:26990349

  17. Risk analysis for new nuclear waste sites: Will it generate public acceptance?

    SciTech Connect

    Inhaber, H.

    1993-11-01

    This report discusses public acceptance of radioactive waste facilities and what seems to be increasingly militant stances against such facilities. The role of risk assessment in possibly enhancing public acceptance is investigated.

  18. Affect and Acceptability: Exploring Teachers' Technology-Related Risk Perceptions

    ERIC Educational Resources Information Center

    Howard, Sarah K.

    2011-01-01

    Educational change, such as technology integration, involves risk. Teachers are encouraged to "take risks", but what risks they are asked to take and how do they perceive these risks? Developing an understanding of teachers' technology-related risk perceptions can help explain their choices and behaviours. This paper presents a way to understand…

  19. Development of a Health Information Technology Acceptance Model Using Consumers’ Health Behavior Intention

    PubMed Central

    2012-01-01

    Background For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers’ intention and behavior is needed to develop and implement effective and efficient strategies. Objective To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers’ behavioral intention of using HIT. Methods This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model’s explanatory power and to make it more applicable to health consumers’ behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers’ use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. Results The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers’ attitude and behavioral intention. Health consumers’ health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. Conclusions An extended TAM in the HIT arena was found to be valid to describe health

  20. Prevention through health risk management.

    PubMed

    Friedman, G M

    1992-08-01

    Risk can lead to catastrophe. Risk-management systems are highly effective in preventing the catastrophes of fire, earthquakes, and work-site injuries. No such effective systems are present to prevent health and social problems. A practical, cost-effective system to manage risk in children is being developed by the nonprofit Arizona Health Evaluation and Longevity Planning (HELP) Foundation. Information regarding such risk is collected in the school setting. This voluntary information comes from the administration, the school nurse, physical fitness testing, blood testing by the local hospital, self-esteem instruments, and parent, teacher, and child questionnaires. The HELP Foundation then develops an individual child and class risk profile that is presented to the teacher, school nurse, principal, and parent. Those involved with each child then prioritize, plan, and implement programs and activities to manage the identified risk(s). Risks is tracked throughout the child's school career by periodic reassessment. Evaluation of change in problem outcome will be a natural extension of the process. PMID:1643740

  1. Health risks of energy systems.

    PubMed

    Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

    1998-08-01

    Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed. PMID:9775447

  2. Biological risk and occupational health.

    PubMed

    Corrao, Carmela Romana Natalina; Mazzotta, Adele; La Torre, Giuseppe; De Giusti, Maria

    2012-01-01

    Many work activities include hazards to workers, and among these biological risk is particularly important, mostly because of different types of exposure, contact with highly dangerous agents, lack of limit values able to compare all exposures, presence of workers with defective immune systems and therefore more susceptible to the risk. Bioaerosols and dust are considered important vehicles of microganisms at workplaces and interaction with other occupational agents is assumed. Moreover, biological risk can be significant in countries with increasing economic development or particular habits and some biological agents are also classified as carcinogenic to human. Specific emerging biological risks have been recently pointed out by Risk Observatory of the European Agency for Safety and Health at work, and we must consider the worker's attitude and behaviour, influenced by his own perception of risk more than his real knowledge, that could over-underestimate the risk itself. Therefore, biological risk at work requires a complex approach in relation to risk assessment and risk management, made more difficult due to the wide variety of biological agents, working environments and working techniques that can determine the exposures. PMID:22785422

  3. Health Practices and Vaginal Microbicide Acceptability among Urban Black Women

    PubMed Central

    Wade, Christine; Chao, Maria T.; Kronenberg, Fredi; Cushman, Linda F.

    2008-01-01

    Abstract Background Intravaginal topical microbicides are being investigated for prevention of HIV transmission. Use of vaginal microbicides will constitute a new type of practice, occurring in the context of other vaginal practices related to contraception, hygiene, and self-care, which are affected by cultural norms and personal beliefs. Given the high rate of HIV infection among black women, research on practices and decision making relevant to microbicide acceptability is needed in this population. Methods Twenty-three black women in New York City, aged 25–64, completed in-person semistructured interviews and self-administered questionnaires. Quantitative analyses examined vaginal practices and willingness to use microbicides. Qualitative analyses explored underlying decision-making processes involved in choices regarding vaginal practices and general healthcare. Results Willingness to use vaginal products for HIV prevention was high, especially among more educated women. Safety was a major concern, and women were cautious about using vaginal products. Whereas some viewed synthetic products as having potentially harmful side effects, others perceived natural products as risky because of insufficient testing. Choices about vaginal practices were affected by assessments of risk and efficacy, prior experience, cultural background, and general approach to healthcare. Conclusions The majority of women in the sample expressed willingness to use a vaginal product for HIV prevention. Decision-making processes regarding vaginal practices were complex and were affected by social, cultural, and personal factors. Although specific preferences may vary, attitudes toward using a vaginal product are likely to be positive when side effects are minimal and the product is considered safe. PMID:18788991

  4. Health risk associated with airborne asbestos.

    PubMed

    Pawełczyk, Adam; Božek, František

    2015-07-01

    The following paper presents an assessment of health risks associated with air polluted with respirable asbestos fibers in towns of southwest Poland. The aim of the work was to determine whether or not any prevention measures are necessary in order to reduce the level of exposure to the pollutant. The risk assessment was carried out based on the air analyses and the latest asbestos toxicity data published by the Environmental Protection Agency (US EPA), USA and Office of Environmental Health Hazard Assessment (OEHHA). It was found that in some sites, the concentration of the asbestos fibers exceeded the acceptable levels, which should be a reason of special concern. The highest concentration of asbestos was found in town centers during the rush hours. In three spots, the calculated maximum health risk exceeded 1E-04 which is considered too high according to the adopted standards. So far, it has not yet been possible to find a reasonable method of ensuring the hazard reduction. PMID:26070993

  5. A new approach to criteria for health risk assessment

    SciTech Connect

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

    2012-01-15

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

  6. Public views of acceptability of perinatal mental health screening and treatment preference: a population based survey

    PubMed Central

    2014-01-01

    Background At a prevalence rate of 13-25%, mental health problems are among the most common morbidities of the prenatal and postnatal periods. They have been associated with increased risk of preterm birth and low birthweight, child developmental delay, and poor child mental health. However, very few pregnant and postpartum women proactively seek help or engage in treatment and less than 15% receive needed mental healthcare. While system-related barriers limit accessibility and availability of mental health services, personal barriers, such as views of mental health and its treatment, are also cited as significant deterrents of obtaining mental healthcare. The purposes of this population-based study were to identify the public’s views regarding mental health screening and treatment in pregnant and postpartum women, and to determine factors associated with those views. Methods A computer-assisted telephone survey was conducted by the Population Research Laboratory with a random sample of adults in Alberta, Canada. Questions were drawn from the Perinatal Depression Monitor, an Australian population-based survey on perinatal mental health; additional questions were developed and tested to reflect the Canadian context. Interviews were conducted in English and were less than 30 minutes in duration. Descriptive and multivariable regression analyses were conducted. Results Among the 1207 respondents, 74.8% had post-secondary education, 16.3% were 18-34 years old, and two-thirds (66.1%) did not have children <18 years living at home. The majority of respondents strongly agreed/agreed that all women should be screened in the prenatal (63.0%) and postpartum periods (72.7%). Respondents reported that when seeking help and support their first choice would be a family doctor. Preferred treatments were talking to a doctor or midwife and counseling. Knowledge of perinatal mental health was the main factor associated with different treatment preferences. Conclusions The high

  7. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... reusable launch vehicle mission risk. (a) To obtain safety approval for an RLV mission, an applicant must demonstrate that the proposed mission does not exceed acceptable risk as defined in this subpart. For...

  8. Acceptance of selective contracting: the role of trust in the health insurer

    PubMed Central

    2013-01-01

    Background In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and both increase the quality of care and contain costs in the health care system. However, health insurers are reluctant to implement selective contracting; they believe their enrolees will not accept this. One reason, insurers believe, is that enrolees do not trust their health insurer. However, this has never been studied. This paper aims to study the role played by enrolees’ trust in the health insurer on their acceptance of selective contracting. Methods An online survey was conducted among 4,422 people insured through a large Dutch health insurance company. Trust in the health insurer, trust in the purchasing strategy of the health insurer and acceptance of selective contracting were measured using multiple item scales. A regression model was constructed to analyse the results. Results Trust in the health insurer turned out to be an important prerequisite for the acceptance of selective contracting among their enrolees. The association of trust in the purchasing strategy of the health insurer with acceptance of selective contracting is stronger for older people than younger people. Furthermore, it was found that men and healthier people accepted selective contracting by their health insurer more readily. This was also true for younger people with a low level of trust in their health insurer. Conclusion This study provides insight into factors that influence people’s acceptance of selective contracting by their health insurer. This may help health insurers to implement selective contracting in a way their enrolees will accept and, thus, help systems of managed competition to develop. PMID:24083663

  9. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

    PubMed Central

    Trinkoff, A.M.; Storr, C.L.; Wilson, M.L.; Gurses, A.P.

    2015-01-01

    Summary Background To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model. Objectives To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. Methods A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Results Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Conclusions Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their

  10. Health risks of alcohol use

    MedlinePlus

    Alcoholism - risks; Alcohol abuse - risks; Alcohol dependence - risks; Risky drinking - risks ... sleep problems or make them worse Increase the risk of suicide Families are often affected when someone ...

  11. 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,…

  12. The role of acceptance and job control in mental health, job satisfaction, and work performance.

    PubMed

    Bond, Frank W; Bunce, David

    2003-12-01

    Acceptance, the willingness to experience thoughts, feelings, and physiological sensations without having to control them or let them determine one's actions, is a major individual determinant of mental health and behavioral effectiveness in a more recent theory of psychopathology. This 2-wave panel study examined the ability of acceptance also to explain mental health, job satisfaction, and performance in the work domain. The authors hypothesized that acceptance would predict these 3 outcomes 1 year later in a sample of customer service center workers in the United Kingdom (N = 412). Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control. These beneficial effects of having more job control were enhanced when people had higher levels of acceptance. The authors discuss the theoretical and practical relevance of this individual characteristic to occupational health and performance. PMID:14640816

  13. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

    PubMed Central

    2016-01-01

    Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses. Results The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior. Conclusions Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals. PMID:26935646

  14. [Considerations about health risk management].

    PubMed

    Bossi, A; Abetti, P; De Luca, S; Masullo, M

    2003-01-01

    From the birth of doctrines of Risk Management to today a lot of time is passed. From the initial application in the field of the insurances and the management of the enterprises, theories inspired to the identification, evaluation and correction of connected risks to the activity and the industrial trial has been figurative to the health, field in which the application of these principles results to be how much never profit and productive of benefits above all for the patients that suffer consequences of errors but also for the physicians and the personnel that, perfectly inserted in an organization aware of the trials to put into effect, can bring their contribution to underline the weak points of the relief trial. The economic cost and consequences of errors can decrease if a new culture is established inspired to the learning and the communication of the adverse events, to minimize the possibility that they again occurs. PMID:14969298

  15. Risk management frameworks for human health and environmental risks.

    PubMed

    Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

    2003-01-01

    A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision

  16. Becoming overweight: is there a health risk?

    PubMed

    Ginter, E; Simko, V

    2014-01-01

    Overweight and obesity is becoming widespread enough to generate an acceptable and misleading social status. By 2030, in the USA up to 86 % of adults will be overweight or obese. Some selected statistical data based on the body mass index (BMI) indicated that overweight was not associated with increased mortality, this provoked a conceivable interest. Added to this is the observation that while the prevalence of obesity is dramatically increasing, the cardiovascular mortality and life expectancy in the European Union and USA has improved. When more sensitive indicators of body adiposity and its distribution than the BMI, like the waist-thigh ratio in both sexes and the waist-hip ratio in women are projected on mortality, it becomes obvious that even overweight is associated with an increased health risk. Gaining excessive body fat is a continuous, frequently progressive process. Present obesity epidemic in childhood will manifest with deleterious consequences only in future years when adolescents reach adulthood. Prevention is thus essential even before the overweight sets in. Improved life expectancy observed in large populations despite obesity epidemic, is a favourable medical success in the management of hypertension, of serum lipid disorders and diabetes. While encouraging, when it is observed in large population, it does not take away the potential health risk of a metabolic disorder in an individual who is overweight (Fig. 7, Ref. 25). PMID:25318909

  17. THE TECHNOLOGY ACCEPTANCE MODEL: ITS PAST AND ITS FUTURE IN HEALTH CARE

    PubMed Central

    HOLDEN, RICHARD J.; KARSH, BEN-TZION

    2009-01-01

    Increasing interest in end users’ reactions to health information technology (IT) has elevated the importance of theories that predict and explain health IT acceptance and use. This paper reviews the application of one such theory, the Technology Acceptance Model (TAM), to health care. We reviewed 16 data sets analyzed in over 20 studies of clinicians using health IT for patient care. Studies differed greatly in samples and settings, health ITs studied, research models, relationships tested, and construct operationalization. Certain TAM relationships were consistently found to be significant, whereas others were inconsistent. Several key relationships were infrequently assessed. Findings show that TAM predicts a substantial portion of the use or acceptance of health IT, but that the theory may benefit from several additions and modifications. Aside from improved study quality, standardization, and theoretically motivated additions to the model, an important future direction for TAM is to adapt the model specifically to the health care context, using beliefs elicitation methods. PMID:19615467

  18. 24 CFR 266.305 - HFAs accepting less than 50 percent of risk.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of risk. 266.305 Section 266.305 Housing and Urban Development Regulations Relating to Housing and... AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Processing, Development, and Approval § 266.305 HFAs accepting less than 50 percent of...

  19. 24 CFR 266.300 - HFAs accepting 50 percent or more of risk.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of risk. 266.300 Section 266.300 Housing and Urban Development Regulations Relating to Housing and... AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Processing, Development, and Approval § 266.300 HFAs accepting 50 percent or more of...

  20. 24 CFR 266.300 - HFAs accepting 50 percent or more of risk.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of risk. 266.300 Section 266.300 Housing and Urban Development Regulations Relating to Housing and... AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Processing, Development, and Approval § 266.300 HFAs accepting 50 percent or more of...

  1. 24 CFR 266.305 - HFAs accepting less than 50 percent of risk.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of risk. 266.305 Section 266.305 Housing and Urban Development Regulations Relating to Housing and... AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Processing, Development, and Approval § 266.305 HFAs accepting less than 50 percent of...

  2. Factors Associated with Acceptability of HIV Self-Testing Among Health Care Workers in Kenya

    PubMed Central

    Kalibala, Samuel; Tun, Waimar; Cherutich, Peter; Nganga, Anne; Oweya, Erick; Oluoch, Patricia

    2016-01-01

    Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIV-ST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing. A post-intervention survey was conducted among 765 HCWs. Forty-one percent attended the information session; of those, 89 % took the HIVST kits and of those, 85 % self-tested. Thirty-four percent of surveyed HCWs used the HIVST to test themselves. Of those who took the HIVST kit and had partners, 73 % gave the kit to their partner and 86 % of them indicated their partner self-tested. Factors positively associated with use of the HIVST on self were being female, being single, and being a HCW from Homa Bay Hospital (located in a high HIV prevalence area). HIVST is acceptable to HCWs and their partners. However, strategies are needed to increase HCWs attendance at pre-implementation information sessions. PMID:24974123

  3. Risk perception and public acceptance toward a highly protested Waste-to-Energy facility.

    PubMed

    Ren, Xiangyu; Che, Yue; Yang, Kai; Tao, Yun

    2016-02-01

    The application of Waste-to-Energy treatment in Municipal Solid Waste faces strong protest by local communities, especially in cities with high population densities. This study introduces insight into the public awareness, acceptance and risk perception toward Waste-to-Energy through a structured questionnaire survey around a Waste-to-Energy facility in Shanghai, China. The Dichotomous-Choice contingent valuation method was applied to study the willingness to accept of residents as an indicator of risk perception and tolerance. The factors influencing risk perception and the protest response choice were analyzed. The geographical distributions of the acceptance of Waste-to-Energy facility and protest response were explored using geographical information systems. The findings of the research indicated an encouraging vision of promoting Waste-to-Energy, considering its benefits of renewable energy and the conservation of land. A high percentage of protest willingness to accept (50.94%) was highlighted with the effect of income, opinion about Waste-to-Energy, gender and perceived impact. The fuzzy classification among people with different opinions on compensation (valid 0, positive or protest willingness to accept) revealed the existing yet rejected demand of compensation among protesters. Geographical distribution in the public attitude can also be observed. Finally significant statistical relation between knowledge and risk perception indicates the need of risk communication, as well as involving public into whole management process. PMID:26577458

  4. Behavioral science perspectives on health hazard/health risk appraisal.

    PubMed Central

    Becker, M H; Janz, N K

    1987-01-01

    Health-promotion efforts often employ HRA as a device for providing an individual with quantitative information about the consequences of personal health-related behaviors and as an attempt to motivate the client to adopt recommendations directed at establishing a healthier lifestyle. From a behavioral science perspective, the HRA approach and process contain elements that (at least in retrospective analysis) appear to be founded in relevant bodies of theory. First, HRA seems to be a reasonably efficient mechanism for transmitting information relative to associations between personal health behaviors and mortality risks. Moreover, while general knowledge and advice about the untoward consequences of risk factors (such as smoking, obesity, high blood pressure, etc.) are currently widespread, HRA provides new and specific information: the client's own relative risks. Some individuals who voluntarily participate in HRA bring to the experience an already high level of readiness to take action; for them, the technique may constitute the final necessary stimulus or "cue to action" [12]. Referring to a "borrowing from the future" phenomenon, Green points out that "some educational efforts are really only triggers to behavior that would have changed eventually anyway" [44, p. 159]. Thus, where motivation is sufficiently high, receipt of HRA feedback information may by itself be capable of inducing behavior change. Second, the focus on awareness and personalization of mortality risk fits well with most theoretical formulations concerning attitudes and beliefs involved in health-related decision making. Although the emphasis on mortality and often distant negative outcomes is problematic, increasing the client's perception of personal vulnerability is a psychologically defensible approach, and fear arousal can generate attitude change (although questions of appropriate level, duration of effects obtained, acceptability, etc. still need to be resolved). Third, HRA might be

  5. 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…

  6. The Health Risks of Asian Americans. Editorial.

    ERIC Educational Resources Information Center

    Yu, Elena S. H.

    1991-01-01

    Although Asian Americans are the fastest growing ethnic minority group in the United States, relatively little is known about the health risks and morbidity of different Asian-American groups. A national survey (National Health Interview Survey) is needed to clarify the health risks of major Asian-American subgroups. (SLD)

  7. Pain Intensity and Patients’ Acceptance of Surgical Complication Risks With Lumbar Fusion

    PubMed Central

    Bono, Christopher M.; Harris, Mitchel B.; Warholic, Natalie; Katz, Jeffrey N.; Carreras, Edward; White, Andrew; Schmitz, Miguel; Wood, Kirkham B.; Losina, Elena

    2014-01-01

    Study Design Cross-sectional study with prospective recruitment Objective To determine the relationship of pain intensity (back and leg) on patients’ acceptance of surgical complication risks when deciding whether or not to undergo lumbar spinal fusion. Background To formulate informed decisions regarding lumbar fusion surgery, preoperative discussions should include a review of the risk of complications balanced with the likelihood of symptom relief. Pain intensity has the potential to influence a patient’s decision to consent to lumbar fusion. We hypothesized that pain intensity is associated with a patient’s acceptance of surgical complication risks. Methods Patients being seen for the first time by a spine surgeon for treatment of a non-traumatic or non-neoplastic spinal disorder completed a structured questionnaire. It posed 24 scenarios, each presenting a combination of risks of 3 complications (nerve damage, wound infection, nonunion) and probabilities of symptom relief. For each scenario, the patient indicated whether he/she would/would not consent to a fusion for low back pain (LBP). The sum of the scenarios in which the patient responded that he or she would elect surgery was calculated to represent acceptance of surgical complication risks. A variety of other data were also recorded, including age, gender, education level, race, history of non-spinal surgery, duration of pain, and history of spinal injections. Data were analyzed using bivariate analyses and multivariate regression analyses. Results The mean number of scenarios accepted by 118 enrolled subjects was 10.2 (median 8, standard deviation 8.5, range 0 to 24, or 42.5% of scenarios). In general, subjects were more likely to accept scenarios with lower risks and higher efficacy. Spearman’s rank correlation estimates demonstrated a moderate association between the LBP intensity and acceptance of surgical complication risks (r=0.37, p=0.0001) while leg pain intensity had a weak but positive

  8. Perception and acceptance of risk from radiation exposure in space flight

    SciTech Connect

    Slovic, P.

    1997-04-30

    There are a number of factors that influence how a person views a particular risk. These include whether the risk is judged to be voluntary and/or controllable, whether the effects are immediate or delayed, and the magnitude of the benefits that are to be gained as a result of being exposed to the risk. An important aspect of the last factor is whether those who suffer the risks are also those who stand to reap the benefits. The manner in which risk is viewed is also significantly influenced by the manner in which it is framed and presented. In short, risk does not exist in the world independent of our minds and cultures, waiting to be measured. Assessments of risk are based on models whose structure is subjective and associated evaluations are laden with assumptions whose inputs are dependent on judgments. In fact, subjectivity permeates every aspect of risk assessment. The assessment of radiation risks in space is no exception. The structuring of the problem includes judgments related to the probability, magnitude, and effects of the various types of radiation likely to be encountered and assumptions related to the quantitative relationship between dose and a range of specific effects, all of which have associated uncertainties. For these reasons, there is no magic formula that will lead us to a precise level of acceptable risk from exposure to radiation in space. Acceptable risk levels must evolve through a process of negotiation that integrates a large number of social, technical, and economic factors. In the end, a risk that is deemed to be acceptable will be the outgrowth of the weighing of risks and benefits and the selection of the option that appears to be best.

  9. Health risk of chrysotile revisited

    PubMed Central

    Dunnigan, Jacques; Hesterberg, Thomas; Brown, Robert; Velasco, Juan Antonio Legaspi; Barrera, Raúl; Hoskins, John; Gibbs, Allen

    2013-01-01

    This review provides a basis for substantiating both kinetically and pathologically the differences between chrysotile and amphibole asbestos. Chrysotile, which is rapidly attacked by the acid environment of the macrophage, falls apart in the lung into short fibers and particles, while the amphibole asbestos persist creating a response to the fibrous structure of this mineral. Inhalation toxicity studies of chrysotile at non-lung overload conditions demonstrate that the long (>20 µm) fibers are rapidly cleared from the lung, are not translocated to the pleural cavity and do not initiate fibrogenic response. In contrast, long amphibole asbestos fibers persist, are quickly (within 7 d) translocated to the pleural cavity and result in interstitial fibrosis and pleural inflammation. Quantitative reviews of epidemiological studies of mineral fibers have determined the potency of chrysotile and amphibole asbestos for causing lung cancer and mesothelioma in relation to fiber type and have also differentiated between these two minerals. These studies have been reviewed in light of the frequent use of amphibole asbestos. As with other respirable particulates, there is evidence that heavy and prolonged exposure to chrysotile can produce lung cancer. The importance of the present and other similar reviews is that the studies they report show that low exposures to chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low with even high exposures experienced over a short duration. PMID:23346982

  10. Acceptability of Delivering and Accessing Health Information Through Text Messaging Among Community Health Advisors

    PubMed Central

    Phillips, Janice; Mohiuddin, Mohammed Omar; McNees, Patrick; Scarinci, Isabel

    2013-01-01

    Background Communication technologies can play a significant role in decreasing communication inequalities and cancer disparities by promoting cancer control and enhancing population and individual health. Studies have shown that technology, such as the mobile phone short message service (SMS) or text messaging, can be an effective health communication strategy that influences individuals’ health-related decisions, behaviors, and outcomes. Objective The purpose of this study was to explore usage of communication technologies, assess the acceptability of mobile technology for delivery and access of health information, and identify cancer and health information needs among Deep South Network for Cancer Control trained Community Health Advisors as Research Partners (CHARPs). Methods A mixed-method design was used, and a triangulation protocol was followed to combine quantitative and qualitative data. Focus groups (4 focus groups; n=37) and self-administered surveys (n=77) were conducted to determine CHARPs mobile phone and text message usage. The objective was to include identification of barriers and facilitators to a mobile phone intervention. Results All participants were African American (37/37, 100%), 11/37 (89%) were women, and the mean age was 53.4 (SD 13.9; focus groups) and 59.9 (SD 8.7; survey). Nearly all (33/37, 89%) of focus group participants reported owning a mobile phone. Of those, 8/33 (24%) owned a smartphone, 22/33 (67%) had a text messaging plan, and 18/33 (55%) and 11/33 (33%) received and sent text messages several times a week or day, respectively. Similar responses were seen among the survey participants, with 75/77 (97%) reporting owning a mobile phone, and of those, 22/75 (30%) owned a smartphone, 39/75 (53%) had a text messaging plan, and 37/75 (50%) received and 27/75 (37%) sent text messages several times a week or day. The benefits of a text messaging system mentioned by focus group participants included alternative form of

  11. Health Risk Appraisal Use at Headquarters

    NASA Technical Reports Server (NTRS)

    Borcherding, Donald

    1997-01-01

    Specific topics which relate to the NASA Health Risk Appraisal (HRA) include: (1) What is a HRA?; (2) Risk factors; (3) Program use at NASA Headquarters; (4) An alternative approach; (5) Group HRA reports; and (6) Future considerations and conclusion.

  12. An analytical framework for flood water conservation considering forecast uncertainty and acceptable risk

    NASA Astrophysics Data System (ADS)

    Ding, Wei; Zhang, Chi; Peng, Yong; Zeng, Ruijie; Zhou, Huicheng; Cai, Ximing

    2015-06-01

    This paper addresses how much flood water can be conserved for use after the flood season through the operation of reservoir by taking into account the residual flood control capacity (the difference between flood conveyance capacity and the expected inflow in a lead time). A two-stage model for dynamic control of the flood-limited water level (the maximum allowed water level during the flood season, DC-FLWL) is established considering forecast uncertainty and acceptable flood risk. It is found that DC-FLWL is applicable when the reservoir inflow ranges from small to medium levels of the historical records, while both forecast uncertainty and acceptable risk in the downstream affect the feasible space of DC-FLWL. As forecast uncertainty increases (under a given risk level) or as acceptable risk level decreases (under a given forecast uncertainty level), the minimum required safety margin for flood control increases, and the chance for DC-FLWL decreases. The derived hedging rules from the modeling framework illustrate either the dominant role of water conservation or flood control or the trade-off between the two objectives under different levels of forecast uncertainty and acceptable risk. These rules may provide useful guidelines for conserving water from flood, especially in the area with heavy water stress. The analysis is illustrated via a case study with a real-world reservoir in northeastern China.

  13. Health Promotion Text Messaging Preferences and Acceptability Among the Medically Underserved.

    PubMed

    Albright, Karen; Krantz, Mori J; Backlund Jarquín, Paige; DeAlleaume, Lauren; Coronel-Mockler, Stephanie; Estacio, Raymond O

    2015-07-01

    The Colorado Healthy Heart Solutions program uses community health workers to provide health promotion and navigation services for participants in medically underserved, predominantly rural areas who are at risk for developing cardiovascular disease. A text messaging program designed to increase participant engagement and adherence to lifestyle changes was pilot tested with English- and Spanish-speaking participants. Preimplementation focus groups with participants informed the development of text messages that were used in a 6-week pilot program. Postimplementation focus groups and interviews then evaluated the pilot program. Participants reported a preference for concise messages received once daily and for positive messages suggesting specific actions that could be feasibly accomplished within the course of the day. Participants also consistently reported the desire for clarity in message delivery and content, indicating that the source of the messages should be easy to recognize, messages should state clearly when participants were expected to respond to the messages, and any responses should be acknowledged. Links to other websites or resources were generally viewed as trustworthy and acceptable, but were preferred for supplementary material only. These results may inform the development of future chronic disease management programs in underserved areas or augment existing programs using text messaging reinforcement. PMID:25586133

  14. A Systematic Review of Patient Acceptance of Consumer Health Information Technology

    PubMed Central

    Or, Calvin K.L.; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation. PMID:19390112

  15. A systematic review of patient acceptance of consumer health information technology.

    PubMed

    Or, Calvin K L; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation. PMID:19390112

  16. Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species

    PubMed Central

    Davidson, Alisha D.; Hewitt, Chad L.; Kashian, Donna R.

    2015-01-01

    Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources. PMID:26536244

  17. Health Risk Assessments for Alumina Refineries

    PubMed Central

    Coffey, Patrick S.

    2014-01-01

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

  18. Profiles of Risk: Maternal Health, Socioeconomic Status, and Child Health

    PubMed Central

    Hardie, Jessica Halliday; Landale, Nancy S.

    2013-01-01

    Child health is fundamental to well-being and achievement throughout the life course. Prior research has demonstrated strong associations between familial socioeconomic resources and children’s health outcomes, with especially poor health outcomes among disadvantaged youth who experience a concentration of risks, yet little is known about the influence of maternal health as a dimension of risk for children. This research used nationally representative U.S. data from the National Health Interview Surveys in 2007 and 2008 (N = 7,361) to evaluate the joint implications of maternal health and socioeconomic disadvantage for youth. Analyses revealed that maternal health problems were present in a substantial minority of families, clustered meaningfully with other risk factors, and had serious implications for children’s health. These findings support the development of health policies and interventions aimed at families. PMID:23794751

  19. Participation in Counseling Programs: High-Risk Participants Are Reluctant to Accept HIV-Prevention Counseling

    PubMed Central

    Earl, Allison; Albarracín, Dolores; Durantini, Marta R.; Gunnoe, Joann B.; Leeper, Josh; Levitt, Justin H.

    2013-01-01

    HIV-prevention intervention effectiveness depends on understanding whether clients with highest need for HIV-prevention counseling accept it. With this objective, a field study with a high-risk community sample from the southeastern United States (N = 350) investigated whether initial knowledge about HIV, motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use correlate with subsequent acceptance of an HIV-prevention counseling session. Ironically, participants with high (vs. low) motivation to use condoms, high (vs. low) condom-use-relevant behavioral skills, and high (vs. low) prior condom use were more likely to accept the HIV-prevention counseling. Moreover, the influence of motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use on acceptance of the counseling was mediated by expectations that the counseling session would be useful. Methods to reduce barriers to recruitment of clients for counseling programs are discussed. PMID:19634960

  20. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL...

  1. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL...

  2. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL...

  3. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING REENTRY OF A REENTRY VEHICLE OTHER THAN A REUSABLE LAUNCH VEHICLE (RLV) Safety...

  4. Addressing Risks to Advance Mental Health Research

    PubMed Central

    Iltis, Ana S.; Misra, Sahana; Dunn, Laura B.; Brown, Gregory K.; Campbell, Amy; Earll, Sarah A.; Glowinski, Anne; Hadley, Whitney B.; Pies, Ronald; DuBois, James M.

    2015-01-01

    Objective Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards (IRBs) may reject study designs that appear too risky. This can discourage needed research, particularly in higher risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. This article provides mental health researchers with practical approaches to: 1) identify and define various intrinsic research risks; 2) communicate these risks to others (e.g., potential participants, regulatory bodies, society); 3) manage these risks during the course of a study; and 4) justify the risks. Methods As part of a National Institute of Mental Health (NIMH)-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. IRB review was not required because there were no human subjects. The NIMH played no role in developing or reviewing the manuscript. Results Challenges, current data, practical strategies, and topics for future research are addressed for each of four key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Conclusions Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain IRB approval. PMID:24173618

  5. Perception of Influencing Factors on Acceptance of Mobile Health Monitoring Service: A Comparison between Users and Non-users

    PubMed Central

    Lee, Jaebeom

    2013-01-01

    Objectives To improve and promote mobile health monitoring services, this study investigated the perception of various factors influencing the acceptance of services between users and non-users. Methods This study drew 9 variables from studies related to mobile health monitoring services and the unified theory of acceptance and the use of technology model. A total of 219 samples were collected by a paper-based survey from users (n = 106) and non-users (n = 113). Analysis was carried out using a two-independent samples t-test. Results The findings indicate that users have a more positive perception of service benefits than non-users. Although there were difference between users and non-users, all respondents had a positive perception of the service benefits. After users used the service, they were less concerned about the risks involved with it. However, both users and non-users had a high negative perception of service risk. Users also had a more positive perception of intimacy and communication associated with the services than non-users. Both users and non-users had a high behavioral intention to use the services. Finally, this study observed that older subjects tended to recognize the higher value of the services. Conclusions This study provides insights to improve and invigorate mobile health monitoring services. This study also offers insights into how to increase the number of users of mobile health monitoring services in South Korea. PMID:24175115

  6. The impact of user's perceived ability on online health information acceptance.

    PubMed

    Kim, Nam Eun; Han, Sang Sook; Yoo, Keun Hee; Yun, Eun Kyoung

    2012-11-01

    The purpose of this study was to explain how perceived ability affects users' acceptance of online health information in Korea. Data were collected by a Web-based survey, and, in total, 449 samples were used for final analysis. The hypothetical model of this study was based on the Technology Acceptance Model. A structural equation modeling was used to evaluate the relationship between the included variables. The final model with appropriate relations exhibited an adequate fit to the data. This study provides evidence that perceived ease of use, perceived usefulness, and perceived credibility significantly affect how individuals use health information from the Internet. The subjective health knowledge and Internet efficacy exerted strong indirect effects on users' attitude and intention to use the online health information via the mediators of perceived ease of use, perceived usefulness, and perceived credibility. This study supports the hypothesis that the perceived ability of users is related to their acceptance of online health information. Users' perceived ability, including subjective health knowledge and Internet efficacy, was confirmed as a prerequisite for their health information use on the Internet. The results demonstrated that perceived ease of use, perceived usefulness, and perceived credibility are substantive mediators. Future research should consider a wider array of characteristics of health information and users and incorporate these characteristics for the provision of more useful, user-centered health information. PMID:23072632

  7. New Mexico Adolescent Health Risks Survey.

    ERIC Educational Resources Information Center

    Antle, David

    To inform students of health risks (posed by behavior, environment, and genetics) and provide schools with collective risk appraisal information as a basis for planning/evaluating health and wellness initiatives, New Mexico administered the Teen Wellness Check in 1985 to 1,573 ninth-grade students from 7 New Mexico public schools. Subjects were…

  8. Air pollution ranks as largest health risk

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-04-01

    The World Health Organization (WHO) reports that 7 million people died in 2012 from air-pollution-related sicknesses, marking air pollution as the single largest environmental health risk. This finding, a result of better knowledge and assessment of the diseases, is more than double previous estimates of the risk of death from air pollution.

  9. Utilizing the health belief model to assess vaccine acceptance of patients on hemodialysis.

    PubMed

    Adams, Angela; Hall, Mellisa; Fulghum, Janis

    2014-01-01

    Vaccine rates in patients on hemodialysis are substantially lower than the Healthy People 2020 targets. The purpose of this study is to utilize the perceptions and cues for action constructs of the Health Belief Model (HBM) to assess the attitudes of patients receiving outpatient hemodialysis regarding acceptance of the seasonal influenza, pneumococcal, and hepatitis B virus vaccines. Vaccine acceptance is defined as receiving the vaccine. Study findings suggest age, perceived susceptibility, and perceived severity increase the odds of getting some vaccines. Findings have implications for the development of patient education materials, interdisciplinary team assessments, and plan of care strategies to increase vaccine acceptance. PMID:25244894

  10. The effect of acceptance training on psychological and physical health outcomes in elders with chronic conditions.

    PubMed

    McDonald, Patricia E; Zauszniewski, Jaclene A; Bekhet, Abir K; DeHelian, Laura; Morris, Diana L

    2011-12-01

    This pilot trial investigated the short and long-term effects of Acceptance Training (ACT) intervention on acceptance, perceived health, functional status, anxiety, and depression in elders with chronic conditions living in retirement communities (RCs). The ACT intervention combined Rational Emotive Behavior Therapy with music, relaxation, and guided imagery during six weekly 2-hour sessions. Face-to-face interviews were conducted with 16 African-American and 46 White elders across four data collection points in six randomly selected RCs using well-established measures of perceived health, functional status, anxiety, and depression, and a measure of acceptance of chronic conditions adapted from a previous measure of acceptance of diabetes. While changes were found in perceived health, functional status, anxiety, and depression, the most significant changes occurred in the elders' acceptance of chronic conditions immediately after the intervention (t = -2.62, p < .02), and these changes persisted for 6 and 12 weeks (t's = -2.74, -3.32, p's < .01), respectively. Although a 40% attrition rate reduced the sample size from 62 (N = 62) to 37 (N = 37), the significant increases in acceptance over time provide initial evidence for the fidelity of the ACT intervention. PMID:23061175

  11. Feasibility and Acceptability of Cell Phone Diaries to Measure HIV Risk Behavior Among Female Sex Workers

    PubMed Central

    Hensel, Devon J.; Fortenberry, J. Dennis; Garfein, Richard S.; Gunn, Jayleen K. L.; Wiehe, Sarah E.

    2015-01-01

    Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group. PMID:24643312

  12. Mental health risk assessment - a guide for GPs.

    PubMed

    Balaratnasingam, Sivasankaran

    2011-06-01

    BACKGROUND Risk assessment of patients in general practice is a challenging area of clinical practice. Competing interests of managing patient wishes, consideration of duty to warn others and invoking the Mental Health Act while practising in a medicolegally accountable manner can be difficult. OBJECTIVE This article summarises the risk assessment of patients with possible mental disorders and provides suggestions regarding measures that may be undertaken to manage risk in psychiatric emergencies. DISCUSSION The evidence of effectiveness for risk assessment interventions in acute settings is limited. While it is not possible for general practitioners to predict the future, and particularly to predict fatal outcomes, they can be expected to meet a standard of care that identifies those at risk and provide an acceptable clinical response. PMID:21655480

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

    PubMed

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

    2004-02-01

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

  14. Social trust, risk perceptions and public acceptance of recycled water: testing a social-psychological model.

    PubMed

    Ross, Victoria L; Fielding, Kelly S; Louis, Winnifred R

    2014-05-01

    Faced with a severe drought, the residents of the regional city of Toowoomba, in South East Queensland, Australia were asked to consider a potable wastewater reuse scheme to supplement drinking water supplies. As public risk perceptions and trust have been shown to be key factors in acceptance of potable reuse projects, this research developed and tested a social-psychological model of trust, risk perceptions and acceptance. Participants (N = 380) were surveyed a few weeks before a referendum was held in which residents voted against the controversial scheme. Analysis using structural equation modelling showed that the more community members perceived that the water authority used fair procedures (e.g., consulting with the community and providing accurate information), the greater their sense of shared identity with the water authority. Shared social identity in turn influenced trust via increased source credibility, that is, perceptions that the water authority is competent and has the community's interest at heart. The findings also support past research showing that higher levels of trust in the water authority were associated with lower perceptions of risk, which in turn were associated with higher levels of acceptance, and vice versa. The findings have a practical application for improving public acceptance of potable recycled water schemes. PMID:24603028

  15. Public Health Risk Conditioned by Chemical Composition of Ground Water

    NASA Astrophysics Data System (ADS)

    Yankovich, E.; Osipova, N.; Yankovich, K.; Matveenko, I.

    2016-03-01

    The article studies the public health potential risk originated from water consumption and estimated on the basis of the groundwater chemical composition. We have processed the results of chemical groundwater analysis in different aquifers of Tomsk district (Tomsk Oblast, Russia). More than 8400 samples of chemical groundwater analyses were taken during long-term observation period. Human health risk assessment of exposure to contaminants in drinking water was performed in accordance with the risk assessment guidance for public health concerning chemical pollution of the environment (Russian reference number: 2.1.10.1920-04-M, 2004). Identified potential risks were estimated for consuming water of each aquifer. The comparative analysis of water quality of different aquifers was performed on the basis of the risk coefficient of the total non-carcinogenic effects. The non-carcinogenic risk for the health of the Tomsk district population due to groundwater consumption without prior sanitary treatment was admitted acceptable. A rather similar picture is observed for all aquifers, although deeper aquifers show lower hazard coefficients.

  16. Sexual Barrier Acceptability Among Multiethnic HIV-Positive and At-Risk Women

    PubMed Central

    Jones, Deborah; Waldrop-Valverde, Drenna; Bruscantini, Laura; Weiss, Stephen

    2011-01-01

    Abstract Background Sexual behavior interventions have been found to reduce sexual risk among HIV-seropositive and high-risk HIV-seronegative women. Methods This study examined the influence of ethnicity and HIV serostatus on sexual barrier acceptability and use at short-term and long-term follow-up among African American and Hispanic (n = 457) women participating in a gender and culturally tailored sexual risk reduction intervention. We hypothesized that sexual barrier acceptability and use would differ between ethnic groups but that this difference would dissipate after intervention participation. We further postulated that HIV-seropositive women would report greater acceptability and use of sexual barriers than seronegative women at baseline and that after participation in the intervention, acceptability and use would increase for both serostatus groups. Results We enrolled 317 African American and 140 Hispanic women, 273 (60%) seropositive and 184 (40%) seronegative. Ethnic differences in the frequency of male and female condom use existed at baseline but were not found at 12-month follow-up. Male condom acceptability was higher among African American women than Hispanic women at baseline and 12-month follow-up. Seropositive women reported higher levels of consistent male condom use, but both ethnic and serostatus groups reported high levels (positive, 40%; negative, 52%) of inconsistent condom use. Most women had little experience with female condoms or lubricating gels and suppositories at baseline. No differences between ethnicities were identified in lubricant use. Conclusions Results support the use of a culturally tailored intervention among these populations to increase sexual barrier use and reduce sexual risk. PMID:21526524

  17. Factors influencing nursing students' acceptance of electronic health records for nursing education (EHRNE) software program.

    PubMed

    Kowitlawakul, Yanika; Chan, Sally Wai Chi; Pulcini, Joyce; Wang, Wenru

    2015-01-01

    The Institute of Medicine (IOM) and the Health Information Technology Act (2009) in America had recommended that electronic health records (EHRs) should be fully adopted by 2014. This has urged educational institutions to prepare healthcare professionals to be competent in using electronic health records (EHRs) while they are in schools. To equip nursing students with competency in using EHRs, an electronic health record for nursing education (EHRNE) has been developed and integrated it into nursing curricula. The purposes of the study were to investigate the factors influencing nursing students' acceptance of the EHRs in nursing education using the extended Technology Acceptance Model with self-efficacy as a conceptual framework. The study is a descriptive study design using self-reported questionnaires with 212 student participants. The IBM SPSS and AMOS 22.0 were used to analyze the data. The results showed that attitude toward using the EHRNE was the most influential factor on students' acceptance. The preliminary findings suggested that to enhance the students' acceptance of the EHRNE, cultivation of a positive attitude toward using this EHR as well as increasing the perceived usefulness is very important. Also, the study's framework could be used in guiding learning health informatics and be applied to nursing students. PMID:24947068

  18. An Analytical Framework for Flood Water Conservation Considering Forecast Uncertainty and Acceptable Risk

    NASA Astrophysics Data System (ADS)

    Ding, W.; Zhang, C.

    2015-12-01

    Reservoir water levels are usually not allowed to exceed the flood limited water level (FLWL) during flood season, which neglects the meteorological and real-time forecast information and leads to the great waste of water resources. With the development of weather forecasting, hydrologic modeling, and hydro-climatic teleconnection, the streamflow forecast precision have improved a lot, which provides the technical support for the flood water utilization. This paper addresses how much flood water can be conserved for use after the flood season through the operation of reservoir based on uncertain forecast information by taking into account the residual flood control capacity (the difference between flood conveyance capacity and the expected inflow in a lead time). A two-stage model for dynamic control of the flood limited water level (the maximum allowed water level during the flood season, DC-FLWL) is established considering forecast uncertainty and acceptable flood risk. It is found that DC-FLWL is applicable when the reservoir inflow ranges from small to medium levels of the historical records, while both forecast uncertainty and acceptable risk in the downstream affect the feasible space of DC-FLWL. As forecast uncertainty increases (under a given risk level) or as acceptable risk level decreases (under a given forecast uncertainty level), the minimum required safety margin for flood control increases, and the chance for DC-FLWL decreases. The derived hedging rules from the modeling framework illustrate either the dominant role of water conservation or flood control or the tradeoff between the two objectives under different levels of forecast uncertainty and acceptable risk. These rules may provide useful guidelines for conserving water from flood, especially in the area with heavy water stress.

  19. Health Risk Behaviors in Parentally Bereaved Youth

    PubMed Central

    Muñiz-Cohen, Melissa; Melhem, Nadine M.; Brent, David A.

    2010-01-01

    Objective To investigate whether parentally bereaved offspring are more likely to engage in health risk behaviors than nonbereaved control offspring. Design Controlled population-based study. Setting Bereaved families were recruited from coroner records and by advertisement. Control families were recruited using random-digit dialing and by advertisement. Participants At 9.0 months after the death, 186 offspring aged 7 to 25 years of parents who died of suicide, accident, or sudden natural death were compared with 167 nonbereaved control offspring. Main Outcome Measures The association of bereavement with health risk behaviors was examined. The prevalences of health risk behaviors on the Youth Risk Behavior Questionnaire were compared between bereaved and nonbereaved offspring. Risk behaviors surveyed were related to unintentional injury, violence, sexual behavior, cigarette smoking, and alcohol or other drug use. Results No statistically significant difference was noted in the examined health risk behaviors between bereaved and nonbereaved offspring. Conclusions Bereaved offspring did not engage in more health risk behaviors compared with nonbereaved offspring. Primary care physicians counseling youth should inquire about health risk behaviors in general. PMID:20603461

  20. Health-risk based approach to setting drinking water standards for long-term space missions

    NASA Technical Reports Server (NTRS)

    Macler, Bruce A.; Dunsky, Elizabeth C.

    1992-01-01

    In order to develop plausible and appropriate drinking water contaminant standards for longer-term NASA space missions, such as those planned for the Space Exploration Initiative, a human health risk characterization was performed using toxicological and exposure values typical of space operations and crew. This risk characterization showed that the greatest acute waterborne health concern was from microbial infection leading to incapacitating gastrointestinal illness. Ingestion exposure pathways for toxic materials yielded de minimus acute health risks unlikely to affect SEI space missions. Risks of chronic health problems were within acceptable public health limits. Our analysis indicates that current Space Station Freedom maximum contamination levels may be unnecessarily strict. We propose alternative environmental contaminant values consistent with both acceptable short and long-term crew health safety.

  1. Managing the risks of on-site health centers.

    PubMed

    Gorman, Kathleen M; Miller, Ross M

    2011-11-01

    This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. PMID:22017191

  2. The Acceptance of e-Health Solutions Among Patients with Chronic Respiratory Conditions

    PubMed Central

    2013-01-01

    Abstract Objective: The main objective of this study was to assess the acceptance of the use of e-health applications by patients suffering from bronchial asthma and other chronic respiratory conditions. Subjects and Methods: The questionnaire, consisting of 73 items, was distributed among 200 patients remaining under the care of a tertiary-care pulmonology center in Krakow, Poland (return rate, 82.5%; n=165). Results: The mean age (standard deviation) of respondents was 50.8 (14.9) years. Of the respondents, 48.5% (n=80) suffered from bronchial asthma, 29.1% (n=48) from chronic obstructive pulmonary disease, and 32.1% (n=53) from other respiratory diseases. The Internet was used by 58.2% (n=96) of respondents. The most frequent types of health-related information searched for online included diseases (59.4%) and treatments (medication, 54.2%; treatment options, 58.3%), as well as information about physicians and healthcare institutions (32.3% and 31.3%, respectively). The differences between acceptance scores for specific e-health applications were significant (analysis of variance, Friedman chi-squared=166.315, p<0.001). The respondents revealed the highest acceptance of e-health solutions allowing them to book appointments with physicians, access laboratory test results, view educational resources, and renew prescriptions. The acceptance of the most popular e-health applications depended on the duration of disease, respondent's age and education, and his or her use of computers and the Internet. Conclusions: Patients suffering from chronic respiratory conditions demonstrate higher levels of acceptance of e-health applications such as appointment booking, prescription renewal, and access to information (laboratory test results, educational resources) than of solutions directly related to medical care (communication with healthcare providers, disease monitoring). PMID:23734700

  3. Health effects of risk-assessment categories

    SciTech Connect

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

    1983-10-01

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

  4. Perception of primary care pediatricians of effectiveness, acceptability, and availability of mental health services.

    PubMed

    Dempster, Nicole R; Wildman, Beth G; Duby, John

    2015-06-01

    Approximately 20% of children in the United States meet the criteria for a psychosocial disorder; however, less than 25% of these children receive psychosocial services. A questionnaire assessed primary care pediatricians' (PCPs) perceptions of effectiveness, availability, and burden of treatment options for children's psychosocial difficulties and parents' acceptance and adherence with these treatments. Repeated measures analysis of variance found that PCPs are more likely to refer children with psychosocial problems to a mental health professional than to prescribe medication. PCPs prescribe medications more than counseling parents themselves or watchful waiting. PCPs reported children's behavior is more likely to improve with mental health services than with medication, though medication is the most available treatment. PCPs believe parent training programs are very effective for treating children's behavior problems, but believe parents are more accepting and compliant with other treatments. Findings indicate PCPs' perceptions of availability and acceptability of treatment options drive their treatment recommendations of psychosocial problems. PMID:24130062

  5. Soy Goes to School: Acceptance of Healthful, Vegetarian Options in Maryland Middle School Lunches

    ERIC Educational Resources Information Center

    Lazor, Kathleen; Chapman, Nancy; Levine, Elyse

    2010-01-01

    Background: Soyfoods provide healthful options for school breakfasts and lunches that are lower in saturated fat, cholesterol, fat, and calories and can help meet demands for vegetarian choices. Researchers tested acceptance of soy-based options substituted for popular lunch items with a diverse student population. Methods: Researchers conducted a…

  6. Health risk and access to employer-provided health insurance.

    PubMed

    Buchmueller, T C

    1995-01-01

    The attractiveness of a job offering health benefits increases with a worker's expected medical expenditures. At the same time, employers have an incentive to screen out high-risk workers. Evidence from the 1984 Survey of Income and Program Participation indicates that employer screening dominates high-risk workers' desire to select jobs that offer insurance. Workers who describe their health as fair or poor, report difficulty with physical tasks, or have a work-related disability are less likely to receive employer-provided health insurance than healthy workers. Part of this effect is explained by the negative impact of poor health on earnings and labor supply. PMID:7713620

  7. Health risk implications from simultaneous exposure to multiple environmental contaminants.

    PubMed

    Genthe, B; Le Roux, W J; Schachtschneider, K; Oberholster, P J; Aneck-Hahn, N H; Chamier, J

    2013-07-01

    Water quality has deteriorated in the upper Olifants River system, South Africa, as a result of land use activities which include mining, agriculture and industries. A health risk assessment was conducted from 2009 to 2011 in the catchment to determine the possible risks local communities face from various pollutants such as microbials, heavy metals and oestrogen in the river water and vegetation. Aluminium and manganese accumulated in plants and vanadium and aluminium concentrations found in selective water samples posed significant health risks when consumed. A quantitative microbial risk assessment revealed that the combined risk of infection ranged from 1 to 26 percent with the Norovirus posing the overall greatest health risk. The anticipated disability adjusted life years resulting from drinking untreated water from these sites are in the order of 10,000 times greater than what is considered acceptable. The oestradiol activity, caused by endocrine disrupting compounds in the water, measured above the trigger value of 0.7ngL(-1). Impoverished communities in the area, who partially depend on river water for potable and domestic use, are exposed to immune-compromising metals that increase their probability of infection from waterborne diseases caused by the excess microbial pathogens in the contaminated surface water. PMID:23669339

  8. Human and Animal Sentinels for Shared Health Risks

    PubMed Central

    Rabinowitz, Peter; Scotch, Matthew; Conti, Lisa

    2009-01-01

    Summary The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions, and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such “shared risks” from environmental hazards has not been realized. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data, and evidence gaps in the linkages between human and animal responses to environmental health hazards. The One Health initiative and growing international collaboration in response to pandemic threats, coupled with development the fields of informatics and genomics, hold promise for improved sharing of knowledge about sentinel events in order to detect and reduce environmental health threats shared between species. PMID:20148187

  9. Risk management issues in postmenopausal health care.

    PubMed

    Edozien, Leroy C

    2007-12-01

    As in other areas of clinical activity, unintended harm to patients may occur in the course of postmenopausal health care, and measures to ensure patient safety should be actively promoted. This paper discusses the application of some basic principles of risk management to postmenopausal health care. To facilitate communication and reduce errors in diagnosis and treatment, risk management should be incorporated in the development of a dedicated menopause service. PMID:18088524

  10. Why should I?--Acceptance of Health Information Technology Among health professionals.

    PubMed

    D'Souza, Joseph M J; Hunter, Inga

    2015-01-01

    Applying the Technology Acceptance Model, the end user intentions to use technology applications is studied. The study finds the end users negative perception of the usefulness of the application as a major factor in its suboptimal utilisation. PMID:26262264

  11. Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander Australians: A Qualitative Study

    PubMed Central

    Mills, Patj Patj Janama Robert; Dingwall, Kylie Maree; Lowell, Anne; Singer, Judy; Rotumah, Darlene; Bennett-Levy, James; Nagel, Tricia

    2016-01-01

    Background Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. Objective This study aimed to explore Aboriginal and Torres Strait Islander community members’ experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Methods Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Results Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. Conclusions When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health

  12. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  13. Acceptability of a Mobile Health Unit for Rural HIV Clinical Trial Enrollment and Participation

    PubMed Central

    Miles, Margaret Shandor; Banks, Bahby; Corbie-Smith, Giselle

    2013-01-01

    Few rural minorities participate in HIV clinical trials. Mobile health units (MHUs) may be one strategy to increase participation. We explored community perceptions of MHU acceptability to increase clinical trial participation for rural minorities living with HIV/AIDS. We conducted 11 focus groups (service providers and community leaders) and 35 interviews (people living with HIV/AIDS). Responses were analyzed using constant comparative and content analysis techniques. Acceptable MHU use included maintaining accessibility and confidentiality while establishing credibility, community ownership and control. Under these conditions, MHUs can service rural locations and overcome geographic barriers to reaching major medical centers for clinical trials. PMID:22350829

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

    PubMed Central

    2000-01-01

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

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

    PubMed

    2000-10-01

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

  16. Adjusting Population Risk for Functional Health Status.

    PubMed

    Fuller, Richard L; Hughes, John S; Goldfield, Norbert I

    2016-04-01

    Risk adjustment accounts for differences in population mix by reducing the likelihood of enrollee selection by managed care plans and providing a correction to otherwise biased reporting of provider or plan performance. Functional health status is not routinely included within risk-adjustment methods, but is believed by many to be a significant enhancement to risk adjustment for complex enrollees and patients. In this analysis a standardized measure of functional health was created using 3 different source functional assessment instruments submitted to the Medicare program on condition of payment. The authors use a 5% development sample of Medicare claims from 2006 and 2007, including functional health assessments, and develop a model of functional health classification comprising 9 groups defined by the interaction of self-care, mobility, incontinence, and cognitive impairment. The 9 functional groups were used to augment Clinical Risk Groups, a diagnosis-based patient classification system, and when using a validation set of 100% of Medicare data for 2010 and 2011, this study found the use of the functional health module to improve the fit of observed enrollee cost, measured by the R(2) statistic, by 5% across all Medicare enrollees. The authors observed complex nonlinear interactions across functional health domains when constructing the model and caution that functional health status needs careful handling when used for risk adjustment. The addition of functional health status within existing risk-adjustment models has the potential to improve equitable resource allocation in the financing of care costs for more complex enrollees if handled appropriately. (Population Health Management 2016;19:136-144). PMID:26348621

  17. Effect of acculturation on the acceptability of potential microbicides and sexual risk-taking

    PubMed Central

    THURMAN, Andrea Ries; HOLDEN, Alan E C; SHAIN, Rochelle N; PERDUE, Sondra; PIPER, Jeanna M

    2009-01-01

    Background The objective was to determine the acceptability and use patterns of potential microbicides among African American (AA), Acculturated Hispanic (AH) and Less-Acculturated Hispanic (LAH) women. We measured baseline sexual risk-taking and the likelihood of behavioral change, given effective microbicides. Methods Interview of 506 Mexican American (MA) and AA women, all of whom have a sexually transmitted infection (STI) enrolled in Project Sexual Awareness for Everyone.. Results The 3 groups reported similarly high acceptance of potential microbicides (76 – 83% p = 0.24). LAHs were most likely to report they would use microbicides covertly (p = 0.03). Given the possibility of effective microbicides, AHs were consistently more likely to report risk disinhibition. AHs, as compared to LAHs and AAs respectively, were most likely to report that they would not use condoms, (53% vs. 33% vs. 30% p < 0.001), would have a one-night stand (18% vs. 8% vs. 6% p = 0.02), or would have sex with a man before they got to know him (18% vs. 8% vs. 6% p = 0.01). AHs were also most likely to say they would or probably would change from baseline safe sexual practices to unsafe sexual behaviors if potential microbicides were available. Age was controlled for in the analysis as AHs were younger than AAs and LAHs. Conclusions Future microbicides were acceptable among this at risk cohort. Acculturation was a predictor of risk disinhibition and should be considered when tailoring STI prevention messages, given the advent of effective microbicides. PMID:19556933

  18. Knowledge, Perceptions and Acceptability to Strengthening Adolescents’ Sexual and Reproductive Health Education amongst Secondary Schools in Gulu District

    PubMed Central

    Herman, Lule; Ovuga, E.; Mshilla, M.; Ojara, S.; Kimbugwe, G.; Adrawa, A. P.; Mahuro, N.

    2014-01-01

    Adolescents in Northern Uganda are at risk of teenage pregnancies, unsafe abortions and sexually transmitted infections (STIs). There is silence on sex both at home and school. This cross sectional descriptive analytical study interviews a random sample of 827 students and 13 teachers on knowledge, perception and acceptability to a comprehensive adolescent sexual and reproductive health education in “O” and “A” level secondary schools in Gulu District. Quantitative data was analysed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually for common codes, sub-categories and categories. Of the 827 students; 54.3% (449) reported being in a sexual relationship especially those aged 15–17 years. Majority 96.1% (807) supported the teaching of a comprehensive ASRHE, citing no negative impact 71.5% (601). Majority 81.6% (686) agreed that such education could help prevention of STIs, abortions and teenage pregnancies, and that it should be taught by health workers 69.0% (580). Majority 76.6% (203) reported that ASRHE was not currently being taught in their schools. Students had low knowledge levels and misconceptions about ASRHE. ASRHE was highly acceptable though not being emphasized; its success in school settings requires multidisciplinary culturally sensitive approaches amongst which health workers should be frontiers. PMID:24748950

  19. Knowledge, Perceptions and Acceptability to Strengthening Adolescents' Sexual and Reproductive Health Education amongst Secondary Schools in Gulu District.

    PubMed

    Herman, Lule; Ovuga, E; Mshilla, M; Ojara, S; Kimbugwe, G; Adrawa, A P; Mahuro, N

    2013-07-25

    Adolescents in Northern Uganda are at risk of teenage pregnancies, unsafe abortions and sexually transmitted infections (STIs). There is silence on sex both at home and school. This cross sectional descriptive analytical study interviews a random sample of 827 students and 13 teachers on knowledge, perception and acceptability to a comprehensive adolescent sexual and reproductive health education in "O" and "A" level secondary schools in Gulu District. Quantitative data was analysed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually for common codes, sub-categories and categories. Of the 827 students; 54.3% (449) reported being in a sexual relationship especially those aged 15-17 years. Majority 96.1% (807) supported the teaching of a comprehensive ASRHE, citing no negative impact 71.5% (601). Majority 81.6% (686) agreed that such education could help prevention of STIs, abortions and teenage pregnancies, and that it should be taught by health workers 69.0% (580). Majority 76.6% (203) reported that ASRHE was not currently being taught in their schools. Students had low knowledge levels and misconceptions about ASRHE. ASRHE was highly acceptable though not being emphasized; its success in school settings requires multidisciplinary culturally sensitive approaches amongst which health workers should be frontiers. PMID:24748950

  20. Designing an intelligent health monitoring system and exploring user acceptance for the elderly.

    PubMed

    Tseng, Kevin C; Hsu, Chien-Lung; Chuang, Yu-Hao

    2013-12-01

    Recently, many healthcare or health monitoring systems are proposed to improve life quality of the elderly in the aging process. The elderly are generally with poor health and low information literacy. Low information literacy might be an obstacle of using such systems. This research considered the characteristics and the needs of the elderly and developed an intelligent health monitoring system for the elderly with low information literacy living in the nursing home. The system is intelligent since it can monitor the health status of the elderly based on clinical and medical knowledge, provide an easy-to-understand and easy-to-use user interface for the elderly, and automatically send important or emergency feedback to caregivers. Finally, we explored the user acceptance for the elderly using our proposed system based on the unified theory of acceptance and user of technology model. The experimental results indicate the developed system is highly accepted by the elderly in terms of performance expectation, endeavor expectation, social influence, and facilitating condition. PMID:24037138

  1. HIV vaccine acceptability among high-risk drug users in Appalachia: a cross-sectional study

    PubMed Central

    2014-01-01

    Background A vaccine could substantially impact the HIV epidemic, but inadequate uptake is a serious concern. Unfortunately, people who use drugs, particularly those residing in rural communities, have been underrepresented in previous research on HIV vaccine acceptability. This study examined HIV vaccine acceptability among high-risk drug users in a rural community in the United States. Methods Interviewer-administered questionnaires included questions about risk behavior and attitudes toward HIV vaccination from 433 HIV-negative drug users (76% with history of injection) enrolled in a cohort study in Central Appalachia. HIV vaccine acceptability was measured on a 4-point Likert scale. Generalized linear mixed models were used to determine correlates to self-report of being “very likely” to receive a 90% effective HIV vaccine (i.e. “maximum vaccine acceptability”, or MVA). Adjusted odds ratios (AORs) and corresponding 95% confidence intervals (CIs) are reported. Results Most (91%) reported that they would accept a preventive HIV vaccine, but concerns about cost, dosing, transportation constraints, vaccine-induced seropositivity, and confidentiality were expressed. Cash incentives, oral-administration, and peer/partner encouragement were anticipated facilitators of uptake. In multivariate analysis, men were significantly less likely to report MVA (AOR: 0.33, CI: 0.21 – 0.52). MVA was more common among participants who believed that they were susceptible to HIV (AOR: 2.31, CI: 1.28 – 4.07), that an HIV vaccine would benefit them (AOR: 2.80, CI: 1.70 – 4.64), and who had positive experiential attitudes toward HIV vaccination (AOR: 1.85, CI: 1.08 – 3.17). MVA was also more common among participants who believed that others would encourage them to get vaccinated and anticipated that their behavior would be influenced by others' encouragement (AOR: 1.81, 95% 1.09 – 3.01). Conclusions To our knowledge, this study was among the first to explore and

  2. Health and environmental risks of energy systems

    SciTech Connect

    Hamilton, L.D.

    1984-01-01

    This paper gives four examples of health risk assessments of energy systems: (1) Comparative risk assessment of the health effects of the coal and nuclear fuel cycles. Estimates differ from previous values chiefly by inclusion of ranges of uncertainty, but some coal-cycle numbers were re-estimated. Upper-boundary public disease risks of air pollution from coal-fired plants dominate. Reactors probably account for most of the potential effect of major nuclear accidents. Accidental death rates in electricity generation are low for reactors and higher for coal. (2) Upper boundary air pollution health risks of existing fossil-based energy technologies in the United States. Preliminary mortality estimates were obtained combining potential impacts of three index pollutants - SO/sub 4/, NO/sub 2/, and CO - as independent measures of risk. Four fuel cycle trajectories leading to three end-uses were analyzed. Example results: domestic wood burning has substantial potential impact, with an upper boundary exceeding that of coal; upper-boundary air pollution impacts of gas can exceed those of oil, because of NO/sub 2/. (3) Health risks of acid deposition and other transported air pollutants, carried out as part of an assessment of the US Congress Office of Technology Assessment (OTA) Acid Rain and Transported Air Pollutants - Implications for Public Policy. Three scenarios were examined, leading to estimates of 40,000 to 50,000 annual premature deaths, depending on year (1978 vs 2000) and scenario (holding total emissions constant vs 30% reduction). (4) health effects of uranium mill tailings piles. Mortality risk is estimated to be minuscule (8.7 x 10/sup -9/ average individual lifetime cancer risk from a model mill, compared with 9.5 x 10/sup -4/ for background radiation). Methods that sum risks over the indefinite future are shown to be to be unrealistic. 39 references, 7 figures, 15 tables.

  3. 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.

  4. Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico.

    PubMed

    Galárraga, Omar; Sosa-Rubí, Sandra G; Infante, César; Gertler, Paul J; Bertozzi, Stefano M

    2014-01-01

    The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9 % for the monthly model, and 80.4 % for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$ 288 per person per year, but it was lower for MSW: USD$ 156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM and MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average WTA estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model to targeted HIV/STI prevention. PMID:23377757

  5. Migration, refugees, and health risks.

    PubMed

    Carballo, M; Nerukar, A

    2001-01-01

    Migration both voluntary and forced is increasing all over the world. People are moving in larger numbers faster and further than at any other time in history. This is happening at a time when many countries are ill-prepared to deal with a changing demography and when policies and attitudes to population movement and immigration are hardening. The health implications of this are many, and, in some cases, illness and death rates associated with migration are exacerbated by a lack of policies needed to make migration a healthy and socially productive process. From a public health point of view, this is having and will continue to have serious ramifications for the people that move, the family they leave behind, and the communities that host the newcomers. PMID:11485671

  6. Investigation of risk factors of psychological acceptance and burnout syndrome among nurses in China.

    PubMed

    Yao, Yongcheng; Yao, Wu; Wang, Wei; Li, Hong; Lan, Yajia

    2013-10-01

    The objectives of this study were to determine reliability of Chinese version of Acceptance and Action Questionnaire-II (AAQ-II), the relationship between psychological acceptance (PA), and burnout syndrome and their risk factors among nurses in China. The reliability of AAQ-II in Chinese was evaluated first by testing on 111 doctors and 108 nurses in China. On the number of 845 nurses selected from nine city hospitals by using stratified cluster sampling method, the Maslach Burnout Inventory-General Survey was administered to establish the presence of burnout, and the AAQ-II was used to measure their PA. Results showed that the AAQ-II in Chinese had a good test-retest reliability. PA was statistically significantly negatively correlated to the three dimensionalities of burnout among nurses in China. Male and female nurses had a significant difference in PA. Risk factors for burnout were age (25-44 years), marital status (married), gender (male), hospital department (emergency) and position (primary title) as well as PA. The findings provide insights into the risk factors of burnout in Chinese nurses and may have clinical implications in preventing burnout in Chinese nurses. PMID:24093745

  7. 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.

  8. Acceptability and Applicability of an American Health Videogame with Story for Childhood Obesity Prevention Among Hong Kong Chinese Children

    PubMed Central

    Wang, Jingjing; Baranowski, Tom; Pitkethly, Amanda Jane; Buday, Richard

    2015-01-01

    Abstract Objective: Positive changes in diet have been observed in research carried out in the United States from the use of “Escape from Diab” (Diab), a health videogame designed to lower the risk of obesity and type 2 diabetes. Whether the American story and characters in Diab might be perceived by Hong Kong Chinese children as interesting has not been explored. This study assessed the acceptability and applicability of Diab among Hong Kong Chinese children, whether the Diab story was understood by them, and whether it had potential to influence them both during the game and afterward. Subjects and Methods: Thirty-four students (21 males, 13 females) 9–12 years of age were included. Upon completion of all the Diab episodes, children completed an immersion scale with 18 items, as well as an individual interview with 10 open-ended questions. Results: Children achieved average immersion after playing Diab with the mean score at 39.1 (standard deviation = 9.0), higher than the median (36) of possible scores (range, 18–54). Four themes using framework analysis emerged from the interviews, including intuitive feelings about the interface, playing experience, perception of the effect of Diab on behavior change, and the applicability of Diab to Hong Kong children. The story and game developed for American children were found acceptable and applicable to Hong Kong Chinese children. Conclusions: The combination of quantitative and qualitative methods confirmed the acceptability and applicability of Diab to Hong Kong Chinese children. PMID:26382015

  9. Types of social support and parental acceptance among transfemale youth and their impact on mental health, sexual debut, history of sex work and condomless anal intercourse

    PubMed Central

    Le, Victory; Arayasirikul, Sean; Chen, Yea-Hung; Jin, Harry; Wilson, Erin C

    2016-01-01

    Introduction Transfemale youth (TFY) are an underserved and understudied population at risk for numerous poor physical and mental health outcomes, most notably HIV. Research suggests that parental acceptance and social support may serve as protective factors against HIV and other risks for TFY; however, it is unclear whether TFY receive primary social support from parents with or without parental acceptance of their gender identity. This study examines differences in parental acceptance, mental health and the HIV risk factors of history of sex work, age at sexual debut and engagement in condomless anal intercourse between TFY with two types of primary social support – non-parental primary social support (NPPSS) and parental primary social support (PPSS). Methods Cross-sectional data collected from 301 TFY from 2012 to 2014 in the San Francisco Bay Area were analyzed to determine differences in parental acceptance, mental health and HIV risk factors between youth with and without PPSS. Univariate statistics and chi-squared tests were conducted to determine if parental acceptance and health outcomes were correlated with type of social support. Results Two-hundred fifty-one participants (83.7%) reported having NPPSS, and 49 (16.3%) reported PPSS. Significantly more youth with PPSS reported affirmative responses on parental acceptance items than their NPPSS counterparts. For example, 87.8% of youth with PPSS reported that their parents believed they could have a happy future as a trans adult, compared with 51.6% of youth with NPPSS (p<0.001). Fewer participants with PPSS reported symptoms of psychological distress (2.0% vs. 12.5%, p=0.057), though this finding was not statistically significant; no significant associations were found between primary social support type and HIV risk factors. Conclusions These results suggest that TFY with parental acceptance of their gender identity may be more likely to reach out to their parents as their primary source of social

  10. An ethical appraisal of hormesis: toward a rational discourse on the acceptability of risks and benefits.

    PubMed

    Renn, O

    2008-08-01

    Hormesis has been defined as a dose-response relationship in which there is a stimulatory response at low doses but an inhibiting response at high doses, resulting in a U- or inverted U-shaped dose response. Until now, regulatory agencies have been reluctant to address this new insight or adjusted their routines for regulating such substances. Should regulators change their principles of decision making and standard setting in the light of the new insights from hormesis research? To answer this question, it is essential to review the ethical implications of hormesis in risk assessment and management. What kind of values should govern the regulation of substances and radiation that may cause positive and negative impacts at the same time (depending on dose and individual variability)? This article tries to address this problem. It deals with the basic ethical principles and foundations of risk management and introduces the essentials of ethics and the application of ethical principles to judging the acceptability of risks to humans and the environment. It will also discuss the merits of an analytic deliberative approach to evaluating complex risks and address the application of this discursive methods to risk management taking into account the hormesis challenge. PMID:19029259

  11. Assessment of health risks of policies

    SciTech Connect

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

    2014-09-15

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

  12. Health risks from indoor formaldehyde exposures in northwest weatherized residences

    SciTech Connect

    Mellinger, P.J.; Sever, L.E.

    1986-10-01

    Conflicting opinions on the potential hazards associated with formaldehyde exposure triggered a national workshop to address the toxicological questions concerning the health effects of formaldehyde. Since quantitative human data are not available to derive a dose-response curve for formaldehyde risk assessment, nonhuman data are used. In the case of formaldehyde, data from animals exposed to high concentrations are used to estimate human risk at much lower concentrations. This study presents the several steps that make up a risk assessment and examines any additional data that might alter significantly the risk estimates presented in the 1984 EIS. Rat inhalation chronic bioassay data from a study sponsored by the Chemical Industry Institute of Toxicology (CIIT) have been used to develop a risk equation that was subsequently used by BPA in its EIS. The CIIT data base remains the only acceptable animal data that can support the estimation of a dose-response curve. The development of mathematical models continues with a great deal of energy, and the use of different models is largely responsible for the great variability of the formaldehyde risk estimates. While one can calculate different values for carcinogenic risk associated with formaldehyde exposure than were presented earlier in the BPA EIS, they are not likely to be any better.

  13. Accepting risk in the acceleration of drug development for rare cancers.

    PubMed

    Ashley, David; Thomas, David; Gore, Lia; Carter, Rob; Zalcberg, John R; Otmar, Renée; Savulescu, Julian

    2015-04-01

    Rare cancers collectively contribute a disproportionate fraction of the total burden of cancer. The oncology community is increasingly facing small numbers of patients with each cancer subtype, requiring cooperation and collaboration to complete multicentre trials that advance knowledge and patient care. At the same time, new insights into the biology of rare cancers have led to an explosion in knowledge and development of targeted agents. These insights and techniques are set to revolutionise the care of patients with cancer. However, drug development strategies and the availability of new agents for rare cancers are at risk of stalling owing to the ever-increasing complexity and costs of clinical trials. Finding solutions to these problems is imperative to the future of cancer care. We propose that a greater degree of risk sharing is needed than is currently accepted to enable the use of new methods with confidence, and to keep pace with scientific advancement. PMID:25846099

  14. Communication technology use and mHealth acceptance among HIV-infected men who have sex with men in Peru: implications for HIV prevention and treatment.

    PubMed

    Krishnan, Archana; Ferro, Enrico G; Weikum, Damian; Vagenas, Panagiotis; Lama, Javier R; Sanchez, Jorge; Altice, Frederick L

    2015-01-01

    The HIV epidemic in Peru is concentrated among men who have sex with men (MSM). Given that MSM have been documented as early adopters of emerging technology, we examined communication technology access and utilization, and mobile health (mHealth) acceptance among Peruvian MSM and transgender women (TGW) in order to gauge opportunities for mHealth-enabled HIV interventions. A convenience sample of 359 HIV-infected MSM and TGW recruited from three sites in Lima, Peru completed standardized assessments of alcohol use disorders (AUDs), risky sexual behavior, and antiretroviral therapy (ART) adherence along with self-constructed measures of communication technology access and utilization, and mHealth acceptance. Most participants (86%) had daily access to any cell phone, including smartphones (30%). The most frequent communication activities were receiving and making calls, and receiving and sending text messages using cell phones. On a 5-point Likert scale, participants expressed interest in using mHealth for medication reminders (M = 3.21, SD = 1.32) and engaging in anonymous online interactions with health professionals to discuss HIV-related issues (M = 3.56, SD = 1.33). Importantly, no significant differences were found in communication technology use and mHealth acceptance among participants with AUDs, depression, and suboptimal ART adherence, all of which are associated with poor HIV treatment outcomes. Findings show support for implementing mHealth-based intervention strategies using cell phones to assess and reduce HIV-risk behaviors among HIV-infected MSM and TGW. PMID:25285464

  15. Investigating the feasibility and acceptability of health psychology-informed obesity training for medical students.

    PubMed

    Chisholm, Anna; Hart, Jo; Mann, Karen; Perry, Mark; Duthie, Harriet; Rezvani, Leila; Peters, Sarah

    2016-04-01

    Health psychologists have succeeded in identifying theory-congruent behaviour change techniques (BCTs) to prevent and reduce lifestyle-related illnesses, such as cardiovascular disease, cancers and diabetes. Obesity management discussions between doctors and patients can be challenging and are often avoided. Despite a clear training need, it is unknown how best to tailor BCT research findings to inform obesity-management training for future healthcare professionals. The primary objective of this descriptive study was to gather information on the feasibility and acceptability of delivering and evaluating health psychology-informed obesity training to UK medical students. Medical students (n = 41) attended an obesity management session delivered by GP tutors. Sessions were audio-recorded to enable fidelity checks. Acceptability of training was explored qualitatively. Tutors consistently delivered training according to the intervention protocol; and students and tutors found the training highly acceptable. This psychology-informed training can be delivered successfully by GP tutors and further research is warranted to explore its efficacy. PMID:26208893

  16. Prioritizing environmental health risks in the UAE.

    PubMed

    Willis, Henry H; Gibson, Jacqueline MacDonald; Shih, Regina A; Geschwind, Sandra; Olmstead, Sarah; Hu, Jianhui; Curtright, Aimee E; Cecchine, Gary; Moore, Melinda

    2010-12-01

    This article presents the results of a comparative environmental risk-ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency-Abu Dhabi (EAD). It represents the first national-level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five-stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented. PMID:20723144

  17. Health risks in perspective: Judging health risks of energy technologies. Revision 5/94

    SciTech Connect

    Rowe, M.D.

    1992-09-01

    The purpose of this report is to provide perspective on the various risks to which man is routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies. This report is not a risk assessment; nor does it contain instructions on how to do a risk assessment. Rather, it provides background information on how most of us think about risks and why it is difficult to do it rationally, it provides a philosophy and data with which to do a better job of judging risks more rationally, and it provides an overview of where risks of energy technologies fit within the spectrum of all risks. Much of the quantitative information provided here is on relative risk of dying of various causes. This is not because risk of dying is seen as the most important kind of risk, but because the statistics on mortality rates by cause are the highest quality data available on health risks in the general population.

  18. Health risks in wastewater irrigation: comparing estimates from quantitative microbial risk analyses and epidemiological studies.

    PubMed

    Mara, D D; Sleigh, P A; Blumenthal, U J; Carr, R M

    2007-03-01

    The combination of standard quantitative microbial risk analysis (QMRA) techniques and 10,000-trial Monte Carlo risk simulations was used to estimate the human health risks associated with the use of wastewater for unrestricted and restricted crop irrigation. A risk of rotavirus infection of 10(-2) per person per year (pppy) was used as the reference level of acceptable risk. Using the model scenario of involuntary soil ingestion for restricted irrigation, the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or =10(6) Escherichia coli per 100ml and when local agricultural practices are highly mechanised. For labour-intensive agriculture the risk of rotavirus infection is approximately 10(-2) pppy when the wastewater contains < or = 10(5) E. coli per 100ml; however, the wastewater quality should be < or = 10(4) E. coli per 100ml when children under 15 are exposed. With the model scenario of lettuce consumption for unrestricted irrigation, the use of wastewaters containing < or =10(4) E. coli per 100ml results in a rotavirus infection risk of approximately 10(-2) pppy; however, again based on epidemiological evidence from Mexico, the current WHO guideline level of < or =1,000 E. coli per 100ml should be retained for root crops eaten raw. PMID:17402278

  19. The readability and audience acceptance of printed health promotion materials used by environmental health departments.

    PubMed

    Harvey, Harold D; Fleming, Paul

    2003-01-01

    A significant part of the work of an environmental health professional is the communication of information to clients, customers, and the public in the context of safety and health promotion or as an adjunct to enforcement activities. While a wide range of communication methods are available today, printed material still forms an important aspect of the communications methodology of environmental health departments. This paper raises a number of questions about the effectiveness of environmental health promotion brochures in common use in the United Kingdom and the problems that could arise from simply assuming that the brochures are conveying the intended message to the target audience. Through a series of case studies conducted in environmental health departments, evaluative data on a range of brochures were gathered in two interlinked stages: a readability test and a target-audience questionnaire survey. The sources of the brochures included the central government, charities, trade unions, and commercial enterprises; some brochures were produced "in house." Results indicated a common mismatch between the estimated reading age of the target audience and the reading age determined by the readability test; concern about the efficacy of using commercially sourced brochures carrying advertising that may conflict with advice on other environmental health issues; "in-house" brochures that appeared to optimize self-promotion rather than the conveyance of topic information; ineffective brochures used as an adjunct to enforcement activity; and the possibility that the latter could be introduced as defense evidence in related legal proceedings. Overall, the study showed that a well-structured method for brochure choice and ongoing evaluation are essential tools for environmental health departments seeking to maximize their resources and effectiveness. PMID:12575638

  20. Evaluating Potential Health Risks in Relocatable Classrooms.

    ERIC Educational Resources Information Center

    Katchen, Mark; LaPierre, Adrienne; Charlin, Cary; Brucker, Barry; Ferguson, Paul

    2001-01-01

    Only limited data exist describing potential exposures to chemical and biological agents when using portable classrooms or outlining how to assess and reduce associated health risks. Evaluating indoor air quality involves examining ventilating rates, volatile organic compounds, and microbiologicals. Open communication among key stakeholders is…

  1. Promoting multi‐micronutrient powders (MNP) in Peru: acceptance by caregivers and role of health personnel

    PubMed Central

    Bartolini, Rosario; Abad, Melissa; Arevalo, Varinia

    2015-01-01

    Abstract Iron deficiency causes anaemia and other adverse effects on the nutritional status and development of millions of children. Multi‐micronutrient powders (MNP) have been shown to reduce anaemia in young children. In Peru, 50% of children 6–36 months are anaemic. Since 2009, the government has started distributing MNP. This qualitative study explored the acceptability of MNP by caregivers and the role of health personnel (HP) in three regions (Apurimac, Ayacucho and Cajamarca), piloting the MNP programme between 2009 and 2011. Data collection consisted of interviews (35) and observations (13) with caregivers and HP (11). In Cajamarca, 16 families were visited three times in their homes to understand caregivers' use and difficulties. Results showed the critical role HP has in influencing caregiver understanding and use of the MNP, as well as the need for training to avoid confusing messages and provide counselling techniques that consider cultural sensitivity to optimize HP interactions with caregivers and adapt the recommendations for MNP use to local family feeding routines. There was greater acceptance of MNP by caregivers giving semi‐solid foods (e.g. purees) to their children than those who served dilute preparations (e.g. soups). Acceptance was similar across regions, but there were some differences between urban and rural settings. Home visits were shown to be a key in improving the use of MNP by caregivers as misunderstandings on preparation, required consistency and optimum practices were common. These findings can contribute to strategies to enhance acceptability and use. Key messages Acceptance and use of multi‐micronutrient powders (MNP) by caregivers greatly depend upon how it is presented, promoted and counselled by health personnel.Counselling for MNP use needs to consider and adapt to the local cultural context and incorporate family and child feeding routines.MNP are presented as part of appropriate feeding practices, encouraging

  2. Adverse or acceptable: negotiating access to a post-apartheid health care contract

    PubMed Central

    2014-01-01

    fragile and post-conflict societies requires the negotiation of a new social contract. Surfacing and engaging with differences in patient and provider expectations of this contract may contribute to more acceptable, accessible health care services. Additionally, the health system is well positioned to highlight and connect the political economy, institutions and social relationships that create and sustain identities of exclusion and inclusion – (re)politicise suffering - and co-ordinate and lead intersectoral action for overcoming affordability and availability barriers to inclusive and equitable health care services. PMID:24885882

  3. Risk assessment of genetically modified crops for nutrition and health.

    PubMed

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods. PMID:19146501

  4. Health risk assessment of irradiated topaz

    SciTech Connect

    Nelson, J.W.; Baum, J.W. )

    1993-01-01

    Irradiated topaz gemstones are currently processed for color improvement by subjecting clear stones to neutron or high-energy electron irradiations, which leads to activation of trace elements in the stones. Assessment of the risk to consumers required the identification and quantification of the resultant radionuclides and the attendant exposure. Representative stones from Brazil, India, Nigeria, Sri Lanka were irradiated and analyzed for gamma ray and beta particle emissions, using sodium iodide and germanium spectrometers; and Geiger-Muller, plastic and liquid scintillation, autoradiography, and thermoluminescent-dosimetry measurement techniques. Based on these studies and other information derived from published literature, dose and related risk estimates were made for typical user conditions. New criteria and methods for routine assays for acceptable release, based on gross beta and gross photon emissions from the stones, were also developed.

  5. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    ERIC Educational Resources Information Center

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

  6. Access to chronic disease care in general practice: the acceptability of implementing systematic waiting-room screening using computer-based patient-reported risk status

    PubMed Central

    Paul, Christine L; Carey, Mariko; Yoong, Sze Lin; D’Este, Catherine; Makeham, Meredith; Henskens, Frans

    2013-01-01

    Background Routine screening and advice regarding risky lifestyle behaviours is appropriate in the primary care setting, but often not implemented. Routine electronic collection of patients’ self-reported data may streamline the collection of such information. Aim To explore the perceptions of GPs and their attending patients regarding the acceptability of waiting-room touchscreen computers for the collection of health behaviour information. Uptake, ease of operation, and the perceived likelihood of future implementation were studied. Design and setting Cross-sectional health-risk survey. General practices in metropolitan areas in Australia. Method Practices were randomly selected by postcode. Consecutive patients who were eligible to take part in the study were approached in the waiting room and invited to do so. Participants completed the touchscreen health survey. A subsample of patients and GPs completed additional items regarding acceptability. Results Twelve general practices participated in the study, with 4058 patients (86%) and 51 of 68 (75%) GPs consenting to complete the health-risk survey, 596 patients and 30 GPs were selected to complete the acceptability survey. A majority of the 30 GPs indicated that the operation of the survey was not disruptive to practice and more than 90% of patients responded positively to all items regarding its operation. More than three-quarters of the patient sample were willing to consider allowing their responses to be kept on file and complete such surveys in the future. Conclusion As waiting-room-based collection of this information appears to be both feasible and acceptable, practitioners should consider collecting and incorporating routine patient-reported health behaviours for inclusion in the medical record. PMID:23998842

  7. 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.

  8. The risks of innovation in health care.

    PubMed

    Enzmann, Dieter R

    2015-04-01

    Innovation in health care creates risks that are unevenly distributed. An evolutionary analogy using species to represent business models helps categorize innovation experiments and their risks. This classification reveals two qualitative categories: early and late diversification experiments. Early diversification has prolific innovations with high risk because they encounter a "decimation" stage, during which most experiments disappear. Participants face high risk. The few decimation survivors can be sustaining or disruptive according to Christensen's criteria. Survivors enter late diversification, during which they again expand, but within a design range limited to variations of the previous surviving designs. Late diversifications carry lower risk. The exception is when disruptive survivors "diversify," which amplifies their disruption. Health care and radiology will experience both early and late diversifications, often simultaneously. Although oversimplifying Christensen's concepts, early diversifications are likely to deliver disruptive innovation, whereas late diversifications tend to produce sustaining innovations. Current health care consolidation is a manifestation of late diversification. Early diversifications will appear outside traditional care models and physical health care sites, as well as with new science such as molecular diagnostics. They warrant attention because decimation survivors will present both disruptive and sustaining opportunities to radiology. Radiology must participate in late diversification by incorporating sustaining innovations to its value chain. Given the likelihood of disruptive survivors, radiology should seriously consider disrupting itself rather than waiting for others to do so. Disruption entails significant modifications of its value chain, hence, its business model, for which lessons may become available from the pharmaceutical industry's current simultaneous experience with early and late diversifications. PMID

  9. Acceptability of a Personally Controlled Health Record in a Community-Based Setting: Implications for Policy and Design

    PubMed Central

    Kaci, Liljana; Mandl, Kenneth D

    2009-01-01

    Background Consumer-centered health information systems that address problems related to fragmented health records and disengaged and disempowered patients are needed, as are information systems that support public health monitoring and research. Personally controlled health records (PCHRs) represent one response to these needs. PCHRs are a special class of personal health records (PHRs) distinguished by the extent to which users control record access and contents. Recently launched PCHR platforms include Google Health, Microsoft’s HealthVault, and the Dossia platform, based on Indivo. Objective To understand the acceptability, early impacts, policy, and design requirements of PCHRs in a community-based setting. Methods Observational and narrative data relating to acceptability, adoption, and use of a personally controlled health record were collected and analyzed within a formative evaluation of a PCHR demonstration. Subjects were affiliates of a managed care organization run by an urban university in the northeastern United States. Data were collected using focus groups, semi-structured individual interviews, and content review of email communications. Subjects included: n = 20 administrators, clinicians, and institutional stakeholders who participated in pre-deployment group or individual interviews; n = 52 community members who participated in usability testing and/or pre-deployment piloting; and n = 250 subjects who participated in the full demonstration of which n = 81 initiated email communications to troubleshoot problems or provide feedback. All data were formatted as narrative text and coded thematically by two independent analysts using a shared rubric of a priori defined major codes. Sub-themes were identified by analysts using an iterative inductive process. Themes were reviewed within and across research activities (ie, focus group, usability testing, email content review) and triangulated to identify patterns. Results Low levels of familiarity with

  10. Risk Analysis for Environmental Health Triage

    SciTech Connect

    Bogen, K T

    2005-11-18

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage.

  11. Frequency and Prioritization of Patient Health Risks from a Structured Health Risk Assessment

    PubMed Central

    Phillips, Siobhan M.; Glasgow, Russell E.; Bello, Ghalib; Ory, Marcia G.; Glenn, Beth A.; Sheinfeld-Gorin, Sherri N.; Sabo, Roy T.; Heurtin-Roberts, Suzanne; Johnson, Sallie Beth; Krist, Alex H.

    2014-01-01

    PURPOSE To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. METHODS Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as “at risk” or “healthy” for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. RESULTS On average, patients had 5.8 (SD = 2.12; range, 0–13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. CONCLUSIONS Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change. PMID:25384812

  12. Acceptance of the German e-mental health portal www.psychenet.de: an online survey.

    PubMed

    Tlach, Lisa; Thiel, Juliane; Härter, Martin; Liebherz, Sarah; Dirmaier, Jörg

    2016-01-01

    Background. Taking into account the high prevalence of mental disorders and the multiple barriers to the use of mental health services, new forms of fostering patient information, involvement, and self-management are needed to complement existing mental health services. The study aimed at investigating acceptance regarding design and content of the e-mental health portal www.psychenet.de. Methods. An online cross-sectional survey was conducted between May 2013 and May 2015 using a self-administered questionnaire including items on perceived ease of use, perceived usefulness, attitude towards using, and perceived trust. Effects of different participants' characteristics on the portals' acceptance were analyzed. Results. The majority of the N = 252 respondents suffered from mental disorders (n = 139) or were relatives from persons with mental disorders (n = 65). The portal was assessed as "good" or "very good" by 71% of the respondents. High levels of agreement (89-96%) were shown for statements on the perceived ease of use, the behavioral intention to use the portal, and the trustworthiness of the portal. Lower levels of agreement were shown for some statements on the perceived usefulness of the portals' content. There were no effects of different participants' characteristics on the perceived ease of use, the perceived usefulness, the attitude towards using the website and the perceived trust. Discussion. This survey provides preliminary evidence that the e-mental health portal www.psychenet.de appears to be a usable, useful and trustworthy information resource for a broad target group. The behavioral usefulness of the portals' content might be improved by integrating more activating patient decision aids. PMID:27547515

  13. Acceptance of the German e-mental health portal www.psychenet.de: an online survey

    PubMed Central

    Tlach, Lisa; Thiel, Juliane; Härter, Martin

    2016-01-01

    Background. Taking into account the high prevalence of mental disorders and the multiple barriers to the use of mental health services, new forms of fostering patient information, involvement, and self-management are needed to complement existing mental health services. The study aimed at investigating acceptance regarding design and content of the e-mental health portal www.psychenet.de. Methods. An online cross-sectional survey was conducted between May 2013 and May 2015 using a self-administered questionnaire including items on perceived ease of use, perceived usefulness, attitude towards using, and perceived trust. Effects of different participants’ characteristics on the portals’ acceptance were analyzed. Results. The majority of the N = 252 respondents suffered from mental disorders (n = 139) or were relatives from persons with mental disorders (n = 65). The portal was assessed as “good” or “very good” by 71% of the respondents. High levels of agreement (89–96%) were shown for statements on the perceived ease of use, the behavioral intention to use the portal, and the trustworthiness of the portal. Lower levels of agreement were shown for some statements on the perceived usefulness of the portals’ content. There were no effects of different participants’ characteristics on the perceived ease of use, the perceived usefulness, the attitude towards using the website and the perceived trust. Discussion. This survey provides preliminary evidence that the e-mental health portal www.psychenet.de appears to be a usable, useful and trustworthy information resource for a broad target group. The behavioral usefulness of the portals’ content might be improved by integrating more activating patient decision aids. PMID:27547515

  14. Acceptance and Use of Health Information Technology By Community-Dwelling Elders

    PubMed Central

    Fischer, Shira H; David, Daniel; Crotty, Bradley H; Dierks, Meghan; Safran, Charles

    2014-01-01

    Objectives With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. Methods Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. Results Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help ‘aging in place,' but these have not been thoroughly evaluated. Elders face many barriers to using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. Conclusions Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use. PMID:24996581

  15. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  16. Evaluation of the Compliance, Acceptance, and Usability of a Web-Based eHealth Intervention for Parents of Children With Infantile Hemangiomas: Usability Study

    PubMed Central

    Totte, Joan; Breugem, Corstiaan; van Os-Medendorp, Harmieke; Pasmans, Suzanne

    2013-01-01

    Background Infantile hemangiomas (IH) are common benign vascular tumors in children. Recognition and timely referral of high risk IH to specialized centers is important. This might be achieved by involving parents in the care for IH by means of an eHealth intervention. Objective The objective of our study was to evaluate parent compliance, acceptance, and usability of an open access, Web-based eHealth intervention (including e-learning and e-consult) designed to increase parents’ knowledge and (risk) evaluation of IH. Methods A cross-sectional study of parents who completed the eHealth intervention between October 2010 and November 2012 was carried out. All parents were sent a study questionnaire. Questions to evaluate compliance (to the advice given by a dermatologist during e-consultation) were asked. Acceptance and usability were evaluated by using the modified Technology Acceptance Model. Results A total of 224 parents completed the eHealth intervention and received the questionnaire, 135/224 parents responded (response rate was 60.3%). There were 128/135 questionnaires that were completed and included. A total of 110/128 (85.9%) parents were compliant to the advice of the dermatologist. There were 116.8/128 (91.3%) that perceived the eHealth intervention as useful and almost all parents (98.4%, 126/128) found the information in the e-learning clear. There were 29/128 (22.7%) that experienced technical problems. The majority of the parents (94.5%, 121/128) found the eHealth intervention reliable and most of them (98.4%, 126/128) would recommend the eHealth intervention to other parents. Noncompliant parents judged the eHealth intervention significantly less reliable compared to compliant parents (71%, 10/14 versus 97.3%, 107/110; P=.003). Conclusions Parents of children with an IH showed a high compliance (85.9%, 110/128) to the advice of the dermatologist given via our Web-based eHealth intervention. This high compliance might be positively influenced by the

  17. Gaining acceptance for the use of in vitro toxicity assays and QIVIVE in regulatory risk assessment.

    PubMed

    Meek, M E Bette; Lipscomb, John C

    2015-06-01

    Testing strategies are anticipated to increasingly rely on in vitro data as a basis to characterize early steps or key events in toxicity at relevant dose levels in human tissues. Such strategies require quantitative in vitro to in vivo extrapolation to characterize dose-response as a basis for comparison with exposure to estimate risk. Current experience in the incorporation of mechanistic and in vitro data in risk assessment is considered here in the context of identified principles to increase the potential for timely acceptance of more progressive and tailored testing strategies by the regulatory community. These principles are outlined as transitioning in a familiar context, tiering to acquire experience and increase confidence, contextual knowledge transfer to facilitate interpretation and communication, coordination and development of expertise and continuing challenge. A proposed pragmatic tiered data driven framework which includes increasing reliance on in vitro data and quantitative in vitro to in vivo extrapolation is considered in the context of these principles. Based on this analysis, possible additional steps that might facilitate timely evolution and potentially, uptake are identified. PMID:25598226

  18. The Careful Puppet Master: Reducing risk and fortifying acceptance testing with Jenkins CI

    NASA Astrophysics Data System (ADS)

    Smith, Jason A.; Richman, Gabriel; DeStefano, John; Pryor, James; Rao, Tejas; Strecker-Kellogg, William; Wong, Tony

    2015-12-01

    Centralized configuration management, including the use of automation tools such as Puppet, can greatly increase provisioning speed and efficiency when configuring new systems or making changes to existing systems, reduce duplication of work, and improve automated processes. However, centralized management also brings with it a level of inherent risk: a single change in just one file can quickly be pushed out to thousands of computers and, if that change is not properly and thoroughly tested and contains an error, could result in catastrophic damage to many services, potentially bringing an entire computer facility offline. Change management procedures can—and should—be formalized in order to prevent such accidents. However, like the configuration management process itself, if such procedures are not automated, they can be difficult to enforce strictly. Therefore, to reduce the risk of merging potentially harmful changes into our production Puppet environment, we have created an automated testing system, which includes the Jenkins CI tool, to manage our Puppet testing process. This system includes the proposed changes and runs Puppet on a pool of dozens of RedHat Enterprise Virtualization (RHEV) virtual machines (VMs) that replicate most of our important production services for the purpose of testing. This paper describes our automated test system and how it hooks into our production approval process for automatic acceptance testing. All pending changes that have been pushed to production must pass this validation process before they can be approved and merged into production.

  19. Environmental and health risk studies at HHWCFs

    SciTech Connect

    Kehoe, C.

    1995-09-01

    Sanitary Fill Company is proposing to expand San Francisco`s household hazardous waste facility. This paper describes our proposal and discusses the environmental review and public involvement processes that are now required. Planning this expansion has been long and expensive. To my knowledge we are among the first programs to conduct a detailed study of the potential health risks associated with household facilities. I will present a summary of our planning process and compare the process to the outcome.

  20. Acceptability of quality reporting and pay for performance among primary health centers in Lebanon.

    PubMed

    Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M

    2013-01-01

    Primary health care (PHC) is emphasized as the cornerstone of any health care system. Enhancing PHC performance is considered a strategy to enhance effective and equitable access to care. This study assesses the acceptability of and factors associated with quality reporting among PHC centers (PHCCs) in Lebanon. The managers of 132 Lebanese Ministry of Health PHCCs were surveyed using a cross-sectional design. Managers' willingness to report quality, participate in comparative quality assessments, and endorse pay-for-performance schemes was evaluated. Collected data were matched to the infrastructural characteristics and services database. Seventy-six percent of managers responded to the questionnaire, 93 percent of whom were willing to report clinical performance. Most expressed strong support for peer-performance comparison and pay-for-performance schemes. Willingness to report was negatively associated with the religious affiliation of centers and presence of health care facilities in the catchment area and favorably associated with use of information systems and the size of population served. The great willingness of PHCC managers to employ quality-enhancing initiatives flags a policy priority for PHC stakeholders to strengthen PHCC infrastructure and to enable reporting in an easy, standardized, and systematic way. Enhancing equity necessitates education and empowerment of managers in remote areas and those managing religiously affiliated centers. PMID:24397238

  1. Acceptability of male circumcision for the prevention of HIV among high-risk heterosexual men in Thailand.

    PubMed

    Tieu, Hong-Van; Phanuphak, Nittaya; Ananworanich, Jintanat; Vatanparast, Rana; Jadwattanakul, Tanate; Pharachetsakul, Nutthasun; Mingkwanrungrueng, Pravit; Buajoom, Raksakul; Teeratakulpisarn, Somsong; Teeratakulpisarn, Nipat; Methajittiphun, Pornpen; Hammer, Scott M; Ann Chiasson, Mary; Phanuphak, Praphan

    2010-06-01

    Limited data are available on circumcision prevalence and acceptability among Thai men to prevent human immunodeficiency virus. Of 408 high-risk heterosexual men, 12.3% were circumcised. 14.2% and 24.9% expressed willingness to be circumcised before and after circumcision education, respectively. Neonatal circumcision acceptability was relatively high. One participant underwent circumcision at 3-month follow-up. PMID:20145588

  2. [Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].

    PubMed

    Fu, Gang; Zeng, Qiang; Zhao, Liang; Zhang, Yue; Feng, Bao-jia; Wang, Rui; Zhang, Lei; Wang, Yang; Hou, Chang-chun

    2015-12-01

    This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors. PMID:27011993

  3. Oil shale health and environmental risk analysis

    SciTech Connect

    Gratt, L.B.

    1983-04-01

    The potential human health and environmental risks of hypothetical one-million-barrels-per-day oil shale industry have been analyzed to serve as an aid in the formulation and management of a program of environmental research. The largest uncertainties for expected fatalities are in the public sector from air pollutants although the occupational sector is estimated to have 60% more expected fatalities than the public sector. Occupational safety and illness have been analyzed for the oil shale fuel cycle from extraction to delivery of products for end use. Pneumoconiosis from the dust environment is the worker disease resulting in the greatest number of fatalities, followed by chronic bronchitis, internal cancer, and skin cancers, respectively. Research recommendations are presented for reducing the uncertainties in the risks analyzed and to fill data gaps to estimate other risks.

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

    PubMed Central

    2010-01-01

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

  5. A toolbox for health risk related decisions

    SciTech Connect

    Easterly, C.E.; Jones, T.D.

    1996-10-01

    Development efforts since the late 1970s have resulted in a generalized method for ranking health hazards. This method provides the basis for a wide range of applications where decisions are needed for allocating resources on the basis of health risk considerations. It has been used for more than a decade to solve real problems, and it is supported by 23 publications in the open literature. The diversity of this generalized methodology allows us to provide support in a great number of problem areas. we give four examples in this manuscript: the relative toxicities of petroleum mixtures; a method to derive Emergency Response Planning Guides; an estimate of the possible carcinogenic potency of tungsten, an alternative material to depleted uranium for heavy armor penetrators; and an approach to low dose extrapolation. Our experience suggests that many more applications of the original concept and variations on it can be of utility in military situations. Some potentially fruitful areas may be in the: development of a health-risk-ranking system for alternative solutions to manufacturing, waste management, and remediation; provision of a basis for identifying levels of hazardous agents which are below health concerns, or which should be of concern; development of a framework for evaluating chemicals and radioactive materials on the same basis, and in the development of a battery of in vitro bioassays which could take the place of long-term whole animal tests.

  6. Excessive Alcohol Use and Risks to Women's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Women's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Women’s Health Although men ...

  7. Excessive Alcohol Use and Risks to Men's Health

    MedlinePlus

    ... Spectrum Disorders (FASDs) Impaired Driving Fact Sheets - Excessive Alcohol Use and Risks to Men's Health Recommend on Facebook Tweet Share Compartir Excessive Alcohol Use and Risks to Men's Health Men are ...

  8. Risk Acceptance Personality Paradigm: How We View What We Don't Know We Don't Know

    NASA Technical Reports Server (NTRS)

    Massie, Michael J.; Morris, A. Terry

    2011-01-01

    The purpose of integrated hazard analyses, probabilistic risk assessments, failure modes and effects analyses, fault trees and many other similar tools is to give managers of a program some idea of the risks associated with their program. All risk tools establish a set of undesired events and then try to evaluate the risk to the program by assessing the severity of the undesired event and the likelihood of that event occurring. Some tools provide qualitative results, some provide quantitative results and some do both. However, in the end the program manager and his/her team must decide which risks are acceptable and which are not. Even with a wide array of analysis tools available, risk acceptance is often a controversial and difficult decision making process. And yet, today's space exploration programs are moving toward more risk based design approaches. Thus, risk identification and good risk assessment is becoming even more vital to the engineering development process. This paper explores how known and unknown information influences risk-based decisions by looking at how the various parts of our personalities are affected by what they know and what they don't know. This paper then offers some criteria for consideration when making risk-based decisions.

  9. 24 CFR 266.300 - HFAs accepting 50 percent or more of risk.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

  10. 24 CFR 266.305 - HFAs accepting less than 50 percent of risk.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

  11. 24 CFR 266.300 - HFAs accepting 50 percent or more of risk.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

  12. 24 CFR 266.300 - HFAs accepting 50 percent or more of risk.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

  13. 24 CFR 266.305 - HFAs accepting less than 50 percent of risk.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

  14. 24 CFR 266.305 - HFAs accepting less than 50 percent of risk.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... acceptability of the proposed mortgagor and management agent; (4) Approve the Affirmative Fair Housing Marketing Plan; and (5) Make any other determinations necessary to ensure acceptability of the proposed...

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

    SciTech Connect

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

    1993-03-01

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

  16. Acceptability of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy: Barriers and facilitators to PrEP uptake among at-risk Peruvian populations

    PubMed Central

    Galea, Jerome T.; Kinsler, Janni J.; Salazar, Ximena; Lee, Sung-Jae; Giron, Maziel; Sayles, Jennifer N.; Cáceres, Carlos; Cunningham, William E.

    2010-01-01

    This study examined Pre-Exposure Prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons, and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, p <0.001), followed by efficacy (21.4, p <0.001) and potential side effects (14.7, p <0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out if proven efficacious in ongoing clinical trials. PMID:21571973

  17. Awareness and acceptance of human papillomavirus vaccination among health sciences students in Malaysia.

    PubMed

    Rajiah, Kingston; Maharajan, Mari Kannan; Chin, Nang Sue; Num, Kelly Sze Fang

    2015-12-01

    The major cause of cervical cancer is human papillomavirus (HPV) for which vaccination is available. The success HPV vaccination programme largely depend on the degree of knowledge of the healthcare providers who can recommend to the public. Health sciences students as future healthcare providers play a major role in HPV vaccination initiatives. The objective of this study was to evaluate the knowledge, attitude, practice and to find out the willingness to pay for HPV vaccination among the health sciences students in a private university. The cross-sectional study was conducted among the university students studying health sciences program using a validated questionnaire to measure their awareness and acceptance of HPV vaccination. The students demonstrated moderate knowledge about HPV infection and vaccination with mean knowledge scores of 9.3 out of 17. Students were showing positive attitude towards HPV vaccination with mean scores of 3.80 out of 5. However, low HPV vaccination uptake rate was reported among the students. Most of the students were willing to recommend HPV vaccine. The participants felt that the cost is the major barrier towards HPV vaccination and they felt the government should cover the cost of vaccination for all. The results of this study may be helpful in establishing educational policies on cervical cancer-related topics in the universities. PMID:26645041

  18. Social Network and Risk-Taking Behavior Most Associated with Rapid HIV Testing, Circumcision, and Preexposure Prophylaxis Acceptability Among High-Risk Indian Men

    PubMed Central

    Kumar, Rupali; Dandona, Rakhi; Kumar, Prem; Kumar, Anil; Lakshmi, Vemu; Laumann, Edward; Mayer, Kenneth; Dandona, Lalit

    2012-01-01

    Abstract Indian truck drivers and their younger apprentice drivers are at increased risk of HIV infection. We determine network and risk practices associated with willingness to adopt HIV prevention interventions currently not being used in India: rapid HIV testing, circumcision, and preexposure prophylaxis (PrEP) in order to inform the National AIDS Control Program (NACP). Truck drivers and truck cleaners were systematically recruited to participate in a social network and risk survey in Hyderabad, Southern India. Three separate composite measures of acceptability of rapid HIV testing, circumcision, and PrEP acceptability were utilized to independently assess the relationship of these prevention interventions with risk-practices and social network characteristics. An 89% participation rate yielded 1602 truck drivers and truck cleaners with 54.2% younger than 30 years of age and 2.8% HIV infected. Twenty-five percent of respondents reported sex with female sex workers (FSW) and 5% with men (MSM). Rapid testing, circumcision, and PrEP acceptability were 97.4%, 9.1%, and 85.9%, respectively. Participants reporting prosocial network characteristics were more accepting of rapid testing (adjusted odds ratio [AORs] 3.07–6.71; p<0.05) and demonstrated variable PrEP acceptability (AORs 0.08–2.22; p<0.001). Sex with FSWs was associated with PrEP acceptability (AOR 4.27; p<0.001); sex with MSM was associated with circumcision acceptability only (AOR 2.66; p<0.01). Social network factors and risk-practices were associated with novel prevention acceptability, but not consistently across intervention type and with variable directionality. The NACP will need to consider that intervention uptake may likely be most successful when efforts are targeted to individuals with specific behavior and social network characteristics. PMID:22973951

  19. Feasibility and Acceptability of an Internet-Based, African Dance-Modified Yoga Program for African-American Women with or at Risk for Metabolic Syndrome

    PubMed Central

    Johnson, Candace C; Taylor, Ann Gill; Anderson, Joel G; Jones, Randy A; Whaley, Diane E

    2014-01-01

    African-American (AA) women are the segment of the population that experiences the highest mortality from metabolic syndrome (MetS). Yoga decreases risk of MetS, yet there have been no yoga studies of AA women with or at risk for MetS. The purpose of this 4-week study was to test the feasibility and acceptability of a culturally tailored, Internet-based intervention, yogic dance (YD), using digital videos in a sample of AA women (ages 35-64) at risk for or with MetS. The investigators examined the rates of accrual, attrition, and reasons for attrition; the feasibility of using the Internet to deliver the intervention; the acceptability of the intervention as structured; and any other benefits and/or limitations of YD. The study used a single-group, mixed-methods design underpinned by social constructivist theory and Pender's Health Promotion Model. Twenty-four women provided consent to enroll in the study. After completing in-person semi-structured interviews and Internet-based measures, including the Physical Activity Readiness Questionnaire, and the modified International Physical Activity Questionnaire, consented participants engaged in 4-weeks of the yogic dance intervention via daily video-based instructions located on the study Web site. After the intervention, four women participated in focus groups to voice their perceptions of barriers to and benefits from YD and the acceptability of using the YD intervention. The investigators analyzed focus group data using content/thematic analysis and validated themes with baseline semi-structured interviews. The majority of the women (79%) found YD acceptable. Themes that emerged from the descriptive data include: (1) Culture is an important aspect of yogic dance; and (2) Increased social support would enhance yogic dance participation. The integrated results from this feasibility study will inform research exploring the complex correlates that influence health behaviors in AA women. PMID:25593785

  20. The presence of health-risk behaviour in Roma family.

    PubMed

    Niksić, Dragana; Kurspahić-Mujcić, Amira

    2007-05-01

    Roma people in B&H are a marginalised population group. Their health condition; is considerably worse than the condition of other population groups. The health problems of Roma people correlate with inadequate living and dwelling conditions. Roma children are facing the impossibility of being health care beneficiaries, because their parents are unemployed. The objective of this survey was to examine the family surrounding of children in age up to 8 years, including the social conditions under which they live and the presence of health risk behaviour. The research presents a descriptive cross-section study. We interviewed 1100 non-Roma parents and children and 383 Roma parents and children (in the communities of domicile Roma people) in B&H Federation. The results obtained indicate that only 17,8 % of Roma parents are secondary-school leavers, while remaining percentage covers those with incomplete primary school or without education at all, against 63,6% of non-Roma parents who have secondary education. The parents consider themselves good providers for their children (59,3% of Roma parents and 75% of non-Roma parents often play with their children). The Roma parents seek for medical attention for their children only in the cases when urgent health problems occur, such as fever/increased body temperature (one-half of the interviewed parents) or diarrhoea (31,9%). Physical punishment of children occurs more frequently in Roma families (23,7% - this is only the top of an iceberg) then in non-Roma families (11,4%). The parents usually beat children by using their hands or punish them by flogging. The domestic violence is accepted amongst Roma people and it has most sever impact on children, who suffer emotionally and physically. In the future, it will be necessary to create the kind of family environment that would enable improvement of health condition and decrease the behaviour that endangers the health of children. PMID:17489751

  1. Under what conditions is euthanasia acceptable to lay people and health professionals?

    PubMed

    Teisseyre, Nathalie; Mullet, Etienne; Sorum, Paul Clay

    2005-01-01

    Euthanasia is legal only in the Netherlands and Belgium, but it is on occasion performed by physicians elsewhere. We recruited in France two convenience samples of 221 lay people and of 189 professionals (36 physicians, 92 nurses, 48 nurse's aides, and 13 psychologists) and asked them how acceptable it would be for a patient's physician to perform euthanasia in each of 72 scenarios. The scenarios were all combinations of three levels of the patient's life expectancy (3 days, 10 days, or 1 month), four levels of the patient's request for euthanasia (no request, unable to formulate a request because in a coma, some form of request, repeated formal requests), three of the family's attitude (do not uselessly prolong care, no opinion, try to keep the patient alive to the very end), and two of the patient's willingness to undergo organ donation (willing or not willing). We found that most lay people and health care professionals structure the factors in the patient scenarios in the same way: they assign most importance to the extent of requests for euthanasia by the patient and least importance (the lay people) or none (the health professionals) to the patient's willingness to donate organs. They also integrate the information from the different factors in the same way: the factors of patient request, patient life expectancy, and (for the lay people) organ donation are combined additively, and the family's attitude toward prolonging care interacts with patient request (playing a larger role when the patient can make no request). Thus we demonstrate a common cognitive foundation for future discussions, at the levels of both clinical care and public policy, of the conditions under which physician-performed euthanasia might be acceptable. PMID:15522491

  2. Managing risk: clinical decision-making in mental health services.

    PubMed

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

    2011-01-01

    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients. PMID:22077745

  3. Planning replacement of natural gas distribution systems under constraints on acceptable risk from explosions.

    PubMed

    Noonan, F

    1991-12-01

    Natural gas distribution systems in the United States were developed primarily in the first half of this century, utilizing materials such as cast iron and then steel. Over time, cast iron and steel pipe sections became weak from corrosion and are subject to failure which in turn can lead to explosions and possible injury and loss of life. Gas utilities maintain system integrity through repair-replacement programs where pipe sections are prioritized for replacement in any given year through cost-benefit analysis; however, the total annual amount to be budgeted for replacement is left to engineering judgment. This approach has left some utilities vulnerable to criticism that their current replacement rate on cast iron pipe is not great enough and that public safety is being compromised. This paper addresses the problem situation by formulating a linear programming replacement decision model which augments cost-benefit analysis with explicit constraints on acceptable risk to human life from fire/explosion. The model is illustrated for a hypothetical utility. PMID:1780504

  4. ‘Croque&bouge’: A feasible and acceptable programme for obesity prevention in preschoolers at risk and their parents

    PubMed Central

    Dudley-Martin, Fiona; Kruseman, Maaike

    2015-01-01

    Objectives: To conceptualize and pilot test a programme of three workshops aiming to prevent the development of overweight in susceptible preschool children. Methods: Three workshops were conducted, targeting both parents and children. The curriculum for parents included discussions on feeding responsibilities, healthy eating, taste development, neophobia and physical activity recommendations. Children participated in various play activities with fruits and vegetables and read stories about hunger and satiety feelings. Recruitment was organized through paediatricians and child-care centres. Evaluation of the programme focused on feasibility, adequacy for children’s age, parents’ perception of impact and, for children, change of the ability to recognize and willingness to taste fruits and vegetables. Results: A total of 21 children and one of their parents participated in the programme. The programme was found to be feasible and adequate for the targeted community. Parents reported perceiving a positive impact of the intervention; however, this finding was not statistically significant. The major difficulty was identifying and recruiting families and engaging the parents in a discussion about weight. Conclusions: This short programme aiming to improve parents’ ability to offer healthy environment and promote healthy eating behaviour was feasible and acceptable for families with young children. When developing and implementing such programmes, close collaboration with paediatricians and other health providers should be sought in order to identify and reach children at risk of obesity and their family. PMID:26770769

  5. Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

    PubMed

    Giacomini, M; Luft, H S; Robinson, J C

    1995-01-01

    This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care. PMID:7639879

  6. Tobacco Road Finland - how did an accepted pleasure turn into an avoidable risk behaviour?

    PubMed

    Hakkarainen, Pekka

    2013-12-01

    Smoking was once defined as an appropriate recreational substance or life comfort, but is now understood as a serious health risk and a public health problem important enough to be controlled by society. In this article the changed social position and development of tobacco regulations in Finland are studied from a perspective of social constructionism. The emergence of recent tobacco controls can be seen as a process whereby tobacco came to be defined as a social problem. I will argue that there were three primary definitions which played a decisive role in this process. Put in historical order, these three definitions contained (1) claims about harms to smokers, (2) claims about harms to others, and (3) claims about tobacco as a highly addictive drug. These conceptions together drove a complementary and mutually reinforcing re-conception of tobacco harms. Consequently, the emergence of these definitions led to the founding of new institutions, practices, and treatments. The leading value in the claim-making process was public health, which transferred the state's interest away from fiscal revenues towards lowering the costs caused by tobacco diseases. Correspondingly, medical science and medical doctors gained a position as the leading authority in the defining the tobacco issue. The latest conceptual innovation is the idea of a tobacco-free Finland by 2040, representing a strategy of 'de-normalising' tobacco use. The reversal in the social and cultural position of tobacco, which in Finland went from one extreme to another, was not based on pressure created by any wider social movements or organised tobacco-specific citizens groups, as in some other countries, but rather by a state health administration supported by a relatively small network of tobacco control advocates. PMID:24331906

  7. [Perception of health risks: psychological and social factors].

    PubMed

    Kurzenhäuser, S; Epp, A

    2009-12-01

    This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals. PMID:19862487

  8. Health and safety risks in production agriculture.

    PubMed Central

    Von Essen, S G; McCurdy, S A

    1998-01-01

    Production agriculture is associated with a variety of occupational illnesses and injuries. Agricultural workers are at higher risk of death or disabling injury than most other workers. Traumatic injury commonly occurs from working with machinery or animals. Respiratory illness and health problems from exposures to farm chemicals are major concerns, and dermatoses, hearing loss, certain cancers, and zoonotic infections are important problems. Innovative means of encouraging safe work practices are being developed. Efforts are being made to reach all groups of farmworkers, including migrant and seasonal workers, farm youth, and older farmers. PMID:9795581

  9. Validation of the French version of the Acceptability E-scale (AES) for mental E-health systems.

    PubMed

    Micoulaud-Franchi, Jean-Arthur; Sauteraud, Alain; Olive, Jérôme; Sagaspe, Patricia; Bioulac, Stéphanie; Philip, Pierre

    2016-03-30

    Despite the increasing use of E-health systems for mental-health organizations, there is a lack of psychometric tools to evaluate their acceptability by patients with mental disorders. Thus, this study aimed to translate and validate a French version of the Acceptability E-scale (AES), a 6-item self-reported questionnaire that evaluates the extent to which patients find E-health systems acceptable. A forward-backward translation of the AES was performed. The psychometric properties of the French AES version, with construct validity, internal structural validity and external validity (Pearson's coefficient between AES scores and depression symptoms on the Beck Depression Inventory II) were analyzed. In a sample of 178 patients (mean age=46.51 years, SD=12.91 years), the validation process revealed satisfactory psychometric properties: factor analysis revealed two factors: "Satisfaction" (3 items) and "Usability" (3 items) and Cronbach's alpha was 0.7. No significant relation was found between AES scores and depression symptoms. The French version of the AES revealed a two-factor scale that differs from the original version. In line with the importance of acceptability in mental health and with a view to E-health systems for patients with mental disorders, the use of the AES in psychiatry may provide important information on acceptability (i.e., satisfaction and usability). PMID:26809367

  10. Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies

    PubMed Central

    Horo, Apollinaire G.; Didi-Kouko Coulibaly, Judith; Koffi, Abdoul; Tchounga, Boris; Seni, Konan; Aka, Kacou Edèle; Kone, Mamourou

    2015-01-01

    Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol's iodine (VILI). Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program. PMID:26167178

  11. [Active health promotion among the aged in a rural region. Participants, acceptance, and implementation].

    PubMed

    Hofreuter-Gätgens, K; Mnich, E; Thomas, D; Salomon, T; von dem Knesebeck, O

    2011-08-01

    The program "active health promotion in old age" focuses on persons aged 60 years and older who are not in need of care and are living independently without cognitive impairment. The objective of the intervention is to improve physical activity, healthy nutrition, and the integration of older people into network structures. The intervention was successfully conducted in an urban setting and has now been transferred to a rural area in southwestern Germany (Baden-Wuerttemberg). It was offered to statutory health insured people of Baden-Wuerttemberg within an integrated care program and was free of charge. This article reports the results of the process evaluation. For data collection, participants were interviewed using a standardized questionnaire. Semistructured interviews were conducted with the intervention team and involved general practitioners. In addition, secondary data were used to analyze selection bias between participants and nonparticipants. Although the rural area has a major impact on recruitment, access, and factors of implementation, results demonstrate that the intervention is highly accepted by participants. Moreover, structural conditions (e.g., fitness clubs, exercise classes) are essential for a successful transfer. PMID:21800241

  12. Patients’ Acceptance towards a Web-Based Personal Health Record System: An Empirical Study in Taiwan

    PubMed Central

    Liu, Chung-Feng; Tsai, Yung-Chieh; Jang, Fong-Lin

    2013-01-01

    The health care sector has become increasingly interested in developing personal health record (PHR) systems as an Internet-based telehealthcare implementation to improve the quality and decrease the cost of care. However, the factors that influence patients’ intention to use PHR systems remain unclear. Based on physicians’ therapeutic expertise, we implemented a web-based infertile PHR system and proposed an extended Technology Acceptance Model (TAM) that integrates the physician-patient relationship (PPR) construct into TAM’s original perceived ease of use (PEOU) and perceived usefulness (PU) constructs to explore which factors will influence the behavioral intentions (BI) of infertile patients to use the PHR. From ninety participants from a medical center, 50 valid responses to a self-rating questionnaire were collected, yielding a response rate of 55.56%. The partial least squares (PLS) technique was used to assess the causal relationships that were hypothesized in the extended model. The results indicate that infertile patients expressed a moderately high intention to use the PHR system. The PPR and PU of patients had significant effects on their BI to use PHR, whereas the PEOU indirectly affected the patients’ BI through the PU. This investigation confirms that PPR can have a critical role in shaping patients’ perceptions of the use of healthcare information technologies. Hence, we suggest that hospitals should promote the potential usefulness of PHR and improve the quality of the physician-patient relationship to increase patients’ intention of using PHR. PMID:24142185

  13. Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold

    PubMed Central

    Griffiths, Elizabeth A; Hendrich, Janek K; Stoddart, Samuel DR; Walsh, Sean CM

    2015-01-01

    Objectives In health technology assessment (HTA) agencies where cost-effectiveness plays a role in decision-making, an incremental cost-effectiveness ratio (ICER) threshold is often used to inform reimbursement decisions. The acceptance of submissions with ICERs higher than the threshold was assessed across different agencies and across indications, in order to inform future reimbursement submissions. Methods All HTA appraisals from May 2000 to May 2014 from National Institute for Health and Care Excellence (NICE), Scottish Medicines Consortium (SMC), Pharmaceutical Benefits Advisory Committee (PBAC), and Canadian Agency for Drugs and Technologies in Health (CADTH) were assessed. Multiple technology appraisals, resubmissions, vaccination programs, and requests for advice were excluded. Submissions not reporting an ICER, or for which an ICER could not be determined were also excluded. The remaining appraisals were reviewed, and the submitted ICER, recommendation, and reasoning behind the recommendation were extracted. Results NICE recommended the highest proportion of submissions with ICERs higher than the threshold (34% accepted without restrictions; 20% with restrictions), followed by PBAC (16% accepted without restrictions; 4% with restrictions), SMC (11% accepted without restrictions; 14% accepted with restrictions), and CADTH (0% accepted without restrictions; 26% with restrictions). Overall, the majority of higher-than-threshold ICER submissions were classified into the “malignant disease and immunosuppression” therapeutic category; however, there was no notable variation in acceptance rates by disease area. Reasons for accepting submissions reporting ICERs above the threshold included high clinical benefit over the standard of care, and addressing an unmet therapeutic need. Conclusion Acceptance of submissions with higher-than-threshold ICERs varied by HTA agency and was not significantly influenced by disease category. Such submissions must be

  14. “Faster, better, and cheaper” at NASA: Lessons learned in managing and accepting risk

    NASA Astrophysics Data System (ADS)

    Paxton, Larry J.

    2007-11-01

    Can Earth observing missions be done "better, faster and cheaper"? In this paper I explore the management and technical issues that arose from the attempt to do things "faster, better and cheaper" at NASA. The FBC mantra lead to some failures and, more significantly, an increase in the cadence of missions. Mission cadence is a major enabler of innovation and the driver for the training and testing of the next generation of managers, engineers, and scientists. A high mission cadence is required to maintain and develop competence in mission design, management, and execution and, for an exploration-driven organization, to develop and train the next generation of leaders: the time between missions must be short enough that careers span the complete life of more than a few missions. This process reduces risk because the "lessons learned" are current and widely held. Increasing the cadence of missions has the added benefit of reducing the pressure to do everything on one particular mission thus reducing mission complexity. Since failures are inevitable in such a complex endeavor, a higher mission cadence has the advantage of providing some resiliency to the scientific program the missions support. Some failures are avoidable (often only in hindsight) but most are due to some combination of interacting factors. This interaction is often only appreciated as a potential failure mode after the fact. There is always the pressure to do more with less: the scope of the project may become too ambitious or the management and oversight of the project may be reduced to fit the money allocated, or the project time line may be lengthened due to external factors (launcher availability, budgetary constraints) without a concomitant increase in the total funding. This leads to increased risk. Risks are always deemed acceptable until they change from a "risk" to a "failure mode". Identifying and managing those risks are particularly difficult when the activities are dispersed

  15. Korean American parental depressive symptoms and children's mental health: the mediating role of parental acceptance-rejection.

    PubMed

    Kim, Eunjung

    2013-01-01

    This study explored the mediating role of parental acceptance-rejection in the relationship between parental depressive symptoms and children's mental health. Self-report data were gathered from 95 mothers and 91 fathers of children (ages 5-10 years) in Korean American families. For mothers and fathers, the relationship between parental depressive symptoms and child psychosocial problems was mediated by parenting behaviors, with parental rejection being a much stronger mediator than parental acceptance. For fathers, the relationship between fathers' depressive symptoms and child social competence was mediated by parenting, with fathers' parental rejection being a slightly stronger mediator than fathers' parental acceptance. PMID:22608945

  16. Risk-rated health insurance programs: a review of designs and important issues.

    PubMed

    Kaelin, M A; Barr, J K; Golaszewski, T; Warshaw, L J

    1992-01-01

    PURPOSE OF THE REVIEW. The purpose of this review is to assist those who work in the field of health promotion when considering the implementation of an individually risk-rated health insurance plan. It does so by introducing the reader to the concept of individually risk-rating health insurance; uncritically reviewing selected risk-rated health insurance plans; and exploring several issues related to plan implementation, administration, and appropriateness. SEARCH METHODS USED. The review is based on the authors' awareness of the literature in the fields of preventive medicine, health promotion, and employee benefits. The six individually risk-rated health insurance programs that are reviewed were chosen because they demonstrate how aspects of the National Association of Insurance Commissioners' Model have been implemented using various combinations of administrative procedures, verification strategies, and types of economic incentives or disincentives. This review is not intended to be a comprehensive review of the literature. SUMMARY OF IMPORTANT FINDINGS. Individually risk-rated health insurance programs have been established using a variety of administrative procedures, verification strategies, and types of economic incentives or disincentives. The frequency with which these programs are being established is increasing. As the number of risk-rated programs grows, it will be increasingly important to address the many issues that implementing such plans generate: How should lifestyle behaviors be verified? Will healthy lifestyles save money? Can employees fully control their risk factors? Is risk-rating socially responsible? MAJOR CONCLUSIONS. As risk-rating becomes more widespread, there will be a continuing need to address the business, medical, ethical, and legal issues these programs create and to refine them accordingly. The health promotion community has both an opportunity and obligation to see to it that individually risk-rated health insurance programs

  17. Toxic chemical hazard classification and risk acceptance guidelines for use in DOE facilities. Revision 2

    SciTech Connect

    Craig, D.K.; Davis, J.S.; Prowse, J.; Hoffman, P.W.

    1995-03-24

    The concentration-limit guidelines presented in this document apply to airborne releases of chemicals evaluated with respect to human health effects for the purposes of hazard classification and categorization, risk assessment and safety analysis. They apply to all DOE facilities and operations involving the use of potentially hazardous chemicals. The guidelines do not address other nonradiological hazards such as fire, pressure releases (including explosions), and chemical reactivity, but the guidelines are applicable to hazardous chemical releases resulting from these events. This report presents the subcommittee`s evaluation and recommendations regarding analyses of accidentally released toxic chemicals. The premise upon which these recommendations are based is that the mechanism of action of toxic chemicals is fundamentally different from that associated with radionuclides, with the exception of carcinogens. The recommendations reported herein are restricted to the airborne pathway because in an accident scenario this typically represents the most immediately significant route of public exposure. However, the subcommittee recognizes that exposure to chemicals through other pathways, in particular waterborne, can have significant impacts on human health and the environment. Although there are a number of chemicals for which absorption through the skin can contribute measurably to the total dose in chronic (e.g., occupational) exposure situations, this pathway has not been considered for the acute exposure scenarios considered in this report. Later studies. will address these issues if it appears desirable.

  18. Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment

    PubMed Central

    Giles, Emma L.; Becker, Frauke; Ternent, Laura; Sniehotta, Falko F.; McColl, Elaine

    2016-01-01

    Background Healthy behaviours are important determinants of health and disease, but many people find it difficult to perform these behaviours. Systematic reviews support the use of personal financial incentives to encourage healthy behaviours. There is concern that financial incentives may be unacceptable to the public, those delivering services and policymakers, but this has been poorly studied. Without widespread acceptability, financial incentives are unlikely to be widely implemented. We sought to answer two questions: what are the relative preferences of UK adults for attributes of financial incentives for healthy behaviours? Do preferences vary according to the respondents’ socio-demographic characteristics? Methods We conducted an online discrete choice experiment. Participants were adult members of a market research panel living in the UK selected using quota sampling. Preferences were examined for financial incentives for: smoking cessation, regular physical activity, attendance for vaccination, and attendance for screening. Attributes of interest (and their levels) were: type of incentive (none, cash, shopping vouchers or lottery tickets); value of incentive (a continuous variable); schedule of incentive (same value each week, or value increases as behaviour change is sustained); other information provided (none, written information, face-to-face discussion, or both); and recipients (all eligible individuals, people living in low-income households, or pregnant women). Results Cash or shopping voucher incentives were preferred as much as, or more than, no incentive in all cases. Lower value incentives and those offered to all eligible individuals were preferred. Preferences for additional information provided alongside incentives varied between behaviours. Younger participants and men were more likely to prefer incentives. There were no clear differences in preference according to educational attainment. Conclusions Cash or shopping voucher

  19. Acceptance, Usability and Health Applications of Virtual Worlds by Older Adults: A Feasibility Study

    PubMed Central

    Winkler, Sandra L

    2016-01-01

    Background Virtual worlds allow users to communicate and interact across various environments, scenarios, and platforms. Virtual worlds present opportunities in health care to reduce the burden of illness and disability by supporting education, rehabilitation, self-management, and social networking. The application of virtual worlds to older adults who bear the burden and cost of health conditions associated with age has not been evaluated. Objective The aim of this study is to explore the usability, ease of use, and enjoyment of a virtual world by older adults, the types of virtual world activities that older adults may engage in, and the perceptions of older adults regarding the application of virtual worlds in health care. Methods This quasi-experimental pre-post design research was guided by the Technology Acceptance Model (TAM). Participants were recruited from a Lifelong Learning Institute (LLI) program at Nova Southeastern University. Participants attended four training sessions over a 5-week period in the Second Life (SL) virtual world. Subjects were surveyed before and after the training on perceived ease of use, attitudes towards technology, behavioral intention to use the system, facilitating conditions, effort expectancy, and self-efficacy. Results Older adults (N=19) completed the informed consent and attended the first training session, and 11 participants (58%, 11/19) completed the full training and the post survey. Completers (82%, 9/11) were more likely than non-completers (37%, 3/8) to consider themselves technologically savvy (P=.048), and to express confidence in being able to use the virtual world (100%, 11/11 vs 37%, 3/8; P=.002). All completers (100%, 11/11) perceived that SL has application in health behaviors and disease and reducing social isolation among people who are homebound. Of the completers, 10 (91%, 10/11) responded that they enjoyed learning how to use SL. Completers suggested that future trainings include more assistants and

  20. Cyanobacterial toxins: risk management for health protection.

    PubMed

    Codd, Geoffrey A; Morrison, Louise F; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles. PMID:15737680

  1. Cyanobacterial toxins: risk management for health protection

    SciTech Connect

    Codd, Geoffrey A.; Morrison, Louise F.; Metcalf, James S

    2005-03-15

    This paper reviews the occurrence and properties of cyanobacterial toxins, with reference to the recognition and management of the human health risks which they may present. Mass populations of toxin-producing cyanobacteria in natural and controlled waterbodies include blooms and scums of planktonic species, and mats and biofilms of benthic species. Toxic cyanobacterial populations have been reported in freshwaters in over 45 countries, and in numerous brackish, coastal, and marine environments. The principal toxigenic genera are listed. Known sources of the families of cyanobacterial toxins (hepato-, neuro-, and cytotoxins, irritants, and gastrointestinal toxins) are briefly discussed. Key procedures in the risk management of cyanobacterial toxins and cells are reviewed, including derivations (where sufficient data are available) of tolerable daily intakes (TDIs) and guideline values (GVs) with reference to the toxins in drinking water, and guideline levels for toxigenic cyanobacteria in bathing waters. Uncertainties and some gaps in knowledge are also discussed, including the importance of exposure media (animal and plant foods), in addition to potable and recreational waters. Finally, we present an outline of steps to develop and implement risk management strategies for cyanobacterial cells and toxins in waterbodies, with recent applications and the integration of Hazard Assessment Critical Control Point (HACCP) principles.

  2. Assessing Abuse Risk beyond Self-Report: Analog Task of Acceptability of Parent-Child Aggression

    ERIC Educational Resources Information Center

    Rodriguez, Christina M.; Russa, Mary Bower; Harmon, Nancy

    2011-01-01

    Objectives: The present investigation reports on the development and initial validation of a new analog task, the Parent-Child Aggression Acceptability Movie Task (P-CAAM), intended to assess respondents' acceptance of parent-child aggression, including both physical discipline and physical abuse. Methods: Two independent samples were utilized to…

  3. The perceived health risks of indoor radon gas and overhead powerlines: a comparative multilevel approach.

    PubMed

    Poortinga, Wouter; Cox, Patrick; Pidgeon, Nick F

    2008-02-01

    Radon and overhead powerlines are two radiation risk cases that have raised varying levels of concern among the general public and experts. Despite both involving radiation-a typically feared and unseen health hazard-individuals' perceptions of the two risk cases may invoke rather different factors. We examined individual and geographic-contextual factors influencing public perceptions of the health risks of indoor radon gas and overhead powerlines in a comparative research design, utilizing a postal questionnaire with 1,528 members of the general public (response rate 28%) and multilevel modeling techniques. This study found that beliefs about the two risk cases mainly differed according to the level of "exposure"-defined here in terms of spatial proximity. We argue that there are two alternative explanations for this pattern of findings: that risk perception itself varies directly with proximity, or that risk is more salient to concerned people in the exposed areas. We also found that while people living in high radon areas are more concerned about the risks of indoor radon gas, they find these risks more acceptable and have more trust in authorities. These results might reflect the positive effects of successive radon campaigns in high radon areas, which may have raised awareness and concern, and at the same time may have helped to increase trust by showing that the government takes the health risks of indoor radon gas seriously, suggesting that genuine risk communication initiatives may have positive impacts on trust in risk management institutions. PMID:18304120

  4. Psychology in health risk messages for workers.

    PubMed

    Cohen, A; Colligan, M J; Berger, P

    1985-08-01

    The content, style, and mode of company communications directed to workers regarding job hazards and health risks are frequently based only on concerns for technical accuracy and legal liability. These considerations as shaping factors in informational messages do not ensure worker understanding and responsiveness. Moreover, the uncertainty of health threats posed by many workplace chemical and physical agents, and the delayed, insidious disorders they may portend, present formidable obstacles in this regard. This report describes guidelines that attempt to overcome these difficulties, with specific reference to printed forms of informational material. The guidelines are based on concepts from the cognitive and social psychology literature, with additional input from experts in those fields as well as representatives from management and labor who have responsibilities for worker health education in their respective organizations. Selected guidelines are presented and critiques are offered of samples of hazard information materials directed to workers in light of the guidelines' prescriptions. Field trials are planned as a follow-up. PMID:4032089

  5. [Are mortality indicators acceptable indicators for the quality of health care?].

    PubMed

    Ravaud, P; Giraudeau, B; Roux, P M; Durieux, P

    1999-10-01

    IMPORTANCE OF PUBLISHING MORTALITY RATES: Mortality rates for certain interventions or disease states have been used over the last decade as indicators of the quality of care provided by a given hospital, unit or, medical team. If published, these rates would be a useful tool for decision makers in the process of fund allocations, for public information, and for promoting improved care in hospitals or units with a low classification. METHODOLOGICAL LIMITATIONS: It is difficult to adjust an indicator of mortality to disease-related risk factors and any modification of this adjustment can have major consequences on the validity of subsequent comparisons. The differences in mortality observed between hospitals and physicians can reflect not only differences in quality of care but also differences in approaches to disease-related risk factors, therapeutic choices, or coding practices. The lack of statistical power is a major limiting factor in interpreting differences in mortality rates. To evidence a statistically significant difference in mortality between two hospitals whose rates are respectively 0.5% and 1% (for example in total hip replacement patients), it would be necessary to include 4673 patients, a number which would correspond to 20 years data for a hospital performing 230 interventions per year. Consequently, the number of interventions performed in the most active hospitals would not be sufficient to make such comparisons. LIMITATIONS AND COUNTER EFFECTS: Some studies have demonstrated that the publication of mortality rates does not have a major influence on patients' decisions nor on physicians' choice of a referral hospital. It would have no effect on improving health care quality of the institutions cited. One the contrary, certain counter effects have been observed: modification in patient recruitment, higher-risk patients being referred to hospitals with unpublished mortality rates. For many authors, procedure indicators are more pertinent than

  6. Incremental net benefit and acceptability of alternative health policies: a case study of mass screening for colorectal cancer.

    PubMed

    Chauvin, Pauline; Josselin, Jean-Michel; Heresbach, Denis

    2012-06-01

    The incremental net benefit (INB) and the related acceptability curves for public health programs provide valuable tools for decision making. We proposed to apply them to the assessment of mass screening of colorectal cancer. The now standard guaiac fecal occult blood test (FOBT) is already implemented in several countries. We considered the innovative immunological FOBT and computed tomography colonography (CTC) as competing screening technologies. Using biennial guaiac FOBT as the reference strategy, we estimated the cost-effectiveness of the following alternatives: biennial immunological FOBT, CTC every 5 years (strategy CTC5), and CTC every 10 years (strategy CTC10). Over a 30-year horizon and from the perspective of a third-party payer, we developed a Markov model on a hypothetical cohort of 100,000 subjects at average risk of colorectal cancer. Close expected net benefits between immunological FOBT and CTC5 induced uncertainty in the choice of the optimal strategy. Probabilistic sensibility analysis then suggested that below a willingness to pay (WTP) per life-years gained (LYG) of 8,587 €/LYG, CTC10 was optimal, while CTC5 would be preferred beyond a WTP of 8,587 €/LYG. PMID:21305335

  7. Occupational Health Promotion Programs to Reduce Cardiovascular Risk.

    ERIC Educational Resources Information Center

    Glasgow, Russell E.; Terborg, James R.

    1988-01-01

    Surveys literature on worksite health promotion programs targeting cardiovascular risk factors. Reviews findings on health-risk appraisal, hypertension control, smoking cessation, weight reduction, exercise, and programs addressing multiple risk factors. Discusses current knowledge, highlights exemplary studies, and identifies problems and…

  8. Health risk assessment: WTE (waste-to-energy) vs. peanut butter

    SciTech Connect

    Michaels, R.A. )

    1988-10-01

    The degree to which society will come to accept potential health risks associated with municipal waste-to-energy plants depends on three factors: the reliability with which exposure and adverse health effects associated with facility emissions can be described, quantified, and gradually reduced; the relative magnitude of the risks compared with those of other waste management options, especially landfilling and recycling; and the relative magnitude of the risks compared with those of more familiar activities, such as driving, flying, smoking, and eating peanut butter sandwiches. Progress in risk assessment has already improved quantification of human exposure to emissions through the food chain, as well as through other pathways within the general categories of inhalation, ingestion, and dermal contact. Where does this progress leave municipal refuse incineration relative to other risks This article explores that issue.

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

    EPA Science Inventory

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

  10. Enhancing user acceptance of mandated mobile health information systems: the ePOC (electronic point-of-care project) experience.

    PubMed

    Burgess, Lois; Sargent, Jason

    2007-01-01

    From a clinical perspective, the use of mobile technologies, such as Personal Digital Assistants (PDAs) within hospital environments is not new. A paradigm shift however is underway towards the acceptance and utility of these systems within mobile-based healthcare environments. Introducing new technologies and associated work practices has intrinsic risks which must be addressed. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a best fit with end user needs. It is envisaged this research will lead to the development of a formalised user acceptance framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a mandated electronic point-of-care information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented. PMID:17911883

  11. Identifying health and safety risks for childcare workers.

    PubMed

    McGrath, Belinda J

    2007-08-01

    Childcare workers are exposed to several health and safety risks in their work environment, the most common being infectious diseases, musculoskeletal injuries, accidents, and occupational stress. Pregnant childcare workers have an additional risk of potential harm to the fetus. Occupational health nurses can work collaboratively with childcare workers to reduce these risks and provide workplace health promotion programs. This article explores the occupational health and safety issues for childcare workers and suggests health promotion strategies that could be implemented by occupational health nurses working in this arena. PMID:17847626

  12. The power of perception: Health risk attributed to air pollution in an urban industrial neighborhood

    SciTech Connect

    Elliott, S.J.; Cole, D.C.; Krueger, P.; Voorberg, N.; Wakefield, S.

    1999-08-01

    This paper describes a multi-stakeholder process designed to assess the potential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on their health and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception to advantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes the instructional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served to legitimate the community's concerns about air quality and to help broaden operational definitions of health. In addition, the results of both health risk assessment exercises served to keep issues of air quality on the local political agenda. Implications of these findings for their understanding of the environmental justice process as well as the ability of communities to influence environmental health policy are discussed.

  13. The acceptability of a computer HIV/AIDS risk assessment to not-in-treatment drug users.

    PubMed

    Williams, M L; Freeman, R C; Bowen, A M; Saunders, L

    1998-12-01

    The purpose of this paper is to report the results of a study assessing the acceptability of a computer HIV risk assessment instrument administered to not-in-treatment drug users. The study asked three questions related to acceptability: (1) are drug users comfortable responding to HIV risk questions using the computer assessment; (2) do drug users feel that they possess the requisite skill to respond to questions using a computer; and (3) do drug users believe that the responses they provide using the computer assessment will remain private and confidential. This study differs from other assessments of the acceptability of computer assisted data collection in that the population of interest has only limited education and interaction with computers. Furthermore, the study was implemented under field conditions. To conduct the study, an existing HIV risk assessment instrument was adapted for use with the computer. Only slight modifications were made to the content of the instrument. To facilitate data collection with this population, audio enhancement and touch screen were used. Three scales measuring comfort, skill and perceived privacy were developed. Results of analysis showed that drug users are comfortable responding to an HIV risk assessment using computer assisted interviewing. Drug users also perceived that they possessed the requisite skill to successfully complete the interview. And, study participants reported that they believed that their responses using the computer interview would remain private and confidential. Only minor differences in scale scores based on sociodemographic characteristics were found among study participants. Implications of the findings are discussed. PMID:9924525

  14. Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields.

    PubMed

    Freudenstein, Frederik; Wiedemann, Peter M; Brown, Tim W C

    2015-01-01

    The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one's own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed. PMID:26229540

  15. Editorial: Lead Risk Assessment and Health Effects

    PubMed Central

    Mielke, Howard W.

    2016-01-01

    In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  16. Editorial: Lead Risk Assessment and Health Effects.

    PubMed

    Mielke, Howard W

    2016-01-01

    In 1980, Clair C. Patterson stated: "Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century". We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson's statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  17. Poor periodontal health: A cancer risk?

    PubMed Central

    Rajesh, K. S.; Thomas, Deepak; Hegde, Shashikanth; Kumar, M. S. Arun

    2013-01-01

    Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis. PMID:24554877

  18. Tobacco industry sponsorship of community-based public health initiatives: why AIDS and domestic violence organizations accept or refuse funds.

    PubMed

    Stone, Meg; Siegel, Michael B

    2004-01-01

    The objective of this study was to understand the reasons community-based public health organizations in the United States accept or refuse tobacco industry sponsorship. A formative pilot study involving 13 interviews with representatives of AIDS and Domestic Violence organizations in California or the Northeast was used. Semistructured interviews were conducted with leaders and fund-raisers working at AIDS and domestic violence organizations that either accepted grants from the tobacco industry or explicitly refused tobacco corporate support. Respondents that accepted grants did so because they believed that the tangible benefits of additional capacity to serve their constituents outweighed the minimal effect they believed refusing funds could have on tobacco control and prevention. Organizations that refused sponsorship either saw tobacco prevention as part of their mission of promoting overall health or social justice, or expressed concern about public association with the tobacco industry. Public health responses to this phenomenon are most effective when they are informed by the realities facing nonprofit leaders as they grapple with the question of whether to accept industry funds. Further research is needed to determine whether accepting sponsorship results in a change in public opinion about tobacco control. Possible interventions include creating positive publicity for organizations that refuse tobacco industry philanthropy. PMID:15643374

  19. 77 FR 21277 - Customer Clearing Documentation, Timing of Acceptance for Clearing, and Clearing Member Risk...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ...\\ Clearing Member Risk Management, 76 FR 45724 (Aug. 1, 2011). \\7\\ Adaption of Regulations to Incorporate... ``risk management.'' See, e.g., proposed Sec. 39.13 relating to risk management for DCOs, 76 FR at 3720... and increases risk.\\38\\ \\38\\ See 76 FR 1214, Jan. 7, 2011. In this rulemaking, the Commission...

  20. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... applicable, and reentry or descent flight, and concludes upon landing on Earth of the RLV. (b) Acceptable...) Identify and describe the structure of the RLV, including physical dimensions and weight; (2) Identify...

  1. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    ERIC Educational Resources Information Center

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  2. Human health and performance risk management—an approach for exploration missions

    NASA Astrophysics Data System (ADS)

    Davis, Jeffrey R.; Fogarty, Jennifer A.; Richard, Elizabeth E.

    During long duration exploration missions, maintaining human health and performance will be essential to enabling success. Therefore, NASA has developed standards through the Health and Medical Technical Authority to insure human health and performance during exploration. Human health standards are the first step in defining acceptable risk for human space flight and take into consideration both short-term (mission) and long-term (lifetime) health risk. These standards are based on the best medical evidence from terrestrial standards; analog spaceflight environments; and spaceflight experience. Standards drive the development of focused program requirements to mitigate risks associated with specific missions. Program requirements include vehicle design as well as health care systems including medical, environmental and countermeasures. NASA has also developed the risk mitigation analysis tool (RMAT), a process to evaluate the effectiveness of risk mitigation strategies. The RMAT facilitates documentation and analysis of the effectiveness of mitigation strategies, enables NASA to baseline a risk mitigation approach based on the best evidence, and provides the traceability from research and technology development projects to specific mission deliverables.

  3. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention.

    PubMed

    Mustanski, Brian; Greene, George J; Ryan, Daniel; Whitton, Sarah W

    2015-01-01

    Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth. PMID:24588408

  4. Accuracy of Parents' Perceptions of Their College Student Children's Health and Health Risk Behaviors

    ERIC Educational Resources Information Center

    Bylund, Carma L.; Imes, Rebecca S.; Baxter, Leslie A.

    2005-01-01

    The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic…

  5. Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems: A Systematic Review

    PubMed Central

    Lobban, Fiona; Emsley, Richard; Bucci, Sandra

    2016-01-01

    Background Psychological interventions are recommended for people with severe mental health problems (SMI). However, barriers exist in the provision of these services and access is limited. Therefore, researchers are beginning to develop and deliver interventions online and via mobile phones. Previous research has indicated that interventions delivered in this format are acceptable for people with SMI. However, a comprehensive systematic review is needed to investigate the acceptability of online and mobile phone-delivered interventions for SMI in depth. Objective This systematic review aimed to 1) identify the hypothetical acceptability (acceptability prior to or without the delivery of an intervention) and actual acceptability (acceptability where an intervention was delivered) of online and mobile phone-delivered interventions for SMI, 2) investigate the impact of factors such as demographic and clinical characteristics on acceptability, and 3) identify common participant views in qualitative studies that pinpoint factors influencing acceptability. Methods We conducted a systematic search of the databases PubMed, Embase, PsycINFO, CINAHL, and Web of Science in April 2015, which yielded a total of 8017 search results, with 49 studies meeting the full inclusion criteria. Studies were included if they measured acceptability through participant views, module completion rates, or intervention use. Studies delivering interventions were included if the delivery method was online or via mobile phones. Results The hypothetical acceptability of online and mobile phone-delivered interventions for SMI was relatively low, while actual acceptability tended to be high. Hypothetical acceptability was higher for interventions delivered via text messages than by emails. The majority of studies that assessed the impact of demographic characteristics on acceptability reported no significant relationships between the two. Additionally, actual acceptability was higher when

  6. Risk management: FIFA's approach for protecting the health of football players

    PubMed Central

    Fuller, Colin W; Junge, Astrid; Dvorak, Jiri

    2012-01-01

    Background Sport and exercise have long-term health benefits, but there is also a risk that participants will sustain injuries and/or ill health from these activities. For this reason, international sports governing bodies have a responsibility to identify the risks that exist within their sport and to provide guidance to participants and other stakeholders on how these risks can be controlled within acceptable levels. Purpose To demonstrate how Fédération Internationale de Football Association (FIFA), as football's governing body, uses a risk management framework to identify, quantify, mitigate and communicate the risks of injury and ill health in football for men, women and children in all environments. Method All the research papers published by FIFA's Medical Assessment and Research Centre (F-MARC) during the period 1994 to 2011 were reviewed and categorised according to an established sport-related risk management framework. Conclusions F-MARC investigated and mitigated 17 areas of risk to footballers' health in a coherent and consistent approach through the process of risk management. PMID:22143999

  7. Public Health Service report on fluoride benefits and risks

    SciTech Connect

    Not Available

    1991-06-14

    This report, Public Health Service Report on Fluoride Benefits and Risks is a summary of the findings, conclusions, and recommendations of Review of Fluoride Benefits and Risks: Report of the Ad Hoc Subcommittee on Fluoride of the Committee to Coordinate Environmental Health and Related Programs, published in February 1991. The full report was prepared by an ad hoc subcommittee of the United States Public Health Service's Committee to Coordinate Environmental Health and Related Programs (CCEHRP) at the request of the Assistant Secretary for Health. The full report can be obtained from the Public Health Service, Department of Health and Human Services.

  8. The Effectiveness of Training Acceptance / Commitment and Training Emotion Regulation on High-Risk Behaviors of Students with Dyscalculia

    PubMed Central

    Narimani, Mohammad; Abbasi, Moslem; Abolghasemi, Abbas; Ahadi, Batoul

    2013-01-01

    Background Now a days the utilization of Acceptance / Commitment and Emotion Regulation Strategy as a comprehensive treatment plan has been discussed in both the prevention and the control of destructive and risky behaviors. Treatment based on Acceptance/Commitment and Emotion Regulation was effective in both the improvement and the control of high-risk behaviors of students with dyscalculia. Objectives The purpose of this study was to investigate the effectiveness of Acceptance and Commitment, and Emotional Regulation training in high-risk behaviors of students with dyscalculia. Materials and Methods This research was experimental, with pre-test, post-test and a control group. The statistical universe of this study included all sixth-grade male students in Ardabil city in the academic year of 2012-2013 (A.H.). The subjects of this study involved 800 sixth-grade elementary students in Ardabil province, selected using a multi-stage cluster sampling. From among them, 60 students with dyscalculia were selected using random sampling method after the initial diagnosis by structured clinical interview and the Keymath Mathematic test. Twenty pupil were selected for either the experimental or the control group. To collect data, the questionnaires of "Keymath Mathematic test" and High-risk Behavior" were used. Results The results of Multivariate Analysis of Variance (MANOVA) showed that "Acceptance / Commitment and Emotion Regulation" treatment trainings were effective in reducing high-risk behaviors, in a manner that they led to a reduction in negative emotions, self-destructive and impulsive behaviors of students with math disorder (dyscalculia). Conclusions It can be concluded that teaching these skills to the students has been influential in enhancing awareness level and change or positive attitude creation in the subjects. Therefore, it is essential to design and implement interventions based on "prevention caused by the peer group, in collaboration with the parents

  9. Review of various approaches for assessing public health risks in regulatory decision making: choosing the right approach for the problem.

    PubMed

    Dearfield, Kerry L; Hoelzer, Karin; Kause, Janell R

    2014-08-01

    Stakeholders in the public health risk analysis community can possess differing opinions about what is meant by "conduct a risk assessment." In reality, there is no one-size-fits-all risk assessment that can address all public health issues, problems, and regulatory needs. Although several international and national organizations (e.g., Codex Alimentarius Commission, Office International des Epizooties, Food and Agricultural Organization, World Health Organization, National Research Council, and European Food Safety Authority) have addressed this issue, confusion remains. The type and complexity of a risk assessment must reflect the risk management needs to appropriately inform a regulatory or nonregulatory decision, i.e., a risk assessment is ideally "fit for purpose" and directly applicable to risk management issues of concern. Frequently however, there is a lack of understanding by those not completely familiar with risk assessment regarding the specific utility of different approaches for assessing public health risks. This unfamiliarity can unduly hamper the acceptance of risk assessment results by risk managers and may reduce the usefulness of such results for guiding public health policies, practices, and operations. Differences in interpretation of risk assessment terminology further complicate effective communication among risk assessors, risk managers, and stakeholders. This article provides an overview of the types of risk assessments commonly conducted, with examples primarily from the food and agricultural sectors, and a discussion of the utility and limitations of these specific approaches for assessing public health risks. Clarification of the risk management issues and corresponding risk assessment design needs during the formative stages of the risk analysis process is a key step for ensuring that the most appropriate assessment of risk is developed and used to guide risk management decisions. PMID:25198609

  10. Catalogue of Risks: Natural, Technical, Social and Health Risks

    NASA Astrophysics Data System (ADS)

    Ebi, Kristie L.

    2009-01-01

    Financial, geophysical, and terrorist-related disasters have been headline news in the past few months. As amply demonstrated on a regular basis, the recognition and evaluation of risks are skills that could be more widespread. As such, Proske's Catalogue of Risks is timely and of potential interest. The book is a revised and expanded version of an earlier German publication that aims to provide an encyclopedic discussion of issues related to risks and disasters, with a goal of facilitating an understanding of the components and assessment of risk. The book includes chapters that discuss the difficulty of coming to a consensus on a definition of risk, a comprehensive range of risks and disasters, objective risk measures, subjective risk judgment, quality of life measures, and legal aspects of risk. The book ends with an example of applying the concepts discussed to ship impacts against bridges.

  11. Measurement of Self-Monitoring Web Technology Acceptance and Use in an e-Health Weight-Loss Trial

    PubMed Central

    Xiao, Lan; Blonstein, Andrea C.

    2013-01-01

    Abstract Background: Research on technology acceptance and use in e-health weight-loss interventions is limited. Using data from a randomized controlled trial of two e-health interventions, we evaluated the acceptance and use of a self-monitoring Web site for weight loss. Materials and Methods: We examined eight theoretical constructs about technology acceptance using adapted 5-point Likert scales and the association of measured Web site usage and weight loss. Results: All scales had high internal consistency (Cronbach's alpha=0.74–0.97) in both interventions and at 3 and 15 months (end of intensive and maintenance intervention, respectively). From 3 to 15 months mean scores changed unfavorably for two constructs (compatibility and behavioral intention) among coach-led intervention participants, who received ongoing feedback on their self-monitoring entries. Among self-directed intervention participants, who received minimal coach support, mean scores changed unfavorably for five constructs (usefulness, ease of use, concern, compatibility, and behavioral intention). At 3 months, usefulness, ease of use, effect, compatibility, and behavioral intention in the coach-led group (Pearson r=0.33–0.5) and usefulness and affect in the self-directed group (r=0.43–0.46) were significantly correlated with Web site usage, which was correlated with weight loss (β=−0.02, p≤0.001 for both interventions). From 3 to 15 months, mean score changes for usefulness and behavioral intention correlated significantly with Web site usage in the coach-led group. Conclusions: The adapted acceptance measures showed acceptable psychometric properties and significant associations with actual Web site use, which correlated with weight loss. Better understanding of technology acceptance and use in e-health weight-loss interventions may improve participant adherence and outcome. PMID:23952787

  12. 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.

  13. Environment, Safety, and Health Risk Assessment Program (ESHRAP)

    SciTech Connect

    Eide, Steven Arvid; Thomas Wierman

    2003-12-01

    The Environment, Safety and Health Risk Assessment Program (ESHRAP) models human safety and health risk resulting from waste management and environmental restoration activities. Human safety and health risks include those associated with storing, handling, processing, transporting, and disposing of radionuclides and chemicals. Exposures to these materials, resulting from both accidents and normal, incident-free operation, are modeled. In addition, standard industrial risks (falls, explosions, transportation accidents, etc.) are evaluated. Finally, human safety and health impacts from cleanup of accidental releases of radionuclides and chemicals to the environment are estimated. Unlike environmental impact statements and safety analysis reports, ESHRAP risk predictions are meant to be best estimate, rather than bounding or conservatively high. Typically, ESHRAP studies involve risk predictions covering the entire waste management or environmental restoration program, including such activities as initial storage, handling, processing, interim storage, transportation, and final disposal. ESHRAP can be used to support complex environmental decision-making processes and to track risk reduction as activities progress.

  14. Low Acceptability of A/H1N1 Pandemic Vaccination in French Adult Population: Did Public Health Policy Fuel Public Dissonance?

    PubMed Central

    Schwarzinger, Michaël; Flicoteaux, Rémi; Cortarenoda, Sébastien; Obadia, Yolande; Moatti, Jean-Paul

    2010-01-01

    Background In July 2009, French public health authorities embarked in a mass vaccination campaign against A/H1N1 2009 pandemic-influenza. We explored the attitudes and behaviors of the general population toward pandemic vaccination. Methodology/Principal Findings We conducted a cross-sectional online survey among 2,253 French representative adults aged 18 to 64 from November 17 to 25, 2009 (completion rate: 93.8%). The main outcome was the acceptability of A/H1N1 vaccination as defined by previous receipt or intention to get vaccinated (“Yes, certainly”, “Yes, probably”). Overall 17.0% (CI 95%, 15.5% to 18.7%) of respondents accepted A/H1N1 vaccination. Independent factors associated with acceptability included: male sex (p = .0001); older age (p = .002); highest or lowest level of education (p = .016); non-clerical occupation (p = .011); having only one child (p = .008); and having received seasonal flu vaccination in prior 3 years (p<.0001). Acceptability was also significantly higher among pregnant women (37.9%) and other at risk groups with chronic diseases (34.8%) (p = .002). Only 35.5% of respondents perceived A/H1N1 influenza illness as a severe disease and 12.7% had experienced A/H1N1 cases in their close relationships with higher acceptability (p<.0001 and p = .006, respectively). In comparison to 26.0% respondents who did not consult their primary care physician, acceptability was significantly higher among 8.0% respondents who were formally advised to get vaccinated, and lower among 63.7% respondents who were not advised to get vaccinated (respectively: 15.8%, 59.5% and 11.7%- p<.0001). Among respondents who refused vaccination, 71.2% expressed concerns about vaccine safety. Conclusions/Significance Our survey occurred one week before the peak of the pandemic in France. We found that alarming public health messages aiming at increasing the perception of risk severity were counteracted by daily personal experience which

  15. The Effect of Genetic Risk Information and Health Risk Assessment on Compliance with Preventive Behaviors.

    ERIC Educational Resources Information Center

    Bamberg, Richard; And Others

    1990-01-01

    Results from a study of 82 males provide no statistical support and limited encouragement that genetic risk information may motivate persons to make positive changes in preventive health behaviors. Health risk assessments were used to identify subjects at risk for coronary heart disease or lung cancer because of genetic factors. (IAH)

  16. Clean Slate transportation and human health risk assessment

    SciTech Connect

    1997-02-01

    Public concern regarding activities involving radioactive material generally focuses on the human health risk associated with exposure to ionizing radiation. This report describes the results of a risk analysis conducted to evaluate risk for excavation, handling, and transport of soil contaminated with transuranics at the Clean Slate sites. Transportation risks were estimated for public transport routes from the Tonopah Test Range (TTR) to the Envirocore disposal facility or to the Area 3 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS) for both radiological risk and risk due to traffic accidents. Human health risks were evaluated for occupational and radiation-related health effects to workers. This report was generated to respond to this public concern, to provide an evaluation of the risk, and to assess feasibility of transport of the contaminated soil for disposal.

  17. Perceived and calculated health risks: do the impacts differ

    SciTech Connect

    Payne, B.A.; Williams, R.G.

    1986-01-23

    In many cases of radioactive and hazardous waste management, some members of the general public perceive that human health risks associated with the wastes are higher than the calculated risks. Calculated risks are projections that have been derived from models, and it is these risks that are usually used as the basis for waste management. However, for various reasons, the calculated risks are often considered by the public as too low or inappropriate. The reasons that calculated risks are not perceived as accurate and the factors that affect these perceptions are explored in this paper. Also discussed are the impacts related to the perceived and calculated health risks: what they are, and if and how they differ. The kinds of potential impacts examined are health effects, land value changes, and social, transportation, and economic effects. The paper concludes with a discussion of the implications of incorporating these different risk perspectives in decisions on waste management.

  18. Primary Care Patients with Depression Are Less Accepting of Treatment Than Those Seen by Mental Health Specialists

    PubMed Central

    Van Voorhees, Benjamin W; Cooper, Lisa A; Rost, Kathryn M; Nutting, Paul; Rubenstein, Lisa V; Meredith, Lisa; Wang, Nae-Yuh; Ford, Daniel E

    2003-01-01

    OBJECTIVE This study examined whether depressed patients treated exclusively in primary care report less need for care and less acceptability of treatment options than those depressed patients treated in the specialty mental health setting after up to 6 months of treatment. DESIGN Cross-sectional study. SETTING Forty-five community primary care practices. PARTICIPANTS A total of 881 persons with major depression who had received mental health services in the previous 6 months and who enrolled in 3 of the 4 Quality Improvement for Depression Collaboration Studies. MEASUREMENTS AND RESULTS Patients were categorized into 1 of 2 groups: 1) having received mental health services exclusively from a primary care provider (45%), or 2) having received any services from a mental health specialist (55%) in the previous 6 months. Compared with patients who received care from mental health specialists, patients who received mental health services exclusively from primary care providers had 2.7-fold the odds (95% confidence interval [CI], 1.6 to 4.4) of reporting that no treatment was definitely acceptable and had 2.4-fold the odds (95% CI, 1.5 to 3.9) of reporting that evidence-based treatment options (antidepressant medication) were definitely not acceptable. These results were adjusted for demographic, social/behavioral, depression severity, and economic factors using multiple logistic regression analysis. CONCLUSIONS Patients with depression treated exclusively by primary care providers have attitudes and beliefs more averse to care than those seen by mental health specialists. These differences in attitudes and beliefs may contribute to lower quality depression care observed in comparisons of primary care and specialty mental health providers. PMID:14687257

  19. The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

    PubMed Central

    2012-01-01

    Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the

  20. Quantitative microbial risk assessment combined with hydrodynamic modelling to estimate the public health risk associated with bathing after rainfall events.

    PubMed

    Eregno, Fasil Ejigu; Tryland, Ingun; Tjomsland, Torulv; Myrmel, Mette; Robertson, Lucy; Heistad, Arve

    2016-04-01

    This study investigated the public health risk from exposure to infectious microorganisms at Sandvika recreational beaches, Norway and dose-response relationships by combining hydrodynamic modelling with Quantitative Microbial Risk Assessment (QMRA). Meteorological and hydrological data were collected to produce a calibrated hydrodynamic model using Escherichia coli as an indicator of faecal contamination. Based on average concentrations of reference pathogens (norovirus, Campylobacter, Salmonella, Giardia and Cryptosporidium) relative to E. coli in Norwegian sewage from previous studies, the hydrodynamic model was used for simulating the concentrations of pathogens at the local beaches during and after a heavy rainfall event, using three different decay rates. The simulated concentrations were used as input for QMRA and the public health risk was estimated as probability of infection from a single exposure of bathers during the three consecutive days after the rainfall event. The level of risk on the first day after the rainfall event was acceptable for the bacterial and parasitic reference pathogens, but high for the viral reference pathogen at all beaches, and severe at Kalvøya-small and Kalvøya-big beaches, supporting the advice of avoiding swimming in the day(s) after heavy rainfall. The study demonstrates the potential of combining discharge-based hydrodynamic modelling with QMRA in the context of bathing water as a tool to evaluate public health risk and support beach management decisions. PMID:26802355

  1. Nuclear power — is the health risk too great?

    PubMed Central

    Wynne, B E

    1982-01-01

    Apparently objective and value-free `scientific' assessments of health risks are often highly value-laden and incorporate contentious social assumptions. Mr Wynne exposes some of the complexities underlying attempts to compare the health risks of nuclear and other sources of energy. PMID:7108912

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

    EPA Science Inventory

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

  3. Rural Adolescent Health Risk Behaviors: Age, Gender, and Ethnic Differences.

    ERIC Educational Resources Information Center

    Salzman, Stephanie A.; Girvan, James T.

    A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…

  4. TOXICOPROTEOMICS AND ITS APPLICATION TO HUMAN HEALTH RISK ASSESSMENT

    EPA Science Inventory

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

  5. Words matter: a qualitative investigation of which weight status terms are acceptable and motivate weight loss when used by health professionals

    PubMed Central

    2011-01-01

    Background Health professionals have an important role to play in the management of obesity, but may be unsure how to raise weight issues with patients. The societal stigma associated with excess weight means that weight status terms may be misunderstood, cause offence and risk upsetting patient-professional relationships. This study investigated the views of people who were overweight or obese on the acceptability of weight status terms and their potential to motivate weight loss when used by health professionals. Methods A qualitative study comprising 34 semi-structured interviews with men and women in their mid-to-late 30s and 50s who were overweight or obese and had recently been informed of their weight status. Thematic framework analysis was conducted to allow the systematic comparison of views by age, gender and apparent motivation to lose weight. Results Although many people favoured 'Overweight' to describe their weight status, there were doubts about its effectiveness to motivate weight loss. Terms including 'BMI' ('Body Mass Index') or referring to the unhealthy nature of their weight were generally considered acceptable and motivational, although a number of men questioned the validity of BMI as an indicator of excess weight. Participants, particularly women, felt that health professionals should avoid using 'Fat'. Whilst response to 'Obese' was largely negative, people recognised that it could be appropriate in a health consultation. Some younger people, particularly those who appeared motivated to lose weight, felt 'Obese' could encourage weight loss, but it was also clear the term could provoke negative emotions if used insensitively. Conclusions Although most people who are overweight or obese accept that it is appropriate for health professionals to discuss weight issues with patients, there is great variation in response to the terms commonly used to describe excess weight. There is no one-size-fits-all approach to discussing weight status: some

  6. Screening for lifestyle and mental health risk factors in the waiting room

    PubMed Central

    Elley, Carolyn Raina; Dawes, Diana; Dawes, Martin; Price, Morgan; Draper, Haeli; Goodyear-Smith, Felicity

    2014-01-01

    Abstract Objective To assess the feasibility and acceptability of administering the validated Case-finding Health Assessment Tool (CHAT) in Canadian family practice waiting rooms to identify risk factors for depression, anxiety, anger control, smoking, drinking, other drug use, gambling, exposure to abuse, and physical inactivity. Design Cross-sectional survey. Setting One urban academic family practice and one inner-city community health centre in British Columbia. Participants Convenience sample of consecutive adult patients (19 years of age or older) and their attending family physicians. Main outcome measures Rates of completion; positive responses to and wanting help with identified lifestyle and mental health risk factors; rates of objections to any questions; and positive and negative comments about the CHAT by participating physicians and patients. Results A total of 265 eligible adults presented in the waiting rooms over 5 full days and 3 half-days, 176 (66%) of whom enrolled in the study; 161 (91%) completed the CHAT, and 107 (66%) completed acceptability feedback forms. The prevalence of risk factors among patients in the academic and inner-city practice samples was different, with 20% and 63%, respectively, recording positive responses to both depression screening questions, 34% and 60% positive for anxiety, 11% and 71% currently smoking, 6% and 22% feeling they needed to cut down on alcohol, 1% and 48% having used recreational drugs in the past year, and 11% and 65% with problems controlling anger. While many requested help with reducing risk factors, such as smoking (20%) and mental health symptoms (25% to 27%), a total of 35% (57 of 161) wanted help with an identified issue that day. Patients and physicians found the CHAT acceptable, with no patients objecting to any question except the alcohol question (2 objected). Most comments were positive. Conclusion The CHAT allowed efficient identification of 9 risk factors, as well as identification of those

  7. 78 FR 52998 - Waiver to Space Exploration Technologies Corporation of Acceptable Risk Limit for Launch

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... for Launch and Reentry, Notice of Waiver, 77 FR 24556 (April 24, 2012). Again, risk was largely a... during September.\\2\\ NASA, the ] U.S. Air Force and other U.S. National Test ranges use 0.0001 as the... Standards for National Test Ranges (2010). If the Falcon 9 v1.1's collective risk were to exceed...

  8. Acceptance of Internet-Based Health Care Services Among Households in Poland: Secondary Analysis of a Population-Based Survey

    PubMed Central

    2012-01-01

    Background Polish society is benefiting from growing access to the Internet, but the use of advanced e-services is still limited. The provision of Internet-based health services depends not only on the penetration of the Internet into society, but also on the acceptance of this technology by potential users. Objective The main objective of this study was focused on the assessment of predictors of acceptance of Internet use for provision of health services (eg, sociodemographic status, the use of information technologies, and consumption of health care services) among households in Poland. Methods The study was based on a secondary analysis of the dataset from the 2011 Social Diagnosis survey (a biannual survey conducted since 2001 about economic and non-economic aspects of household and individual living conditions in Poland). Analysis of the questionnaire results focused on the situations of the households included in the study. The predictors for 2 outcome variables describing the acceptance of households for Internet use for provision of a full health care service, or at least access to information and download of required forms, were assessed using multivariate logistic regression. Results After excluding those households that would not consider the use of health care services or for which predictor variables assumed missing values, the final analyses were conducted on data from 8915 households. Acceptance of the use of the Internet for provision of full health care services in Polish households was significantly higher among households in urban locations with ≥ 200,000 inhabitants than among households in rural areas; it was also higher with salaried employment as the source of income than with self-employment in agriculture (odds ratio [OR] = 0.53, 95% CI 0.40 - 0.70), retirement pension (OR = 0.46, 95% CI 0.39 - 0.54), disability pension (OR = 0.48, 95% CI 0.34 - 0.68), or with several simultaneous income sources (OR = 0.66; 95% CI 0.57 - 0

  9. The Impact of an Incentive-Based Worksite Health Promotion Program on Modifiable Health Risk Factors.

    ERIC Educational Resources Information Center

    Poole, Kathleen; Kumpfer, Karol; Pett, Marjorie

    2001-01-01

    Examined the impact of participating in an incentive-based employee health promotion program on modifiable health risk factors over 4 years. Data from physiological and self-report measures indicated that modifiable health risks improved over time (smoking, physical activity, systolic and diastolic blood pressure, and seat belt use). Cholesterol…

  10. Mental Health and Health Risk Behaviours of Homeless Adolescents and Youth: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

    2016-01-01

    Background: Homeless youth, as a vulnerable population are susceptible to various mental and health risk behaviours. However, less is known of the mental health status of these homeless youth and its role in risky sexual behaviours; neither do we understand the reasons homeless youth give for their engagement in various health risk behaviour.…

  11. Bridging Student Health Risks and Academic Achievement through Comprehensive School Health Programs.

    ERIC Educational Resources Information Center

    Symons, Cynthia Wolford; Cinelli, Bethann; James, Tammy C.; Groff, Patti

    1997-01-01

    Research confirms a direct link between student health risk behavior and education outcomes, education behaviors, and student attitudes. This article discusses barriers to comprehensive school health programming; summarizes relevant information concerning several health-risk behaviors (intentional injuries, diet, physical activity, sexual-risk…

  12. Health Risk Appraisal (HRA) Use in the Classroom.

    ERIC Educational Resources Information Center

    Petri, Cynthia J.

    Health risk appraisals (HRAs) may be useful in the classroom. Potential benefits include: increasing awareness of potential risk, decreasing feelings of overestimated risks, providing feedback, obtaining group data, and increasing motivation to make positive behavior changes. The HRA process involves three components: administering questionnaires…

  13. [Health risk assessment of coke oven PAHs emissions].

    PubMed

    Bo, Xin; Wang, Gang; Wen, Rou; Zhao, Chun-Li; Wu, Tie; Li, Shi-Bei

    2014-07-01

    Polycyclic aromatic hydrocarbons (PAHs) produced by coke oven are with strong toxicity and carcinogenicity. Taken typical coke oven of iron and steel enterprises as the case study, the dispersion and migration of 13 kinds of PAHs emitted from coke oven were analyzed using AERMOD dispersion model, the carcinogenic and non-carcinogenic risks at the receptors within the modeling domain were evaluated using BREEZE Risk Analyst and the Human Health Risk Assessment Protocol for Hazardous Waste Combustion (HHRAP) was followed, the health risks caused by PAHs emission from coke oven were quantitatively evaluated. The results indicated that attention should be paid to the non-carcinogenic risk of naphthalene emission (the maximum value was 0.97). The carcinogenic risks of each single pollutant were all below 1.0E-06, while the maximum value of total carcinogenic risk was 2.65E-06, which may have some influence on the health of local residents. PMID:25244863

  14. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness. PMID:23924828

  15. Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

    PubMed Central

    2012-01-01

    Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and

  16. On the public perception of the risks from nuclear weapons: Would oralloy be more acceptable than plutonium

    SciTech Connect

    Kunsman, D.M.

    1993-03-01

    We technologists generally only address risk magnitudes in our analyses, although other studies have found nineteen additional dimensions for the way the public perceives risk. These include controllability, voluntariness, catastrophic potential, and trust in the institution putting forth the risk. We and the geneml public use two different languages, and to understand what their concerns are, we need to realize that the culture surrounding nuclear weapons is completely alien to the general public. Ultimately, the acceptability of a risk is a values question, not a technical question. For most of the risk dimensions, the public would perceive no significant difference between using oralloy and plutonium. This does not mean that the suggested design change should not be proposed, only that the case for, or against, it be made comprehensively using the best information available today. The world has changed: the ending of the cold war has decreased the benefit of nuclear weapons in the minds of the public and the specter of Chernobyl has increased the perceived risks of processes that use radioactive materials. Our analyses need to incorporate the lessons pertinent to this newer world.

  17. On the public perception of the risks from nuclear weapons: Would oralloy be more acceptable than plutonium?

    SciTech Connect

    Kunsman, D.M.

    1993-03-01

    We technologists generally only address risk magnitudes in our analyses, although other studies have found nineteen additional dimensions for the way the public perceives risk. These include controllability, voluntariness, catastrophic potential, and trust in the institution putting forth the risk. We and the geneml public use two different languages, and to understand what their concerns are, we need to realize that the culture surrounding nuclear weapons is completely alien to the general public. Ultimately, the acceptability of a risk is a values question, not a technical question. For most of the risk dimensions, the public would perceive no significant difference between using oralloy and plutonium. This does not mean that the suggested design change should not be proposed, only that the case for, or against, it be made comprehensively using the best information available today. The world has changed: the ending of the cold war has decreased the benefit of nuclear weapons in the minds of the public and the specter of Chernobyl has increased the perceived risks of processes that use radioactive materials. Our analyses need to incorporate the lessons pertinent to this newer world.

  18. Effectuality of Cleaning Workers' Training and Cleaning Enterprises' Chemical Health Hazard Risk Profiling

    PubMed Central

    Suleiman, Abdulqadir M.; Svendsen, Kristin V.H.

    2015-01-01

    Background Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Methods Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. Results In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Conclusion Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step. PMID:26929848

  19. Community perceptions of air pollution and related health risks in Nairobi slums.

    PubMed

    Egondi, Thaddaeus; Kyobutungi, Catherine; Ng, Nawi; Muindi, Kanyiva; Oti, Samuel; van de Vijver, Steven; Ettarh, Remare; Rocklöv, Joacim

    2013-10-01

    Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people's response and acceptance of related policies. Therefore, understanding people' perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were low among the residents indicating the need for promoting awareness on air pollution sources and related health risks. PMID:24157509

  20. Health risks from computed tomographic screening.

    PubMed

    Krantz, Seth B; Meyers, Bryan F

    2015-05-01

    Results of the recent National Lung Cancer Screening Trial show a significant survival benefit for annual screening with a low-dose computed tomographic (CT) scan in high-risk individuals. This result has led the US Preventive Services Task Force to recommend annual low-dose CT scans for this at-risk population. Less well characterized are the risks from screening. The primary risks from screening are radiation exposure, false-positive results and unnecessary diagnostic and therapeutic procedures, overdiagnosis and overtreatment, and increased psychological distress. This article reviews these risks, which must be considered and weighed against the benefits when discussing enrollment with patients. PMID:25901559

  1. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

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

  2. Health Promotion and Risk Behaviors among Adolescents in Turkey

    ERIC Educational Resources Information Center

    Ortabag, Tulay; Ozdemir, Serpil; Bakir, Bilal; Tosun, Nuran

    2011-01-01

    Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…

  3. Marketing cardiovascular disease risk reduction programs at the workplace. The Pawtucket Heart Health Program experience.

    PubMed

    Linnan, L A; Harden, E A; Bucknam, L; Carleton, R A

    1990-09-01

    The workplace offers a unique setting in which to offer CVD risk reduction programs. Marketing these programs involves at least two distinct processes. First, a corporation must agree to accept and support workplace health programming. Second, workplace programs must be effectively marketed to eligible employees, dependents, and retirees. After identifying critical barriers to the effective marketing of workplace programs, a stepwise approach used by the Pawtucket Heart Health Program to successfully overcome these obstacles is used. Using real world examples and practical tips, a discussion of implications for marketing future programs to the corporate and employee audience is shared. PMID:2397012

  4. Assessing the health risks of natural CO2 seeps in Italy

    PubMed Central

    Roberts, Jennifer J.; Wood, Rachel A.; Haszeldine, R. Stuart

    2011-01-01

    Industrialized societies which continue to use fossil fuel energy sources are considering adoption of Carbon Capture and Storage (CCS) technology to meet carbon emission reduction targets. Deep geological storage of CO2 onshore faces opposition regarding potential health effects of CO2 leakage from storage sites. There is no experience of commercial scale CCS with which to verify predicted risks of engineered storage failure. Studying risk from natural CO2 seeps can guide assessment of potential health risks from leaking onshore CO2 stores. Italy and Sicily are regions of intense natural CO2 degassing from surface seeps. These seeps exhibit a variety of expressions, characteristics (e.g., temperature/flux), and location environments. Here we quantify historical fatalities from CO2 poisoning using a database of 286 natural CO2 seeps in Italy and Sicily. We find that risk of human death is strongly influenced by seep surface expression, local conditions (e.g., topography and wind speed), CO2 flux, and human behavior. Risk of accidental human death from these CO2 seeps is calculated to be 10-8 year-1 to the exposed population. This value is significantly lower than that of many socially accepted risks. Seepage from future storage sites is modeled to be less that Italian natural flux rates. With appropriate hazard management, health risks from unplanned seepage at onshore storage sites can be adequately minimized. PMID:21911398

  5. Assessing the health risks of natural CO2 seeps in Italy.

    PubMed

    Roberts, Jennifer J; Wood, Rachel A; Haszeldine, R Stuart

    2011-10-01

    Industrialized societies which continue to use fossil fuel energy sources are considering adoption of Carbon Capture and Storage (CCS) technology to meet carbon emission reduction targets. Deep geological storage of CO(2) onshore faces opposition regarding potential health effects of CO(2) leakage from storage sites. There is no experience of commercial scale CCS with which to verify predicted risks of engineered storage failure. Studying risk from natural CO(2) seeps can guide assessment of potential health risks from leaking onshore CO(2) stores. Italy and Sicily are regions of intense natural CO(2) degassing from surface seeps. These seeps exhibit a variety of expressions, characteristics (e.g., temperature/flux), and location environments. Here we quantify historical fatalities from CO(2) poisoning using a database of 286 natural CO(2) seeps in Italy and Sicily. We find that risk of human death is strongly influenced by seep surface expression, local conditions (e.g., topography and wind speed), CO(2) flux, and human behavior. Risk of accidental human death from these CO(2) seeps is calculated to be 10-8 year-1 to the exposed population. This value is significantly lower than that of many socially accepted risks. Seepage from future storage sites is modeled to be less that Italian natural flux rates. With appropriate hazard management, health risks from unplanned seepage at onshore storage sites can be adequately minimized. PMID:21911398

  6. Assessing the health risks of natural CO2 seeps in Italy

    SciTech Connect

    Roberts, J.J.; Wood, R.A.; Haszeldine, R.S.

    2011-10-04

    Industrialized societies which continue to use fossil fuel energy sources are considering adoption of Carbon Capture and Storage (CCS) technology to meet carbon emission reduction targets. Deep geological storage of CO2 onshore faces opposition regarding potential health effects of CO2 leakage from storage sites. There is no experience of commercial scale CCS with which to verify predicted risks of engineered storage failure. Studying risk from natural CO2 seeps can guide assessment of potential health risks from leaking onshore CO2 stores. Italy and Sicily are regions of intense natural CO2 degassing from surface seeps. These seeps exhibit a variety of expressions, characteristics (e.g., temperature/ flux), and location environments. Here we quantify historical fatalities from CO2 poisoning using a database of 286 natural CO2 seeps in Italy and Sicily. We find that risk of human death is strongly influenced by seep surface expression, local conditions (e.g., topography and wind speed), CO2 flux, and human behavior. Risk of accidental human death from these CO2 seeps is calculated to be 10-8 year-1 to the exposed population. This value is significantly lower than that of many socially accepted risks. Seepage from future storage sites is modeled to be less than Italian natural flux rates. With appropriate hazard management, health risks from unplanned seepage at onshore storage sites can be adequately minimized.

  7. A Need for Better Studies to Identify Those Populations at Greatest Risk of a Pollutant-Related Health Effect

    EPA Science Inventory

    This invited editorial on a paper accepted for publication in the Journal of Pediatrics details scientific advances needed to improve the identification of those populations at greatest risk of a pollutant-related health effect with a primary focus on air pollution.

  8. [Experience of justification of hygienic standards of food safety with the use of criteria for the risk population health].

    PubMed

    Zaytseva, N V; Tutelyan, V A; Shur, P Z; Khotimchenko, S A; Sheveleva, S A

    2014-01-01

    In the article there is presented the experience of justification of hygienic standards of food safety with the use of criteria for the risk for population health. Health risk assessment under the impact of tetracyclines with food showed that the content of residual amounts of these antibiotics at the level of 10 mg/kg (permissible residual tetracycline accepted in Customs Union Member Countries (CUMC) will not increase the risk to public health, including the most sensitive groups of the population. The assessment ofthe health risk associated with the receipt of ractopamine with food, showed that eating foods containing ractopamine at ADI level (0-1 mg/kg body weight), and even at the limit of quantification levels in meat products, is inadmissible because of unacceptable risk of functional disorders and diseases of the cardiovascular system. The results of the substantiation of the permissible levels of nitrates content in crop production showed that at the level of exposure according to hygienic standards established in the CUMC as at the recommended and actual consumption levels of products ofplant origin, the health risk as carcinogenic and non-carcinogenic, does not exceed acceptable levels. The results of the assessment of the risk associated with the permissible levels of L. monocytogenes in certain food groups showed that an exposure level of hygienic standards established in the CUMC, standards of Codex Alimentarius Commission and EU documents (before release to the market by the manufacturer) the health risk does not exceed the maximum permissible level of the appearance of serious diseases. Adoption of standards of Codex Alimentarius Commission and the EU (for handling products in the market) is not acceptable because it can lead to an unacceptable risk of listeriosis for the population of the Russian Federation as a whole, and for the most sensitive groups. PMID:25831934

  9. Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa

    PubMed Central

    Morojele, Neo K.; Kitleli, Naledi; Ngako, Kgalabi; Kekwaletswe, Connie T.; Nkosi, Sebenzile; Fritz, Katherine; Parry, Charles D.H.

    2014-01-01

    Abstract Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and referrals to the patrons of the bars. A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the community at large) was an important contributor to the feasibility and acceptability of the intervention. PMID:24750106

  10. Acceptance and Usage of Electronic Health Record Systems in Small Medical Practices

    ERIC Educational Resources Information Center

    Tannan, Ritu

    2012-01-01

    One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based…

  11. Developing a risk-based air quality health index

    NASA Astrophysics Data System (ADS)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  12. Pathways to Health Risk Exposure in Adult Film Performers

    PubMed Central

    Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  13. Pathways to health risk exposure in adult film performers.

    PubMed

    Grudzen, Corita R; Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2009-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers' exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  14. Community Health Risk Assessment of Primary Aluminum Smelter Emissions

    PubMed Central

    Larivière, Claude

    2014-01-01

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

  15. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    NASA Astrophysics Data System (ADS)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  16. Ergogenic risks elevate health risks in young athletes.

    PubMed

    Giesemer, Bernard A

    2003-11-01

    Young athletes may use many products and techniques in an attempt to increase competitive edge in sports. The doping techniques that were previously seen in elite adult athletes are now being noted in increasingly competitive elementary, middle, and high school male and female athletes. The risk of significant morbidity and mortality associated with the use of these products is substantially increased when other risk factors are present. The risk for heat-related illness and possible heat-related mortality is higher in physiologically immature, overweight, and poorly conditioned young athletes. These are the same athletes who may be more likely to use stimulant or anabolic steroid products in attempts to catch up on training and conditioning regimens, improve their competitive advantage, or improve their physiques. The risk for heat-related incidents is higher in young athletes who are predisposed to these events because of a family trait or a previous heat-related adverse event in their own medical histories. Combinations of these factors (eg, high osmotic dietary supplements, stimulants, pre-existing medical factors, adverse ambient conditions) may significantly increase a young athlete's chances of a serious, potentially fatal event. Similarly, the risk of cardiac-related sudden death in a young athlete is significantly increased by the use of stimulants such as methamphetamine. As is the case with heat-related adverse events, the risk of cardiac-related morbidity and mortality may be significantly increased when other variables are present, such as the presence of other medications and pre-existing medical factors. As athletic competition becomes increasingly intense for younger athletes, pediatricians need to be aware of the possibility that their young patients are using ergogenic aids that may increase the risk for sudden death significantly. Pediatricians should be aware of the products available to these young competitors, and of the co-factors that

  17. Service User- and Carer-Reported Measures of Involvement in Mental Health Care Planning: Methodological Quality and Acceptability to Users

    PubMed Central

    Gibbons, Chris J.; Bee, Penny E.; Walker, Lauren; Price, Owen; Lovell, Karina

    2014-01-01

    Background: Increasing service user and carer involvement in mental health care planning is a key healthcare priority but one that is difficult to achieve in practice. To better understand and measure user and carer involvement, it is crucial to have measurement questionnaires that are both psychometrically robust and acceptable to the end user. Methods: We conducted a systematic review using the terms “care plan$,” “mental health,” “user perspective$,” and “user participation” and their linguistic variants as search terms. Databases were searched from inception to November 2012, with an update search at the end of September 2014. We included any articles that described the development, validation or use of a user and/or carer-reported outcome measures of involvement in mental health care planning. We assessed the psychometric quality of each instrument using the “Evaluating the Measurement of Patient-Reported Outcomes” (EMPRO) criteria. Acceptability of each instrument was assessed using novel criteria developed in consultation with a mental health service user and carer consultation group. Results: We identified eleven papers describing the use, development, and/or validation of nine user/carer-reported outcome measures. Psychometric properties were sparsely reported and the questionnaires met few service user/carer-nominated attributes for acceptability. Where reported, basic psychometric statistics were of good quality, indicating that some measures may perform well if subjected to more rigorous psychometric tests. The majority were deemed to be too long for use in practice. Discussion: Multiple instruments are available to measure user/carer involvement in mental health care planning but are either of poor quality or poorly described. Existing measures cannot be considered psychometrically robust by modern standards, and cannot currently be recommended for use. Our review has identified an important knowledge gap, and an urgent need to

  18. The Relationship of Depression to Health Risk Behaviors and Health Perceptions in Korean College Students.

    ERIC Educational Resources Information Center

    Kim, Oksoo

    2002-01-01

    Investigates the relationship of depression to health risk behaviors and health perceptions in Korean college students. The level of students' depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse than those who were less…

  19. Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

    PubMed Central

    Rothstein, Mark A.; Harrell, Heather L.

    2011-01-01

    Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

  20. Progress toward regulatory acceptance of risk-informed inspection programs for nuclear power plants

    NASA Astrophysics Data System (ADS)

    Hedden, Owen F.; Cowfer, C. David

    1996-11-01

    This paper will describe work within the American Society of Mechanical Engineers committee responsible for rules for inservice inspection of nuclear power plants. Work is progressing with the objective of producing proposals for risk-informed inspection programs that will be incorporated by the US Nuclear Regulatory Commission into the Federal Regulations Governing the construction and inservice inspection of al domestic commercial power plants. The paper will describe in detail the two primary proposals now under development and review. Both are directed toward enhancing safety while reducing the expense of periodic examination of piping welds. The first proposal provides a sound technical basis for reducing the number of Class 1 piping weld examinations as much as 60 percent while improving or maintaining equivalent safety. This is accomplished by using risk-informed techniques to re-establish the most important areas to examine. The second is a broader approach addressing all piping systems considered to be important under risk-informed assessment techniques. Both proposals are based on recent insights into risk analysis techniques developed within the pressure vessel industry, and both require evaluation of theoretical analysis and inputs of practical experience related to a wide variety of detrimental conditions. These proposals are being supported by pilot programs in a number of operating nuclear power plants. The authors will also attempt to explain the institutional constraints inherent in the process of obtaining regulatory recognition of proposals developed cooperatively by industry and the regulatory agency.

  1. Prevalence of enteropathogenic bacteria in treated effluents and receiving water bodies and their potential health risks.

    PubMed

    Teklehaimanot, Giorgis Z; Genthe, B; Kamika, I; Momba, M N B

    2015-06-15

    The failure of wastewater treatment plants to produce effluents of a high microbiological quality is a matter of great concern in terms of water resource pollution. A more serious concern is that this water source is used by communities in developing countries for multiple purposes, which include drinking, recreation and agriculture. The current study investigated the prevalence and potential health risks of enteropathogenic bacteria (Salmonella typhimurium, Shigella dysenteriae and Vibrio cholerae) in the treated effluents of three selected South African Wastewater Treatment Works as well as their receiving water bodies. Culture-based and polymerase chain reaction techniques were used to detect and identify the pathogenic bacteria. The conventional methods revealed that of the 272 water samples collected, 236 samples (86.8%) tested presumptively positive for Salmonella spp., 220 samples (80.9%) for Shigella spp. and 253 samples (93.0%) for V. cholerae. Molecular test results indicated that out of the randomly selected presumptive positive samples (145), zero to 60% of samples were positive for S. typhimurium and S. dysenteriae and 20% to 60% for V. cholerae. For the health risk assessment, the daily combined risk of S. typhimurium, S. dysenteriae and V. cholerae infection was above the lowest acceptable risk limit of 10(-4) as estimated by the World Health Organization for drinking water. This study showed that the target treated wastewater effluents and their receiving water bodies could pose a potential health risk to the surrounding communities. PMID:25777950

  2. Health risk assessment of phthalate esters (PAEs) in drinking water sources of China.

    PubMed

    Wang, Wen-Long; Wu, Qian-Yuan; Wang, Chao; He, Tao; Hu, Hong-Ying

    2015-03-01

    Phthalate esters (PAEs) with endocrine disruption effects and carcinogenicity are widely detected in water environment. Occurrences of PAEs in source water and removal efficiencies of PAEs by drinking water treatment plants (DWTPs) in China were surveyed from publications in the last 10 years. Concentration of diethylhexyl phthalate (DEHP) in source water with median value of 1.3 μg/L was higher than that of dimethyl phthalate (DMP), diethyl phthalate (DEP), and di-n-butyl phthalate (DnBP). If the removal efficiencies of DEHP and DnBP reached 60 and 90 %, respectively, the calculated PAE concentration in drinking water can generally meet Standards for Drinking Water Quality in China. The health risks of PAEs, including non-carcinogenic and carcinogenic risks via the "water source-DWTP-oral ingestion/dermal permeation" pathway, were evaluated with Monte Carlo simulation and sensitivity analysis under certain removal efficiencies from 0 to 95 %. The carcinogenic risk of DEHP was lower than the upper acceptable carcinogenic risk level (10(-4)), while the probability of DEHP's carcinogenic risk between lower (10(-6)) and upper (10(-4)) acceptable carcinogenic risk level decreased from about 21.2 to 0.4 % through increasing DEHP removal efficiency from 0 to 95 %. The non-carcinogenic risk of DEHP was higher than that of DEP and DnBP. In all cases, the total non-carcinogenic risk of DEP, DnBP, and DEHP was lower than 1, indicating that there would be unlikely incremental non-carcinogenic risk to humans. Both carcinogenic risk and non-carcinogenic risk of PAEs in drinking water to female were a little higher than those to male. PMID:25253058

  3. Health Risks Information Reaches Secondary School Smokers

    ERIC Educational Resources Information Center

    Ridout, Fran; Charlton, Anne; Hutchison, Iain

    2008-01-01

    This cross-sectional study aimed to assess smoking prevention and cessation education delivered as part of the UK National Curriculum and to evaluate the relative effectiveness of health, social influence and other/non-health components. In all, 1789 students aged 11-15 from 12 secondary schools completed online surveys assessing smoking status,…

  4. Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia

    PubMed Central

    Jackson, Ruth; Tesfay, Fisaha Haile; Godefay, Hagos; Gebrehiwot, Tesfay Gebregzabher

    2016-01-01

    Background The maternal health system in Ethiopia links health posts in rural communities (kebeles) with district (woreda) health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs) assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs’ and mother’s attitudes to maternal health services in Adwa Woreda, Tigray Region. Methods In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women’s social status and mobility; and women’s perceptions of skilled birth attendant’s care. All data were analyzed thematically. Findings There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women), and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women’s Development Groups (WDGs), and referral by ambulance to health facilities either before a woman’s Expected Due Date (EDD) or if labour started at home. Conclusion With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women’s groups to improve maternal

  5. [Distribution Characteristics of Heavy Metals in Environmental Samples Around Electroplating Factories and the Health Risk Assessment].

    PubMed

    Guo, Peng-ran; Lei, Yong-qian; Zhou, Qiao-li; Wang, Chang; Pan, Jia-chuan

    2015-09-01

    This study aimed to investigate the pollution degree and human health risk of heavy metals in soil and air samples around electroplating factories. Soil, air and waste gas samples were collected to measure 8 heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) in two electroplating factories, located in Baiyun district of Guangzhou city. Geoaccumulation index and USEPA Risk Assessment Guidance for Superfund (RAGS) were respectively carried out. Results showed that concentrations of Hg and Pb in waste gas and Cr in air samples were higher than limits of the corresponding quality standards, and concentrations of Cd, Hg and Zn in soil samples reached the moderate pollution level. The HQ and HI of exposure by heavy metals in air and soil samples were both lower than 1, indicating that there was no non-carcinogen risk. CRAs and CRCr in soil samples were beyond the maximum acceptable level of carcinogen risk (10(-4)), and the contribution rate of CRCr to TCR was over 81%. CRCr, CRNi and TCR in air samples were in range of 10(-6) - 10(-4), indicating there was possibly carcinogen risk but was acceptable risk. CR values for children were higher than adults in soils, but were higher for adults in air samples. Correlation analysis revealed that concentrations of heavy metals in soils were significantly correlated with these in waste gas samples, and PCA data showed pollution sources of Cd, Hg and Zn in soils were different from other metals. PMID:26717709

  6. Characterizing public health and microbial risks due to water contaminants

    EPA Science Inventory

    This research track evaluates risks associated with the occurrence of waterborne disease in the population. A clear understanding of the health burden associated with exposure to contaminated drinking water is critical to developing regulations that are protective of public healt...

  7. Health Care Providers: A Missing Link in Understanding Acceptability of the Female Condom

    ERIC Educational Resources Information Center

    Mantell, Joanne E.; West, Brooke S.; Sue, Kimberly; Hoffman, Susie; Exner, Theresa M.; Kelvin, Elizabeth; Stein, Zena A.

    2011-01-01

    Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female…

  8. Uncertainties associated with assessing the public health risk from Legionella

    PubMed Central

    Whiley, Harriet; Keegan, Alexandra; Fallowfield, Howard; Ross, Kirstin

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose, and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practices for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practices. PMID:25309526

  9. Educated guesses: health risk assessment in environmental impact statements.

    PubMed

    Harvey, P D

    1990-01-01

    Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions. PMID:2278245

  10. 76 FR 39399 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

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

  11. 76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

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

  12. A qualitative study of HPV vaccine acceptability among health workers, teachers, parents, female pupils, and religious leaders in northwest Tanzania

    PubMed Central

    Remes, Pieter; Selestine, Veronica; Changalucha, John; Ross, David A.; Wight, Daniel; de Sanjosé, Silvia; Kapiga, Saidi; Hayes, Richard J.; Watson-Jones, Deborah

    2012-01-01

    Background As human papillomavirus (HPV) vaccines become available in developing countries, acceptability studies can help to better understand potential barriers and facilitators of HPV vaccination and guide immunisation programs. Methods Prior to a cluster-randomised phase IV trial of HPV vaccination delivery strategies in Mwanza Region, Tanzania, qualitative research was conducted to assess attitudes and knowledge about cervical cancer and HPV, and acceptability of and potential barriers to HPV vaccination of Tanzanian primary schoolgirls. Semi-structured interviews (n = 31) and group discussions (n = 12) were conducted with a total of 169 respondents (parents, female pupils, teachers, health workers and religious leaders). Results While participants had heard of cancer in general, most respondents had no knowledge of cervical cancer, HPV, or HPV vaccines. Only health workers had heard of cervical cancer but very few knew its cause or had any awareness about HPV vaccines. After participants were provided with information about cervical cancer and HPV vaccination, the majority stated that they would support HPV vaccination of their daughter to protect them against cervical cancer. Opt-out consent for vaccination was considered acceptable. Most preferred age-based vaccination, saying this would target more girls before sexual debut than class-based vaccination. Potential side effects and infertility concerns were raised by 5/14 of participating male teachers. Discussion Reported acceptability of HPV vaccination amongst parents, teachers and other community members was high in this population. Respondents stressed the need to provide adequate information about the vaccine to parents, that also addresses side effects and infertility concerns. PMID:22732428

  13. HEALTH RISKS OF HUMAN EXPOSURE TO WASTEWATER

    EPA Science Inventory

    The primary objective of this research was to determine the health effects, if any, associated with occupational exposure to biological agents present in municipal wastewater. An additional objective was to determine the sensitivity of the methodology for detecting potential heal...

  14. Glutaraldehyde: a potential health risk to nurses

    SciTech Connect

    Newman, M.A.; Kachuba, J.B.

    1992-06-01

    This article discusses the potential toxicity of glutaraldehyde, a chemical commonly used in endoscopy units. The literature review cites adverse health effects experienced by workers exposed to glutaraldehyde. The sampling methodology for glutaraldehyde relative to the Occupational Safety and Health standard for glutaraldehyde is presented. Air monitoring should be performed to assess employee exposure to airborne glutaraldehyde in endoscopy departments. Recommendations for reducing exposure to glutaraldehyde in endoscopy units are included.

  15. Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

    PubMed Central

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds. PMID:24223467

  16. Acceptability, Language, and Structure of Text Message-Based Behavioral Interventions for High-Risk Adolescent Females: A Qualitative Study

    PubMed Central

    Ranney, Megan L.; Choo, Esther K.; Cunningham, Rebecca M.; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J.; Morrow, Kathleen

    2014-01-01

    Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants’ needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. PMID:24559973

  17. Human health risk assessment of heavy metals in urban stormwater.

    PubMed

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (<150μm) were considered to represent the maximum and minimum risk levels, respectively. The study outcomes confirmed that Cr, Mn and Pb pose the highest risks, although these elements are generally present in low concentrations. The study also found that even though the presence of a single heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas. PMID:27046140

  18. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

  19. Weight Misperception and Health Risk Behaviors Among Early Adolescents

    PubMed Central

    Pasch, Keryn E.; Klein, Elizabeth G.; Laska, Melissa N.; Velazquez, Cayley E.; Moe, Stacey G.; Lytle, Leslie A.

    2011-01-01

    Objectives To examine associations between weight misperception and youth health risk and protective factors. Methods Three thousand ten US seventh-graders (72.1% white, mean age: 12.7 years) self-reported height, weight, risk, and projective factors. Analyses were conducted to determine cross-sectional and longitudinal associations between weight overestimation and health risk and protective factors. Results Risk and protective factors had significant cross-sectional associations with weight overestimation. However, only depressive symptoms and reduced optimism predicted weight overestimation in eighth grade. Weight overestimation did not predict engagement in risky behaviors. Conclusions Weight overestimation and risk factors appear to co-occur, suggesting a constellation of risk that warrants further research. PMID:22251770

  20. Acceptability of meningococcal serogroup B vaccine among parents and health care workers in Italy: a survey.

    PubMed

    Mameli, Chiara; Faccini, Marino; Mazzali, Cristina; Picca, Marina; Colella, Giacomo; Duca, Pier Giorgio; Zuccotti, Gian Vincenzo

    2014-01-01

    A new meningococcal serogroup B vaccine (4 CMenB) has recently been licensed. This study assessed the acceptability of 4 CMenB vaccine among parents and healthcare workers (HCWs). From May to July 2013 in Milan, Italy, self-administered questionnaires were distributed to 2050 parents of infants presenting at immunization clinics for the mandatory hexavalent vaccination and submitted to 350 HCWs involved in immunization practices. 1842 parents (89.1%) responded to the survey; 64.4% of parents wanted their child to receive the 4 CMenB vaccine and 5.1% would not vaccinate their children. Multivariate analysis showed that recognition of the severity of meningitis [a life threatening vs a mild or unthreatening disease (Odds ratio (OR): 2.3; confidence interval (CI): 1.4-3.6], awareness of vaccination as a beneficial preventive measure (very beneficial vs not beneficial OR = 6.4; CI 3.0-13.7) and knowledge of the Meningococcal C vaccine (OR = 1.4; CI 1.1-1.8) were strongly associated to willingness to receive 4 CMenB vaccine. On the contrary, level of education was associated with refusal of immunization (university vs education level lower than middle school OR = 0.68; CI 0.47-0.97). Among the parents who were willing to immunize their children, 66.9% would agree with three injections to be administered during the same visit. A total of 291 HCWs (83.1%) agreed to participate in the survey; 73% considered 4 CMenB vaccine a priority in infants' immunization schedule; 26.8% of HCWs suggested the concomitant administration with routine infant immunization. Parental and HCWs acceptability of 4 CMenB vaccine was high. Increasing knowledge about meningitis and vaccine prevention might further increase the acceptability of this vaccine. PMID:25483638

  1. Environmental risks and children's health: what can PRAMS tell us?

    PubMed

    Korfmacher, Katrina Smith; Suter, Barbara J; Cai, Xueya; Brownson, Susan A; Dozier, Ann M

    2014-07-01

    Environmental exposures during pregnancy have a lasting impact on children's health. We combined environmental and maternal risk factor survey data to inform efforts to protect children's health. We made recommendations for future use of such data. A modified version of the Pregnancy Risk Assessment Monitoring System (PRAMS) mail survey was conducted based on weighted sampling design with low-income and non-low income women in Monroe County, NY (1,022 respondents). A series of environmental questions were included in the questionnaire. Data were analyzed using Chi square tests and Poisson loglinear regression model to identify patterns in environmental health risk and sociodemographic characteristics. We identified women who rented their homes, had lower incomes, and lived in inner city zip codes as "high environmental health risk" (HEHR). HEHR respondents were more likely to report that a health care provider talked with them about lead and on average reported more behaviors to protect their children from lead poisoning. Combining environmental and perinatal risk factor data could yield important recommendations for medical practice, health education, and policy development. However, at present PRAMS gathers only limited and inconsistent environmental data. We found that existing PRAMS environmental questions are insufficient. Further work is needed to develop updated and more comprehensive environmental health survey questions and implement them consistently across the country. PMID:23955384

  2. Acceptability and applicability of an American health videogame with story for childhood obesity prevention among Hong Kong Chinese children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Positive changes in diet have been observed in research carried out in the United States from the use of "Escape from Diab" (Diab), a health videogame designed to lower the risk of obesity and type 2 diabetes. Whether the American story and characters in Diab might be perceived by Hong Kong Chinese ...

  3. Victimization and Health Risk Factors among Weapon-Carrying Youth

    ERIC Educational Resources Information Center

    Stayton, Catherine; McVeigh, Katharine H.; Olson, E. Carolyn; Perkins, Krystal; Kerker, Bonnie D.

    2011-01-01

    Objective: To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. Methods: 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Results: Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization.…

  4. Weight Misperception and Health Risk Behaviors among Early Adolescents

    ERIC Educational Resources Information Center

    Pasch, Keryn E.; Klein, Elizabeth G.; Laska, Melissa N.; Velazquez, Cayley E.; Moe, Stacey G.; Lytle, Leslie A.

    2011-01-01

    Objectives: To examine associations between weight misperception and youth health risk and protective factors. Methods: Three thousand ten US seventh-graders (72.1% white, mean age: 12.7 years) self-reported height, weight, risk, and protective factors. Analyses were conducted to determine cross-sectional and longitudinal associations between…

  5. INCORPORATING HUMAN INTERINDIVIDUAL BIOTRANSFORMATION VARIANCE IN HEALTH RISK ASSESSMENT

    EPA Science Inventory

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

  6. The FRIENDS Emotional Health Program for Minority Groups at Risk

    ERIC Educational Resources Information Center

    Iizuka, Cristina A.; Barrett, Paula M.; Gillies, Robyn; Cook, Clayton R.; Miller, Debbie

    2014-01-01

    Background: Despite the existence of evidence-based interventions for promoting mental health in children, the number of children at risk remains high. One of the reasons is that such interventions are not reaching specific groups at risk such as low socioeconomic status and ethnic minority groups. This study evaluated an adaptation of a…

  7. Health Risk Behavior and Sexual Assault among Ethnically Diverse Women

    ERIC Educational Resources Information Center

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…

  8. Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health

    PubMed Central

    Betancourt, Theresa S.; Brennan, Robert T.; Rubin-Smith, Julia; Fitzmaurice, Garrett M.; Gilman, Stephen E.

    2011-01-01

    Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether post-conflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N=260, ages 10–17 at baseline) were recruited from the roster of an NGO-run Interim Care Center in Kono District and interviewed in 2002, 2004 and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and post-conflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and post-conflict risk factors, which were partly mitigated by post-conflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and post-conflict stigma while increased community acceptance was associated with decreases in externalizing problems (B=−1.09). High baseline levels of internalizing problems were associated with surviving rape while increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (B=−0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and post-conflict stigma, but partially mitigated by social support, being in school and increased community acceptance (B=1.93). Conclusions Psychosocial interventions for former child soldiers may be more effective if they account for post-conflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified; sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended. PMID

  9. Risk distribution across multiple health insurance funds in rural Tanzania

    PubMed Central

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Introduction Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Methods Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. Results There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Conclusion Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest. PMID:25574326

  10. Assessing human health risk in the USDA forest service

    SciTech Connect

    Hamel, D.R.

    1990-12-31

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

  11. BMI-specific waist circumference is better than skinfolds for health-risk determination in the general population.

    PubMed

    Dogra, Shilpa; Clarke, Janine; Roy, Joel; Fowles, Jonathon

    2015-02-01

    Distribution of fat is important when considering health risk; however, the value added from skinfold measurements (SKF) when using body mass index (BMI) refined by waist circumference (WC) is not well understood. The purpose of this study was to assess the utility of SKF compared with WC in determination of health risk in the general population. Data from the Canadian Health Measures Survey (cycles 1 and 2; N = 5217) were used. Health outcomes included directly measured blood pressure, cholesterol, glycated haemoglobin, lung function, self-reported health, and chronic conditions. Technical errors of measurements (TEM), sensitivity, and specificity analysis and linear regressions were conducted. Data indicated that TEM for SKF was above the acceptable 5% in most age and sex categories. Sensitivity and specificity of chronic conditions was not improved with the inclusion of SKF in models containing WC (in those aged 45-69 years) and SKF did not explain any additional variance in regression models containing WC. Health outcomes for those in the normal weight and overweight BMI category were significantly worse in those classified as high risk based on WC, whereas SKF did not consistently discriminate risk. In conclusion, evidence-based WC cut-points were shown to identify health risk, particularly in normal weight and overweight individuals. Thus, BMI refined by WC appears to be more appropriate than SKF for assessment of body composition when determining health risk in the general population. PMID:25591950

  12. Physical Activity Protects against the Health Risks of Obesity.

    ERIC Educational Resources Information Center

    Welk, Gregory J.; Blair, Steven N.

    2000-01-01

    This paper reviews the relationships between physical fitness and body composition and their combined effect on health. After discussing the epidemiologic evidence for a protective effect of physical fitness on the health risks associated with obesity, it describes the Aerobics Center Longitudinal Study, an ongoing observational study that…

  13. Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

    2016-06-01

    This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students. PMID:26538523

  14. Impact of free on-site vaccine and/or healthcare workers training on hepatitis B vaccination acceptability in high-risk subjects: a pre-post cluster randomized study.

    PubMed

    Launay, O; Le Strat, Y; Tosini, W; Kara, L; Quelet, S; Lévy, S; Danan, J; Réveillon, J; Houdayer, J; Bouvet, E; Lévy-Bruhl, D

    2014-10-01

    Despite recommendations for adults at high-risk of hepatitis B virus (HBV) infection, HBV vaccine uptake remains low in this population. A pre-post randomized cluster study was conducted to evaluate the impact of on-site free HBV vaccine availability and/or healthcare worker training on HBV vaccination acceptability in high-risk adults consulting in 12 free and anonymous HIV and hepatitis B/C testing centres (FATC). The FATC were randomly allocated into three groups receiving a different intervention: training on HBV epidemiology, risk factors and vaccination (Group A), free vaccination in the FATC (Group B), both interventions (Group C). The main outcomes were the increase in HBV vaccination acceptability (receipt of at least one dose of vaccine) and vaccine coverage (receipt of at least two doses of vaccine) after intervention. Respectively, 872 and 809 HBV-seronegative adults at high-risk for HBV infection were included in the pre- and post-intervention assessments. HBV vaccination acceptability increased from 14.0% to 75.6% (p <0.001) in Group B and from 17.1% to 85.8% (p <0.001) in Group C and HBV vaccine coverage increased from 9.4% to 48.8% (p <0.001) in Group B and from 11.2% to 41.0% (p <0.001) in Group C. The association of training and free on-site vaccine availability was more effective than free on-site vaccine availability alone to increase vaccination acceptability (ratio 1.14; from 1.02 to 1.26; p 0.017). No effect of training alone was observed. These results support the policy of making HBV vaccine available in health structures attended by high-risk individuals. Updating healthcare workers' knowledge on HBV virus and its prevention brings an additional benefit to vaccination acceptability. PMID:24850059

  15. Taking risks to save lives and health.

    PubMed

    Mohamad, K

    1993-01-01

    To reduce the serious health consequences of illegal abortion, the Indonesian Planned Parenthood Association is providing menstrual regulation services. At present, the Association has 15 comprehensive family planning clinics located in 13 out of 27 province capitals. Initially, menstrual regulation was available only in cases of contraceptive failure, but indicators for this service were quickly broadened to meet the large demand for termination of unwanted pregnancies. The ambiguity of the 1992 health law's wording on abortion--abortion is not explicitly mentioned, in an apparent effort to alienate neither anti-abortion forces nor promoters of safe abortion--threatens to stalemate further gains for Indonesian women. Although abortionists are rarely prosecuted, family planning organizations must be cautious to avoid liability suits. The situation in Indonesia is an example of women's health being held hostage to political interests. PMID:12345326

  16. The health risks of new-wave vegetarianism.

    PubMed

    Szabo, L

    1997-05-15

    Many young people call themselves vegetarians because they don't eat meat, but the eating style they are adopting is fraught with health risks. In this article, which won CMAJ's 1996 Army Chouinard Memorial Essay Contest for Canadian journalism students, Laura Brydges Szabo looks at the "new vegetarianism" and the recommendations health care professionals are making to young people intent on following this incomplete diet. The contest encourages journalism students to write on health care topics. PMID:9164409

  17. The health risks of new-wave vegetarianism

    PubMed Central

    Szabo, L

    1997-01-01

    Many young people call themselves vegetarians because they don't eat meat, but the eating style they are adopting is fraught with health risks. In this article, which won CMAJ's 1996 Army Chouinard Memorial Essay Contest for Canadian journalism students, Laura Brydges Szabo looks at the "new vegetarianism" and the recommendations health care professionals are making to young people intent on following this incomplete diet. The contest encourages journalism students to write on health care topics. PMID:9164409

  18. Window panes of eternity. Health, disease, and inherited risk.

    PubMed Central

    Scriver, C. R.

    1982-01-01

    Personal health reflects harmony between individual and experience; it is optimal homeostasis. Disease is an outcome of incongruity leading to dishomeostasis. Relative to earlier times, disease in modern society has higher "heritability" (in the broad meaning of the term). Inherited risks are facts compatible with anticipation and prevention of disease. This viewpoint has major implications for medical practice, deployment of health services, themes of research, and education of health care personnel and citizens. PMID:6763817

  19. Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments.

    PubMed

    Perrodin, Yves; Donguy, Gilles; Emmanuel, Evens; Winiarski, Thierry

    2014-07-01

    Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a "threshold effect" (risk quotient <1), and an acceptable risk for substances having a "non-threshold effect", with the notable exception of arsenic (individual risk equal to 3.10(-6)). PMID:24742547

  20. When Is Lead a Health Risk?

    ERIC Educational Resources Information Center

    Renner, Rebecca

    1995-01-01

    Although some communities welcome environmental cleanup, others reject official advice about the hazards of living in a high-lead environment. Discusses a predictive model developed by the Environmental Protection Agency and its ability to provide new guidance. Examines mechanisms for human exposure to lead, in particular, the risk to children.…

  1. Evaluation of health risks for contaminated aquifers.

    PubMed Central

    Piver, W T; Jacobs, T L; Medina, M A

    1997-01-01

    This review focuses on progress in the development of transport models for heterogeneous contaminated aquifers, the use of predicted contaminant concentrations in groundwater for risk assessment for heterogeneous human populations, and the evaluation of aquifer remediation technologies. Major limitations and areas for continuing research for all methods presented in this review are identified. Images Figure 2. PMID:9114282

  2. Health Warnings on Alcoholic Beverages: Perceptions of the Health Risks and Intentions towards Alcohol Consumption

    PubMed Central

    Wigg, Sophie; Stafford, Lorenzo D.

    2016-01-01

    Objectives Research has demonstrated that packaging which includes pictorial health warnings are more effective in altering smokers’ perceptions and intentions as well as changing smoking behaviours compared to text-only health warnings. However, very few studies have investigated the effectiveness of health warnings on alcoholic beverages Methods Participants (N = 60) viewed alcoholic beverages presenting one of three health warnings (No health warning, Text-only, Pictorial) and then responded to questions relating to level of fear arousal and their perceptions toward alcohol use. Results We found that pictorial health warnings were associated with significantly higher fear arousal, increased perceptions of the health risks of consuming alcohol as well as greater intentions to reduce and quit alcohol consumption compared to the control. Conclusions These novel findings suggest pictorial health warnings on alcoholic beverages may be an important way of making the public aware of the health risks of alcohol consumption. PMID:27105210

  3. Modelling of Radiological Health Risks from Gold Mine Tailings in Wonderfonteinspruit Catchment Area, South Africa

    PubMed Central

    Mathuthu, Manny; Kamunda, Caspah; Madhuku, Morgan

    2016-01-01

    Mining is one of the major causes of elevation of naturally-occurring radionuclide material (NORM) concentrations on the Earth’s surface. The aim of this study was to evaluate the human risk associated with exposure to NORMs in soils from mine tailings around a gold mine. A broad-energy germanium detector was used to measure activity concentrations of these NORMs in 66 soil samples (56 from five mine tailings and 10 from the control area). The RESidual RADioactivity (RESRAD) OFFSITE modeling program (version 3.1) was then used to estimate the radiation doses and the cancer morbidity risk of uranium-238 (238U), thorium-232 (232Th), and potassium-40 (40K) for a hypothetical resident scenario. According to RESRAD prediction, the maximum total effective dose equivalent (TEDE) during 100 years was found to be 0.0315 mSv/year at year 30, while the maximum total excess cancer morbidity risk for all the pathways was 3.04 × 10−5 at year 15. The US Environmental Protection Agency considers acceptable for regulatory purposes a cancer risk in the range of 10−6 to 10−4. Therefore, results obtained from RESRAD OFFSITE code has shown that the health risk from gold mine tailings is within acceptable levels according to international standards. PMID:27338424

  4. Modelling of Radiological Health Risks from Gold Mine Tailings in Wonderfonteinspruit Catchment Area, South Africa.

    PubMed

    Mathuthu, Manny; Kamunda, Caspah; Madhuku, Morgan

    2016-01-01

    Mining is one of the major causes of elevation of naturally-occurring radionuclide material (NORM) concentrations on the Earth's surface. The aim of this study was to evaluate the human risk associated with exposure to NORMs in soils from mine tailings around a gold mine. A broad-energy germanium detector was used to measure activity concentrations of these NORMs in 66 soil samples (56 from five mine tailings and 10 from the control area). The RESidual RADioactivity (RESRAD) OFFSITE modeling program (version 3.1) was then used to estimate the radiation doses and the cancer morbidity risk of uranium-238 ((238)U), thorium-232 ((232)Th), and potassium-40 ((40)K) for a hypothetical resident scenario. According to RESRAD prediction, the maximum total effective dose equivalent (TEDE) during 100 years was found to be 0.0315 mSv/year at year 30, while the maximum total excess cancer morbidity risk for all the pathways was 3.04 × 10(-5) at year 15. The US Environmental Protection Agency considers acceptable for regulatory purposes a cancer risk in the range of 10(-6) to 10(-4). Therefore, results obtained from RESRAD OFFSITE code has shown that the health risk from gold mine tailings is within acceptable levels according to international standards. PMID:27338424

  5. Modelling microbial health risk of wastewater reuse: A systems perspective.

    PubMed

    Beaudequin, Denise; Harden, Fiona; Roiko, Anne; Stratton, Helen; Lemckert, Charles; Mengersen, Kerrie

    2015-11-01

    There is a widespread need for the use of quantitative microbial risk assessment (QMRA) to determine reclaimed water quality for specific uses, however neither faecal indicator levels nor pathogen concentrations alone are adequate for assessing exposure health risk. The aim of this study was to build a conceptual model representing factors contributing to the microbiological health risks of reusing water treated in maturation ponds. This paper describes the development of an unparameterised model that provides a visual representation of theoretical constructs and variables of interest. Information was collected from the peer-reviewed literature and through consultation with experts from regulatory authorities and academic disciplines. In this paper we explore how, considering microbial risk as a modular system, following the QMRA framework enables incorporation of the many factors influencing human exposure and dose response, to better characterise likely human health impacts. By using and expanding upon the QMRA framework we deliver new insights into this important field of environmental exposures. We present a conceptual model of health risk of microbial exposure which can be used for maturation ponds and, more importantly, as a generic tool to assess health risk in diverse wastewater reuse scenarios. PMID:26277638

  6. A study of Minnesota's high-risk health insurance pool.

    PubMed

    Zellner, B B; Haugen, D K; Dowd, B

    1993-01-01

    This is a report of a study of Minnesota's high-risk health insurance pool for "medically uninsurable" persons. The study consisted of a survey of current and past enrollees carried out in the Spring of 1990 and an analysis of the claims and membership files for 1988 and 1989. The main policy conclusion we reached is that Minnesota's high-risk pool is an adequate approach to the problem raised by risk segmentation on the basis of health status, providing that enrollment remains a small fraction of the population. The recent high, enrollment growth rates the Minnesota risk pool has experienced raise the possibility that basic structural reforms of the nongroup and small-group health insurance markets are needed. PMID:8314605

  7. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  8. Risk equalisation and voluntary health insurance: The South Africa experience.

    PubMed

    McLeod, Heather; Grobler, Pieter

    2010-11-01

    South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with income cross-subsidies, risk-adjusted payments and mandatory membership has been envisaged in policy papers since 1994. Subsequent work has seen the design of a Risk Equalisation Fund intended to operate between competing private health insurance funds. The paper outlines the South African health system and describes the risk equalisation formula that has been developed. The risk factors are age, gender, maternity events, numbers with certain chronic diseases and numbers with multiple chronic diseases. The Risk Equalisation Fund has been operating in shadow mode since 2005 with data being collected but no money changing hands. The South African experience of risk equalisation is of wider interest as it demonstrates an attempt to introduce more solidarity into a small but highly competitive private insurance market. The measures taken to combat over-reporting of chronic disease should be useful for countries or funders considering adding chronic disease to their risk equalisation formulae. PMID:20619476

  9. 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

  10. 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

  11. Risk Selection under Public Health Insurance with Opt-Out.

    PubMed

    Panthöfer, Sebastian

    2016-09-01

    This paper studies risk selection between public and private health insurance when some, but not all, individuals can opt out of otherwise mandatory public insurance. Using a theoretical model, I show that public insurance is adversely selected when insurers and insureds are symmetrically informed about health-related risks, and that there can be adverse or advantageous selection when insureds are privately informed. Using data from the German Socio-Economic Panel, I find that (i) public insurance is, on balance, adversely selected under the German public health insurance with opt out scheme, (ii) individuals advantageously select public insurance based on risk aversion and residential location, and (iii) there is suggestive evidence of asymmetric information in the market for private health insurance. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27237082

  12. Health risk appraisal: review of evidence for effectiveness.

    PubMed Central

    Schoenbach, V J; Wagner, E H; Beery, W L

    1987-01-01

    Since its introduction some two decades ago, health risk appraisal (HRA) has become a standard offering in the health promotion repertoire. The technique's distinctive feature is its use of epidemiologic data to generate quantitative risk messages for the client. Yet despite the dedication and considerable investments that have gone into HRA's development, dissemination, and use, there is only limited empirical evidence that these quantitative risk messages have any effect on clients. There do not appear to be any formal studies of HRA's effect on participation in health promotion programs, although increasing recruitment is regarded as a major benefit of using HRA. There are few indications of HRA effects on health beliefs. Most positive reports of effects on behavior change come from uncontrolled studies; several randomized controlled trials have yielded ambiguous findings. Virtually no data exist concerning the impact of the quantitative risk messages that distinguish HRA from other assessment techniques and that have motivated the substantial efforts toward developing and refining HRA. HRA has evident appeal and is probably a useful health education device for middle-class, middle-aged, nonminority clients. It may well have desirable effects on health-related beliefs, attitudes, and behaviors when accompanied by counseling or education, but available evidence has not established its effectiveness. Given the difficulty of obtaining definitive evidence of the effectiveness of HRA and specifically of its use of quantitative risk projections, the need for such evidence is debatable. An adequately funded and reviewed research program to examine whether projections of absolute risk affect knowledge, beliefs, attitudes, and intention to change is recommended as the most fruitful next step. Epidemiologically based HRA procedures that provide feedback in terms of qualitative statements or relative risk may be a promising approach to prospective health assessment. PMID

  13. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  14. [Risk communication in analysis of occupational health risk for industrial workers].

    PubMed

    Barg, A O; Lebedeva-Nesevrya, N A

    2015-01-01

    The article covers problems of risk communication system function on industrial enterprise. Sociologic study in machinery construction enterprise of Perm area helped to consider main procedures of informing on occupational risk for health of workers exposed to occupational hazards, to describe features and mechanisms of risk communication, to specify its model. The authors proved that main obstacles for efficient system of occupational risks communication are insufficiently thorough legal basis, low corporative social responsibility of the enterprise and low social value of health for workers. This article was prepared with the support of the Russian Humanitarian Science Foundation (Project No. 14-16-59011). PMID:26596113

  15. Health risk assessment of heavy metals in the water environment of Zhalong Wetland, China.

    PubMed

    Zhang, Nannan; Zang, Shuying; Sun, Qingzhan

    2014-05-01

    Concentrations of the Cu, Cd, Cr, As, Zn and Ni in water samples from 272 sampling stations in the water environment of Zhalong Wetland, China were studied. Health risk assessment associated with six heavy metals and metalloid was conducted using health risk assessment model from United States Environmental Protection Agency. It can be concluded that the mean concentrations of Cu, Ni, Zn, As, Cd and Cu were 0.19, 0.45, 0.52, 4.9, 0.12 and 0.24 μg L(-1), respectively. The carcinogenic risk of Cr, As and Cd in the discharged area, experimental area, buffer area and core area were lower than the maximum allowance risk level recommended by International Commission on Radiological Protection (ICRP 5.0 × 10(-5) a(-1)). The non-carcinogenic risks (Cu, Zn, Ni) was also lower than the maximum allowance levels recommended by ICRP. Though it was lower than the level, it was very approaching to maximum acceptable risk level, need to draw attention to the relevant departments. PMID:24414855

  16. Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia.

    PubMed

    Shiely, Frances; Saifuddin, Mohammed Syafiek

    2014-03-01

    More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying. PMID:23970646

  17. Human Health Risk Assessment of Trichloroethylene from Industrial Complex A

    PubMed Central

    Sin, Saemi

    2012-01-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10?5 for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10?5 and 1.97 × 10?5 for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed. PMID:24278607

  18. Comparative quantification of health risks: Conceptual framework and methodological issues

    PubMed Central

    Murray, Christopher JL; Ezzati, Majid; Lopez, Alan D; Rodgers, Anthony; Vander Hoorn, Stephen

    2003-01-01

    Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty. PMID:12780936

  19. Prospective risk analysis of health care processes: a systematic evaluation of the use of HFMEA in Dutch health care.

    PubMed

    Habraken, M M P; Van der Schaaf, T W; Leistikow, I P; Reijnders-Thijssen, P M J

    2009-07-01

    The aim of this study was to evaluate the use of Healthcare Failure Mode and Effect Analysis (HFMEA) in Dutch health care by means of user feedback. Thirteen HFMEA analyses of various health care processes were successfully concluded and on average took 69 person-hours (excluding reporting). These results show that HFMEA can successfully be applied in Dutch health care. However, the user feedback also uncovered several perceived drawbacks, such as the fact that HFMEA is very time-consuming and that, particularly, the risk assessment part of HFMEA is difficult to carry out. Moreover, a lack of guidance with regard to the identification of failure mode causes and effective actions might influence the quality of the outcomes of an HFMEA analysis. Several suggestions are put forward to improve the perceived utility and acceptance of HFMEA. Nevertheless, future research is necessary to evaluate the actual effects of these recommendations. Error modelling and risk analysis, and their contribution to explaining human performance in socio-technical systems, traditionally belong to the field of ergonomics. The user feedback on HFMEA and the suggestions that are put forward may also be useful for (H)FMEA and hazard analysis and critical control point applications in sectors other than health care. PMID:19562591

  20. Association between Aluminum and Silicon Concentrations in Isfahan Drinking Water and Their Health Risk Assessments

    PubMed Central

    Pourgheysari, Hajar; Hajizadeh, Yaghoub; Tarrahi, Mohammad Javad; Ebrahimi, Afshin

    2015-01-01

    Background: High concentrations of elements such as aluminum (Al) and silicon (Si) in drinking water can affect human health. It is suggested that high daily intake of Al is associated with increased risk of neurodegenerative disorders. Si, as an antidote of Al, may decrease Al bioavailability. The study was conducted to estimate Al and Si concentration and correlation in water and evaluate their health risk. Methods: In this cross-sectional study, water samples were collected from 20 points of water distribution system and the water treatment plant of Isfahan in spring and summer. Samples were analyzed using DR-5000. The health risk was evaluated via calculating chronic daily intake (CDI) and hazard index (HI). Results: Significant negative correlation was documented between Al and Si (R = −0.482, P = 0.037 in spring, and R = −0.452, P = 0.049 in summer). These values were approximately similar in all types of Al and Si. The amounts of CDI for Al in spring and summer were 6.67E-04 and 0.002 mg/kg/day, respectively. The Al HI values were below 1 in both seasons. Conclusions: The significant correlation between Al and Si concentrations suggests that Si can eliminate Al in water, and probably it might do the same in the body. The health risk of Al intake from tap water was negligible, it was assessed in an acceptable range with an HI value of less than the standard levels. The health risk of Si remained unknown due to lack of information regarding its toxicity and adverse health effects. PMID:26682032

  1. Factors Associated with Acceptance of Peers with Mental Health Problems in Childhood and Adolescence

    ERIC Educational Resources Information Center

    Swords, Lorraine; Heary, Caroline; Hennessy, Eilis

    2011-01-01

    Background: Research suggests that children's reactions to peers with mental health problems are related to the maintenance and outcomes of these problems. However, children's perceptions of such peers, particularly those with internalising problems, are neither well researched nor understood. The present study aimed to test a series of models…

  2. Cell Phone Usage among Adolescents in Uganda: Acceptability for Relaying Health Information

    ERIC Educational Resources Information Center

    Mitchell, Kimberly J.; Bull, Sheana; Kiwanuka, Julius; Ybarra, Michele L.

    2011-01-01

    The increase in cell phone use has manifested a growing interest in using this technology for health promotion. The portability and "always on" features of the cell phone, along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years.…

  3. Peer health advisor program to reduce the health risks of university students.

    PubMed Central

    Carey, M I

    1984-01-01

    Health promoters in the United States need to address the challenge of reducing health risks in young adults. The conditions that lead to the largest percentages of early disabilities and deaths are related to lifestyle characteristics. As health care costs continue spiraling upward, many professionals question the use of solely medical solutions to health problems. Health leaders have called for a change in priorities from curing the sick to keeping people well. Reducing health risks will increase longevity, improve quality of life, and reduce health care costs. It is widely believed that during the adolescent and young adult years many important health habits are formed and set. An individual person's health destiny can, in fact, be greatly shaped by the attitudes, behavior, and knowledge adopted during the early years of independence. For these reasons, wellness and self-care programming for college students is vital and worthy of being rigorously explored and evaluated. In this health promotion proposal, peers deliver a Lifestyle Health Planning Program to university students. They can encourage an internal locus of control over health matters and a perception of choice in those they counsel. The peer advisors conduct one-on-one sessions and outreach programs in the subject areas of fitness, nutrition, health-impairing habits, stress management, and sexuality. Promoting self-responsibility during college years can set lifelong positive health habits. A group of trained peer health advisors can be an innovative device to implement a health promotion program in a university setting. PMID:6440207

  4. Human health risk assessment of pharmaceuticals in water: an uncertainty analysis for meprobamate, carbamazepine, and phenytoin.

    PubMed

    Kumar, Arun; Xagoraraki, Irene

    2010-01-01

    This study presents a step-wise development of a quantitative pharmaceutical risk assessment (QPhRA, hereafter) framework, including Monte Carlo uncertainty analysis for meprobamate, carbamazepine, and phenytoin during (1) accidental exposures of stream water and fish consumption and (2) direct ingestion of finished drinking water for children and adults. Average hazard quotients of these pharmaceuticals (i.e., the ratio of values of chronic daily intake to acceptable daily intake) were found to lie between 1x10(-10) and 3x10(-5) and 99 th percentile values of hazard quotients were found to be less than 1x10(-4) for both sub-populations, indicating no potential risks of adverse effects due to pharmaceuticals exposures. In addition, pharmaceutical concentrations were also observed to be lower than their respective calculated acceptable daily intake-equivalent drinking water levels, indicating no potential human health risks. To the authors' knowledge, for the first time in QPhRA studies, this study has attempted to characterize and quantify effects of factors, such as considerations for sensitive sub-populations using subpopulation-specific toxic endpoints and use of pharmaceutical concentrations in stream and finished drinking waters on risk estimates. Acceptable daily intake was observed to be the primary contributor (>93% variance contribution) in the overall uncertainties of estimates of hazard quotients, followed by fish consumptions and pharmaceutical concentrations in water. Further research efforts are required to standardize use of acceptable daily intake values to reduce large variability in estimation of hazard quotients. PMID:20152876

  5. Trends in task shifting in HIV treatment in Africa: Effectiveness, challenges and acceptability to the health professions

    PubMed Central

    Mayers, Pat

    2015-01-01

    Background Task shifting has been suggested to meet the demand for initiating and managing more patients on antiretroviral therapy. Although the idea of task shifting is not new, it acquires new relevance in the context of current healthcare delivery. Aim To appraise current trends in task shifting related to HIV treatment programmes in order to evaluate evidence related to the effectiveness of this strategy in addressing human resource constraints and improving patient outcomes, challenges identified in practice and the acceptability of this strategy to the health professions. Method Electronic databases were searched for studies published in English between January 2009 and December 2014. Keywords such as ‘task shifting’, ‘HIV treatment’, ‘human resources’ and ‘health professions’ were used. Results Evidence suggests that task shifting is an effective strategy for addressing human resource constraints in healthcare systems in many countries and provides a cost-effective approach without compromising patient outcomes. Challenges include inadequate supervision support and mentoring, absent regulatory frameworks, a lack of general health system strengthening and the need for monitoring and evaluation. The strategy generally seems to be accepted by the health professions although several arguments against task shifting as a long-term approach have been raised. Conclusion Task shifting occurs in many settings other than HIV treatment programmes and is viewed as a key strategy for governing human resources for healthcare. It may be an opportune time to review current task shifting recommendations to include a wider range of programmes and incorporate initiatives to address current challenges. PMID:26245622

  6. Public acceptability of government intervention to change health-related behaviours: a systematic review and narrative synthesis

    PubMed Central

    2013-01-01

    Background Governments can intervene to change health-related behaviours using various measures but are sensitive to public attitudes towards such interventions. This review describes public attitudes towards a range of policy interventions aimed at changing tobacco and alcohol use, diet, and physical activity, and the extent to which these attitudes vary with characteristics of (a) the targeted behaviour (b) the intervention and (c) the respondents. Methods We searched electronic databases and conducted a narrative synthesis of empirical studies that reported public attitudes in Europe, North America, Australia and New Zealand towards interventions relating to tobacco, alcohol, diet and physical activity. Two hundred studies met the inclusion criteria. Results Over half the studies (105/200, 53%) were conducted in North America, with the most common interventions relating to tobacco control (110/200, 55%), followed by alcohol (42/200, 21%), diet-related interventions (18/200, 9%), interventions targeting both diet and physical activity (18/200, 9%), and physical activity alone (3/200, 2%). Most studies used survey-based methods (160/200, 80%), and only ten used experimental designs. Acceptability varied as a function of: (a) the targeted behaviour, with more support observed for smoking-related interventions; (b) the type of intervention, with less intrusive interventions, those already implemented, and those targeting children and young people attracting most support; and (c) the characteristics of respondents, with support being highest in those not engaging in the targeted behaviour, and with women and older respondents being more likely to endorse more restrictive measures. Conclusions Public acceptability of government interventions to change behaviour is greatest for the least intrusive interventions, which are often the least effective, and for interventions targeting the behaviour of others, rather than the respondent him or herself. Experimental studies

  7. The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study

    PubMed Central

    Moffatt, Suzanne; Mackintosh, Joan; White, Martin; Howel, Denise; Sandell, Adam

    2006-01-01

    Background Qualitative research is increasingly used alongside randomised controlled trials (RCTs) to study a range of factors including participants' experiences of a trial. The need for a sound evidence base within public health will increase the need for RCTs of non-clinical interventions. Welfare rights advice has been proposed as an intervention with potential to reduce health inequalities. This qualitative study, nested within an RCT of the impact of welfare rights advice, examined the acceptability of the intervention, the acceptability of the research process and the perceived impact of the intervention. Methods 25 men and women aged 60 years or over were recruited from four general practices in Newcastle upon Tyne (UK), a sub-sample of those who consented to be contacted (n = 96) during the RCT baseline interview. Semi-structured interviews were undertaken and analysed using the Framework Method. Results Participants viewed the trial positively although, despite agreeing that the information leaflet was clear, some had agreed to participate without being fully aware of what was involved. Some participants were unaware of the implications of randomisation. Most thought it fair, but a few concerns were raised about the control condition. The intervention was acceptable and made participants feel confident about applying for benefit entitlements. 14 out of 25 participants received some financial award; median weekly income gain was £57 (€84, $101). The perceived impact of additional finances was considerable and included: increased affordability of necessities and occasional expenses; increased capacity to deal with emergencies; and a reduction in stress related to financial worries. Overall, perceived independence and ability to participate in society increased. Most participants perceived benefits to their mental well-being, but no-one reported an improvement in physical health. The RCT showed little or no effect on a wide range of outcome measures

  8. Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

    PubMed Central

    Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

    2016-01-01

    Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827

  9. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    PubMed Central

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society. PMID:24771993

  10. Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

    NASA Astrophysics Data System (ADS)

    de Barros, F.; Rubin, Y.; Maxwell, R. M.

    2013-12-01

    In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

  11. In vitro assessment of equivalence of occupational health risk: welders.

    PubMed Central

    Stern, R M

    1983-01-01

    The possibility of using in vitro testing to determine the equivalence of risk for various occupational groups is discussed. In the absence of epidemiological evidence or relevant animal in vivo bioassays on which to determine the health effects of specific occupational exposures, it is proposed to use similarities in the in vitro response to substances with known (or strongly suspected) and unknown risk to demonstrate their risk equivalence. Identification and evaluation of a high risk "hot spot" due to exposure to Cr(VI) for stainless steel welders is discussed in terms of recent developments in collection, analysis and bioassay of welding fumes. PMID:6641655

  12. Topical Review: ADHD and Health-Risk Behaviors: Toward Prevention and Health Promotion.

    PubMed

    Schoenfelder, Erin N; Kollins, Scott H

    2016-08-01

    Across the lifespan, attention deficit/hyperactivity disorder (ADHD) is associated with increased health risk behaviors including substance abuse, binge eating and obesity, and unsafe sexual behavior. These risks are directly linked to the neurocognitive deficits associated with ADHD, and are also mediated by the cascade of psychosocial impairments and stressors caused by ADHD across development. However, little is known about optimal approaches to improve health outcomes in this high-risk population. This topical review provides an overview of health risks associated with ADHD and the limited existing research relevant to health promotion for children and adolescents with ADHD. Future research questions and implications for clinicians are also addressed-especially how psychologists and medical practitioners may improve child health through early screenings, increasing medication adherence, and treating psychosocial impairments. PMID:26717959

  13. Inferences, Risk Modeling, and Prediction of Health Effects of Ionizing Radiation.

    PubMed

    Dainiak, Nicholas

    2016-03-01

    The combined expertise of radiation epidemiologists and laboratory experimentalists is required to accurately define health risks from exposure to a low/very low radiation dose. Although stochastic risk can be estimated when a known threshold dose is exceeded, risk must be inferred from data transference at sub-threshold doses. The clinician's dilemma is evident when complying with accepted medical practice that is complicated by potential long-term, adverse outcomes. By contrast, radiation protection regulators must make prudent judgments without complete knowledge of the scope and consequences of their actions. Only by combining the strengths of epidemiological and experimental laboratory approaches can accurate predictive modeling be achieved after exposure to a low/very low dose. PMID:26808880

  14. Assessing the health and development of ART-conceived young adults: A study of feasibility, parent recall, and acceptability

    PubMed Central

    Fisher, Jane RW; Hammarberg, Karin; Baker, HW Gordon; McBain, John C

    2008-01-01

    Background Assisted reproductive technologies (ART) to treat infertility have been available for nearly three decades. There have been a number of systematic comparisons of the health and development of ART-conceived with spontaneously-conceived (SC) children. Data are equivocal, some finding no differences and others that there are more health and developmental problems in the ART group. It is agreed that perinatal mortality and morbidity are worse after assisted than spontaneous conception and the impact of the hormonally altered intrauterine environment on puberty and later fertility of offspring are unknown. To date however, there has been no investigation of the health and development of ART-conceived young adults, including from the world's few prospective cohorts of ART conceived children. Obtaining these data requires contact to be made with people at least twenty years after discharge from the treating service. Given the ethical difficulties of approaching families to participate in research up to two decades after cessation of treatment, the aim of this exploratory qualitative investigation was to assess the feasibility and acceptability of approaching mothers treated for infertility prior to 1988, and their recall of the health and development of their ART-conceived young adult children. Methods Mothers treated for infertility at the Royal Women's Hospital Reproductive Biology Unit in Melbourne, Australia prior to 1988 were approached by a senior clinician and invited to participate in individual semi-structured interviews which could include their partners and/or young adult children if they wished. Recruitment continued until theoretic saturation had been reached. Results Ten mothers, two of their husbands and five young adults participated in interviews, and the health and development of 15 ART-conceived young adults were described. The experience of conception, pregnancy, birth and the health and development of the children were recalled vividly and

  15. An Interactive Website to Reduce Sexual Risk Behavior: Process Evaluation of TeensTalkHealth

    PubMed Central

    Sieving, Renee E; Terveen, Loren G; Rosser, BR Simon; Kodet, Amy J; Rothberg, Vienna D

    2015-01-01

    Background Different theoretical frameworks support the use of interactive websites to promote sexual health. Although several Web-based interventions have been developed to address sexual risk taking among young people, no evaluated interventions have attempted to foster behavior change through moderated interaction among a virtual network of adolescents (who remain anonymous to one another) and health professionals. Objective The objective was to conduct a summative process evaluation of TeensTalkHealth, an interactive sexual health website designed to promote condom use and other healthy decision making in the context of romantic and sexual relationships. Methods Evaluation data were obtained from 147 adolescents who participated in a feasibility and acceptability study. Video vignettes, teen-friendly articles, and other content served as conversation catalysts between adolescents and health educators on message boards. Results Adolescents’ perceptions that the website encouraged condom use across a variety of relationship situations were very high. Almost 60% (54/92, 59%) of intervention participants completed two-thirds or more of requested tasks across the 4-month intervention. Adolescents reported high levels of comfort, perceived privacy, ease of website access and use, and perceived credibility of health educators. Potential strategies to enhance engagement and completion of intervention tasks during future implementations of TeensTalkHealth are discussed, including tailoring of content, periodic website chats with health educators and anonymous peers, and greater incorporation of features from popular social networking websites. Conclusions TeensTalkHealth is a feasible, acceptable, and promising approach to complement and enhance existing services for youth. PMID:26336157

  16. Health Risk Assessment of Irradiated Topaz

    NASA Astrophysics Data System (ADS)

    Nelson, Kevin Lyle

    1991-06-01

    Radiation-produced blue topaz, indistinguishable from natural blue topaz, is produced by several different techniques. Published information on radionuclides present, activity levels, equipment necessary to detect activated nuclides and dosimetric assessment is lacking. Using a 60 megawatt nuclear reactor, fifty-one samples of colorless topaz from Nigeria, Sri Lanka, India and Brazil were irradiated with thermal and fast neutron fluences ranging from 1.8 times 10 13 to 9.2 times 1018 neutrons cm^{-2}. Seventeen MeV electrons produced by a linear accelerator were also used to irradiate 36 colorless topaz from the same countries. Gamma ray or positron-emitting nuclides were identified using calibrated well-type NaI or germanium detectors. For germanium detectors having relative efficiencies of approximately 20 percent, an analysis time of one hour or more was needed. Geiger Mueller (G-M) detectors, scintillators (plastic and liquid), gas flow proportional counters, a ZnS detector and autoradiography techniques were used to measure charged particle activity. Isotopes produced from neutron activation included 182Ta, ^ {59}Fe, 46Sc, 51Cr, 54Mn, 124Sb, ^{32 }P, 77As, ^ {183}Ta, 77Ge, 72Ga, and ^{24 }Na. Possible nuclides produced from 17 MeV electron treatment include ^{68 }Ga, 64Cu, ^ {49}Cr, and 18F. Positive identification of the electron activated nuclides was not possible because of the short half-lives involved (<1 day). Of the possible pure beta emitters activated during neutron bombardment, 32P and 35S are the most likely to be produced. The identification of 32P was made using a three point beta absorption analysis with a G-M detector. Skin and breast cancer risk estimates were calculated for various sized topaz containing NRC exempt concentration levels. When compared to a negligible individual risk level (NIRL) of 10^{-7}, the risk of an irradiated topaz in contact with the skin or three inches from breast tissue was a small fraction of the NIRL. At a risk

  17. Are the lowest-cost healthful food plans culturally and socially acceptable?

    PubMed Central

    Maillot, Matthieu; Darmon, Nicole; Drewnowski, Adam

    2014-01-01

    Objective Nutritious yet inexpensive foods do exist. However, many such foods are rejected by the low-income consumer. Is it because their use violates unspoken social norms? The present study was designed to assess the variety and cost of the lowest-cost market basket of foods that simultaneously met required dietary standards and progressively stricter consumption constraints. Design A mathematical optimisation model was used to develop the lowest-cost food plans to meet three levels of nutritional requirements and seven levels of consumption constraints. Subjects: The nationally representative INCA (National Individual Survey of Food Consumption) dietary survey study of 1332 adults provided population estimates of food consumption patterns in France. Food plan costs were based on retail food prices. Results The lowest-cost food plans that provided 9204 kJ/d (2200 kcal/d) for men and 7531 kJ/d (1800 kcal/d) for women and met specified dietary standards could be obtained for ,1?50 h/d. The progressive imposition of consumption constraints designed to create more mainstream French diets sharply increased food plan costs, without improving nutritional value. Conclusions Minimising diet costs, while meeting nutrition standards only, led to food plans that provided little variety and deviated substantially from social norms. Aligning the food plan with mainstream consumption led to higher costs. Food plans designed for low-income groups need to be socially acceptable as well as affordable and nutritious. PMID:20105388

  18. Umami Increases Consumer Acceptability, and Perception of Sensory and Emotional Benefits without Compromising Health Benefit Perception.

    PubMed

    Miyaki, Takashi; Retiveau-Krogmann, Annlyse; Byrnes, Erin; Takehana, Shunji

    2016-02-01

    This study was undertaken to understand how consumers in the United States perceive umami-rich products, specifically low sodium chicken noodle soup. Results suggest that the addition of monosodium l-glutamate (MSG) at a concentration of 0.1% to 0.5%, alone or in synergy with 5'-ribonucleotides of inosine monophosphate (IMP) at 0.1% not only increases consumer acceptance but also positively impacts other aspects of consumer perception. Regardless of concentration of MSG and IMP, samples enhanced in umami compounds were perceived as more savory, flavorful, and less bland while providing a more homemade, fresh, and healthy wholesome taste than a control sample. From a functional and emotional benefit standpoint, when consuming umami-rich samples, consumers reported feeling significantly higher general satisfaction (they felt more content, relaxed, satisfied, less disappointed, dissatisfied…) and heightened positive emotions (happy, excited, indulgent…) than under the control condition. The feeling of being healthy while consuming the dish was not compromised. Last, when asked how they would feel if serving the soup sample to their family or friends, consumers projected feeling more positively under the umami-rich conditions (more happy, competent, loving, less dissatisfied or disappointed) compared to the control condition. PMID:26720057

  19. Are Text Messages a Feasible and Acceptable Way to Reach Female Entertainment Workers in Cambodia with Health Messages? A Cross-Sectional Phone Survey

    PubMed Central

    2016-01-01

    Background Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions. Objective The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services. Methods This cross-sectional phone survey was conducted in May 2015 with 97 FEWs aged 18–35 years and currently working at an entertainment venue in Phnom Penh. Results Of the 96 respondents, 51% reported sending text messages daily; of them, 47% used Khmer script and 45% used Romanized Khmer. Younger FEWs were more likely to report daily texting (P<.001). Most FEWs (98%) in this study reported feeling comfortable receiving private health messages despite the fact that 39% were sharing their phone with others. Younger FEWs were less likely to share their phone with others (P=.02). Of all of the FEWs, 47% reported owning a smartphone, and younger women were more likely to own a smartphone than were older women (P=.08). Conclusions The findings from this study support the development of mHealth interventions targeting high-risk groups in urban areas of Cambodia. Our data suggest that mHealth interventions using texting may be a feasible way of reaching FEWs in Phnom Penh. PMID:27207374

  20. Food safety risks and consumer health.

    PubMed

    Chassy, Bruce M

    2010-11-30

    The major food safety risks are not eating a healthy diet, and failure to avoid foodborne illness. Over one billion people in the world suffer from food insecurity and malnutrition. Nutritionally enhanced transgenic crops such as Golden Rice are one potential strategy for reducing malnutrition in the world. Transgenic crops are subjected to a rigorous pre-market safety assessment. The safety of novel proteins and other products is established, and through compositional analysis and animal studies, the safety of any observed changes is evaluated. These studies provide evidence that the new product is as safe as, or safer than, comparable varieties. It must be asked, however, if this rigorous analysis is necessary, because unregulated crops produced by other breeding methods also undergo genetic changes and contain unintended effects. Golden Rice poses infinitesimally small, if any, risk to consumers whilst it has the potential to spare millions of lives each year. However, because it is a transgenic crop, it cannot be deployed without years of expensive pre-market safety review. Paradoxically, if Golden Rice had been produced by less precise conventional methods of breeding, it would already be in the hands of poor farmers. It is concluded that the hyper-precautionary regulatory process applied to transgenic crops works to the extreme disadvantage of the hungry and the poor. PMID:20621653

  1. Nanoparticles – known and unknown health risks

    PubMed Central

    Hoet, Peter HM; Brüske-Hohlfeld, Irene; Salata, Oleg V

    2004-01-01

    Manmade nanoparticles range from the well-established multi-ton production of carbon black and fumed silica for applications in plastic fillers and car tyres to microgram quantities of fluorescent quantum dots used as markers in biological imaging. As nano-sciences are experiencing massive investment worldwide, there will be a further rise in consumer products relying on nanotechnology. While benefits of nanotechnology are widely publicised, the discussion of the potential effects of their widespread use in the consumer and industrial products are just beginning to emerge. This review provides comprehensive analysis of data available on health effects of nanomaterials. PMID:15588280

  2. Child Social Exclusion Risk and Child Health Outcomes in Australia

    PubMed Central

    Mohanty, Itismita; Edvardsson, Martin; Abello, Annie; Eldridge, Deanna

    2016-01-01

    Introduction This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE) index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia’s only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services. Methods The paper used data from the National Centre for Social and Economic Modelling (NATSEM), University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW) data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database. Results The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH) and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children’s health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index. Conclusions The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children’s health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage. PMID:27152596

  3. Review of health risks of low testosterone and testosterone administration

    PubMed Central

    Jia, Huanguang; Sullivan, Charles T; McCoy, Sean C; Yarrow, Joshua F; Morrow, Matthew; Borst, Stephen E

    2015-01-01

    Hypogonadism is prevalent in older men and testosterone replacement therapy (TRT) for older hypogonadal men is a promising therapy. However, a number of important clinical concerns over TRT safety remain unsolved due to a lack of large-scale randomized clinical trials directly comparing the health risks of untreated hypogonadism vs long-term use of TRT. Meta-analyses of clinical trials of TRT as of 2010 have identified three major adverse events resulting from TRT: polycythemia, an increase in prostate-related events, and a slight reduction in serum high-density lipoprotein cholesterol. There are other purported health risks but their incidence can be neither confirmed nor denied based on the small number of subjects that have been studied to date. Furthermore, subsequent literature is equivocal with regard to the safety and utility of TRT and this topic has been subject to contentious debate. Since January 2014, the United States Food and Drug Administration has released two official announcements regarding the safety of TRT and clinical monitoring the risks in TRT users. Additionally, the health risks related to the clinical presentation of low or declining testosterone levels not been resolved in the current literature. Because TRT is prescribed in the context of putative risks resulting from reduced testosterone levels, we reviewed the epidemiology and reported risks of low testosterone levels. We also highlight the current information about TRT utilization, the risks most often claimed to be associated with TRT, and current or emerging alternatives to TRT. PMID:25879005

  4. Health, safety and environmental risk management in laboratory fields

    PubMed Central

    Yarahmadi, Rasoul; Moridi, Parvin; Roumiani, YarAllah

    2016-01-01

    Background: Research project risks are uncertain contingent events or situations that, if transpire, will have positive or negative effects on objectives of a project. The Management of Health and Safety at Work (MHSW) Regulations 1999 require all employers and the self-employed persons to assess the risks from their work on anyone who may be affected by their activities. Risk assessment is the first step in risk-management procedure, and due to its importance, it has been deemed to be a vital process while having a unique place in the researchbased management systems. Methods: In this research, a two-pronged study was carried out. Firstly, health and safety issues were studied and analyzed by means of ISO 14121. Secondly, environmental issues were examined with the aid of Failure Mode and Effect Analysis. Both processes were utilized to determine the risk level independently for each research laboratory and corrective measure priorities in each field (laboratory). Results: Data analysis showed that the total main and inherent risks in laboratory sites reduced by 38% to 86%. Upon comparing the average risk levels before and after implementing the control and protective actions utilizing risk management approaches which were separate from health, safety and environmental aspects, a highly effective significance (p<0.001) was obtained for inherent risk reduction. Analysis of health, safety and environmental control priorities with the purpose of comparing the ratio of the number of engineering measures to the amount of management ones showed a relatively significant increase. Conclusion: The large number of engineering measures was attributed to the employment of a variety of timeworn machinery (old technologies) along with using devices without basic protection components. PMID:27284544

  5. The age of risk: risk perception and determination following the Mental Health Act 2007.

    PubMed

    Glover-Thomas, Nicola

    2011-01-01

    Reforms to the mental health law framework for England and Wales, which were introduced by the Mental Health Act 2007, are now having a practical effect on day-to-day mental health decision-making. The 2007 Act amends the Mental Health Act 1983, which governs the compulsory hospitalisation and treatment of people with mental disorder; and represents the culmination of a protracted and controversial reform process which has spanned much of the last 15 years. One of the key foci in the 2007 Act is the question of the risk posed by the patient, primarily to others; a result of both the social and political impetus behind the reform process and mounting public anxiety at the management of the mentally disordered. The new Act seeks, as with past legislation, to find the elusive balance between protecting and facilitating the individual's autonomy while also providing an effective framework for the wider public right to protection. The 2007 Act solidifies the dominance of risk by providing a legitimating framework in which risk can be assessed, monitored, and managed. This attitudinal change is demonstrated by the gradual and almost insidious adoption of risk terminology within the practical decision-making setting and the increasing use of risk assessment and management tools. This article is informed by an empirical study which examined individual professional and institutional responses to the mental health legislation in relation to risk. It examines whether the amended legislative framework amplifies risk as an increasingly dominant concern within decision-making. The paper then goes on to consider how decision-makers use risk to assist with their daily roles. Extrapolated from data obtained through the study, several models of risk determination are then discussed. Finally, some thought is given to whether the extension of the risk concept has the potential to become more fundamental within the organisation and legitimisation of mental health care. PMID:22038745

  6. A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand.

    PubMed

    Newman, Peter A; Roungprakhon, Surachet; Tepjan, Suchon; Yim, Suzy; Walisser, Rachael

    2012-01-01

    A safe and efficacious preventive HIV vaccine would be a tremendous asset for low- and middle-income country (LMIC) settings, which bear the greatest global impact of AIDS. Nevertheless, substantial gaps between clinical trial efficacy and real-world effectiveness of already licensed vaccines demonstrate that availability does not guarantee uptake. In order to advance an implementation science of HIV vaccines centred on LMIC settings, we explored sociocultural and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand, the site of the largest HIV vaccine trial ever conducted. Cross-cutting challenges for HIV vaccine uptake - social stigma, discrimination in healthcare settings and out-of-pocket vaccine cost - emerged in addition to population-specific barriers and opportunities. A 'social vaccine' describes broad sociocultural and structural interventions - culturally relevant vaccine promotion galvanised by communitarian norms, mitigating anti-gay, anti-injecting drug user and HIV-related stigma, combating discrimination in healthcare, decriminalising adult sex work and injecting drug use and providing vaccine cost subsidies - that create an enabling environment for HIV vaccine uptake among most-at-risk populations. By approaching culturally relevant social and structural interventions as integral mechanisms to the success of new HIV prevention technologies, biomedical advances may be leveraged in renewed opportunities to promote and optimise combination prevention. PMID:22780324

  7. Occupational health and safety risks and potential health consequences perceived by U.S. workers, 1985.

    PubMed Central

    Shilling, S; Brackbill, R M

    1987-01-01

    Data from the Health Promotion and Disease Prevention Questionnaire, part of the 1985 National Health Interview Survey, were used to report workers' perceptions of occupational risk in their present jobs. This information will be used to monitor progress between 1985 and 1990 toward achieving broad goals in health promotion and disease prevention. The proportions of currently employed persons who perceived exposure to health-endangering substances, work conditions, or risks of injuries were reported for age, race, sex, and occupation groups. Occupational groups were further characterized by the proportion of men and women who reported specific exposures (such as exposure to chemicals or to loud noise) and specific health consequences of exposure (such as risk of developing cancer or hearing impairment). Greater proportions of men than women reported perceived risk from exposure to health-endangering substances, work conditions, and injuries in their present job. Also, a greater proportion of workers perceived risk of injury in their present job than other occupational risk categories. The greatest proportions of perceived exposure to occupational risk were reported by farm operators and managers, police and firefighters, and by workers in forestry and fishing occupations. Among workers reporting perceived exposures, chemicals, noise, and risk of injuries from vehicles were cited by the greatest proportion of workers, as were such health consequences as lung and respiratory problems and hearing impairment. Data from this study may be used to target employment groups for health promotion or education and to develop indepth studies of specific occupational groups to reduce or prevent risk at the worksite. PMID:3101121

  8. Associations between multiple health risk behaviors and mental health among Chinese college students.

    PubMed

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety. PMID:26222809

  9. Environmental degradation and health risks in Beijing, China.

    PubMed

    Qi, Jun; Yang, Linsheng; Wang, Wuyi

    2007-01-01

    As China's capital city, Beijing is experiencing unprecedented environmental degradation accompanied by complex interactions between urbanization and global environmental change, which places human health at risk on a large spatial and temporal scale. For sustainable development that supports environmental and human health in Beijing and during the upcoming "green" Olympic games in 2008, experts and political leaders must acknowledge the urgent health risks from environmental changes related to urbanization. A range of urban health hazards and associated health risks in Beijing result from a variety of factors including heat islands, air pollution, water crisis, soil pollution, infectious diseases, and urban consumerism; in addition, some hazardous health conditions are associated with inequality in living and working conditions. The authors suggest 2 main areas for policy action and research direction: (1) the need to get full-scale information related to environmental monitoring data and health data (and then to provide new methodological approaches and techniques to implement interventions) and (2) the need for effective cooperation among different sectors. PMID:18171645

  10. Effective use of risk assessments and the public comment process to achieve acceptable remediation goals for mercury-contaminated sites

    SciTech Connect

    Miller, J.Q.; Barnett, M.

    1996-04-01

    As a result of recalculating risk levels using new information, the remediation goals and cleanup strategy for the Lower East Fork Poplar Creek floodplains have been significantly changed to reflect an important reduction in cleanup costs while ensuring protectionof human health and the environment. This project and its stakeholders have made the risk assessment more effective by better defining the contaminant and adjusting assessment parameters. As a result, the remediation goal initially set at 50 ppM Hg has been changed to 400 ppM, resulting in significant reductions in both the destruction of the floodplain landscape and project costs. Volume of soils to be excavated has been decreased from 1 million cubic yards to 25,000 cubic yards, and the cost has been reduced from about $1 billion to less than $20 million. The Record of Decision for Lower East Fork Poplar Creek was approved in August 1995.

  11. Assessment of public health risk associated with viral contamination in harvested urban stormwater for domestic applications.

    PubMed

    Lim, Keah-Ying; Hamilton, Andrew J; Jiang, Sunny C

    2015-08-01

    Capturing stormwater is becoming a new standard for sustainable urban stormwater management, which can be used to supplement water supply portfolios in water-stressed cities. The key advantage of harvesting stormwater is to use low impact development (LID) systems for treatment to meet water quality requirement for non-potable uses. However, the lack of scientific studies to validate the safety of such practice has limited its adoption. Microbial hazards in stormwater, especially human viruses, represent the primary public health threat. Using adenovirus and norovirus as target pathogens, we investigated the viral health risk associated with a generic scenario of urban stormwater harvesting practice and its application for three non-potable uses: 1) toilet flushing, 2) showering, and 3) food-crop irrigation. The Quantitative Microbial Risk Assessment (QMRA) results showed that food-crop irrigation has the highest annual viral infection risk (median range: 6.8×10(-4)-9.7×10(-1) per-person-per-year or pppy), followed by showering (3.6×10(-7)-4.3×10(-2)pppy), and toilet flushing (1.1×10(-7)-1.3×10(-4)pppy). Disease burden of each stormwater use was ranked in the same order as its viral infection risk: food-crop irrigation>showering>toilet flushing. The median and 95th percentile risk values of toilet-flushing using treated stormwater are below U.S. EPA annual risk benchmark of ≤10(-4)pppy, whereas the disease burdens of both toilet-flushing and showering are within the WHO recommended disease burdens of ≤10(-6)DALYspppy. However, the acceptability of showering risk interpreted based on the U.S. EPA and WHO benchmarks is in disagreement. These results confirm the safety of stormwater application in toilet flushing, but call for further research to fill the data gaps in risk modeling as well as risk benchmarks. PMID:25863500

  12. The analysis of human health risk with a detailed procedure operating in a GIS environment.

    PubMed

    Morra, P; Bagli, S; Spadoni, G

    2006-05-01

    An approach for quantifying the human health risk caused by industrial sources, which, daily or accidentally, emit dangerous pollutants able to impact on different environmental media, is introduced. The approach is performed by the HHRA-GIS tool which employs an integrated, multimedia, multi-exposure pathways and multi-receptors risk assessment model able to manage all the steps of the analysis in a georeferenced structure. Upper-bound excess lifetime cancer risk and noncarcinogenic hazards are the risk measures, the spatial distribution of which is calculated and mapped on the involved territory, once all the pathways and receptors of the study area are identified. A sensitivity analysis completes the calculations allowing to understand how risk estimates are dependent on variability in the factors contributing to risk. The last part of the paper makes use of a case study concerning a working industrial site to put in evidence in which way the designed tool can help local authorities and policy makers in managing risks and planning remedial and reduction actions. The considered geographical area is a hypothetical territory characterized by residential, agricultural and industrial zones. The presence of two sources of contamination, a municipal waste incinerator (MWI) and a contaminated site, are evaluated by the tool application. Various typologies of receptors have been taken into account, each of them characterized by different anatomical and dietary properties. The achieved results are analyzed, compared with acceptable and background values and alternatives of minor environmental impact calculated. PMID:16356549

  13. A 21st century roadmap for human health risk assessment.

    PubMed

    Pastoor, Timothy P; Bachman, Ammie N; Bell, David R; Cohen, Samuel M; Dellarco, Michael; Dewhurst, Ian C; Doe, John E; Doerrer, Nancy G; Embry, Michelle R; Hines, Ronald N; Moretto, Angelo; Phillips, Richard D; Rowlands, J Craig; Tanir, Jennifer Y; Wolf, Douglas C; Boobis, Alan R

    2014-08-01

    The Health and Environmental Sciences Institute (HESI)-coordinated Risk Assessment in the 21st Century (RISK21) project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment, and involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. This paper provides a brief overview of the tiered RISK21 framework called the roadmap and risk visualization matrix, and articulates the core principles derived by RISK21 participants that guided its development. Subsequent papers describe the roadmap and matrix in greater detail. RISK21 principles include focusing on problem formulation, utilizing existing information, starting with exposure assessment (rather than toxicity), and using a tiered process for data development. Bringing estimates of exposure and toxicity together on a two-dimensional matrix provides a clear rendition of human safety and risk. The value of the roadmap is its capacity to chronicle the stepwise acquisition of scientific information and display it in a clear and concise fashion. Furthermore, the tiered approach and transparent display of information will contribute to greater efficiencies by calling for data only as needed (enough precision to make a decision), thus conserving animals and other resources. PMID:25070413

  14. Perceived Risk of Mental Health Problems in Primary Care

    PubMed Central

    Paúl, Constança; Teixeira, Laetitia; Azevedo, Maria João; Alves, Sara; Duarte, Mafalda; O’Caoimh, Rónán; Molloy, William

    2015-01-01

    In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83–2.69 for institutionalization; OR = 1.66, 95% CI 1.41–1.94 for hospitalization; OR = 1.69, 95% CI 1.42–2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes. PMID:26635600

  15. Health of North American forests: Stress and risk assessment

    SciTech Connect

    Smith, W.H. )

    1990-01-01

    The 1980s will be remembered by forest professionals as a decade of intense and widespread societal concern for the vitality and integrity of forest systems. Daily reports of tropical deforestation and temperate forest decline have heightened social consciousness of forest health. It is therefore appropriate, as we enter the 1990s, to assess the health of our forests and propose new initiatives in this critically important area. Making generalizations about the health of North American forests is difficult because of the extraordinary diversity of forests, management regimes, and stress factors. This overview article summarizes forest health fundamentals, significant health risks, and priorities in future forest health management for temperate forests of the United States.

  16. Impact of actinide recycle on nuclear fuel cycle health risks

    SciTech Connect

    Michaels, G.E.

    1992-06-01

    The purpose of this background paper is to summarize what is presently known about potential impacts on the impacts on the health risk of the nuclear fuel cycle form deployment of the Advanced Liquid Metal Reactor (ALMR){sup 1} and Integral Fast Reactor (IF){sup 2} technology as an actinide burning system. In a companion paper the impact on waste repository risk is addressed in some detail. Therefore, this paper focuses on the remainder of the fuel cycle.

  17. Effective Health Risk Communication About Pandemic Influenza for Vulnerable Populations

    PubMed Central

    Tinker, Timothy

    2009-01-01

    The consequences of pandemic influenza for vulnerable populations will depend partly on the effectiveness of health risk communications. Strategic planning should fully consider how life circumstances, cultural values, and perspectives on risk influence behavior during a pandemic. We summarize recent scientific evidence on communication challenges and examine how sociocultural, economic, psychological, and health factors can jeopardize or facilitate public health interventions that require a cooperative public. If ignored, current communication gaps for vulnerable populations could result in unequal protection across society during an influenza pandemic. We offer insights on communication preparedness gleaned from scientific studies and the deliberations of public health experts at a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008. PMID:19797744

  18. Historical perspectives on the uses and health risks of beryllium

    SciTech Connect

    Preuss, O.P.

    1985-07-01

    Unawareness of the health risks of beryllium resulted in a decade of unmitigated exposure of several thousand workers and numerous cases of beryllium disease in employees and nearby residents. Subsequent adoption of exposure limits and their implementation with effective technical controls reduced the occurrence of new cases, which were mainly due to accidental exposures, to a minimum. The fact that continuously growing production and consumption did not alter this trend demonstrates the effectiveness of the present threshold limit value. It shows that the potential health hazard can be well contained and that beryllium can be produced and fabricated without undue risk to employees or the general public.

  19. A Model for Risk Assessment in Health Care.

    PubMed

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

    The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge. PMID:27332383

  20. Overweight, Obesity, Youth, and Health-Risk Behaviors

    PubMed Central

    Farhat, Tilda; Iannotti, Ronald J.; Simons-Morton, Bruce

    2010-01-01

    Background The prevalence and severity of obesity have increased among children and adolescents. While the medical and psychosocial consequences of youth obesity have been well-documented, less information exists on the association of overweight/obesity with health risk behaviors, which are considered to be a primary threat to adolescent health. Objectives This study examined the association of overweight and obesity with health-risk behaviors among U.S. youth. Methods Self-reported height and weight, substance use, violence and bullying were assessed in a nationally representative sample of students aged 11 to 17 years (N=7825) who participated in the 2005/6 Health Behaviors in School-Aged Children survey. Data were analyzed in 2009. Results Significant gender and age differences in the relationship of overweight/obesity with risk behaviors were observed. Overweight and obesity were significantly associated with substance use among girls only: frequent smoking and drinking were associated with overweight and obesity among younger girls, whereas they were associated with obesity among older girls. Frequent smoking and cannabis use were associated with overweight among younger girls only. Relationships between violent behavior and overweight/obesity were mainly observed among boys: Younger obese boys were more likely to be victims of bullying, whereas older obese boys were more likely to carry weapons, compared to boys of normal weight. Conclusions Overweight and obese youth are at risk of developing health compromising behaviors which may compound medical and social problems associated with excess weight. PMID:20171527

  1. Methylcyclopentadienyl manganese tricarbonyl: health risk uncertainties and research directions.

    PubMed Central

    Davis, J M

    1998-01-01

    With the way cleared for increased use of the fuel additive methylcyclopentadienyl manganese tricarbonyl (MMT) in the United States, the issue of possible public health impacts associated with this additive has gained greater attention. In assessing potential health risks of particulate Mn emitted from the combustion of MMT in gasoline, the U.S. Environmental Protection Agency not only considered the qualitative types of toxic effects associated with inhaled Mn, but conducted extensive exposure-response analyses using various statistical approaches and also estimated population exposure distributions of particulate Mn based on data from an exposure study conducted in California when MMT was used in leaded gasoline. Because of limitations in available data and the need to make several assumptions and extrapolations, the resulting risk characterization had inherent uncertainties that made it impossible to estimate health risks in a definitive or quantitative manner. To support an improved health risk characterization, further investigation is needed in the areas of health effects, emission characterization, and exposure analysis. PMID:9539013

  2. Clinical mentorship to improve pediatric quality of care at the health centers in rural Rwanda: a qualitative study of perceptions and acceptability of health care workers

    PubMed Central

    2014-01-01

    Background Despite evidence supporting Integrated Management of Childhood Illness (IMCI) as a strategy to improve pediatric care in countries with high child mortality, its implementation faces challenges related to lack of or poor post-didactic training supervision and gaps in necessary supporting systems. These constraints lead to health care workers’ inability to consistently translate IMCI knowledge and skills into practice. A program providing mentoring and enhanced supervision at health centers (MESH), focusing on clinical and systems improvement was implemented in rural Rwanda as a strategy to address these issues, with the ultimate goal of improving the quality of pediatric care at rural health centers. We explored perceptions of MESH from the perspective of IMCI clinical mentors, mentees, and district clinical leadership. Methods We conducted focus group discussions with 40 health care workers from 21 MESH-supported health centers. Two FGDs in each district were carried out, including one for nurses and one for director of health centers. District medical directors and clinical mentors had individual in-depth interviews. We performed a hermeneutic analysis using Atlas.ti v5.2. Results Study participants highlighted program components in five key areas that contributed to acceptability and impact, including: 1) Interactive, collaborative capacity-building, 2) active listening and relationships, 3) supporting not policing, 4) systems improvement, and 5) real-time feedback. Staff turn-over, stock-outs, and other facility/systems gaps were identified as barriers to MESH and IMCI implementation. Conclusion Health care workers reported high acceptance and positive perceptions of the MESH model as an effective strategy to build their capacity, bridge the gap between knowledge and practice in pediatric care, and address facility and systems issues. This approach also improved relationships between the district supervisory team and health center-based care

  3. Health benefits and risks of plant proteins.

    PubMed

    Krajcovicova-Kudlackova, M; Babinska, K; Valachovicova, M

    2005-01-01

    Plant proteins have a reduced content of essential amino acids in comparison to animal proteins. A significant reduction of limiting amino acids (methionine, lysine, tryptophan) means lower protein synthesis. In subjects with predominant or exclusive consumption of plant food a higher incidence of hypoproteinemia due to significant reduction of methionine and lysine intakes was observed. On the other hand, lower intake of these amino acids provides a preventive effect against cardiovascular disease via cholesterol regulation by an inhibited hepatic phospholipid metabolism. Vegetarians have a significantly higher intake of non-essential amino acids arginine and pyruvigenic amino acids glycine, alanine, serine. When plant protein is high in non-essential amino acids, down-regulation of insulin and up-regulation of glucagon is a logical consequence. The action of glucagon in the liver is mediated by stimulation of adenyl cyclase that raises cyclic-AMP (adenosine-3,5-monophosphate) concentrations. Cyclic-AMP down-regulates the synthesis of a number of enzymes required for de novo lipogenesis and cholesterol synthesis, up-regulates key gluconeogenic enzymes and the LDL receptors and decreases the IGF-1 activity (insulin-like growth factor). Cyclic-AMP thus provides a reduction of atherosclerosis risk factors as well as a retardation of cancer development. A sufficient consumption of plant proteins has the protective effects against chronic degenerative diseases (Tab. 2, Ref. 26). PMID:16201743

  4. Human Health Risk Assessment Calculator. In: SMARTe20ll, EPA/600/C-10/007

    EPA Science Inventory

    This calculator is aimed at supporting a human health risk assessment. Risk scenarios can be built by combining various health effects, exposure pathways, exposure parameters, and analytes. Scenario risk are calculated for each exposure pathway and analyte combination. The out...

  5. Air pollution and health risks due to vehicle traffic.

    PubMed

    Zhang, Kai; Batterman, Stuart

    2013-04-15

    Traffic congestion increases vehicle emissions and degrades ambient air quality, and recent studies have shown excess morbidity and mortality for drivers, commuters and individuals living near major roadways. Presently, our understanding of the air pollution impacts from congestion on roads is very limited. This study demonstrates an approach to characterize risks of traffic for on- and near-road populations. Simulation modeling was used to estimate on- and near-road NO2 concentrations and health risks for freeway and arterial scenarios attributable to traffic for different traffic volumes during rush hour periods. The modeling used emission factors from two different models (Comprehensive Modal Emissions Model and Motor Vehicle Emissions Factor Model version 6.2), an empirical traffic speed-volume relationship, the California Line Source Dispersion Model, an empirical NO2-NOx relationship, estimated travel time changes during congestion, and concentration-response relationships from the literature, which give emergency doctor visits, hospital admissions and mortality attributed to NO2 exposure. An incremental analysis, which expresses the change in health risks for small increases in traffic volume, showed non-linear effects. For a freeway, "U" shaped trends of incremental risks were predicted for on-road populations, and incremental risks are flat at low traffic volumes for near-road populations. For an arterial road, incremental risks increased sharply for both on- and near-road populations as traffic increased. These patterns result from changes in emission factors, the NO2-NOx relationship, the travel delay for the on-road population, and the extended duration of rush hour for the near-road population. This study suggests that health risks from congestion are potentially significant, and that additional traffic can significantly increase risks, depending on the type of road and other factors. Further, evaluations of risk associated with congestion must

  6. The Impact of Preventive Health Behaviors and Risk Factors on Health Status of Ghanaians

    PubMed Central

    Saeed, Bashiru I. I.; Abdul-Aziz, A. R.; Nguah, Samuel Blay; Zhao, Xicang

    2013-01-01

    The article here investigated the impact of Preventive Health Behaviors and Risk Factors as measures of Health Status of Ghanaians. We carry out a cross-sectional analysis of 5573 adults who participated and had indicated that they needed to state their health description in the three years prior to the phase 2007 World Health Organization, a study on Global Ageing and Adult health (SAGE) conducted in Ghana. The ordinal logistic regression model was employed for analysis using R. The results suggest that, there is incontrovertible evidence showing a strong relationship between preventive health behaviors and health status of Ghanaians. Again, the lifestyle of Ghanaians clearly manifests in their positive correlation with the good and moderate health state due to the high percentage (38.96% and 39.04%) respectively. The outcome points to a potential link with the Ghanaian social and health policies. PMID:23985114

  7. The effectiveness of acceptance and commitment therapy bibliotherapy for enhancing the psychological health of Japanese college students living abroad.

    PubMed

    Muto, Takashi; Hayes, Steven C; Jeffcoat, Tami

    2011-06-01

    International students often experience significant psychological distress but empirically tested programs are few. Broadly distributed bibliotherapy may provide a cost-effective approach. About half of the Japanese international students in a western university in the United States (N=70) were randomly assigned to a wait-list or to receive a Japanese translation of a broadly focused acceptance and commitment therapy (ACT) self-help book. Although recruited without regard to health status, the sample was highly distressed with nearly 80% exceeding clinical cutoffs on one or more measures. After a 2-months period for the first treatment group to read the book and a 2-month follow up, wait-list participants also received the book. Students receiving the book showed significantly better general mental health at post and follow up. Moderately depressed or stressed, and severely anxious students showed improvement compared to those not receiving the book. These patterns were repeated when the wait-list participants finally received the book. Improvements in primary outcomes were related to how much was learned about an ACT model from the book. Follow-up outcomes were statistically mediated by changes in psychological flexibility, but not vice versa and were moderated by level of initial flexibility. Overall, the data suggest that ACT bibliotherapy improved the mental health and psychological flexibility of Japanese international students. PMID:21496516

  8. Mom Power: Preliminary Outcomes of a Group Intervention to Improve Mental Health and Parenting Among High-Risk Mothers

    PubMed Central

    Muzik, Maria; Rosenblum, Katherine L.; Alfafara, Emily A.; Schuster, Melisa M.; Miller, Nicole M.; Waddell, Rachel M.; Kohler, Emily Stanton

    2015-01-01

    Purpose Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child’s early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers’ mental health, parenting competence and engagement in treatment. Methods Mothers were referred from community health providers for a Phase 1 trial to assess feasibility, acceptability and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty and single parenthood. 99 mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post- self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and PTSD), parenting and intervention satisfaction. Results Results indicate that MP participation was associated with reduction in depression, PTSD and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70% of the 10 groups (completers; N=68) improved on parenting and mental health outcomes, in contrast to non-completers (N=12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Conclusions Results indicate that MP is feasible, acceptable and holds promise for improving maternal mental health and parenting competence among high-risk dyads

  9. Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

    PubMed

    Muzik, Maria; Rosenblum, Katherine L; Alfafara, Emily A; Schuster, Melisa M; Miller, Nicole M; Waddell, Rachel M; Stanton Kohler, Emily

    2015-06-01

    Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers' mental health, parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among

  10. A profile of health risks among blue-collar workers.

    PubMed

    Gottlieb, N H; Weinstein, R P; Baun, W B; Bernacki, E J

    1992-01-01

    Despite national objectives for extending health promotion programs to blue-collar workers and to small work sites, baseline behavior information for planning such programs is lacking. This study seeks to describe the health risks and norms specific to a population of male, blue-collar gas pipeline workers in remote sites. These workers (n = 395) completed a health risk appraisal and a "health gauge" survey designed to measure nutrition, physical activity, tobacco use, participatory patterns in health-enhancing activities, group norms, and change efforts. Selected behaviors were similar to those of other Texas men (eg, smoking 27% versus 26%) although others were not (eg, smokeless tobacco 18% versus 8%). Multivariate analysis confirmed the relationship of friends' behavior patterns, risk-taking, and interpersonal experience to four lifestyle health behaviors. With 75% or more of workers expressing an interest in various programs, the findings suggest that programming for this population can be successful if tailored to current behaviors and the worksite culture. PMID:1552385

  11. Children in nonparental care: health and social risks.

    PubMed

    Beal, Sarah J; Greiner, Mary V

    2016-01-01

    Approximately 2.3 million children in the United States live separately from both parents; 70-90% of those children live with a relative. Compared with children living with one or both parents, children in nonparental care are in poorer health, are at heightened risk for experiencing disruptions and instability in caregiving, and are vulnerable to other social antecedents of child health (e.g., neglect, poverty, maltreatment). Given the significant impact of adversity in childhood on health across the lifespan, which is increased among children in nonparental care, it is informative to consider the health risks of children living in nonparental care specifically. Research examining the contributions of poverty, instability, child maltreatment, and living in nonparental care, including meta-analyses of existing studies, are warranted. Longitudinal studies describing pathways into and out of nonparental care and the course of health throughout those experiences are also needed. Despite these identified gaps, there is sufficient evidence to indicate that attention to household structure is not only relevant but also essential for the clinical care of children and may aid in identifying youth at risk for developing poor health across the lifespan. PMID:26466078

  12. Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

    PubMed Central

    Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

    2014-01-01

    Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

  13. Exploring Mexican adolescents' perceptions of environmental health risks: a photographic approach to risk analysis.

    PubMed

    Börner, Susanne; Albino, Juan Carlos Torrico; Caraveo, Luz María Nieto; Tejeda, Ana Cristina Cubillas

    2015-05-01

    The objective of this study was to explore Mexican adolescents' perceptions of environmental health risks in contaminated urban areas, and to test the environmental photography technique as a research tool for engaging adolescents in community-based health research. The study was conducted with 74 adolescents from two communities in the city of San Luis Potosi, Mexico. Participants were provided with disposable cameras and asked to take photographs of elements and situations which they believed affected their personal health both at home and outside their homes. They were also asked to describe each photograph in writing. Photographs and written explanations were analyzed by using quantitative and qualitative content analysis. Risk perception plays a crucial role in the development of Risk Communication Programs (RCPs) aimed at the improvement of community health. The photography technique opens up a promising field for environmental health research since it affords a realistic and concise impression of the perceived risks. Adolescents in both communities perceived different environmental health risks as detrimental to their well-being, e.g. waste, air pollution, and lack of hygiene. Yet, some knowledge gaps remain which need to be addressed. PMID:26017963

  14. Health risks from increases in methylmercury exposure.

    PubMed Central

    Mottet, N K; Shaw, C M; Burbacher, T M

    1985-01-01

    Our present knowledge of the human health effects of methylmercury exposure is derived from study of major outbreaks of human poisonings in Japan and Iraq and experimental studies on primates. Methylmercury readily passes through such physiological barriers as the blood-brain barrier, blood-testes barrier, and the placenta. Its major pathological effects are on the nervous and reproductive systems and the developing embryo/fetus. The neurotoxicity of methylmercury is well established in both humans and non-human primates. Lesions in the cerebral and cerebellar gray matter consist of necrosis and lysis of neurons, phagocytosis and gliosis. The changes are most prominent in the deep sulci and may have a vascular component. A late effect is cerebral atrophy. At high dose levels the liver, kidneys, and other organs may also have degenerative changes. Although not yet described in humans, a major effect of exposure of female primates is an adverse effect on pregnancy. Maternal female M. fascicularis blood mercury levels above 1 ppm are associated with a decreased pregnancy rate and increased abortion rate. To date our experimental data lack sufficient numbers to detect infrequent pregnancy effects below 1 ppm. Preliminary studies also reveal that methylmercury may also decrease the number and function (swim speed) of sperm. Both human and primate studies demonstrate deleterious effects of methylmercury on the developing embryo/fetus. Autopsies on human and primate infants reveal retarded brain development and the occurrence of a cerebral palsy-like behavior in the newborns, whereas the mother may be free of signs and symptoms of methylmercury toxicity. The fetal blood level of mercury is higher than the maternal level.(ABSTRACT TRUNCATED AT 250 WORDS) Images FIGURE 1. FIGURE 2. FIGURE 3. FIGURE 5. PMID:3908085

  15. Covariations of Adolescent Weight-Control, Health-Risk and Health-Promoting Behaviors.

    ERIC Educational Resources Information Center

    Rafiroiu, Anca Codruta; Sargent, Roger G.; Parra-Medina, Deborah; Drane, Wanzer J.; Valois, Robert F.

    2003-01-01

    Assessed the prevalence of dieting, investigating clusters of risk behaviors among adolescents. Data from the 1999 South Carolina Youth Risk Behavior Survey indicated that weight control behaviors related to several other important health behaviors. Differences existed between adolescents who used extreme weight loss measures and moderate dieters…

  16. Cell phone usage among adolescents in Uganda: acceptability for relaying health information.

    PubMed

    Mitchell, Kimberly J; Bull, Sheana; Kiwanuka, Julius; Ybarra, Michele L

    2011-10-01

    The increase in cell phone use has manifested a growing interest in using this technology for health promotion. The portability and 'always on' features of the cell phone, along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years. Self-reported quantitative survey data from 1503 secondary school students in Mbarara, Uganda collected in 2008-2009 suggest that 27% currently have cell phones and about half (51%) of all students and 61% of those who owned a cell phone believe that they would access a text messaging-based HIV prevention program if it were available. Other forms of program delivery modality (e.g. Internet, religious organizations, schools) were preferred to text messaging however. We are in need of effective HIV prevention programs that can reach large audiences at low cost and are culturally relevant for the East African context. Researchers are encouraged to consider translation of effective HIV prevention programs for cell phone delivery in Africa. PMID:21536715

  17. Cell phone usage among adolescents in Uganda: acceptability for relaying health information

    PubMed Central

    Mitchell, Kimberly J.; Bull, Sheana; Kiwanuka, Julius; Ybarra, Michele L.

    2011-01-01

    The increase in cell phone use has manifested a growing interest in using this technology for health promotion. The portability and ‘always on’ features of the cell phone, along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years. Self-reported quantitative survey data from 1503 secondary school students in Mbarara, Uganda collected in 2008–2009 suggest that 27% currently have cell phones and about half (51%) of all students and 61% of those who owned a cell phone believe that they would access a text messaging-based HIV prevention program if it were available. Other forms of program delivery modality (e.g. Internet, religious organizations, schools) were preferred to text messaging however. We are in need of effective HIV prevention programs that can reach large audiences at low cost and are culturally relevant for the East African context. Researchers are encouraged to consider translation of effective HIV prevention programs for cell phone delivery in Africa. PMID:21536715

  18. Effect of a health claim and personal characteristics on consumer acceptance of fruit juices with different concentrations of açaí (Euterpe oleracea Mart.).

    PubMed

    Sabbe, Sara; Verbeke, Wim; Deliza, Rosires; Matta, Virginia; Van Damme, Patrick

    2009-08-01

    This study evaluates the effect of a health claim and personal characteristics on the acceptance of two unfamiliar açaí fruit juices that have a low (40% açaí) versus a high (4% açaí) a priori overall liking. Hedonic and sensory measures as well as health- and nutrition-related attribute perceptions and purchase intention were rated before and after health information was presented. Differences in information effects due to interactions with juice type, consumer background attitudes and socio-demographics were investigated. Providing health information yielded a positive, though rather small increase, in overall liking, perceived healthiness and perceived nutritional value of both juices, as well as in their purchase intention. Sensory experiences remained predominant in the acceptance of the fruit juices, although the health claim had a stronger effect on the perceived healthiness and nutritional value of the least-liked juice. Background attitudes and socio-demographic characteristics influenced consumers' acceptance of both unfamiliar fruit juices. Health-oriented consumers were more likely to compromise on taste for an eventual health benefit, though they still preferred the best tasting juice. Consumers with a high food neophobia reported a lower liking for both unfamiliar fruit juices. Older respondents and women were more likely to accept fruit juices that claim a particular health benefit. PMID:19467277

  19. Environmental health risk assessment and management for global climate change

    NASA Astrophysics Data System (ADS)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  20. Assessing the Health and Performance Risks of Carbon Dioxide Exposures

    NASA Technical Reports Server (NTRS)

    James, John T.; Meyers, V. E.; Alexander, D.

    2010-01-01

    Carbon dioxide (CO2) is an anthropogenic gas that accumulates in spacecraft to much higher levels than earth-normal levels. Controlling concentrations of this gas to acceptable levels to ensure crew health and optimal performance demands major commitment of resources. NASA has many decades of experience monitoring and controlling CO2, yet we are uncertain of the levels at which subtle performance decrements develop. There is limited evidence from ground-based studies that visual disturbances can occur during brief exposures and visual changes have been noted in spaceflight crews. These changes may be due to CO2 alone or in combination with other known spaceflight factors such as increased intracranial pressure due to fluid shifts. Discerning the comparative contribution of each to performance decrements is an urgent issue if we hope to optimize astronaut performance aboard the ISS. Long-term, we must know the appropriate control levels for exploration-class missions to ensure that crewmembers can remain cooperative and productive in a highly stressful environment. Furthermore, we must know the magnitude of interindividual variability in susceptibility to the adverse effects of CO2 so that the most tolerant crewmembers can be identified. Ground-based studies have been conducted for many years to set exposure limits for submariners; however, these studies are typically limited and incompletely reported. Nonetheless, NASA, in cooperation with the National Research Council, has set exposure limits for astronauts using this limited database. These studies do not consider the interactions of spaceflight-induced fluid shifts and CO2 exposures. In an attempt to discern whether CO2 levels affect the incidence of headache and visual disturbances in astronauts we performed a retrospective study comparing average CO2 levels and the prevalence of headache and visual disturbances. Our goal is to narrow gaps in the risk profile for in-flight CO2 exposures. Such studies can

  1. Development, feasibility and performance of a health risk appraisal questionnaire for older persons

    PubMed Central

    Stuck, Andreas E; Kharicha, Kalpa; Dapp, Ulrike; Anders, Jennifer; von Renteln-Kruse, Wolfgang; Meier-Baumgartner, Hans Peter; Harari, Danielle; Swift, Cameron G; Ivanova, Katja; Egger, Matthias; Gillmann, Gerhard; Higa, Jerilyn; Beck, John C; Iliffe, Steve

    2007-01-01

    Background Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E) developed in the U.S. has unique features but has not been tested outside the United States. Methods Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O) instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K.) (N = 1090), Hamburg (Germany) (N = 804), and Solothurn (Switzerland) (N = 748) in a sub-sample of an international randomised controlled study. Results Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation. Conclusion The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided information on

  2. Health Status and Health Risks of the "Hidden Majority" of Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Emerson, Eric

    2011-01-01

    Little is known about the health status of and health risks faced by adults with intellectual disability who do not use intellectual disability services. Self-report data collected from 1,022 people with mild intellectual disability in England indicated that people who do not use intellectual disability services are more likely to smoke tobacco…

  3. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    EPA Science Inventory

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  4. [Urbanization--a factor that increases the risk for health].

    PubMed

    Fridman, K B; Kriukova, T V

    2015-01-01

    The negative impact of urbanization on public health is obvious. However; due to the comprehensiveness and polymorphicity of its manifestations there are not established criteria for them. Health risk methodology allows, in principle, to obtain quantitative indices of the separate results of the impact on the health status of the citizens of metropolis that can be extremely effective in this area. The total cross-media riskfrom traffic pollution, drinking water quality, open ponds, noise, etc. permits to use of hygiene criteria in urban planning, insurance, taxation, etc. PMID:26031033

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

    PubMed

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

    2016-01-01

    The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers). PMID:27311142

  6. Communicating Health Risks under Pressure: Homeland Security Applications

    SciTech Connect

    Garrahan, K.G.; Collie, S.L.

    2006-07-01

    The U.S. Environmental Protection Agency's (EPA) Office of Research and Development (ORD) Threat and Consequence Assessment Division (TCAD) within the National Homeland Security Research Center (NHSRC) has developed a tool for rapid communication of health risks and likelihood of exposure in preparation for terrorist incidents. The Emergency Consequence Assessment Tool (ECAT) is a secure web-based tool designed to make risk assessment and consequence management faster and easier for high priority terrorist threat scenarios. ECAT has been designed to function as 'defensive play-book' for health advisors, first responders, and decision-makers by presenting a series of evaluation templates for priority scenarios that can be modified for site-specific applications. Perhaps most importantly, the risk communication aspect is considered prior to an actual release event, so that management or legal advisors can concur on general risk communication content in preparation for press releases that can be anticipated in case of an actual emergency. ECAT serves as a one-stop source of information for retrieving toxicological properties for agents of concern, estimating exposure to these agents, characterizing health risks, and determining what actions need to be undertaken to mitigate the risks. ECAT has the capability to be used at a command post where inputs can be checked and communicated while the response continues in real time. This front-end planning is intended to fill the gap most commonly identified during tabletop exercises: a need for concise, timely, and informative risk communication to all parties. Training and customization of existing chemical and biological release scenarios with modeling of exposure to air and water, along with custom risk communication 'messages' intended for public, press, shareholders, and other partners enable more effective communication during times of crisis. For DOE, the ECAT could serve as a prototype that would be amenable to

  7. Exploring perceptions of cancer risk, neighborhood environmental risks, and health behaviors of blacks.

    PubMed

    Rice, LaShanta J; Brandt, Heather M; Hardin, James W; Ingram, Lucy Annang; Wilson, Sacoby M

    2015-06-01

    Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100% Black, 81% female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37%) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p < .05) with non-alcohol consumption, having a colon cancer screening test, being female, and being age 25-44 or 45-64. Cancer worry was significantly associated (p < .05) with being a current smoker, having a "fair" diet, non-alcohol consumption, and having any colon cancer screening test. Perceived cancer risk is an important indicator of health behaviors among Blacks. Direct or indirect experiences with cancer and/or the environment and awareness of family history of cancer may explain cancer risk perceptions. PMID:25315713

  8. Can washing-pretreatment eliminate the health risk of municipal solid waste incineration fly ash reuse?

    PubMed

    Wang, Yao; Pan, Yun; Zhang, Lingen; Yue, Yang; Zhou, Jizhi; Xu, Yunfeng; Qian, Guangren

    2015-01-01

    Although the reuse of washing-pretreated MSWI fly ash bas been a hot topic, the associated risk is still an issue of great concern. The present study investigated the influence of washing-pretreatment on the total contents and bioaccessibility of heavy metals in MSWI fly ash. Furthermore, the study incorporated bioaccessibility adjustment into probabilistic risk assessment, to quantify the health risk from multi-pathway exposure to the concerned chemicals as a result of reusing washed MSWI fly ash. The results revealed that both water-washing and acid-washing process have resulted in the concentrated heavy metal content, and have reduced the bioaccessibility of heavy metals. Besides, the acid-washing process increased the cancer risk in most cases, while the effect of water-washing process was uncertain. However, both water-washing and acid-washing pretreatment could decrease the hazard index based on bioaccesilbility. Despite the uncertainties accompanying these procedures, the results indicated that, in this application scenario, only water-washing or acid-washing process cannot reduce the actual risk from all samples to acceptable level, especially for cancer risk. PMID:25450931

  9. Human health risk assessment simulations in a distributed environment for shuttle launch

    NASA Astrophysics Data System (ADS)

    Thirumalainambi, Rajkumar; Bardina, Jorge

    2004-09-01

    During the launch of a rocket under prevailing weather conditions, commanders at Cape Canaveral Air Force station evaluate the possibility of whether wind blown toxic emissions might reach civilian and military personnel in the near by area. In our model, we focused mainly on Hydrogen chloride (HCL), Nitrogen oxides (NOx) and Nitric acid (HNO3), which are non-carcinogenic chemicals as per United States Environmental Protection Agency (USEPA) classification. We have used the hazard quotient model to estimate the number of people at risk. It is based on the number of people with exposure above a reference exposure level that is unlikely to cause adverse health effects. The risk to the exposed population is calculated by multiplying the individual risk and the number in exposed population. The risk values are compared against the acceptable risk values and GO or NO-go situation is decided based on risk values for the Shuttle launch. The entire model is simulated over the web and different scenarios can be generated which allows management to choose an optimum decision.

  10. Health risk assessment of inhabitants exposed to PAHs particulate matter in air.

    PubMed

    Froehner, Sandro; Maceno, Marcell; Machado, Karina Scurupa; Grube, Marianne

    2011-01-01

    The presence of polycyclic aromatic hydrocarbon compounds (PAHs) was investigated in the particulate matter of samples taken at six sampling sites in the city of Curitiba (southern Brazil). The concentrations of suspended particulate matter ranged from 11.02 to 177.27 ng/m(3). The analysis showed that 14 of the 16 PAHs are considered a priority compound by the USEPA (US Environmental Protection Agency). The mixture of PAHs was predominantly composed of PAHs with 3 and 4 aromatic rings. Isomer pair ratios show that the main source of PAHs was from burning fossil fuels (gasoline and diesel oil), although other sources may have contributed also. Benzo(a)pyrene, (BaP), regarded one of the most toxic PAHs, was present in all samples, but with concentrations lower than the maximum concentrations defined by some EU Countries. The risk assessment was conducted using the toxic equivalent factor (TEF) considering the toxicity of the individual PAHs compared to BaP. The BaP(eq) for all samples was between 0.42-1.12 ng/m(3). The equivalent BaP(eq) indicated low health risk associated with exposure to the total PAHs content in air. The incremental lifetime cancer risk (ILCR) model was used to find the risk level for workers close to the emitting pollution sources. Outdoor exposure showed no risk for the amount of PAHs emitted. The acceptable risk is 10(-6); however, all results were lower than this value. PMID:21644163

  11. Human Health Risk Assessment Simulations in a Distributed Environment for Shuttle Launch

    NASA Technical Reports Server (NTRS)

    Thirumalainambi, Rajkumar; Bardina, Jorge

    2004-01-01

    During the launch of a rocket under prevailing weather conditions, commanders at Cape Canaveral Air Force station evaluate the possibility of whether wind blown toxic emissions might reach civilian and military personnel in the near by area. In our model, we focused mainly on Hydrogen chloride (HCL), Nitrogen oxides (NOx) and Nitric acid (HNO3), which are non-carcinogenic chemicals as per United States Environmental Protection Agency (USEPA) classification. We have used the hazard quotient model to estimate the number of people at risk. It is based on the number of people with exposure above a reference exposure level that is unlikely to cause adverse health effects. The risk to the exposed population is calculated by multiplying the individual risk and the number in exposed population. The risk values are compared against the acceptable risk values and GO or NO-go situation is decided based on risk values for the Shuttle launch. The entire model is simulated over the web and different scenaria can be generated which allows management to choose an optimum decision.

  12. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities

    PubMed Central

    Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof

    2016-01-01

    Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077

  13. Associations of muscular fitness with psychological positive health, health complaints, and health risk behaviors in Spanish children and adolescents.

    PubMed

    Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José

    2012-01-01

    We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the Health Behavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents. PMID:22158258

  14. Youth "At Risk"? Young People, Sexual Health and Consent

    ERIC Educational Resources Information Center

    Powell, Anastasia

    2007-01-01

    In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper…

  15. Older Women: A Population at Risk for Mental Health Problems.

    ERIC Educational Resources Information Center

    Wisniewski, Wendy; Cohen, Donna

    The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

  16. A 21st Century Roadmap for Human Health Risk Assessment

    EPA Science Inventory

    For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, t...

  17. Do You Know the Health Risks of Being Overweight?

    MedlinePlus

    ... and conducts clinical studies on prevention and treatment. Kidney Disease What is kidney disease? Your kidneys are two bean-shaped organs that ... problems that can harm your health. How is kidney disease linked to overweight? Obesity increases the risk of ...

  18. Contextual Stress and Health Risk Behaviors among African American Adolescents

    ERIC Educational Resources Information Center

    Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.

    2011-01-01

    This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…

  19. Environmental Epigenetics: Potential Application in Human Health Risk Assessment

    EPA Science Inventory

    Although previous studies have shown a significant involvement of epigenetic dysregulation in human diseases, the applicability of epigenetic data in the current human health risk assessment paradigm is unclear. The goals of this study are to compare the relative sensitivities of...

  20. Health and Risk Behaviors of Massachusetts Youth, 2007: The Report

    ERIC Educational Resources Information Center

    Massachusetts Department of Elementary and Secondary Education, 2008

    2008-01-01

    This paper presents the results of two coordinated surveys of Massachusetts adolescents, the 2007 Massachusetts Youth Risk Behavior Survey (ESE) and the Massachusetts Youth Health Survey (DPH). These two surveys were supported by funding from the Centers for Disease Control and Prevention (CDC) and administered in a random selection of 124 public…

  1. Effects of suicide bereavement on mental health and suicide risk.

    PubMed

    Pitman, Alexandra; Osborn, David; King, Michael; Erlangsen, Annette

    2014-06-01

    Between 48 million and 500 million people are thought to experience suicide bereavement every year. Over the past decade, increased policy attention has been directed towards suicide bereavement, but with little evidence to describe the effect of exposure or to provide appropriate responses. We used a systematic approach to carry out a narrative review of studies of the effect of suicide bereavement on mortality, mental health, and social functioning, and compared them with effects from other bereavements. We found 57 studies that satisfied strict inclusion criteria. Results from these studies suggested that exposure to suicide of a close contact is associated with several negative health and social outcomes, depending on an individual's relationship to the deceased. These effects included an increased risk of suicide in partners bereaved by suicide, increased risk of required admission to psychiatric care for parents bereaved by the suicide of an offspring, increased risk of suicide in mothers bereaved by an adult child's suicide, and increased risk of depression in offspring bereaved by the suicide of a parent. Some evidence was shown for increased rejection and shame in people bereaved by suicide across a range of kinship groups when data were compared with reports of relatives bereaved by other violent deaths. Policy recommendations for support services after suicide bereavement heavily rely on the voluntary sector with little input from psychiatric services to address described risks. Policymakers should consider how to strengthen health and social care resources for people who have been bereaved by suicide to prevent avoidable mortality and distress. PMID:26360405

  2. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    NASA Astrophysics Data System (ADS)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  3. Heavy metal pollution and health risk assessment in the Wei River in China.

    PubMed

    Yang, Xuefu; Duan, Jinming; Wang, Lei; Li, Wei; Guan, Jianling; Beecham, Simon; Mulcahy, Dennis

    2015-03-01

    From data collected monthly at 26 monitoring cross sections in the Wei River in the Shaanxi Region of China during the period 2008-2012, the temporal pollution characteristics of heavy metals (Hg, Cd, Cr(VI), Pb, and As) were analyzed based on a heavy metal pollution index (HPI). The monthly HPI values of the five heavy metals in the river fluctuated greatly in 2008 and then declined gradually with time. This general trend of reduction in HPI appears not to have a seasonal variation and most likely resulted from the continued improvement in heavy metal pollution control strategies implemented by local environmental agencies combined with a significant improvement in wastewater treatment capacities. Among the five heavy metals, Cd and Pb were below 0.1 and 3 μg L(-1), respectively, at all the sampling points in the studied areas in the year 2012. The detection rates of As, Hg, and Cr(VI) were in the order of Hg > Cr(VI) > As. Hg, Cr(VI), and As exceeded, in a month of the dry season in 2012, the standard limits for category III surface waters according to the China Environment Quality Standards for Surface Water (CEQSSW). Based on the assessment using the HPI method, the pollution status of these heavy metals in water of the Wei River in the Shaanxi Region was generally at an acceptable level, but exhibited distinctive characteristics between the main stream river and tributaries. Most of the tributaries were more seriously polluted than the main river. A health risk assessment was conducted based on the Human Health Risk Assessment (HHRA) method recommended by the United States Environmental Protection Agency (USEPA). Apart from As, the health risk for the five heavy metals in the region were at acceptable levels for drinking water sources (hazard quotient (HQ) < 1, carcinogenic risk (CR) ranged from 10(-4)-10(-6)) according to the Risk Assessment Guidance for Superfund (RAGS), USEPA. Arsenic was identified as the most important pollutant of concern

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

    PubMed

    Cogliano, Vincent James

    2016-02-01

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

  5. Health Risk Assessment of Heavy Metals in Soils from Witwatersrand Gold Mining Basin, South Africa

    PubMed Central

    Kamunda, Caspah; Mathuthu, Manny; Madhuku, Morgan

    2016-01-01

    The study evaluates the health risk caused by heavy metals to the inhabitants of a gold mining area. In this study, 56 soil samples from five mine tailings and 17 from two mine villages were collected and analyzed for Asernic (As), Lead (Pb), Mercury (Hg), Cadmium (Cd), Chromium (Cr), Cobalt (Co), Nickel (Ni), Copper (Cu) and Zinc (Zn) using ICP-MS. Measured concentrations of these heavy metals were then used to calculate the health risk for adults and children. Their concentrations were such that Cr > Ni > As > Zn > Cu > Co > Pb > Hg > Cd, with As, Cr and Ni higher than permissible levels. For the adult population, the Hazard Index value for all pathways was found to be 2.13, making non-carcinogenic effects significant to the adult population. For children, the Hazard Index value was 43.80, a value >>1, which poses serious non-carcinogenic effect to children living in the gold mining area. The carcinogenic risk was found to be 1.7 × 10−4 implying that 1 person in every 5882 adults may be affected. In addition, for children, in every 2725 individuals, 1 child may be affected (3.67 × 10−4). These carcinogenic risk values were both higher than acceptable values. PMID:27376316

  6. The arsenic content in marketed seafood and associated health risks for the residents of Shandong, China.

    PubMed

    Wu, Xing; Gao, Mi; Wang, Lei; Luo, Yongju; Bi, Ran; Li, Lixia; Xie, Lingtian

    2014-04-01

    Seafood is considered as the main source of arsenic in the human diet. In this study, we quantified the total arsenic content in 200 samples of 22 species collected from eight cities in Shandong, China. Subsequently, we evaluated the health risks associated with seafood consumption for three consumption scenarios based on the quantification of inorganic arsenic in three commonly consumed seafood species. The bivalves had the highest total arsenic concentrations in three categories of seafood (fish, shrimp, and bivalves) and the mean total arsenic concentrations ranged from 0.037 μg/g ww in fish to 3.4 μg/g in bivalves. The results suggested that organisms which had a closer relationship with sediments may accumulate more arsenic. Bivalves were the major contributor for the arsenic intakes in the seafood consumers. The margins of exposure (MOEs) estimated in the present work showed that there existed a health risk for the consumers. The carcinogen risks exceeded the acceptable range for life cancer risk. Our results suggested that more attention should be paid to the safety of seafood consumption, especially of benthic economic species and for special consumers. PMID:24530733

  7. Health Risk Assessment of Heavy Metals in Soils from Witwatersrand Gold Mining Basin, South Africa.

    PubMed

    Kamunda, Caspah; Mathuthu, Manny; Madhuku, Morgan

    2016-01-01

    The study evaluates the health risk caused by heavy metals to the inhabitants of a gold mining area. In this study, 56 soil samples from five mine tailings and 17 from two mine villages were collected and analyzed for Asernic (As), Lead (Pb), Mercury (Hg), Cadmium (Cd), Chromium (Cr), Cobalt (Co), Nickel (Ni), Copper (Cu) and Zinc (Zn) using ICP-MS. Measured concentrations of these heavy metals were then used to calculate the health risk for adults and children. Their concentrations were such that Cr > Ni > As > Zn > Cu > Co > Pb > Hg > Cd, with As, Cr and Ni higher than permissible levels. For the adult population, the Hazard Index value for all pathways was found to be 2.13, making non-carcinogenic effects significant to the adult population. For children, the Hazard Index value was 43.80, a value >1, which poses serious non-carcinogenic effect to children living in the gold mining area. The carcinogenic risk was found to be 1.7 × 10(-4) implying that 1 person in every 5882 adults may be affected. In addition, for children, in every 2725 individuals, 1 child may be affected (3.67 × 10(-4)). These carcinogenic risk values were both higher than acceptable values. PMID:27376316

  8. Toward a national health risk management approach in Australia.

    PubMed

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required. PMID:11905388

  9. Critical appraisal of the efficacy, safety, and patient acceptability of hydroxyprogesterone caproate injection to reduce the risk of preterm birth

    PubMed Central

    Vidaeff, Alex C; Belfort, Michael A

    2013-01-01

    Prevention of preterm delivery is a major desiderate in contemporary obstetrics and a societal necessity. The means to achieve this goal remain elusive. Progesterone has been used in an attempt to prevent preterm delivery since the 1970s, but the evidence initially accumulated was fraught by mixed results and was based on mostly underpowered studies with variable eligibility criteria, including history of spontaneous abortion as an indication for treatment. More recent randomized controlled clinical trials restimulated the interest in progesterone supplementation, suggesting that progesterone may favorably influence the rate of preterm delivery. Preterm delivery is a complex disorder and consequently it is unlikely that one generalized prevention strategy will be effective in all patients. Further, an additional impediment in accepting progesterone as the “magic bullet” in the prevention of preterm delivery is that its mechanism of action is not fully understood and the optimal formulations, route of administration, and dose have yet to be established. We have concerned ourselves in this review with the most recent status of 17 alpha-hydroxyprogesterone caproate (17OH-PC) supplementation for prevention of preterm delivery. Our intention is to emphasize the efficacy, safety, and patient acceptability of this intervention, based on a comprehensive and unbiased review of the available literature. Currently there are insufficient data to suggest that 17OH-PC is superior or inferior to natural progesterone. Based on available evidence, we suggest a differential approach giving preferential consideration to either 17OH-PC or other progestins based on obstetric history and cervical surveillance. Progestin therapy for risk factors other than a history of preterm birth and/or a short cervix in the current pregnancy is not currently supported by the published evidence. The experience to date with 17OH-PC indicates that there are population subgroups that may be harmed by

  10. Eating disorders "mental health literacy" in low risk, high risk and symptomatic women: implications for health promotion programs.

    PubMed

    Mond, Jonathan M; Hay, Phillipa J; Paxton, Susan J; Rodgers, Bryan; Darby, Anita; Nillson, Jodi; Quirk, Frances; Owen, Cathy

    2010-01-01

    Attitudes and beliefs concerning the nature and treatment of bulimia nervosa (BN) were compared among young adult women at low risk of an eating disorder (n = 332), at high risk (n = 83), or already showing symptoms (n = 94). Participants completed a self-report questionnaire that included a measure of eating disorder symptoms. A vignette of a fictional person suffering from BN was presented, followed by a series of questions addressing the nature and treatment of the problem described. High-risk and symptomatic participants were more likely than low-risk participants to report that they would not approach anyone for advice or help, were they to have BN or a similar problem, because they would not want anyone to know. Symptomatic participants were more likely to believe that someone with BN would be discriminated against, more likely to consider bulimic behaviors to be acceptable, and more likely to view BN as being common among women in the community, than low-risk participants, participants in the high-risk group being intermediate on each of these questions. The findings suggest that the attitudes and beliefs of individuals with eating disorder symptoms differ systematically from those of individuals at high risk, but who do not yet have symptoms, and from those at low risk. They also indicate specific attitudes and beliefs that may need to be addressed in prevention and early intervention programs. The potential benefits of assessing individuals' attitudes and beliefs concerning the nature and treatment of eating-disordered behaviour and tailoring program content accordingly may be worthy of investigation. PMID:20603729

  11. Options for management of municipal solid waste in New York City: A preliminary comparison of health risks and policy implications

    PubMed Central

    Moy, Pearl; Krishnan, Nikhil; Ulloa, Priscilla; Cohen, Steven; Brandt-Rauf, Paul W.

    2008-01-01

    Landfill disposal and waste-to-energy (WTE) incineration remain the two principal options for managing municipal solid waste (MSW). One critical determinant of the acceptability of these options is the different health risks associated with each. In this analysis relying on published data and exposure modeling, we have performed health risk assessments for landfill disposal versus WTE treatment options for the management of New York City’s MSW. These are based on the realistic scenario of using a waste transfer station (WTS) in Brooklyn and then transporting the untreated MSW by truck to a landfill in Pennsylvania or using a WTE facility in Brooklyn and then transporting the resultant ash by truck to a landfill in Pennsylvania. The overall results indicate that the individual cancer risks for both options would be considered generally acceptable, although the risk from landfilling is approximately 5 times greater than from WTE treatment; the individual non-cancer health risks for both options would be considered generally unacceptable, although once again the risk from landfilling is approximately 5 times greater than from WTE treatment. If one considers only the population in Brooklyn that would be directly affected by the siting of either a WTS or a WTE facility in their immediate neighborhood, individual cancer and non-cancer health risks for both options would be considered generally acceptable, but risks for the former remain considerably higher than for the latter. These results should be considered preliminary due to several limitations of this study such as: consideration of risks only from inhalation exposures; assumption that only volume and not composition of the waste stream is altered by WTE treatment; reliance on data from the literature rather than actual measurements of the sites considered, assuming comparability of the sites. However, the results of studies such as this, in conjunction with ecological, socioeconomic and equity considerations

  12. Using exposomics to assess cumulative risks and promote health.

    PubMed

    Smith, Martyn T; de la Rosa, Rosemarie; Daniels, Sarah I

    2015-12-01

    Under the exposome paradigm all nongenetic factors contributing to disease are considered to be 'environmental' including chemicals, drugs, infectious agents, and psychosocial stress. We can consider these collectively as environmental stressors. Exposomics is the comprehensive analysis of exposure to all environmental stressors and should yield a more thorough understanding of chronic disease development. We can operationalize exposomics by studying all the small molecules in the body and their influence on biological pathways that lead to impaired health. Here, we describe methods by which this may be achieved and discuss the application of exposomics to cumulative risk assessment in vulnerable populations. Since the goal of cumulative risk assessment is to analyze, characterize, and quantify the combined risks to health from exposures to multiple agents or stressors, it seems that exposomics is perfectly poised to advance this important area of environmental health science. We should therefore support development of tools for exposomic analysis and begin to engage impacted communities in participatory exposome research. A first step may be to apply exposomics to vulnerable populations already studied by more conventional cumulative risk approaches. We further propose that recent migrants, low socioeconomic groups with high environmental chemical exposures, and pregnant women should be high priority populations for study by exposomics. Moreover, exposomics allows us to study interactions between chronic stress and environmental chemicals that disrupt stress response pathways (i.e., 'stressogens'). Exploring the impact of early life exposures and maternal stress may be an interesting and accessible topic for investigation by exposomics using biobanked samples. PMID:26475350

  13. Key Scientific Issues in the Health Risk Assessment of Trichloroethylene

    PubMed Central

    Chiu, Weihsueh A.; Caldwell, Jane C.; Keshava, Nagalakshmi; Scott, Cheryl Siegel

    2006-01-01

    Trichloroethylene (TCE) is a common environmental contaminant at hazardous waste sites and in ambient and indoor air. Assessing the human health risks of TCE is challenging because of its inherently complex metabolism and toxicity and the widely varying perspectives on a number of critical scientific issues. Because of this complexity, the U.S. Environmental Protection Agency (EPA) drew upon scientific input and expertise from a wide range of groups and individuals in developing its 2001 draft health risk assessment of TCE. This scientific outreach, which was aimed at engaging a diversity of perspectives rather than developing consensus, culminated in 2000 with 16 state-of-the-science articles published together as an Environmental Health Perspectives supplement. Since that time, a substantial amount of new scientific research has been published that is relevant to assessing TCE health risks. Moreover, a number of difficult or controversial scientific issues remain unresolved and are the subject of a scientific consultation with the National Academy of Sciences coordinated by the White House Office of Science and Technology Policy and co-sponsored by a number of federal agencies, including the U.S. EPA. The articles included in this mini-monograph provide a scientific update on the most prominent of these issues: the pharmacokinetics of TCE and its metabolites, mode(s) of action and effects of TCE metabolites, the role of peroxisome proliferator–activated receptor in TCE toxicity, and TCE cancer epidemiology. PMID:16966103

  14. Acceptance speech.

    PubMed

    Carpenter, M

    1994-01-01

    In Bangladesh, the assistant administrator of USAID gave an acceptance speech at an awards ceremony on the occasion of the 25th anniversary of oral rehydration solution (ORS). The ceremony celebrated the key role of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) in the discovery of ORS. Its research activities over the last 25 years have brought ORS to every village in the world, preventing more than a million deaths each year. ORS is the most important medical advance of the 20th century. It is affordable and client-oriented, a true appropriate technology. USAID has provided more than US$ 40 million to ICDDR,B for diarrheal disease and measles research, urban and rural applied family planning and maternal and child health research, and vaccine development. ICDDR,B began as the relatively small Cholera Research Laboratory and has grown into an acclaimed international center for health, family planning, and population research. It leads the world in diarrheal disease research. ICDDR,B is the leading center for applied health research in South Asia. It trains public health specialists from around the world. The government of Bangladesh and the international donor community have actively joined in support of ICDDR,B. The government applies the results of ICDDR,B research to its programs to improve the health and well-being of Bangladeshis. ICDDR,B now also studies acute respiratory diseases and measles. Population and health comprise 1 of USAID's 4 strategic priorities, the others being economic growth, environment, and democracy, USAID promotes people's participation in these 4 areas and in the design and implementation of development projects. USAID is committed to the use and improvement of ORS and to complementary strategies that further reduce diarrhea-related deaths. Continued collaboration with a strong user perspective and integrated services will lead to sustainable development. PMID:12345470

  15. Building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraception

    PubMed Central

    Chin-Quee, Dawn; Bratt, John; Malkin, Morrisa; Nduna, Mavis Mwale; Otterness, Conrad; Jumbe, Lydia; Mbewe, Reuben Kamoto

    2013-01-01

    ABSTRACT Background: A critical shortage of doctors, nurses, and midwives in many sub-Saharan African countries inhibits efforts to expand access to family planning services, especially in rural areas. One way to fill this gap is for community health workers (CHWs) to provide injectable contraceptives, an intervention for which there is growing evidence and international support. In 2009, with approval from the Government of Zambia (GoZ), FHI 360 collaborated with ChildFund Zambia to design and implement such an intervention as part of its existing CHW family planning program. Methods: The safety of CHW provision of injectable DMPA (depot medroxyprogesterone acetate) was measured by client reports and by a 21-item structured observation checklist. Feasibility and acceptability were measured by interviews with CHWs and a subset of DMPA clients. The impact of adding DMPA to pill and condom provision was assessed by family planning uptake among the clients of trained CHWs from February 2010 to February 2011. Costs were documented using spreadsheets over the period November 2009 to February 2011. Results: Scores were high on all measures of safety, feasibility, and acceptability. Couple-years of protection (CYP, protection from pregnancy for 1 year) was provided to 51 condom clients, 391 pill clients, and 2,206 DMPA clients. Of the 1,739 clients new to family planning, 85% chose injectable DMPA, while 13% chose pills and 2% chose condoms. Continuation rates were also high, at 63% after 1 year as compared with 47% for pill users. Incremental costs per couple-year were US$21.24 if 50% of users continue with CHW-provided DMPA. Conclusion: The study affirms that the provision of injectable contraceptives by CHWs is safe, acceptable, and feasible in the Zambian context, with very high rates of uptake in hard-to-reach areas. High continuation rates among clients mean that costs of the intervention can be low when added to an existing community-based distribution program

  16. Approaches to characterizing human health risks of exposure to fibers.

    PubMed Central

    Vu, V T; Lai, D Y

    1997-01-01

    Naturally occurring and man-made (synthetic) fibers of respirable sizes are substances that have been identified by the U.S. Environmental Protection Agency (U.S. EPA) as priority substances for risk reduction and pollution prevention under the Toxic Substances Control Act (TSCA). The health concern for respirable fibers is based on the link of occupational asbestos exposure and environmental erionite fiber exposure to the development of chronic respiratory diseases, including interstitial lung fibrosis, lung cancer, and mesothelioma in humans. There is also considerable laboratory evidence indicating that a variety of fibers of varying physical and chemical characteristics can elicit fibrogenic and carcinogenic effects in animals under certain exposure conditions. This paper discusses key scientific issues and major default assumptions and uncertainties pertaining to the risk assessment of inhaled fibers. This is followed by a description of the types of assessment performed by the U.S. EPA to support risk management actions of new fibers and existing fibers under TSCA. The scope and depth of these risk assessments, however, vary greatly depending on whether the substance under review is an existing or a new fiber, the purpose of the assessment, the availability of data, time, and resources, and the intended nature of regulatory action. In general, these risk assessments are of considerable uncertainty because health hazard and human exposure information is often incomplete for most fibers. Furthermore, how fibers cause diseases and what specific determinants are critical to fiber-induced toxicity and carcinogenicity are still not completely understood. Further research to improve our knowledge base in fiber toxicology and additional toxicity and exposure data gathering are needed to more accurately characterize the health risks of inhaled fibers. PMID:9400747

  17. Improvement in Cardiovascular Risk Prediction with Electronic Health Records.

    PubMed

    Pike, Mindy M; Decker, Paul A; Larson, Nicholas B; St Sauver, Jennifer L; Takahashi, Paul Y; Roger, Véronique L; Rocca, Walter A; Miller, Virginia M; Olson, Janet E; Pathak, Jyotishman; Bielinski, Suzette J

    2016-06-01

    The aim of this study was to compare the QRISKII, an electronic health data-based risk score, to the Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) score. Risk estimates were calculated for a cohort of 8783 patients, and the patients were followed up from November 29, 2012, through June 1, 2015, for a cardiovascular disease (CVD) event. During follow-up, 246 men and 247 women had a CVD event. Cohen's kappa statistic for the comparison of the QRISKII and FRS was 0.22 for men and 0.23 for women, with the QRISKII classifying more patients in the higher-risk groups. The QRISKII and ASCVD were more similar with kappa statistics of 0.49 for men and 0.51 for women. The QRISKII shows increased discrimination with area under the curve (AUC) statistics of 0.65 and 0.71, respectively, compared to the FRS (0.59 and 0.66) and ASCVD (0.63 and 0.69). These results demonstrate that incorporating additional data from the electronic health record (EHR) may improve CVD risk stratification. PMID:26960568

  18. The accuracy of substitution rules for health risk appraisals.

    PubMed

    Berlin, J A; Thorington, B D; McKinlay, J B; McKinlay, S M

    1990-01-01

    Abstract Health Risk Appraisals (HRAs) have been in increasingly wide use over the past 20 years as health education tools designed to encourage healthy behaviors. A major criticism of HRAs has been the error introduced by missing or incorrectly-specified responses by clients, especially regarding physiological measures such as blood pressure and cholesterol. Four HRAs were randomly assigned to members of a random sample of Massachusetts residents as part of a trial to assess the reliability and validity of HRA instruments. Two rules for substituting unknown physiological measures were evaluated: the existing rule for an HRA and a new rule, which simply substitutes the age- and gender-specific mean physiological values. Ordinary least squares regression was used to compare risk scores generated from known physiological measures, taken in respondents' homes, with risk scores generated by substitution. Regression slopes were mostly close to 1.0, most intercepts were relatively close to 0.0, and correlations were all extremely high, suggesting good performance of substitution rules on a group level. However, outliers from the regressions tended to be individuals at high risk whose risk was underestimated by the substitution rules. These results raise ethical questions about the use of substitution rules and reinforce the need for taking actual physiological measurements. PMID:22204466

  19. A Risk-based Model Predictive Control Approach to Adaptive Interventions in Behavioral Health.

    PubMed

    Zafra-Cabeza, Ascensión; Rivera, Daniel E; Collins, Linda M; Ridao, Miguel A; Camacho, Eduardo F

    2011-07-01

    This paper examines how control engineering and risk management techniques can be applied in the field of behavioral health through their use in the design and implementation of adaptive behavioral interventions. Adaptive interventions are gaining increasing acceptance as a means to improve prevention and treatment of chronic, relapsing disorders, such as abuse of alcohol, tobacco, and other drugs, mental illness, and obesity. A risk-based Model Predictive Control (MPC) algorithm is developed for a hypothetical intervention inspired by Fast Track, a real-life program whose long-term goal is the prevention of conduct disorders in at-risk children. The MPC-based algorithm decides on the appropriate frequency of counselor home visits, mentoring sessions, and the availability of after-school recreation activities by relying on a model that includes identifiable risks, their costs, and the cost/benefit assessment of mitigating actions. MPC is particularly suited for the problem because of its constraint-handling capabilities, and its ability to scale to interventions involving multiple tailoring variables. By systematically accounting for risks and adapting treatment components over time, an MPC approach as described in this paper can increase intervention effectiveness and adherence while reducing waste, resulting in advantages over conventional fixed treatment. A series of simulations are conducted under varying conditions to demonstrate the effectiveness of the algorithm. PMID:21643450

  20. Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China.

    PubMed

    Cao, Suzhen; Duan, Xiaoli; Zhao, Xiuge; Chen, Yiting; Wang, Beibei; Sun, Chengye; Zheng, Binghui; Wei, Fusheng

    2016-03-01

    Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area. PMID:26774306

  1. Health Risk Assessment for Cyanobacterial Toxins in Seafood

    PubMed Central

    Mulvenna, Vanora; Dale, Katie; Priestly, Brian; Mueller, Utz; Humpage, Andrew; Shaw, Glen; Allinson, Graeme; Falconer, Ian

    2012-01-01

    Cyanobacteria (blue-green algae) are abundant in fresh, brackish and marine waters worldwide. When toxins produced by cyanobacteria are present in the aquatic environment, seafood harvested from these waters may present a health hazard to consumers. Toxicity hazards from seafood have been internationally recognised when the source is from marine algae (dinoflagellates and diatoms), but to date few risk assessments for cyanobacterial toxins in seafood have been presented. This paper estimates risk from seafood contaminated by cyanobacterial toxins, and provides guidelines for safe human consumption. PMID:22690165

  2. Human health risk characterization of petroleum coke calcining facility emissions.

    PubMed

    Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D

    2015-12-01

    Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 μg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk. PMID:26520182

  3. A pilot study of immigration status, homosexual self-acceptance, social support, and HIV reduction in high risk Asian and Pacific Islander men.

    PubMed

    Lloyd, L S; Faust, M; Roque, J S; Loue, S

    1999-04-01

    This article reports the results of a cross-sectional study that was conducted to describe the sexual behavior and HIV risk reduction behaviors of homosexual and bisexual Asian and Pacific Islander men and to relate immigration status, self-acceptance as a homosexual, and levels of social support to the adoption of safe sexual behaviors in this population. Thirty-one gay and bisexual Asian and Pacific Islander men in San Diego County, California, participated. Generally high levels of knowledge about HIV and transmission risks as well as self-acceptance and social support were found. While most (84%) reported some attempts to increase condom use in the previous 6 months, 42% reported engaging in unprotected intercourse during that same time period. An inverse relationship between self-acceptance and utilization of risk reduction strategies was found. No association was found between immigration status or self-reported HIV status and level of HIV knowledge, level of HIV risk behavior, or level of HIV risk reduction efforts. The findings are discussed within the context of other social network studies and HIV prevention programs for gay and bisexual Asian and Pacific Islander men. PMID:16228708

  4. Rejection and Acceptance across Contexts: Parents and Peers as Risks and Buffers for Early Adolescent Psychopathology. The TRAILS Study

    ERIC Educational Resources Information Center

    Sentse, Miranda; Lindenberg, Siegwart; Omvlee, Annelies; Ormel, Johan; Veenstra, Rene

    2010-01-01

    In a large sample of early adolescents (T2: n = 1023; M age = 13.51; 55.5% girls) it was investigated whether the effects of parental and peer acceptance and rejection on psychopathology (externalizing and internalizing problems) remain when taking into account both contexts simultaneously. Moreover, we examined whether acceptance in one context…

  5. Feasibility and Acceptability of Global Positioning System (GPS) Methods to Study the Spatial Contexts of Substance Use and Sexual Risk Behaviors among Young Men Who Have Sex with Men in New York City: A P18 Cohort Sub-Study

    PubMed Central

    Duncan, Dustin T.; Kapadia, Farzana; Regan, Seann D.; Goedel, William C.; Levy, Michael D.; Barton, Staci C.; Friedman, Samuel R.; Halkitis, Perry N.

    2016-01-01

    Background No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population. Methods Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre- and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre- and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics. Results Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days. Conclusions Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors. PMID:26918766

  6. Psychometric Properties and Validity of a Multi-dimensional Risk Perception Scale Developed in the Context of a Microbicide Acceptability Study.

    PubMed

    Vargas, Sara E; Fava, Joseph L; Severy, Lawrence; Rosen, Rochelle K; Salomon, Liz; Shulman, Lawrence; Guthrie, Kate Morrow

    2016-02-01

    Currently available risk perception scales tend to focus on risk behaviors and overall risk (vs partner-specific risk). While these types of assessments may be useful in clinical contexts, they may be inadequate for understanding the relationship between sexual risk and motivations to engage in safer sex or one's willingness to use prevention products during a specific sexual encounter. We present the psychometric evaluation and validation of a scale that includes both general and specific dimensions of sexual risk perception. A one-time, audio computer-assisted self-interview was administered to 531 women aged 18-55 years. Items assessing sexual risk perceptions, both in general and in regards to a specific partner, were examined in the context of a larger study of willingness to use HIV/STD prevention products and preferences for specific product characteristics. Exploratory and confirmatory factor analyses yielded two subscales: general perceived risk and partner-specific perceived risk. Validity analyses demonstrated that the two subscales were related to many sociodemographic and relationship factors. We suggest that this risk perception scale may be useful in research settings where the outcomes of interest are related to motivations to use HIV and STD prevention products and/or product acceptability. Further, we provide specific guidance on how this risk perception scale might be utilized to understand such motivations with one or more specific partners. PMID:26621151

  7. Synthetic-fuel plants: potential tumor risks to public health.

    PubMed

    Moskowitz, P D; Morris, S C; Fischer, H; Thode, H C; Hamilton, L D

    1985-09-01

    This article quantifies potential public health risks from tumor-producing pollutants emitted from two synthetic-fuel plants (direct liquefaction--Exxon Donor Solvent: and indirect liquefaction--Lurgi Fischer-Tropsch) located at a representative site in the eastern United States. In these analyses gaseous and aqueous waste streams were characterized; exposures via inhalation, terrestrial and aquatic food chains, and drinking water supplies were modeled. Analysis suggested that emissions of "polycyclic aromatic hydrocarbons," "aromatic amines," "neutral N, O, S heterocyclics," "nitriles," and "other trace elements" pose the largest quantifiable risks to public health. Data and analysis for these pollutant categories should be refined to more accurately match compound-specific estimated exposure levels with tumorigenic potency estimates. Before these results are used for regulatory purposes, more detailed analysis for selected pollutant classes are needed, and more sophisticated aquatic exposure models must be developed. Also, differences in geographic scales among the environmental transport models used need to be rectified. PMID:3843682

  8. Assessment of regional human health risks from lead contamination in Yunnan province, southwestern China.

    PubMed

    Lu, Lu; Cheng, Hongguang; Liu, Xuelian; Xie, Jing; Li, Qian; Zhou, Tan

    2015-01-01

    Identification and management the 'critical risk areas' where hotspot lead exposures are a potential risk to human health, become a major focus of public health efforts in China. But the knowledge of health risk assessment of lead pollution at regional and national scales is still limited in China. In this paper, under the guidance of 'sources-pathways-receptors' framework, regional human health risk assessment model for lead contamination was developed to calculate the population health risk in Yunnan province. And the cluster and AHP (analytic hierarchy process) analysis was taken to classify and calculate regional health risk and the decomposition of the regional health risk in the greatest health risk region, respectively. The results showed that Yunnan province can be divided into three areas. The highest health risk levels, located in northeastern Yunnan, including Kunming, Qujing, Zhaotong region. In those regions, lead is present at high levels in air, food, water and soil, and high population density which pose a high potential population risk to the public. The current study also reveals that most regional health risk was derived from the child receptors (age above 3 years) 4.3 times than the child receptors (age under 3 years), and ingestion of lead-contaminated rice was found to be the most significant contributor to the health risk (accounting for more than 49% health risk of total). This study can provide a framework for regional risk assessment in China and highlighted some indicators and uncertainties. PMID:25893826

  9. Assessment of Regional Human Health Risks from Lead Contamination in Yunnan Province, Southwestern China

    PubMed Central

    Lu, Lu; Cheng, Hongguang; Liu, Xuelian; Xie, Jing; Li, Qian; Zhou, Tan

    2015-01-01

    Identification and management the 'critical risk areas' where hotspot lead exposures are a potential risk to human health, become a major focus of public health efforts in China. But the knowledge of health risk assessment of lead pollution at regional and national scales is still limited in China. In this paper, under the guidance of 'sources-pathways-receptors' framework, regional human health risk assessment model for lead contamination was developed to calculate the population health risk in Yunnan province. And the cluster and AHP (analytic hierarchy process) analysis was taken to classify and calculate regional health risk and the decomposition of the regional health risk in the greatest health risk region, respectively. The results showed that Yunnan province can be divided into three areas. The highest health risk levels, located in northeastern Yunnan, including Kunming, Qujing, Zhaotong region. In those regions, lead is present at high levels in air, food, water and soil, and high population density which pose a high potential population risk to the public. The current study also reveals that most regional health risk was derived from the child receptors (age above 3 years) 4.3 times than the child receptors (age under 3years), and ingestion of lead-contaminated rice was found to be the most significant contributor to the health risk (accounting for more than 49 % health risk of total). This study can provide a framework for regional risk assessment in China and highlighted some indicators and uncertainties. PMID:25893826

  10. Health benefits and possible risks of broccoli - an overview.

    PubMed

    Latté, Klaus Peter; Appel, Klaus-Erich; Lampen, Alfonso

    2011-12-01

    Chemopreventive effects of broccoli, a highly valued vegetable, have been known for a long time. Several studies have demonstrated that broccoli might be beneficial by reducing the risk for the development of certain forms of cancer. These effects are generally attributed to glucosinolate-derived degradation products like isothiocyanates and indoles which are formed by the hydrolytic action of plant myrosinase and/or glucosidases deriving from the human microbial flora. However, recent in vitro and experimental animal studies indicate that broccoli, its extracts and the glucosinolate-derived degradation products might also have undesirable effects, especially genotoxic activities. However, the relevance of the genotoxic activities to human health is not known yet. This paper gives an overview on genotoxic, anti-genotoxic/chemopreventive, nutritive and antinutritive properties of broccoli, its ingredients and their degradation products. A qualitative comparison of the benefit and risk of broccoli consumption benefit-risk assessment shows that the benefit from intake in modest quantities and in processed form outweighs potential risks. For other preparations (fortified broccoli-based dietary supplements, diets with extraordinary high daily intake, consumption as a raw vegetable) further studies both for potential risks and beneficial effects are needed in order to assess the benefit and risk in the future. PMID:21906651

  11. Advancing the Next Generation of Health Risk Assessment

    PubMed Central

    Anastas, Paul T.; Birnbaum, Linda S.; Clark, Rebecca M.; Dix, David J.; Edwards, Stephen W.; Preuss, Peter W.

    2012-01-01

    Background: Over the past 20 years, knowledge of the genome and its function has increased dramatically, but risk assessment methodologies using such knowledge have not advanced accordingly. Objective: This commentary describes a collaborative effort among several federal and state agencies to advance the next generation of risk assessment. The objective of the NexGen program is to begin to incorporate recent progress in molecular and systems biology into risk assessment practice. The ultimate success of this program will be based on the incorporation of new practices that facilitate faster, cheaper, and/or more accurate assessments of public health risks. Methods: We are developing prototype risk assessments that compare the results of traditional, data-rich risk assessments with insights gained from new types of molecular and systems biology data. In this manner, new approaches can be validated, traditional approaches improved, and the value of different types of new scientific information better understood. Discussion and Conclusions: We anticipate that these new approaches will have a variety of applications, such as assessment of new and existing chemicals in commerce and the design of chemical products and processes that reduce or eliminate the use or generation of hazardous substances. Additionally, results of the effort are likely to spur further research and test methods development. Full implementation of new approaches is likely to take 10–20 years. PMID:22875311

  12. Health Risk Assessment of Groundwater Arsenic Pollution in Southern Taiwan

    NASA Astrophysics Data System (ADS)

    Liang, Ching-Ping

    2015-04-01

    This study investigates the risk of arsenic (As) exposure to the residents in Pingtung Plain of Taiwan, where more than 50% of people extracts groundwater to meet the drinking purpose and monitoring groundwater shows that a considerable portion of groundwater has an As concentration of more than safe drinking water guideline of 10μg/L-1. Exposure and risk assessment are carried out in accordance with the provisional daily intake (PTDI) recommended by the FAO/WHO as well as hazard quotient and cancer risk standards based on the US Environmental Protection Agency. The variability of body weights and drinking water consumption scenarios are considered in exposure and risk assessment. Results shows that daily intake exceeds 2.1μg day-1 kg-1 BW for 2% of population, HQ level above unity for 20% , and can risk greater than 10-6 for 80%. These results implies that drinking water directly from groundwater will place many people at the risk of exposure and any efforts to supply safe drinking water is imperial for governing in order to protect the human health of inhabitants in Pingtung Plain.

  13. Global health risks and cosmopolitisation: from emergence to interference.

    PubMed

    Figuié, Muriel

    2013-02-01

    According to Beck's 'World at Risk' theory, global risks push nations towards a cosmopolitisation of their health policy and open opportunities for a democratic turn. This article provides an empirical analysis of Beck's theory, based on the experience of Vietnamese authorities from 2003 to 2007 in managing the emerging avian flu virus. It shows how Vietnam's framing of avian flu has shifted, under the pressure from international organisations and the US administration, from an epizootic and zoonotic risk (or a classic risk) to a pandemic threat (or a late modern risk). Vietnam's response was part of its overall strategy to join the World Trade Organization and it was limited by Vietnam's defence of its sovereignty. This strategy has been successful for Vietnam but has limited the possibility of cosmopolitan and democratic transformations. The case study highlights the constructed dimension of risks of late modernity and their possible instrumentalisation: it minimises the role of a community of fear relative to a community of trade. PMID:23517415

  14. Assessment of health risk from heavy metal contamination of shellfish from the Persian Gulf.

    PubMed

    Raissy, Mehdi

    2016-01-01

    The present study assessed the risk of consumption of shrimp and lobster contaminated with mercury, arsenic, cadmium, and lead from the Persian Gulf. The concentrations of mercury, arsenic, lead, and cadmium in shrimp was 62.5, 178.2, 325.2, and 193.5 μg kg(-1) and in lobsters was 53.2, 103.9, 640.6, and 163.1 μg kg(-1), respectively. The maximum daily consumption of shrimp and lobster was calculated to estimate health risks associated with their consumption. The results showed that the maximum allowable consumption of shrimp and lobster was 18-140 g/day for mercury, 33-214 g/day for arsenic, 59-454 g/day for cadmium, and 72-916 g/day for lead. The concentration of metals was within recommended limits for human consumption with the exception of lead, which was found to be above acceptable levels and represents a health risk. PMID:26703978

  15. Using Virtual Reality to Provide Health Care Information to People With Intellectual Disabilities: Acceptability, Usability, and Potential Utility

    PubMed Central

    Conboy-Hill, Suzanne; Taylor, Dave

    2011-01-01

    Background People with intellectual disabilities have poor access to health care, which may be further compromised by a lack of accessible health information. To be effective, health information must be easily understood and remembered. People with intellectual disabilities learn better from multimodal information sources, and virtual reality offers a 3-dimensional (3D) computer-generated environment that can be used for providing information and learning. To date, research into virtual reality experiences for people with intellectual disabilities has been limited to skill-based training and leisure opportunities within the young to mid age ranges. Objective This study assessed the acceptability, usability, and potential utility of a virtual reality experience as a means of providing health care-related information to people with intellectual disabilities. We designed a prototype multimodal experience based on a hospital scenario and situated on an island in the Second Life 3D virtual world. We wanted to know how people of different ages and with varying levels of cognitive function would participate in the customized virtual environment, what they understood from being there, and what they remembered a week later. Methods The study drew on qualitative data. We used a participatory research approach that involved working alongside people with intellectual disabilities and their supporters in a community setting. Cognitive function was assessed, using the Matrix Analogies Test and the British Picture Vocabulary Scale, to describe the sample. Participants, supported by facilitators, were video recorded accessing and engaging with the virtual environment. We assessed recall 1 week later, using a specialized interview technique. Data were downloaded into NVivo 8 and analyzed using the framework analysis technique. Results Study participants were 20 people aged between 20 and 80 years with mild to severe intellectual disabilities. All participants were able to access

  16. Concepts for risk-based surveillance in the field of veterinary medicine and veterinary public health: Review of current approaches

    PubMed Central

    Stärk, Katharina DC; Regula, Gertraud; Hernandez, Jorge; Knopf, Lea; Fuchs, Klemens; Morris, Roger S; Davies, Peter

    2006-01-01

    Background Emerging animal and zoonotic diseases and increasing international trade have resulted in an increased demand for veterinary surveillance systems. However, human and financial resources available to support government veterinary services are becoming more and more limited in many countries world-wide. Intuitively, issues that present higher risks merit higher priority for surveillance resources as investments will yield higher benefit-cost ratios. The rapid rate of acceptance of this core concept of risk-based surveillance has outpaced the development of its theoretical and practical bases. Discussion The principal objectives of risk-based veterinary surveillance are to identify surveillance needs to protect the health of livestock and consumers, to set priorities, and to allocate resources effectively and efficiently. An important goal is to achieve a higher benefit-cost ratio with existing or reduced resources. We propose to define risk-based surveillance systems as those that apply risk assessment methods in different steps of traditional surveillance design for early detection and management of diseases or hazards. In risk-based designs, public health, economic and trade consequences of diseases play an important role in selection of diseases or hazards. Furthermore, certain strata of the population of interest have a higher probability to be sampled for detection of diseases or hazards. Evaluation of risk-based surveillance systems shall prove that the efficacy of risk-based systems is equal or higher than traditional systems; however, the efficiency (benefit-cost ratio) shall be higher in risk-based surveillance systems. Summary Risk-based surveillance considerations are useful to support both strategic and operational decision making. This article highlights applications of risk-based surveillance systems in the veterinary field including food safety. Examples are provided for risk-based hazard selection, risk-based selection of sampling strata as

  17. Health risk assessment of hazardous metals for population via consumption of seafood from Ogoniland, Rivers State, Nigeria; a case study of Kaa, B-Dere, and Bodo City.

    PubMed

    Nkpaa, K W; Patrick-Iwuanyanwu, K C; Wegwu, M O; Essien, E B

    2016-01-01

    This study was designed to investigate the human health risk through consumption of seafood from contaminated sites in Kaa, B-Dere, and Bodo City all in Ogoniland. The potential non-carcinogenic health risk for consumers were investigated by assessing the estimated daily intake and target hazard quotients for Cr, Cd, Zn, Pb, Mn, and Fe while carcinogenic health effect from Cr, Cd, and Pb was also estimated. The estimated daily intake from seafood consumption was below the threshold values for Cr, Mn, and Zn while they exceeded the threshold for Cd, Pb, and Fe. The target hazard quotients for Zn and Cr were below 1. Target hazard quotients values for Cd, Pb, Mn, and Fe were greater than 1 except for Fe level in Liza falcipinis from Kaa. Furthermore, estimation of carcinogenic risk for Cr in all samples under study exceeded the accepted risk level of 10E-4. Also, Cd carcinogenic risk level for L. falcipinis and Callinectes pallidus collected from B-Dere and C. pallidus collected from Bodo City was 1.1E-3 which also exceeded the accepted risk level of 10E-4 for Cd. Estimation of carcinogenic risk for Pb was within the acceptable range of 10E-4. Consumers of seafood from these sites in Ogoniland may be exposed to metal pollution. PMID:26635021

  18. Multiple Health Risk Behaviors in Adolescents: An Examination of Youth Risk Behavior Survey Data

    ERIC Educational Resources Information Center

    Coleman, Casey; Wileyto, E. Paul; Lenhart, Clare M.; Patterson, Freda

    2014-01-01

    Background: Chronic disease risk factors tend to cooccur. Purpose: This study examined the cooccurrence of 8 negative health behaviors in a representative sample of urban adolescents to inform educational interventions. Methods: The prevalence, cooccurrence, and clustering of suicide attempt, lifetime history of sexual activity, tobacco use, cell…

  19. Health risk behaviors and medical sequelae of childhood sexual abuse.

    PubMed

    Springs, F E; Friedrich, W N

    1992-06-01

    The relationship between childhood sexual abuse and subsequent health risk behaviors and medical problems was examined in 511 women who had used a family practice clinic in a rural midwestern community during a 2-year period (1988 and 1989). These women completed a questionnaire that assessed various health risk behaviors--smoking, drinking, drug abuse, number of sexual partners, and age at first intercourse--and a medical symptom checklist that assessed 38 medical problems related to major systems of body function, the somatization scale from the SCL-90, a screen for sexual abuse, and a brief measure of social support. The results indicated that sexually abused women, who represented 22.1% of the sample, reported significantly more medical problems, greater levels of somatization, and more health risk behaviors than did the nonabused women. More severe abuse (for example, penetration or multiple abusers) correlated with more severe problems. Extent of social support correlated inversely with the number of gynecologic problems reported in the sexually abused group. Fewer than 2% of the sexually abused women had discussed the abuse with a physician. To identify and assist victims of sexual abuse, physicians should become experienced with nonthreatening methods of eliciting such information when the medical history is obtained. PMID:1434879

  20. Do the Health Benefits of Cycling Outweigh the Risks?

    PubMed Central

    de Hartog, Jeroen Johan; Boogaard, Hanna; Nijland, Hans; Hoek, Gerard

    2010-01-01

    Background Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. Objective We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks. Data sources and extraction We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies. Data synthesis We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3–14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8–40 days lost) and the increase in traffic accidents (5–9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents. Conclusions On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport. PMID:20587380

  1. Managing corporate governance risks in a nonprofit health care organization.

    PubMed

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves. PMID:20200865

  2. Applying the lessons of high risk industries to health care.

    PubMed

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  3. The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population

    PubMed Central

    Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M.; Kreitzer, Mary Jo

    2013-01-01

    Background: Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. Methods: High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Results: Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. Discussion: The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving

  4. Risk of dependence associated with health, social support, and lifestyle

    PubMed Central

    Alcañiz, Manuela; Brugulat, Pilar; Guillén, Montserrat; Medina-Bustos, Antonia; Mompart-Penina, Anna; Solé-Auró, Aïda

    2015-01-01

    OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence. PMID:26018786

  5. [Health risk among workers employed in rubber footwear plant].

    PubMed

    Szubert, Z; Wilczyńska, U; Sobala, W

    2001-01-01

    The aim of the study was to assess the health risk of workers performing specific jobs in the process of the rubber footwear production by defining the cause and length of temporary work disability, as well as mortality causes and level. The analysis was carried out in the groups of workers performing the following jobs: mixing, mill operation, pressing and vulcanizing (A); semi-product preparation and calendaring (B); finishing and sorting (C); production of polyvinyl chloride footwear (D); and auxiliary works (E). The sickness absence study covered all workers (208 men and 315 women) employed in a large rubber footwear company and performing all above-listed jobs in 1995. Standardized sick days ratio was used to analyze the risk of temporary work disability. Mortality rate was estimated on the basis of the results of the cohort study performed in the same company among workers who had worked at least three months during the years 1945-1985. The follow-up continued until 31 December 1997. The present study included sub-cohorts composed of 5628 men and 7197 women, performing jobs listed above. The results of both studies indicated the enhanced risk of cardiovascular diseases among workers employed in the basic phases of the production process. The increased risk of the diseases of the digestive system was observed in men and women employed in: finishing, sorting and packing of the products (group C); in men involved in mixing, pressing and vulcanizing (group A); and in women engaged in auxiliary works (group E). In addition, the enhanced risk of sickness absence due to the diseases of the respiratory, digestive, or genitourinary systems was related to the enhanced risk of death from malignant neoplasms in a given site. The analysis showed that the temporary work disability may be regarded as a parameter useful in early assessment of health effects of the work environmental hazards. PMID:11928670

  6. [Health risks linked to recent migratory patterns: myth or reality?].

    PubMed

    Durieux-Paillard, Sophie

    2016-05-01

    The migratory crisis currently faced by Europe is of exceptional magnitude since the Second World War. It is mainly related to the conflict in Syria, as well as recurring violations of human rights in other regions of the world. Widely relayed by the media, the unusual number of refugee applicants and the precariousness of their migration routes raise the question of the health risk. From the old concept of quarantine to the new paradigm of migrants' health, it is important to contextualize the screening measures, taking into account the epidemiology of communicable diseases in the countries of origin and of the regions crossed, the ruptures of access to treatments for chronic diseases, but also the impact of multiple trauma (war, violence) on the mental health of refugees. PMID:27323478

  7. Evidence-based health information and risk competence

    PubMed Central

    Mühlhauser, Ingrid; Albrecht, Martina; Steckelberg, Anke

    2015-01-01

    Consumers and patients want to be included in decisions regarding their own health and have an ethically justified claim on informed decisions. Therefore, sound information is required, but health information is often misleading and based on different interests. The risks of disease and the benefits of medical interventions tend to be overestimated, whereas harm is often underestimated. Evidence-based health information has to fulfil certain criteria, for instance, it should be evidence-based, independent, complete, true as well as understandable. The aim of a medical intervention has to be explained. The different therapeutic options including the option not to intervene have to be delineated. The probabilities for success, lack of success and unwanted side effects have to be communicated in a numerical and understandable manner. Patients have the right to reject medical interventions without any sanctions. PMID:26195924

  8. FIFTH NHEERL SYMPOSIUM FLYER -- INDICATORS IN HEALTH AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    Announcement for NHEERL Fifth Symposium - Indicators in Health and Ecological Risk Assessment. The purpose of the symposium is to address assessment of risk to public health or environmental resources which requires competent characterization of stressors and corresponding effec...

  9. FIFTH NHEERL SYMPOSIUM POSTER -- INDICATORS IN HEALTH AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    Poster for announcing NHEERL Fifth Symposium - Indicators in Health and Ecological Risk Assessment. The purpose of the symposium is to address assessment of risk to public health or environmental resources which requires competent characterization of stressors and corresponding ...

  10. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study.

    PubMed

    Brooks, Ronald A; Landovitz, Raphael J; Kaplan, Rachel L; Lieber, Eli; Lee, Sung-Jae; Barkley, Thomas W

    2012-02-01

    The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation. PMID:22149764

  11. Acceptance speech.

    PubMed

    Yusuf, C K

    1994-01-01

    I am proud and honored to accept this award on behalf of the Government of Bangladesh, and the millions of Bangladeshi children saved by oral rehydration solution. The Government of Bangladesh is grateful for this recognition of its commitment to international health and population research and cost-effective health care for all. The Government of Bangladesh has already made remarkable strides forward in the health and population sector, and this was recognized in UNICEF's 1993 "State of the World's Children". The national contraceptive prevalence rate, at 40%, is higher than that of many developed countries. It is appropriate that Bangladesh, where ORS was discovered, has the largest ORS production capacity in the world. It was remarkable that after the devastating cyclone in 1991, the country was able to produce enough ORS to meet the needs and remain self-sufficient. Similarly, Bangladesh has one of the most effective, flexible and efficient control of diarrheal disease and epidemic response program in the world. Through the country, doctors have been trained in diarrheal disease management, and stores of ORS are maintained ready for any outbreak. Despite grim predictions after the 1991 cyclone and the 1993 floods, relatively few people died from diarrheal disease. This is indicative of the strength of the national program. I want to take this opportunity to acknowledge the contribution of ICDDR, B and the important role it plays in supporting the Government's efforts in the health and population sector. The partnership between the Government of Bangladesh and ICDDR, B has already borne great fruit, and I hope and believe that it will continue to do so for many years in the future. Thank you. PMID:12345479

  12. Uses of Youth Risk Behavior Survey and School Health Profiles Data: Applications for Improving Adolescent and School Health

    ERIC Educational Resources Information Center

    Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari

    2011-01-01

    Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…

  13. Bioaccessibility and health risk of heavy metals in ash from the incineration of different e-waste residues.

    PubMed

    Tao, Xiao-Qing; Shen, Dong-Sheng; Shentu, Jia-Li; Long, Yu-Yang; Feng, Yi-Jian; Shen, Chen-Chao

    2015-03-01

    Ash from incinerated e-waste dismantling residues (EDR) may cause significant health risks to people through ingestion, inhalation, and dermal contact exposure pathways. Ashes of four classified e-waste types generated by an incineration plant in Zhejiang, China were collected. Total contents and the bioaccessibilities of Cd, Cu, Ni, Pb, and Zn in ashes were measured to provide crucial information to evaluate the health risks for incinerator workers and children living in vicinity. Compared to raw e-waste in mixture, ash was metal-enriched by category incinerated. However, the physiologically based extraction test (PBET) indicates the bioaccessibilities of Ni, Pb, and Zn were less than 50 %. Obviously, bioaccessibilities need to be considered in noncancer risk estimate. Total and PBET-extractable contents of metal, except for Pb, were significantly correlated with the pH of the ash. Noncancer risks of ash from different incinerator parts decreased in the order bag filter ash (BFA) > cyclone separator ash (CFA) > bottom ash (BA). The hazard quotient for exposure to ash were decreased as ingestion > dermal contact > inhalation. Pb in ingested ash dominated (>80 %) noncancer risks, and children had high chronic risks from Pb (hazard index >10). Carcinogenic risks from exposure to ash were under the acceptable level (<10(-6)) both for children and workers. Exposure to ash increased workers' cancer risks and children's noncancer risks. Given the risk estimate is complex including toxicity/bioaccessibility of metals, the ways of exposure, and many uncertainties, further researches are required before any definite decisions on mitigating health risks caused by exposure to EDR incinerated ash are made. PMID:25249049

  14. Estimation of human health risk associated with the consumption of pesticide-contaminated vegetables from Kumasi, Ghana.

    PubMed

    Akoto, Osei; Gavor, Sandra; Appah, Martin K; Apau, Joseph

    2015-05-01

    Analysis of pesticides consisting of 12 organophosphates (OPs), 10 organochlorines (OCs), and 6 pyrethroids in vegetables from Kumasi was conducted. Vegetable samples comprising 20 each of eggplants, okra, and tomatoes were analyzed. The method involves solvent extraction of pesticide residues followed by cleanup using silica gel. Residue analysis was carried out using a GC equipped with pulsed flame photometric detector for OP residues and electron capture detector for OC and pyrethroid residues. The results revealed that methamidophos exceeded the maximum residue limits (MRLs) in all vegetable commodities. Levels of malathion and dimethoate also exceeded the MRLs in eggplant and tomato samples. Endrin, α-endosulfan, γ-hexachlorocyclohexane (HCH), γ-chlordane, and heptachlor exceeded their MRLs in okra samples whereas methoxychlor, allethrin, and deltamethrin exceeded in eggplant samples. Health risk estimation revealed that dimethoate in tomato and endrin, heptachlor, γ-HCH, and γ-chlordane in okra could not pose potential toxicity to the consumer. The combined risk index showed no health risk to consumers due to intake of pyrethroid OC and OP residue on these vegetables. The overall risk index for combined pesticides due to consumption of all the vegetables was higher than 1, which signifies potential health risk to consumers. OPs were the major risk contributor for both eggplant and tomatoes which accounted for 87.78 and 95.84%, respectively, of the combined risk of pesticides in the vegetables. However, OC with 97.94% of the combined risk index was the major risk contributor for the okra. The carcinogenic risk of the OCs in okra was of no concern since their carcinogenic rates were below the acceptable risk level. PMID:25864079

  15. Lack of health maintenance examinations and risk in myeloma patients.

    PubMed

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (