Science.gov

Sample records for assessing cumulative health

  1. 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.

  2. Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

    SciTech Connect

    Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

    2007-07-01

    Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

  3. Cumulative Risk Assessment: An Overview of Methodological Approaches for Evaluating Combined Health Effects from Exposure to Multiple Environmental Stressors

    PubMed Central

    Sexton, Ken

    2012-01-01

    Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain. PMID:22470298

  4. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: the Case of Radon and Smoking

    EPA Science Inventory

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case exam...

  5. Cumulative health risk assessment of 17 perfluoroalkylated and polyfluoroalkylated substances (PFASs) in the Swedish population.

    PubMed

    Borg, Daniel; Lund, Bert-Ove; Lindquist, Nils-Gunnar; Håkansson, Helen

    2013-09-01

    Humans are simultaneously exposed to a multitude of chemicals. Human health risk assessment of chemicals is, however, normally performed on single substances, which may underestimate the total risk, thus bringing a need for reliable methods to assess the risk of combined exposure to multiple chemicals. Per- and polyfluoroalkylated substances (PFASs) is a large group of chemicals that has emerged as global environmental contaminants. In the Swedish population, 17 PFASs have been measured, of which the vast majority lacks human health risk assessment information. The objective of this study was to for the first time perform a cumulative health risk assessment of the 17 PFASs measured in the Swedish population, individually and in combination, using the Hazard Index (HI) approach. Swedish biomonitoring data (blood/serum concentrations of PFASs) were used and two study populations identified: 1) the general population exposed indirectly via the environment and 2) occupationally exposed professional ski waxers. Hazard data used were publicly available toxicity data for hepatotoxicity and reproductive toxicity as well as other more sensitive toxic effects. The results showed that PFASs concentrations were in the low ng/ml serum range in the general population, reaching high ng/ml and low μg/ml serum concentrations in the occupationally exposed. For those congeners lacking toxicity data with regard to hepatotoxicity and reproductive toxicity read-across extrapolations was performed. Other effects at lower dose levels were observed for some well-studied congeners. The risk characterization showed no concern for hepatotoxicity or reproductive toxicity in the general population except in a subpopulation eating PFOS-contaminated fish, illustrating that high local exposure may be of concern. For the occupationally exposed there was concern for hepatotoxicity by PFOA and all congeners in combination as well as for reproductive toxicity by all congeners in combination, thus a

  6. Modeling joint exposures and health outcomes for cumulative risk assessment: the case of radon and smoking.

    PubMed

    Chahine, Teresa; Schultz, Bradley D; Zartarian, Valerie G; Xue, Jianping; Subramanian, S V; Levy, Jonathan I

    2011-09-01

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors.

  7. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: The Case of Radon and Smoking

    PubMed Central

    Chahine, Teresa; Schultz, Bradley D.; Zartarian, Valerie G.; Xue, Jianping; Subramanian, SV; Levy, Jonathan I.

    2011-01-01

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case example, given its large attributable risk, effect modification due to smoking, and significant variability in radon concentrations and smoking patterns. In spite of this fact, no study to date has estimated geographic and sociodemographic patterns of both radon and smoking in a manner that would allow for inclusion of radon in community-based cumulative risk assessment. In this study, we apply multi-level regression models to explain variability in radon based on housing characteristics and geological variables, and construct a regression model predicting housing characteristics using U.S. Census data. Multi-level regression models of smoking based on predictors common to the housing model allow us to link the exposures. We estimate county-average lifetime lung cancer risks from radon ranging from 0.15 to 1.8 in 100, with high-risk clusters in areas and for subpopulations with high predicted radon and smoking rates. Our findings demonstrate the viability of screening-level assessment to characterize patterns of lung cancer risk from radon, with an approach that can be generalized to multiple chemical and non-chemical stressors. PMID:22016710

  8. Cumulative effects of anti-androgenic chemical mixtures and their relevance to human health risk assessment

    EPA Science Inventory

    Kembra L. Howdeshell and L. Earl Gray, Jr.Toxicological studies of defined chemical mixtures assist human health risk assessment by characterizing the joint action of chemicals. This presentation will review the effects of anti-androgenic chemical mixtures on reproductive tract d...

  9. A Screening Method for Assessing Cumulative Impacts

    PubMed Central

    Alexeeff, George V.; Faust, John B.; August, Laura Meehan; Milanes, Carmen; Randles, Karen; Zeise, Lauren; Denton, Joan

    2012-01-01

    The California Environmental Protection Agency (Cal/EPA) Environmental Justice Action Plan calls for guidelines for evaluating “cumulative impacts.” As a first step toward such guidelines, a screening methodology for assessing cumulative impacts in communities was developed. The method, presented here, is based on the working definition of cumulative impacts adopted by Cal/EPA [1]: “Cumulative impacts means exposures, public health or environmental effects from the combined emissions and discharges in a geographic area, including environmental pollution from all sources, whether single or multi-media, routinely, accidentally, or otherwise released. Impacts will take into account sensitive populations and socio-economic factors, where applicable and to the extent data are available.” The screening methodology is built on this definition as well as current scientific understanding of environmental pollution and its adverse impacts on health, including the influence of both intrinsic, biological factors and non-intrinsic socioeconomic factors in mediating the effects of pollutant exposures. It addresses disparities in the distribution of pollution and health outcomes. The methodology provides a science-based tool to screen places for relative cumulative impacts, incorporating both the pollution burden on a community- including exposures to pollutants, their public health and environmental effects- and community characteristics, specifically sensitivity and socioeconomic factors. The screening methodology provides relative rankings to distinguish more highly impacted communities from less impacted ones. It may also help identify which factors are the greatest contributors to a community’s cumulative impact. It is not designed to provide quantitative estimates of community-level health impacts. A pilot screening analysis is presented here to illustrate the application of this methodology. Once guidelines are adopted, the methodology can serve as a screening

  10. HEALTH AND ENVIRONMENTAL SCIENCES INSTITUTE'S EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of input...

  11. Incorporating Nonchemical Stressors Into Cumulative Risk Assessments

    PubMed Central

    Rider, Cynthia V.; Dourson, Michael L.; Hertzberg, Richard C.; Mumtaz, Moiz M.; Price, Paul S.; Simmons, Jane Ellen

    2012-01-01

    The role of nonchemical stressors in modulating the human health risk associated with chemical exposures is an area of increasing attention. On 9 March 2011, a workshop titled “Approaches for Incorporating Nonchemical Stressors into Cumulative Risk Assessment” took place during the 50th Anniversary Annual Society of Toxicology Meeting in Washington D.C. Objectives of the workshop included describing the current state of the science from various perspectives (i.e., regulatory, exposure, modeling, and risk assessment) and presenting expert opinions on currently available methods for incorporating nonchemical stressors into cumulative risk assessments. Herein, distinct frameworks for characterizing exposure to, joint effects of, and risk associated with chemical and nonchemical stressors are discussed. PMID:22345310

  12. Cumulative health risk assessment of co-occurring mycotoxins of deoxynivalenol and its acetyl derivatives in wheat and maize: case study, Shanghai, China.

    PubMed

    Han, Zheng; Nie, Dongxia; Ediage, Emmanuel Njumbe; Yang, Xianli; Wang, Jianhua; Chen, Bo; Li, Shuguang; On, Stephen L W; De Saeger, Sarah; Wu, Aibo

    2014-12-01

    Humans are naturally and frequently exposed to a multitude of mycotoxins, but health risk assessments are usually performed on individual mycotoxins, which may underestimate the total risks. In this study, we assessed for the first time the cumulative health risks of concomitant exposure via dietary intake (DI) to multiple mycotoxins, namely deoxynivalenol (DON) and its acetyl derivatives of 3-acetyldeoxynivalenol (3-ADON) and 15-acetyldeoxynivalenol (15-ADON), based on the concentration addition (CA) concept. A cross-sectional study was conducted in seven districts in Shanghai, China with 1269 participants and 330 wheat and maize samples analyzed. After probabilistic analysis using Monte Carlo simulation, the results showed no health risks to the population in Shanghai considering individual mycotoxins. However, if the cumulative health risks were calculated based on the combined consideration of DON with either 3-ADON or 15-ADON or both, the DI values in 95th percentile were up to 1087 ng/kg body weight/day, exceeding the Provisional Maximum Tolerable Daily Intake (PMTDI) of 1000 ng/kg body weight/day and hence representing potential health risks to the population in Shanghai. The integrated study proposed here could be a model strategy for cumulative health risk assessment on the co-occurring hazards in the fields of food safety combined with environmental contaminants.

  13. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... to consider available information concerning the cumulative effects on human health resulting from... used to further refine the very conservative nature of this cumulative risk assessment. DATES: Comments... stakeholders including environmental, human health, farm worker, and agricultural advocates; the...

  14. Cumulative impact assessment: A case study

    SciTech Connect

    Irving, J.S.; Bain, M.B.

    1989-01-01

    The National Environmental Policy Act of 1969 (NEPA) indirectly addressed cumulative impacts. Attempts to include cumulative impacts in environmental impact assessments, however, did not began until the early 1980's. One such effort began when The Federal Energy and Regulatory Commission (FERC) received over 1200 applications for hydroelectric projects in the Pacific Northwest. Federal and State Agencies, Indian tribes and environmental groups realized the potential cumulative effect such development could have on fish and wildfire resources. In response, the FERC developed the Cluster Impact Assessment Procedure (CIAP). The CIAP consisted of public scoping meetings; interactive workshops designed to identify projects with potential for cumulative effects, important resources, available data; and preparation of a NEPA document (EA or EIS). The procedure was modifies to assess the cumulative impacts of fifteen hydroelectric projects in the Salmon River Basin, Idaho. The methodology achieved its basic objective of evaluating the impact of hydroelectric development on fish and wildfire resources. In addition, the use of evaluative techniques to determine project interactions and degrees of impact hindered acceptance of the conclusions. Notwithstanding these problems, the studies provided a basis for decision-makers to incorporate the potential effects of cumulative impacts into the decision-making process. 22 refs., 2 figs., 4 tabs.

  15. A feasibility study on assessing public health impacts of cumulative air pollution reduction activities in a small geographic area

    EPA Science Inventory

    Background and Objective: The rnain objective ofthis study was to examine the feasibility ofconducting a local (e.g., city level) assessment ofthe public health impacts ofcumulative air pollution reduction activities (a.k.a. accountability) from the federal, state, local and vo...

  16. CUMULATIVE RISK ASSESSMENT FOR QUANTITATIVE RESPONSE DATA

    EPA Science Inventory

    The Relative Potency Factor approach (RPF) is used to normalize and combine different toxic potencies among a group of chemicals selected for cumulative risk assessment. The RPF method assumes that the slopes of the dose-response functions are all equal; but this method depends o...

  17. Improving cumulative effects assessment in Alberta: Regional strategic assessment

    SciTech Connect

    Johnson, Dallas Lalonde, Kim; McEachern, Menzie; Kenney, John; Mendoza, Gustavo; Buffin, Andrew; Rich, Kate

    2011-09-15

    The Government of Alberta, Canada is developing a regulatory framework to better manage cumulative environmental effects from development in the province. A key component of this effort is regional planning, which will lay the primary foundation for cumulative effects management into the future. Alberta Environment has considered the information needs of regional planning and has concluded that Regional Strategic Assessment may offer significant advantages if integrated into the planning process, including the overall improvement of cumulative environmental effects assessment in the province.

  18. Cumulative health risk assessment of halogenated and parent polycyclic aromatic hydrocarbons associated with particulate matters in urban air.

    PubMed

    Sun, Jian-Lin; Jing, Xin; Chang, Wen-Jing; Chen, Zheng-Xia; Zeng, Hui

    2015-03-01

    Halogenated polycyclic aromatic hydrocarbons (HPAHs) have been reported to occur widely in urban air. Nevertheless, knowledge about the human health risk associated with inhalation exposure to HPAHs is scarce so far. In the present study, nine HPAHs and 16 PAHs were determined in atmospheric particulate matter (PM) collected from Shenzhen, China to address this issue. Concentrations of Σ9HPAHs varied from 0.1 to 1.5 ng/m(3) and from 0.09 to 0.4 ng/m(3) in PM10 and PM2.5 samples, respectively. As for individuals, 9-bromoanthracene, 7-bromobenz(a)anthracene, and 9,10-dibromoanthracene were the dominant congeners. Levels of Σ16PAHs in PM10 and PM2.5 samples ranged from 3.2 to 81 ng/m(3) and from 2.8 to 85 ng/m(3), respectively. Among individual PAHs, chrysene, benzo[b]fluoranthene, and indeno[1,2,3-c,d]pyrene were the main congeners. According to the season, concentrations of HPAHs and PAHs in atmospheric PM10/PM2.5 samples show a similar decreasing trend with an order: winter>autumn>spring>summer. The daily intake (DI) of PM10/PM2.5-bound HPAHs and PAHs were estimated. Our results indicated that children have the highest DI levels via inhalation exposure. The incremental lifetime cancer risk (ILCR) induced by PM10/PM2.5-bound HPAHs and PAHs were calculated. The ILCR values showed a similar decreasing trend with an order: adults>children>seniors>adolescent. Overall, the ILCR values induced by HPAHs and PAHs were far below the priority risk level (10(-4)), indicating no obvious cancer risk. To our knowledge, this is the first study to investigate the human health risk associated with inhalation exposure to PM10/PM2.5-bound HPAHs. PMID:25483369

  19. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    PubMed Central

    MacDonell, Margaret M.; Haroun, Lynne A.; Teuschler, Linda K.; Rice, Glenn E.; Hertzberg, Richard C.; Butler, James P.; Chang, Young-Soo; Clark, Shanna L.; Johns, Alan P.; Perry, Camarie S.; Garcia, Shannon S.; Jacobi, John H.; Scofield, Marcienne A.

    2013-01-01

    The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities. PMID:23762048

  20. Data analysis techniques: a tool for cumulative exposure assessment.

    PubMed

    Lalloué, Benoît; Monnez, Jean-Marie; Padilla, Cindy; Kihal, Wahida; Zmirou-Navier, Denis; Deguen, Séverine

    2015-01-01

    Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise, etc.or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare. We propose to use statistical factor and cluster analyses to create a composite exposure index with a data-driven approach, in view to assess the environmental burden experienced by populations. We illustrate this approach in a large French metropolitan area. The study was carried out in the Great Lyon area (France, 1.2 M inhabitants) at the census Block Group (BG) scale. We used as environmental indicators ambient air NO2 annual concentrations, noise levels and proximity to green spaces, to industrial plants, to polluted sites and to road traffic. They were synthesized using Multiple Factor Analysis (MFA), a data-driven technique without a priori modeling, followed by a Hierarchical Clustering to create BG classes. The first components of the MFA explained, respectively, 30, 14, 11 and 9% of the total variance. Clustering in five classes group: (1) a particular type of large BGs without population; (2) BGs of green residential areas, with less negative exposures than average; (3) BGs of residential areas near midtown; (4) BGs close to industries; and (5) midtown urban BGs, with higher negative exposures than average and less green spaces. Other numbers of classes were tested in order to assess a variety of clustering. We present an approach using statistical factor and cluster analyses techniques, which seem overlooked to assess cumulative exposure in complex environmental settings. Although it cannot be applied directly for risk or health effect assessment, the resulting index can help to identify hot spots of cumulative exposure, to prioritize urban policies or to compare the environmental burden across study areas in an epidemiological framework.

  1. Considering Environmental and Occupational Stressors in Cumulative Risk Assessments

    EPA Science Inventory

    While definitions vary across the global scientific community, cumulative risk assessments (CRAs) typically are described as exhibiting a population focus and analyzing the combined risks posed by multiple stressors. CRAs also may consider risk management alternatives as an anal...

  2. Tools to Assess Community-Based Cumulative Risk and Exposures

    EPA Science Inventory

    Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

  3. EPA/STAR Cumulative Risk Assessment Research

    EPA Science Inventory

    Exposure to different combinations of environmental stressors can contribute to increased risk for negative health consequences. Extensive studies show associations between disadvantaged communities and suboptimal health. Stressful social environments may also make a population t...

  4. Uncertainty in Mixtures and Cumulative Risk Assessment

    EPA Science Inventory

    Humans and environmental species are rarely exposed to single chemicals. These chemicals typically affect multiple tissues through multiple modes of action, which may depend on the dose. Mixtures risk assessment may employ dose response information from the mixture of interest,...

  5. CUMULATIVE RISK ASSESSMENT: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS

    EPA Science Inventory

    INTRODUCTION: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS FOR CUMULATIVE RISK

    Hugh A. Barton1 and Carey N. Pope2
    1US EPA, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC
    2Department of...

  6. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... environment. The EPA is developing guidelines for the assessment of cumulative risk as defined and..., characterization, and possible quantification of the combined risks to health or the environment from multiple... development of regulations and permits. This notice solicits information and citations pertaining...

  7. Stakeholder attitudes towards cumulative and aggregate exposure assessment of pesticides.

    PubMed

    Verbeke, Wim; Van Loo, Ellen J; Vanhonacker, Filiep; Delcour, Ilse; Spanoghe, Pieter; van Klaveren, Jacob D

    2015-05-01

    This study evaluates the attitudes and perspectives of different stakeholder groups (agricultural producers, pesticide manufacturers, trading companies, retailers, regulators, food safety authorities, scientists and NGOs) towards the concepts of cumulative and aggregate exposure assessment of pesticides by means of qualitative in-depth interviews (n = 15) and a quantitative stakeholder survey (n = 65). The stakeholders involved generally agreed that the use of chemical pesticides is needed, primarily for meeting the need of feeding the growing world population, while clearly acknowledging the problematic nature of human exposure to pesticide residues. Current monitoring was generally perceived to be adequate, but the timeliness and consistency of monitoring practices across countries were questioned. The concept of cumulative exposure assessment was better understood by stakeholders than the concept of aggregate exposure assessment. Identified pitfalls were data availability, data limitations, sources and ways of dealing with uncertainties, as well as information and training needs. Regulators and food safety authorities were perceived as the stakeholder groups for whom cumulative and aggregate pesticide exposure assessment methods and tools would be most useful and acceptable. Insights obtained from this exploratory study have been integrated in the development of targeted and stakeholder-tailored dissemination and training programmes that were implemented within the EU-FP7 project ACROPOLIS. PMID:25455887

  8. Integrating Nonchemicals in Cumulative Risk Assessment (CRA):A Case Study of Particulate Matter (PM) and Heart Rate Variability (HRV)

    EPA Science Inventory

    Cumulative risk assessments (CRAs) quantitatively or qualitatively evaluate the risks of combined exposures to chemical and nonchemical stressors. CRAs also examine vulnerabilities (e.g., pre-existing health condition, genetic predisposition, poverty) as these may lead to variabi...

  9. DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT. J E Simmons1, C Gennings2, M Casey2, M J Plewa3, E D Wagner3, W H Carter, Jr.2, A McDonald1,Y M Sey1, L K Teuschler3 1NHEERL, ORD, U.S. EPA, RTP NC, USA; 2VCU, Richmond, VA, USA;3Univ. Illinois, Urba...

  10. Study on the cumulative impact of reclamation activities on ecosystem health in coastal waters.

    PubMed

    Shen, Chengcheng; Shi, Honghua; Zheng, Wei; Li, Fen; Peng, Shitao; Ding, Dewen

    2016-02-15

    The purpose of this study is to develop feasible tools to investigate the cumulative impact of reclamations on coastal ecosystem health, so that the strategies of ecosystem-based management can be applied in the coastal zone. An indicator system and model were proposed to assess the cumulative impact synthetically. Two coastal water bodies, namely Laizhou Bay (LZB) and Tianjin coastal waters (TCW), in the Bohai Sea of China were studied and compared, each in a different phase of reclamations. Case studies showed that the indicator scores of coastal ecosystem health in LZB and TCW were 0.75 and 0.68 out of 1.0, respectively. It can be concluded that coastal reclamations have a historically cumulative effect on benthic environment, whose degree is larger than that on aquatic environment. The ecosystem-based management of coastal reclamations should emphasize the spatially and industrially intensive layout.

  11. Cumulative risk assessment of pesticide residues in food.

    PubMed

    Boobis, Alan R; Ossendorp, Bernadette C; Banasiak, Ursula; Hamey, Paul Y; Sebestyen, Istvan; Moretto, Angelo

    2008-08-15

    There is increasing need to address the potential risks of combined exposures to multiple residues from pesticides in the diet. The available evidence suggests that the main concern is from dose addition of those compounds that act by the same mode of action. The possibility of synergy needs to be addressed on a case-by-case basis, where there is a biologically plausible hypothesis that it may occur at the levels of residues occurring in the diet. Cumulative risk assessment is a resource-intense activity and hence a tiered approach to both toxicological evaluation and intake estimation is recommended, and the European Food Safety Authority (EFSA) has recently published such a proposal. Where assessments have already been undertaken by some other authority, full advantage should be taken of these, subject of course to considerations of quality and relevance. Inclusion of compounds in a cumulative assessment group (CAG) should be based on defined criteria, which allow for refinement in a tiered approach. These criteria should include chemical structure, mechanism of pesticidal action, target organ and toxic mode of action. A number of methods are available for cumulating toxicity. These are all inter-related, but some are mathematically more complex than others. The most useful methods, in increasing levels of complexity and refinement, are the hazard index, the reference point index, the Relative Potency Factor method and physiologically based toxicokinetic modelling, although this last method would only be considered should a highly refined assessment be necessary. Four possible exposure scenarios are of relevance for cumulative risk assessment, acute and chronic exposure in the context of maximum residue level (MRL)-setting, and in relation to exposures from the actual use patterns, respectively. Each can be addressed either deterministically or probabilistically. Strategies for dealing with residues below the limit of detection, limit of quantification or limit

  12. Bringing science into river systems cumulative effects assessment practice

    SciTech Connect

    Seitz, Nicole E.; Westbrook, Cherie J.; Noble, Bram F.

    2011-04-15

    Fast-paced watershed change, driven by anthropogenic development, is threatening the sustainability of freshwater resources across the globe. Developments within watersheds interact in a manner that is additive and synergistic over space and time. Such cumulative environmental effects are defined as the results of actions that are individually minor but collectively significant when added to other past, present, and reasonably foreseeable future actions. Cumulative effects assessment (CEA) then is broadly defined as the process of evaluating the potential impacts of such collective actions on the environment and is a requirement in many countries, including in Canada at the federal level under the Canadian Environmental Assessment Act. However, current approaches to CEA for river systems are proving to be ineffective, which is largely attributed to the disconnect between CEA science and practice. We highlight this gap herein by discussing contradictions in the CEA literature, challenges in quantifying cumulative interactions, including overcoming spatiotemporal scale issues, multiple hydrologic and ecological pathways, and lack of predictive analysis. Our analysis shows there is a need for improved CEA for river systems, and in responding to this need we propose a conceptual framework for better integrating science and practice for improved CEA for river systems using one of the most adversely affected rivers basins in Canada, the Athabasca River, as our model. We conclude by addressing the challenges inherent to CEA with the intent of providing scientists with ways to help improve CEA of river systems.

  13. Cumulative effects of noise and odour annoyances on environmental and health related quality of life.

    PubMed

    Oiamo, Tor H; Luginaah, Isaac N; Baxter, Jamie

    2015-12-01

    Noise and odour annoyances are important considerations in research on health effects of air pollution and traffic noise. Cumulative exposures can occur via several chemical hazards or a combination of chemical and stressor-based hazards, and related health outcomes can be generalized as manifestations of physiological and/or psychological stress responses. A major research challenge in this field is to understand the combined health effects of physiological and psychological responses to exposure. The SF-12 Health Survey is a health related quality of life (HRQoL) instrument designed for the assessment of functional mental and physical health in clinical practice and therefore well suited to research on physiological health outcomes of exposure. However, previous research has not assessed its sensitivity to psychological stress as measured by noise annoyance and odour annoyance. The current study validated and tested this application of the SF-12 Health Survey in a cross-sectional study (n = 603) that included exposure assessment for traffic noise and air pollution in Windsor, Ontario, Canada. The results indicated that SF-12 scores in Windsor were lower than Canadian normative data. A structural equation model demonstrated that this was partially due to noise and odour annoyances, which were associated with covarying exposures to ambient nitrogen dioxide and traffic noise. More specifically, noise annoyance had a significant and negative effect on both mental and physical health factors of the SF-12 and there was a significant covariance between noise annoyance and odour annoyance. The study confirmed a significant effect of psychological responses to cumulative exposures on HRQoL. The SF-12 Health Survey shows promise with respect to assessing the cumulative health effects of outdoor air pollution and traffic noise.

  14. Vulnerability as a Function of Individual and Group Resources in Cumulative Risk Assessment

    PubMed Central

    deFur, Peter L.; Evans, Gary W.; Hubal, Elaine A. Cohen; Kyle, Amy D.; Morello-Frosch, Rachel A.; Williams, David R.

    2007-01-01

    Background The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the “Framework for Cumulative Risk Assessment” [EPA/630/P02/001F. Washington DC:Risk Assessment Forum, U.S. Environmental Protection Agency (2003)]. Simultaneously, several reports concluded that some individuals and groups are more vulnerable to environmental risks than the general population. However, vulnerability has received little specific attention in the risk assessment literature. Objective Our objective is to examine the issue of vulnerability in cumulative risk assessment and present a conceptual framework rather than a comprehensive review of the literature. In this article we consider similarities between ecologic and human communities and the factors that make communities vulnerable to environmental risks. Discussion The literature provides substantial evidence on single environmental factors and simple conditions that increase vulnerability or reduce resilience for humans and ecologic systems. This observation is especially true for individual people and populations of wildlife. Little research directly addresses the topic of vulnerability in cumulative risk situations, especially at the community level. The community level of organization has not been adequately considered as an end point in either human or ecologic risk assessment. Furthermore, current information on human risk does not completely explain the level of response in cumulative risk conditions. Ecologic risk situations are similarly more complex and unpredictable for cases of cumulative risk. Conclusions Psychosocial conditions and responses are the principal missing element for humans. We propose a model for including psychologic and social factors as an integral component of cumulative risk assessment. PMID

  15. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  16. Evaluating cumulative risk assessment for environmental justice: a community case study.

    PubMed

    Fox, Mary A

    2002-04-01

    A key feature of cumulative risk assessment (CRA) is the ability to estimate differential health risks from environmental exposures within populations. Identifying populations at increased risk from environmental exposures is the first step toward mitigating such risks as required by the fair treatment mandate of environmental justice. CRA methods remain under development except for a limited application in pesticide regulations. The goals of this research were to advance CRA methods and to test their application in a community case study. We compared cumulative risk and health assessments for South and Southwest Philadelphia communities. The analysis found positive correlations between cumulative risk and mortality measurements for total mortality in Whites and non-Whites when we conducted the risk assessment using a multi-end point toxicological database developed for this project. Cumulative risk scores correlated positively with cause-specific mortality in non-Whites. Statistically significant increases in total and respiratory mortality rates were associated with incremental increases in the hazard ratio cumulative risk scores, with ranges of 2-6% for total and 8-23% for respiratory. Regression analyses controlled for percent non-White population and per capita income, indicating that risk scores represent an environmental effect on health independent of race and income. This case study demonstrated the successful application of CRA at the community level. CRA adds a health dimension to pollutant concentrations to produce a more comprehensive understanding of environmental inequities that can inform decision making. CRA is a viable tool to identify high-risk areas and to guide surveillance, research, or interventions.

  17. U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making

    PubMed Central

    Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C.

    2012-01-01

    Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA’s general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself. PMID:22829786

  18. U.S. EPA authority to use cumulative risk assessments in environmental decision-making.

    PubMed

    Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C

    2012-06-01

    Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA's general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself.

  19. Lower cumulative stress is associated with better health for physically active adults in the community.

    PubMed

    Stults-Kolehmainen, Matthew A; Tuit, Keri; Sinha, Rajita

    2014-03-01

    Both cumulative adversity, an individual's lifetime exposure to stressors, and insufficient exercise are associated with poor health outcomes. The purpose of this study was to ascertain whether exercise buffers the association of cumulative adverse life events (CALE) with health in a community-wide sample of healthy adults (ages 18-50 years; women: n = 219, 29.5 ± 9.2 years; men: n = 176, 29.4 ± 8.7 years, mean ± standard deviation). Participants underwent the Cumulative Adversity Interview, which divides life events into three subsets: major life events (MLE), recent life events (RLE) and traumatic experiences (TLE). These individuals also completed the Cornell Medical Index and a short assessment for moderate or greater intensity exercise behavior, modified from the Nurses' Health Study. Results indicated that higher CALE was associated with greater total health problems (r = 0.431, p < 0.001). Interactions between stress and exercise were not apparent for RLE and TLE. However, at low levels of MLE, greater exercise was related to fewer total, physical, cardiovascular and psychological health problems (p value <0.05). Conversely, at high levels of MLE, the benefits of exercise appear to be absent. Three-way interactions were observed between sex, exercise and stress. Increased levels of exercise were related to better physical health in men, at all levels of CALE. Only women who reported both low levels of CALE and high levels of exercise had more favorable physical health outcomes. A similar pattern of results emerged for RLE. Together, these data suggest that increased exercise is related to better health, but these effects may vary by cumulative stress exposure and sex. PMID:24392966

  20. Assessing the cumulative effects of projects using geographic information systems

    SciTech Connect

    Atkinson, Samuel F.; Canter, Larry W.

    2011-09-15

    Systems that allow users to store and retrieve spatial data, provide for analyses of spatial data, and offer highly detailed display of spatial data are referred to as geographic information systems, or more typically, GIS. Since their initial usage in the 1960s, GISs have evolved as a means of assembling and analyzing diverse data pertaining to specific geographical areas, with spatial locations of the data serving as the organizational basis for the information systems. The structure of GISs is built around spatial identifiers and the methods used to encode data for storage and manipulation. This paper examines how GIS has been used in typical environmental assessment, its use for cumulative impact assessment, and explores litigation that occurred in the United States Federal court system where GIS was used in some aspect of cumulative effects. The paper also summarizes fifteen case studies that range from area wide transportation planning to wildlife and habitat impacts, and draws together a few lessons learned from this review of literature and litigation.

  1. Neutron source capability assessment for cumulative fission yields measurements

    SciTech Connect

    Descalle, M A; Dekin, W; Kenneally, J

    2011-04-06

    A recent analysis of high-quality cumulative fission yields data for Pu-239 published in the peer-reviewed literature showed that the quoted experimental uncertainties do not allow a clear statement on how the fission yields vary as a function of energy. [Prussin2009] To make such a statement requires a set of experiments with well 'controlled' and understood sources of experimental errors to reduce uncertainties as low as possible, ideally in the 1 to 2% range. The Inter Laboratory Working Group (ILWOG) determined that Directed Stockpile Work (DSW) would benefit from an experimental program with the stated goal to reduce the measurement uncertainties significantly in order to make a definitive statement of the relationship of energy dependence to the cumulative fission yields. Following recent discussions between Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory (LANL), there is a renewed interest in developing a concerted experimental program to measure fission yields in a neutron energy range from thermal energy (0.025 eV) to 14 MeV with an emphasis on discrete energies from 0.5 to 4 MeV. Ideally, fission yields would be measured at single energies, however, in practice there are only 'quasi-monoenergetic' neutrons sources of finite width. This report outlines a capability assessment as of June 2011 of available neutron sources that could be used as part of a concerted experimental program to measure cumulative fission yields. In a framework of international collaborations, capabilities available in the United States, at the Atomic Weapons Establishment (AWE) in the United Kingdom and at the Commissariat Energie Atomique (CEA) in France are listed. There is a need to develop an experimental program that will reduce the measurement uncertainties significantly in order to make a definitive statement of the relationship of energy dependence to the cumulative fission yields. Fission and monoenergetic neutron sources are available that

  2. 6.3 Incorporating Susceptibility Information into Cumulative Risk Assessment

    EPA Science Inventory

    In recent years, there has been an increased focus on understanding the differential health effects of environmental chemical exposures and on incorporating this information into risk assessments for environmental chemicals. Susceptibility is defined as increased likelihood of an...

  3. Cumulative impacts on wetlands: Linking scientific assessments and regulatory alternatives

    NASA Astrophysics Data System (ADS)

    Lee, Lyndon C.; Gosselink, James G.

    1988-09-01

    This article is an extension and application of Preston and Bedford (1988), especially as relevant to bottomland hardwood (BLH) forests of the southeastern United States. The most important cumulative effects in BLH forests result from incremental forest loss (nibbling) and from synergisms resulting from this nibbling. Present regulatory procedures are ineffective in preventing incremental forest loss because of the focus on permit site evaluation, rather than on large landscapes. Three examples are given to illustrate the need for a landscape focus. This perspective requires preplanning or goal-setting to establish the desired conditions to be maintained in the regulated landscape unit. Spatial and temporal scales are of particular concern for landscape impact assessment. Natural drainage basins of about 106 ha, as identified in U.S. Geological Survey hydrologic units, appear to appropriate spatial units: they have fairly natural boundaries, are of sufficient size to support populations of large, wide-ranging mammals, and are compatible with existing maps and databases. Time scales should be sufficiently long to include recovery of wetland ecosystems from human perturbations. In practice, available data sets limit analysis to no longer than 50 yr. Eight indicators of landscape integrity are identified, based on generally available long-term data sets. Linking technical information concerning cumulative effects on landscapes to the evaluation of cumulative impacts in regulatory programs (i.e., goal-setting) is a serious issue that can benefit from precedents found in the field of epidemiology, and in the establishment of clean air and clean water standards. We suggest that reference data sets must be developed, relating BLH function to structure (forest area). These can be used to set goals for individual watersheds, based on their present conditions and the magnitude and type of perceived development pressures. Thus the crucial steps in establishing a successful

  4. Contribution of locally grown foods in cumulative exposure assessments.

    PubMed

    Lobscheid, Agnes B; Maddalena, Randy L; McKone, Thomas E

    2004-01-01

    Both laboratory and field studies confirm the importance of vegetation for scavenging semivolatile organic chemicals (SVOCs) from the atmosphere and a number of exposure studies have found that the dietary pathway is often a significant contributor to cumulative exposure for these chemicals. However, little information exists on the atmospheric source-to-dietary intake linkage for SVOCs. Because of higher SVOC emissions to urban regions, this linkage is particularly important for foods that are grown, distributed and consumed in or near urban regions. The food pathway can also contribute to dietary exposure for populations that are remote from a pollutant source if the pollutants can migrate to agricultural regions and subsequently to the agricultural commodities distributed to that population. We use available data, the characteristic travel distance, and the CalTOX multimedia model framework to assess the contribution of local sources of food to cumulative SVOC intake. Based on published concentration data for foods, our exposure calculations indicate that the potential intake through ingestion can be up to 1000 times that of inhalation for certain persistent SVOCs. We use the population-based intake fraction (iF) to determine how SVOC intake can vary among food commodities and exposure pathways, and to determine the contribution of airborne emitted SVOCs to the diet in the Northern Hemisphere. We focus on three representative multimedia SVOCs-benzo(a)pyrene, fluoranthene, and 2,3,7,8-tetrachlorodibenzo-p-dioxin. The approach presented here provides a useful framework and starting point for source-to-intake assessments for the ambient air-to-dietary exposure pathway.

  5. [Cumulative risk assessment for consumers of agricultural crops polluted with one chemical class pesticide residues (case of triazole fungicides)].

    PubMed

    Koval'chuk, N M; Omel'chuk, S T

    2011-01-01

    Different indices of cumulative risk assessment of combination of residues of pesticides which may simultaneously be present in raw agricultural crops, based on toxic evaluation of such combination have been presented. Risk for population health due to consumption of raw agricultural crops with triazole residues is acceptable on hazard index, point of departure index and cumulative risk index, exceeds allowable level on criterion "total margin of exposure". PMID:22768736

  6. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27398233

  7. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course.

  8. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-04-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course.

  9. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27534725

  10. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors

    PubMed Central

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-01-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the “real world” environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27398233

  11. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    PubMed

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

  12. Project 6: Cumulative Risk Assessment (CRA) Methods and Applications

    EPA Science Inventory

    Project 6: CRA Methods and Applications addresses the need to move beyond traditional risk assessment practices by developing CRA methods to integrate and evaluate impacts of chemical and nonchemical stressors on the environment and human health. Project 6 has three specific obje...

  13. 76 FR 82296 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period AGENCY... established in the Federal Register of November 9, 2011 (76 FR 69726) (FRL-8888-9). In that notice, the Agency announced the availability of EPA's cumulative risk assessment for the pyrethroids. Based on this...

  14. A Modeling System to Examine Near-Road and Near-Source Air Toxics for Community-Scale Cumulative Assessments.

    EPA Science Inventory

    Cumulative assessments consider a range of potential stressors that might impact the health of a receptor, such as a local neighborhood or wetland area. When receptors are located near pollution sources such as highways or ports (within 500-1,000 m), then they could be at risk of...

  15. HESI EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of inp...

  16. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    EPA Science Inventory

    Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific metho...

  17. Approaches and Sources of Uncertainty in Mixtures and Cumulative Risk Assessment

    EPA Science Inventory

    Approaches and Sources of Uncertainty in Mixtures and Cumulative Risk Assessment JC Lipscomb U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Cincinnati, Ohio, USA Humans and environmental species are rarel...

  18. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

    PubMed Central

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). Conclusions Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

  19. Cumulative Adversity Sensitizes Neural Response to Acute Stress: Association with Health Symptoms

    PubMed Central

    Seo, Dongju; Tsou, Kristen A; Ansell, Emily B; Potenza, Marc N; Sinha, Rajita

    2014-01-01

    Cumulative adversity (CA) increases stress sensitivity and risk of adverse health outcomes. However, neural mechanisms underlying these associations in humans remain unclear. To understand neural responses underlying the link between CA and adverse health symptoms, the current study assessed brain activity during stress and neutral-relaxing states in 75 demographically matched, healthy individuals with high, mid, and low CA (25 in each group), and their health symptoms using the Cornell Medical Index. CA was significantly associated with greater adverse health symptoms (P=0.01) in all participants. Functional magnetic resonance imaging results indicated significant associations between CA scores and increased stress-induced activity in the lateral prefrontal cortex, insula, striatum, right amygdala, hippocampus, and temporal regions in all 75 participants (p<0.05, whole-brain corrected). In addition to these regions, the high vs low CA group comparison revealed decreased stress-induced activity in the medial orbitofrontal cortex (OFC) in the high CA group (p<0.01, whole-brain corrected). Specifically, hypoactive medial OFC and hyperactive right hippocampus responses to stress were each significantly associated with greater adverse health symptoms (p<0.01). Furthermore, an inverse correlation was found between activity in the medial OFC and right hippocampus (p=0.01). These results indicate that high CA sensitizes limbic–striatal responses to acute stress and also identifies an important role for stress-related medial OFC and hippocampus responses in the effects of CA on increasing vulnerability to adverse health consequences. PMID:24051900

  20. Non-Chemical Stressors and Cumulative Risk Assessment: An Overview of Current Initiatives and Potential Air Pollutant Interactions

    PubMed Central

    Lewis, Ari S.; Sax, Sonja N.; Wason, Susan C.; Campleman, Sharan L.

    2011-01-01

    Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit

  1. CONSIDERATIONS FOR DEVELOPING A DOSIMETRY-BASED CUMULATIVE RISK ASSESSMENT APPROACH FOR MIXTURES OF ENVIRONMENTAL CONTAMINANTS (Final Report)

    EPA Science Inventory

    This final report, Considerations for Developing a Dosimetry-Based Cumulative Risk Assessment Approach for Mixtures of Environmental Contaminants, addresses the justification for developing physiologically based pharmacokinetic (PBPK) models for cumulative risk assessment....

  2. Using Secondary Data to Evaluate Diverse Groups of Chemical and Nonchemical Stressors in Cumulative Risk Assessment

    EPA Science Inventory

    A main impediment of performing cumulative risk assessments (CRAs) is having data for multiple chemical and nonchemical stressors in the same individuals or populations. Therefore, secondary data analysis can be utilized as a screening approach to integrate population characteri...

  3. A Summary of Publications on Methods and Tools for Assessing Cumulative Risk, Project Summary

    EPA Science Inventory

    This collection of eight publications on cumulative risk assessment was developed collaboratively among scientists within EPA’s Office of Research and Development and three other organizations. These include scientific collaborations through an Interagency Agreement with Argonne...

  4. Assessing cumulative impacts to elk and mule deer in the Salmon River Basin, Idaho

    SciTech Connect

    O'Neil, T.A.; Witmer, G.W.

    1988-01-01

    In this paper, we illustrate the method, using the potential for cumulative impacts to elk and mule deer from multiple hydroelectric development in the Salmon River Basin of Idaho. We attempted to incorporate knowledge of elk and mule deer habitat needs into a paradigm to assess cumulative impacts and aid in the regulatory decision making process. Undoubtedly, other methods could be developed based on different needs or constraints, but we offer this technique as a means to further refine cumulative impact assessment. Our approach is divided into three phases: analysis, evaluation, and documentation. 36 refs., 2 figs., 3 tabs.

  5. Ultrasonic assessment of cumulative internal damage in filled polymers (II)

    SciTech Connect

    Knollman, G.C.; Martinson, R.H.; Bellin, J.L.

    1980-06-01

    An ultrasonic technique previously developed for studying dewetting and cumulative internal damage in filled polymers, such as solid rocket propellents, has been improved. The previous theoretical treatment is here expanded to include internal vacuoles of general spheroidal (rather than spherical) shape. Experimental measurements of sound speed and attenuation in a solid propellant material are utilized together with the modified theoretical model to calculate the internal damage parameters of effective vacuole size and number density as functions of applied uniaxial tensile strain. Results obtained from the model near the point of material failure are in excellent agreement with those provided by independent microscopic observations made on several rupture surfaces of propellant samples stressed to failure.

  6. Cumulative risk assessment of the exposure to pyrethroids through fruits consumption in China - Based on a 3-year investigation.

    PubMed

    Li, Zhixia; Nie, Jiyun; Lu, Zeqi; Xie, Hanzhong; Kang, Lu; Chen, Qiusheng; Li, An; Zhao, Xubo; Xu, Guofeng; Yan, Zhen

    2016-10-01

    In the present study, the long-term and short-term cumulative risks of pyrethroids exposured for the Chinese general population and children through fruits consumption were evaluated. A total of 1450 fruit samples and seven pyrethroids were included based on the pesticide residues monitoring programme of China from 2013 to 2015. The exposure was estimated using both deterministic approach and semi-probabilistic model for comparison. The hazard index approach was used to assess cumulative risk. 26% of samples contained pyrethroid residues with concentrations ranged from 0.0050 mg/kg to 1.2 mg/kg, of which 30% simultaneously with 2-4 mixture residues. Results demonstrated that the cumulative health risks were extremely low for both general population and children (1-6 years old) of China in the long term. Acute risk estimations calculated by deterministic method were several or many times overestimated than the results based on semi-probabilistic method. Acute cumulative exposure of children to pyrethroid compounds in 0.76% samples were exceeded 1 in worst case scenario. More detailed assessments with adequate data in the future use probabilistic method is expected to reduce the uncertainties of cumulative dietary exposure. PMID:27515867

  7. Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden.

    PubMed

    Leopold, Liliya

    2016-06-01

    According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states.

  8. Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden.

    PubMed

    Leopold, Liliya

    2016-06-01

    According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states. PMID:27284078

  9. Cumulative Adverse Financial Circumstances: Associations with Patient Health Status and Behaviors

    ERIC Educational Resources Information Center

    Bisgaier, Joanna; Rhodes, Karin V.

    2011-01-01

    This article examines associations between cumulative adverse financial circumstances and patient health in a sample of 1,506 urban emergency department (ED) patients. Study participants completed a previously validated Social Health Survey between May and October 2009. Five categories of economic deprivation were studied: food insecurity, housing…

  10. Cumulative Risk Assessment and Environmental Equity in Air Permitting: Interpretation, Methods, Community Participation and Implementation of a Unique Statute

    PubMed Central

    Ellickson, Kristie M.; Sevcik, Sarah M.; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C.

    2011-01-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider “cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility’s emissions are likely to be deposited.” Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase ‘environmental equity’. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the “cumulative levels and effects analysis”. PMID:22163199

  11. Cumulative risk assessment and environmental equity in air permitting: interpretation, methods, community participation and implementation of a unique statute.

    PubMed

    Ellickson, Kristie M; Sevcik, Sarah M; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C

    2011-11-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider "cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited." Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase 'environmental equity'. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the "cumulative levels and effects analysis".

  12. A Conceptual Framework for the Assessment of Cumulative Exposure to Air Pollution at a Fine Spatial Scale

    PubMed Central

    Wahida, Kihal-Talantikite; Padilla, Cindy M.; Denis, Zmirou-Navier; Olivier, Blanchard; Géraldine, Le Nir; Philippe, Quenel; Séverine, Deguen

    2016-01-01

    Many epidemiological studies examining long-term health effects of exposure to air pollutants have characterized exposure by the outdoor air concentrations at sites that may be distant to subjects’ residences at different points in time. The temporal and spatial mobility of subjects and the spatial scale of exposure assessment could thus lead to misclassification in the cumulative exposure estimation. This paper attempts to fill the gap regarding cumulative exposure assessment to air pollution at a fine spatial scale in epidemiological studies investigating long-term health effects. We propose a conceptual framework showing how major difficulties in cumulative long-term exposure assessment could be surmounted. We then illustrate this conceptual model on the case of exposure to NO2 following two steps: (i) retrospective reconstitution of NO2 concentrations at a fine spatial scale; and (ii) a novel approach to assigning the time-relevant exposure estimates at the census block level, using all available data on residential mobility throughout a 10- to 20-year period prior to that for which the health events are to be detected. Our conceptual framework is both flexible and convenient for the needs of different epidemiological study designs. PMID:26999170

  13. Poor Child Health, Family Capital and Cumulative Inequality in Academic Achievement

    PubMed Central

    Jackson, Margot

    2015-01-01

    Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered; the duration and stability of poor health; and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N=9,252) to ask: 1) if child health is a source of cumulative inequality in academic achievement; 2) whether this relationship depends on the timing and duration of poor health; and 3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists, and that whether we observe shrinking or widening inequality as children age depends on when we measure their health, and whether children have access to compensatory resources. PMID:25926564

  14. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    PubMed Central

    August, Laura Meehan; Faust, John B.; Cushing, Lara; Zeise, Lauren; Alexeeff, George V.

    2012-01-01

    Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure. PMID:23202671

  15. Tools Available to Communities for Conducting Cumulative Exposure and Risk Assessments

    EPA Science Inventory

    This paper summarizes and assesses over 70 tools that could aid with gathering information and taking action on environmental issues related to community-based cumulative risk assessments (CBCRA). Information on tool use, development and research needs, was gathered from websites...

  16. A method proposal for cumulative environmental impact assessment based on the landscape vulnerability evaluation

    SciTech Connect

    Pavlickova, Katarina; Vyskupova, Monika

    2015-01-15

    Cumulative environmental impact assessment deals with the occasional use in practical application of environmental impact assessment process. The main reasons are the difficulty of cumulative impact identification caused by lack of data, inability to measure the intensity and spatial effect of all types of impacts and the uncertainty of their future evolution. This work presents a method proposal to predict cumulative impacts on the basis of landscape vulnerability evaluation. For this purpose, qualitative assessment of landscape ecological stability is conducted and major vulnerability indicators of environmental and socio-economic receptors are specified and valuated. Potential cumulative impacts and the overall impact significance are predicted quantitatively in modified Argonne multiple matrixes while considering the vulnerability of affected landscape receptors and the significance of impacts identified individually. The method was employed in the concrete environmental impact assessment process conducted in Slovakia. The results obtained in this case study reflect that this methodology is simple to apply, valid for all types of impacts and projects, inexpensive and not time-consuming. The objectivity of the partial methods used in this procedure is improved by quantitative landscape ecological stability evaluation, assignment of weights to vulnerability indicators based on the detailed characteristics of affected factors, and grading impact significance. - Highlights: • This paper suggests a method proposal for cumulative impact prediction. • The method includes landscape vulnerability evaluation. • The vulnerability of affected receptors is determined by their sensitivity. • This method can increase the objectivity of impact prediction in the EIA process.

  17. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    PubMed Central

    Barzyk, Timothy M.; Wilson, Sacoby; Wilson, Anthony

    2015-01-01

    Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1) planning, scoping, and problem formulation; (2) risk analysis and ranking, and (3) risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels. PMID:25918910

  18. [Recommendations for the analysis of cumulated data in antimicrobial susceptibility in health institutions].

    PubMed

    2010-04-01

    Due to the great variability in antimicrobial resistance patterns, local reports of cumulative antimicrobial susceptibility data are necessary in every health center. The purpose is to guide clinical decisions and the early detection of patterns that allow preventive measures to avoid dissemination of resistant strains. The main objective of this guide is to provide recommendations for the analysis of antimicrobial susceptibility data and elaboration of a local report. Recommendations provided in this guide are based on the Clinical and Laboratory Standards Institute (CLSI) document "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data" (3). Key aspects related to information gathering and data processing, analysis and presentation are described.

  19. Incorporating cumulative effects into environmental assessments of mariculture: Limitations and failures of current siting methods

    SciTech Connect

    King, Sarah C. Pushchak, Ronald

    2008-11-15

    Assessing and evaluating the cumulative impacts of multiple marine aquaculture facilities has proved difficult in environmental assessment. A retrospective review of 23 existing mariculture farms in southwestern New Brunswick was conducted to determine whether cumulative interactions would have justified site approvals. Based on current scientific evidence of cumulative effects, six new criteria were added to a set of far-field impacts and other existing criteria were expanded to include regional and cumulative environmental impacts in Hargrave's [Hargrave BT. A traffic light decision system for marine finfish aquaculture siting. Ocean Coast Manag 2002; 45:215-35.] Traffic Light Decision Support System (DSS) presently used in Canadian aquaculture environmental assessments. Before mitigation, 19 of the 23 sites failed the amended set of criteria and after considering mitigation, 8 sites failed. Site and ecosystem indices yielded varying site acceptability scores; however, many sites would not have been approved if siting decisions had been made within a regional management framework and cumulative impact criteria were considered in the site evaluation process.

  20. Cumulative Violence Exposure, Emotional Nonacceptance, and Mental Health Symptoms in a Community Sample of Women

    PubMed Central

    Sundermann, Jane M.; Chu, Ann T.; DePrince, Anne P.

    2012-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence) – referred to here as cumulative violence exposure – are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims’ emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of three types of symptoms central to complex trauma responses: depression, dissociation, and Posttraumatic stress disorder (PTSD) symptoms. A non-treatment seeking community sample of women (N = 89; Mage = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test three mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women’s cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations. PMID:23282048

  1. Cumulative violence exposure, emotional nonacceptance, and mental health symptoms in a community sample of women.

    PubMed

    Sundermann, Jane M; Chu, Ann T; DePrince, Anne P

    2013-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence)--referred to here as cumulative violence exposure--are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims' emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of 3 types of symptoms central to complex trauma responses: depression, dissociation, and posttraumatic stress disorder (PTSD) symptoms. A non-treatment-seeking community sample of women (N = 89; M age = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test 3 mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women's cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations.

  2. Cumulative impact assessments and bird/wind farm interactions: Developing a conceptual framework

    SciTech Connect

    Masden, Elizabeth A.; Fox, Anthony D.; Furness, Robert W.; Bullman, Rhys; Haydon, Daniel T.

    2010-01-15

    The wind power industry has grown rapidly in the UK to meet EU targets of sourcing 20% of energy from renewable sources by 2020. Although wind power is a renewable energy source, there are environmental concerns over increasing numbers of wind farm proposals and associated cumulative impacts. Individually, a wind farm, or indeed any action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. EU and UK legislation requires a cumulative impact assessment (CIA) as part of Environmental Impact Assessments (EIA). However, in the absence of detailed guidance and definitions, such assessments within EIA are rarely adequate, restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Here we propose a conceptual framework to promote transparency in CIA through the explicit definition of impacts, actions and scales within an assessment. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development EIAs. We propose that benefits would be gained from elevating CIA to a strategic level, as a component of spatially explicit planning.

  3. The Validation of a Case-Based, Cumulative Assessment and Progressions Examination

    PubMed Central

    Coker, Adeola O.; Copeland, Jeffrey T.; Gottlieb, Helmut B.; Horlen, Cheryl; Smith, Helen E.; Urteaga, Elizabeth M.; Ramsinghani, Sushma; Zertuche, Alejandra; Maize, David

    2016-01-01

    Objective. To assess content and criterion validity, as well as reliability of an internally developed, case-based, cumulative, high-stakes third-year Annual Student Assessment and Progression Examination (P3 ASAP Exam). Methods. Content validity was assessed through the writing-reviewing process. Criterion validity was assessed by comparing student scores on the P3 ASAP Exam with the nationally validated Pharmacy Curriculum Outcomes Assessment (PCOA). Reliability was assessed with psychometric analysis comparing student performance over four years. Results. The P3 ASAP Exam showed content validity through representation of didactic courses and professional outcomes. Similar scores on the P3 ASAP Exam and PCOA with Pearson correlation coefficient established criterion validity. Consistent student performance using Kuder-Richardson coefficient (KR-20) since 2012 reflected reliability of the examination. Conclusion. Pharmacy schools can implement internally developed, high-stakes, cumulative progression examinations that are valid and reliable using a robust writing-reviewing process and psychometric analyses. PMID:26941435

  4. 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.

  5. 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

  6. Estimating Greenspace Exposure and Benefits for Cumulative Risk Assessment Applications (Summary Report)

    EPA Science Inventory

    This document provides a summary of the technical meeting on greenspace (GS) and cumulative risk assessment convened May 4−5, 2015 in Cincinnati, OH, by the U.S. Environmental Protection Agency (EPA) Office of Research and Development (ORD) National Center for Environmental As...

  7. Assessing cumulative impacts within state environmental review frameworks in the United States

    SciTech Connect

    Ma Zhao; Becker, Dennis R.; Kilgore, Michael A.

    2009-11-15

    Cumulative impact assessment (CIA) is the process of systematically assessing a proposed action's cumulative environmental effects in the context of past, present, and future actions, regardless of who undertakes such actions. Previous studies have examined CIA efforts at the federal level but little is known about how states assess the cumulative impacts of nonfederal projects. By examining state environmental review statutes, administrative rules, agency-prepared materials, and a national survey of the administrators of state environmental review programs, this study identifies the legal and administrative frameworks for CIA. It examines current CIA practice, discusses the relationship between CIA policy and its implementation, and explores the opportunities for improvement. The results of the study show that twenty-nine state environmental review programs across twenty-six states required the assessment of cumulative environmental impacts. More than half of these programs have adopted specific procedures for implementing their policies. Some programs assessed cumulative impacts using a standard review document, and others have created their own documentations incorporated into applications for state permits or funding. The majority of programs have adopted various scales, baselines, significance criteria, and coordination practices in their CIA processes. Mixed methods were generally used for data collection and analysis; qualitative methods were more prevalent than quantitative methods. The results also suggest that a program with comprehensive and consistent environmental review policies and procedures does not always imply extensive CIA requirements and practices. Finally, this study discusses the potential for improving existing CIA processes and promoting CIA efforts in states without established environmental review programs.

  8. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach.

    PubMed

    Chang, J W; Chen, C Y; Yan, B R; Chang, M H; Tseng, S H; Kao, Y M; Chen, J C; Lee, C C

    2014-06-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.

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

    PubMed

    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.

  11. Conceptual and methodological challenges to integrating SEA and cumulative effects assessment

    SciTech Connect

    Gunn, Jill; Noble, Bram F.

    2011-03-15

    The constraints to assessing and managing cumulative environmental effects in the context of project-based environmental assessment are well documented, and the potential benefits of a more strategic approach to cumulative effects assessment (CEA) are well argued; however, such benefits have yet to be clearly demonstrated in practice. While it is widely assumed that cumulative effects are best addressed in a strategic context, there has been little investigation as to whether CEA and strategic environmental assessment (SEA) are a 'good fit' - conceptually or methodologically. This paper identifies a number of conceptual and methodological challenges to the integration of CEA and SEA. Based on results of interviews with international experts and practitioners, this paper demonstrates that: definitions and conceptualizations of CEA are typically weak in practice; approaches to effects aggregation vary widely; a systems perspective lacks in both SEA and CEA; the multifarious nature of SEA complicates CEA; tiering arrangements between SEA and project-based assessment are limited to non-existing; and the relationship of SEA to regional planning remains unclear.

  12. Revision of the Beginning Breastfeeding Survey: A Cumulative Assessment of Breastfeeding

    PubMed Central

    Mulder, Pamela

    2015-01-01

    Background and Purpose Women use their cumulative breastfeeding experiences, in combination with other factors, to make their infant feeding decisions. This pilot study assessed the reliability and predictive validity of the revised Beginning Breastfeeding Survey-Cumulative (BBS-C). Methods 25 women were recruited prenatally from a university hospital. The BBS-C was completed before hospital discharge. Infant feeding outcomes were measured at 1 and 3 months postpartum. Results Participants were 17–40 years old, mostly married, Whites, and well-educated. Coefficient alpha was .92–.94. The BBS-C predicted an infant not receiving breast milk, not feeding from the breast, and receiving infant formula feedings. Conclusions In this sample, the BBS-C had strong reliability and predictive validity. Further testing should assess reliability and predictive validity in a wider range of populations and settings. PMID:23786136

  13. DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PESTICIDES

    EPA Science Inventory

    The US EPAs N-Methyl Carbamate Cumulative Risk Assessment (NMCRA) assesses the effect on acetylcholine esterase (AChE) activity of exposure to 10 N-methyl carbamate (NMC) pesticides through dietary, drinking water, and residential exposures.

  14. A feasibility study of cumulative risk assessment methods for drinking water disinfection by-product mixtures.

    PubMed

    Teuschler, Linda K; Rice, Glenn E; Wilkes, Charles R; Lipscomb, John C; Power, Fred W

    Humans are exposed daily to complex mixtures of chemicals, including drinking water disinfection by-products (DBPs) via oral, dermal, and inhalation routes. Some positive epidemiological and toxicological studies suggest reproductive and developmental effects and cancer are associated with consumption of chlorinated drinking water. Thus, the U.S. Environmental Protection Agency (EPA) conducted research to examine the feasibility of evaluating simultaneous exposures to multiple DBPs via all three exposure routes. A cumulative risk assessment approach was developed for DBP mixtures by combining exposure modeling and physiologically based pharmacokinetic modeling results with a new mixtures risk assessment method, the cumulative relative potency factors (CRPF) approach. Internal doses were estimated for an adult female and an adult male, each of reproductive age, and for a child (age 6 yr) inclusive of oral, dermal, and inhalation exposures. Estimates of the daily internal doses were made for 13 major DBPs, accounting for activity patterns that affect the amount of human contact time with drinking water (e.g., tap water consumed, time spent showering), building characteristics (e.g., household air volumes), and physicochemical properties of the DBPs (e.g., inhalation rates, skin permeability rates, blood: air partition coefficients). A novel cumulative risk assessment method, the CRPF approach, is advanced that integrates the principles of dose addition and response addition to produce multiple-route, chemical mixture risk estimates using total absorbed doses. Research needs to improve this approach are presented.

  15. Role of slope stability in cumulative impact assessment of hydropower development: North Cascades, Washington

    SciTech Connect

    Lee, R.R.; Staub, W.P.

    1993-08-01

    Two environmental assessments considered the potential cumulative environmental impacts resulting from the development of eight proposed hydropower projects in the Nooksack River Basin and 11 proposed projects in the Skagit River Basin, North Cascades, Washington, respectively. While not identified as a target resource, slope stability and the alteration of sediment supply to creeks and river mainstems significantly affect other resources. The slope stability assessment emphasized the potential for cumulative impacts under disturbed conditions (e.g., road construction and timber harvesting) and a landslide-induced pipeline rupture scenario. In the case of small-scale slides, the sluicing action of ruptured pipeline water on the fresh landslide scarp was found to be capable of eroding significantly more material than the original landslide. For large-scale landslides, sluiced material was found to be a small increment of the original landslide. These results predicted that hypothetical accidental pipeline rupture by small-scale landslides may result in potential cumulative impacts for 12 of the 19 projects with pending license applications in both river basins. 5 refs., 2 tabs.

  16. Cumulative risk and developmental health: an argument for the importance of a family-wide science.

    PubMed

    Browne, Dillon T; Plamondon, Andre; Prime, Heather; Puente-Duran, Sofia; Wade, Mark

    2015-01-01

    A substantial body of research links social disadvantage and developmental health via a cascade running from poverty, to cumulative psychosocial risk, to disrupted family dynamics, to child biological regulatory systems and neurocognitive processing, and finally to morbidity across the lifespan. Most research in this area employs single-dyad or between-family methodology. While informative, there are limitations to this approach. Specifically, it is impossible to determine how risk alters psychosocial environments that are similar for all persons within a household, versus processes that are unique to particular children. This is important in light of literature citing the primacy of child-specific environments in driving developmental health. Methodologically speaking, there are both benefits and challenges to family-wide approaches that differentiate between- and within-family environments. This review describes literature linking cumulative risk and developmental health via family process, while articulating the importance of family-wide approaches. Areas of shortcoming and recommendations for a family-wide science are provided.

  17. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    PubMed

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children.

  18. Framework tool for a rapid cumulative effects assessment: case of a prominent wetland in Myanmar.

    PubMed

    Pradhan, N; Habib, H; Venkatappa, M; Ebbers, T; Duboz, R; Shipin, O

    2015-06-01

    The wetland of focus, Inle Lake, located in central Myanmar, is well known for its unique biodiversity and culture, as well as for ingenious floating garden agriculture. During the last decades, the lake area has seen extensive degradation in terms of water quality, erosion, deforestation, and biodiversity concomitant with a major shift to unsustainable land use. The study was conducted, with an emphasis on water quality, to analyze environmental impacts (effects) changing the ecosystem and to comprehensively evaluate the environmental state of the ecosystem through an innovative Rapid Cumulative Effects Assessment framework tool. The assessment started with a framework-forming Participatory Rural Appraisal (PRA), which quantified and prioritized impacts over space and time. Critically important impacts were assessed for "intra-inter interactions" using the loop analysis simulation. Water samples were analyzed while geographic information system (GIS) and remote sensing were used to identify water pollution hotspots. It was concluded that out of a plethora of impacts, pollution from municipal sources, sedimentation, and effects exerted by floating gardens had the most detrimental impacts, which cumulatively affected the entire ecosystem. The framework tool was designed in a broad sense with a reference to highly needed assessments of poorly studied wetlands where degradation is evident, but scarcely quantified, and where long-term field studies are fraught with security issues and resource unavailability (post-conflict, poor and remote regions, e.g., Afghanistan, Laos, Sudan, etc.). PMID:25963760

  19. Current Status of Development of Methods to Assess Effects of Cumulative or Aggregated Underwater Sounds on Marine Mammals.

    PubMed

    Fleishman, Erica; Streever, Bill; Angliss, Robyn; Clark, Christopher W; Ellison, William T; Frankel, Adam; Gedamke, Jason; Leu, Matthias; McKenna, Megan; Racca, Roberto; Simmons, Samantha; Suydam, Robert

    2016-01-01

    There are no standards for assessment of the cumulative effects of underwater sound. Quantitative assessments typically consider a single source, whereas qualitative assessments may include multiple sources but rarely identify response variables. As a step toward understanding the cumulative effects of underwater sound, we assessed the aggregated sounds of multiple sources received by migrating bowhead whales (Balaena mysticetus). The quantitative method models the sound field from multiple sources and simulates movement of a population through it. The qualitative method uses experts to assess the responses of individuals and populations to sound sources and identify the potential mechanisms. These methods increase the transparency of assessments. PMID:26610973

  20. Current Status of Development of Methods to Assess Effects of Cumulative or Aggregated Underwater Sounds on Marine Mammals.

    PubMed

    Fleishman, Erica; Streever, Bill; Angliss, Robyn; Clark, Christopher W; Ellison, William T; Frankel, Adam; Gedamke, Jason; Leu, Matthias; McKenna, Megan; Racca, Roberto; Simmons, Samantha; Suydam, Robert

    2016-01-01

    There are no standards for assessment of the cumulative effects of underwater sound. Quantitative assessments typically consider a single source, whereas qualitative assessments may include multiple sources but rarely identify response variables. As a step toward understanding the cumulative effects of underwater sound, we assessed the aggregated sounds of multiple sources received by migrating bowhead whales (Balaena mysticetus). The quantitative method models the sound field from multiple sources and simulates movement of a population through it. The qualitative method uses experts to assess the responses of individuals and populations to sound sources and identify the potential mechanisms. These methods increase the transparency of assessments.

  1. Towards a framework for assessment and management of cumulative human impacts on marine food webs.

    PubMed

    Giakoumi, Sylvaine; Halpern, Benjamin S; Michel, Loïc N; Gobert, Sylvie; Sini, Maria; Boudouresque, Charles-François; Gambi, Maria-Cristina; Katsanevakis, Stelios; Lejeune, Pierre; Montefalcone, Monica; Pergent, Gerard; Pergent-Martini, Christine; Sanchez-Jerez, Pablo; Velimirov, Branko; Vizzini, Salvatrice; Abadie, Arnaud; Coll, Marta; Guidetti, Paolo; Micheli, Fiorenza; Possingham, Hugh P

    2015-08-01

    Effective ecosystem-based management requires understanding ecosystem responses to multiple human threats, rather than focusing on single threats. To understand ecosystem responses to anthropogenic threats holistically, it is necessary to know how threats affect different components within ecosystems and ultimately alter ecosystem functioning. We used a case study of a Mediterranean seagrass (Posidonia oceanica) food web and expert knowledge elicitation in an application of the initial steps of a framework for assessment of cumulative human impacts on food webs. We produced a conceptual seagrass food web model, determined the main trophic relationships, identified the main threats to the food web components, and assessed the components' vulnerability to those threats. Some threats had high (e.g., coastal infrastructure) or low impacts (e.g., agricultural runoff) on all food web components, whereas others (e.g., introduced carnivores) had very different impacts on each component. Partitioning the ecosystem into its components enabled us to identify threats previously overlooked and to reevaluate the importance of threats commonly perceived as major. By incorporating this understanding of system vulnerability with data on changes in the state of each threat (e.g., decreasing domestic pollution and increasing fishing) into a food web model, managers may be better able to estimate and predict cumulative human impacts on ecosystems and to prioritize conservation actions. PMID:25704365

  2. Towards a framework for assessment and management of cumulative human impacts on marine food webs.

    PubMed

    Giakoumi, Sylvaine; Halpern, Benjamin S; Michel, Loïc N; Gobert, Sylvie; Sini, Maria; Boudouresque, Charles-François; Gambi, Maria-Cristina; Katsanevakis, Stelios; Lejeune, Pierre; Montefalcone, Monica; Pergent, Gerard; Pergent-Martini, Christine; Sanchez-Jerez, Pablo; Velimirov, Branko; Vizzini, Salvatrice; Abadie, Arnaud; Coll, Marta; Guidetti, Paolo; Micheli, Fiorenza; Possingham, Hugh P

    2015-08-01

    Effective ecosystem-based management requires understanding ecosystem responses to multiple human threats, rather than focusing on single threats. To understand ecosystem responses to anthropogenic threats holistically, it is necessary to know how threats affect different components within ecosystems and ultimately alter ecosystem functioning. We used a case study of a Mediterranean seagrass (Posidonia oceanica) food web and expert knowledge elicitation in an application of the initial steps of a framework for assessment of cumulative human impacts on food webs. We produced a conceptual seagrass food web model, determined the main trophic relationships, identified the main threats to the food web components, and assessed the components' vulnerability to those threats. Some threats had high (e.g., coastal infrastructure) or low impacts (e.g., agricultural runoff) on all food web components, whereas others (e.g., introduced carnivores) had very different impacts on each component. Partitioning the ecosystem into its components enabled us to identify threats previously overlooked and to reevaluate the importance of threats commonly perceived as major. By incorporating this understanding of system vulnerability with data on changes in the state of each threat (e.g., decreasing domestic pollution and increasing fishing) into a food web model, managers may be better able to estimate and predict cumulative human impacts on ecosystems and to prioritize conservation actions.

  3. Cumulative or sequential assessment during hermit crab shell fights: effects of oxygen on decision rules.

    PubMed Central

    Briffa, M; Elwood, R W

    2000-01-01

    Agonistic interactions between animals are often settled by the use of repeated signals which advertise the resource-holding potential of the sender. According to the sequential assessment game this repetition increases the accuracy with which receivers may assess the signal, but under the cumulative assessment model the repeated performances accumulate to give a signal of stamina. These models may be distinguished by the temporal pattern of signalling they predict and by the decision rules used by the contestants. Hermit crabs engage in shell fights over possession of the gastropod shells that they inhabit. During these interactions the two roles of signaller and receiver may be examined separately because they are fixed for the duration of the encounter. Attackers rap their shell against that of the defender in a series of bouts whereas defenders remain tightly withdrawn into their shells for the duration of the contest. At the end of a fight the attacker may evict the defender from its shell or decide to give up without first effecting an eviction; the decision for defenders is either to maintain a grip on its shell or to release the shell and allow itself to be evicted. We manipulated fatigue levels separately for attackers and defenders, by varying the oxygen concentration of the water that they are held in prior to fighting, and examined the effects that this has on the likelihood of each decision and on the temporal pattern of rapping. We show that the vigour of rapping and the likelihood of eviction are reduced when the attacker is subjected to low oxygen but that this treatment has no effect on rates of eviction when applied to defenders. We conclude that defenders compare the vigour of rapping with an absolute threshold rather than with a relative threshold when making their decision. The data are compatible with the cumulative assessment model and with the idea that shell rapping signals the stamina of attackers, but do not fit the predictions of the

  4. Appraising the sustainability of project alternatives: An increasing role for cumulative effects assessment

    SciTech Connect

    Senner, Robert

    2011-09-15

    Evaluating and comparing development alternatives with regard to sustainability is an important goal for comprehensive project appraisal. In the United States, this component has been largely missing from standard environmental impact assessment practice. Cumulative effects assessment provides a way to appraise the sustainability of project alternatives in terms of their probable contributions to long-term trends affecting the condition of valued environmental components. Sustainability metrics and predictors are being developed as criteria for rating systems and evaluation processes that are applied to community planning, building design, and transportation infrastructure. Increasing interest in adaptive management is also providing cost-effective solutions to optimizing safety and function throughout the long-term operation of a facility or infrastructure. Recent federal legislation is making it easier to integrate sustainability features into development alternatives through early, community-based planning.

  5. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    PubMed

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low. PMID:25341819

  6. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    PubMed

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low.

  7. Procedures for assessment of cumulative impacts of coal mining on the hydrologic balance

    USGS Publications Warehouse

    Lumb, Alan M.

    1982-01-01

    Techniques were developed to assess the probable cumulative impacts of anticipated surface mining upon the hydrology of and area. An activity profile of cumulative drainage area versus river miles downstream from the surface mining site is constructed that shows major water uses, flood prone areas, and stream classifications. From the summary shown by the activity profile, an impact matrix is used as a checklist for the importance of the impacts under categories such as water supply, flood prone areas, water contact recreation, etc. Based on the categories checked on the impact matrix, a simple, less accurate model or a more comprehensive and accurate one can be used to quantify the impacts. Quantified impacts are then displayed on an impact profile showing the percentage change in a hydrologic characteristic versus distance downstream of the surface mining site. The simple model for quantification considers only dilution from tributary areas during critical periods whereas the comprehensive model routes flows and quality of water continuously through the year and considers, in addition to dilution, instream processes such as settling, biological uptake , and chemical reactions. (USGS)

  8. Alchemy to reason: Effective use of Cumulative Effects Assessment in resource management

    SciTech Connect

    Hegmann, George; Yarranton, G.A.

    2011-09-15

    Cumulative Effects Assessment (CEA) is a tool that can be useful in making decisions about natural resource management and allocation. The decisions to be made include those (i) necessary to construct planning and regulatory frameworks to control development activity so that societal goals will be achieved and (ii) whether or not to approve individual development projects, with or without conditions. The evolution of CEA into a more successful tool cannot occur independently of the evolution of decision making processes. Currently progress is painfully slow on both fronts. This paper explores some opportunities to accelerate improvements in decision making in natural resource management and in the utility of CEA as a tool to assist in making such decisions. The focus of the paper is on how to define the public interest by determining what is acceptable.

  9. Assessing Cumulative Thermal Stress in Fish During Chronic Exposure to High Temperature

    SciTech Connect

    Bevelhimer, M.S.; Bennett, W.R.

    1999-11-14

    As environmental laws become increasingly protective, and with possible future changes in global climate, thermal effects on aquatic resources are likely to receive increasing attention. Lethal temperatures for a variety of species have been determined for situations where temperatures rise rapidly resulting in lethal effects. However, less is known about the effects of chronic exposure to high (but not immediately lethal) temperatures and even less about stress accumulation during periods of fluctuating temperatures. In this paper we present a modeling framework for assessing cumulative thermal stress in fish. The model assumes that stress accumulation occurs above a threshold temperature at a rate depending on the degree to which the threshold is exceeded. The model also includes stress recovery (or alleviation) when temperatures drop below the threshold temperature as in systems with large daily variation. In addition to non-specific physiological stress, the model also simulates thermal effects on growth.

  10. Evaluating Exposures to Chemical and Non-Chemical Stressors in a Cumulative Risk Assessment

    EPA Science Inventory

    Characteristically toxicological and epidemiological studies involving chemical mixtures (e.g., multi-pollutant exposures) have been increasing. Human health assessment of chemical and nonchemical mixture risk remains rare. Recently, there has been an increased emphasis on integr...

  11. Cumulative risk assessment lessons learned: a review of case studies and issue papers.

    PubMed

    Gallagher, Sarah S; Rice, Glenn E; Scarano, Louis J; Teuschler, Linda K; Bollweg, George; Martin, Lawrence

    2015-02-01

    Cumulative risk assessments (CRAs) examine potential risks posed by exposure to multiple and sometimes disparate environmental stressors. CRAs are more resource intensive than single chemical assessments, and pose additional challenges and sources of uncertainty. CRAs may examine the impact of several factors on risk, including exposure magnitude and timing, chemical mixture composition, as well as physical, biological, or psychosocial stressors. CRAs are meant to increase the relevance of risk assessments, providing decision makers with information based on real world exposure scenarios that improve the characterization of actual risks and hazards. The U.S. Environmental Protection Agency has evaluated a number of CRAs, performed by or commissioned for the Agency, to seek insight into CRA concepts, methods, and lessons learned. In this article, ten case studies and five issue papers on key CRA topics are examined and a set of lessons learned are identified for CRA implementation. The lessons address the iterative nature of CRAs, importance of considering vulnerability, need for stakeholder engagement, value of a tiered approach, new methods to assess multiroute exposures to chemical mixtures, and the impact of geographical scale on approach and purpose.

  12. HEALTH NEEDS ASSESSMENT

    PubMed Central

    Bani, Ibrahim A.

    2008-01-01

    This paper takes a public health approach to briefly examine: (i) the concept of community health care need assessment; (ii) the roles of academic institutions in health needs assessment; (iii) Jazan study to address the health care needs in Jazan region, Saudi Arabia. The methods included an analysis of the literature, distillation of experience from the recently Jazan Health Need Assessment Survey, and WHO reports. The most important perceived health problems in Jazan region are shortage of health care providers, increased prevalence of communicable diseases and poor environmental health. The academic institutions, Ministry of Health and other health care institutions need to work together to look for innovative approaches, especially to increase the awareness of the society on public health issues, and give more support to increase national and regional funding for community based studies. The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools. PMID:23012162

  13. (BOSC) DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PRESTICIDES

    EPA Science Inventory

    THE US EPA'S N-METHYL CARBAMATE CUMULATIVE RISK ASSESSMENT (NMCRA) ASSESSES THE EFFECT ON ACETYLCHOLINE ESTERASE (AChE) ACTIVITY OF EXPOSURE TO 10 N-METHLY CARBAMATE (NMC)PESTICIDES THROUGH DIETARY, DRINKING WATER, AND RESIDENTIAL EXPOSURES. THESE DATA THUS INFORM, BUT DO NOT COM...

  14. PHYSIOLOGICALLY-BASED PHARMACOKINETICS/PHARMACODYNAMIC MODELING AND CUMULATIVE RISK ASSESSMENT: CASE STUDY FOR THE N-METHYL CARBMATE PESTICIDES

    EPA Science Inventory

    The Food Quality Protection Act of 1996 [PL 104-170: 110 STAT. 1513] requires EPA to consider potential cumulative human health risks resulting from aggregate exposure to pesticide chemicals acting through a common mechanism of toxicity. This includes all anticipated dietary e...

  15. Methodologies for Assessing the Cumulative Environmental Effects of Hydroelectric Development of Fish and Wildlife in the Columbia River Basin, Volume 1, Recommendations, 1987 Final Report.

    SciTech Connect

    Stull, Elizabeth Ann

    1987-07-01

    This volume is the first of a two-part set addressing methods for assessing the cumulative effects of hydropower development on fish and wildlife in the Columbia River Basin. Species and habitats potentially affected by cumulative impacts are identified for the basin, and the most significant effects of hydropower development are presented. Then, current methods for measuring and assessing single-project effects are reviewed, followed by a review of methodologies with potential for use in assessing the cumulative effects associated with multiple projects. Finally, two new approaches for cumulative effects assessment are discussed in detail. Overall, this report identifies and reviews the concepts, factors, and methods necessary for understanding and conducting a cumulative effects assessment in the Columbia River Basin. Volume 2 will present a detailed procedural handbook for performing a cumulative assessment using the integrated tabular methodology introduced in this volume. 308 refs., 18 figs., 10 tabs.

  16. An approach for assessing cumulative effects in a model river, the Athabasca River basin.

    PubMed

    Squires, Allison J; Westbrook, Cherie J; Dubé, Monique G

    2010-01-01

    Novel approaches addressing aquatic cumulative effects over broad temporal and spatial scales are required to track changes and assist with sustainable watershed management. Cumulative effects assessment (CEA) requires the assessment of changes due to multiple stressors both spatially and temporally. The province of Alberta, Canada, is currently experiencing significant economic growth as well as increasing awareness of water dependencies. There has been an increasing level of industrial, urban, and other land-use related development (pulp and paper mills, oil sands developments, agriculture, and urban development) within the Athabasca River basin. Much of the historical water quantity and quality data for this basin have not been integrated or analyzed from headwaters to mouth, which affects development of a holistic, watershed-scale CEA. The main objectives of this study were 1) to quantify spatial and temporal changes in water quantity and quality over the entire Athabasca River mainstem across historical (1966–1976) and current day (1996–2006) time periods and 2) to evaluate the significance of any changes relative to existing benchmarks (e.g., water quality guidelines). Data were collected from several federal, provincial, and nongovernment sources. A 14% to 30% decrease in discharge was observed during the low flow period in the second time period in the lower 3 river reaches with the greatest decrease occurring at the mouth of the river. Dissolved Na, sulfate, chloride, and total P concentrations in the second time period were greater than, and in some cases double, the 90th percentiles calculated from the first time period in the lower part of the river. Our results show that significant changes have occurred in both water quantity and quality between the historical and current day Athabasca River basin. It is known that, in addition to climatic changes, rivers which undergo increased agricultural, urban, and industrial development can experience

  17. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

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

  18. Probability, conditional probability and complementary cumulative distribution functions in performance assessment for radioactive waste disposal

    SciTech Connect

    Helton, J.C.

    1996-03-01

    A formal description of the structure of several recent performance assessments (PAs) for the Waste Isolation Pilot Plant (WIPP) is given in terms of the following three components: a probability space (S{sub st}, S{sub st}, p{sub st}) for stochastic uncertainty, a probability space (S{sub su}, S{sub su}, p{sub su}) for subjective uncertainty and a function (i.e., a random variable) defined on the product space associated with (S{sub st}, S{sub st}, p{sub st}) and (S{sub su}, S{sub su}, p{sub su}). The explicit recognition of the existence of these three components allows a careful description of the use of probability, conditional probability and complementary cumulative distribution functions within the WIPP PA. This usage is illustrated in the context of the U.S. Environmental Protection Agency`s standard for the geologic disposal of radioactive waste (40 CFR 191, Subpart B). The paradigm described in this presentation can also be used to impose a logically consistent structure on PAs for other complex systems.

  19. A conceptual framework for assessing cumulative impacts on the hydrology of nontidal wetlands

    USGS Publications Warehouse

    Winter, T.C.

    1988-01-01

    Wetlands occur in geologic and hydrologic settings that enhance the accumulation or retention of water. Regional slope, local relief, and permeability of the land surface are major controls on the formation of wetlands by surface-water sources. However, these landscape features also have significant control over groundwater flow systems, which commonly play a role in the formation of wetlands. Because the hydrologic system is a continuum, any modification of one component will have an effect on contiguous components. Disturbances commonly affecting the hydrologic system as it relates to wetlands include weather modification, alteration of plant communities, storage of surface water, road construction, drainage of surface water and soil water, alteration of groundwater recharge and discharge areas, and pumping of groundwater. Assessments of the cumulative effects of one or more of these disturbances on the hydrologic system as related to wetlands must take into account uncertainty in the measurements and in the assumptions that are made in hydrologic studies. For example, it may be appropriate to assume that regional groundwater flow systems are recharged in uplands and discharged in lowlands. However, a similar assumption commonly does not apply on a local scale, because of the spatial and temporal dynamics of groundwater recharge. Lack of appreciation of such hydrologic factors can lead to misunderstanding of the hydrologic function of wetlands within various parts of the landscape and mismanagement of wetland ecosystems. ?? 1988 Springer-Verlag New York Inc.

  20. A conceptual framework for assessing cumulative impacts on the hydrology of nontidal wetlands

    NASA Astrophysics Data System (ADS)

    Winter, Thomas C.

    1988-09-01

    Wetlands occur in geologic and hydrologic settings that enhance the accumulation or retention of water. Regional slope, local relief, and permeability of the land surface are major controls on the formation of wetlands by surface-water sources. However, these landscape features also have significant control over groundwater flow systems, which commonly play a role in the formation of wetlands. Because the hydrologic system is a continuum, any modification of one component will have an effect on contiguous components. Disturbances commonly affecting the hydrologic system as it relates to wetlands include weather modification, alteration of plant communities, storage of surface water, road construction, drainage of surface water and soil water, alteration of groundwater recharge and discharge areas, and pumping of groundwater. Assessments of the cumulative effects of one or more of these disturbances on the hydrologic system as related to wetlands must take into account uncertainty in the measurements and in the assumptions that are made in hydrologic studies. For example, it may be appropriate to assume that regional groundwater flow systems are recharged in uplands and discharged in lowlands. However, a similar assumption commonly does not apply on a local scale, because of the spatial and temporal dynamics of groundwater recharge. Lack of appreciation of such hydrologic factors can lead to misunderstanding of the hydrologic function of wetlands within various parts of the landscape and mismanagement of wetland ecosystems.

  1. Benchmark Dose Analysis from Multiple Datasets: The Cumulative Risk Assessment for the N-Methyl Carbamate Pesticides

    EPA Science Inventory

    The US EPA’s N-Methyl Carbamate (NMC) Cumulative Risk assessment was based on the effect on acetylcholine esterase (AChE) activity of exposure to 10 NMC pesticides through dietary, drinking water, and residential exposures, assuming the effects of joint exposure to NMCs is dose-...

  2. VULNERABILITY AS A FUNCTION OF INDIVIDUAL AND GROUP RESOURCES IN CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    Background: The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the ...

  3. MtSNPscore: a combined evidence approach for assessing cumulative impact of mitochondrial variations in disease

    PubMed Central

    Bhardwaj, Anshu; Mukerji, Mitali; Sharma, Shipra; Paul, Jinny; Gokhale, Chaitanya S; Srivastava, Achal K; Tiwari, Shrish

    2009-01-01

    Background Human mitochondrial DNA (mtDNA) variations have been implicated in a broad spectrum of diseases. With over 3000 mtDNA variations reported across databases, establishing pathogenicity of variations in mtDNA is a major challenge. We have designed and developed a comprehensive weighted scoring system (MtSNPscore) for identification of mtDNA variations that can impact pathogenicity and would likely be associated with disease. The criteria for pathogenicity include information available in the literature, predictions made by various in silico tools and frequency of variation in normal and patient datasets. The scoring scheme also assigns scores to patients and normal individuals to estimate the cumulative impact of variations. The method has been implemented in an automated pipeline and has been tested on Indian ataxia dataset (92 individuals), sequenced in this study, and other publicly available mtSNP dataset comprising of 576 mitochondrial genomes of Japanese individuals from six different groups, namely, patients with Parkinson's disease, patients with Alzheimer's disease, young obese males, young non-obese males, and type-2 diabetes patients with or without severe vascular involvement. MtSNPscore, for analysis can extract information from variation data or from mitochondrial DNA sequences. It has a web-interface that provides flexibility to update/modify the parameters for estimating pathogenicity. Results Analysis of ataxia and mtSNP data suggests that rare variants comprise the largest part of disease associated variations. MtSNPscore predicted possible role of eight and 79 novel variations in ataxia and mtSNP datasets, respectively, in disease etiology. Analysis of cumulative scores of patient and normal data resulted in Matthews Correlation Coefficient (MCC) of ~0.5 and accuracy of ~0.7 suggesting that the method may also predict involvement of mtDNA variation in diseases. Conclusion We have developed a novel and comprehensive method for evaluation

  4. Metals in residential soils and cumulative risk assessment in Yaqui and Mayo agricultural valleys, northern Mexico.

    PubMed

    Meza-Montenegro, Maria M; Gandolfi, A Jay; Santana-Alcántar, María Ernestina; Klimecki, Walter T; Aguilar-Apodaca, María Guadalupe; Del Río-Salas, Rafael; De la O-Villanueva, Margarita; Gómez-Alvarez, Agustín; Mendivil-Quijada, Héctor; Valencia, Martín; Meza-Figueroa, Diana

    2012-09-01

    This investigation examines the extent of soil metal pollution associated with the Green Revolution, relative to agricultural activities and associated risks to health in the most important agricultural region of Mexico. Metal contents in bulk soil samples are commonly used to assess contamination, and metal accumulations in soils are usually assumed to increase with decreasing particle size. This study profiled the spatial distribution of metals (Ni, Cr, Pb, Cu, Fe, Cd, V, Hg, Co, P, Se, and Mn) in bulk soil and fine-grained fractions (soil-derived dust) from 22 towns and cities. The contamination of soil was assessed through the use of a geoaccumulation index (Igeo) and pollution index (PI). The results of this study indicated that a number of towns and cities are moderately to highly polluted by soil containing Be, Co, Hg, P, S, V, Zn, Se, Cr, and Pb in both size fractions (coarse and fine). Hazard index in fine fraction (HI(children)=2.1) shows that risk assessment based on Co, Mn, V, and Ni spatially related to power plants, have the potential to pose health risks to local residents, especially children. This study shows that risk assessment based on metal content in bulk soil could be overestimated when compared to fine-grained fraction. Our results provide important information that could be valuable in establishing risk assessment associated with residential soils within agricultural areas, where children can ingest and inhale dust.

  5. An Assessment of Cumulative Axial and Torsional Fatigue in a Cobalt-Base Superalloy

    NASA Technical Reports Server (NTRS)

    Kalluri, Sreeramesh; Bonacuse, Peter J.

    2010-01-01

    Cumulative fatigue under axial and torsional loading conditions can include both load-order (higMow and low/high) as well as load-type sequence (axial/torsional and torsional/axial) effects. Previously reported experimental studies on a cobalt-base superalloy, Haynes 188 at 538 C, addressed these effects. These studies characterized the cumulative axial and torsional fatigue behavior under high amplitude followed by low amplitude (Kalluri, S. and Bonacuse, P. J., "Cumulative Axial and Torsional Fatigue: An Investigation of Load-Type Sequance Effects," in Multiaxial Fatigue and Deformation: Testing and Prediction, ASTM STP 1387, S. Kalluri, and P. J. Bonacuse, Eds., American Society for Testing and Materials, West Conshohocken, PA, 2000, pp. 281-301) and low amplitude followed by high amplitude (Bonacuse, P. and Kalluri, S. "Sequenced Axial and Torsional Cumulative Fatigue: Low Amplitude Followed by High Amplitude Loading," Biaxial/Multiaxial Fatigue and Fracture, ESIS Publication 31, A. Carpinteri, M. De Freitas, and A. Spagnoli, Eds., Elsevier, New York, 2003, pp. 165-182) conditions. In both studies, experiments with the following four load-type sequences were performed: (a) axial/axial, (b) torsional/torsional, (c) axial/torsional, and (d) torsional/axial. In this paper, the cumulative axial and torsional fatigue data generated in the two previous studies are combined to generate a comprehensive cumulative fatigue database on both the load-order and load-type sequence effects. This comprehensive database is used to examine applicability of the Palmgren-langer-Miner linear damage rule and a nonlinear damage curve approach for Haynes 188 subjected to the load-order and load-type sequencing described above. Summations of life fractions from the experiments are compared to the predictions from both the linear and nonlinear cumulative fatigue damage approaches. The significance of load-order versus load-type sequence effects for axial and torsional loading conditions

  6. Playing it safe: assessing cumulative impact and social vulnerability through an environmental justice screening method in the South Coast Air Basin, California.

    PubMed

    Sadd, James L; Pastor, Manuel; Morello-Frosch, Rachel; Scoggins, Justin; Jesdale, Bill

    2011-05-01

    Regulatory agencies, including the U.S. Environmental Protection Agency (US EPA) and state authorities like the California Air Resources Board (CARB), have sought to address the concerns of environmental justice (EJ) advocates who argue that chemical-by-chemical and source-specific assessments of potential health risks of environmental hazards do not reflect the multiple environmental and social stressors faced by vulnerable communities. We propose an Environmental Justice Screening Method (EJSM) as a relatively simple, flexible and transparent way to examine the relative rank of cumulative impacts and social vulnerability within metropolitan regions and determine environmental justice areas based on more than simply the demographics of income and race. We specifically organize 23 indicator metrics into three categories: (1) hazard proximity and land use; (2) air pollution exposure and estimated health risk; and (3) social and health vulnerability. For hazard proximity, the EJSM uses GIS analysis to create a base map by intersecting land use data with census block polygons, and calculates hazard proximity measures based on locations within various buffer distances. These proximity metrics are then summarized to the census tract level where they are combined with tract centroid-based estimates of pollution exposure and health risk and socio-economic status (SES) measures. The result is a cumulative impacts (CI) score for ranking neighborhoods within regions that can inform diverse stakeholders seeking to identify local areas that might need targeted regulatory strategies to address environmental justice concerns.

  7. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

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

  8. Contested Cumulations:

    PubMed Central

    Pickstone, John V.

    2007-01-01

    Summary The treatment of cancer through the twentieth century may be seen as the successive addition of modalities: first surgery; then radiotherapy, especially between the world wars; and then chemotherapy, from the 1960s. This paper explores some of the systematic differences between the modalities, and how these additions were negotiated in different countries, with different long-term consequences for the development of services and specialization. It focuses chiefly on the United Kingdom and the United States, the former exemplifying a centralized health polity, and the latter, liberal markets combined with large and crucial postwar inputs from government. The differences between health polities were especially important for interwar radiotherapy, which in its centralized form appeared as paradigmatic of the analytical/rationalizing mode in modern medicine. Chemotherapy exemplified a more inventive and experimentalist mode that became common after World War II, and that, through the practice of trials, shaped the new subprofession of medical oncology. The interactions of the modalities, at various levels, are modeled as contested cumulations showing strong path dependency. The paper ends by reviewing the present situation, especially for Britain, and by underlining the relevance of history. PMID:17369667

  9. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    PubMed Central

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  10. Health psychology and sexual health assessment.

    PubMed

    Browes, S

    This article examines the application of health psychology models to sexual health promotion. The Health Belief Model and Protection Motivation Theory can be applied to assessment and identification of clients' perspectives about the threat of illness and behavioural responses to that threat. Assessing clients' individual beliefs about issues of sexual health is important for supporting clients to view themselves as agents of their own sexual health and to make safer decisions about their sexual behaviour.

  11. Assessing the implications of human land-use change for the transient climate response to cumulative carbon emissions

    NASA Astrophysics Data System (ADS)

    Simmons, C. T.; Matthews, H. D.

    2016-03-01

    Recent research has shown evidence of a linear climate response to cumulative CO2 emissions, which implies that the source, timing, and amount of emissions does not significantly influence the climate response per unit emission. Furthermore, these analyses have generally assumed that the climate response to land-use CO2 emissions is equivalent to that of fossil fuels under the assumption that, once in the atmosphere, the radiative forcing induced by CO2 is not sensitive to the emissions source. However, land-cover change also affects surface albedo and the strength of terrestrial carbon sinks, both of which have an additional climate effect. In this study, we use a coupled climate-carbon cycle model to assess the climate response to historical and future cumulative land-use CO2 emissions, in order to compare it to the response to fossil fuel CO2. We find that when we isolate the CO2-induced (biogeochemical) temperature changes associated with land-use change, then the climate response to cumulative land-use emissions is equivalent to that of fossil fuel CO2. We show further that the globally-averaged albedo-induced biophysical cooling from land-use change is non-negligible and may be of comparable magnitude to the biogeochemical warming, with the result that the net climate response to land-use change is substantially different from a linear response to cumulative emissions. However, our new simulations suggest that the biophysical cooling from land-use change follows its own independent (negative) linear response to cumulative net land-use CO2 emissions, which may provide a useful scaling factor for certain applications when evaluating the full transient climate response to emissions.

  12. Valued ecosystem components for watershed cumulative effects: an analysis of environmental impact assessments in the South Saskatchewan River watershed, Canada.

    PubMed

    Ball, Murray A; Noble, Bram F; Dubé, Monique G

    2013-07-01

    The accumulating effects of human development are threatening water quality and availability. In recognition of the constraints to cumulative effects assessment (CEA) under traditional environmental impact assessment (EIA), there is an emerging body of research dedicated to watershed-based cumulative effects assessment (WCEA). To advance the science of WCEA, however, a standard set of ecosystem components and indicators is required that can be used at the watershed scale, to inform effects-based understanding of cumulative change, and at the project scale, to inform regulatory-based project based impact assessment and mitigation. A major challenge, however, is that it is not clear how such ecosystem components and indicators for WCEA can or should be developed. This study examined the use of aquatic ecosystem components and indicators in EIA practice in the South Saskatchewan River watershed, Canada, to determine whether current practice at the project scale could be "scaled up" to support ecosystem component and indicator development for WCEA. The hierarchy of assessment components and indicators used in a sample of 35 environmental impact assessments was examined and the factors affecting aquatic ecosystem component selection and indicator use were identified. Results showed that public environmental impact statements are not necessarily publically accessible, thus limiting opportunities for data and information sharing from the project to the watershed scale. We also found no consistent terminology across the sample of impact statements, thus making comparison of assessment processes and results difficult. Regulatory compliance was found to be the dominant factor influencing the selection of ecosystem components and indicators for use in project assessment, rather than scientific reasoning, followed by the mandate of the responsible government agency for the assessment, public input to the assessment process, and preexisting water licensing arrangements external

  13. Assessing Nonchemical factors in Cumulative Risk Assessment (CRA): A Case Study of the Association between Lower Heart Rate Variability and Particulate Matter

    EPA Science Inventory

    There has been increased interest in the integration of chemicals (e.g. particulate matter, lead) and nonchemicals (e.g., genetics, gender, lifestyle) in cumulative risk assessment (CRA). Because few toxicological or epidemiological studies on these complex mixtures have been con...

  14. [Assessment on the ecological suitability in Zhuhai City, Guangdong, China, based on minimum cumulative resistance model].

    PubMed

    Li, Jian-fei; Li, Lin; Guo, Luo; Du, Shi-hong

    2016-01-01

    Urban landscape has the characteristics of spatial heterogeneity. Because the expansion process of urban constructive or ecological land has different resistance values, the land unit stimulates and promotes the expansion of ecological land with different intensity. To compare the effect of promoting and hindering functions in the same land unit, we firstly compared the minimum cumulative resistance value of promoting and hindering functions, and then looked for the balance of two landscape processes under the same standard. According to the ecology principle of minimum limit factor, taking the minimum cumulative resistance analysis method under two expansion processes as the evaluation method of urban land ecological suitability, this research took Zhuhai City as the study area to estimate urban ecological suitability by relative evaluation method with remote sensing image, field survey, and statistics data. With the support of ArcGIS, five types of indicators on landscape types, ecological value, soil erosion sensitivity, sensitivity of geological disasters, and ecological function were selected as input parameters in the minimum cumulative resistance model to compute urban ecological suitability. The results showed that the ecological suitability of the whole Zhuhai City was divided into five levels: constructive expansion prohibited zone (10.1%), constructive expansion restricted zone (32.9%), key construction zone (36.3%), priority development zone (2.3%), and basic cropland (18.4%). Ecological suitability of the central area of Zhuhai City was divided into four levels: constructive expansion prohibited zone (11.6%), constructive expansion restricted zone (25.6%), key construction zone (52.4%), priority development zone (10.4%). Finally, we put forward the sustainable development framework of Zhuhai City according to the research conclusion. On one hand, the government should strictly control the development of the urban center area. On the other hand, the

  15. [Assessment on the ecological suitability in Zhuhai City, Guangdong, China, based on minimum cumulative resistance model].

    PubMed

    Li, Jian-fei; Li, Lin; Guo, Luo; Du, Shi-hong

    2016-01-01

    Urban landscape has the characteristics of spatial heterogeneity. Because the expansion process of urban constructive or ecological land has different resistance values, the land unit stimulates and promotes the expansion of ecological land with different intensity. To compare the effect of promoting and hindering functions in the same land unit, we firstly compared the minimum cumulative resistance value of promoting and hindering functions, and then looked for the balance of two landscape processes under the same standard. According to the ecology principle of minimum limit factor, taking the minimum cumulative resistance analysis method under two expansion processes as the evaluation method of urban land ecological suitability, this research took Zhuhai City as the study area to estimate urban ecological suitability by relative evaluation method with remote sensing image, field survey, and statistics data. With the support of ArcGIS, five types of indicators on landscape types, ecological value, soil erosion sensitivity, sensitivity of geological disasters, and ecological function were selected as input parameters in the minimum cumulative resistance model to compute urban ecological suitability. The results showed that the ecological suitability of the whole Zhuhai City was divided into five levels: constructive expansion prohibited zone (10.1%), constructive expansion restricted zone (32.9%), key construction zone (36.3%), priority development zone (2.3%), and basic cropland (18.4%). Ecological suitability of the central area of Zhuhai City was divided into four levels: constructive expansion prohibited zone (11.6%), constructive expansion restricted zone (25.6%), key construction zone (52.4%), priority development zone (10.4%). Finally, we put forward the sustainable development framework of Zhuhai City according to the research conclusion. On one hand, the government should strictly control the development of the urban center area. On the other hand, the

  16. Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors

    EPA Science Inventory

    ABSTRACT Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial, reflect increased interest in consideratio of the totality of variables affecting human health and the growing desire to develop co...

  17. Cumulative hydrologic impact assessments on surface-water in northeastern Wyoming using HEC-1; a pilot study

    SciTech Connect

    Anderson, A.J.; Eastwood, D.C.; Anderson, M.E.

    1997-12-31

    The Surface Mining Control and Reclamation Act of 1977 requires that areas in which multiple mines will affect one watershed be analyzed and the cumulative impacts of all mining on the watershed be assessed. The purpose of the subject study was to conduct a cumulative hydrologic impact assessment (CHIA) for surface-water on a watershed in northeastern Wyoming that is currently being impacted by three mines. An assessment of the mining impact`s affect on the total discharge of the watershed is required to determine whether or not material damage to downstream water rights is likely to occur as a result of surface mining and reclamation. The surface-water model HEC-1 was used to model four separate rainfall-runoff events that occurred in the study basin over three years (1978-1980). Although these storms were used to represent pre-mining conditions, they occurred during the early stages of mining and the models were adjusted accordingly. The events were selected for completeness of record and antecedent moisture conditions (AMC). Models were calibrated to the study events and model inputs were altered to reflect post-mining conditions. The same events were then analyzed with the new model inputs. The results were compared with the pre-mining calibration. Peak flow, total discharge and timing of flows were compared for pre-mining and post-mining models. Data were turned over to the State of Wyoming for assessment of whether material damage to downstream water rights is likely to occur.

  18. Assessing cumulative impacts to wintering Bald Eagles and their habitats in western Washington

    SciTech Connect

    Witmer, G.W.; O'Neil, T.A.

    1988-01-01

    Bald Eagles (Haliaeetus leucocephalus) of Washington, the largest wintering population in the lower 48 states, are subject to numerous pressures and impacts from human activites. An evaluative method potential cumulative impacts of multiple hydroelectric development and logging activities on known and potential eagle use areas. Four resource components include food supply, roost sites, mature riparian forest, and disturbance. In addition to actual estimates of losses in food supply (fish biomass in kg) and habitat (km/sup 2/) in one river basin, impact levels from 0 (none) to 4 (high) were assigned for each development and for each component based on the impacts anticipated and the estimated value of the site to eagles. Midwinter eagle surveys, aerial photography, topographic and forest stand maps, and site visits were used in the analysis. Impacts were considered additive for all but the disturbance component, which was adjusted for potential synergism between developments. Adjustments were made for mitigation before the impacts were aggregated into a single, dimensionless cumulative impact score. 50 refs., 1 fig., 1 tab.

  19. Linking large scale landscape change to water quality and quantity response in the lower Athabasca River, Canada: toward Cumulative Effects Assessment

    NASA Astrophysics Data System (ADS)

    Seitz, N. E.; Westbrook, C. J.; Dubé, M.; Squires, A.

    2010-12-01

    Fast-paced watershed change, driven by anthropogenic development, is threatening the sustainability of freshwater resources across the globe. The accumulation of multiple landscape stressors that interact over space and time are defined as cumulative effects and are subject to Cumulative Effects Assessment (CEA), the process of evaluating the impact a development project may have on the ecological surroundings, under the Canadian Environmental Assessment Act. One of the shortcomings of CEA for river systems is determining appropriate indicators of ecosystem health. The Athabasca River is amongst the most stressed river systems in Canada. The lower reaches of the Athabasca River (88,000 km2) were chosen for study because they have been subject to development of a diverse range of land uses. Our objectives were to: i) evaluate land use change in the lower reaches of the Athabasca River Basin from 1976-2006 and ii) identify appropriate CEA indicators by evaluating whether any anthropogenic land use changes can be linked to observed changes in river water quality and quantity in the form of stressor- and- effect- based relationships. Landscape change was quantified with datasets describing forest harvest, forest fires, census of agriculture, census of population, and water consumption, and satellite imagery. River response was quantified with concentration data for six solutes, specific conductance and turbidity, and discharge and river stage data. Linkages between landscape change and river response were evaluated using correlation analyses and step-wise, multiple regression. Notable landscape changes include increased industrial development (particularly expansion of oil sands mining) and forest cut-blocks, made evident from the satellite imagery and supporting ancillary datasets. Preliminary results suggest appropriate CEA indicators for discharge and water quality in this river may be water abstraction and forest harvest, respectively. The results highlight the

  20. Modeling cumulative effects in life cycle assessment: the case of fertilizer in wheat production contributing to the global warming potential.

    PubMed

    Laratte, Bertrand; Guillaume, Bertrand; Kim, Junbeum; Birregah, Babiga

    2014-05-15

    This paper aims at presenting a dynamic indicator for life cycle assessment (LCA) measuring cumulative impacts over time of greenhouse gas (GHG) emissions from fertilizers used for wheat cultivation and production. Our approach offers a dynamic indicator of global warming potential (GWP), one of the most used indicator of environmental impacts (e.g. in the Kyoto Protocol). For a case study, the wheat production in France was selected and considered by using data from official sources about fertilizer consumption and production of wheat. We propose to assess GWP environmental impact based on LCA method. The system boundary is limited to the fertilizer production for 1 ton of wheat produced (functional unit) from 1910 to 2010. As applied to wheat production in France, traditional LCA shows a maximum GWP impact of 500 kg CO2-eq for 1 ton of wheat production, whereas the GWP impact of wheat production over time with our approach to dynamic LCA and its cumulative effects increases to 18,000 kg CO2-eq for 1 ton of wheat production. In this paper, only one substance and one impact assessment indicator are presented. However, the methodology can be generalized and improved by using different substances and indicators.

  1. A Levels-of-Evidence Approach for Assessing Cumulative Ecosystem Response to Estuary and River Restoration Programs

    SciTech Connect

    Diefenderfer, Heida L.; Thom, Ronald M.; Johnson, Gary E.; Skalski, J. R.; Vogt, Kristiina A.; Ebberts, Blaine D.; Roegner, G. Curtis; Dawley, Earl

    2011-03-01

    Even though large-scale ecological restoration programs are beginning to supplement isolated projects implemented on rivers and tidal waterways, the effects of restoration success often continue to be evaluated at project scales or by integration in an additive manner. Today our scientific understanding is sufficient that we can begin to apply lessons learnt from assessing cumulative impacts of anthropogenic stressors on ecosystems to the assessment of ecological restoration. Integration of this knowledge has the potential to increase the efficacy of restoration projects conducted at several locations but co-managed within the confines of a larger integrative program. We introduce here a framework based on a levels-of-evidence approach that facilitates assessment of the cumulative landscape effects of individual restoration actions taken at many different locations. It incorporates data collection at restoration and reference sites, hydrodynamic modeling, geographic information systems, and meta-analyses in a five-stage process: design, data, analysis, synthesis and evaluation, and application. This framework evolved from the need to evaluate the efficacy of restoration projects designed to increase rearing habitat for outmigrating juvenile salmonids, which are being implemented in numerous wetlands on the 235-km tidal portion of the Columbia River, U.S.A.

  2. Modeling cumulative effects in life cycle assessment: the case of fertilizer in wheat production contributing to the global warming potential.

    PubMed

    Laratte, Bertrand; Guillaume, Bertrand; Kim, Junbeum; Birregah, Babiga

    2014-05-15

    This paper aims at presenting a dynamic indicator for life cycle assessment (LCA) measuring cumulative impacts over time of greenhouse gas (GHG) emissions from fertilizers used for wheat cultivation and production. Our approach offers a dynamic indicator of global warming potential (GWP), one of the most used indicator of environmental impacts (e.g. in the Kyoto Protocol). For a case study, the wheat production in France was selected and considered by using data from official sources about fertilizer consumption and production of wheat. We propose to assess GWP environmental impact based on LCA method. The system boundary is limited to the fertilizer production for 1 ton of wheat produced (functional unit) from 1910 to 2010. As applied to wheat production in France, traditional LCA shows a maximum GWP impact of 500 kg CO2-eq for 1 ton of wheat production, whereas the GWP impact of wheat production over time with our approach to dynamic LCA and its cumulative effects increases to 18,000 kg CO2-eq for 1 ton of wheat production. In this paper, only one substance and one impact assessment indicator are presented. However, the methodology can be generalized and improved by using different substances and indicators. PMID:24631622

  3. Issues and approaches in assessing cumulative impacts on waterbird habitat in wetlands

    NASA Astrophysics Data System (ADS)

    Weller, Milton W.

    1988-09-01

    Wetlands are attractive to vertebrates because of their abundant nutrient resources and habitat diversity. Because they are conspicuous, vertebrates commonly are used as indicators of changes in wetlands produced by environmental impacts. Such impacts take place at the landscape level where extensive areas are lost; at the wetland complex level where some (usually small) units of a closely spaced group of wetlands are drained or modified; or at the level of the individual wetland through modification or fragmentation that impacts its habitat value. Vertebrates utilize habitats differently according to age, sex, geographic location, and season, and habitat evaluations based on isolated observations can be biased. Current wetland evaluation systems incorporate wildlife habitat as a major feature, and the habitat evaluation procedure focuses only on habitat. Several approaches for estimating bird habitat losses are derived from population curves based on natural and experimentally induced population fluctuations. Additional research needs and experimental approaches are identified for addressing cumulative impacts on wildlife habitat values.

  4. Resource Asymmetries and Cumulative Advantages: Canadian and US Research Universities and the Field of Global Health

    ERIC Educational Resources Information Center

    Oleksiyenko, Anatoly; Sa, Creso M.

    2010-01-01

    Global health is becoming an important area of inquiry and learning in North American research universities, stemming from on-going and new commitments to the field by multiple governmental and non-governmental agents. External demands for research and education in global health require enhanced inter-disciplinary, inter-sectoral and international…

  5. In vivo measurements of lead-210 for assessing cumulative radon exposure in uranium miners

    SciTech Connect

    Guilmette, R.A.; Laurer, G.R.; Lambert, W.E.; Gilliland, F.D.

    1995-12-01

    It has long been recognized that a major contributor to the uncertainty in risk analysis of lung cancer in uranium and other hard rock miners is the estimation of total radon progeny exposure of individual miners under study. These uncertainties arise from the fact that only a limited number of measurements of airborne {sup 222}Rn progeny concentrations were made in the mines during the times that the miners were being exposed, and that dosimeters capable of integrating the Rn progeny exposures of the miners did not exist. Historically, the cumulative exposures for individual uranium and other hard rock miners have been calculated by combining the employee`s work history, which may or may not have included time spent at different jobs within the mines and at different locations within the mines, with whatever periodic measurements of Rn and Rn progeny were available. The amount and quality of the measurement data varied enormously from mine to mine and from population to population. Because the quality of the exposure data collected during the period of active mining in the United STates cannot now be altered substantially, significant improvement in individual miner exposure estimates is only likely to be achieved if a new cumulative exposure metric is developed and implemented. The decay chain of Rn includes the production of {sup 210}Pb, which can accumulate in the skeleton in amounts proportional to the intake of Rn progeny. We hypothesize that the in vivo measurement of {sup 210}Pb in the skulls of miners will provide such a metric. In summary, the primary purpose of this pilot study to demonstrate the feasibility of measuring {sup 210}Pb in the heads of former uranium miners has been accomplished.

  6. Multiple uses of indicators and indices in cumulative effects assessment and management

    SciTech Connect

    Canter, L.W.; Atkinson, S.F.

    2011-09-15

    Both environmental indicators and multi-metric indices are useful for describing baseline conditions and qualitatively predicting the cumulative consequences of multiple actions. Several examples and case studies associated with indicators and/or indices are presented herein. They can be easily modified for usage in CEAM. Habitat suitability models reflect special indices related to habitat needs and quality for specific species or broad habitat types. Such models have been used to address direct and indirect effects, and with some modification, they can be also used to address cumulative effects of multiple actions. This review has indicated that there are numerous examples of such tools which have been or could be used in both EIA and CEAM. Some key lessons are: (1) in conducting CEAM studies, it is useful to think from the mindset that 'I am the VEC or indicator, and what is my historical and current condition and how have I, or will I, be affected by multiple past, present, and future actions?'; (2) due to the likely absence of detailed information on future actions, the described tools can still be used to 'predict' future conditions by focusing on qualitative up-or-down changes in individual indicators or indices with their aggregated displays; and (3) numerous regional and site-specific tools are currently available, with one example being indices of biological integrity for specific watersheds and water bodies. Such tools, even though they may not have been developed for CEAM usage, can certainly benefit CEAM studies and practice. Finally, usage of selected and appropriate tools as described herein can aid in conducting science-based, systematic, and documentable CEAM studies.

  7. Assessing Long-Term, System-Wide Cumulative Benefits of Multiple Restoration Projects

    NASA Astrophysics Data System (ADS)

    Kondolf, G. M.

    2005-12-01

    Most river restoration projects in North America have been at a relatively small scale, and even most large restoration programs consist of multiple small projects. The CALFED Bay-Delta Program, encompassing the San Francisco Estuary system and its watershed in northern California, is one of the largest ongoing restoration programs in the nation, with over 500 million invested in restoration projects from 1997 to 2004. Yet when we look at the results of these and other restoration efforts to date in the context of habitat losses and fish population declines since European settlement in 1850, it is clear that even a restoration effort on this scale will not reverse large-scale historical changes, so restoration in this context must involve making incremental improvements within a highly altered system. The question becomes how to best allocate the (always limited) available resources strategically to achieve realistic restoration goals. For example, is it better to make small investments in many rivers or concentrate on larger projects in one or a few? An overall conceptual model on a basin scale and over a long time period is needed as a framework in which to evaluate the cumulative contributions of different possible projects. Along the Merced and Tuolumne Rivers, multiple abandoned gravel pits interrupt sediment transport continuity and provide habitat for exotic fish that prey on juvenile salmon. To reduce predation and restore river function, some of these pits have been repaired (and the channel restored), at a cost to date of about 30 million. Assuming different response functions, we can project the potential cumulative benefits of multiple projects.

  8. A geographic model to assess and limit cumulative ecological degradation from Marcellus Shale exploitation in New York, USA

    USGS Publications Warehouse

    Davis, John B.; Robinson, George R.

    2012-01-01

    When natural resources are exploited, environmental costs and economic benefits are often asymmetric. An example is apparent in the environmental impacts from fossil fuel extraction by hydraulic fracturing. So far, most scrutiny has been focused on water quality in affected aquifers, with less attention paid to broader ecological impacts beyond individual drilling operations. Marcellus Shale methane exploitation in New York State, USA, has been delayed because of a regulatory moratorium, pending evaluation that has been directed primarily at localized impacts. We developed a GIS-based model, built on a hexagonal grid underlay nested within the U.S. Environmental Protection Agency’s EMAP system, to examine potential cumulative ecological impacts. In a two-step process, we characterized > 19,000 hexagons, each sized to approximate the footprint of one drilling site (2.57 km²), using ecological attributes; we then developed a method for apportioning resource access that includes assessments of cumulative ecological costs. Over one-quarter of the hexagons were excluded as off-limits on the basis of six criteria: slope suitability, regulated wetland cover, protected-land cover, length of high-quality streams, mapped road density, and open water cover. Three additional criteria were applied to assess the estimated conservation vulnerability of the remaining sites: density of grassland birds (North American Breeding Bird Survey), percent core forest (Coastal Change Analysis Program), and total density of all state-mapped streams; these were determined and used in combination to rank the 14,000 potentially accessible sites. In a second step, an iterative process was used to distribute potential site access among all towns (sub-county governments) within the Marcellus Shale Formation. At each iteration, one site was selected per town, either randomly or in rank order of increasing vulnerability. Results were computed as percent cumulative impact versus the number of

  9. METHODOLOGY FOR THE EVALUATION OF CUMULATIVE EPISODIC EXPOSURE TO CHEMICAL STRESSORS IN AQUATIC RISK ASSESSMENT.

    EPA Science Inventory

    An ecological risk assessment method was developed to evaluate the magnitude, duration, and episodic nature of chemical stressors on aquatic communities. The percent of an ecosystem's species at risk from a designated chemical exposure scenario is generated. In effects assessment...

  10. Phthalate metabolites in urine of Chinese young adults: Concentration, profile, exposure and cumulative risk assessment.

    PubMed

    Gao, Chong-Jing; Liu, Li-Yan; Ma, Wan-Li; Ren, Nan-Qi; Guo, Ying; Zhu, Ning-Zheng; Jiang, Ling; Li, Yi-Fan; Kannan, Kurunthachalam

    2016-02-01

    Phthalates are widely used in consumer products. People are frequently exposed to phthalates due to their applications in daily life. In this study, 14 phthalate metabolites were analyzed in 108 urine samples collected from Chinese young adults using high-performance liquid chromatography-tandem mass spectrometry. The total concentrations of 14 phthalate metabolites ranged from 71.3 to 2670 ng/mL, with the geometric mean concentration of 306 ng/mL. mBP and miBP were the two most abundant compounds, accounting for 48% of the total concentrations. Principal component analysis suggested two major sources of phthalates: one dominated by the DEHP metabolites and one by the group of mCPP, mBP and miBP metabolites. The estimated daily intakes of DMP, DEP, DBP, DiBP and DEHP were 1.68, 2.14, 4.12, 3.52 and 1.26-2.98 μg/kg-bw/day, respectively. In a sensitivity analysis, urinary concentration and body weight were the most influential variables for human exposure estimation. Furthermore, cumulative risk for hazard quotient (HQ) and hazard index (HI) were evaluated. Nearly half of Chinese young adults had high HI values exceeding the safe threshold. This is the first study on the occurrence and human exposure to urinary phthalate metabolites with Chinese young adults.

  11. Using Marginal Structural Modeling to Estimate the Cumulative Impact of an Unconditional Tax Credit on Self-Rated Health.

    PubMed

    Pega, Frank; Blakely, Tony; Glymour, M Maria; Carter, Kristie N; Kawachi, Ichiro

    2016-02-15

    In previous studies, researchers estimated short-term relationships between financial credits and health outcomes using conventional regression analyses, but they did not account for time-varying confounders affected by prior treatment (CAPTs) or the credits' cumulative impacts over time. In this study, we examined the association between total number of years of receiving New Zealand's Family Tax Credit (FTC) and self-rated health (SRH) in 6,900 working-age parents using 7 waves of New Zealand longitudinal data (2002-2009). We conducted conventional linear regression analyses, both unadjusted and adjusted for time-invariant and time-varying confounders measured at baseline, and fitted marginal structural models (MSMs) that more fully adjusted for confounders, including CAPTs. Of all participants, 5.1%-6.8% received the FTC for 1-3 years and 1.8%-3.6% for 4-7 years. In unadjusted and adjusted conventional regression analyses, each additional year of receiving the FTC was associated with 0.033 (95% confidence interval (CI): -0.047, -0.019) and 0.026 (95% CI: -0.041, -0.010) units worse SRH (on a 5-unit scale). In the MSMs, the average causal treatment effect also reflected a small decrease in SRH (unstabilized weights: β = -0.039 unit, 95% CI: -0.058, -0.020; stabilized weights: β = -0.031 unit, 95% CI: -0.050, -0.007). Cumulatively receiving the FTC marginally reduced SRH. Conventional regression analyses and MSMs produced similar estimates, suggesting little bias from CAPTs.

  12. Cumulative and residual effects of potato cropping system management strategies on crop and soil health parameters

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil and crop management practices can greatly affect parameters related to soil health, as well as crop productivity and disease development, and may provide options for more sustainable production. Different 3-yr potato cropping systems focused on specific management goals of soil conservation (SC...

  13. The EPA's Human Exposure Research Program for Assessing Cumulative Risk in Communities

    EPA Science Inventory

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available...

  14. APPROACHES FOR INCORPORATING NON-CHEMICAL STRESSORS INTO CUMULATIVE RISK ASSESSMENTS

    EPA Science Inventory

    Over the past twenty years, the risk assessment paradigm has gradually shifted from an individual chemical approach to a community-based model. Inherent in community-based risk assessment is consideration of the totality of stressors affecting a defined population including both ...

  15. Stigmatized Biologies: Examining the Cumulative Effects of Oral Health Disparities for Mexican American Farmworker Children

    PubMed Central

    Horton, Sarah; Barker, Judith C.

    2012-01-01

    Severe early childhood caries (ECC) can leave lasting effects on children’s physical development, including malformed oral arches and crooked permanent dentition. This article examines the way that ECC sets up Mexican American farm worker children in the United States for lasting dental problems and social stigma as young adults. We examine the role of dietary and environmental factors in contributing to what we call “stigmatized biologies,” and that of market-based dental public health insurance systems in cementing their enduring effects. We adapt Margaret Lock’s term, local biology, to illustrate the way that biology differs not only because of culture, diet, and environment but also because of disparities in insurance coverage. By showing the long-term effects of ECC and disparate dental treatment on farmworker adults, we show how the interaction of immigrant caregiving practices and underinsurance can have lasting social effects. An examination of the long-term effects of farm worker children’s ECC illustrates the ways that market-based health care systems can create embodied differences that in turn reproduce a system of social inequality. PMID:20550093

  16. An Overview of Measurement Method Tools Available to Communities for Conducting Exposure and Cumulative Risk Assessments

    EPA Science Inventory

    Community-based programs for assessing and mitigating nvironmental risks represent a challenge to participants because each brings a different level of understanding of the issues affecting the community. These programs often require the collaboration of several community sectors...

  17. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    ERIC Educational Resources Information Center

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  18. Assessing Cumulative Impact and Risk - Approaches at the U.S. Environmental Protection Agency

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) has a mission and regulatory mandate to protect human health and the environment. EPA’s primary role is to implement environmental laws by developing and enforcing national regulation. Cogent to the goals of this workshop, key envi...

  19. Methodologies for Assessing the Cumulative Environmental Effects of Hydroelectric Development on Fish and Wildlife in the Columbia River Basin, Volume 2, Example and Procedural Guidelines, 1987 Final Report.

    SciTech Connect

    Stull, Elizabeth Ann

    1987-07-01

    A hypothetical example of multiple hydroelectric development is used to demonstrate the applicability of the integrated tabular methodology (ITM) that was recommended for cumulative effects assessment in Volume 1. The example consists of an existing mainstem dam and four proposed small hydroelectric developments in a small river basin containing elk summer and winter range and chinook salmon spawning areas. Single-project impact assessments are used collectively in the methodology to estimate the cumulative effects of the projects on elk and salmon. The steps in cumulative assessment are (1) establishing a conceptual and schematic representation of each cumulative effect, (2) calculating interaction coefficients for each pair of projects, (3) developing interaction and impact matrices, (4) multiplying these matrices, (5) evaluating the contribution of shared project features to cumulative effects, and (6) incorporating the effects of already existing projects. The ITM is most effective when single-project assessments are accomplished in a detailed, quantitative manner. The methodology involves the use of impact response curves (such as fry emergence as a function of fine sediment or habitat suitability as a function of road density) for each impact being assessed. 14 refs., 15 figs., 16 tabs.

  20. Cumulative organophosphate pesticide exposure and risk assessment among pregnant women living in an agricultural community: a case study from the CHAMACOS cohort.

    PubMed Central

    Castorina, Rosemary; Bradman, Asa; McKone, Thomas E; Barr, Dana B; Harnly, Martha E; Eskenazi, Brenda

    2003-01-01

    Approximately 230,000 kg of organophosphate (OP) pesticides are applied annually in California's Salinas Valley. These activities have raised concerns about exposures to area residents. We collected three spot urine samples from pregnant women (between 1999 and 2001) enrolled in CHAMACOS (Center for the Health Assessment of Mothers and Children of Salinas), a longitudinal birth cohort study, and analyzed them for six dialkyl phosphate metabolites. We used urine from 446 pregnant women to estimate OP pesticide doses with two deterministic steady-state modeling methods: method 1, which assumed the metabolites were attributable entirely to a single diethyl or dimethyl OP pesticide; and method 2, which adapted U.S. Environmental Protection Agency (U.S. EPA) draft guidelines for cumulative risk assessment to estimate dose from a mixture of OP pesticides that share a common mechanism of toxicity. We used pesticide use reporting data for the Salinas Valley to approximate the mixture to which the women were exposed. Based on average OP pesticide dose estimates that assumed exposure to a single OP pesticide (method 1), between 0% and 36.1% of study participants' doses failed to attain a margin of exposure (MOE) of 100 relative to the U.S. EPA oral benchmark dose(10) (BMD(10)), depending on the assumption made about the parent compound. These BMD(10) values are doses expected to produce a 10% reduction in brain cholinesterase activity compared with background response in rats. Given the participants' average cumulative OP pesticide dose estimates (method 2) and regardless of the index chemical selected, we found that 14.8% of the doses failed to attain an MOE of 100 relative to the BMD(10) of the selected index. An uncertainty analysis of the pesticide mixture parameter, which is extrapolated from pesticide application data for the study area and not directly quantified for each individual, suggests that this point estimate could range from 1 to 34%. In future analyses, we

  1. Health impact assessment in Korea

    SciTech Connect

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

    2011-07-15

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

  2. Health technology assessment in Singapore.

    PubMed

    Pwee, Keng Ho

    2009-07-01

    The Republic of Singapore is an island city-state in Southeast Asia. Its population enjoys good health and the Singapore Ministry of Health's mission is to promote good health and reduce illness, ensure access to good and affordable health care, and pursue medical excellence. This is achieved through a healthcare system that includes both private and public sector elements. The financing philosophy of Singapore's healthcare delivery system is based on individual responsibility and community support. Health care in Singapore is financed by a combination of taxes, employee medical benefits, compulsory health savings, insurance, and out-of-pocket payment. The capability for health technology assessment in Singapore was developed concurrently with its medical device regulation system in the 1990s. The first formal unit with health technology assessment (HTA) functions was established in September 1995. Today, HTA features in decision making for the Standard Drug List, licensing of medical clinics, the Health Service Development Programme, healthcare subsidies, and policy development. The public sector healthcare delivery clusters have also recently started health services research units with HTA functions. Singapore is organizing the 6th Health Technology Assessment International (HTAi) Annual Meeting in June 2009. Bringing this prestigious international conference to Asia for the first time will help raise awareness of HTA in the region.

  3. Cumulative exergy extraction from the natural environment (CEENE): a comprehensive life cycle impact assessment method for resource accounting.

    PubMed

    Dewulf, J; Bösch, M E; De Meester, B; Van der Vorst, G; Van Langenhove, H; Hellweg, S; Huijbregts, M A J

    2007-12-15

    The objective of the paper is to establish a comprehensive resource-based life cycle impact assessment (LCIA) method which is scientifically sound and that enables to assess all kinds of resources that are deprived from the natural ecosystem, all quantified on one single scale, free of weighting factors. The method is based on the exergy concept. Consistent exergy data on fossils, nuclear and metal ores, minerals, air, water, land occupation, and renewable energy sources were elaborated, with well defined system boundaries. Based on these data, the method quantifies the exergy "taken away" from natural ecosystems, and is thus called the cumulative exergy extraction from the natural environment (CEENE). The acquired data set was coupled with a state-of-the art life cycle inventory database, ecoinvent. In this way, the method is able to quantitatively distinguish eight categories of resources withdrawn from the natural environment: renewable resources, fossil fuels, nuclear energy, metal ores, minerals, water resources, land resources, and atmospheric resources. Third, the CEENE method is illustrated for a number of products that are available in ecoinvent, and results are compared with common resource oriented LCIA methods. The application to the materials in the ecoinvent database showed that fossil resources and land use are of particular importance with regard to the total CEENE score, although the other resource categories may also be significant.

  4. VA telemental health: suicide assessment.

    PubMed

    Godleski, Linda; Nieves, J Edwin; Darkins, Adam; Lehmann, Laurent

    2008-01-01

    The Department of Veterans Affairs (VA) encompasses one of the largest telemental health networks in the world, with over 45,000 videoconferencing and over 5,000 home telemental health encounters annually. Recently, the VA designated suicide prevention as a major priority, with telehealth modalities providing opportunities for remote interventions. Suicide risk assessments, using videoconferencing, are now documented in the literature, as are current studies that find telemental health to be equivalent to face-to-face treatment. Remote assessment of suicidality, however, involves complex legal issues: licensing requirements for remote delivery of care, legal procedures for involuntary detainment and commitment of potentially harmful patients, and liability questions related to the remote nature of the mental health service. VA best practices for remote suicide risk assessment include paradigms for establishing procedures in the context of legal challenges (licensing and involuntary detainment/commitment), for utilizing clinical assessment and triage decision protocols, and for contingency planning to optimize patient care and reduce liability.

  5. Quantifying Chronic Stress Exposure for Cumulative Risk Assessment: Lessons Learned from a Case Study of Allostatic Load

    EPA Science Inventory

    Although multiple methods of quantifying environmental chemical exposures have been validated for use in human health risk assessment, quantifying chronic stress exposure is more challenging. Stress is a consequence of perceiving an “exposure” (e.g., violence, poverty) as more th...

  6. Combining Field and Modeling Tools As an Approach to Assess Cumulative Surface Erosion in Alberta Eastern Slopes and Foothills.

    NASA Astrophysics Data System (ADS)

    Anderson, A.; Wagner, M. J.; Hirshfield, F.; Howard, M.; Silins, U.; Benda, L. E.

    2014-12-01

    Alberta is a large province with diverse forested landscapes and heavy industrial, range and recreation use. Hillslopes are generally stable but the cumulative surface erosion from bare areas (e.g. roads, well pad, trails, burns and pipelines) is a major concern for downstream water users, aquatic ecology and stream habitat. Most streams are not exhibiting issues from additional coarse soil (e.g. obvious changes to geomorphology) however, soils with high proportion of fines and phosphorus have been attributed to long lasting aquatic ecology impacts and associated downstream water quality issues. For this project we take a watershed scale approach to determine if we can reduce field effort by using high quality digital terrain data available for most of Alberta combined with tools such as the Geomorphic Road Analysis and Inventory Package (GRAIP) and landscape scale GIS assessment and modeling tools such as NetMap. We examine two contrasting regions of Alberta: (1) a tributary of the Oldman River in southwest Alberta that has steep topography, intense storms and heavy motorized recreation from the neighboring 1.5 Million people, and (2) the Foothills area that has fine lacustrine soil, low topography and extremely heavy industrial activity from energy, mining and forestry. We present the initial results of field data combined with GIS analysis for the eastern slopes as part of a larger project that is assessing these tools in represented end member watersheds for forested areas within the foothills and eastern slopes region (area of Alberta where watersheds have meaningful topography). Initial results suggest that GIS and associated modeling are very useful in providing rapid direction for field campaigns to refine the level of uncertainty, make prescriptive field plans and will likely be platforms that can track changes in predicated watershed scale erosion rates through time.

  7. Accumulating Research: A Systematic Account of How Cumulative Meta-Analyses Would Have Provided Knowledge, Improved Health, Reduced Harm and Saved Resources

    PubMed Central

    Clarke, Mike; Brice, Anne; Chalmers, Iain

    2014-01-01

    Background “Cumulative meta-analysis” describes a statistical procedure to calculate, retrospectively, summary estimates from the results of similar trials every time the results of a further trial in the series had become available. In the early 1990s, comparisons of cumulative meta-analyses of treatments for myocardial infarction with advice promulgated through medical textbooks showed that research had continued long after robust estimates of treatment effects had accumulated, and that medical textbooks had overlooked strong, existing evidence from trials. Cumulative meta-analyses have subsequently been used to assess what could have been known had new studies been informed by systematic reviews of relevant existing evidence and how waste might have been reduced. Methods and Findings We used a systematic approach to identify and summarise the findings of cumulative meta-analyses of studies of the effects of clinical interventions, published from 1992 to 2012. Searches were done of PubMed, MEDLINE, EMBASE, the Cochrane Methodology Register and Science Citation Index. A total of 50 eligible reports were identified, including more than 1,500 cumulative meta-analyses. A variety of themes are illustrated with specific examples. The studies showed that initially positive results became null or negative in meta-analyses as more trials were done; that early null or negative results were over-turned; that stable results (beneficial, harmful and neutral) would have been seen had a meta-analysis been done before the new trial; and that additional trials had been much too small to resolve the remaining uncertainties. Conclusions This large, unique collection of cumulative meta-analyses highlights how a review of the existing evidence might have helped researchers, practitioners, patients and funders make more informed decisions and choices about new trials over decades of research. This would have led to earlier uptake of effective interventions in practice, less

  8. What roles do contemporaneous and cumulative incomes play in the income-child health gradient for young children? Evidence from an Australian panel.

    PubMed

    Khanam, Rasheda; Nghiem, Hong Son; Connelly, Luke Brian

    2014-08-01

    The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income-child health gradient and whether the contemporaneous or cumulative effects of income play important mitigating roles. We exploit a rich panel dataset with three panel waves called the Longitudinal Study of Australian children. Given the availability of three waves of data, we are able to apply a range of econometric techniques (e.g. fixed and random effects) to control for unobserved heterogeneity. The paper makes several contributions to the extant literature. First, it shows that an apparent income gradient becomes relatively attenuated in our dataset when the cumulative and contemporaneous effects of household income are distinguished econometrically. Second, it demonstrates that the income-child health gradient becomes statistically insignificant when controlling for parental health and health-related behaviours or unobserved heterogeneity.

  9. What roles do contemporaneous and cumulative incomes play in the income-child health gradient for young children? Evidence from an Australian panel.

    PubMed

    Khanam, Rasheda; Nghiem, Hong Son; Connelly, Luke Brian

    2014-08-01

    The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income-child health gradient and whether the contemporaneous or cumulative effects of income play important mitigating roles. We exploit a rich panel dataset with three panel waves called the Longitudinal Study of Australian children. Given the availability of three waves of data, we are able to apply a range of econometric techniques (e.g. fixed and random effects) to control for unobserved heterogeneity. The paper makes several contributions to the extant literature. First, it shows that an apparent income gradient becomes relatively attenuated in our dataset when the cumulative and contemporaneous effects of household income are distinguished econometrically. Second, it demonstrates that the income-child health gradient becomes statistically insignificant when controlling for parental health and health-related behaviours or unobserved heterogeneity. PMID:23780648

  10. Sensor based soil health assessment

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  11. Cumulative Exposure Assessment for Trace-Level Polycyclic Aromatic Hydrocarbons (PAHs) using Human Blood and Plasma Analysis

    EPA Science Inventory

    Humans experience chronic cumulative trace-level exposure to mixtures of volatile, semi-volatile, and non-volatile polycyclic aromatic hydrocarbons (PAHs) present in the environment as by-products of combustion processes. Certain PAHs are known or suspected human carcinogens and ...

  12. Assessing the Role of Current and "Cumulative" Exposure in Simultaneous Bilingual Acquisition: The Case of Dutch Gender

    ERIC Educational Resources Information Center

    Unsworth, Sharon

    2013-01-01

    This paper investigates the role of amount of current and "cumulative" exposure in bilingual development and ultimate attainment by exploring the extent to which simultaneous bilingual children's knowledge of grammatical gender is affected by current and previous amount of exposure, including in the early years. Elicited production and…

  13. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  14. Health impact assessment in New Zealand.

    PubMed

    Soeberg, Matthew

    2006-01-01

    Health impact assessment (HIA) has its origins in environmental impact assessment methodology. New Zealand's approach to health impact assessment is consistent with other countries. During the 1990s, legislation that related to the management of natural and physical resources provided the basis for public health engagement in impact assessment. In the mid 1990s, the Public Health Commission released guidelines on health impact assessment that adopted a risk assessment approach and was aimed at particular environmental projects. The transition to policy-level impact assessment occurred in 2000 with the national health strategy identifying impact assessment as one its key objectives. Guidelines developed by the Public Health Advisory Committee in 2004 have been applied in a small number of policy-level health impact assessments in New Zealand. One of these projects was the review of a Liveable Communities Plan, a policy proposal for town centre growth and development.

  15. Unknown age in health disorders: A method to account for its cumulative effect and an application to feline viruses interactions.

    PubMed

    Hellard, Eléonore; Pontier, Dominique; Siberchicot, Aurélie; Sauvage, Frank; Fouchet, David

    2015-06-01

    Parasite interactions have been widely evidenced experimentally but field studies remain rare. Such studies are essential to detect interactions of interest and access (co)infection probabilities but face methodological obstacles. Confounding factors can create statistical associations, i.e. false parasite interactions. Among them, host age is a crucial covariate. It influences host exposition and susceptibility to many infections, and has a mechanical effect, older individuals being more at risk because of a longer exposure time. However, age is difficult to estimate in natural populations. Hence, one should be able to deal at least with its cumulative effect. Using a SI type dynamic model, we showed that the cumulative effect of age can generate false interactions theoretically (deterministic modeling) and with a real dataset of feline viruses (stochastic modeling). The risk to wrongly conclude to an association was maximal when parasites induced long-lasting antibodies and had similar forces of infection. We then proposed a method to correct for this effect (and for other potentially confounding shared risk factors) and made it available in a new R package, Interatrix. We also applied the correction to the feline viruses. It offers a way to account for an often neglected confounding factor and should help identifying parasite interactions in the field, a necessary step towards a better understanding of their mechanisms and consequences. PMID:25979281

  16. [Offshore ecosystem health status assessment: a review].

    PubMed

    Dai, Ben-lin; Hua, Zu-lin; Mu, Fei-hu; Xu, Ning; He, Yu-long

    2013-04-01

    With the promotion of the concept of sustainable development, the issues of aquatic ecosystem health attract substantial attention, and considerable work has been carried out on the health assessment of waters, e. g. , rivers and lakes. However, the health assessment of offshore ecosystem is still at its exploratory stage. Based on the investigations on the related references at home and abroad, this paper analyzed the concepts of offshore ecosystem health assessment, summarized the main methods for the assessment, the principles for screening related indicators, and the research philosophy, and systematically listed the quantitative indices for the assessment. Aiming at the main existing issues in the researches of offshore ecosystem health, the future research directions about the offshore ecosystem health were suggested. It was considered that the concept and connotation analyses, the screening of assessment indicators, the choice of assessment scale, and the integration of assessment methods should be further strengthened to improve the assessment of offshore ecosystem health.

  17. Impaired assessment of cumulative lifetime familiarity for object concepts after left anterior temporal-lobe resection that includes perirhinal cortex but spares the hippocampus.

    PubMed

    Bowles, Ben; Duke, Devin; Rosenbaum, R Shayna; McRae, Ken; Köhler, Stefan

    2016-09-01

    The ability to recognize the prior occurrence of objects can operate effectively even in the absence of successful recollection of episodic contextual detail about a relevant past object encounter. The pertinent process, familiarity assessment, is typically probed in humans with recognition-memory tasks that include an experimentally controlled study phase for a list of items. When meaningful stimuli such as words or pictures of common objects are employed, participants must judge familiarity with reference to the recent experimental encounter rather than their lifetime of autobiographical experience, which may have involved hundreds or thousands of exposures across numerous episodic contexts. Humans can, however, also judge the cumulative familiarity of objects concepts they have encountered over their lifetime. At present, little is known about the cognitive and neural mechanisms that support this ability. Here, we tested an individual (NB) with a rare left anterior temporal-lobe lesion that included perirhinal cortex but spared the hippocampus, who had previously been found to exhibit selective impairments in familiarity assessment on verbal recognition-memory tasks. As NB exhibits normal recollection abilities, her case presents a unique opportunity to examine potential links between both types of familiarity. In Experiment 1, we demonstrated that NB's impairment in making recognition judgments affects cumulative frequency judgments for exposure to concept names in a recent study episode. Experiments 2 and 3 revealed, with a task borrowed from the semantic-memory literature, that NB's impairments do indeed extend to abnormalities in judging cumulative lifetime familiarity for object concepts. These abnormalities were not limited to verbal processing, and were present even when pictures were offered as additional cues. Moreover, they showed sensitivity to concept structure as reflected in semantic feature norms; we only observed them for judgments on object

  18. Merging the fields of mental health and social enterprise: lessons from abroad and cumulative findings from research with homeless youths.

    PubMed

    Ferguson, Kristin M

    2012-08-01

    Despite the growing integration of supported employment within the mental health system in the United States as well as the widespread use of social enterprises abroad, the fields of mental health and social enterprises remain largely separate in the USA. The mental health field currently lacks a response that strengthens homeless youths' existing human and social capital, provides them with marketable job skills and employment, and impacts their mental health. To address this gap, this paper establishes a case for using social enterprises with homeless youths, drawing on both global precedents and findings from a mixed-methods study of a social enterprise intervention with homeless youths. Recommendations are offered for how to integrate social enterprises with mental health treatment as well as how to evaluate their impact on mental health outcomes.

  19. Assessing cumulative impacts of forest development on the distribution of furbearers using expert-based habitat modeling.

    PubMed

    Bridger, M C; Johnson, C J; Gillingham, M P

    2016-03-01

    Cumulative impacts of anthropogenic landscape change must be considered when managing and conserving wildlife habitat. Across the central-interior of British Columbia, Canada, industrial activities are altering the habitat of furbearer species. This region has witnessed unprecedented levels of anthropogenic landscape change following rapid development in a number of resource sectors, particularly forestry. Our objective was to create expert-based habitat models for three furbearer species: fisher (Pekania pennanti), Canada lynx (Lynx canadensis), and American marten (Martes americana) and quantify habitat change for those species. We recruited 10 biologist and 10 trapper experts and then used the analytical hierarchy process to elicit expert knowledge of habitat variables important to each species. We applied the models to reference landscapes (i.e., registered traplines) in two distinct study areas and then quantified the change in habitat availability from 1990 to 2013. There was strong agreement between expert groups in the choice of habitat variables and associated scores. Where anthropogenic impacts had increased considerably over the study period, the habitat models showed substantial declines in habitat availability for each focal species (78% decline in optimal fisher habitat, 83% decline in optimal lynx habitat, and 79% decline in optimal marten habitat). For those traplines with relatively little forest harvesting, the habitat models showed no substantial change in the availability of habitat over time. The results suggest that habitat for these three furbearer species declined significantly as a result of the cumulative impacts of forest harvesting. Results of this study illustrate the utility of expert knowledge for understanding large-scale patterns of habitat change over long time periods.

  20. Assessing cumulative impacts of forest development on the distribution of furbearers using expert-based habitat modeling.

    PubMed

    Bridger, M C; Johnson, C J; Gillingham, M P

    2016-03-01

    Cumulative impacts of anthropogenic landscape change must be considered when managing and conserving wildlife habitat. Across the central-interior of British Columbia, Canada, industrial activities are altering the habitat of furbearer species. This region has witnessed unprecedented levels of anthropogenic landscape change following rapid development in a number of resource sectors, particularly forestry. Our objective was to create expert-based habitat models for three furbearer species: fisher (Pekania pennanti), Canada lynx (Lynx canadensis), and American marten (Martes americana) and quantify habitat change for those species. We recruited 10 biologist and 10 trapper experts and then used the analytical hierarchy process to elicit expert knowledge of habitat variables important to each species. We applied the models to reference landscapes (i.e., registered traplines) in two distinct study areas and then quantified the change in habitat availability from 1990 to 2013. There was strong agreement between expert groups in the choice of habitat variables and associated scores. Where anthropogenic impacts had increased considerably over the study period, the habitat models showed substantial declines in habitat availability for each focal species (78% decline in optimal fisher habitat, 83% decline in optimal lynx habitat, and 79% decline in optimal marten habitat). For those traplines with relatively little forest harvesting, the habitat models showed no substantial change in the availability of habitat over time. The results suggest that habitat for these three furbearer species declined significantly as a result of the cumulative impacts of forest harvesting. Results of this study illustrate the utility of expert knowledge for understanding large-scale patterns of habitat change over long time periods. PMID:27209791

  1. [Cumulative exposure to pesticide residues in food].

    PubMed

    Kostka, Grazyna; Urbanek-Olejnik, Katarzyna; Liszewska, Monika

    2011-01-01

    The results of food monitoring studies indicate that humans are constantly exposed to residues ofplant protection products (pesticides) in marketed food products. Hence, assessment of the risk to consumers associated with the consumption of products containing residues of the active substances of pesticides is a key stage in both the registration of pesticides and official control of foodstuffs. However there are frequent cases of exposure not only to individual active substances but also to mixtures of pesticide residues. These levels are usually low, below of effective action, and interaction such as synergism orpotentiation is not expected to occur At the same time, literature data indicate that for mixtures sharing a common MOA (Mode of Action/Mechanism of Action), the probability of additive effects is high, even after adjusting for the low levels of the mixed pesticide residues present. Accordingly, health risk assessment for consumers exposed to such mixtures (cumulative/aggregate risk) has become an issue of topical importance. EU-level initiatives regarding the development of appropriate methodology for the estimation of cumulative/aggregate risk have brought about considerable progress in this area. The article discusses various aspects of estimation of cumulative risk for consumers associated with exposure to mixtures of pesticide residues in food.

  2. Racial/Ethnic Disparities in Cumulative Environmental Health Impacts in California: Evidence From a Statewide Environmental Justice Screening Tool (CalEnviroScreen 1.1)

    PubMed Central

    Faust, John; August, Laura Meehan; Cendak, Rose; Wieland, Walker; Alexeeff, George

    2015-01-01

    Objectives. We used an environmental justice screening tool (CalEnviroScreen 1.1) to compare the distribution of environmental hazards and vulnerable populations across California communities. Methods. CalEnviroScreen 1.1 combines 17 indicators created from 2004 to 2013 publicly available data into a relative cumulative impact score. We compared cumulative impact scores across California zip codes on the basis of their location, urban or rural character, and racial/ethnic makeup. We used a concentration index to evaluate which indicators were most unequally distributed with respect to race/ethnicity and poverty. Results. The unadjusted odds of living in one of the 10% most affected zip codes were 6.2, 5.8, 1.9, 1.8, and 1.6 times greater for Hispanics, African Americans, Native Americans, Asian/Pacific Islanders, and other or multiracial individuals, respectively, than for non-Hispanic Whites. Environmental hazards were more regressively distributed with respect to race/ethnicity than poverty, with pesticide use and toxic chemical releases being the most unequal. Conclusions. Environmental health hazards disproportionately burden communities of color in California. Efforts to reduce disparities in pollution burden can use simple screening tools to prioritize areas for action. PMID:26378826

  3. Assessing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Cuff, Patricia A.

    2014-01-01

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

  4. Assessing Cumulative Impacts of Coal Bed Methane Development on Surface Water Quality and its Suitability for Irrigation in the Powder River Basin

    NASA Astrophysics Data System (ADS)

    Dawson, H. E.

    2003-12-01

    This paper presents a mass balance approach to assessing the cumulative impacts of discharge from Coal Bed Methane (CBM) wells on surface water quality and its suitability for irrigation in the Powder River Basin. Key water quality parameters for predicting potential effects of CBM development on irrigated agriculture are sodicity, expressed as sodium adsorption ratio (SAR) and salinity, expressed as electrical conductivity (EC). The assessment was performed with the aid of a spreadsheet model, which was designed to estimate steady-state SAR and EC at gauged stream locations after mixing with CBM produced water. Model input included ambient stream water quality and flow, CBM produced water quality and discharge rates, conveyance loss (quantity of water loss that may occur between the discharge point and the receiving streams), beneficial uses, regulatory thresholds, and discharge allocation at state-line boundaries. Historical USGS data were used to establish ambient stream water quality and flow conditions. The resultant water quality predicted for each stream station included the cumulative discharge of CBM produced water in all reaches upstream of the station. Model output was presented in both tabular and graphical formats, and indicated the suitability of pre- and post-mixing water quality for irrigation. Advantages and disadvantages of the spreadsheet model are discussed. This approach was used by federal agencies to support the development of the January 2003 Environmental Impact Statements (EIS) for the Wyoming and Montana portions of the Powder River Basin.

  5. Cumulative Retrospective Exposure Assessment (REA) as a predictor of amphibole asbestos lung burden: validation procedures and results for industrial hygiene and pathology estimates

    PubMed Central

    Roggli, Victor L.; Boelter, Fred W.; Rasmuson, Eric J.; Redinger, Charles F.

    2014-01-01

    Context A detailed evaluation of the correlation and linearity of industrial hygiene retrospective exposure assessment (REA) for cumulative asbestos exposure with asbestos lung burden analysis (LBA) has not been previously performed, but both methods are utilized for case-control and cohort studies and other applications such as setting occupational exposure limits. Objective (a) To correlate REA with asbestos LBA for a large number of cases from varied industries and exposure scenarios; (b) to evaluate the linearity, precision, and applicability of both industrial hygiene exposure reconstruction and LBA; and (c) to demonstrate validation methods for REA. Methods A panel of four experienced industrial hygiene raters independently estimated the cumulative asbestos exposure for 363 cases with limited exposure details in which asbestos LBA had been independently determined. LBA for asbestos bodies was performed by a pathologist by both light microscopy and scanning electron microscopy (SEM) and free asbestos fibers by SEM. Precision, reliability, correlation and linearity were evaluated via intraclass correlation, regression analysis and analysis of covariance. Plaintiff’s answers to interrogatories, work history sheets, work summaries or plaintiff’s discovery depositions that were obtained in court cases involving asbestos were utilized by the pathologist to provide a summarized brief asbestos exposure and work history for each of the 363 cases. Results Linear relationships between REA and LBA were found when adjustment was made for asbestos fiber-type exposure differences. Significant correlation between REA and LBA was found with amphibole asbestos lung burden and mixed fiber-types, but not with chrysotile. The intraclass correlation coefficients (ICC) for the precision of the industrial hygiene rater cumulative asbestos exposure estimates and the precision of repeated laboratory analysis were found to be in the excellent range. The ICC estimates were performed

  6. Assessing the cumulative effect of the weather variability on wetlands and the hydrological connection between wetlands and downstream waters

    NASA Astrophysics Data System (ADS)

    Yeo, I. Y.; Lang, M. W.; Lee, S.; Mccarty, G.; Peng, Y.; Huang, C.

    2014-12-01

    Wetlands are crucial ecosystem features that provide important ecological benefits to improve water quality and reduce the climate change impact. This ecosystem functioning of wetlands is largely dependent upon their hydrological characteristics and linkage to the downstream waters. However, the cumulative impacts of the climate on wetlands and the hydrological connection between wetlands and downstream waters have been rarely quantified at the landscape scale. This study reports findings from time series satellite observation that can illustrate the changes in extent of wetland inundation at a high spatial resolution (30-m) over the period 1985-2010. This remote sensing based observation provides crucial information to gain insights onto inter-annual variability of inundation dynamics, and we analyze this product with the drought indices, streamflows, the USFS NWI-hydrologic modifier. This study focuses on natural palustrine wetlands, densely distributed in the coastal plain of the Chesapeake Bay Watershed (CBW). We observe inundation patterns change in response to the weather variability, and it is proportionally related to the downstream flow discharge. While those wetlands with a longer hydro-period (i.e., permanently ponded wetlands during the growing season) show the strongest relationship with stream discharge (including baseflow, contributed from the shallow groundwater), inundation patterns of headwater/isolated wetlands are also strongly related to stream discharge. It shows the strong relationship between wetlands and downstream water regardless of geographic isolation and their mutual reliance on groundwater. The study provides the support for the conservation of wetlands through section 404 of the Clean Water Act.

  7. Ground-Truthing Validation to Assess the Effect of Facility Locational Error on Cumulative Impacts Screening Tools

    EPA Science Inventory

    Over the past three decades, a number of researchers in the fields of environmental justice (EJ) and environmental public health have highlighted the existence of regional and local scale differences in exposure to air pollution, as well as calculated health risk and impacts of a...

  8. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

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

  9. Exposure to phthalates in 5-6 years old primary school starters in Germany--a human biomonitoring study and a cumulative risk assessment.

    PubMed

    Koch, Holger M; Wittassek, Matthias; Brüning, Thomas; Angerer, Jürgen; Heudorf, Ursel

    2011-06-01

    We determined the internal exposure of 111 German primary school starters by analyzing urinary metabolites of six phthalates: butyl benzyl phthalate (BBzP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di (2-ethylhexyl) phthalate (DEHP), di-iso-nonyl phthalate (DiNP) and di-iso-decylphthalate (DiDP). From the urinary metabolite levels, we calculated daily intakes and related these values to Tolerable Daily Intake (TDI) values. By introducing the concept of a relative cumulative Tolerable Daily Intake (TDI(cum)) value, we tried to account for the cumulative exposure to several of the above-mentioned phthalates. The TDI(cum) was derived as follows: the daily intake (DI) calculated from the metabolite level was divided by the TDI for each phthalate; this ratio was multiplied by 100% indicating the TDI percentage for which the DI accounted. Finally the % TDIs of the different phthalates were totalled to get the TDI(cum). A TDI(cum) above 100% is a potential cause for concern. We confirmed the ubiquitous exposure of the children to all phthalates investigated. Exposures were within range of levels previously reported for GerES, albeit slightly lower. Regarding daily intakes, two children exceeded the TDI for DnBP, whereas one child closely approached the TDI for DEHP. 24% of the children exceeded the TDI(cum) for the three most critical phthalates: DEHP, DnBP and DiBP. Furthermore, 54% of the children had total exposures that used up more than 50% the TDI(cum). Therefore, the overall exposure to a number of phthalates, and the knowledge that these phthalates (and other anti-androgens) act in a dose-additive manner, urgently warrants a cumulative risk assessment approach.

  10. Model-based tolerance intervals derived from cumulative historical composition data: application for substantial equivalence assessment of a genetically modified crop.

    PubMed

    Hong, Bonnie; Fisher, Tracey L; Sult, Theresa S; Maxwell, Carl A; Mickelson, James A; Kishino, Hirohisa; Locke, Mary E H

    2014-10-01

    Compositional analysis is a requisite component of the substantial equivalence framework utilized to assess genetically modified (GM) crop safety. Statistical differences in composition data between GM and non-GM crops require a context in which to determine biological relevance. This context is provided by surveying the natural variation of key nutrient and antinutrient levels within the crop population with a history of safe use. Data accumulated from various genotypes with a history of safe use cultivated in relevant commercial crop-growing environments over multiple seasons are discussed as the appropriate data representative of this natural variation. A model-based parametric tolerance interval approach, which accounts for the correlated and unbalanced data structure of cumulative historical data collected from multisite field studies conducted over multiple seasons, is presented. This paper promotes the application of this tolerance interval approach to generate reference ranges for evaluation of the biological relevance of statistical differences identified during substantial equivalence assessment of a GM crop.

  11. Assessing cumulative watershed stressors: Using LIDAR to assess the amount of open lands and young forest associated with in-channel erosion for North Shore tributaries

    EPA Science Inventory

    Hydrologists with the US Forest Service have demonstrated the cumulative impacts of land use change, particularly additional open lands and young forest (< 15 yrs) on bank full flows and in-channel erosion. Mapping these impacts has been difficult due to challenges associated ...

  12. 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.

  13. Mobile health: assessing the barriers.

    PubMed

    Terry, Nicolas P

    2015-05-01

    Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.

  14. Direct releases to the surface and associated complementary cumulative distribution functions in the 1996 performance assessments for the Waste Isolation Pilot Plant: Direct brine release

    SciTech Connect

    STOELZEL,D.M.; O'BRIEN,D.G.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,J.D.; SCOTT,L.N.

    2000-05-19

    The following topics related to the treatment of direct brine releases to the surface environment in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented (1) mathematical description of models, (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented analyses indicate that direct brine releases do not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for direct brine releases fall substantially to the left of the boundary line specified in the US Environmental Protection Agency's standard for the geologic disposal of radioactive waste (4O CFR 191.40 CFR 194).

  15. Direct releases to the surface and associated complementary cumulative distribution functions in the 1996 performance assessment for the Waste Isolation Pilot Plant: Cuttings, cavings and spallings

    SciTech Connect

    BERGLUND,J.W.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,J.D.; SMITH,L.N.; ANDERSON,R.P.

    2000-05-22

    The following topics related to the treatment of cuttings, cavings and spallings releases to the surface environment in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented: (1) mathematical description of models. (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented results indicate that direct releases due to cuttings, cavings and spallings do not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for cuttings, cavings and spallings releases fall substantially to the left of the boundary line specified in the US Environmental Protection Agency standard for the geologic disposal of radioactive waste (40 CFR 191, 40 CFR 194).

  16. Alabama Allied Health Needs Assessment Study.

    ERIC Educational Resources Information Center

    Morris, Libby V.

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

  17. The West Virginia Health Education Assessment Project

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  18. [Comprehensive assessment of urban ecosystem health].

    PubMed

    Sang, Yanhong; Chen, Xingeng; Wu, Renhai; Peng, Xiaochun

    2006-07-01

    Ecosystem health is one of the research hotspots in ecology. This paper discussed the concept of urban ecosystem health, and from the viewpoint of complex ecosystem, presented a new method and a calculation model for the comprehensive assessment of urban ecosystem health to overcome the current researches shortcomings. The application of the method and model in Foshan City of Guangdong Province showed that the assessment results could reflect not only the overall health status of the city, but also the relative health level of the city's sub-systems.

  19. Environmentally relevant mixtures in cumulative assessments: an acute study of toxicokinetics and effects on motor activity in rats exposed to a mixture of pyrethroids.

    PubMed

    Starr, James M; Scollon, Edward J; Hughes, Michael F; Ross, David G; Graham, Stephen E; Crofton, Kevin M; Wolansky, Marcelo J; Devito, Michael J; Tornero-Velez, Rogelio

    2012-12-01

    Due to extensive use, human exposure to multiple pyrethroid insecticides occurs frequently. Studies of pyrethroid neurotoxicity suggest a common mode of toxicity and that pyrethroids should be considered cumulatively to model risk. The objective of this work was to use a pyrethroid mixture that reflects human exposure to common pyrethroids to develop comparative toxicokinetic profiles in rats, and then model the relationship between brain concentration and motor activity. Data from a national survey of child care centers were used to make a mixture reflecting proportions of the most prevalent pyrethroids: permethrin, cypermethrin, β-cyfluthrin, deltamethrin, and esfenvalerate. The mixture was administered orally at one of two concentrations (11.2 and 27.4 mg/kg) to adult male rats. At intervals from 1 to 24h, motor activity was assessed and the animals were sacrificed. Pyrethroid concentrations were measured in the blood, liver, fat, and brain. After controlling for dose, there were no differences in any tissue concentrations, except blood at the initial time point. Elimination half-lives for all pyrethroids in all tissues were < 7h. Brain concentrations of all pyrethroids (when cis- and trans-permethrin were pooled) at the initial time point were proportional to their relative doses. Decreases in motor activity indicated dose additivity, and the relationship between pyrethroid brain concentration and motor activity was described by a four-parameter sigmoidal E(max) model. This study links environmental data with toxicokinetic and neurobehavioral assays to support cumulative risk assessments of pyrethroid pesticides. The results support the additive model of pyrethroid effect on motor activity and suggest that variation in the neurotoxicity of individual pyrethroids is related to toxicodynamic rather than toxicokinetic differences.

  20. The internationalization of health technology assessment.

    PubMed

    Menon, D; Marshall, D

    1996-01-01

    Health technology assessment as a formalized set of activities has a relatively short history. At its current stage of development, it is clear that it has global dimensions and impact. In this paper we review the history of health technology assessment, its development as a form of health services research, and its "institutionalization." We then identify the reasons for its internationalization, review current international initiatives, and propose actions to be taken to improve cooperation among countries.

  1. The Relationship between Cumulative Credits and Student Learning Outcomes: A Cross-Sectional Assessment of Information Literacy and Communication Skills

    ERIC Educational Resources Information Center

    Thonney, Teresa; Montgomery, Joe C.

    2015-01-01

    This article relates the efforts of faculty at one community college to define standards for achievement of two SLOs (critical thinking and effective communication) and to gather and analyze evidence of how well students meet those standards. Faculty from 13 disciplines assessed writing samples from 265 students. We found that, in general,…

  2. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    PubMed

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful.

  3. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    PubMed

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful. PMID:26455783

  4. The Analysis of Cumulative Influence of Factors of Environment on a State of Health of the Population of Vladimir Region

    PubMed Central

    Trifonova, Tatyana Anatolyevna; Shirkin, Leonid Alekseevich

    2015-01-01

    There was investigated the contribution of factors of environment to formation of health for adult population on indicators of mid-annual rates of growth/decrease of disease of system of blood circulation and of some interfaced nosology on an example of the population of Vladimir region. The differential criterion of primary disease of system of blood circulation is considered as an indicator, integrally reflecting degree of adaptation to environment conditions on population and suitable for construction short-term prognostic estimations. It is shown that business factors or the factors of a standard of living characterized by economic indicators, are leading risk factors in disease of system of blood circulation in Vladimir region which contribution is estimated by size of 38 %. With use of regressive equations were received look-ahead estimations of annual rates of primary disease of system of blood circulation. In the regional centre Vladimir was observed more intense situation on rates of disease of system of blood circulation, than in Vladimir region. PMID:25948468

  5. Cumulative Inequality and Racial Disparities in Health: Private Insurance Coverage and Black/White Differences in Functional Limitations

    PubMed Central

    Taylor, Miles G.

    2014-01-01

    Objectives. To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. Method. Data come from 7 waves of the Health and Retirement Study (1996–2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. Results. In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. Discussion. Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans. PMID:24569001

  6. Urban ecosystem health assessment: a review.

    PubMed

    Su, Meirong; Fath, Brian D; Yang, Zhifeng

    2010-05-15

    Due to the important role of cities for regional, national, and international economic development and the concurrent degradation of the urban environmental quality under rapid urbanization, a systematic diagnosis of urban ecosystem health for sustainable ecological management is urgently needed. This paper reviews the related research on urban ecosystem health assessment, beginning from the inception of urban ecosystem health concerns propelled by the development needs of urban ecosystems and the advances in ecosystem health research. Concepts, standards, indicators, models, and case studies are introduced and discussed. Urban ecosystem health considers the integration of ecological, economic, social and human health factors, and as such it is a value-driven concept which is strongly influenced by human perceptions. There is not an absolute urban ecosystem standard because of the uncertainty caused by the changing human needs, targets, and expectation of urban ecosystem over time; thus, suitable approaches are still needed to establish health standards of urban ecosystems. Several conceptual models and suitable indicator frameworks have been proposed to organize the multiple factors to represent comprehensively the health characteristics of an urban ecosystem, while certain mathematical methods have been applied to deal with the indicator information to get a clear assessment of the urban ecosystem health status. Instead of perceiving the urban ecosystem assessment as an instantaneous measurement of the health state, it is suggested to conceptualize the urban ecosystem health as a process, which impels us to focus more studies on the dynamic trends of health status and projecting possible development scenarios.

  7. 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.

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

    PubMed

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

    2016-02-01

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

  9. Model-based tolerance intervals derived from cumulative historical composition data: application for substantial equivalence assessment of a genetically modified crop.

    PubMed

    Hong, Bonnie; Fisher, Tracey L; Sult, Theresa S; Maxwell, Carl A; Mickelson, James A; Kishino, Hirohisa; Locke, Mary E H

    2014-10-01

    Compositional analysis is a requisite component of the substantial equivalence framework utilized to assess genetically modified (GM) crop safety. Statistical differences in composition data between GM and non-GM crops require a context in which to determine biological relevance. This context is provided by surveying the natural variation of key nutrient and antinutrient levels within the crop population with a history of safe use. Data accumulated from various genotypes with a history of safe use cultivated in relevant commercial crop-growing environments over multiple seasons are discussed as the appropriate data representative of this natural variation. A model-based parametric tolerance interval approach, which accounts for the correlated and unbalanced data structure of cumulative historical data collected from multisite field studies conducted over multiple seasons, is presented. This paper promotes the application of this tolerance interval approach to generate reference ranges for evaluation of the biological relevance of statistical differences identified during substantial equivalence assessment of a GM crop. PMID:25208038

  10. An assessment of cumulative impacts of coal mining on the hydrology in part of the Powder River structural basin, Wyoming; a progress report

    USGS Publications Warehouse

    Jordan, P.R.; Bloyd, R.M.; Daddow, P.B.

    1984-01-01

    The U.S. Geological Survey and the Wyoming Department of Environmental Quality are involved in a cooperative effort to assess the probable cumulative impacts of coal mining on the hydrology of a part of the Powder River Structural Basin in Wyoming. It was assumed that the principal impacts on the ground-water system due to mining will occur in the relatively shallow aquifers which can be grouped into three homogeneous aquifers, namely, the Wyodak coal, the overburden, and the under burden. Emphasis of this report is on the results of analysis of surface-water resources in the Caballo Creek drainage. A surface-water model of the Caballo Creek drainage was developed using the Hydrological Simulation Program-Fortran model to help assess the impacts of mining activities on streamflow. The Caballo Creek drainage was divided into 10 land segments and 6 stream reaches in the modeling process. Three simulation runs show little, if any, change in streamflow between pre- and post-mining conditions and very little change between pre-mining and during-mining conditions. The principal reason for the absence of change is the high infiltration rate used in the model for all three conditions. (USGS)

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

    PubMed

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

    2015-01-01

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

  12. The Challenge of Planning Conservation Strategies in Threatened Seascapes: Understanding the Role of Fine Scale Assessments of Community Response to Cumulative Human Pressures.

    PubMed

    Guarnieri, Giuseppe; Bevilacqua, Stanislao; De Leo, Francesco; Farella, Giulio; Maffia, Anna; Terlizzi, Antonio; Fraschetti, Simonetta

    2016-01-01

    Assessing the distribution and intensity of human threats to biodiversity is a prerequisite for effective spatial planning, harmonizing conservation purposes with sustainable development. In the Mediterranean Sea, the management of Marine Protected Areas (MPAs) is rarely based on explicit consideration of the distribution of multiple stressors, with direct assessment of their effects on ecosystems. This gap limits the effectiveness of protection and is conducive to conflicts among stakeholders. Here, a fine scale assessment of the potential effects of different combinations of stressors (both land- and marine-based) on vulnerable rocky habitats (i.e. lower midlittoral and shallow infralittoral) along 40 km of coast in the western Mediterranean (Ionian Sea) has been carried out. The study area is a paradigmatic example of socio-ecological interactions, where several human uses and conservation measures collide. Significant differences in the structure of assemblages according to different combinations of threats were observed, indicating distinct responses of marine habitats to different sets of human pressures. A more complex three-dimensional structure, higher taxon richness and β-diversity characterized assemblages subject to low versus high levels of human pressure, consistently across habitats. In addition, the main drivers of change were: closeness to the harbour, water quality, and the relative extension of beaches. Our findings suggest that, although efforts to assess cumulative impacts at large scale may help in individuating priority areas for conservation purposes, the fact that such evaluations are often based on expert opinions and not on actual studies limits their ability to represent real environmental conditions at local scale. Systematic evaluations of local scale effects of anthropogenic drivers of change on biological communities should complement broad scale management strategies to achieve effective sustainability of human exploitation of

  13. The Challenge of Planning Conservation Strategies in Threatened Seascapes: Understanding the Role of Fine Scale Assessments of Community Response to Cumulative Human Pressures.

    PubMed

    Guarnieri, Giuseppe; Bevilacqua, Stanislao; De Leo, Francesco; Farella, Giulio; Maffia, Anna; Terlizzi, Antonio; Fraschetti, Simonetta

    2016-01-01

    Assessing the distribution and intensity of human threats to biodiversity is a prerequisite for effective spatial planning, harmonizing conservation purposes with sustainable development. In the Mediterranean Sea, the management of Marine Protected Areas (MPAs) is rarely based on explicit consideration of the distribution of multiple stressors, with direct assessment of their effects on ecosystems. This gap limits the effectiveness of protection and is conducive to conflicts among stakeholders. Here, a fine scale assessment of the potential effects of different combinations of stressors (both land- and marine-based) on vulnerable rocky habitats (i.e. lower midlittoral and shallow infralittoral) along 40 km of coast in the western Mediterranean (Ionian Sea) has been carried out. The study area is a paradigmatic example of socio-ecological interactions, where several human uses and conservation measures collide. Significant differences in the structure of assemblages according to different combinations of threats were observed, indicating distinct responses of marine habitats to different sets of human pressures. A more complex three-dimensional structure, higher taxon richness and β-diversity characterized assemblages subject to low versus high levels of human pressure, consistently across habitats. In addition, the main drivers of change were: closeness to the harbour, water quality, and the relative extension of beaches. Our findings suggest that, although efforts to assess cumulative impacts at large scale may help in individuating priority areas for conservation purposes, the fact that such evaluations are often based on expert opinions and not on actual studies limits their ability to represent real environmental conditions at local scale. Systematic evaluations of local scale effects of anthropogenic drivers of change on biological communities should complement broad scale management strategies to achieve effective sustainability of human exploitation of

  14. The Challenge of Planning Conservation Strategies in Threatened Seascapes: Understanding the Role of Fine Scale Assessments of Community Response to Cumulative Human Pressures

    PubMed Central

    Guarnieri, Giuseppe; Bevilacqua, Stanislao; De Leo, Francesco; Farella, Giulio; Maffia, Anna; Terlizzi, Antonio; Fraschetti, Simonetta

    2016-01-01

    Assessing the distribution and intensity of human threats to biodiversity is a prerequisite for effective spatial planning, harmonizing conservation purposes with sustainable development. In the Mediterranean Sea, the management of Marine Protected Areas (MPAs) is rarely based on explicit consideration of the distribution of multiple stressors, with direct assessment of their effects on ecosystems. This gap limits the effectiveness of protection and is conducive to conflicts among stakeholders. Here, a fine scale assessment of the potential effects of different combinations of stressors (both land- and marine-based) on vulnerable rocky habitats (i.e. lower midlittoral and shallow infralittoral) along 40 km of coast in the western Mediterranean (Ionian Sea) has been carried out. The study area is a paradigmatic example of socio-ecological interactions, where several human uses and conservation measures collide. Significant differences in the structure of assemblages according to different combinations of threats were observed, indicating distinct responses of marine habitats to different sets of human pressures. A more complex three-dimensional structure, higher taxon richness and β-diversity characterized assemblages subject to low versus high levels of human pressure, consistently across habitats. In addition, the main drivers of change were: closeness to the harbour, water quality, and the relative extension of beaches. Our findings suggest that, although efforts to assess cumulative impacts at large scale may help in individuating priority areas for conservation purposes, the fact that such evaluations are often based on expert opinions and not on actual studies limits their ability to represent real environmental conditions at local scale. Systematic evaluations of local scale effects of anthropogenic drivers of change on biological communities should complement broad scale management strategies to achieve effective sustainability of human exploitation of

  15. Assessing the safety of co-exposure to food packaging migrants in food and water using the maximum cumulative ratio and an established decision tree.

    PubMed

    Price, Paul; Zaleski, Rosemary; Hollnagel, Heli; Ketelslegers, Hans; Han, Xianglu

    2014-01-01

    Food contact materials can release low levels of multiple chemicals (migrants) into foods and beverages, to which individuals can be exposed through food consumption. This paper investigates the potential for non-carcinogenic effects from exposure to multiple migrants using the Cefic Mixtures Ad hoc Team (MIAT) decision tree. The purpose of the assessment is to demonstrate how the decision tree can be applied to concurrent exposures to multiple migrants using either hazard or structural data on the specific components, i.e. based on the acceptable daily intake (ADI) or the threshold of toxicological concern. The tree was used to assess risks from co-exposure to migrants reported in a study on non-intentionally added substances (NIAS) eluting from food contact-grade plastic and two studies of water bottles: one on organic compounds and the other on ionic forms of various elements. The MIAT decision tree assigns co-exposures to different risk management groups (I, II, IIIA and IIIB) based on the hazard index, and the maximum cumulative ratio (MCR). The predicted co-exposures for all examples fell into Group II (low toxicological concern) and had MCR values of 1.3 and 2.4 (indicating that one or two components drove the majority of the mixture's toxicity). MCR values from the study of inorganic ions (126 mixtures) ranged from 1.1 to 3.8 for glass and from 1.1 to 5.0 for plastic containers. The MCR values indicated that a single compound drove toxicity in 58% of the mixtures. MCR values also declined with increases in the hazard index for the screening assessments of exposure (suggesting fewer substances contributed as risk potential increased). Overall, it can be concluded that the data on co-exposure to migrants evaluated in these case studies are of low toxicological concern and the safety assessment approach described in this paper was shown to be a helpful screening tool.

  16. RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

    EPA Science Inventory

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

  17. Content Assessment of Selected College Health Textbooks.

    ERIC Educational Resources Information Center

    Huetteman, Julie Doidge

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

  18. An Assessment of Environmental Health Needs

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

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

  19. Assessing nursing students' knowledge of health literacy.

    PubMed

    McCleary-Jones, Voncella

    2012-01-01

    Because patients' limited level of health literacy can have a negative impact on patient health outcomes, it is important to address this topic in the nursing curricula. The author discusses a comparative study that assessed baccalaureate nursing students' knowledge of health literacy before and after implementation of an asynchronous online educational module. With a significant difference between the pretest and posttest scores, the findings provide information that can inform curriculum planning in baccalaureate nursing programs.

  20. Rethinking cumulative exposure in epidemiology, again.

    PubMed

    de Vocht, Frank; Burstyn, Igor; Sanguanchaiyakrit, Nuthchyawach

    2015-01-01

    The use of cumulative exposure, the product of intensity and duration, has enjoyed great popularity in epidemiology of chronic diseases despite numerous known caveats in its interpretation. We briefly review the history of use of cumulative exposure in epidemiology and propose an alternative method for relating time-integrated exposures to health risks. We argue, as others before us have, that cumulative exposure metrics obscures the interplay of exposure intensity and duration. We propose to use a computationally simple alternative in which duration and intensity of exposure are modelled as a main effect and their interaction, cumulative exposure, only be added if there is evidence of deviation from this additive model. We also consider the Lubin-Caporaso model of interplay of exposure intensity and duration. The impact of measurement error in intensity on model selection was also examined. The value of this conceptualization is demonstrated using a simulation study and further illustrated in the context of respiratory health and occupational exposure to latex dust. We demonstrate why cumulative exposure has been so popular because the cumulative exposure metric per se gives a robust answer to the existence of an association, regardless of the underlying true mechanism of disease. Treating cumulative exposure as the interaction of main effects of exposure duration and intensity enables epidemiologists to derive more information about mechanism of disease then fitting cumulative exposure metric by itself, and without the need to collect additional data. We propose that the practice of fitting duration, intensity and cumulative exposure separately to epidemiologic data should lead to conceptualization of cumulative exposure as interaction of main effects of duration and intensity of exposure. PMID:25138292

  1. The Prenatal Assessment of Fetal Health

    PubMed Central

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

    1979-01-01

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

  2. Smart Sensors Assess Structural Health

    NASA Technical Reports Server (NTRS)

    2010-01-01

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

  3. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

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

  4. Health assessment of exposure to developmental toxicants

    SciTech Connect

    Kimmel, C.A.

    1987-07-01

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

  5. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

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

  6. Radionuclide and colloid transport in the Culebra Dolomite and associated complementary cumulative distribution functions in the 1996 performance assessment for the Waste Isolation Pilot Plant

    SciTech Connect

    RAMSEY, JAMES L.; BLAINE,R.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,J.D.; SMITH,L.N.; WALLACE,M.

    2000-05-22

    The following topics related to radionuclide and colloid transport in the Culebra Dolomite in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented: (1) mathematical description of models, (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, and (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty. The presented results indicate that radionuclide and colloid transport in the Culebra Dolomite does not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, no radionuclide transport to the boundary with the accessible environment was observed; thus the associated CCDFs for comparison with the boundary line specified in the US Environmental Protection Agency's standard for the geologic disposal of radioactive waste (40 CFR 191, 40 CFR 194) are degenerate in the sense of having a probability of zero of exceeding a release of zero.

  7. Radionuclide transport in the vicinity of the repository and associated complementary cumulative distribution functions in the 1996 performance assessment for the Waste Isolation Pilot Plant

    SciTech Connect

    STOCKMAN,CHRISTINE T.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,JAY DEAN; SHINTA,A.; SMITH,L.N.

    2000-05-22

    The following topics related to radionuclide transport in the vicinity of the repository in the 1996 performance assessment for the Waste Isolation Pilot Plant are presented (1) mathematical description of models, (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented results indicate that no releases to the accessible environment take place due to radionuclide movement through the anhydrite marker beds, through the Dewey Lake Red Beds or directly to the surface, and also that the releases to the Culebra Dolomite are small. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for release to the Culebra Dolomite fall to the left of the boundary line specified in the US Environmental Protection Agency's standard for the geologic disposal of radioactive waste (40 CFR 191, 40 CFR 194).

  8. Spatial and temporal assessment of cumulative disturbance impacts due to military training, burning, haying, and their interactions on land condition of Fort Riley.

    PubMed

    Wang, Guangxing; Murphy, Dana; Oller, Adam; Howard, Heidi R; Anderson, Alan B; Rijal, Santosh; Myers, Natalie R; Woodford, Philip

    2014-07-01

    The effects of military training activities on the land condition of Army installations vary spatially and temporally. Training activities observably degrade land condition while also increasing biodiversity and stabilizing ecosystems. Moreover, other anthropogenic activities regularly occur on military lands such as prescribed burns and agricultural haying-adding to the dynamics of land condition. Thus, spatially and temporally assessing the impacts of military training, prescribed burning, agricultural haying, and their interactions is critical to the management of military lands. In this study, the spatial distributions and patterns of military training-induced disturbance frequency were derived using plot observation and point observation-based method, at Fort Riley, Kansas from 1989 to 2001. Moreover, spatial and variance analysis of cumulative impacts due to military training, burning, haying, and their interactions on the land condition of Fort Riley were conducted. The results showed that: (1) low disturbance intensity dominated the majority of the study area with exception of concentrated training within centralized areas; (2) high and low values of disturbance frequency were spatially clustered and had spatial patterns that differed significantly from a random distribution; and (3) interactions between prescribed burning and agricultural haying were not significant in terms of either soil erosion or disturbance intensity although their means and variances differed significantly between the burned and non-burned areas and between the hayed and non-hayed areas.

  9. Psychophysiological assessment of stress and screening of health risk in peacekeeping operations.

    PubMed

    Nikolova, Rouja; Aleksiev, Lyubomir; Vukov, Mircho

    2007-01-01

    Medical surveillance for military personnel participating in peacekeeping missions (PKMs) is required to define the effect of stress on health status. The aim of this study was to determine the effect of stress on the autonomic cardiovascular control and health risk of 72 Bulgarian peacekeepers participating in a PKM in Kosovo. The assessment of psychophysiological stress and determination of stress characteristics were implemented with analysis of heart rate variability and personal interviews. As a response to the cumulative exposure to the effect of stress on cognitive function, we observed reductions in parasympathetic function and baroreceptor modulation of heart rhythm. The alteration in cardiovascular control was registered as decreases in short-term variability and spectral powers of cardiointervals in the respiratory sinus arrhythmia and Traube-Hering-Mayer bands. The advantage of psychophysiological stress assessment and screening of health risk in PKMs is that results indicate the mechanisms of the effects of stress on cognitive function and health status. PMID:17274265

  10. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  11. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  12. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  13. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  14. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  15. Mental health assessment of rape offenders

    PubMed Central

    Sarkar, Jaydip

    2013-01-01

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

  16. Pesticide residues in cashew apple, guava, kaki and peach: GC-μECD, GC-FPD and LC-MS/MS multiresidue method validation, analysis and cumulative acute risk assessment.

    PubMed

    Jardim, Andréia Nunes Oliveira; Mello, Denise Carvalho; Goes, Fernanda Caroline Silva; Frota Junior, Elcio Ferreira; Caldas, Eloisa Dutra

    2014-12-01

    A multiresidue method for the determination of 46 pesticides in fruits was validated. Samples were extracted with acidified ethyl acetate, MgSO4 and CH3COONa and cleaned up by dispersive SPE with PSA. The compounds were analysed by GC-FPD, GC-μECD or LC-MS/MS, with LOQs from 1 to 8 μg/kg. The method was used to analyse 238 kaki, cashew apple, guava, and peach fruit and pulp samples, which were also analysed for dithiocarbamates (DTCs) using a spectrophotometric method. Over 70% of the samples were positive, with DTC present in 46.5%, λ-cyhalothrin in 37.1%, and omethoate in 21.8% of the positive samples. GC-MS/MS confirmed the identities of the compounds detected by GC. None of the pesticides found in kaki, cashew apple and guava was authorised for these crops in Brazil. The risk assessment has shown that the cumulative acute intake of organophosphorus or pyrethroid compounds from the consumption of these fruits is unlikely to pose a health risk to consumers. PMID:24996324

  17. Pesticide residues in cashew apple, guava, kaki and peach: GC-μECD, GC-FPD and LC-MS/MS multiresidue method validation, analysis and cumulative acute risk assessment.

    PubMed

    Jardim, Andréia Nunes Oliveira; Mello, Denise Carvalho; Goes, Fernanda Caroline Silva; Frota Junior, Elcio Ferreira; Caldas, Eloisa Dutra

    2014-12-01

    A multiresidue method for the determination of 46 pesticides in fruits was validated. Samples were extracted with acidified ethyl acetate, MgSO4 and CH3COONa and cleaned up by dispersive SPE with PSA. The compounds were analysed by GC-FPD, GC-μECD or LC-MS/MS, with LOQs from 1 to 8 μg/kg. The method was used to analyse 238 kaki, cashew apple, guava, and peach fruit and pulp samples, which were also analysed for dithiocarbamates (DTCs) using a spectrophotometric method. Over 70% of the samples were positive, with DTC present in 46.5%, λ-cyhalothrin in 37.1%, and omethoate in 21.8% of the positive samples. GC-MS/MS confirmed the identities of the compounds detected by GC. None of the pesticides found in kaki, cashew apple and guava was authorised for these crops in Brazil. The risk assessment has shown that the cumulative acute intake of organophosphorus or pyrethroid compounds from the consumption of these fruits is unlikely to pose a health risk to consumers.

  18. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  19. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  20. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  1. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  2. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND... assessments and health effects studies. (a) ATSDR shall provide a report of the results of a health......

  3. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  4. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND... assessments and health effects studies. (a) ATSDR shall provide a report of the results of a health......

  7. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND... assessments and health effects studies. (a) ATSDR shall provide a report of the results of a health......

  8. Identification and Quantification of Cumulative Factors that Increase Environmental Exposures and Impacts

    EPA Science Inventory

    Evaluating the combined adverse effects of multiple stressors upon human health is an imperative component of cumulative risk assessment (CRA)1. In addition to chemical stressors, other non-chemical factors are also considered. For examples, smoking will elevate the risks of havi...

  9. Lifestyle Assessment: Helping Patients Change Health Behaviors

    PubMed Central

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

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

  10. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

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

  11. Advanced Health Assessment in Nurse Practitioner Programs.

    ERIC Educational Resources Information Center

    Kelley, Frances J.; Kopac, Catharine

    2001-01-01

    Responses from 140 nursing schools indicated that most taught health assessment to nurse practitioners as a separate course; public institutions were more involved in computer-assisted instruction. Faculty cited scarce resources and limited time to develop new teaching strategies. Most agreed that graduate courses should focus on differential…

  12. Watershed Health Assessment Tools Investigating Fisheries

    EPA Science Inventory

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

  13. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    PubMed

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-01

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning. PMID:26999177

  14. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China

    PubMed Central

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-01-01

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m3 and 0.30 mg-year/m3 for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m3 and 0.01 mg/m3 for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning. PMID:26999177

  15. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    PubMed

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-16

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning.

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

    PubMed

    1992-02-14

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

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

    PubMed

    1992-02-14

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

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

    PubMed Central

    Lock, K.; McKee, M.

    2005-01-01

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

  19. Untapped potential of health impact assessment.

    PubMed

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

    2013-04-01

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

  20. Untapped potential of health impact assessment

    PubMed Central

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

    2013-01-01

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

  1. Environmentally-Relevant Mixtures in Cumulative Assessments: An Acute Study of Toxicokinetics and Effects on Motor Activity in Rats Exposed to a Mixture of Pyrethroids

    EPA Science Inventory

    Due to extensive use, human exposure to multiple pyrethroid insecticides occurs frequently. Studies of pyrethroid neurotoxicity suggest a common mode of toxicity and that pyrethroids should be considered cumulatively to model risk. The objective of this work was to use a pyrethro...

  2. Software quality assessment for health care systems.

    PubMed

    Braccini, G; Fabbrini, F; Fusani, M

    1997-01-01

    The problem of defining a quality model to be used in the evaluation of the software components of a Health Care System (HCS) is addressed. The model, based on the ISO/IEC 9126 standard, has been interpreted to fit the requirements of some classes of applications representative of Health Care Systems, on the basis of the experience gained both in the field of medical Informatics and assessment of software products. The values resulting from weighing the quality characteristics according to their criticality outline a set of quality profiles that can be used both for evaluation and certification.

  3. Managing cumulative impacts: A key to sustainability?

    SciTech Connect

    Hunsaker, C.T.

    1994-12-31

    This paper addresses how science can be more effectively used in creating policy to manage cumulative effects on ecosystems. The paper focuses on the scientific techniques that we have to identify and to assess cumulative impacts on ecosystems. The term ``sustainable development`` was brought into common use by the World Commission on Environment and Development (The Brundtland Commission) in 1987. The Brundtland Commission report highlighted the need to simultaneously address developmental and environmental imperatives simultaneously by calling for development that ``meets the needs of the present generation without compromising the needs of future generations.`` We cannot claim to be working toward sustainable development until we can quantitatively assess cumulative impacts on the environment: The two concepts are inextricibally linked in that the elusiveness of cumulative effects likely has the greatest potential of keeping us from achieving sustainability. In this paper, assessment and management frameworks relevant to cumulative impacts are discussed along with recent literature on how to improve such assessments. When possible, examples are given for marine ecosystems.

  4. Health Impact Assessment of Urban Development Project

    PubMed Central

    Shojaei, Parisa; Karimlou, Masoud; Mohammadi, Farahnaz; Malekafzali, Hosein

    2016-01-01

    Background: Health impact assessment (HIA) has emerged to identify those activities and policies likely to have major impacts on the health of a population. Method: In this research, qualitative method was applied to identifying health determinants that urban man made lake affect on them, formatting and weighing the hierarchy of the factors, calculating AHP, and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method for decide and ranking alternatives. Results: According to the results of the study, from the structural determinants point of view, the most positive effect of man-made lake was on Recreational services by 89.5% and the most negative one was on housing. According to intermediary determinants and general average, the most positive effect of lake was on physical activity and quality of air by 88.9% and the most negative one was on noise pollution by 46.7%. Ultimately, considering the positive and negative effects of lake between constructing and not constructing the lake option, the construction option was selected. Conclusion: There is substantial potential to improve public health by bringing decision makers’ attention to the health consequences of their actions; city councilpersons, zoning commissioners, and other decision makers typically have little background in health. PMID:27157160

  5. Health impact assessment of liquid biofuel production.

    PubMed

    Fink, Rok; Medved, Sašo

    2013-01-01

    Bioethanol and biodiesel as potential substitutes for fossil fuels in the transportation sector have been analyzed for environmental suitability. However, there could be impacts on human health during the production, therefore adverse health effects have to be analyzed. The aim of this study is to analyze to what health risk factors humans are exposed to in the production of biofuels and what the size of the health effects is. A health impact assessment expressed as disability adjusted life years (DALYs) was conducted in SimaPro 7.1 software. The results show a statistically significant lower carcinogenic impact of biofuels (p < 0.05) than fossil fuels. Meanwhile, the impact of organic respirable compounds is smaller for fossil fuels (p < 0.05) than for biofuels. Analysis of inorganic compounds like PM₁₀,₂.₅, SO₂ or NO(x) shows some advantages of sugar beet bioethanol and soybean biodiesel production (p < 0.05), although production of sugarcane bioethanol shows larger impacts of respirable inorganic compounds than for fossil fuels (p < 0.001). Although liquid biofuels are made of renewable energy sources, this does not necessary mean that they do not represent any health hazards. PMID:22774773

  6. 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

  7. Teaching health assessment in the virtual classroom.

    PubMed

    Lashley, Mary

    2005-08-01

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

  8. Assessing the performance of health technology assessment organizations: a framework.

    PubMed

    Lafortune, Louise; Farand, Lambert; Mondou, Isabelle; Sicotte, Claude; Battista, Renaldo

    2008-01-01

    In light of growing demands for public accountability, the broadening scope of health technology assessment organizations (HTAOs) activities and their increasing role in decision-making underscore the importance for them to demonstrate their performance. Based on Parson's social action theory, we propose a conceptual model that includes four functions an organization needs to balance to perform well: (i) goal attainment, (ii) production, (iii) adaptation to the environment, and (iv) culture and values maintenance. From a review of the HTA literature, we identify specific dimensions pertaining to the four functions and show how they relate to performance. We compare our model with evaluations reported in the scientific and gray literature to confirm its capacity to accommodate various evaluation designs, contexts of evaluation, and organizational models and perspectives. Our findings reveal the dimensions of performance most often assessed and other important ones that, hitherto, remain unexplored. The model provides a flexible and theoretically grounded tool to assess the performance of HTAOs.

  9. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

  10. Cumulative Timers for Microprocessors

    NASA Technical Reports Server (NTRS)

    Battle, John O.

    2007-01-01

    It has been proposed to equip future microprocessors with electronic cumulative timers, for essentially the same reasons for which land vehicles are equipped with odometers (total-distance-traveled meters) and aircraft are equipped with Hobbs meters (total-engine-operating time meters). Heretofore, there has been no way to determine the amount of use to which a microprocessor (or a product containing a microprocessor) has been subjected. The proposed timers would count all microprocessor clock cycles and could only be read by means of microprocessor instructions but, like odometers and Hobbs meters, could never be reset to zero without physically damaging the chip.

  11. Risk assessment and toxicology databases for health effects assessment

    SciTech Connect

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

    1990-12-31

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

  12. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

  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.

  14. Health impact assessment of urban waterway decisions.

    PubMed

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

    2014-12-25

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

  15. Health Impact Assessment of Urban Waterway Decisions

    PubMed Central

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

    2014-01-01

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

  16. Assessing Hmong Farmers’ Safety and Health

    PubMed Central

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

    2014-01-01

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

  17. Assessing Hmong farmers' safety and health.

    PubMed

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

    2014-05-01

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

  18. Assessing Psychological Health: The Contribution of Psychological Strengths

    ERIC Educational Resources Information Center

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Lurie, Elinore; And Others

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

  20. Environmental, health and safety assessment of photovoltaics

    NASA Technical Reports Server (NTRS)

    Rose, E. C.

    1983-01-01

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

  1. Mobile technology for mental health assessment.

    PubMed

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

    2016-06-01

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

  2. Mobile technology for mental health assessment

    PubMed Central

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

    2016-01-01

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

  3. Mobile technology for mental health assessment.

    PubMed

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

    2016-06-01

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

  4. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

    The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

  5. [Health status and health needs assessment--state of the art of the public health practice in Croatia].

    PubMed

    Vuletić, Silvije; Sogorić, Selma; Malatestinić, Dulija; Bozicević, Ivana

    2010-12-01

    Public health practice performance is measured through its three core functions, i.e. assessment, policy development and assurance. We describe the existing health status and health care needs assessment practices in the Republic of Croatia. Health care needs assessment in Croatia includes mortality and morbidity information available through vital records but does not include community input (opinion and attitude) and participation. Health needs are not analyzed in order to determine the causes of health problems. Analysis of health needs of the population groups at highest risk also does not exist. Resources assessment is not part of the process, so we do not know how adequate the existing health resources are. In the Croatian health care system practice, the assessment function is limited through the almost exclusive use of the routine health and demographic statistics. Academic public health has introduced other kinds of more participative, subgroups oriented, qualitative methodologies but in daily routine, these methods are hardly used. Since health needs assessment is one of the core public health functions, in the future its practice has to be reoriented from pure monitoring towards identifying and solving community health problems. Partnership with community has to be a cornerstone for more efficient health needs assessment practice. In the light of previous statement, we present and discuss new trends in the assessment practice in Croatia, i.e. revision of routine health data collection, ways of performing intervention aimed health surveys, naturalistic approach in health needs assessment, and health needs research of population groups at highest risk.

  6. Simulation-based assessments in health professional education: a systematic review

    PubMed Central

    Ryall, Tayne; Judd, Belinda K; Gordon, Christopher J

    2016-01-01

    Introduction The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education. Methods A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (Medline), and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included. Results A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the research papers included small participant numbers, poor methodological quality, and predominance of studies from medicine, which preclude any definite conclusions. Conclusion Simulation has now been embedded across a range of health professional

  7. Remote Sensing of Bioindicators for Forest Health Assessment

    NASA Astrophysics Data System (ADS)

    Kefauver, Shawn Carlisle

    The impacts of tropospheric ozone on forest health in Mediterranean type climates in California, USA and Catalonia, Spain were investigated using a combination of remote sensing, Geographic Information System (GIS), and field studies focused on sensitive bioindicator conifer species and ambient ozone monitoring. For the field validation of impacts of tropospheric ozone on conifer health, the Ozone Injury Index (OII) was applied to the bioindicator species Pinus ponderosa, Pinus jeffreyi, and Pinus uncinata. Combining these three tools, it was possible to build meaningful ecological models covering large areas to enhance our understanding of the biotic and abiotic interactions which affect forest health. Regression models predicting ozone injury improved considerably when incorporating ozone exposure with GIS related to plant water status, including water availability and water usage, as a proxies for estimating the stomatal conductance and ozone uptake R2=0.35, p = 0.016 in Catalonia, R2=0.36, p < 0.001 in Yosemite and R2=0.33, p = 0.007 in Sequoia/Kings Canyon National Parks in California). Individual OII components in Catalonia were modeled with improved success compared to the original full OII, in particular visible chlorotic mottling (R2=0.60, p < 0.001). The visual chlorotic mottling component of the OII was the most strongly correlated to remote sensing indices, in particular the photochemical reflectance index (PRI; R2=0.28, p=0.0044 for OIIVI-amount and R 2=0.33 and p=0.0016 for OIIVI -severity). Regression models assessing ozone injury to conifers using imaging spectroscopy techniques also improved when incorporating the GIS proxies of stomatal conductance (R 2=0.59, p<0.0001 for OII in California and R2=0.68, p<0.0001 for OIIVI in Catalonia). Finally, taking advantage of a time series of ambient ozone monitoring in Catalonia, it was found that all models improved when incorporating the cumulative exposure to ozone over a period of three years (R2=0.56, p

  8. Canadian and international EIA frameworks as they apply to cumulative effects

    SciTech Connect

    Connelly, Robert

    2011-09-15

    This paper presents a brief history of the development of cumulative effects, the current requirements in North America and elsewhere in the world, challenges at the project level, thoughts on how emerging concepts of strategic environmental assessment and regional assessment may offer means to improve the examination of cumulative effects and offers suggestions for current and future needs in cumulative effects assessment.

  9. Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

    PubMed

    Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

    2015-01-01

    The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food. PMID:25753750

  10. Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

    PubMed

    Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

    2015-01-01

    The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

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

    PubMed

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

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

    PubMed Central

    Springer, Andrew E.; Evans, Alexandra E.

    2016-01-01

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

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

    PubMed

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

  14. Health hazards of fire fighters: exposure assessment.

    PubMed Central

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

    1988-01-01

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

  15. Health-effects assessment for acenaphthene

    SciTech Connect

    Not Available

    1987-07-01

    Because of the lack of data for the carcinogenicity and threshold toxicity of acenaphthene risk assessment values cannot be derived. The ambient water-quality criterion of 0.2 mg/l is based on organoleptic data, which has no known relationship to potential human health effects. Acenaphthene has been shown to produce nuclear and cytological changes in microbial and plant species. Results of acenaphthene mutagenicity studies in microorganisms and carcinogenicity study are negative. Despite the negative results in the newt (Triturus cristatus) the fact that acenaphthene is a polynuclear aromatic hydrocarbon (PAH), a class of chemicals that contain carcinogens, the carcinogenic potential of acenaphthene is of great concern. Inadequate evidence to allow any conclusion regarding carcinogenicity for humans appropriately places acenaphthene in EPA Group D.

  16. Assessing clinical competency in the health sciences

    NASA Astrophysics Data System (ADS)

    Panzarella, Karen Joanne

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

  17. Steps and pips in the history of the cumulative recorder.

    PubMed

    Lattal, Kennon A

    2004-11-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his colleagues to its perfection in the 1950s, and then into the 1960s when it proliferated as different scientific instrument companies began marketing their own models of the cumulative recorder. With the rise of digital computers, the demise of the cumulative recorder as a scientific instrument was inevitable; however, the value of the cumulative record as a monitoring device to assess schedule control of behavior continues. The cumulative recorder remains, along with the operant conditioning chamber, an icon of Skinner's approach to psychology.

  18. Steps and pips in the history of the cumulative recorder.

    PubMed

    Lattal, Kennon A

    2004-11-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his colleagues to its perfection in the 1950s, and then into the 1960s when it proliferated as different scientific instrument companies began marketing their own models of the cumulative recorder. With the rise of digital computers, the demise of the cumulative recorder as a scientific instrument was inevitable; however, the value of the cumulative record as a monitoring device to assess schedule control of behavior continues. The cumulative recorder remains, along with the operant conditioning chamber, an icon of Skinner's approach to psychology. PMID:15693527

  19. Steps and pips in the history of the cumulative recorder.

    PubMed Central

    Lattal, Kennon A

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his colleagues to its perfection in the 1950s, and then into the 1960s when it proliferated as different scientific instrument companies began marketing their own models of the cumulative recorder. With the rise of digital computers, the demise of the cumulative recorder as a scientific instrument was inevitable; however, the value of the cumulative record as a monitoring device to assess schedule control of behavior continues. The cumulative recorder remains, along with the operant conditioning chamber, an icon of Skinner's approach to psychology. PMID:15693527

  20. Assessing the health risks of aluminum.

    PubMed

    Orme, J; Ohanian, E V

    1990-03-01

    Aluminum is a ubiquitous substance with over 4,000 uses. Aluminum, as aluminum sulfate, is commonly used in the United States as a coagulant in the treatment of drinking water. For many years aluminum was not considered to be toxic to humans. However, reports associating aluminum with several skeletal and neurological disorders in humans suggest that exposure to aluminum may pose a health hazard. In 1983 the US Environmental Protection Agency (EPA) announced plans to regulate a number of substances, including aluminum, in drinking water. Aluminum was considered because of its occurrence and apparent toxicity. Upon further evaluation of the health effects data the EPA proposed not to regulate aluminum as a result of the uncertainty of the toxicity of ingested aluminum. Putative causal associations between aluminum exposure and neurological disorders such as Alzheimer's disease have yet to be substantiated. Although several issues regarding the toxicity of ingested aluminum are unresolved, aluminum has been specified in the 1986 Amendments to the Safe Drinking Water Act, as one of 83 substances in drinking water to be regulated by 1989. Additional data are needed before the potential risk of aluminum can be assessed; therefore the EPA has deferred possible regulation until 1991. PMID:24202565

  1. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

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

    2012-05-18

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

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

    EPA Science Inventory

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

  3. Health-effects assessment for acrolein

    SciTech Connect

    Not Available

    1987-07-01

    This report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyses under Executive Order 12991 for decision making under CERCLA. All estimates of acceptable intakes and carcinogenic potency presented in the document should be considered as preliminary and reflect limited resources allocated to the project. The intent in these assessments is to suggest acceptable exposure levels whenever sufficient data are available. The interim values presented reflect the relative degree of hazard associated with exposure or risk to the chemical(s) addressed. Whenever possible, two categories of values have been estimated for systematic toxicants (toxicants for which cancer is not the endpoint of concern). The first, RfDS or subchronic reference dose, is an estimate of an exposure level that would not be expected to cause adverse effects when exposure occurs during a limited time interval. The RfD is an estimate of an exposure level that would not be expected to cause adverse effects when exposure occurs for a significant portion of the lifespan. For compounds for which there is sufficient evidence of carcinogenicity, q1*s have been computed, if appropriate, based on oral and inhalation data if available.

  4. Use of biomarkers to assess environmental health

    NASA Astrophysics Data System (ADS)

    Shugart, Lee R.; Halbrook, Richard S.

    1993-03-01

    Environmental pollution has received considerable coverage in the news media. This has stimulated public interest and generated pressure on private industries and governmental agencies to take corrective action. Because the environmental issues have at times been presented in a simplistic and sensational manner, the corrective response by regulatory agencies and industry is often cursory and narrow. An approach, using biomarkers (biological responses), for assessing the biological and ecological significance of contaminants present in the environment is described. Living organisms integrate exposure to contaminants in their environment and respond in some measurable and predictable way. Responses are observed at several levels of biological organization from the biomolecular level, where pollutants can cause damage to critical cellular macromolecules and elicit defensive strategies such as detoxication and repair mechanisms, to the organismal level, where severe disturbances are manifested as impairment in growth, reproduction, developmental abnormalities, or decreased survival. Biomarkers can provide, not only evidence of exposure to a broad spectrum of anthropogenic chemicals, but also a temporally-integrated measure of bioavailable contaminant levels. A suite of biomarkers are evaluated over time to determine the magnitude of the problem and possible consequences. Pragmatically, the biomarker approach will help to assess the health of the environment, and, in addition, will enable scientists to defend the advice they provide concerning environmental issues.

  5. 42 CFR 457.560 - Cumulative cost-sharing maximum.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cumulative cost-sharing maximum. 457.560 Section 457.560 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...

  6. 42 CFR 457.560 - Cumulative cost-sharing maximum.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cumulative cost-sharing maximum. 457.560 Section 457.560 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO...

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  8. Algorithm Calculates Cumulative Poisson Distribution

    NASA Technical Reports Server (NTRS)

    Bowerman, Paul N.; Nolty, Robert C.; Scheuer, Ernest M.

    1992-01-01

    Algorithm calculates accurate values of cumulative Poisson distribution under conditions where other algorithms fail because numbers are so small (underflow) or so large (overflow) that computer cannot process them. Factors inserted temporarily to prevent underflow and overflow. Implemented in CUMPOIS computer program described in "Cumulative Poisson Distribution Program" (NPO-17714).

  9. A scalable climate health justice assessment model.

    PubMed

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

    2015-05-01

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

  10. A scalable climate health justice assessment model

    PubMed Central

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

    2014-01-01

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

  11. Health Impact Assessment as a Student Service Learning Experience

    ERIC Educational Resources Information Center

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

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

  12. Reproductive Health Assessment After Disaster: introduction to the RHAD toolkit.

    PubMed

    Zotti, Marianne E; Williams, Amy M

    2011-08-01

    This article reviews associations between disaster and the reproductive health of women, describes how Hurricane Katrina influenced our understanding about postdisaster reproductive health needs, and introduces a new toolkit that can help health departments assess postdisaster health needs among women of reproductive age.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  14. A cross-cultural longitudinal examination of the effect of cumulative adversity on the mental and physical health of older adults.

    PubMed

    Palgi, Yuval; Shrira, Amit

    2016-03-01

    Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the life span, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs' mental and physical health than on Jews' health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures.

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

    PubMed

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

    2004-01-01

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

  16. [Application and benefit evaluation of tiered health risk assessment approach on site contaminated by benzene].

    PubMed

    Jiang, Lin; Zhong, Mao-Sheng; Liang, Jin; Yao, Jue-Jun; Xia, Tian-Xiang; Fan, Yan-Ling; Li, Jing-Dong; Tang, Zheng-Qiang

    2013-03-01

    The procedures of implementing tiered health risk assessment approach were introduced in detail, and took a large-scale site polluted by benzene in Beijing as an example, the difference on the remediation target of benzene in soil, as well as the corresponding soil remediation volume and costs, were compared. The results indicate that the benzene concentration in soil within 1.5 m in depth and the one below should be remediated to 0.26 mg x kg(-1) and 0.15 mg x kg(-1), respectively, in order to keep the cumulative carcinogenic health risk below 1 x 10(-6) based on tiered II assessment. However, according to tiered III assessment result, which is based on the benzene in soil gas within the contaminated areas in the investigated site, the soil in the corresponding depth should only be remediated to 2.6 mg x kg(-1) and 1.5 mg x kg(-1), respectively. That means the soil remediation volume delimited on tiered III assessment result is less than the one on tiered II by 139 537 m3 and the corresponding remediation costs will be reduced by 57 million Yuan, meaning the enormous economic benefits compared to the costs (around 100 thousands Yuan) spent to carry out tiered III assessment in the site.

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

    ERIC Educational Resources Information Center

    Sullivan, Marianne; Levine, Jack

    2014-01-01

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

  18. Implementation of health risk assessments with family health history: barriers and benefits.

    PubMed

    Wu, R Ryanne; Orlando, Lori A

    2015-09-01

    Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues.

  19. 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.

  20. Environmental, health, and safety assessment of photovoltaics

    SciTech Connect

    Rose, E.C.

    1983-10-15

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

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

    PubMed Central

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

    2013-01-01

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

  2. Assessing chronic and climate-induced water risk through spatially distributed cumulative deficit measures: A new picture of water sustainability in India

    NASA Astrophysics Data System (ADS)

    Devineni, Naresh; Perveen, Shama; Lall, Upmanu

    2013-04-01

    India is a poster child for groundwater depletion and chronic water stress. Often, water sustainability is measured through an estimate of the difference between the average supply and demand in a region. However, water supply and demand are highly variable in time and space. Hence, measures of scarcity need to reflect temporal imbalances even for a fixed location. We introduce spatially distributed indices of water stress that integrate over time variations in water supply and demand. The indices reflect the maximum cumulative deficit in a regional water balance within year and across years. This can be interpreted as the amount that needs to be drawn from external storage (either aquifers or surface reservoirs or interarea transfers) to meet the current demand pattern given a variable climate and renewable water supply. A simulation over a long period of record (historical or projected) provides the ability to quantify risk. We present an application at a district level in India considering more than a 100 year data set of rainfall as the renewable supply, and the recent water use pattern for each district. Consumption data are available through surveys at the district level, and consequently, we use this rather than river basins as the unit of analysis. The rainfall endogenous to each district is used as a potentially renewable water supply to reflect the supply-demand imbalances directly at the district level, independent of potential transfers due to upstream-induced runoff or canals. The index is useful for indicating whether small or large surface storage will suffice, or whether the extent of groundwater storage or external transfers, or changes in demand are needed to achieve a sustainable solution. Implications of the analysis for India and for other applications are discussed.

  3. Health Assessment and the Right to Health in Sweden: Asylum Seekers’ Perspectives

    PubMed Central

    Lobo Pacheco, Lubin; Jonzon, Robert; Hurtig, Anna-Karin

    2016-01-01

    Background Swedish law entitles asylum seekers to a voluntary health assessment and to “health care that cannot be postponed”. The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective. Methods The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health. Findings Forty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such. Conclusions Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and

  4. American College Health Association-National College Health Assessment Spring 2007 Reference Group Data Report (Abridged)

    ERIC Educational Resources Information Center

    Journal of American College Health, 2008

    2008-01-01

    Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The…

  5. Aeronautical Engineering: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (158) through NASA SP-7037 (169) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, report number, and accession number indexes.

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

    ERIC Educational Resources Information Center

    Trent, Ava M.

    2002-01-01

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

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

    PubMed

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

    2013-11-06

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

  8. Urban Ecosystem Health Assessment: Perspectives and Chinese Practice

    PubMed Central

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

    2013-01-01

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

  9. The Development of a Secondary School Health Assessment Model

    ERIC Educational Resources Information Center

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

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

  10. American College Health Association National College Health Assessment Spring 2006 Reference Group Data Report (Abridged): The American College Health Association

    ERIC Educational Resources Information Center

    Journal of American College Health, 2007

    2007-01-01

    Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey developed by the ACHA in 1998 to assist institutions of higher education in achieving this goal. The…

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

    PubMed

    Fosbrook, Susan Curro

    2015-01-01

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

  12. 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...

  13. 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...

  14. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    PubMed Central

    Vos, Amber A.; van Veen, Mieke J.; Birnie, Erwin; Denktaş, Semiha; Steegers, Eric A.P.; Bonsel, Gouke J.

    2015-01-01

    Introduction Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting. PMID:25780351

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

    SciTech Connect

    Morgan, Richard K.

    2011-07-15

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

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

    PubMed Central

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

    2014-01-01

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

  17. Health risk assessment of personal inhalation exposure to volatile organic compounds in Tianjin, China.

    PubMed

    Zhou, Jian; You, Yan; Bai, Zhipeng; Hu, Yandi; Zhang, Jiefeng; Zhang, Nan

    2011-01-01

    Volatile Organic Compounds (VOCs) exposure can induce a range of adverse human health effects. To date, however, personal VOCs exposure and residential indoor and outdoor VOCs levels have not been well characterized in the mainland of China, less is known about health risk of personal exposure to VOCs. In this study, personal exposures for 12 participants as well as residential indoor/outdoor, workplace and in vehicle VOCs concentrations were measured simultaneously in Tianjin, China. All VOCs samples were collected using passive samplers for 5 days and were analyzed using Thermal Desorption GC-MS method. U.S. Environmental Protect Agency's Inhalation Unit Risks were used to calculate the inhalation cancer health risk. To assess uncertainty of health risk estimate, Monte Carlo simulation and sensitivity analysis were implemented. Personal exposures were greater than residential indoor exposures as expected with the exception of carbon tetrachloride. Exposure assessment showed modeled and measured concentrations are statistically linearly correlated for all VOCs (P<0.01) except chloroform, confirming that estimated personal exposure using time-weighted model can provide reasonable estimate of personal inhalation exposure to VOCs. Indoor smoking and recent renovation were identified as two major factors influencing personal exposure based on the time-activity pattern and factor analysis. According to the cancer risk analysis of personal exposure, benzene, chloroform, carbon tetrachloride and 1,3-butadiene had median upper-bound lifetime cancer risks that exceeded the U.S. EPA benchmark of 1 per one million, and benzene presented the highest median risks at about 22 per one million population. The median cumulative cancer risk of personal exposure to 5 VOCs was approximately 44 per million, followed by indoor exposure (37 per million) and in vehicle exposure (36 per million). Sensitivity analysis suggested that improving the accuracy of exposure measurement in further

  18. [Health impact assessment of building and investment projects].

    PubMed

    Thriene, B

    2003-02-01

    For regional planning and approval procedures for building projects of a certain order of magnitude and power rating according to the German Federal Act on the Prevention of Emissions with Integrated Environmental Impact Assessment (EIA), the German public health departments, acting as public authorities, increasingly perform health impact assessments (HIA). The amended Act on Environmental Impact Assessment, the Decree on industrial plants which require approval (4th Federal Decree on Emission Prevention) and the Health Service Acts of the Federal States of Germany form the legal basis for the assessment of health issues with regard to approval procedures for building and investment projects. In the framework of the "Action Programme for the Environment and Health", the present article aims at making this process binding and to ensure responsibility and general involvement of the Public Health departments in all German Federal States. Future criteria, basic principles and procedures for single-case testing as well as assessment standards should meet these requirements. The Federal Ministry for the Environment and the Federal Ministry for Health should agree on Health Impact Assessment (HIA ) as well as on the relaxant stipulations in their procedures and general administrative regulations for implementing the Environmental Impact Assessment Act (EIA). Current EIA procedures focus on urban development and road construction, industrial investment projects, intensive animal husbandry plants, waste incineration plants, and wind energy farms. This paper illustrates examples meeting with varying degrees of public acceptance. However, being involved in the regional planning procedure for the project "Extension of the federal motorway A 14 from Magdeburg to Schwerin", the Public Health Service also shares global responsibility for health and climate protection. Demands for shortest routing conflict with objectives of environmental protection which should be given long

  19. [Health impact assessment of building and investment projects].

    PubMed

    Thriene, B

    2003-02-01

    For regional planning and approval procedures for building projects of a certain order of magnitude and power rating according to the German Federal Act on the Prevention of Emissions with Integrated Environmental Impact Assessment (EIA), the German public health departments, acting as public authorities, increasingly perform health impact assessments (HIA). The amended Act on Environmental Impact Assessment, the Decree on industrial plants which require approval (4th Federal Decree on Emission Prevention) and the Health Service Acts of the Federal States of Germany form the legal basis for the assessment of health issues with regard to approval procedures for building and investment projects. In the framework of the "Action Programme for the Environment and Health", the present article aims at making this process binding and to ensure responsibility and general involvement of the Public Health departments in all German Federal States. Future criteria, basic principles and procedures for single-case testing as well as assessment standards should meet these requirements. The Federal Ministry for the Environment and the Federal Ministry for Health should agree on Health Impact Assessment (HIA ) as well as on the relaxant stipulations in their procedures and general administrative regulations for implementing the Environmental Impact Assessment Act (EIA). Current EIA procedures focus on urban development and road construction, industrial investment projects, intensive animal husbandry plants, waste incineration plants, and wind energy farms. This paper illustrates examples meeting with varying degrees of public acceptance. However, being involved in the regional planning procedure for the project "Extension of the federal motorway A 14 from Magdeburg to Schwerin", the Public Health Service also shares global responsibility for health and climate protection. Demands for shortest routing conflict with objectives of environmental protection which should be given long

  20. An assessment of health hazard/health risk appraisal.

    PubMed Central

    Wagner, E H; Beery, W L; Schoenbach, V J; Graham, R M

    1982-01-01

    A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. PMID:7065313

  1. The differential impacts of episodic, chronic, and cumulative physical bullying and cyberbullying: the effects of victimization on the school experiences, social support, and mental health of rural adolescents.

    PubMed

    Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L

    2014-01-01

    Few studies have examined the impacts of past, current, and chronic physical bullying and cyberbullying on youth, especially in rural settings. This study augments this scant literature by exploring the school experiences, social support, and mental health outcomes for rural, middle school youth. The participants for this 2-year longitudinal study were 3,127 youth from 28 middle schools. Participants were classified as nonvictims, past victims (i.e., victimized during Year 1 but not Year 2), current victims (i.e., victimized during Year 2 but not Year 1), and chronic victims (i.e., victimized during both Year 1 and Year 2). Findings illustrated that chronic victimization resulted in the lowest levels of school satisfaction, social support, future optimism, and self-esteem. Chronic victims also reported the highest levels of school hassles, perceived discrimination, peer rejection, anxiety, depression, and externalizing behaviors. In terms of episodic victimization, current year victimization was associated with worse outcomes than past year victimization. Implications and limitations were discussed.

  2. Cumulative dietary exposure of the population of Denmark to pesticides.

    PubMed

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa; Christensen, Tue; Poulsen, Mette Erecius; Andersen, Jens Hinge

    2015-09-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme during the period 2004-2011. Food consumption data were obtained from DANSDA (the DAnish National Survey of Diet and physical Activity) for the period 2005-2008. The calculations were made using three different models to cope with residues below the limit of reporting (LOR). We concluded that a model that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI by a factor of 2.

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

    PubMed

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

    2016-01-01

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

  4. Prospect theory in the health domain: a quantitative assessment.

    PubMed

    Attema, Arthur E; Brouwer, Werner B F; I'Haridon, Olivier

    2013-12-01

    It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full function had not yet been quantified in the health domain. This paper is therefore the first to simultaneously measure utility of life duration, probability weighting, and loss aversion in this domain. We observe loss aversion and risk aversion for gains and losses, which for gains can be explained by probabilistic pessimism. Utility for gains is almost linear. For losses, we find less weighting of probability 1/2 and concave utility. This contrasts with the common finding of convex utility for monetary losses. However, CPT was proposed to explain choices among lotteries involving monetary outcomes. Life years are arguably very different from monetary outcomes and need not generate convex utility for losses. Moreover, utility of life duration reflects discounting, causing concave utility. PMID:24103499

  5. Prospect theory in the health domain: a quantitative assessment.

    PubMed

    Attema, Arthur E; Brouwer, Werner B F; I'Haridon, Olivier

    2013-12-01

    It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full function had not yet been quantified in the health domain. This paper is therefore the first to simultaneously measure utility of life duration, probability weighting, and loss aversion in this domain. We observe loss aversion and risk aversion for gains and losses, which for gains can be explained by probabilistic pessimism. Utility for gains is almost linear. For losses, we find less weighting of probability 1/2 and concave utility. This contrasts with the common finding of convex utility for monetary losses. However, CPT was proposed to explain choices among lotteries involving monetary outcomes. Life years are arguably very different from monetary outcomes and need not generate convex utility for losses. Moreover, utility of life duration reflects discounting, causing concave utility.

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

    SciTech Connect

    Pennock, Michael; Ura, Karma

    2011-01-15

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

  7. Assessing the cumulative impacts of surface mining and coal bed methane development on shallow aquifers in the Powder River Basin, Wyoming

    SciTech Connect

    Peacock, K.

    1997-12-31

    Large scale surface coal mining taken place along the cropline of the Wyodak-Anderson coal seam since approximately 1977. Groundwater impacts due to surface mining of coal and other energy-related development is a primary regulatory concern and an identified Office of Surface Mining deficiency in the Wyoming coal program. The modeled aquifers are the upper unit (coal) of the Paleocene Fort Union Formation and the overlying Eocene Wasatch Formation. A regional groundwater model covering 790 square miles was constructed using MODFLOW, to simulate the impacts from three surface coal mines and coal bed methane development occurring downdip. Assessing anisotropy of the coal aquifer, quality checking of in situ aquifer tests and database quality control were precursors to modelling. Geologic data was kriged to develop the structural model of the aquifers. A Geographic Information System (GIS) was utilized to facilitate storage, analysis, display, development of input modelling arrays and assessment of hydrologic boundaries. Model output presents the predicted impacts of likely development scenarios, including impacts from coal bed methane development and surface coal mining through anticipated life of mining, and surface mining impacts independent of gas development.

  8. Aggregate Exposure and Cumulative Risk Assessment—Integrating Occupational and Non-occupational Risk Factors

    PubMed Central

    Lentz, T. J.; Dotson, G. S.; Williams, P. R.D.; Maier, A.; Gadagbui, B.; Pandalai, S. P.; Lamba, A.; Hearl, F.; Mumtaz, M.

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

  9. History of the international societies in health technology assessment: International Society for Technology Assessment in Health Care and Health Technology Assessment International.

    PubMed

    Banta, David; Jonsson, Egon; Childs, Paul

    2009-07-01

    The International Society for Technology Assessment in Health Care (ISTAHC) was formed in 1985. It grew out of the increasing awareness of the international dimensions of health technology assessment (HTA) and the need for new communication methods at the international level. The main function of ISTAHC was to present an annual conference, which gradually grew in size, and also to generally improve in quality from to year. ISTAHC overextended itself financially early in the first decade of the 2000s and had to cease its existence. A new society, Health Technology Assessment international (HTAi), based on many of the same ideas and people, grew up beginning in the year 2003. The two societies have played a large role in making the field of HTA visible to people around the world and providing a forum for discussion on the methods and role of HTA.

  10. Toward effectiveness assessment of health management education in Canada.

    PubMed

    Caro, D H

    1994-01-01

    A growing theme in the management education literature is that of effectiveness assessment. Integrated effectiveness assessment systems represent an important challenge in health management education in Canada. This article examines the service effectiveness paradigm that evolved from comprehensive auditing developments in the public domain. It presents an integrated model of effectiveness assessment systems and the barriers that currently impede its full development and implementation in Canada. Finally, the evolving effectiveness assessment challenge--which will fundamentally change health management education in Canada--is examined.

  11. Defining and assessing health-related quality of life.

    PubMed

    Holcík, J; Koupilová, I

    1999-11-01

    In recent years, there has been an increasing interest in quality of life assessment in clinical research and practice, as well as in public health and policy analysis. Indicators of health-related quality of life are important not only for health professionals and their patients, but also for health administrators and health economists in health care planning and policy making. Most studies on the outcome of treatments and interventions now include some kind of a quality of life measure. This usually takes a form of an assessment of symptoms and physical functioning, measurement of psychological well-being, life satisfaction, or coping and adjustment. Numerous scales of psychological health, physical health status and physical functioning have been developed for use in the assessment of health outcomes and a wide range of instruments for measurement of health-related quality of life is available. These fall into two broad categories of generic and disease-specific instruments. The selection of an instrument depends upon its measurement properties but also upon the specific context in which the instrument is going to be used. Adequate attention needs to be paid to the translation and validation of instruments for use across countries and cultural contexts.

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

    SciTech Connect

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

    2010-04-15

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

  13. Expenditures for public health: assessing historical and prospective trends.

    PubMed

    Kinner, Kyle; Pellegrini, Cindy

    2009-10-01

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Walters, Norma J.

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

  17. Mental Health/Counseling Needs Assessment.

    ERIC Educational Resources Information Center

    Workman, John F.; And Others

    A study was conducted in fall 1980 at Los Angeles Valley College (LAVC) to develop a greater understanding of the mental health/counseling needs of students. Specifically, the study sought to determine which stress-inducing conditions (stressors) had the greatest effect on students and the kinds of interventions and strategies that might be…

  18. Assessing herbal products with health claims.

    PubMed

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

    2015-01-01

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

  19. US Policy approaches for assessing soil health

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  20. Health technology assessment in the HIV setting: the case of monotherapy.

    PubMed

    Restelli, Umberto; Croce, Davide; Porazzi, Emanuele; Scolari, Francesca; Bonfanti, Marzia; Galli, Massimo; Gianotti, Nicola; Rizzardini, Giuliano; Garagiola, Elisabetta; Vanzago, Anna; Foglia, Emanuela

    2014-07-01

    Despite the success of multiple-drug therapy regimens, the idea of treating human immunodeficiency virus (HIV) infection with fewer drugs is captivating due to issues of convenience, long-term toxicities and costs. This study investigated the impact on a local health budget of the introduction of a protease inhibitor (PI)-based antiretroviral monotherapy. An analysis of 23,721 administrative records of HIV-infected patients and a health technology assessment (HTA) were performed to assess cost-effectiveness, budget, organizational, ethics, and equity impact. Data showed that monotherapy had a annual cost of € 7,076 (patient with undetectable viral load) and € 7,860 (patient with detectable viral load), and that its implementation would realise economic savings of between 12 and 24 million euro (between 4.80% and 9.72% of the 2010 total regional budget expenditure for HIV management) in the first year, with cumulated savings of between 48 and 145 million euro over the following five years. Organizational, ethical and equity impact did not indicate any significant differences. The study suggests that for specific categories of patients monotherapy may be an alternative to existing therapies. Its implementation would not result in higher operating costs, and would lead to a reduction in total expenditure. PMID:25180841

  1. Cumulative Evaluations in Surface Transportation.

    ERIC Educational Resources Information Center

    Horan, Thomas A.

    1992-01-01

    An overview is given of four evaluation studies conducted to determine the need for and possible parameters of a "postinterstate" highway policy. How these studies sought to provide cumulative information for policy makers is discussed. They investigated the scope of problems, the federal role, cost issues, and technology. (SLD)

  2. Evaluating Cumulative OP Pesticide Body Burden of Children: A National Case Study

    PubMed Central

    Payne-Sturges, Devon; Cohen, Jonathan; Castorina, Rosemary; Axelrad, Daniel A.; Woodruff, Tracey J.

    2009-01-01

    Biomonitoring is a valuable tool for identifying exposures to chemicals that pose potential harm to human health. However, to date there has been little published on ways to evaluate the relative public health significance of biomonitoring data for different chemicals, and even less on cumulative assessment of multiple chemicals. The objectives of our study are to develop a methodology for a health risk interpretation of biomonitoring data, and to apply it using NHANES 1999–2002 body burden data for organophosphorus (OP) pesticides. OP pesticides present a particularly challenging case given the non-specificity of many metabolites monitored through NHANES. We back-calculate OP pesticide exposures from urinary metabolite data, and compare cumulative dose estimates with available toxicity information for a common mechanism of action (brain cholinesterase inhibition) using data from U.S. EPA. Our results suggest that approximately 40% of children in the United States may have had insufficient margins of exposure (MOEs) for neurological impacts from cumulative exposures to OP pesticides (MOE less than 1,000). Limitations include uncertainty related to assumptions about likely precursor pesticide compounds of the urinary metabolites, sources of exposure, and intra-individual and temporal variability. PMID:19921915

  3. Methodological challenges in health risk assessment. Final report

    SciTech Connect

    Not Available

    1987-10-12

    Risk assessment, a major activity of both health and regulatory agencies, is subject to large and unavoidable uncertainties. Thus, different teams of knowledgeable experts can come to different conclusions about risks to human health from various sorts of hazards. This report examines and compares analyses by two or more agencies of ten health hazards or potential hazards: ethylene dibromide, formaldehyde, Tris, dioxin (limited to cancer risks of contaminated soil), lead (reproductive effects), cotton dust, noise (long-term hearing impairment), passive smoking, dietary fat (cancer risks), and the radiation hazards of mammography. Each set of risk assessments is analyzed in depth. The report then turns to cross-cutting analyses of such matters as setting priorities for risk assessment, approaches and methods used to evaluate different kinds of risks, and the relationships between risk assessment and risk management. Overall, the report found large differences among risk assessments of the same hazard, but these differences are often quite appropriate.

  4. Reaching remote health workers in Malawi: baseline assessment of a pilot mHealth intervention.

    PubMed

    Lemay, Nancy Vollmer; Sullivan, Tara; Jumbe, Brian; Perry, Cary Peabody

    2012-01-01

    mHealth has great potential to change the landscape of health service delivery in less developed countries--expanding the reach of health information to frontline health workers in remote areas. Formative, process, and summative evaluation each play an important role in mHealth interventions. K4Health conducted a Health Information Needs Assessment in Malawi from July to September 2009 (formative evaluation) that found widespread use of cell phones among health workers offering new opportunities for knowledge exchange, especially in areas where access to health information is limited. K4Health subsequently designed an 18-month demonstration project (January 2010 to June 2011) to improve the exchange and use of family planning/reproductive health and HIV/AIDS knowledge among health workers, which included the introduction of a short message service (SMS) network. K4Health conducted a pretest of the mHealth intervention from June to October 2010. A baseline assessment was carried out in November 2010 before expanding the SMS network and included use of qualitative and quantitative measures and comparison groups (summative evaluation). Routinely collected statistics also guide the program (process evaluation). This article describes the approach and main findings of the SMS baseline study and contributes to a growing body of evidence measuring the effectiveness and efficiency of mHealth programs using a strong evaluation design.

  5. 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...

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

    ERIC Educational Resources Information Center

    Knoll, Dorothy; Meiers, Chris; Honeck, Sara

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Ronald, Linda; And Others

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

  8. "Lifetime Fitness for Health" Course Assessment: Implications for Curriculum Improvement

    ERIC Educational Resources Information Center

    Cardinal, Bradley J.; Cardinal, Marita K.; Burger, Molly E.

    2005-01-01

    Every other year, comprehensive school health education programs and policies are assessed nationally using the School Health Education Profile (SHEP) survey (Grunbaum et al., 1998). The data are collected in modules that are completed by different stakeholders within the school system. As part of a cooperative agreement with the Centers for…

  9. An analytical platform for cumulative impact assessment based on multiple futures: the impact of petroleum drilling and forest harvesting on moose (Alces alces) and marten (Martes americana) habitats in northeastern British Columbia.

    PubMed

    Strimbu, Bogdan; Innes, John

    2011-07-01

    The combined influence on the environment of all projects occurring in a single area is evaluated through cumulative impact assessments (CIA), which consider the consequences of multiple projects, each insignificant on its own, yet important when evaluated collectively. Traditionally, future human activities are included in CIA using an analytical platform, commonly based on complex models that supply precise predictions but with reduced accuracy. To compensate for the lack of accuracy in current CIA approaches, we propose a shift in the paradigm governing CIA. The paradigm shift involves a change in the focus of CIA investigations from the detailed analysis of one unlikely future to the identification of the patterns describing multiple potential future changes in the environment. To illustrate the approach, a set of 144 possible and equally likely futures were developed that aimed to identify the potential impacts of forest harvesting and petroleum drilling on the habitat suitability of moose and marten in northeast British Columbia, Canada. The evolution of two measures of habitat suitability (average habitat suitability index and surface of the stands with habitat suitability index >0.5) revealed that the human activities could induce cycles in the habitat dynamics of moose and marten. The planning period of 100 years was separated into three distinct periods following a sinusoidal pattern (i.e., increase - constant - decrease in the habitat suitability measures). The attributes that could induce significant changes in the assessment of environment are the choice of harvesting age and species.

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2015-10-01

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

  12. Self-Assessments of Health among the Elderly.

    ERIC Educational Resources Information Center

    Benedict, Annette

    Self-assessments of health are important because they appear to be good predictors of future physical health. To examine age differences in self-reports of health, the self-ratings of 149 adults (53.8 percent over 65 years of age; 46.2 percent 64 or younger; average age 57.1) were compared. Subjects were elderly participants in a community…

  13. Health needs and eHealth readiness assessment of health care organizations in Kabul and Bamyan, Afghanistan.

    PubMed

    Durrani, H; Khoja, S; Naseem, A; Scott, R E; Gul, A; Jan, R

    2012-06-01

    This study assessed the need and readiness of health care institutions in Kabul and Bamyan, Afghanistan for successful implementation of information and communication technology in health care (eHealth). A mixed methods design was adopted at 2 institutions in the Aga Khan Development Network in Afghanistan: the French Medical Institute for Children in Kabul and Bamyan Provincial Hospital, Bamyan. Information for the needs assessment was obtained from interviews and focus groups and eHealth readiness was assessed using a validated survey tool. The needs of institutions in the Aga Khan Development Network in Afghanistan were categorized as follows: provision of care needs; learning needs; and information management needs. eHealth readiness on average was lower in Bamyan compared with Kabul in all areas of the readiness assessment. Other institutions in Afghanistan may benefit from adopting the model of needs and readiness assessment used for Aga Khan Development Network institutions. PMID:22888626

  14. 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.

  15. An Assessment of Environmental Health Needs for Manned Spacecraft

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

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

  16. Do patient preferences for health information vary by health literacy or numeracy? A qualitative assessment.

    PubMed

    Gaglio, Bridget; Glasgow, Russell E; Bull, Sheana S

    2012-01-01

    Seeking health information can be a complicated process for a patient. Patients must know the topic of interest, where to look or ask, how to assess and comprehend, and how to evaluate the credibility and trustworthiness of the sources. In this study, the authors describe preferences of patients with multiple risk factors for cardiovascular disease with varying health literacy and numeracy abilities for receiving health information. Participants were recruited from 2 health care systems. Health literacy and numeracy were assessed and participants completed an orally administered survey consisting of open-ended questions about obtaining health information and preferences for health information. In-depth interviews were conducted with a subset of participants. A diverse sample of 150 individuals (11.3% Latino, 37.3% African American, 44.7% with income less than $15,000/year) participated. Most participants had adequate functional health literacy, while 65% had low numeracy skills. Regardless of health literacy or numeracy ability, participants overwhelmingly preferred to receive health information during a face-to-face conversation with their health care provider. While individuals with adequate functional health literacy identified a variety of health information sources, actions are needed to ensure multiple modalities are available and are in plain, clear language that reinforces patients' understanding and application of information to health behavior.

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

    PubMed

    Argimon, Josep Maria

    2015-11-01

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

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

    PubMed

    Argimon, Josep Maria

    2015-11-01

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

  19. Forensic mental health assessment in France: recommendations for quality improvement.

    PubMed

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods. PMID:24631526

  20. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

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

  1. Human Health Effects, Task Force Assessment, Preliminary Report.

    ERIC Educational Resources Information Center

    Aronow, Wilbert S.; And Others

    Presented in this preliminary report is one of seven assessments conducted by a special task force of Project Clean Air, the Human Health Effects Task Force. The reports summarize assessments of the state of knowledge on various air pollution problems, particularly in California, and make tentative recommendations as to what the University of…

  2. Forensic mental health assessment in France: recommendations for quality improvement.

    PubMed

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

  3. Models and Methods for Assessing Refugee Mental Health Needs.

    ERIC Educational Resources Information Center

    Deinard, Amos S.; And Others

    This background paper on refugee needs assessment discusses the assumptions, goals, objectives, strategies, models, and methods that the state refugee programs can consider in designing their strategies for assessing the mental health needs of refugees. It begins with a set of background assumptions about the ethnic profile of recent refugee…

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

    SciTech Connect

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

    1990-12-01

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

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

    PubMed

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

    2014-05-01

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

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

    PubMed Central

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

    2014-01-01

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

  7. Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

    PubMed

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

    2013-03-22

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

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

    SciTech Connect

    Not Available

    1992-12-01

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

  9. Health technology assessment: Off-site sterilization

    PubMed Central

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

    2016-01-01

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

  10. Assessment of health impacts in electricity generation and use

    SciTech Connect

    Morris, S.C.

    1995-11-01

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

  11. 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.

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

    PubMed Central

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

    2013-01-01

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

  13. 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

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

    PubMed

    Butt, Zeeshan

    2016-09-01

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

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

    PubMed

    Butt, Zeeshan

    2016-09-01

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

  16. Epigenome: Biosensor of Cumulative Exposure to Chemical and Nonchemical Stressors Related to Environmental Justice

    PubMed Central

    Gruber, David; Sonawane, Babasaheb

    2014-01-01

    Understanding differential disease susceptibility requires new tools to quantify the cumulative effects of environmental stress. Evidence suggests that social, physical, and chemical stressors can influence disease through the accumulation of epigenetic modifications. Geographically stable epigenetic alterations could identify plausible mechanisms for health disparities among the disadvantaged and poor. Relations between neighborhood-specific epigenetic markers and disease would identify the most appropriate targets for medical and environmental intervention. Complex interactions among genes, the environment, and disease require the examination of how epigenetic changes regulate susceptibility to environmental stressors. Progress in understanding disparities in disease susceptibility may depend on assessing the cumulative effect of environmental stressors on genetic substrates. We highlight key concepts regarding the interface between environmental stress, epigenetics, and chronic disease. PMID:25122010

  17. Epigenome: biosensor of cumulative exposure to chemical and nonchemical stressors related to environmental justice.

    PubMed

    Olden, Kenneth; Lin, Yu-Sheng; Gruber, David; Sonawane, Babasaheb

    2014-10-01

    Understanding differential disease susceptibility requires new tools to quantify the cumulative effects of environmental stress. Evidence suggests that social, physical, and chemical stressors can influence disease through the accumulation of epigenetic modifications. Geographically stable epigenetic alterations could identify plausible mechanisms for health disparities among the disadvantaged and poor. Relations between neighborhood-specific epigenetic markers and disease would identify the most appropriate targets for medical and environmental intervention. Complex interactions among genes, the environment, and disease require the examination of how epigenetic changes regulate susceptibility to environmental stressors. Progress in understanding disparities in disease susceptibility may depend on assessing the cumulative effect of environmental stressors on genetic substrates. We highlight key concepts regarding the interface between environmental stress, epigenetics, and chronic disease.

  18. [Assessing and evaluating physical activity during counseling in health care].

    PubMed

    Hagströmer, Maria; Wisén, Anita; Hassmén, Peter

    2015-01-01

    To make individualized counseling possible, valid and reliable measures of physical activity are necessary. In health care, quality must be continuously secured and developed. Follow-up of life-style habits such as physical activity does not differ from monitoring of other treatment in the health care setting.  After counseling and appropriate period of time, evaluation should be done to assess if there has been any change in the physical activity level. For assessment and evaluation of physical activity in routine clinical practice the National Board for Health and Social Welfare indicator questions regarding physical activity are recommended. For a more detailed assessment and evaluation of physical activity and sedentary behavior comprehensive validated instruments/diaries should be used. For precise and objective assessment and evaluation of both physical activity and sedentary behavior, movement sensors are recommended.

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

    SciTech Connect

    Not Available

    1992-12-01

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

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

    PubMed Central

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

    2016-01-01

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

  1. 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

  2. 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

  3. Cumulative life damage in dermatology

    PubMed Central

    Ibler, Kristina; Jemec, Gregor B.E.

    2011-01-01

    Cumulative life damage is an old concept of considerable face validity, which has attracted more scientific interest in the fields of sociology and psychology than in medicine over the years. The research examines the interconnectivity of the many factors which shape the development of individuals or institutions over time. By focussing on time, context and process, life course research highlights the different effects seemingly similar events may have at different points in time and in different contexts. PMID:25386260

  4. Community environmental health assessment strengthens environmental public health services in the Peruvian Amazon.

    PubMed

    Hubbard, Brian; Gelting, Richard; Baffigo, Virginia; Sarisky, John

    2005-01-01

    In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities

  5. [Vegetation landscape health assessment in Changshan Archipelago, North Yellow Sea].

    PubMed

    Suo, An-ning; Sun, Yong-guang; Li, Bin-yong; Lin, Yong; Zhang, Yong-hua

    2015-04-01

    Island vegetation is an important component of island ecosystem. Multi-targets of island ecosystem health integrated with landscape ecology theory were employed to construct the index system for island vegetation health assessment in terms of landscape vigor, landscape stressing intensity and landscape stability. The Changshan Archipelago in the North Yellow Sea was chosen as a case to apply the island vegetation health assessment index system. The results showed that the overall vegetation health status in Changshan Archipelago was good and had a big island variation. The vegetation health index for Haiyang Island and Zhangzi Island was above 0.80, belonging to first eco-health level area, whereas that for Dachangshan Island, Xiaochangshan Island and Dawangjia Island ranged from 0.70 to 0.80, which could be categorized as the second eco-health level area. Guanglu Island and Shichen Island could be termed as the third eco-health level area with the vegetation health index below 0.70. The distance of island to mainland, area of island together with industrial structure were the main driving forces for the variation of vegetation landscape heath between different islands.

  6. Assessment of Cumulative Trauma Disorder (CTD) Risk for 3 Different Tasks Constructing and Repairing Multi-Layer Insulation (MLI) Blankets, Preparing the Dough for a Pizza, and Operating the Becton-Dickinson FACSAria Flow Cytometer

    NASA Technical Reports Server (NTRS)

    Gentzler, Marc; Kline, Martin; Palmer, Andrew; Terrone, Mark

    2007-01-01

    The Cumulative Trauma Disorder (CTD) risks for three different tasks using McCauley-Bell and Badiru's (1993) formula based on task, personal, and organizational factors were examined. For the Multi-Layer Insulation (MLI) blanket task, the results showed that the task, personal, and organizational risks were at about the same level. The personal risk factors for this task were evaluated using a hypothetical female employee age 52. For the pizza dough task, it was shown that the organizational risk was particularly high, with task related factors also at quite dangerous levels. On the other hand, there was a very low level of personal risk factors, based on a female age 17. The flow cytometer task was assessed with three different participants, a11 of whom had quite disparate levels of personal risk, which slightly affected the overall CTD risk. This reveals how individual difference variables certainly need to be considered. The task and organizational risks for this task were rated at about the same moderate level. The overall CTD risk averaged across the three participants was .335, indicating some risk. Compruing across the tasks revealed that the pizza dough task created the greatest overall CTD risk by far (.568), with the MLI (.325) and flow cytometer task (.335) having some risk associated with them. Future research should look into different tasks for more of a comparison

  7. Assessing landscape health: a case study from northeastern Italy.

    PubMed

    Bertollo, P

    2001-03-01

    This article investigates the concept of biophysical landscape health for what are termed "highly governed landscapes." It proposes a definition of landscape health along with a preliminary diagnostic model and methods. The idea of landscape health derives from the emerging integrative science of ecosystem health, which seeks to diagnose ecosystem condition as humans diagnose human health. Highly governed landscapes, such as the reclaimed areas of coastal northeastern Italy, are landscapes that have been subject to even greater degrees of human manipulation than normal cultural landscapes. These highly altered landscapes are not easily served by existing environmental paradigms and concepts of health are seen to have numerous advantages. This paper condenses a broader investigation of landscape health into three main sections. A brief review of the literature is followed by a case study, which details two different phases of landscape transformation in the Lower Piave area of northeastern Italy. A definition and general parameters of biophysical landscape health are then presented after this background stage. Some key parameters of biophysical health include absence of distress and risk factors, sustainability, biodiversity, resilience, and balance. For certain parameters, a preliminary landscape health diagnostic framework is presented that includes potential diagnostic methods and thresholds based on findings from this case study. At the paper's conclusion, a summary diagnostic model is presented, which suggests a process needed to implement landscape health assessment into practice. PMID:11148762

  8. Some insights on grassland health assessment based on remote sensing.

    PubMed

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  9. Some insights on grassland health assessment based on remote sensing.

    PubMed

    Xu, Dandan; Guo, Xulin

    2015-01-29

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment.

  10. Some Insights on Grassland Health Assessment Based on Remote Sensing

    PubMed Central

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  11. 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.

  12. Survey of Ambient Air Pollution Health Risk Assessment Tools.

    PubMed

    Anenberg, Susan C; Belova, Anna; Brandt, Jørgen; Fann, Neal; Greco, Sue; Guttikunda, Sarath; Heroux, Marie-Eve; Hurley, Fintan; Krzyzanowski, Michal; Medina, Sylvia; Miller, Brian; Pandey, Kiran; Roos, Joachim; Van Dingenen, Rita

    2016-09-01

    Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer-based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration-response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools' inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).

  13. 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.

  14. Assessing and responding to infant mental health needs.

    PubMed

    Cousins, Judy

    2013-09-01

    Early recognition of mental health problems in maltreated infants, coupled with tailored support to aid recovery, has the potential to offer significant benefits to a population whose needs have perhaps remained hidden in the past. All forms of maltreatment may adversely affect infant mental health, but perhaps none more so than emotional neglect. Universal contact with families with young children makes health visitors ideally placed to provide early support to this vulnerable group, but such practice requires considerable knowledge and understanding. This paper examines how emotional neglect can impact on an infant's mental health and explores how health visitors can assess and respond effectively to this key health need. Throughout, the term 'infant' is used to describe children from birth to age three.

  15. Indochinese refugee health assessment and treatment.

    PubMed

    Sutherland, J E; Avant, R F; Franz, W B; Monzon, C M; Stark, N M

    1983-01-01

    Many Southeast Asian refugees have resettled in the United States. This report reviews data from 426 refugees who underwent comprehensive examination and treatment at the Mayo Clinic. Health problems identified were primarily selected contagious illnesses and stress syndromes with functional complaints. Counseling was necessary in 17 percent of adults for psychosomatic problems or psychiatric disorders. When family-planning issues were applicable and addressed, 80 percent of women chose some method of contraception. The prevalence rate of intestinal parasites was 82 percent, and pathogens necessitated persistent treatment and follow-up. Tuberculosis skin-sensitivity testing was positive in 54 percent; the risk of active disease warrants prophylactic treatment until age 35 years. Hepatitis antigen was positive in 13 percent; precautions should be taken for potentially exposed professionals. Hematologic genetic disorders were very common and accounted for most of the 25 percent incidence of microcytosis. Physicians should become aware of cultural attitudes and treatment acceptance among Indochinese patients and should carefully investigate for infectious diseases. PMID:6848638

  16. [Hygienic assessment of students' nutrition and health].

    PubMed

    Proskuriakova, L A

    2008-01-01

    A randomized study of lifestyle, quality of life, and the degree of depression was carried out in 399 Novokuznetsk high-school students (219 young men and 180 young women). Daily dietary pattern and eating behavior were studied in the students experiencing the highest psychoemotional stress caused by their adjustment to a new behavioral stereotype at higher school. Varying depression was observed in 16.5% of the students. The findings suggest the students' poor awareness of healthy lifestyle; however, 70.5% regarded their life as satisfactory. The students' diets characterized by the low levels of essential nutrients may diminish the body's adaptive abilities and provoke the development of various abnormalities. Eating behavioral disorders were observed in 21.5% of the respondents. Correlation analysis showed that the higher level of depression in young males, the more pronounced emotional eating behavioral disorders are (r = 0.31; p < or = 0.05). Such a correlation was not detected in young females. The higher degree of depression was found to affect the students' life quality (r = -0.37; p < or = 0.05). The study has provided a municipal special program "Health and Education" for 2007-2011, which will make it possible to carry out among students a regional policy aimed at popularizing the principles of healthy lifestyle, forming proper dietary habits and mechanisms of optimal behavioral models and their introduction.

  17. Occupational exposure to environmental tobacco smoke and health risk assessment.

    PubMed Central

    Jaakkola, M S; Samet, J M

    1999-01-01

    This article addresses concepts of environmental tobacco smoke (ETS) exposure assessment relevant for health risk assessment based on human studies. We present issues that should be considered when selecting a method for ETS exposure assessment for the purposes of health risk assessment and review data on ETS exposure levels in the workplace and in home environments. Two types of estimates are needed for a quantitative risk assessment of the health effects resulting from occupational ETS exposure: (italic)a(/italic)) an unbiased estimate of the exposure-effect (or dose-response) relation between ETS and the health effect of interest, and (italic)b(/italic)) estimates of the distribution of ETS exposure in different workplaces. By combining the estimated exposure-effect relation with information on exposure distribution for a population of interest, we can calculate the proportions of disease cases attributable to occupational ETS exposure as well as the excess number of cases due to specified exposure conditions. Several dimensions of the exposure profile should be considered when assessing ETS exposure for estimating the exposure-effect relation, including the magnitude of exposure and the biologically relevant time specificity of exposure. The magnitude of exposure is determined by the ETS source strength, environmental factors modifying concentrations, and duration of exposure. Time specificity considerations include the latency period for each health outcome of interest, the time-exposure profile relevant for different disease mechanisms, and the sensitive age period with regard to health effects. The most appropriate indicator of ETS exposure depends on these factors and on the time period that can be assessed with different methods. Images Figure 1 Figure 3 Figure 4 PMID:10592138

  18. 42 CFR 90.4 - Contents of requests for health assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Contents of requests for health assessments. 90.4 Section 90.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  19. 42 CFR 90.4 - Contents of requests for health assessments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Contents of requests for health assessments. 90.4 Section 90.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  20. 42 CFR 90.4 - Contents of requests for health assessments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Contents of requests for health assessments. 90.4 Section 90.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  1. Multipathway human health risk assessment concerning air emissions from combustion of Orimulsion fuel

    SciTech Connect

    Teaf, C.M.; Coleman, R.M.; Manning, M.J.; Covert, D.J.; Phelps, J.L.

    1995-12-31

    A multipathway human health risk assessment was conducted concerning air emissions from the combustion of Orimulsion. Exposure was considered for nearby residents who might be exposed by oral, dermal or inhalation pathways, including ingestion of analytes that may be present in meat and agricultural products from nearby areas. Occupational exposure were evaluated via the same intake pathways, except for potential ingestion of food products. Pathways included airborne exposures, deposition on crops, exposures to soils, and uptake by livestock and plants. Livestock intake included ingestion of analytes retained by plants and inhalation of soil-bound particulates. Analytes of potential concern included compounds identified as combustion products of the orimulsion fuel. Air concentrations of analytes, and the areal distribution of these concentrations resulting from stack emissions, were predicted using transport and deposition models. A worst cast scenario for air and cumulative soil concentrations was considered to represent the entire facility project lifetime (20 years) for dry deposition as well as predicted air concentrations occurring at continuous 100% facility operating capacity. Potential exposures to sulfuric acid mist and lead were shown to be much less than levels protective of human populations. Based upon the airborne emissions estimates and the deposition estimates for other constituents of interest, as well as the strongly conservative estimates of the potential for human intake, local health risks contributed from the combustion of Orimulsion fuel at the facility were judged to be negligible.

  2. Health impact assessment needs in south-east Asian countries.

    PubMed Central

    Caussy, Deoraj; Kumar, Priti; Than Sein, U.

    2003-01-01

    A situation analysis was undertaken to assess impediments to health impact assessment (HIA) in the South-East Asia Region of WHO (SEARO). The countries of the region were assessed on the policy framework and procedures for HIA, existing infrastructure required to support HIA, the capacity for undertaking HIA, and the potential for intersectoral collaboration. The findings show that environmental impact assessment (EIA) is being used implicitly as a substitute for HIA, which is not explicitly or routinely conducted in virtually all countries of the Region. Therefore, policy, infrastructure, capacity, and intersectoral collaboration need strengthening for the routine implementation of HIA. PMID:12894329

  3. [Health assessment of river ecosystem in Haihe River Basin, China].

    PubMed

    Hao, Li-Xia; Sun, Ran-Hao; Chen, Li-Ding

    2014-10-01

    With the development of economy, the health of river ecosystem is severely threatened because of the increasing effects of human activities on river ecosystem. In this paper, the authors assessed the river ecosystem health in aspects of chemical integrity and biological integrity, using the criterion in water quality, nutrient, and benthic macroinvertebrates of 73 samples in Haihe River Basin. The research showed that the health condition of river ecosystem in Haihe River Basin was bad overall since the health situation of 72. 6% of the samples was "extremely bad". At the same time, the health situation in Haihe River Basin exhibited obvious regional gathering effect. We also found that the river water quality was closely related to human activities, and the eutrophication trend of water body was evident in Haihe River Basin. The biodiversity of the benthic animal was low and lack of clean species in the basin. The indicators such as ammonia nitrogen, total nitrogen and total phosphorus were the key factors that affected the river ecosystem health in Haihe River Basin, so the government should start to curb the deterioration of river ecosystem health by controlling these nutrients indicators. For river ecosystem health assessment, the multi-factors comprehensive evaluation method was superior to single-factor method.

  4. Expanding Health Technology Assessments to Include Effects on the Environment.

    PubMed

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. PMID:27021760

  5. Expanding Health Technology Assessments to Include Effects on the Environment.

    PubMed

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA.

  6. Cumulative stress and autonomic dysregulation in a community sample.

    PubMed

    Lampert, Rachel; Tuit, Keri; Hong, Kwang-Ik; Donovan, Theresa; Lee, Forrester; Sinha, Rajita

    2016-05-01

    Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p < 0.05). In hierarchical regression analyses, total cumulative stress and chronic stress each was significantly associated with SDNN and ULF even after the highly significant contributions of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

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

    SciTech Connect

    Not Available

    1988-03-09

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

  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. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    ERIC Educational Resources Information Center

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  10. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    ERIC Educational Resources Information Center

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

  11. 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...

  12. Health technology assessment in Iran: challenges and views

    PubMed Central

    Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

    2014-01-01

    Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

  13. E-health readiness assessment: promoting "hope" in the health-care institutions of Pakistan.

    PubMed

    Khoja, Shariq; Scott, Richard; Gilani, Salman

    2008-01-01

    e-Health readiness refers to the preparedness of health-care institutions to implement programmes that involve use of Information and Communication Technology (ICT) in provision and management of health services. Level of readiness depends on a number of factors that lead to success or failure of e-health programmes, and thus increase or decrease hope of achieving the desired results. This report presents results from in-depth interviews conducted during a larger study and presents views of managers and health-care providers from various institutions in Pakistan about the usefulness of e-health readiness assessment tools. Participants emphasized the need for implementing e-health programmes in the country, while appreciating the need for readiness assessment tools, and the way these tools could avoid failures related to implementation of e-health programmes. Participants also linked e-health readiness with the process of change management, essential for sustainable implementation of e-health programmes in the health-care institutions of developing countries.

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

    SciTech Connect

    Not Available

    1992-05-01

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

  15. Adaptive strategies for cumulative cultural learning.

    PubMed

    Ehn, Micael; Laland, Kevin

    2012-05-21

    The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning.

  16. The Algebra of the Cumulative Percent Operation.

    ERIC Educational Resources Information Center

    Berry, Andrew J.

    2002-01-01

    Discusses how to help students avoid some pervasive reasoning errors in solving cumulative percent problems. Discusses the meaning of ."%+b%." the additive inverse of ."%." and other useful applications. Emphasizes the operational aspect of the cumulative percent concept. (KHR)

  17. 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

  18. Health technology assessment. Evaluation of biomedical innovative technologies.

    PubMed

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  19. Health technology assessment. Evaluation of biomedical innovative technologies.

    PubMed

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival. PMID:20659860

  20. Assessing Quality across Health Care Subsystems in Mexico

    PubMed Central

    Puig, Andrea; Pagán, José A.; Wong, Rebeca

    2012-01-01

    Recent healthcare reform efforts in Mexico have focused on the need to improve the efficiency and equity of a fragmented healthcare system. In light of these reform initiatives, there is a need to assess whether healthcare subsystems are effective at providing high-quality healthcare to all Mexicans. Nationally representative household survey data from the 2006 Encuesta Nacional de Salud y Nutrición (National Health and Nutrition Survey) were used to assess perceived healthcare quality across different subsystems. Using a sample of 7234 survey respondents, we found evidence of substantial heterogeneity in healthcare quality assessments across healthcare subsystems favoring private providers over social security institutions. These differences across subsystems remained even after adjusting for socioeconomic, demographic, and health factors. Our analysis suggests that improvements in efficiency and equity can be achieved by assessing the factors that contribute to heterogeneity in quality across subsystems. PMID:19305224

  1. Cumulant expansions for atmospheric flows

    NASA Astrophysics Data System (ADS)

    Ait-Chaalal, Farid; Schneider, Tapio; Meyer, Bettina; Marston, J. B.

    2016-02-01

    Atmospheric flows are governed by the equations of fluid dynamics. These equations are nonlinear, and consequently the hierarchy of cumulant equations is not closed. But because atmospheric flows are inhomogeneous and anisotropic, the nonlinearity may manifest itself only weakly through interactions of nontrivial mean fields with disturbances such as thermals or eddies. In such situations, truncations of the hierarchy of cumulant equations hold promise as a closure strategy. Here we show how truncations at second order can be used to model and elucidate the dynamics of turbulent atmospheric flows. Two examples are considered. First, we study the growth of a dry convective boundary layer, which is heated from below, leading to turbulent upward energy transport and growth of the boundary layer. We demonstrate that a quasilinear truncation of the equations of motion, in which interactions of disturbances among each other are neglected but interactions with mean fields are taken into account, can capture the growth of the convective boundary layer. However, it does not capture important turbulent transport terms in the turbulence kinetic energy budget. Second, we study the evolution of two-dimensional large-scale waves, which are representative of waves seen in Earth's upper atmosphere. We demonstrate that a cumulant expansion truncated at second order (CE2) can capture the evolution of such waves and their nonlinear interaction with the mean flow in some circumstances, for example, when the wave amplitude is small enough or the planetary rotation rate is large enough. However, CE2 fails to capture the flow evolution when strongly nonlinear eddy-eddy interactions that generate small-scale filaments in surf zones around critical layers become important. Higher-order closures can capture these missing interactions. The results point to new ways in which the dynamics of turbulent boundary layers may be represented in climate models, and they illustrate different classes

  2. A Resource Cost Aware Cumulative

    NASA Astrophysics Data System (ADS)

    Simonis, Helmut; Hadzic, Tarik

    We motivate and introduce an extension of the well-known cumulative constraint which deals with time and volume dependent cost of resources. Our research is primarily interested in scheduling problems under time and volume variable electricity costs, but the constraint equally applies to manpower scheduling when hourly rates differ over time and/or extra personnel incur higher hourly rates. We present a number of possible lower bounds on the cost, including a min-cost flow, different LP and MIP models, as well as greedy algorithms, and provide a theoretical and experimental comparison of the different methods.

  3. Differing forms, differing purposes: A typology of health impact assessment

    SciTech Connect

    Harris-Roxas, Ben Harris, Elizabeth

    2011-07-15

    There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between different forms of HIAs. This paper describes the three historical and disciplinary fields from which HIA has emerged - environmental health, a social view of health, and health equity. It also puts forward a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-led HIAs. This paper argues that these different forms of HIA serve different purposes and are not necessarily in competition; rather they allow HIA to be responsive to a range of population health concerns and purposes.

  4. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    NASA Technical Reports Server (NTRS)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  5. A framework for assessing e-health preparedness.

    PubMed

    Wickramasinghe, Nilmini S; Fadlalla, Adam M A; Geisler, Elie; Schaffer, Jonathan L

    2005-01-01

    Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative.

  6. A framework for assessing e-health preparedness.

    PubMed

    Wickramasinghe, Nilmini S; Fadlalla, Adam M A; Geisler, Elie; Schaffer, Jonathan L

    2005-01-01

    Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative. PMID:18048213

  7. Assessing Students with Serious Mental Health and Behavioral Problems: Clinical Assessment for Educators.

    ERIC Educational Resources Information Center

    Hansen, Jo-Ida C.; Conlon, Amy L.

    The current intervention trend for many of the mental health and behavioral problems faced by today's youth is an integrative approach that involves the community, families, and schools. Clinical assessment for serious mental health and behavioral problems can be an important component in the development of school-based screening programs. The…

  8. Holistic health assessment tool for patients on maintenance hemodialysis.

    PubMed

    Singhania, P R; Mandalika, S

    2012-07-01

    The recent emphasis on assessment of the psychological status, availability of newer and better methods of interpreting the anthropometric measurements of renal patients on dialysis therapy prompted the authors to develop the "Holistic Health Assessment Tool for dialysis patients (HHAT-D)." A total of 30 subjects (25-65 years), enrolled from dialysis centers in Mumbai were administered the HHAT-D tool to assess anthropometric, biochemical, functional, and psychological status (knowledge, needs, that coping strategies) along with dietary intake. The results showed that majority of the patients (73.3%) were mild to moderately malnourished. A highly significant negative correlation of anthropometric measurements (BMI, lean body mass, mid arm circumference, arm muscle area, bicep skin fold thickness, % usual body weight, and % standard body weight) with the HHAT-D scores (P<0.01) confirmed the validity of the tool in assessing the degree of malnutrition. The poor health status of the patients was further confirmed by the average (40%) to poor (36.6%) flexibility status and poor dietary nutrient intake. Moderate (36.6%) to high (60%) coping effectiveness was recorded in the patients as assessed using the "coping effectiveness inventory." A high degree of interitem correlation (Cronbach's coefficient alpha-test value 0.836) also proved the reliability of the HHAT-D tool. Thus, the HHAT-D was found to be a specific and reliable tool for assessment of holistic health status of patients on maintenance hemodialysis to improve quality of life and facilitate faster recovery.

  9. An approach for assessing human health vulnerability and public health interventions to adapt to climate change.

    PubMed

    Ebi, Kristie L; Kovats, R Sari; Menne, Bettina

    2006-12-01

    Assessments of the potential human health impacts of climate change are needed to inform the development of adaptation strategies, policies, and measures to lessen projected adverse impacts. We developed methods for country-level assessments to help policy makers make evidence-based decisions to increase resilience to current and future climates, and to provide information for national communications to the United Nations Framework Convention on Climate Change. The steps in an assessment should include the following: a) determine the scope of the assessment; b) describe the current distribution and burden of climate-sensitive health determinants and outcomes; c) identify and describe current strategies, policies, and measures designed to reduce the burden of climate-sensitive health determinants and outcomes; d) review the health implications of the potential impacts of climate variability and change in other sectors; e) estimate the future potential health impacts using scenarios of future changes in climate, socioeconomic, and other factors; f) synthesize the results; and g) identify additional adaptation policies and measures to reduce potential negative health impacts. Key issues for ensuring that an assessment is informative, timely, and useful include stakeholder involvement, an adequate management structure, and a communication strategy.

  10. [Health technology assessment in public health interventions: is prevention better than cure?].

    PubMed

    Espallargues, Mireia; Pons, Joan M V; Almazán, Caridad; de Solà-Morales, Oriol

    2011-06-01

    Medical activities are increasingly performed with preventive purposes, as part of community programs for secondary prevention but also as part of many clinical activities. However, there are few evaluations of preventive and health promotion activities and, in general, these evaluations only assess aspects of efficacy/effectiveness with little consideration of cost and cost-effectiveness and even less of the ethical, legal, social or organizational consequences. Given the growing interest in evaluation of these interventions from different perspectives, health technology assessment (HTA) has emerged as a multidisciplinary analysis strategy with distinct methodological approaches that may be useful to health administrations and policy-makers for decision making at different levels (micro, meso and macro). This manuscript discusses the characteristics and differential aspects related to assessment of preventive and health promotion activities. This type of evaluation poses constraints, limitations and challenges that should be considered during the process of HTA. In the case of public health there are additional challenges, because the evidence must satisfy a diverse audience, including public health professionals, clinicians, politicians, managers, economists and consumers. The challenge is even greater when evaluating complex, integrated community interventions in which local and contextual aspects are of tremendous importance. In addition, assessment of ethical issues is of the utmost importance since these issues comprise the origin of health services and the target populations are usually healthy.

  11. The need for health impact assessment in China: Potential benefits for public health and steps forward

    SciTech Connect

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  12. Experience and lessons from health impact assessment for human rights impact assessment.

    PubMed

    Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

    2015-01-01

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated. PMID:26377091

  13. Experience and lessons from health impact assessment for human rights impact assessment.

    PubMed

    Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

    2015-09-16

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated.

  14. A paradox of cumulative culture.

    PubMed

    Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

    2015-08-21

    Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem.

  15. A paradox of cumulative culture.

    PubMed

    Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

    2015-08-21

    Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem. PMID:25979371

  16. 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…

  17. 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...

  18. POLLUTION AND ECOSYSTEM HEALTH - ASSESSING ECOLOGICAL CONDITION OF COASTAL ECOSYSTEMS

    EPA Science Inventory

    Summers, Kevin. 2004. Pollution and Ecosystem Health - Assessing Ecological Condition of Coastal Ecosystems. Presented at the White Water to Blue Water (WW2BW) Miami Conference, 21-26 March 2004, Miami, FL. 1 p. (ERL,GB R973).

    Throughout the coastal regions and Large Mari...

  19. 75 FR 1373 - Beaches Environmental Assessment and Coastal Health Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... of the potential risks associated with water contact activities in the coastal recreation waters that... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act..., and local governments to support microbiological monitoring and public notification of the...

  20. An Assessment of Nursing Attitudes toward Computers in Health Care.

    ERIC Educational Resources Information Center

    Carl, David L.; And Others

    The attitudes and perceptions of practicing nurses, student nurses, and nurse educators toward computerization of health care were assessed using questionnaires sent to two general hospitals and five nursing education programs. The sample consisted of 83 first-year nursing students, 84 second-year nursing students, 52 practicing nurses, and 26…

  1. 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...

  2. Connecticut's New Comprehensive and Universal Early Childhood Health Assessment Form

    ERIC Educational Resources Information Center

    Crowley, Angela A.; Whitney, Grace-Ann C.

    2005-01-01

    Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's…

  3. An Assessment of Health Risk for First-Year Students.

    ERIC Educational Resources Information Center

    Grayson, J. Paul

    1997-01-01

    At York University (Ontario), a large, urban commuter university, the self-assessed health of first-year students is lower than that of Canadian undergraduates in general and those in the 18 to 24 age category not enrolled in college. Among first-year students, Chinese females and females who anticipated that family problems would interfere with…

  4. Development of the Geriatric Oral Health Assessment Index.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Dolan, Teresa A.

    1990-01-01

    This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI has demonstrated a high level of internal consistency and reliability. Poor GOHAI scores were significantly correlated to having fewer teeth, wearing a removable denture, and perceiving the need for dental treatment.…

  5. Mental Health Assessment of Infants in Foster Care

    ERIC Educational Resources Information Center

    Silver, Judith; Dicker, Sheryl

    2007-01-01

    Infants placed in foster care are at high risk for emotional and behavioral problems. Assessment of their mental health must account for their often-adverse life experiences prior to placement and the involvement of multiple systems that shape their lives in lieu of parents' authority. This article presents practice guidelines for infant mental…

  6. 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...

  7. Assessing Health Literacy in Deaf American Sign Language Users.

    PubMed

    McKee, Michael M; Paasche-Orlow, Michael K; Winters, Paul C; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, health care messages, and health care communication, which, when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version (ASL-NVS). We found that 48% of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research. PMID:26513036

  8. Assessing Health Literacy in Deaf American Sign Language Users.

    PubMed

    McKee, Michael M; Paasche-Orlow, Michael K; Winters, Paul C; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, health care messages, and health care communication, which, when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version (ASL-NVS). We found that 48% of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research.

  9. Soil Health Assessment Approaches and the Cornell Framework

    NASA Astrophysics Data System (ADS)

    van Es, Harold

    2016-04-01

    Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

  10. Randomized Controlled Trials in Health Technology Assessment: Overkill or Overdue?

    PubMed Central

    Bentzen, Søren M.

    2012-01-01

    Evidence-based medicine has become a cornerstone in the development of radiation oncology and the randomized controlled phase III trial remains the gold standard for assessing differential benefits in clinical outcome between therapies. Health technologies aimed at improving treatment quality should primarily be tested using process measures or operational characteristics, the reason being that the sensitivity and specificity of clinical outcome is low for detecting quality improvements. The ongoing discussion of the relative merits of intensity modulated photon vs. proton radiotherapy is used to illustrate these concepts. Concerns over clinical and individual equipoise as well as the potential limitations of health economics considerations in this setting are also discussed. Working in a technology and science based medical discipline, radiation oncology researchers need to further develop methodology for critical assessment of health technologies as a complement to randomized controlled trials. PMID:18237799

  11. Reflections on the evolution of health technology assessment in Europe.

    PubMed

    Sorenson, Corinna; Chalkidou, Kalipso

    2012-01-01

    Health technology assessment (HTA) has assumed an increasing role in health systems in recent years, with many countries establishing agencies or programmes to evaluate health technology and other interventions to inform policy decisions and clinical practice. This paper reflects upon its development and evolution in Europe over the last decade, with a focus on England, France, Germany and Sweden. In particular, we explore how HTA has evolved over time as well as its impact on policy and practice. While countries share many of the same objectives, there are differences in the way HTA agencies and programmes are organised, operate, and influence decision making. Despite these differences, all systems are faced with opportunities and challenges related to stakeholder involvement and acceptance, the suitability and transparency of assessment requirements and methods, balancing evidence and values in decision making, and demonstrating impact.

  12. [Tobacco cadmium health risk assessment and reduction techniques: A review].

    PubMed

    Cao, Chen-liang; Ma, Yi-bing; Li, Ju-mei; Wei, Dong-pu; Shi, Yi

    2015-04-01

    Tobacco is one of the cadmium accumulation and tolerance plants. Decreasing cadmium content of tobacco contributes to environmental safety and human health. Three aspects on tobacco cadmium research were reviewed in this paper, i.e. uptake and distribution of cadmium in tobacco, and health risk assessment of cadmium in tobacco and reduction measures. The current situations and existing challenges in the research field were discussed. The cadmium tolerance mechanisms of tobacco were reviewed, the factors on cadmium uptake were analyzed, and the general distribution of cadmium in tobacco was summarized. From the point of health risk assessment, the lack of cadmium limits in tobacco was identified, the recommended formula to calculate cadmium limits of tobacco based on atmosphere cadmium limits and digestion cadmium limits was provided and the cadmium limits of tobacco were estimated using each formula, and suggestions on cadmium limits in tobacco were presented. At last, we put forward several effective reduction measures to lower cadmium level in tobacco leaves.

  13. 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.

  14. 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

  15. The American College Health Association National College Health Assessment (ACHA-NCHA), Spring 2003 Reference Group Report

    ERIC Educational Resources Information Center

    Journal of American College Health, 2005

    2005-01-01

    Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey instrument developed by the American College Health Association (ACHA) in 1998 to assist institutions of higher…

  16. Integrating Human Health into Environmental Impact Assessment: An Unrealized Opportunity for Environmental Health and Justice

    PubMed Central

    Bhatia, Rajiv; Wernham, Aaron

    2008-01-01

    Objectives The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. Data sources We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. Data synthesis We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. Conclusions The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice. PMID:18709140

  17. Using automated continual performance assessment to improve health care.

    PubMed

    Wulff, K R; Westphal, J R; Shray, S L; Hunkeler, E F

    1997-01-01

    Inefficiency in the work of health care providers is evident and contributes to health care costs. In the early 20th century, industrial engineers developed scientific methods for studying work to improve performance (efficiency) by measuring results--i.e., quality, cost, and productivity. In the mid-20th century, business managers developed ways to apply these methods to improve the work process. These scientific methods and management approaches can be applied to improving medical work. Fee-for-service practice has had incentives to maximize productivity, and prepaid practice has had incentives to minimize costs, but no sector of the health care system has systematically pursued the optimization of all performance variables: quality, cost, and productivity. We have reviewed evolving methods for the automation of continual assessment of performance in health care using touch screen and computer telephone, logging and scheduling software, appropriate combinations of generic or disease-specific health status questionnaires, physiologic measurements or laboratory assays from computerized records, and cost and productivity data from computerized registration logs. We propose that the results of outcome assessment be rapidly and continually transmitted to providers, patients, and managers so that health care processes can be progressively improved. The evolving systems we have described are the practical tools that can help us achieve our performance goals.

  18. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    PubMed

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. PMID:26774008

  19. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    PubMed

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016.

  20. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    PubMed

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness.

  1. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    PubMed

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. PMID:27015612

  2. Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study

    PubMed Central

    Hakulinen, Christian; Pulkki-Råback, Laura; Elovainio, Marko; Kubzansky, Laura D.; Jokela, Markus; Hintsanen, Mirka; Juonala, Markus; Kivimäki, Mika; Josefsson, Kim; Hutri-Kähönen, Nina; Kähönen, Mika; Viikari, Jorma; Keltikangas-Järvinen, Liisa; Raitakari, Olli T

    2015-01-01

    Objective Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity as well as having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. Methods Participants were 2265 men and women (age range: 24-39 years in 2001) from the on-going Cardiovascular Risk in Young Finns study whose carotid IMT were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life-events, parental health behavior family, socioeconomic status, and childhood emotional environment). Results The cumulative risk score was associated with higher IMT in 2007 (b=.004; se=.001; p<.001) and increased IMT progression from 2001 to 2007 (b=.003; se=.001; p=.001). The associations were robust to adjustment for conventional cardiovascular risk factors in childhood and adulthood, including adulthood health behavior, adulthood socioeconomic status and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life-events was associated with higher IMT in 2001 (b=.007; se=.003; p=.016) and poorer parental health behavior predicted higher IMT in 2007 (b=.004; se=.002; p=.031) after adjustment for age, sex and childhood cardiovascular risk factors. Conclusions Early life psychosocial environment influences cardiovascular risk later in life and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood. PMID:26809108

  3. New trends in assessing the outcomes of mental health interventions

    PubMed Central

    Thornicroft, Graham; Slade, Mike

    2014-01-01

    Assessing the outcomes of interventions in mental health care is both important and challenging. The aim of this paper is to advance the field of outcomes research by proposing a taxonomy of the decisions that clinicians and researchers need to consider when evaluating outcomes. Our taxonomy has eight components, framed as decisions: Whose outcome will be considered? Which scientific stage is being investigated? What outcome domain(s) matter? What level of assessment will be used? Will clinical and/or recovery outcomes be assessed? Whose perspective will be considered? Will deficits and/or strengths be the focus? Will invariant or individualized measures be preferred? We propose a future focus on understanding what matters most to people using mental health services, and on the use of measures rated by service users as the primary approach to evaluating outcome. PMID:24890055

  4. Health Impact Assessment, Physical Activity and Federal Lands Trail Policy

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard L.

    2016-01-01

    Objectives The objectives of this paper are to describe the application of Health Impact Assessment (HIA) to inform trail decisions affecting a rural, under-resourced community and propose the routine integration of HIAs to enhance NEPA environmental assessments and environmental impact statements for trail decisions on federal lands. Methods Screening, scoping, assessment, recommendations, reporting, monitoring and evaluation are being used to examine the health impact of trail location and design. Results HIA recommendations are being integrated into the public lands National Environmental Protection Act process for planning access to a new segment of the Continental Divide National Scenic Trail. Potential users from a nearby rural New Mexico community and a region of almost one million may benefit from this HIA-informed planning. Conclusions HIA can be integrated into the policy and decision-making process for trails on public lands. PMID:27213163

  5. Health-related quality of life assessment in clinical practice.

    PubMed

    Meers, C; Singer, M A

    1996-01-01

    Assessment of biochemical responses to therapy is routine in the management of patients with end stage renal disease (ESRD). Assessment of health-related quality of life (HRQOL), however, is less common. Previous research indicates that HRQOL is a meaningful indicator that should be integrated into clinical practice. HRQOL is longitudinally evaluated in in-centre hemodialysis patients using the RAND 36-item Health Survey 1.0. Caregivers incorporate scores from this instrument into their assessment of patient functioning and well-being. HRQOL scores can be utilized to evaluate responses to changes in therapy, and to direct clinical decision-making, adding an important dimension to holistic, quality care for ESRD patients. PMID:8900807

  6. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    SciTech Connect

    Simpson, Sarah . E-mail: sarah.simpson@unsw.edu.au; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-10-15

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.

  7. Assessing Organizational Readiness for a Participatory Occupational Health/Health Promotion Intervention in Skilled Nursing Facilities.

    PubMed

    Zhang, Yuan; Flum, Marian; West, Cheryl; Punnett, Laura

    2015-09-01

    The long-term care sector is characterized by high morbidity and employee turnover, along with associated costs. Effective health protection and health promotion are important to improve physical and psychosocial well-being of caregivers. Assessment of organizational readiness for change is an essential precursor to the successful implementation of workplace programs addressing work climate, structure of tasks and relationships, and other issues that may be perceived as challenging by some within the institution. This study qualitatively assessed readiness of five skilled nursing facilities for a participatory occupational health/health promotion intervention. Selection criteria were developed to screen for program feasibility and ability to conduct prospective evaluations, and information was collected from managers and employees (interviews and focus groups). Three centers were selected for the program, and the first year of formative evaluation and intervention experience was then reviewed to evaluate and modify our selection criteria after the fact. Lessons learned include adding assessment of communication and the structure of problem solving to our selection criteria, improving methods to assess management support in a concrete (potentially nonverbal) form, and obtaining a stated financial commitment and resources to enable the team to function. Assessment of organizational readiness for change is challenging, although necessary to implement effective and sustainable health promotion programs in specific organizations.

  8. Assessing Organizational Readiness for a Participatory Occupational Health/Health Promotion Intervention in Skilled Nursing Facilities.

    PubMed

    Zhang, Yuan; Flum, Marian; West, Cheryl; Punnett, Laura

    2015-09-01

    The long-term care sector is characterized by high morbidity and employee turnover, along with associated costs. Effective health protection and health promotion are important to improve physical and psychosocial well-being of caregivers. Assessment of organizational readiness for change is an essential precursor to the successful implementation of workplace programs addressing work climate, structure of tasks and relationships, and other issues that may be perceived as challenging by some within the institution. This study qualitatively assessed readiness of five skilled nursing facilities for a participatory occupational health/health promotion intervention. Selection criteria were developed to screen for program feasibility and ability to conduct prospective evaluations, and information was collected from managers and employees (interviews and focus groups). Three centers were selected for the program, and the first year of formative evaluation and intervention experience was then reviewed to evaluate and modify our selection criteria after the fact. Lessons learned include adding assessment of communication and the structure of problem solving to our selection criteria, improving methods to assess management support in a concrete (potentially nonverbal) form, and obtaining a stated financial commitment and resources to enable the team to function. Assessment of organizational readiness for change is challenging, although necessary to implement effective and sustainable health promotion programs in specific organizations. PMID:25715335

  9. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

    PubMed Central

    Korfmacher, Katrina Smith; Cory-Slechta, Deborah A.; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L.; Dotson-Newman, Ogonnaya; Clougherty, Jane E.; French, Robert; Levy, Jonathan I.; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K.

    2015-01-01

    Abstract Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), “Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments.” Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts. PMID:27688822

  10. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

    PubMed Central

    Korfmacher, Katrina Smith; Cory-Slechta, Deborah A.; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L.; Dotson-Newman, Ogonnaya; Clougherty, Jane E.; French, Robert; Levy, Jonathan I.; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K.

    2015-01-01

    Abstract Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), “Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments.” Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.

  11. Assessment of long-term health risks after accidental exposure using haemoglobin adducts of epichlorohydrin.

    PubMed

    Wollin, Klaus-Michael; Bader, Michael; Müller, Michael; Lilienblum, Werner; Csicsaky, Michael

    2014-12-15

    On September 9th, 2002, two goods trains collided in Bad Münder, Lower Saxony, causing the release of more than 40 metric tonnes of epichlorohydrin (1-chloro-2,3-epoxypropane) into the environment. A human biomonitoring study was performed to evaluate the accidental exposure to epichlorohydrin and to assess the possible long-term, i.e. carcinogenic health effects. This was done on the basis of a biochemical effect monitoring using the N-(3-chloro-2-hydroxypropyl)valine and the N-(2,3-dihydroxypropyl)valine haemoglobin adducts of epichlorohydrin in blood to respond to missing ambient monitoring immediately after the crash. N-(3-chloro-2-hydroxypropyl)valine adduct levels above the LOQ (25 pmol/g globin) ranged from 32.0 to 116.4 pmol/g globin in 6 out of 628 samples. The N-(2,3-dihydroxypropyl)valine adduct was not detected above the LOD (10 pmol/g globin) in any of the blood samples. Based on the quantified N-(3-chloro-2-hydroxypropyl)valine adduct values, the body doses after two days of exposure were estimated to be in the range of 1.7-6.2 nmol/kg body weight. The reverse estimation of the external exposure leads to cumulative additional lifetime cancer risks ranging from 2.61×10(-8) to 9.48×10(-8). The estimated excess lifetime cancer risks have to be assessed as extremely low. Our biomonitoring study facilitated the dialogue between individuals and groups concerned and authorities, because suspected or occurred exposures and risks to human health could be quantified and interpreted in a sound manner.

  12. Assessing the privacy policies in mobile personal health records.

    PubMed

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs. PMID:25571104

  13. Quantitative estimation in Health Impact Assessment: Opportunities and challenges

    SciTech Connect

    Bhatia, Rajiv; Seto, Edmund

    2011-04-15

    Health Impact Assessment (HIA) considers multiple effects on health of policies, programs, plans and projects and thus requires the use of diverse analytic tools and sources of evidence. Quantitative estimation has desirable properties for the purpose of HIA but adequate tools for quantification exist currently for a limited number of health impacts and decision settings; furthermore, quantitative estimation generates thorny questions about the precision of estimates and the validity of methodological assumptions. In the United States, HIA has only recently emerged as an independent practice apart from integrated EIA, and this article aims to synthesize the experience with quantitative health effects estimation within that practice. We use examples identified through a scan of available identified instances of quantitative estimation in the U.S. practice experience to illustrate methods applied in different policy settings along with their strengths and limitations. We then discuss opportunity areas and practical considerations for the use of quantitative estimation in HIA.

  14. 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.

  15. Health technology assessment in Latin America and the Caribbean.

    PubMed

    Banta, David

    2009-07-01

    The Pan American Health Organization (PAHO), Regional Office of the World Health Organization (WHO) for the Americas, has tried to promote health technology assessment (HTA) in Latin America for 25 years. A certain awareness of HTA developed in several countries because of these efforts. In the late 1990's, there was a strong movement for health reform in Latin America, and HTA became part of that movement. Countries that now are actively institutionalizing HTA include Brazil, Mexico, Chile, and Argentina. Other countries, such as Costa Rica, Colombia, Cuba, Peru, Panamá, Paraguay, Trinidad and Tobago, and Uruguay, are following these trends and some others seem to be moving in this direction within the next few years.

  16. Finding Qualitative Research Evidence for Health Technology Assessment.

    PubMed

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making.

  17. Assessing Consumer Health Vocabulary Familiarity: An Exploratory Study

    PubMed Central

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

    2007-01-01

    Background Accurate assessment of the difficulty of consumer health texts is a prerequisite for improving readability. General purpose readability formulas based primarily on word length are not well suited for the health domain, where short technical terms may be unfamiliar to consumers. To address this need, we previously developed a regression model for predicting “average familiarity” with consumer health vocabulary (CHV) terms. Objective The primary goal was to evaluate the ability of the CHV term familiarity model to predict (1) surface-level familiarity of health-related terms and (2) understanding of the underlying meaning (concept familiarity) among actual consumers. Secondary goals involved exploring the effect of demographic factors (eg, health literacy) on surface-level and concept-level familiarity and describing the relationship between the two levels of familiarity. Methods Survey instruments for assessing surface-level familiarity (45 items) and concept-level familiarity (15 items) were developed. All participants also completed a demographic survey and a standardized health literacy assessment, S-TOFHLA. Results Based on surveys completed by 52 consumers, linear regression suggests that predicted CHV term familiarity is a statistically significantly predictor (P < .001) of participants’ surface-level and concept-level familiarity performance. Health literacy was a statistically significant predictor of surface-level familiarity scores (P < .001); its effect on concept-level familiarity scores warrants further investigation (P = 0.06). Educational level was not a significant predictor of either type of familiarity. Participant scores indicated that conceptualization lagged behind recognition, especially for terms predicted as “likely to be familiar” (P = .006). Conclusions This exploratory study suggests that the CHV term familiarity model is predictive of consumer recognition and understanding of terms in the health domain. Potential uses

  18. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine.

    PubMed

    Steuten, Lotte M G

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved "upstream" so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bridges between oral health and systems medicine since what happens in oral health affects systems pathophysiology, and vice versa. This article offers a synthesis of the latest trends and approaches in early phase HTA, with a view to near future applications in oral health, systems medicine, and biomarker-guided precision medicine. In brief, this review underscores that demonstrating health outcomes of biomarkers and next-generation diagnostics is particularly challenging because they do not always influence long-term outcomes directly, but rather impact subsequent care processes. Biomarker testing costs are typically less of a barrier to uptake in practice than the biomarker's impact on longer term health outcomes. As a single biomarker or next-generation diagnostic in oral health can inform decisions about numerous downstream diagnosis-treatment combinations, early stage "upstream" HTA is crucial in prioritizing the most valuable diagnostic applications to pursue first. For the vast array of oral health biomarkers currently developed, early HTA is necessary to timely and iteratively assess their comparative effectiveness and anticipate the inevitable questions about value for money from regulators and payers.

  19. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine.

    PubMed

    Steuten, Lotte M G

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved "upstream" so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bridges between oral health and systems medicine since what happens in oral health affects systems pathophysiology, and vice versa. This article offers a synthesis of the latest trends and approaches in early phase HTA, with a view to near future applications in oral health, systems medicine, and biomarker-guided precision medicine. In brief, this review underscores that demonstrating health outcomes of biomarkers and next-generation diagnostics is particularly challenging because they do not always influence long-term outcomes directly, but rather impact subsequent care processes. Biomarker testing costs are typically less of a barrier to uptake in practice than the biomarker's impact on longer term health outcomes. As a single biomarker or next-generation diagnostic in oral health can inform decisions about numerous downstream diagnosis-treatment combinations, early stage "upstream" HTA is crucial in prioritizing the most valuable diagnostic applications to pursue first. For the vast array of oral health biomarkers currently developed, early HTA is necessary to timely and iteratively assess their comparative effectiveness and anticipate the inevitable questions about value for money from regulators and payers. PMID:26760958

  20. Who comes to a workplace health risk assessment?

    PubMed

    Dobbins, T A; Simpson, J M; Oldenburg, B; Owen, N; Harris, D

    1998-01-01

    Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.