78 FR 44947 - Children's Health Protection Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9838-5] Children's Health Protection Advisory Committee AGENCY: Environmental Protection Agency (EPA). ACTION: Request for Nominations to the Children's Health... from a range of qualified candidates to be considered for appointment to its Children's Health...

Over-the-Counter and Out-of-Control: Legal Strategies to Protect Youths From Abusing Products for Weight Control

PubMed Central

Taylor, Lisa M.; Austin, S. Bryn

2013-01-01

Abuse of widely available, over-the-counter drugs and supplements such as laxatives and diet pills for weight control by youths is well documented in the epidemiological literature. Many such products are not medically recommended for healthy weight control or are especially susceptible to abuse, and their misuse can result in serious health consequences. We analyzed the government’s role in regulating these products to protect public health. We examined federal and state regulatory authority, and referred to international examples to inform our analysis. Several legal interventions are indicated to protect youths, including increased warnings and restrictions on access through behind-the-counter placement or age verification. We suggest future directions for governments internationally to address this pervasive public health problem. PMID:23237149

LEGAL BASES FOR DISCLOSING CONFIDENTIAL PATIENT INFORMATION FOR PUBLIC HEALTH: DISTINGUISHING BETWEEN HEALTH PROTECTION AND HEALTH IMPROVEMENT

PubMed Central

Taylor, Mark J.

2015-01-01

The disclosure of confidential patient data without an individual's explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5. PMID:25995294

Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation.

PubMed

Gonzales, Ernest; Shen, Huei-Wern; Perry, Tam E; Wang, Yi

2018-01-01

This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults' health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 ( N = 682) in the Health and Retirement Study (2008-2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites.

Response Across the Health-Literacy Spectrum of Kidney Transplant Recipients to a Sun-Protection Education Program Delivered on Tablet Computers: Randomized Controlled Trial

PubMed Central

Friedewald, John J; Desai, Amishi; Gordon, Elisa J

2015-01-01

Background Sun protection can reduce skin cancer development in kidney transplant recipients, who have a greater risk of developing squamous cell carcinoma than the general population. Objective A culturally sensitive sun-protection program (SunProtect) was created in English and Spanish with the option of choosing audio narration provided by the tablet computer (Samsung Galaxy Tab 2 10.1). The intervention, which showed skin cancer on patients with various skin tones, explained the following scenarios: skin cancer risk, the ability of sun protection to reduce this risk, as well as offered sun-protection choices. The length of the intervention was limited to the time usually spent waiting during a visit to the nephrologist. Methods The development of this culturally sensitive, electronic, interactive sun-protection educational program, SunProtect, was guided by the “transtheoretical model,” which focuses on decision making influenced by perceptions of personal risk or vulnerability to a health threat, importance (severity) of the disease, and benefit of sun-protection behavior. Transportation theory, which holds that narratives can have uniquely persuasive effects in overcoming preconceived beliefs and cognitive biases because people transported into a narrative world will alter their beliefs based on information, claims, or events depicted, guided the use of testimonials. Participant tablet use was self-directed. Self-reported responses to surveys were entered into the database through the tablet. Usability was tested through interviews. A randomized controlled pilot trial with 170 kidney transplant recipients was conducted, where the educational program (SunProtect) was delivered through a touch-screen tablet to 84 participants. Results The study involved 62 non-Hispanic white, 60 non-Hispanic black, and 48 Hispanic/Latino kidney transplant recipients. The demographic survey data showed no significant mean differences between the intervention and control

The dental health of children subject to a child protection plan.

PubMed

Keene, Emily J; Skelton, Ruth; Day, Peter F; Munyombwe, Theresa; Balmer, Richard C

2015-11-01

In the United Kingdom, child maltreatment is an area of increased awareness and concern. To compare the dental health of children subject to child protection plans with controls. Children had to be aged between two and 11 years, medically healthy, and subject either to a child protection plan or attending the paediatric outpatient orthopaedic or general surgery clinics (control group). All children had a standardized oral examination. Seventy-nine children were examined in each group. Children with child protection plans had statistically higher levels of primary tooth decay than controls (mean dmft 3.82 and 2.03, Mann-Whitney U test P = 0.002). After adjusting for socioeconomic status, the incidence rate ratios for the occurrence of dental caries in the primary dentition in children with a child protection plan was 1.76 (95% CI: 1.44-2.15) relative to the controls. There was no statistical difference in the levels of permanent tooth decay between the study and control groups (mean DMFT 0.71 and 0.30, respectively). The care index was significantly lower (P = 0.008, Mann-Whitney U test) in the study group (1.69%) compared to the control group (6.02%). Children subject to child protection plans had significantly higher levels of dental caries in the primary dentition. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Public health challenges in sun protection.

PubMed

Eide, Melody J; Weinstock, Martin A

2006-01-01

Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Rights to request privacy protection for protected health information. 164.522 Section 164.522 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.522 Rights...

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Rights to request privacy protection for protected health information. 164.522 Section 164.522 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.522 Rights...

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Rights to request privacy protection for protected health information. 164.522 Section 164.522 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.522 Rights...

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Rights to request privacy protection for protected health information. 164.522 Section 164.522 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.522 Rights...

Response Across the Health-Literacy Spectrum of Kidney Transplant Recipients to a Sun-Protection Education Program Delivered on Tablet Computers: Randomized Controlled Trial.

PubMed

Robinson, June K; Friedewald, John J; Desai, Amishi; Gordon, Elisa J

2015-08-18

Sun protection can reduce skin cancer development in kidney transplant recipients, who have a greater risk of developing squamous cell carcinoma than the general population. A culturally sensitive sun-protection program (SunProtect) was created in English and Spanish with the option of choosing audio narration provided by the tablet computer (Samsung Galaxy Tab 2 10.1). The intervention, which showed skin cancer on patients with various skin tones, explained the following scenarios: skin cancer risk, the ability of sun protection to reduce this risk, as well as offered sun-protection choices. The length of the intervention was limited to the time usually spent waiting during a visit to the nephrologist. The development of this culturally sensitive, electronic, interactive sun-protection educational program, SunProtect, was guided by the "transtheoretical model," which focuses on decision making influenced by perceptions of personal risk or vulnerability to a health threat, importance (severity) of the disease, and benefit of sun-protection behavior. Transportation theory, which holds that narratives can have uniquely persuasive effects in overcoming preconceived beliefs and cognitive biases because people transported into a narrative world will alter their beliefs based on information, claims, or events depicted, guided the use of testimonials. Participant tablet use was self-directed. Self-reported responses to surveys were entered into the database through the tablet. Usability was tested through interviews. A randomized controlled pilot trial with 170 kidney transplant recipients was conducted, where the educational program (SunProtect) was delivered through a touch-screen tablet to 84 participants. The study involved 62 non-Hispanic white, 60 non-Hispanic black, and 48 Hispanic/Latino kidney transplant recipients. The demographic survey data showed no significant mean differences between the intervention and control groups in age, sex, income, or time since

Linking India Global Health Professions Student Survey data to the World Health Organization Framework Convention on Tobacco Control.

PubMed

Sinha, D N; Singh, G; Gupta, P C; Pednekar, M; Warrn, C W; Asma, S; Lee, J

2010-07-01

The 2003 India Tobacco Control Act (ITCA) includes provisions designed to reduce tobacco consumption and protect citizens from exposure to secondhand smoke. India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) on February 27, 2005. The WHO FCTC is the world's first public health treaty that aims to promote and protect public health and reduce the devastating health and economic impact of tobacco. The Global Health Professions Student Survey (GHPSS) was developed to track tobacco use among third-year dental, medical, nursing, and pharmacy students across countries. Data from the dental (2005), medical (2006), nursing(2007), and pharmacy (2008) GHPSS conducted in India showed high prevalence of tobacco use and a general lack of training by health professionals in patient cessation counseling techniques. The Ministry of Health and Family Welfare could use this information to monitor and evaluate the existing tobacco control program effort in India as well as to develop and implement new tobacco control program initiatives.

Regulatory Disruption and Arbitrage in Health-Care Data Protection.

PubMed

Terry, Nicolas P

This article explains how the structure of U.S. health-care data protection (specifically its sectoral and downstream properties) has led to a chronically uneven policy environment for different types of health-care data. It examines claims for health-care data protection exceptionalism and competing demands such as data liquidity. In conclusion, the article takes the position that healthcare- data exceptionalism remains a valid imperative and that even current concerns about data liquidity can be accommodated in an exceptional protective model. However, re-calibrating our protection of health-care data residing outside of the traditional health-care domain is challenging, currently even politically impossible. Notwithstanding, a hybrid model is envisioned with downstream HIPAA model remaining the dominant force within the health-care domain, but being supplemented by targeted upstream and point-of-use protections applying to health-care data in disrupted spaces.

Can functional emotion regulation protect children's mental health from war trauma? A Palestinian study.

PubMed

Diab, Marwan; Peltonen, Kirsi; Qouta, Samir R; Palosaari, Esa; Punamäki, Raija-Leena

2017-04-19

Effective emotion regulation (ER) is expected to protect mental health in traumatic stress. We first analysed the protective (moderator) function of different ER strategies and the associations between ER and mental health. Second, we tested gender differences in the protective function of ER and the associations between ER strategies and mental health. Participants were 482 Palestinian children (girls 49.4%; 10-13 years, M = 11.29, SD = .68) whose ER was assessed by the Emotion Regulation Questionnaire and mental health by post-traumatic stress (Children's Impact Event Scale), depressive, and psychological distress (Strengths and Difficulties Questionnaire) symptoms, and by psychosocial well-being (Mental Health Continuum-Short Form). War trauma involved 42 events. Results showed, first, that none of the ER strategies could protect a child's mental health from negative impact of war trauma, but self-focused ER was associated with low depressive symptoms, and other-facilitated ER with high psychological well-being. However, controlling of emotions formed a comprehensive risk for children's mental health. Second, gender differences were found in the protective role of ER, as self-focused and distractive ER formed a vulnerability among boys. The results are discussed in the context of emotional and regulative demands of war and life-threat. © 2017 International Union of Psychological Science.

Health promotion and the First Amendment: government control of the informational environment.

PubMed

Gostin, L O; Javitt, G H

2001-01-01

Government efforts to protect public health often include controlling health information. The government may proscribe messages conveyed by commercial entities (e.g., false or misleading), recommend messages from commercial entities (e.g., warnings and safety instructions), and convey health messages (e.g., health communication campaigns). Through well-developed, albeit evolving, case law, government control of private speech has been constrained to avoid impinging on such values as free expression, truthfulness, and autonomous decision making. No simple legal framework has been developed for the government's own health messages to mediate between the legitimate goals of health protection and these other values. Nevertheless, government recommendations on matters of health raise difficult social and ethical questions and involve important societal trade-offs. Accordingly, this article proposes legal and ethical principles relating to government control of the health information environment.

38 CFR 17.91 - Protection of health-care eligibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Protection of health-care... MEDICAL Vocational Training and Health-Care Eligibility Protection for Pension Recipients § 17.91 Protection of health-care eligibility. Any veteran whose entitlement to VA pension is terminated by reason of...

45 CFR 164.526 - Amendment of protected health information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Amendment of protected health information. 164.526....526 Amendment of protected health information. (a) Standard: Right to amend. (1) Right to amend. An individual has the right to have a covered entity amend protected health information or a record about the...

Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

PubMed

Andersen, Mette Rye; Storm, Hans H

2015-06-01

The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

Two Decades of Enhancing Children’s Environmental Health Protection at the U.S. Environmental Protection Agency

PubMed Central

Firestone, Michael; Berger, Martha; Foos, Brenda; Etzel, Ruth

2016-01-01

Summary: This article provides an overview of public health efforts by the U.S. Environmental Protection Agency (EPA) during the past two decades to protect children’s health from environmental hazards. It highlights examples of concrete steps and accomplishments toward improving environmental protection and health outcomes achieved through public policy, rules and regulations, increased scientific understanding, and public health messaging. Additionally, examples of future challenges for better understanding and improving children’s environmental health are discussed. PMID:27905272

[Measurement and study report as a part of the control system for human safety and health protection against electromagnetic fields and electromagnetic radiation (0 Hz-300 GHz)].

PubMed

Aniołczyk, Halina

2007-01-01

The National Control System for safety and health protection against electromagnetic fields (EMF) and electromagnetic radiation (EMR) (0 Hz-300 GHz) is constantly analyzed in view of Directive 2004/40/EC. Reports on the effects of investments (at the designing stage or at the stage of looking for their localization) on the environment and measurement and study reports on the objects already existing or being put into operation are important elements of this system. These documents should meet both national and European Union's legislation requirements. The overriding goal of the control system is safety and health protection of humans against electromagnetic fields in the environment and in occupational settings. The author pays a particular attention to provisions made in directives issued by relevant ministers and to Polish standards, which should be documented in measurement and study reports published by the accredited laboratories and relating to the problems of human safety and health protection. Similar requirements are valid for the Reports. Therefore, along with measurement outcomes, the reports should include data on the EMF exposure classification at work-posts and the assessment of occupational risk resulting from EMF exposure or at least thorough data facilitating such a classification.

76 FR 25342 - Children's Health Protection Advisory Committee; Request for Nominations to the Children's Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9302-1] Children's Health Protection Advisory Committee; Request for Nominations to the Children's Health Protection Advisory Committee AGENCY: Environmental... nominations from a range of qualified candidates to be considered for appointment to its Children's Health...

Constitutional rights to health, public health and medical care: the status of health protections in 191 countries.

PubMed

Heymann, Jody; Cassola, Adèle; Raub, Amy; Mishra, Lipi

2013-07-01

United Nations (UN) member states have universally recognised the right to health in international agreements, but protection of this right at the national level remains incomplete. This article examines the level and scope of constitutional protection of specific rights to public health and medical care, as well as the broad right to health. We analysed health rights in the constitutions of 191 UN countries in 2007 and 2011. We examined how rights protections varied across the year of constitutional adoption; national income group and region; and for vulnerable groups within each country. A minority of the countries guaranteed the rights to public health (14%), medical care (38%) and overall health (36%) in their constitutions in 2011. Free medical care was constitutionally protected in 9% of the countries. Thirteen per cent of the constitutions guaranteed children's right to health or medical care, 6% did so for persons with disabilities and 5% for each of the elderly and the socio-economically disadvantaged. Valuable next steps include regular monitoring of the national protection of health rights recognised in international agreements, analyses of the impact of health rights on health outcomes and longitudinal multi-level studies to assess whether specific formulations of the rights have greater impact.

45 CFR 164.524 - Access of individuals to protected health information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Health Information § 164.524 Access of individuals to protected health information. (a) Standard: Access to protected health information—(1) Right of access. Except as otherwise provided in paragraph (a)(2... protected health information about the individual in a designated record set, for as long as the protected...

45 CFR 164.524 - Access of individuals to protected health information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Health Information § 164.524 Access of individuals to protected health information. (a) Standard: Access to protected health information—(1) Right of access. Except as otherwise provided in paragraph (a)(2... protected health information about the individual in a designated record set, for as long as the protected...

Improving health care workers' protection against infection of Ebola hemorrhagic fever through video surveillance.

PubMed

Xi, Huijun; Cao, Jie; Liu, Jingjing; Li, Zhaoshen; Kong, Xiangyu; Wang, Yonghua; Chen, Jing; Ma, Su; Zhang, Lingjuan

2016-08-01

The purpose of this study was to investigate the importance of supervision through video surveillance in improving the quality of personal protection in preparing health care workers working in Ebola treatment units. Wardens supervise, remind, and guide health care workers' behavior through onsite voice and video systems when they are in the suspected patient observation ward and in the patient diagnosed ward of the Ebola treatment center. The observation results were recorded, and timely feedback was given to the health care workers. After 2 months of supervision, 1,797 cases of incorrect personal protection behaviors were identified and corrected. The error rate continuously declined. The declined rate of the first 2 weeks was statistically different from other time periods. Through reminding and supervising, nonstandard personal protective behaviors can be discovered and corrected, which can help health care workers standardize personal protection. The timely feedback from video surveillance can also offer psychologic support and encouragement promptly to ease psychologic pressure. Finally, this can ensure health care workers stay at a zero infection rate during patient treatment. Personal protective equipment protocol supervised by wardens through a video monitoring process can be used as an effective complement to conventional mutual supervision methods and can help health care workers avoid Ebola infection during treatment. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Skin Cancer Protective Behaviors among the Elderly: Explaining Their Response to a Health Education Program Using the Health Belief Model.

ERIC Educational Resources Information Center

Carmel, Sara; And Others

1996-01-01

In 4 kibbutzim, 43 adults over 60 completed a questionnaire on sun-exposure protective behaviors before and 2 weeks and 4 months after a skin cancer intervention. Beliefs about skin cancer did not change, but beliefs about the value of health and internal health locus of control changed significantly. (SK)

[Regulating radiological protection and the role of health authorities].

PubMed

Arias, César F

2006-01-01

This article summarizes the development of protection against ionizing radiation and explains current thinking in the field. It also looks at the decisive role that regulatory agencies for radiological protection must play and the important contributions that can be made by health authorities. The latter should take an active part in at least three aspects: the formal education of health personnel regarding radiological protection; the medical care of individuals who are accidentally overexposed, and the radiological protection of patients undergoing radiological procedures. To this end, health professionals must possess sufficient knowledge about radiological protection, promote the use of proper equipment, and apply the necessary quality assurance procedures. Through their effective intervention, national health authorities can greatly contribute to reducing unnecessary doses of radiation during medical procedures involving radiation sources and decrease the chances that radiological accidents will take place.

2001 Children's Health Protection Advisory Committee Letters

EPA Pesticide Factsheets

These letters are all to or about Christine Todd Whitman, regarding recommendations on strengthening the agency's children's health protection program, public health expertise on staff at EPA, and her leadership role on children's environmental health.

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... health information. 164.522 Section 164.522 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES...). (b)(1) Standard: Confidential communications requirements. (i) A covered health care provider must... communications of protected health information from the covered health care provider by alternative means or at...

Indian community health insurance schemes provide partial protection against catastrophic health expenditure.

PubMed

Devadasan, Narayanan; Criel, Bart; Van Damme, Wim; Ranson, Kent; Van der Stuyft, Patrick

2007-03-15

More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE). We studied two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP) payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit packages with low maximum limits, exclusion of some

Attitude control fault protection - The Voyager experience

NASA Technical Reports Server (NTRS)

Litty, E. C.

1980-01-01

The length of the Voyager mission and the communication delay caused by the distances involved made fault protection a necessary part of the Voyager Attitude and Articulation Control Subsystem (AACS) design. An overview of the Voyager attitude control fault protection is given and flight experiences relating to fault protection are provided.

75 FR 43993 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel: Patient Protection...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel: Patient Protection and Affordable Care Act (PPACA), Emerging Infections Program (EIP), Enhancing Epidemiology and Laboratory Capacity...

Privacy in the digital world: medical and health data outside of HIPAA protections.

PubMed

Glenn, Tasha; Monteith, Scott

2014-11-01

Increasing quantities of medical and health data are being created outside of HIPAA protection, primarily by patients. Data sources are varied, including the use of credit cards for physician visit and medication co-pays, Internet searches, email content, social media, support groups, and mobile health apps. Most medical and health data not covered by HIPAA are controlled by third party data brokers and Internet companies. These companies combine this data with a wide range of personal information about consumer daily activities, transactions, movements, and demographics. The combined data are used for predictive profiling of individual health status, and often sold for advertising and other purposes. The rapid expansion of medical and health data outside of HIPAA protection is encroaching on privacy and the doctor-patient relationship, and is of particular concern for psychiatry. Detailed discussion of the appropriate handling of this medical and health data is needed by individuals with a wide variety of expertise.

Reading About the Flu Online: How Health-Protective Behavioral Intentions Are Influenced by Media Multitasking, Polychronicity, and Strength of Health-Related Arguments.

PubMed

Kononova, Anastasia; Yuan, Shupei; Joo, Eunsin

2017-06-01

As health organizations increasingly use the Internet to communicate medical information and advice (Shortliffe et al., 2000; World Health Organization, 2013), studying factors that affect health information processing and health-protective behaviors becomes extremely important. The present research applied the elaboration likelihood model of persuasion to explore the effects of media multitasking, polychronicity (preference for multitasking), and strength of health-related arguments on health-protective behavioral intentions. Participants read an online article about influenza that included strong and weak suggestions to engage in flu-preventive behaviors. In one condition, participants read the article and checked Facebook; in another condition, they were exposed only to the article. Participants expressed greater health-protective behavioral intentions in the media multitasking condition than in the control condition. Strong arguments were found to elicit more positive behavioral intentions than weak arguments. Moderate and high polychronics showed greater behavioral intentions than low polychronics when they read the article in the multitasking condition. The difference in intentions to follow strong and weak arguments decreased for moderate and high polychronics. The results of the present study suggest that health communication practitioners should account for not only media use situations in which individuals typically read about health online but also individual differences in information processing, which puts more emphasis on the strength of health-protective suggestions when targeting light multitaskers.

Electronic Health Record in Italy and Personal Data Protection.

PubMed

Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca

2016-06-01

The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health.

45 CFR 164.528 - Accounting of disclosures of protected health information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Accounting of disclosures of protected health... Health Information § 164.528 Accounting of disclosures of protected health information. (a) Standard: Right to an accounting of disclosures of protected health information. (1) An individual has a right to...

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty

PubMed Central

Gama, Elvis

2016-01-01

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world’s poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. PMID:26927589

Hospital respiratory protection practices in 6 U.S. states: A public health evaluation study

PubMed Central

Peterson, Kristina; Novak, Debra; Stradtman, Lindsay; Wilson, David; Couzens, Lance

2015-01-01

Background Lessons learned from the influenza A (H1N1) virus revealed a need to better understand hospitals’ respiratory protection programmatic practice gaps. This article reports findings from a multistate assessment of hospitals’ adherence to the Occupational Safety and Health Administration’s respiratory protection program (RPP) requirements and the Centers for Disease Control and Prevention’s infection control guidance. Methods Onsite surveys were conducted in 98 acute care hospitals in 6 U.S. states, including >1,500 hospital managers, unit managers, and health care workers. Descriptive statistics were used to assess hospital adherence. Results Most acute care hospitals adhere to requirements for initial medical evaluations, fit testing, training, and recommended respiratory protection when in close contact with patients who have suspected or confirmed seasonal influenza. Low hospital adherence was found for respiratory protection with infectious diseases requiring airborne precautions, aerosol-generating procedures with seasonal influenza, and checking of the respirator’s user seal. Hospitals’ adherence was also low with follow-up program evaluations, medical re-evaluations, and respirator maintenance. Conclusion Efforts should be made to closely examine ways of strengthening hospitals’ RPPs to ensure the program’s ongoing effectiveness and workers’ proper selection and use of respiratory protection. Implications for improved RPPs and practice are discussed. PMID:25564126

The Fitbit Fault Line: Two Proposals to Protect Health and Fitness Data at Work.

PubMed

Brown, Elizabeth A

2016-01-01

Employers are collecting and using their employees' health data, mined from wearable fitness devices and health apps, in new, profitable, and barely regulated ways. The importance of protecting employee health and fitness data will grow exponentially in the future. This is the moment for a robust discussion of how law can better protect employees from the potential misuse of their health data. While scholars have just begun to examine the problem of health data privacy, this Article contributes to the academic literature in three important ways. First, it analyzes the convergence of three trends resulting in an unprecedented growth of health-related data: the Internet of Things, the Quantified Self movement, and the Rise of Health Platforms. Second, it describes the insufficiencies of specific data privacy laws and federal agency actions in the context of protecting employee health data from employer misuse. Finally, it provides two detailed and workable solutions for remedying the current lack of protection of employee health data that will realign employer use with reasonable expectations of health and fitness privacy. The Article proceeds in four Parts. Part I describes the growth of self-monitoring apps, devices, and other sensor-enabled technology that can monitor a wide range of data related to an employee's health and fitness and the relationship of this growth to both the Quantified Self movement and the Internet of Things. Part II explains the increasing use of employee monitoring through a wide range of sensors, including wearable devices, and the potential uses of that health and fitness data. Part III explores the various regulations and agency actions that might protect employees from the potential misuse of their health and fitness data and the shortcomings of each. Part IV proposes two specific measures that would help ameliorate the ineffective legal protections that currently exist in this context. In order to improve employee notice of and control

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty.

PubMed

Gama, Elvis

2015-11-27

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world's poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. © 2016 by Kerman University of Medical Sciences.

45 CFR 164.520 - Notice of privacy practices for protected health information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Health Information § 164.520 Notice of privacy practices for protected health information. (a) Standard... legal duties with respect to protected health information. (2) Exception for group health plans. (i) An... receive protected health information other than summary health information as defined in § 164.504(a) or...

45 CFR 164.520 - Notice of privacy practices for protected health information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Health Information § 164.520 Notice of privacy practices for protected health information. (a) Standard... legal duties with respect to protected health information. (2) Exception for group health plans. (i) An... receive protected health information other than summary health information as defined in § 164.504(a) or...

Concept of Educational Assistance to Health Protection of the Individual

PubMed Central

Levanova, Elena Aleksandrovna; Kokorina, Olga Rafailovna; Nikitin, Yuriy Vladimirovich; Perepelkina, Tatiyna Vladislavovna; Segodina, Polina Anatolievna

2016-01-01

The article describes the theoretical and practical need for the development of the concept of assistance to health protection of the individual in order to address the problem of health protection of students and teachers in the conditions of a higher pedagogical education. The problem of studying human health, its entirety, systemacity and connection with the environment attracts particular attention in recent years. This was one of the reasons to study the problem of “healthy lifestyle” as the qualitative characteristic of a human life aimed at health, due to the fact that a healthy lifestyle is one of the determinants of health. This is made possible with the use of specific health-protecting technologies aimed at searching for ways and means of protection and conservation of health of students and teachers in the conditions of the educational process and using educational tools, which is currently included into the priorities of education. PMID:26493439

49 CFR 192.461 - External corrosion control: Protective coating.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false External corrosion control: Protective coating... for Corrosion Control § 192.461 External corrosion control: Protective coating. (a) Each external protective coating, whether conductive or insulating, applied for the purpose of external corrosion control...

49 CFR 192.461 - External corrosion control: Protective coating.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false External corrosion control: Protective coating... for Corrosion Control § 192.461 External corrosion control: Protective coating. (a) Each external protective coating, whether conductive or insulating, applied for the purpose of external corrosion control...

Social Isolation, Psychological Health, and Protective Factors in Adolescence

ERIC Educational Resources Information Center

Hall-Lande, Jennifer A.; Eisenberg, Marla E.; Christenson, Sandra L.; Neumark-Sztainer, Dianne

2007-01-01

This study investigates the relationships among social isolation, psychological health, and protective factors in adolescents. Feelings of social isolation may influence psychological health in adolescents, but protective factors such as family connectedness, school connectedness, and academic achievement may also play a key role. The sample…

Lifecourse Models for Ensuring Children's Health Protection

EPA Science Inventory

New knowledge about environmental risks to human reproduction and development directly relevant to children’s health protection derives from the fields of developmental and reproductive toxicology, exposure science, epidemiology, risk assessment, and public health. Together, thi...

Indian community health insurance schemes provide partial protection against catastrophic health expenditure

PubMed Central

Devadasan, Narayanan; Criel, Bart; Van Damme, Wim; Ranson, Kent; Van der Stuyft, Patrick

2007-01-01

Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE). We studied two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP) payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit packages with low maximum limits

Noise Protection

NASA Technical Reports Server (NTRS)

1980-01-01

Environmental Health Systems puts forth an increasing effort in the U.S. to develop ways of controlling noise, particularly in industrial environments due to Federal and State laws, labor union insistence and new findings relative to noise pollution impact on human health. NASA's Apollo guidance control system aided in the development of a noise protection product, SMART. The basis of all SMART products is SMART compound a liquid plastic mixture with exceptional energy/sound absorbing qualities. The basic compound was later refined for noise protection use.

Providing health care to improve community perceptions of protected areas.

PubMed

Chapman, Colin A; van Bavel, Bianca; Boodman, Carl; Ghai, Ria R; Gogarten, Jan F; Hartter, Joel; Mechak, Lauren E; Omeja, Patrick A; Poonawala, Sofia; Tuli, Dan; Goldberg, Tony L

2015-10-01

Impoverished communities often turn to illegal extraction of resources from protected areas to alleviate economic pressures or to make monetary gains. Such practices can cause ecological damage and threaten animal populations. These communities also often face a high disease burden and typically do not have access to affordable health care. Here we argue that these two seemingly separate challenges may have a common solution. In particular, providing health care to communities adjacent to protected areas may be an efficient and effective way to reduce the disease burden while also improving local perceptions about protected areas, potentially reducing illegal extraction. We present a case study of a health centre on the edge of Kibale National Park, Uganda. The centre has provided care to c. 7,200 people since 2008 and its outreach programme extends to c. 4,500 schoolchildren each year. Contrasting the provision of health care to other means of improving community perceptions of protected areas suggests that health clinics have potential as a conservation tool in some situations and should be considered in future efforts to manage protected areas.

48 CFR 2052.235-71 - Safety, health, and fire protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

....235-71 Safety, health, and fire protection. As prescribed in 2035.70(a)(2), the contracting officer... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Safety, health, and fire..., Health, and Fire Protection (JAN 1993) The contractor shall take all reasonable precautions in the...

48 CFR 2052.235-71 - Safety, health, and fire protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

....235-71 Safety, health, and fire protection. As prescribed in 2035.70(a)(2), the contracting officer... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Safety, health, and fire..., Health, and Fire Protection (JAN 1993) The contractor shall take all reasonable precautions in the...

48 CFR 2052.235-71 - Safety, health, and fire protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

....235-71 Safety, health, and fire protection. As prescribed in 2035.70(a)(2), the contracting officer... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Safety, health, and fire..., Health, and Fire Protection (JAN 1993) The contractor shall take all reasonable precautions in the...

48 CFR 2052.235-71 - Safety, health, and fire protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

....235-71 Safety, health, and fire protection. As prescribed in 2035.70(a)(2), the contracting officer... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Safety, health, and fire..., Health, and Fire Protection (JAN 1993) The contractor shall take all reasonable precautions in the...

Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

PubMed Central

Orkin, F. Mark; Meinck, Franziska; Boyes, Mark E.; Yakubovich, Alexa R.; Sherr, Lorraine

2016-01-01

Background The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. Methods We conducted a longitudinal survey of adolescents (10–18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of ‘cash’ (economic provision) and ‘care’ (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. Findings Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys’ hunger and girls’ school dropout. For tuberculosis, and for boys’ sexual exploitation and girls’ mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. Interpretation National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and

Can Social Protection Improve Sustainable Development Goals for Adolescent Health?

PubMed

Cluver, Lucie D; Orkin, F Mark; Meinck, Franziska; Boyes, Mark E; Yakubovich, Alexa R; Sherr, Lorraine

2016-01-01

The first policy action outlined in the Sustainable Development Goals (SDGs) is the implementation of national social protection systems. This study assesses whether social protection provision can impact 17 indicators of five key health-related SDG goals amongst adolescents in South Africa. We conducted a longitudinal survey of adolescents (10-18 years) between 2009 and 2012. Census areas were randomly selected in two urban and two rural health districts in two South African provinces, including all homes with a resident adolescent. Household receipt of social protection in the form of 'cash' (economic provision) and 'care' (psychosocial support) social protection, and health-related indicators within five SDG goals were assessed. Gender-disaggregated analyses included multivariate logistic regression, testing for interactions between social protection and socio-demographic covariates, and marginal effects models. Social protection was associated with significant adolescent risk reductions in 12 of 17 gender-disaggregated SDG indicators, spanning SDG 2 (hunger); SDG 3 (AIDS, tuberculosis, mental health and substance abuse); SDG 4 (educational access); SDG 5 (sexual exploitation, sexual and reproductive health); and SDG 16 (violence perpetration). For six of 17 indicators, combined cash plus care showed enhanced risk reduction effects. Two interactions showed that effects of care varied by poverty level for boys' hunger and girls' school dropout. For tuberculosis, and for boys' sexual exploitation and girls' mental health and violence perpetration, no effects were found and more targeted or creative means will be needed to reach adolescents on these challenging burdens. National social protection systems are not a panacea, but findings suggest that they have multiple and synergistic positive associations with adolescent health outcomes. Such systems may help us rise to the challenges of health and sustainable development.

The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors.

PubMed

Fredriksen-Goldsen, Karen I; Emlet, Charles A; Kim, Hyun-Jun; Muraco, Anna; Erosheva, Elena A; Goldsen, Jayn; Hoy-Ellis, Charles P

2013-08-01

Based on resilience theory, this paper investigates the influence of key health indicators and risk and protective factors on health outcomes (including general health, disability, and depression) among lesbian, gay male, and bisexual (LGB) older adults. A cross-sectional survey was conducted with LGB older adults, aged 50 and older (N = 2,439). Logistic regressions were conducted to examine the contributions of key health indicators (access to health care and health behaviors), risk factors (lifetime victimization, internalized stigma, and sexual identity concealment), and protective factors (social support and social network size) to health outcomes, when controlling for background characteristics. The findings revealed that lifetime victimization, financial barriers to health care, obesity, and limited physical activity independently and significantly accounted for poor general health, disability, and depression among LGB older adults. Internalized stigma was also a significant predictor of disability and depression. Social support and social network size served as protective factors, decreasing the odds of poor general health, disability, and depression. Some distinct differences by gender and sexual orientation were also observed. High levels of poor general health, disability, and depression among LGB older adults are of major concern. These findings highlight the important role of key risk and protective factors, which significantly influences health outcomes among LGB older adults. Tailored interventions must be developed to address the distinct health issues facing this historically disadvantaged population.

Apollo experience report: Protection of life and health

NASA Technical Reports Server (NTRS)

Wooley, B. C.

1972-01-01

The development, implementation, and effectiveness of the Apollo Lunar Quarantine Program and the Flight Crew Health Stabilization Program are discussed as part of the broad program required for the protection of the life and health of U.S. astronauts. Because the goal of the Apollo Program has been the safe transport of men to the moon and back to earth, protection of the astronauts and of the biosphere from potentially harmful lunar contaminants has been required. Also, to ensure mission success, the continuing good health of the astronauts before and during a mission has been necessary. Potential applications of specific aspects of the health and quarantine programs to possible manned missions to other planets are discussed.

Perceived prejudice in healthcare and women's health protective behavior.

PubMed

Facione, Noreen C; Facione, Peter A

2007-01-01

The literature documents significant claims of experienced prejudice in healthcare delivery in relationship to ethnicity, race, female gender, and homosexual orientation. Studies link perceived prejudice with negative healthcare outcomes, particularly in hypertension, heart disease, depression, and human immunodeficiency virus or acquired immune deficiency syndrome. To examine the impact of perceived prejudice in healthcare delivery on women's early cancer detection behavior and women's decisions to seek care for illness symptoms. Community women stratified by age, income, education, and race or ethnicity were surveyed regarding healthcare visits and cancer detection behavior. Perceived and experienced prejudice in healthcare delivery was measured by the Perceived Prejudice in Health Care Scale and follow-up interview. Experienced prejudice in healthcare delivery was linked significantly with failed adherence to cancer screening guidelines and fewer provider visits for serious illness. After controlling for demographics, experienced prejudice explained significant variance in perceived access to care. Although many who experienced prejudice in relationship to their race, income level, sexual orientation, or a combination of these returned for healthcare services, others were alienated sufficiently to decrease their health protective behavior. Subjective perceptions of prejudice are a significant influence in women's health protective behaviors. These findings demonstrate that policies requiring healthcare teams to be trained in professional ethics and cultural competence are vital to the goal of quality in care delivery and are needed to achieve optimal healthcare outcomes for women.

Relationship between basic protective health behaviours and health related quality of life in Greek urban hospital employees.

PubMed

Tountas, Yannis; Manios, Yannis; Dimitrakaki, Christine; Tzavara, Chara

2007-01-01

The study aimed to explore the association between the presence of several protective health behaviors and physical and mental wellbeing/functioning among healthy hospital employees in Greece. A randomly selected representative sample of 395 employees working in seven hospitals, both public and private, within the wider region of Athens participated in the study. Participants were assigned to the following professional categories: administrative, auxiliary and technical personnel, medical doctors and nurses. Four basic protective health behaviors were examined: following the Mediterranean diet, exercising, no smoking and moderate alcohol drinking. Employees' health related quality of life was assessed with the self-administered SF-36 generic health status measure. Technical and administrative hospital personnel reported more healthy behaviors than medical and auxiliary personnel. There was an increased likelihood of scoring higher in almost all SF-36 Physical health subscales in the accumulation of the above four protective heath behaviors. In terms of mental health, even the presence of two or more protective health behaviors significantly increase the score on most SF-36 Mental health subscales. Results indicate that the protective role of basic health behaviors extends beyond physical health to mental wellbeing.

45 CFR 164.502 - Uses and disclosures of protected health information: General rules.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Health Information § 164.502 Uses and disclosures of protected health information: General rules. (a) Standard. A covered entity or business associate may not use or disclose protected health information... protected health information as follows: (i) To the individual; (ii) For treatment, payment, or health care...

10 CFR 20.2007 - Compliance with environmental and health protection regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Compliance with environmental and health protection regulations. 20.2007 Section 20.2007 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Waste Disposal § 20.2007 Compliance with environmental and health protection regulations. Nothing...

10 CFR 20.2007 - Compliance with environmental and health protection regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Compliance with environmental and health protection regulations. 20.2007 Section 20.2007 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Waste Disposal § 20.2007 Compliance with environmental and health protection regulations. Nothing...

10 CFR 20.2007 - Compliance with environmental and health protection regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Compliance with environmental and health protection regulations. 20.2007 Section 20.2007 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Waste Disposal § 20.2007 Compliance with environmental and health protection regulations. Nothing...

10 CFR 20.2007 - Compliance with environmental and health protection regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Compliance with environmental and health protection regulations. 20.2007 Section 20.2007 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Waste Disposal § 20.2007 Compliance with environmental and health protection regulations. Nothing...

10 CFR 20.2007 - Compliance with environmental and health protection regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Compliance with environmental and health protection regulations. 20.2007 Section 20.2007 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Waste Disposal § 20.2007 Compliance with environmental and health protection regulations. Nothing...

Law on the protection of public health, 30 June 1989.

PubMed

1989-01-01

This document contains major provisions of Viet Nam's 1989 law on the protection of public health. Chapter 1 sets out the rights of citizens to health care and health-promoting activities and environments as well as the obligations of citizens to implement the public health provisions of the law. Chapter 7 covers maternal-child health care and family planning (FP). Individuals may choose their method of birth control, and couples should have no more than two children. Coercion in the implementation of FP is forbidden. Women have the right to abortion and to reproductive health care. Abortions and IUD removals must be performed by licensed individuals. Employers of women must respect reproductive health policies dealing with pregnancy, child birth, breast feeding, and FP. Women may not be employed in arduous jobs or in jobs that are harmful to health. Health services for children will be expanded to provide necessary services, and parents must see that their children have the appropriate examinations and immunizations. The care of handicapped children will be organized by the Ministry of Health and the Minister of Labour, War Invalids, and Social Affairs.

Protective effect of intradermal BCG against leprosy; a case-control study in central Brazil.

PubMed

Rodrigues, M L; Silva, S A; Neto, J C; de Andrade, A L; Martelli, C M; Zicker, F

1992-09-01

A case-control study was undertaken to evaluate the protective efficacy of intradermal BCG against leprosy in a high-endemic area of leprosy in central Brazil. Sixty-two cases and 186 controls were included in the study. Cases were all newly diagnosed leprosy patients under 16 years of age attending an outpatient health service, and all of them were schoolchildren. Three controls under 16 years old, frequency matched by sex and age group, were selected from schools geographically located in the area from which the cases came. The presence of BCG was negatively associated with leprosy, indicating a 5.3 risk of leprosy for those nonvaccinated and protective efficacy of 81%. Paucibacillary patients were more likely to have a BCG scar than multibacillary patients.

[Financial protection in health: updates for Mexico to 2014].

PubMed

Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar

2016-06-01

Objetive: Document financial protection in health in Mexico up to 2014. We up date the measures of impoverishing and catastrophic health expenditure to 2014, to analyse shifts since the implementation of the System for Social Protection in Health and the Seguro Popular using time series data from the Household Income and Expenditure Survey. Between 2004 and 2014 there has been a continued improvement in levels of financial protection. Excessive expenditure reached its lowest point: -2.0% in 2012 and 2.1% in 2014. Impoverishing expenditure dropped to 1.3% in 2004, compared to 0.5% in 2014, and catastrophic expenditures from 2.7% to 2.1%. The time series of data on financial protection show a clear pattern of improvement between 2000 and 2014 and level off and low levels in 2012 and 2014. Still, levels continue to be relatively high for households in the poorest quintile, in rural areas and with an elderly person.

Effects of a health-educational and psychological intervention on socio-cognitive determinants of skin protection behaviour in individuals with occupational dermatoses.

PubMed

Matterne, Uwe; Diepgen, Thomas L; Weisshaar, Elke

2010-02-01

Occupational skin diseases are a significant public health concern. Little is known about the cognitive representations individuals with occupational skin disease have towards measures of personal skin protection and occupational safety and whether they change during an intervention. We aimed to evaluate whether social cognitions as embodied by the theory of planned behaviour become more favourable during a tertiary inpatient individual prevention programme (TIP) and whether the model's predictions hold in a setting to which the model has not been applied. We used a longitudinal design. A questionnaire, assessing the theory of planned behaviour variables attitude, subjective and descriptive norm, perceived behavioural control and behavioural intention was developed and administered to 101 patients before (at admission) and after (at discharge) a 3-week inpatient TIP. The scales showed good internal consistency. Before the TIP, patients had favourable cognitions towards skin protection measures and these improved during the TIP. Attitude, perceived behavioural control and intention to perform skin protection significantly increased during TIP. Attitude and perceived behavioural control were significant predictors of behavioural intention in multiple regression analyses with perceived behavioural control being the strongest predictor in the equations. Descriptive norm was a significant predictor of intention only at admission but not at discharge. This is the first study attempting to explain the motivation to perform skin protection measures in patients with occupational skin disease by applying an otherwise well established health-behaviour theory. The results emphasise the importance of health-educational and psychological interventions for patients with occupational skin disease. Promoting personal control over and attitudes towards skin protection measures may enhance the occupational health of individuals with occupational skin disease.

45 CFR 164.502 - Uses and disclosures of protected health information: general rules.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Health Information § 164.502 Uses and disclosures of protected health information: general rules. (a) Standard. A covered entity may not use or disclose protected health information, except as permitted or.... A covered entity is permitted to use or disclose protected health information as follows: (i) To the...

History of children's environmental health protection at EPA

EPA Pesticide Factsheets

In 1995 the Environmental Protection Agency was directed to explicitly and consistently take into account environmental health risks to infants and children in all risk characterizations and public health standards set for the United States.

Safety survey report EBR-II safety survey, ANL-west health protection, industrial safety and fire protection survey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dunbar, K.A.

1972-01-10

A safety survey covering the disciplines of Reactor Safety, Nuclear Criticality Safety, Health Protection and Industrial Safety and Fire Protection was conducted at the ANL-West EBR-II FEF Complex during the period January 10-18, 1972. In addition, the entire ANL-West site was surveyed for Health Protection and Industrial Safety and Fire Protection. The survey was conducted by members of the AEC Chicago Operations Office, a member of RDT-HQ and a member of the RDT-ID site office. Eighteen recommendations resulted from the survey, eleven in the area of Industrial Safety and Fire Protection, five in the area of Reactor Safety and twomore » in the area of Nuclear Criticality Safety.« less

Monitoring and Protecting Health and Human Rights in Mexico.

PubMed

Gómez-Dantés; Frenk; Zorrilla

1995-01-01

This paper describes a unique system through which health care-related human rights are now being monitored and protected in Mexico. Based on the ombudsman concept, the system focuses on identifying and responding to violations of human rights and dignity which may occur in the context of health care delivery. Experience thus far has been encouraging; the Mexican population has identified and used the National Commission of Human Rights as a forum for a variety of health-related complaints. The Mexican system, while requiring strengthening and expansion, is an effort to integrate the monitoring and protection of health-related human rights into the broader field of human rights work in Mexico.

[Occupational health protection in business economics--business plan for health intervention].

PubMed

Rydlewska-Liszkowska, Izabela

2011-01-01

One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

49 CFR 192.463 - External corrosion control: Cathodic protection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false External corrosion control: Cathodic protection. 192.463 Section 192.463 Transportation Other Regulations Relating to Transportation (Continued... for Corrosion Control § 192.463 External corrosion control: Cathodic protection. (a) Each cathodic...

49 CFR 192.463 - External corrosion control: Cathodic protection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false External corrosion control: Cathodic protection. 192.463 Section 192.463 Transportation Other Regulations Relating to Transportation (Continued... for Corrosion Control § 192.463 External corrosion control: Cathodic protection. (a) Each cathodic...

49 CFR 192.463 - External corrosion control: Cathodic protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false External corrosion control: Cathodic protection. 192.463 Section 192.463 Transportation Other Regulations Relating to Transportation (Continued... for Corrosion Control § 192.463 External corrosion control: Cathodic protection. (a) Each cathodic...

49 CFR 192.463 - External corrosion control: Cathodic protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false External corrosion control: Cathodic protection. 192.463 Section 192.463 Transportation Other Regulations Relating to Transportation (Continued... for Corrosion Control § 192.463 External corrosion control: Cathodic protection. (a) Each cathodic...

49 CFR 192.463 - External corrosion control: Cathodic protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false External corrosion control: Cathodic protection. 192.463 Section 192.463 Transportation Other Regulations Relating to Transportation (Continued... for Corrosion Control § 192.463 External corrosion control: Cathodic protection. (a) Each cathodic...

[The right to have health protection].

PubMed

Mayer-Serra, Carlos Elizondo

2007-01-01

This article intends to analyze how the health good or the right to have health protection should be distributed, following the definition established by the Mexican Constitution. This legal definition will be contrasted with the way in which the expenditure on health is actually distributed and financed, and the implications of this. The distribution of this expenditure, in turn, will be compared to another social good of great relevance: education, which consumes an even larger proportion of the national fiscal resources. Finally, the article will suggest a possible explanation for this fact and provide some ideas regarding its implications.

Financial protection in health in Turkey: the effects of the Health Transformation Programme.

PubMed

Yardim, Mahmut S; Cilingiroglu, Nesrin; Yardim, Nazan

2014-03-01

Financial protection should be the principal objective of any health system. Commonly used indicators for financial protection are out-of-pocket (OOP) payments as a share of total health expenditure and the amount of households driven into poverty by catastrophic health expenditures (CHEs). In the last decade, OOP health payments consisted of approximately one-fifth of the health finance resources in Turkey. Until the year 2008, Turkish health system covered different public and private financing programmes as well as different types of service provision. After 2008, universal financial coverage became a part of the Health Transformation Programme (HTP). This study aimed to evaluate the financial protection in health in the era of health reforms in Turkey between 2003 and 2009. Household expenditures were derived from nationally representative Turkish Household Budget Surveys (HBSs), 2003, 2006 and 2009. Proportion of households facing CHE and impoverishment are calculated by using the methodology proposed by Ke Xu. Probability of incurring and volume of OOP spending were assessed across the health insurance groups by two-part model approach using logistic and OLS regression methods. Our findings showed that the probability of incurring and volume of OOP spending increased gradually in publicly insured households between 2003 and 2009. However, there was a diminishing trend in CHE in Turkey during the period under consideration. The official data showing an ∼3-fold increase in per capita health care use since 2003 and our study findings on decreasing CHE in this period can be interpreted as positive impact of HTP. On the other hand, increased household consumption as a share of OOP health payment and the deterioration in the progressivity of OOP spending in this period should be monitored closely.

Personal Protective Equipment Supply Chain: Lessons Learned from Recent Public Health Emergency Responses.

PubMed

Patel, Anita; D'Alessandro, Maryann M; Ireland, Karen J; Burel, W Greg; Wencil, Elaine B; Rasmussen, Sonja A

Personal protective equipment (PPE) that protects healthcare workers from infection is a critical component of infection control strategies in healthcare settings. During a public health emergency response, protecting healthcare workers from infectious disease is essential, given that they provide clinical care to those who fall ill, have a high risk of exposure, and need to be assured of occupational safety. Like most goods in the United States, the PPE market supply is based on demand. The US PPE supply chain has minimal ability to rapidly surge production, resulting in challenges to meeting large unexpected increases in demand that might occur during a public health emergency. Additionally, a significant proportion of the supply chain is produced off-shore and might not be available to the US market during an emergency because of export restrictions or nationalization of manufacturing facilities. Efforts to increase supplies during previous public health emergencies have been challenging. During the 2009 H1N1 influenza pandemic and the 2014 Ebola virus epidemic, the commercial supply chain of pharmaceutical and healthcare products quickly became critical response components. This article reviews lessons learned from these responses from a PPE supply chain and systems perspective and examines ways to improve PPE readiness for future responses.

[Telematics in the public health sector. Where is the protection of health data?].

PubMed

Voßhoff, Andrea; Raum, Bertram; Ernestus, Walter

2015-10-01

There is a long history of telematics in the German health system. Apart from the growing technical possibilities in the field, it is important to concentrate on the protection of health data in telematics applications. Health data in the hands of service providers or other third parties entails certain risks for the patient's personality rights, because these institutions may not be bound by the practice of medical confidentiality. In addition, big data processing risks make the individual lives of patients and insured persons totally transparent. Measures to reduce these risks have to be taken by the providers as well as by the users of telematics infrastructure; they are the ones who should explicitly address the relevant risks and dangers in a data protection and IT-security concept and develop adequate strategies to cope with these dangers. Additionally, the German legislator remains obliged to create a regulatory framework for the protection of patients' rights.

Office of Children's Health Protection: Publications Catalog (August 2010)

EPA Pesticide Factsheets

2010 list of all materials from the EPA Office of Children's Health Protection. Categories: general environmental health, climate change, air quality, pesticides, water, fish consumption, schools, lead.

Low dose radiation adaptive protection to control neurodegenerative diseases.

PubMed

Doss, Mohan

2014-05-01

Concerns have been expressed recently regarding the observed increased DNA damage from activities such as thinking and exercise. Such concerns have arisen from an incomplete accounting of the full effects of the increased oxidative damage. When the effects of the induced adaptive protective responses such as increased antioxidants and DNA repair enzymes are taken into consideration, there would be less endogenous DNA damage during the subsequent period of enhanced defenses, resulting in improved health from the thinking and exercise activities. Low dose radiation (LDR), which causes oxidative stress and increased DNA damage, upregulates adaptive protection systems that may decrease diseases in an analogous manner. Though there are ongoing debates regarding LDR's carcinogenicity, with two recent advisory committee reports coming to opposite conclusions, data published since the time of the reports have overwhelmingly ruled out its carcinogenicity, paving the way for consideration of its potential use for disease reduction. LDR adaptive protection is a promising approach to control neurodegenerative diseases, for which there are no methods of prevention or cure. Preparation of a compelling ethics case would pave the way for LDR clinical studies and progress in dealing with neurodegenerative diseases.

32 CFR 228.2 - Control of activities on protected property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Control of activities on protected property. 228... DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.2 Control of activities on protected property. Persons in and on protected property shall at all times comply with official signs of a...

32 CFR 228.2 - Control of activities on protected property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Control of activities on protected property. 228... DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.2 Control of activities on protected property. Persons in and on protected property shall at all times comply with official signs of a...

32 CFR 228.2 - Control of activities on protected property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Control of activities on protected property. 228... DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.2 Control of activities on protected property. Persons in and on protected property shall at all times comply with official signs of a...

32 CFR 228.4 - Control of vehicles on protected property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Control of vehicles on protected property. 228.4... (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.4 Control of vehicles on protected property. Drivers of all vehicles entering or while on protected property shall comply with the signals and...

32 CFR 228.4 - Control of vehicles on protected property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Control of vehicles on protected property. 228.4... (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.4 Control of vehicles on protected property. Drivers of all vehicles entering or while on protected property shall comply with the signals and...

32 CFR 228.4 - Control of vehicles on protected property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Control of vehicles on protected property. 228.4... (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.4 Control of vehicles on protected property. Drivers of all vehicles entering or while on protected property shall comply with the signals and...

32 CFR 228.2 - Control of activities on protected property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Control of activities on protected property. 228... DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.2 Control of activities on protected property. Persons in and on protected property shall at all times comply with official signs of a...

32 CFR 228.4 - Control of vehicles on protected property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Control of vehicles on protected property. 228.4... (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.4 Control of vehicles on protected property. Drivers of all vehicles entering or while on protected property shall comply with the signals and...

Experiences Recruiting Indian Worksites for an Integrated Health Protection and Health Promotion Randomized Control Trial in Maharashtra, India

ERIC Educational Resources Information Center

Shulman Cordeira, L.; Pednekar, M. S.; Nagler, E. M.; Gautam, J.; Wallace, L.; Stoddard, A. M.; Gupta, P. C.; Sorensen, G. C.

2015-01-01

This article provides an overview of the recruitment strategies utilized in the Mumbai Worksites Tobacco Control Study, a cluster randomized trial testing the effectiveness of an integrated tobacco control and occupational safety and health program in Indian manufacturing worksites. From June 2012 to June 2013, 20 companies were recruited.…

78 FR 48683 - National Institute for Occupational Safety and Health (NIOSH) Personal Protective Technology (PPT...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... comments should be formatted as Microsoft Word. Please make reference to CDC-2013-0016 and Docket Number... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [CDC-2013-0016... Protective Equipment: 2013-2018'', now available for public comment at http://www.regulations.gov . DATES...

Legal protections to promote response willingness among the local public health workforce.

PubMed

Rutkow, Lainie; Vernick, Jon S; Thompson, Carol B; Piltch-Loeb, Rachael; Barnett, Daniel J

2015-04-01

The legal environment may improve response willingness among local health department (LHD) workers. We examined whether 3 hypothetical legal protections influence LHD workers' self-reported response willingness for 4 emergency scenarios and whether specific demographic factors are associated with LHD workers' response willingness given these legal protections. Our 2011-2012 survey included questions on demographics and about attitudes and beliefs regarding LHD workers' willingness to respond to 4 emergency scenarios given specific legal protections (i.e., ensuring priority health care for workers' families, granting workers access to mental health services, and guaranteeing access to personal protective equipment). Data were collected from 1238 LHD workers in 3 states. Across scenarios, between 60% and 83% of LHD workers agreed that they would be more willing to respond given the presence of 1 of the 3 hypothetical legal protections. Among the 3 legal protections, a guarantee of personal protective equipment elicited the greatest agreement with improved response willingness. Specific legal protections augment a majority of LHD workers' response willingness. Policymakers must, however, balance improved response willingness with other considerations, such as the ethical implications of prioritizing responders over the general public. (Disaster Med Public Health Preparedness. 2015;9:98-102).

Large-scale Health Information Database and Privacy Protection.

PubMed

Yamamoto, Ryuichi

2016-09-01

Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients' medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

Pesticide management approach towards protecting the safety and health of farmers in Southeast Asia.

PubMed

Mohammad, Norsyazwani; Abidin, Emilia Zainal; How, Vivien; Praveena, Sarva Mangala; Hashim, Zailina

2018-06-27

It is estimated that pesticide production and use have increased continuously in the countries of Southeast Asia in recent years. Within the context of protecting the safety and health of workers in the agricultural sector, there is an existing gap in the implementation of the pesticide management framework because safety and health effects arising from occupational exposures continue to be reported. This study aims to provide narrative similarities, differences and weaknesses of the existing pesticide management system in Southeast Asian countries (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam) within the context of occupational safety and health. This is preliminary traditional review study. Pesticide regulation and management at the country level were identified using web-based search engines such as Scopus, ScienceDirect, PubMed and Google. Book, reports, legislation document and other documents retrieved were also gathered from international organizations and specific websites of governmental agency in Southeast Asian countries. The scope of this review is only limited to literature written in English. In total, 44 review articles, reports and documents were gathered for this study. The approach of pesticide management in protecting safety and health in the agricultural setting were benchmarked according to the elements introduced by the United States Environmental Protection Agency, namely, (1) the protection of workers and (2) the practice of safety. All countries have assigned a local authority and government organization to manage and control pesticide use in the agricultural sector. The countries with the highest usage of pesticide are Thailand, Philippines and Malaysia. Most Southeast Asian countries have emphasized safety practice in the management of pesticide usage, but there were less emphasis on the element of protection of workers within the framework in Indonesia, Myanmar, Thailand and Vietnam

45 CFR 164.520 - Notice of privacy practices for protected health information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.520 Notice of privacy practices for protected health information. (a) Standard... 45 Public Welfare 1 2014-10-01 2014-10-01 false Notice of privacy practices for protected health...

78 FR 60874 - National Institute for Occupational Safety and Health Personal Protective Technology Program and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [CDC-2013-0015... extension of comment period. SUMMARY: On August 14, 2013, the Director of the National Institute for... September 17, 2013 to provide (1) a summary of the work conducted by the NIOSH Personal Protective...

The role of narcissism in health-risk and health-protective behaviors.

PubMed

Hill, Erin M

2016-09-01

This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors. © The Author(s) 2015.

What factors can be protective for both self-rated oral health and general health?

PubMed

Ekbäck, Gunnar; Persson, Carina; Lindén-Boström, Margareta

2015-01-01

The aim of this study was to analyze if the same protective factors are significant for both self-rated health and oral health. It was hypothesized that these factors should be the same. The material is based on a population sample of 17 113 women and men aged 18-84 years in one county in central Sweden.The response rate was 61%. The data were collected through a postal questionnaire "Life and Health" in 2008. The questionnaire comprised of 149 questions and was divided into a number of areas, e.g. socioeconomic conditions, quality of life, social relations, lifestyle, and health. To analyze the strength of the protective factors whilst taking into account the relationships between the various independent variables, multivariate analyses were conducted using binary multiple logistic regression. The outcome measures with the strongest association to general health is belonging to the age group 18-34 years, positive faith in the future, good sleeping pattern and to be employed/self-employed/retired. The outcomes with the strongest association to oral health are good finances, belonging to the age group 18-34 years, to be born in Sweden and positive faith in the future. Conclusions. This study shows that, in general, the same protective factors are significant for both self-rated health and self-rated oral health, making it possible to use the same approach to strengthen both general health and oral health. One important outcome, not often considered, is having positive faith in the future. It is a task for the health care system to strengthen people's faith in the future, partly through a very high quality care when needed, but also through active health promotion that increases the chances of a healthy life, both from a public health perspective as from an oral health perspective.

45 CFR 164.526 - Amendment of protected health information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Amendment of protected health information. 164.526 Section 164.526 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164...

45 CFR 164.526 - Amendment of protected health information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Amendment of protected health information. 164.526 Section 164.526 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164...

45 CFR 164.526 - Amendment of protected health information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Amendment of protected health information. 164.526 Section 164.526 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164...

45 CFR 164.526 - Amendment of protected health information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Amendment of protected health information. 164.526 Section 164.526 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164...

Protecting patients with cardiovascular diseases from catastrophic health expenditure and impoverishment by health finance reform.

PubMed

Sun, Jing; Liabsuetrakul, Tippawan; Fan, Yancun; McNeil, Edward

2015-12-01

To compare the incidences of catastrophic health expenditure (CHE) and impoverishment, the risk protection offered by two health financial reforms and to explore factors associated with CHE and impoverishment among patients with cardiovascular diseases (CVDs) in rural Inner Mongolia, China. Cross-sectional study conducted in 2014 in rural Inner Mongolia, China. Patients with CVDs aged over 18 years residing in the sample areas for at least one year were eligible. The definitions of CHE and impoverishment recommended by WHO were adopted. The protection of CHE and impoverishment was compared between the New Cooperative Medical Scheme (NCMS) alone and NCMS plus National Essential Medicines Scheme (NEMS) using the percentage change of incidences for CHE and impoverishment. Logistic regression was used to explore factors associated with CHE and impoverishment. The incidences of CHE and impoverishment under NCMS plus NEMS were 11.26% and 3.30%, respectively, which were lower than those under NCMS alone. The rates of protection were higher among households with patients with CVDs covered by NCMS plus NEMS (25.68% and 34.65%, respectively). NCMS plus NEMS could protect the poor households more from CHE but not impoverishment. NCMS plus NEMS protected more than one-fourth of households from CHE and more than one-third from impoverishment. NCMS plus NEMS was more effective at protecting households with patients with CVDs from CHE and impoverishment than NCMS alone. An integration of NCMS with NEMS should be expanded. However, further strategies to minimise catastrophic health expenditure after this health finance reform are still needed. © 2015 John Wiley & Sons Ltd.

Evaluation of influenza prevention in the workplace using a personally controlled health record: randomized controlled trial.

PubMed

Bourgeois, Florence T; Simons, William W; Olson, Karen; Brownstein, John S; Mandl, Kenneth D

2008-03-14

Personally controlled health records (PCHRs) are accessible over the Internet and allow individuals to maintain and manage a secure copy of their medical data. These records provide a new opportunity to provide customized health recommendations to individuals based on their record content. Health promotion programs using PCHRs can potentially be used in a variety of settings and target a large range of health issues. The aim was to assess the value of a PCHR in an employee health promotion program for improving knowledge, beliefs, and behavior around influenza prevention. We evaluated a PCHR-based employee health promotion program using a randomized controlled trial design. Employees at Hewlett Packard work sites who reported reliable Internet access and email use at least once every 2 days were recruited for participation. PCHRs were provided to all participants for survey administration, and tailored, targeted health messages on influenza illness and prevention were delivered to participants in the intervention group. Participants in the control group received messages addressing cardiovascular health and sun protection. The main outcome measure was improvement in knowledge, beliefs, and behavior around influenza prevention. Secondary outcomes were influenza vaccine rates among household members, the impact of cardiovascular health and sun protection messages on the control group, and the usability and utility of the PCHR-based program for employees. The intervention did not have a statistically significant effect on the influenza knowledge elements we assessed but did impact certain beliefs surrounding influenza. Participants in the intervention group were more likely to believe that the influenza vaccine was effective (OR = 5.6; 95% CI = 1.7-18.5), that there were actions they could take to prevent the flu (OR = 3.2; 95% CI = 1.1-9.2), and that the influenza vaccine was unlikely to cause a severe reaction (OR = 4.4; 95% CI = 1.3-15.3). Immunization rates did

Control and protection system for paralleled modular static inverter-converter systems

NASA Technical Reports Server (NTRS)

Birchenough, A. G.; Gourash, F.

1973-01-01

A control and protection system was developed for use with a paralleled 2.5-kWe-per-module static inverter-converter system. The control and protection system senses internal and external fault parameters such as voltage, frequency, current, and paralleling current unbalance. A logic system controls contactors to isolate defective power conditioners or loads. The system sequences contactor operation to automatically control parallel operation, startup, and fault isolation. Transient overload protection and fault checking sequences are included. The operation and performance of a control and protection system, with detailed circuit descriptions, are presented.

32 CFR 228.2 - Control of activities on protected property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Control of activities on protected property. 228.2 Section 228.2 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.2 Control of activities on protected...

32 CFR 228.4 - Control of vehicles on protected property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Control of vehicles on protected property. 228.4 Section 228.4 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.4 Control of vehicles on protected property...

Protecting children: intuition and awareness in the work of health visitors.

PubMed

Ling, M S; Luker, K A

2000-09-01

Protecting children: intuition and awareness in the work of health visitors This paper is based upon an ethnographic study of a group of health visitors engaged in child protection work. The purpose of this paper is to explore the meanings individual health visitors attach to events concerned with identifying children who may be at risk of harm from child abuse, and also the idiosyncratic nature of health visiting in this complex but everyday social situation. The paper focuses on understanding the importance of a particular form of knowledge which the health visitors referred to as 'intuitive awareness'.

Longitudinal Effects of Health-Harming and Health-Protective Behaviors within Adolescent Romantic Dyads

PubMed Central

Aalsma, Matthew C.; Carpentier, Melissa; Azzouz, Faouzi; Fortenberry, Dennis

2012-01-01

Most models exploring adolescent health behavior have focused on individual influences to understand behavior change. The goal of the current study was to assess the role of adolescent romantic partners on the expression of health behavior. Our sample utilized two waves of data from the US National Longitudinal Study of Adolescent Health (1994, 1996), which included 80 romantic dyads (160 individuals). A longitudinal multilevel analysis was conducted. We assessed individual and romantic partner health-harming behaviors (i.e., delinquency, alcohol use, smoking, and marijuana use), health-protective behaviors (i.e., physical activity, physical inactivity, sleep patterns, seatbelt use, and contraception motivations), as well as the role of gender and age. Participants average age was 16 years at baseline. We found evidence for partner similarity and partner influence with the majority of health-harming behaviors. Specifically, partner influence was evident for smoking and alcohol use with partner influence approaching significance for marijuana use. We found limited evidence for partner similarity and partner influence for health-protective behaviors. The importance of assessing romantic dyads was evident in these data. Interventions focusing on health-harming behavior for adolescent populations are important public health goals. It is recommended that future intervention efforts with adolescent health-harming behaviors should target not only peers, but also consider the role of romantic partners. PMID:22424832

Effectiveness of a pragmatic school-based universal intervention targeting student resilience protective factors in reducing mental health problems in adolescents.

PubMed

Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wolfenden, Luke; Richards, Jody; Leane, Catherine; Green, Sue; Lecathelinais, Christophe; Oldmeadow, Christopher; Attia, John; Gillham, Karen; Wiggers, John

2017-06-01

Worldwide, 10-20% of adolescents experience mental health problems. Strategies aimed at strengthening resilience protective factors provide a potential approach for reducing mental health problems in adolescents. This study evaluated the effectiveness of a universal, school-based intervention targeting resilience protective factors in reducing mental health problems in adolescents. A cluster randomised controlled trial was conducted in 20 intervention and 12 control secondary schools located in socio-economically disadvantaged areas of NSW, Australia. Data were collected from 3115 students at baseline (Grade 7, 2011), of whom 2149 provided data at follow up (Grade 10, 2014; enrolments in Grades 7 to 10 typically aged 12-16 years; 50% male; 69.0% retention). There were no significant differences between groups at follow-up for three mental health outcomes: total SDQ, internalising problems, and prosocial behaviour. A small statistically significant difference in favour of the control group was found for externalising problems. Findings highlight the continued difficulties in developing effective, school-based prevention programs for mental health problems in adolescents. ANZCTR (Ref no: ACTRN12611000606987). Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Official control of plant protection products in Poland: detection of illegal products.

PubMed

Miszczyk, Marek; Płonka, Marlena; Stobiecki, Tomasz; Kronenbach-Dylong, Dorota; Waleczek, Kazimierz; Weber, Roland

2018-04-03

Market presence of illegal and counterfeit pesticides is now a global problem. According to data published in 2012 by the European Crop Protection Association (ECPA), illegal products represent over 10% of the global market of plant protection products. Financial benefits are the main reason for the prevalence of this practice. Counterfeit and illegal pesticides may contain substances that may pose a threat to the environment, crops, animals, and humans, inconsistent with the label and registration dossier. In Poland, action against illegal and counterfeit plant protection products is undertaken by the Main Inspectorate of Plant Health and Seed Inspection (PIORiN), the police, the prosecution, and the pesticide producers. Results of chemical analyses carried out by the Institute of Plant Protection - National Research Institute Sośnicowice Branch, Pesticide Quality Testing Laboratory (PQTL IPP-NRI Sosnicowice Branch) indicate that a majority of illegal pesticides in Poland are detected in the group of herbicides. Products from parallel trade tend to have the most irregularities. This article describes the official quality control system of plant protection products in Poland and presents the analytical methods for testing pesticides suspected of adulteration and recent test results.

A privacy protection for an mHealth messaging system

NASA Astrophysics Data System (ADS)

Aaleswara, Lakshmipathi; Akopian, David; Chronopoulos, Anthony T.

2015-03-01

In this paper, we propose a new software system that employs features that help the organization to comply with USA HIPAA regulations. The system uses SMS as the primary way of communication to transfer information. Lack of knowledge about some diseases is still a major reason for some harmful diseases spreading. The developed system includes different features that may help to communicate amongst low income people who don't even have access to the internet. Since the software system deals with Personal Health Information (PHI) it is equipped with an access control authentication system mechanism to protect privacy. The system is analyzed for performance to identify how much overhead the privacy rules impose.

Personal health record systems and their security protection.

PubMed

Win, Khin Than; Susilo, Willy; Mu, Yi

2006-08-01

The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.

Protecting Home Health Care Workers: A Challenge to Pandemic Influenza Preparedness Planning

PubMed Central

McPhaul, Kathleen; Phillips, Sally; Gershon, Robyn; Lipscomb, Jane

2009-01-01

The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities. Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care. We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process. PMID:19461108

Protecting Labor Rights: Roles for Public Health

PubMed Central

Gaydos, Megan; Yu, Karen; Weintraub, June

2013-01-01

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards. PMID:24179278

Protecting labor rights: roles for public health.

PubMed

Bhatia, Rajiv; Gaydos, Megan; Yu, Karen; Weintraub, June

2013-11-01

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some public health agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine public health functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards.

Evaluation of a model training program for respiratory-protection preparedness at local health departments.

PubMed

Alfano-Sobsey, Edie; Kennedy, Bobby; Beck, Frank; Combs, Brian; Kady, Wendy; Ramsey, Steven; Stockweather, Allison; Service, Will

2006-04-01

Respiratory-protection programs have had limited application in local health departments and have mostly focused on protecting employees against exposure to tuberculosis (TB). The need to provide the public health workforce with effective respiratory protection has, however, been underscored by recent concerns about emerging infectious diseases, bioterrorism attacks, drug-resistant microbes, and environmental exposures to microbial allergens (as in recent hurricane flood waters). Furthermore, OSHA has revoked the TB standard traditionally followed by local health departments, replacing it with a more stringent regulation. The additional OSHA requirements may place increased burdens on health departments with limited resources and time. For these reasons, the North Carolina Office of Public Health Preparedness and Response and industrial hygienists of the Public Health Regional Surveillance Teams have developed a training program to facilitate implementation of respiratory protection programs at local health departments. To date, more than 1,400 North Carolina health department employees have been properly fit-tested for respirator use and have received training in all aspects of respiratory protection. This article gives an overview of the development and evaluation of the program. The training approach presented here can serve as a model that other health departments and organizations can use in implementing similar respiratory-protection programs.

[Survey on individual occupational health protection behaviors of welding workers using theory of reasoned action].

PubMed

Xing, Ming-luan; Zhou, Xu-dong; Yuan, Wei-ming; Chen, Qing; Zhang, Mei-bian; Zou, Hua; Zhao, Hai-ying

2012-03-01

To apply theory of reasoned action at survey on welding workers occupational health protection behaviors and explore related influencing factors. nine companies were randomly selected from areas with many welding works in Zhejiang Province. All welding workers were surveyed using a questionnaire based on theory of reasoned action. 10.06%, 26.80% and 37.50% of the respondents never or seldom used eyeshade, mask and earplug, respectively. After controlling the socio-demographic factors, welding workers' behavioral belief was correlated with the behaviors of eyeshade-mask and earplug use (χ(2) = 31.88, 18.77 and 37.77, P < 0.01). the subjective norm of company was correlated with all protection behaviors (χ(2) = 20.60, 10.98 and 19.86, P < 0.01), the subjective norm of colleague was correlated with mask and earplug use, (χ(2) = 27.43, 36.39, P < 0.01), and the subjective norm of family was correlated with mask use (χ(2) = 5.73, P < 0.05). Theory of reasoned action is suitable for welding worker occupational health related behaviors. It is useful to improve occupational health education, to effectively select health education objective and to tailor health education contents.

Development of a Health-Protective Drinking Water Level for Perchlorate

PubMed Central

Ting, David; Howd, Robert A.; Fan, Anna M.; Alexeeff, George V.

2006-01-01

We evaluated animal and human toxicity data for perchlorate and identified reduction of thyroidal iodide uptake as the critical end point in the development of a health-protective drinking water level [also known as the public health goal (PHG)] for the chemical. This work was performed under the drinking water program of the Office of Environmental Health Hazard Assessment of the California Environmental Protection Agency. For dose–response characterization, we applied benchmark-dose modeling to human data and determined a point of departure (the 95% lower confidence limit for 5% inhibition of iodide uptake) of 0.0037 mg/kg/day. A PHG of 6 ppb was calculated by using an uncertainty factor of 10, a relative source contribution of 60%, and exposure assumptions specific to pregnant women. The California Department of Health Services will use the PHG, together with other considerations such as economic impact and engineering feasibility, to develop a California maximum contaminant level for perchlorate. We consider the PHG to be adequately protective of sensitive subpopulations, including pregnant women, their fetuses, infants, and people with hypothyroidism. PMID:16759989

Evaluation of Influenza Prevention in the Workplace Using a Personally Controlled Health Record: Randomized Controlled Trial

PubMed Central

Simons, William W; Olson, Karen; Brownstein, John S; Mandl, Kenneth D

2008-01-01

Background Personally controlled health records (PCHRs) are accessible over the Internet and allow individuals to maintain and manage a secure copy of their medical data. These records provide a new opportunity to provide customized health recommendations to individuals based on their record content. Health promotion programs using PCHRs can potentially be used in a variety of settings and target a large range of health issues. Objectives The aim was to assess the value of a PCHR in an employee health promotion program for improving knowledge, beliefs, and behavior around influenza prevention. Methods We evaluated a PCHR-based employee health promotion program using a randomized controlled trial design. Employees at Hewlett Packard work sites who reported reliable Internet access and email use at least once every 2 days were recruited for participation. PCHRs were provided to all participants for survey administration, and tailored, targeted health messages on influenza illness and prevention were delivered to participants in the intervention group. Participants in the control group received messages addressing cardiovascular health and sun protection. The main outcome measure was improvement in knowledge, beliefs, and behavior around influenza prevention. Secondary outcomes were influenza vaccine rates among household members, the impact of cardiovascular health and sun protection messages on the control group, and the usability and utility of the PCHR-based program for employees. Results The intervention did not have a statistically significant effect on the influenza knowledge elements we assessed but did impact certain beliefs surrounding influenza. Participants in the intervention group were more likely to believe that the influenza vaccine was effective (OR = 5.6; 95% CI = 1.7-18.5), that there were actions they could take to prevent the flu (OR = 3.2; 95% CI = 1.1-9.2), and that the influenza vaccine was unlikely to cause a severe reaction (OR = 4.4; 95% CI

2004 Children's Health Protection Advisory Committee Meeting Agendas

EPA Pesticide Factsheets

Objectives for the three meetings in 2004 include discussing schools-related work, mercury regulation, the Food Quality Protection Act, Children's Health Indicators, early life exposure to carcinogens, and smart growth.

Planetary health: protecting human health on a rapidly changing planet.

PubMed

Myers, Samuel S

2018-12-23

The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health. I highlight several overarching themes that emerge from planetary health and suggest advances in the way we train, reward, promote, and fund the generation of health scientists who will be tasked with breaking out of their disciplinary silos to address this urgent constellation of health threats. I propose that protecting the health of future generations requires taking better care of Earth's natural systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Financial risk protection and universal health coverage: evidence and measurement challenges.

PubMed

Saksena, Priyanka; Hsu, Justine; Evans, David B

2014-09-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.

Economic Shocks and Public Health Protections in US Metropolitan Areas

PubMed Central

Hogg, Rachel A.

2015-01-01

Objectives. We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods. The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results. Public health activities fell by nearly 5% in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25% of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions. Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns. PMID:25689201

Large-scale Health Information Database and Privacy Protection*1

PubMed Central

YAMAMOTO, Ryuichi

2016-01-01

Japan was once progressive in the digitalization of healthcare fields but unfortunately has fallen behind in terms of the secondary use of data for public interest. There has recently been a trend to establish large-scale health databases in the nation, and a conflict between data use for public interest and privacy protection has surfaced as this trend has progressed. Databases for health insurance claims or for specific health checkups and guidance services were created according to the law that aims to ensure healthcare for the elderly; however, there is no mention in the act about using these databases for public interest in general. Thus, an initiative for such use must proceed carefully and attentively. The PMDA*2 projects that collect a large amount of medical record information from large hospitals and the health database development project that the Ministry of Health, Labour and Welfare (MHLW) is working on will soon begin to operate according to a general consensus; however, the validity of this consensus can be questioned if issues of anonymity arise. The likelihood that researchers conducting a study for public interest would intentionally invade the privacy of their subjects is slim. However, patients could develop a sense of distrust about their data being used since legal requirements are ambiguous. Nevertheless, without using patients’ medical records for public interest, progress in medicine will grind to a halt. Proper legislation that is clear for both researchers and patients will therefore be highly desirable. A revision of the Act on the Protection of Personal Information is currently in progress. In reality, however, privacy is not something that laws alone can protect; it will also require guidelines and self-discipline. We now live in an information capitalization age. I will introduce the trends in legal reform regarding healthcare information and discuss some basics to help people properly face the issue of health big data and privacy

Regulation for the enforcement of federal health care provider conscience protection laws. Final rule.

PubMed

2011-02-23

The Department of Health and Human Services issues this final rule which provides that enforcement of the federal statutory health care provider conscience protections will be handled by the Department's Office for Civil Rights, in conjunction with the Department's funding components. This Final Rule rescinds, in part, and revises, the December 19, 2008 Final Rule entitled "Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law" (the "2008 Final Rule"). Neither the 2008 final rule, nor this final rule, alters the statutory protections for individuals and health care entities under the federal health care provider conscience protection statutes, including the Church Amendments, Section 245 of the Public Health Service Act, and the Weldon Amendment. These federal statutory health care provider conscience protections remain in effect.

Farmers sun exposure, skin protection and public health campaigns: An Australian perspective.

PubMed

Smit-Kroner, Christel; Brumby, Susan

2015-01-01

Non-melanoma skin cancer is a common and costly cancer in agricultural populations. Prevention and early detection are an effective way to decrease the burden of disease and associated costs. To examine sun exposure and skin protection practices in agricultural workers and farmers a thematic review of the literature between 1983 and 2014 was undertaken. Comparison between studies was complicated by differences in study design, definitions of skin protection, and analytic methods used. Farmers are the most exposed to harmful ultraviolet (UV) radiation of all outdoor workers and the level of reported skin protection by farmers is suboptimal. Years of public health campaigns have failed to adequately address farmers' specific needs. Increased rates of skin cancer and subsequent higher costs are expected. Estimates of sun exposure and skin protection practice indicate that protective clothing is the most promising avenue to improve on farmers' skin protection. Early detection needs to be part of public health campaigns. This review explores the quantitative data about Australian farmers and their skin protective behaviours. We investigate what the documented measurable effect of the public health campaign Slip!Slop!Slap! has had on agricultural workers and farmers and make recommendations for future focus.

Fundamentals of health physics for the radiation-protection officer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murphy, B.L.; Traub, R.J.; Gilchrist, R.L.

1983-03-01

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

Personal Protective Equipment. Module SH-12. Safety and Health.

ERIC Educational Resources Information Center

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

This student module on personal protective equipment is one of 50 modules concerned with job safety and health. This module explains the need for personal protective equipment, how it is selected, and the way in which the equipment is supposed to work. Following the introduction, 13 objectives (each keyed to a page in the text) the student is…

14 CFR 27.861 - Fire protection of structure, controls, and other parts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fire protection of structure, controls, and... Protection § 27.861 Fire protection of structure, controls, and other parts. Each part of the structure, controls, rotor mechanism, and other parts essential to a controlled landing that would be affected by...

14 CFR 27.861 - Fire protection of structure, controls, and other parts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fire protection of structure, controls, and... Protection § 27.861 Fire protection of structure, controls, and other parts. Each part of the structure, controls, rotor mechanism, and other parts essential to a controlled landing that would be affected by...

14 CFR 29.861 - Fire protection of structure, controls, and other parts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fire protection of structure, controls, and... Protection § 29.861 Fire protection of structure, controls, and other parts. Each part of the structure, controls, and the rotor mechanism, and other parts essential to controlled landing and (for category A...

14 CFR 29.861 - Fire protection of structure, controls, and other parts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fire protection of structure, controls, and... Protection § 29.861 Fire protection of structure, controls, and other parts. Each part of the structure, controls, and the rotor mechanism, and other parts essential to controlled landing and (for category A...

Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

PubMed Central

Saksena, Priyanka; Hsu, Justine; Evans, David B.

2014-01-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC. PMID:25244520

Unscientific health practice and disciplinary and consumer protection litigation.

PubMed

Freckelton, Ian

2011-06-01

Evidence-based health care is expected of their practitioners by contemporary health professions. This requires health care to have a foundation in scholarly literature and to have a scientifically valid methodology. However, there are many instances of registered and unregistered practitioners either providing assessment and treatment that does not conform to such requirements or making representations about likely efficacy that are unjustifiable by reference to peer-reviewed clinical knowledge. Sometimes such conduct is predatory and deliberately exploitative; other times it is simply misconceived on the part of practitioners who regard themselves as medical pioneers. This editorial situates such conduct within unscientific and unorthodox health practice. It surveys recent consumer protection and disciplinary decisions to evaluate the role of the law in regulating such conduct. It argues in favour of an assertive legal response to protect vulnerable patients or potential patients against forms of treatment and promises of outcomes that are unscientific and deceptive.

Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

PubMed Central

Veale, Jaimie F.; Peter, Tracey; Travers, Robb; Saewyc, Elizabeth M.

2017-01-01

Abstract Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants. Results: Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups. Among 14–18 year olds, we examined school connectedness, family connectedness, and perception of friends caring separately, and family connectedness was always the strongest protective predictor in multivariate models. In all the mental health outcomes we examined, transgender youth reporting low levels of enacted stigma experiences and high levels of protective factors tended to report favorable mental health outcomes. Conversely, the majority of participants reporting high levels of enacted stigma and low levels of protective factors reported adverse mental health outcomes. Conclusion: While these findings are limited by nonprobability sampling procedures and potential additional unmeasured risk and protective factors, the results provide positive evidence for the Minority Stress Model in this population and affirm the need for policies and programs to support schools and families to support transgender youth. PMID:29279875

[Communication on health and safety risk control in contemporary society: an interdisciplinary approach].

PubMed

Rangel-S, Maria Ligia

2007-01-01

This paper discusses communication as a technology for risk control with health and safety protection and promotion, within the context of a "risk society". As a component of Risk Analysis, risk communication is a technology that appears in risk literature, with well defined objectives, principles and models. These aspects are described and the difficulties are stressed, taking into consideration the multiple rationales related to risks in the culture and the many different aspects of risk regulation and control in the so-called "late modernity". Consideration is also given to the complexity of the communications process, guided by theoretical and methodological discussions in the field. In order to understand the true value of the communications field for risk control with health and safety protection and promotion, this paper also offers an overview of communication theories that support discussions of this matter, proposing a critical approach to models that include the dimensions of power and culture in the context of a capitalist society.

Perceived Competence and Comfort in Respiratory Protection

PubMed Central

Burgel, Barbara J.; Novak, Debra; Burns, Candace M.; Byrd, Annette; Carpenter, Holly; Gruden, MaryAnn; Lachat, Ann; Taormina, Deborah

2015-01-01

In response to the Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training, a nationwide survey was conducted in May 2012 to assess occupational health nurses’ educational preparation, roles, responsibilities, and training needs in respiratory protection. More than 2,000 occupational health nurses responded; 83% perceived themselves as competent, proficient, or expert in respiratory protection, reporting moderate comfort with 12 respiratory program elements. If occupational health nurses had primary responsibility for the respiratory protection program, they were more likely to perceive higher competence and more comfort in respiratory protection, after controlling for occupational health nursing experience, highest education, occupational health nursing certification, industry sector, Association of Occupational Health Professionals in Healthcare membership, taking a National Institute for Occupational Safety and Health spirometry course in the prior 5 years, and perceiving a positive safety culture at work. These survey results document high perceived competence and comfort in respiratory protection. These findings support the development of targeted educational programs and interprofessional competencies for respiratory protection. PMID:23429638

Nutrition and Other Protective Behaviors Motivated by Environmental Health Risk Awareness.

PubMed

Jones, Elizabeth W; Feng, Limin; Dixon, Jane K; Dixon, John P; Hofe, Carolyn R; Gaetke, Lisa M

2016-01-01

Research findings have suggested that exposure to environmental pollutants contributes to increased health risks, which may be modulated by certain nutrition and other protective health behaviors. Nutrition professionals play an important role in effectively disseminating this information and in devising specific community-based nutrition education programs for audiences located in areas with environmental health issues. To assess awareness of environmental health problems and motivation to adopt protective health behaviors for use in planning nutrition education programs for communities exposed to environmental pollutants. Data were collected from a modified, validated Environmental Health Engagement Profile (EHEP) survey instrument administered to adults (n=774) participating in community events in Kentucky based on location relative to hazardous waste sites. The modified EHEP survey instrument showed good internal consistency reliability, and demographic characteristics were evaluated. Correlation analyses revealed significant positive correlations in all groups, separately and combined, between awareness of environmental pollution in an individual's surroundings and the extent of concern that pollutants cause adverse health effects (P < 0.01) and between concern that pollutants cause adverse health effects and taking personal actions to protect against such environmental insults (P < 0.01). The groups having the highest level of awareness posed by pollution are those residing near federally designated hazardous waste sites. These results suggest that determining and expanding an audience's knowledge and perceptions of environmental health risks will enhance effective nutrition education program planning.

Physical Activity Protects against the Health Risks of Obesity.

ERIC Educational Resources Information Center

Welk, Gregory J.; Blair, Steven N.

2000-01-01

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

75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

Protecting health from climate change in the WHO European Region.

PubMed

Wolf, Tanja; Martinez, Gerardo Sanchez; Cheong, Hae-Kwan; Williams, Eloise; Menne, Bettina

2014-06-16

"How far are we in implementing climate change and health action in the WHO European Region?" This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers to a comprehensive questionnaire that focused around eight thematic areas (Governance; Vulnerability, impact and adaptation (health) assessments; Adaptation strategies and action plans; Climate change mitigation; Strengthening health systems; Raising awareness and building capacity; Greening health services; and Sharing best practices). Strong areas of development are climate change vulnerability and impact assessments, as well as strengthening health systems and awareness raising. Areas where implementation would benefit from further action are the development of National Health Adaptation Plans, greening health systems, sharing best practice and reducing greenhouse gas emissions in other sectors. At the Parma Conference in 2010, the European Ministerial Commitment to Act on climate change and health and the European Regional Framework for Action to protect health from climate change were endorsed by fifty three European Member States. The results of this questionnaire are the most comprehensive assessment so far of the progress made by WHO European Member States to protecting public health from climate change since the agreements in Parma and the World Health Assembly Resolution in 2008.

Highlights of the Forest Health Protection Whitebark Pine Restoration Program

Treesearch

John Schwandt

2011-01-01

In 2005, Forest Health Protection (FHP) initiated a rangewide health assessment for whitebark pine (Pinus albicaulis). This assessment summarized the forest health condition of whitebark pine throughout its range and also documented information needs, potential restoration strategies, and challenges to restoration that need to be addressed (Schwandt 2006). This led to...

Does social capital protect mental health among migrants in Sweden?

PubMed

Lecerof, Susanne Sundell; Stafström, Martin; Westerling, Ragnar; Östergren, Per-Olof

2016-09-01

Poor mental health is common among migrants. This has been explained by migration-related and socio-economic factors. Weak social capital has also been related to poor mental health. Few studies have explored factors that protect mental health of migrants in the post-migration phase. Such knowledge could be useful for health promotion purposes. Therefore, this study aimed to analyse associations between financial difficulties, housing problems and experience of discrimination and poor mental health; and to detect possible effect modification by social capital, among recently settled Iraqi migrants in Sweden. A postal questionnaire in Arabic was sent to recently settled Iraqi citizens. The response rate was 51% (n = 617). Mental health was measured by the GHQ-12 instrument and social capital was defined as social participation and trust in others. Data were analysed by means of logistic regression. Poor mental health was associated with experience of discrimination (OR 2.88, 95% CI 1.73-4.79), housing problems (OR 2.79, 95% CI 1.84-4.22), and financial difficulties (OR 2.14, 95% CI 1.44-3.19), after adjustments. Trust in others seemed to have a protective effect for mental health when exposed to these factors. Social participation had a protective effect when exposed to experience of discrimination. Social determinants and social capital in the host country play important roles in the mental health of migrants. Social capital modifies the effect of risk factors and might be a fruitful way to promote resilience to factors harmful to mental health among migrants, but must be combined with policy efforts to reduce social inequities. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sexual orientation and sex differences in adult chronic conditions, health risk factors, and protective health practices, Oregon, 2005-2008.

PubMed

Garland-Forshee, Rodney Y; Fiala, Steven C; Ngo, Duyen L; Moseley, Katarina

2014-08-07

Research on lesbian, gay, and bisexual (LGB) individuals' health and health practices has primarily consisted of convenience studies focused on HIV/AIDS, substance use, or mental illness. We examined health-related disparities among Oregon LGB men and women compared with heterosexual men and women using data from a population-based survey. Data from the 2005 through 2008 Oregon Behavioral Risk Factor Surveillance System were used to examine associations between sexual orientation and chronic conditions, health limitations, health risk factors, and protective health practices. Compared with heterosexual women, lesbian and bisexual women were significantly more likely to smoke cigarettes, be obese, binge drink, and have chronic conditions, and less likely to engage in protective health practices. Compared with heterosexual men, gay men were significantly less likely to be obese, more likely to binge drink, and more likely to engage in protective health practices. Compared with heterosexual men, bisexual men were significantly more likely to have a physical disability, smoke cigarettes, binge drink, and more likely to get an HIV test. Health disparities among Oregon LGB individuals were most prominent among lesbian and bisexual women. Gay men had the most protective health practices, but they were more likely than heterosexual men to engage in risky behaviors that lead to chronic diseases later in life. Targeted public health interventions should be provided in environments that avoid stigmatizing and discriminating against LGB individuals where they live, work, learn, and socialize.

Protecting Human Health in a Changing Environment: 2018 Summer Enrichment Program

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) in Research Triangle Park, NC is offering a free 1-week Summer Enrichment Program to educate students about how the Agency protects human health and the environment.

Health Protection Features of Student Youth in Research University

ERIC Educational Resources Information Center

Antonova, Tatyana V.; Kozhanov, Vladimir V.; Kolodovsky, Alexander A.; Shivrinskaya, Svetlana E.; Kudyashev, Nail K.

2016-01-01

The relevance of the study is conditioned by the adverse dynamics of students' physical and mental health, which creates objective obstacles to the development of research universities. The article aims to find out particular health protection features of student youth in research universities. The leading approach of the study is the systematic…

Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States.

PubMed

Riosmena, Fernando; Kuhn, Randall; Jochem, Warren C

2017-02-01

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20-49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants' changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full "assimilation"); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).

Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States

PubMed Central

Riosmena, Fernando; Kuhn, Randall; Jochem, Warren C.

2017-01-01

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20–49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants’ changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full —assimilation ); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans). PMID:28092071

Nutrition and Other Protective Behaviors Motivated by Environmental Health Risk Awareness

PubMed Central

Jones, Elizabeth W.; Feng, Limin; Dixon, Jane K.; Dixon, John P.; Hofe, Carolyn R.; Gaetke, Lisa M.

2016-01-01

Background Research findings have suggested that exposure to environmental pollutants contributes to increased health risks, which may be modulated by certain nutrition and other protective health behaviors. Nutrition professionals play an important role in effectively disseminating this information and in devising specific community-based nutrition education programs for audiences located in areas with environmental health issues. Objective To assess awareness of environmental health problems and motivation to adopt protective health behaviors for use in planning nutrition education programs for communities exposed to environmental pollutants. Method Data were collected from a modified, validated Environmental Health Engagement Profile (EHEP) survey instrument administered to adults (n=774) participating in community events in Kentucky based on location relative to hazardous waste sites. Results The modified EHEP survey instrument showed good internal consistency reliability, and demographic characteristics were evaluated. Correlation analyses revealed significant positive correlations in all groups, separately and combined, between awareness of environmental pollution in an individual’s surroundings and the extent of concern that pollutants cause adverse health effects (P < 0.01) and between concern that pollutants cause adverse health effects and taking personal actions to protect against such environmental insults (P < 0.01). The groups having the highest level of awareness posed by pollution are those residing near federally designated hazardous waste sites. Conclusion These results suggest that determining and expanding an audience’s knowledge and perceptions of environmental health risks will enhance effective nutrition education program planning. PMID:28090221

Travel health: sun protection and skin cancer prevention for travellers.

PubMed

Wood, Cate

The UK population likes to travel to sunny parts of the world, where the risk of sunburn is greater than it is at home. Sunburn and the cultural desire for a tan is one of the risk factors for the increase in skin cancer. The rise in foreign travel has resulted in an increased demand for pre-travel health services, with nurses in primary care acting as the main providers.Within these consultations, the traveller and their travel plans are risk assessed.Travel health consultations give an ideal opportunity to discuss and advise the public regarding sun burn and skin cancer protection. However, there are also other ways to impart safety in the sun message to travellers. Skin protection is a health promoting activity provided as a part of public health provision and all nurses can play a role in prevention.

[Legal aspects of prevention. The constitutional principle of optimal health protection].

PubMed

von Wartburg, W P

1978-12-01

With respect to the health services, a State founded upon the rule of law is in duty bound to act with restraint. Its aim should be to guarantee that public health is maintained in optimal fashion. For this purpose it must endeavour to exert an effective influence on environmental factors. The three main categories of activity with which the health services are concerned, i.e. protection of health, promotion of health, and health care should be governed by the principles inherent in a State based upon the rule of law. As regards preventive measures, this means that the State has to shape the environment and society in such a way as to meet the requirements of a modern system for the protection of public health, its objective in this context being to eliminate or minimise health risks. A rational government programme for the promotion of public health must also be designed to promote a more health-conscious pattern of behaviour in the population at large and to encourage those citizens requiring treatment to invoke the aid of the health care services without delay.

A 21st century approach to assessing the protection of workers' health.

PubMed

Rosskam, Ellen

2011-01-01

This article presents a rights-based approach to the way occupational health and safety is understood, departing from medical, engineering, and technocratic approaches that dominated the field throughout the 20th century. Moving toward a 21st century concept of the good society - based on citizenship rights and principles of universalism - a social protection-based system of assessing governments' performance in protecting workers' health and well-being is proffered. A Work Security Index (WSI) is used as a benchmarking system for evaluating national or local level governments' performance in this domain. Data from 95 countries in all regions of the world were used. A pioneering tool the WSI grouped and ranked countries based on governments' protection of workers' health and safety. Data represent findings from 95 national governments, as well as workers and employers. Among 95 countries, most have much work to do to provide the minimum measures to protect their working populations. Results reveal that women workers face particular social and economic insecurities and inequalities. We attempt to inform a broad audience about the WSI, how it can be used at multiple levels in any country for the protection of workers' health, safety, and well-being, and the need to do so.

The American Association of Occupational Health Nurses' Respiratory Protection Education Program and Resources Webkit for Occupational Health Professionals.

PubMed

Pompeii, Lisa; Byrd, Annette; Delclos, George L; Conway, Sadie H

2016-12-01

Organizations are required to adhere to the Occupational Safety and Health Administration's (OSHA) Respiratory Protection Standard (29 CFR 1910.134) if they have workers that wear a respirator on the job. They must also have an employee "suitably trained" to administer their program. The National Institute for Occupational Safety and Health and its National Personal Protective Technology Laboratory have worked to champion the occupational health nurse in this role by collaborating with the American Association of Occupational Health Nurses to develop free, online respiratory protection training and resources (RPP Webkit). This article describes the development, content, and success of this training. To date, 724 participants have completed the training, 32.6% of whom lead their organization's respiratory protection program, 15.3% who indicated they will lead a program in the near future, and 52% who did not lead a program, but indicated that the training was relevant to their work. The majority "strongly agreed" the training was applicable to their work and it enhanced their professional expertise. © 2016 The Author(s).

Tracking Smoke with Models to Protect Public Health

EPA Pesticide Factsheets

Smoke plumes rising above a wildland fire are a visible sign of air pollution. What they emit, where they go, and how they are transported are all of interest to atmospheric modelers who are working to protect public health

The predictive protective control of the heat exchanger

NASA Astrophysics Data System (ADS)

Nevriva, Pavel; Filipova, Blanka; Vilimec, Ladislav

2016-06-01

The paper deals with the predictive control applied to flexible cogeneration energy system FES. FES was designed and developed by the VITKOVICE POWER ENGINEERING joint-stock company and represents a new solution of decentralized cogeneration energy sources. In FES, the heating medium is flue gas generated by combustion of a solid fuel. The heated medium is power gas, which is a gas mixture of air and water steam. Power gas is superheated in the main heat exchanger and led to gas turbines. To protect the main heat exchanger against damage by overheating, the novel predictive protective control based on the mathematical model of exchanger was developed. The paper describes the principle, the design and the simulation of the predictive protective method applied to main heat exchanger of FES.

Protection detail. Protecting against breach of electronic protected health information.

PubMed

Blass, Gerry; Miller, Susan A

2010-01-01

Covered entities need to conduct risk assessments that cover the requirements of HIPAA, HITECH and Meaningful use, and create a process for steady and consistent mitigation of known gaps and vulnerabilities based on risk. Reducing risk of vulnerabilities of unauthorized access to your ePHI can be done via safeguards and controls, plus audits and monitoring. When reducing risk is outside of a covered entities control, audits and monitoring are required in order to demonstrate due diligence. Know where your ePHI is stored, where it is at risk, and take steps now to reduce or eliminate the risk. Encrypt vulnerable locations. Encrypt sensitive data. By doing so, you will be protecting your organization by reducing risk of breach of ePHI. Finally, don't forget what is sometimes considered to be the hardest part--documenting your compliance activities in order to demonstrate evidence of due diligence in and avoid major $$$$ penalties for negligence under the HITECH Act of 2009.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

PubMed

Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

2017-12-01

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

The problem of creating habits: establishing health-protective dental behaviors.

PubMed

McCaul, K D; Glasgow, R E; O'Neill, H K

1992-01-01

We describe three experiments testing treatments to promote the performance of health-protective dental behaviors. Subjects included 55 women from an introductory psychology course (Experiment 1), 45 men and women (Experiment 2), and 81 older-than-average students identified as at risk for gum disease (Experiment 3). The interventions, derived from social cognitive theory, included health education, skills training, and self-monitoring. In each study, we examined the contribution of additional treatment components, including social support (Experiment 1), intensive contact (Experiment 2), and flexible goal setting (Experiment 3). Across experiments, the behavioral results were remarkably similar: Subjects exhibited excellent adherence while in the study but, at follow-up, reported behavior that differed little from baseline. We discuss parallels between attempts to promote health-protective dental behaviors and other health-promotion programs, and we describe different perspectives from which to address the problem of creating healthy habits.

Protecting Privacy and Confidentiality in Environmental Health Research.

PubMed

Resnik, David B

2010-01-01

Environmental health researchers often need to make difficult decisions on how to protect privacy and confidentiality when they conduct research in the home or workplace. These dilemmas are different from those normally encountered in clinical research. Although protecting privacy and confidentiality is one of the most important principles of research involving human subjects, it can be overridden to prevent imminent harm to individuals or if required by law. Investigators should carefully consider the facts and circumstances and use good judgment when deciding whether to breach privacy or confidentiality.

Interagency collaboration between child protection and mental health services: practices, attitudes and barriers.

PubMed

Darlington, Yvonne; Feeney, Judith A; Rixon, Kylie

2005-10-01

The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers, 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level.

Building national public health capacity for managing chemical events: A case study of the development of health protection services in the United Kingdom

PubMed Central

Palmer, Stephen; Coleman, Gary

2013-01-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved ‘adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases. PMID:23447032

Building national public health capacity for managing chemical events: a case study of the development of health protection services in the United Kingdom.

PubMed

Palmer, Stephen; Coleman, Gary

2013-05-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved 'adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases.

Linking temporal medical records using non-protected health information data.

PubMed

Bonomi, Luca; Jiang, Xiaoqian

2017-01-01

Modern medical research relies on multi-institutional collaborations which enhance the knowledge discovery and data reuse. While these collaborations allow researchers to perform analytics otherwise impossible on individual datasets, they often pose significant challenges in the data integration process. Due to the lack of a unique identifier, data integration solutions often have to rely on patient's protected health information (PHI). In many situations, such information cannot leave the institutions or must be strictly protected. Furthermore, the presence of noisy values for these attributes may result in poor overall utility. While much research has been done to address these challenges, most of the current solutions are designed for a static setting without considering the temporal information of the data (e.g. EHR). In this work, we propose a novel approach that uses non-PHI for linking patient longitudinal data. Specifically, our technique captures the diagnosis dependencies using patterns which are shown to provide important indications for linking patient records. Our solution can be used as a standalone technique to perform temporal record linkage using non-protected health information data or it can be combined with Privacy Preserving Record Linkage solutions (PPRL) when protected health information is available. In this case, our approach can solve ambiguities in results. Experimental evaluations on real datasets demonstrate the effectiveness of our technique.

Prevention and control of mental illnesses and mental health: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

PubMed

Nishtar, Sania; Minhas, Fareed A; Ahmed, Ashfaq; Badar, Asma; Mohamud, Khalif Bile

2004-12-01

As part of the National Action Plan for Non-communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD), mental illnesses have been grouped alongside non-communicable diseases (NCD) within a combined strategic framework in order to synchronize public health actions. The systematic approach for mental illnesses is centred on safeguarding the rights of the mentally ill, reducing stigma and discrimination, and de-institutionalisation and rehabilitation of the mentally ill in the community outlining roles of healthcare providers, the community, legislators and policy makers. The approach has implications for support functions in a number of areas including policy building, manpower and material development and research. Priority action areas for mental health as part of NAP-NCD include the integration of surveillance of mental illnesses in a comprehensive population-based NCD surveillance system; creating awareness about mental health as part of an integrated NCD behavioural change communication strategy; integration of mental health with primary healthcare; the development of sustainable public health infrastructure to support community mental health initiatives; building capacity of the health system in support of prevention and control activities; effective implementation of existing legislation and harmonizing working relationships with law enforcing agencies. NAP-NCD also stresses on the need to integrate mental health into health services as part of a sustainable and integrated medical education programme for all categories of healthcare providers and the availability of essential psychotropic drugs at all healthcare levels. It lays emphasis on protecting the interests of special groups such as prisoners, refugees and displaced persons, women, children and individuals with disabilities. Furthermore, it promotes need-based research for contemporary mental health issues.

Individual privacy versus public good: protecting confidentiality in health research.

PubMed

O'Keefe, Christine M; Rubin, Donald B

2015-10-15

Health and medical data are increasingly being generated, collected, and stored in electronic form in healthcare facilities and administrative agencies. Such data hold a wealth of information vital to effective health policy development and evaluation, as well as to enhanced clinical care through evidence-based practice and safety and quality monitoring. These initiatives are aimed at improving individuals' health and well-being. Nevertheless, analyses of health data archives must be conducted in such a way that individuals' privacy is not compromised. One important aspect of protecting individuals' privacy is protecting the confidentiality of their data. It is the purpose of this paper to provide a review of a number of approaches to reducing disclosure risk when making data available for research, and to present a taxonomy for such approaches. Some of these methods are widely used, whereas others are still in development. It is important to have a range of methods available because there is also a range of data-use scenarios, and it is important to be able to choose between methods suited to differing scenarios. In practice, it is necessary to find a balance between allowing the use of health and medical data for research and protecting confidentiality. This balance is often presented as a trade-off between disclosure risk and data utility, because methods that reduce disclosure risk, in general, also reduce data utility. Copyright © 2015 John Wiley & Sons, Ltd.

Self-harm in adolescence: protective health assets in the family, school and community.

PubMed

Klemera, Ellen; Brooks, Fiona M; Chester, Kayleigh L; Magnusson, Josefine; Spencer, Neil

2017-07-01

The aim of this paper was to examine if the multiple environments of the adolescent including family, peers, school and neighbourhood might function as protective health assets against self-harming behaviour during adolescence. The present study utilised data collected from 1608 respondents aged 15 years as part of the England WHO Health Behaviour in School-aged Children (HBSC) Study. Multilevel modelling was undertaken using the package MLwiN (version 2.33) to investigate the potential domains and dimensions of family life, school culture and environment, and neighbourhood factors that may operate as protective health assets. The results indicated that while peer support did not appear to operate as a protective health asset in the context of self-harm, key dimensions of adolescent/parent interaction and adolescent experience of the school culture and their neighbourhood were associated with reduced likelihood of self-harming behaviours during adolescence. The Findings highlight the significance of belonging and connectedness as important constituent elements of protective health assets for young people. Interventions that address the multiple environments of the young person, may offer an effective means to reduce the levels of self-harm.

Measuring financial protection against catastrophic health expenditures: methodological challenges for global monitoring.

PubMed

Hsu, Justine; Flores, Gabriela; Evans, David; Mills, Anne; Hanson, Kara

2018-05-31

Monitoring financial protection against catastrophic health expenditures is important to understand how health financing arrangements in a country protect its population against high costs associated with accessing health services. While catastrophic health expenditures are generally defined to be when household expenditures for health exceed a given threshold of household resources, there is no gold standard with several methods applied to define the threshold and household resources. These different approaches to constructing the indicator might give different pictures of a country's progress towards financial protection. In order for monitoring to effectively provide policy insight, it is critical to understand the sensitivity of measurement to these choices. This paper examines the impact of varying two methodological choices by analysing household expenditure data from a sample of 47 countries. We assess sensitivity of cross-country comparisons to a range of thresholds by testing for restricted dominance. We further assess sensitivity of comparisons to different methods for defining household resources (i.e. total expenditure, non-food expenditure and non-subsistence expenditure) by conducting correlation tests of country rankings. We found country rankings are robust to the choice of threshold in a tenth to a quarter of comparisons within the 5-85% threshold range and this increases to half of comparisons if the threshold is restricted to 5-40%, following those commonly used in the literature. Furthermore, correlations of country rankings using different methods to define household resources were moderate to high; thus, this choice makes less difference from a measurement perspective than from an ethical perspective as different definitions of available household resources reflect varying concerns for equity. Interpreting comparisons from global monitoring based on a single threshold should be done with caution as these may not provide reliable insight into

The quest for universal health coverage: achieving social protection for all in Mexico.

PubMed

Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio

2012-10-06

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries. Copyright

Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

PubMed

Sehulster, Lynne; Chinn, Raymond Y W

2003-06-06

The health-care facility environment is rarely implicated in disease transmission, except among patients who are immunocompromised. Nonetheless, inadvertent exposures to environmental pathogens (e.g., Aspergillus spp. and Legionella spp.) or airborne pathogens (e.g., Mycobacterium tuberculosis and varicella-zoster virus) can result in adverse patient outcomes and cause illness among health-care workers. Environmental infection-control strategies and engineering controls can effectively prevent these infections. The incidence of health-care--associated infections and pseudo-outbreaks can be minimized by 1) appropriate use of cleaners and disinfectants; 2) appropriate maintenance of medical equipment (e.g., automated endoscope reprocessors or hydrotherapy equipment); 3) adherence to water-quality standards for hemodialysis, and to ventilation standards for specialized care environments (e.g., airborne infection isolation rooms, protective environments, or operating rooms); and 4) prompt management of water intrusion into the facility. Routine environmental sampling is not usually advised, except for water quality determinations in hemodialysis settings and other situations where sampling is directed by epidemiologic principles, and results can be applied directly to infection-control decisions. This report reviews previous guidelines and strategies for preventing environment-associated infections in health-care facilities and offers recommendations. These include 1) evidence-based recommendations supported by studies; 2) requirements of federal agencies (e.g., Food and Drug Administration, U.S. Environmental Protection Agency, U.S. Department of Labor, Occupational Safety and Health Administration, and U.S. Department of Justice); 3) guidelines and standards from building and equipment professional organizations (e.g., American Institute of Architects, Association for the Advancement of Medical Instrumentation, and American Society of Heating, Refrigeration, and Air

Food protection activities of the Pan American Health Organization.

PubMed

1994-03-01

One of the most widespread health problems in the Caribbean and Latin America is contaminated food and foodborne illness. The Pan American Health Organization (PAHO) has been a major force in activities to strengthen food protection. The program within the regional Program of Technical Cooperation is administered by the Veterinary Public Health program and under the guidance of the Pan American Institute for Food protection and Zoonoses in Buenos Aires, Argentina. A food action plan for 1986-90 was established at the 1986 Pan American Sanitary Conference, and extended to cover 1991-95. Program activities during the 1990s covered cholera, epidemiologic surveillance, street food vendors, shellfish poisoning, meat, national programs, information systems, air catering, food irradiation, and tourism. The action plan for 1991-95 promoted greater political support and cooperation within and between related sectors and institutions, management, and education. The aims were to organize national integrated programs, to strengthen laboratory services, to strengthen inspection services, to establish epidemiologic surveillance systems, and to promote food protection through community participation. Program activities included the initiatives of the Veterinary Public Health Program in 1991 to distribute literature on the transmission of cholera by foods. Studies were conducted in Bolivia, Colombia, and Peru on food contamination. Microbiologists received training on standard methods for detecting Vibrio cholerae in foods. A working group of experts from 10 countries examined the issues and produced a guide for investigating the incidence of foodborne disease. PAHO has contributed to the formation of an Inter-American Network for Epidemiologic Surveillance of Foodborne Diseases. PAHO has worked to improve hygienic practices among street food vendors. Seminars on paralytic shellfish poisoning were conducted in 1990; the outcome was a network working to strengthen national

Effectiveness of a theory-based mobile phone text message intervention for improving protective behaviors of pregnant women against air pollution: a randomized controlled trial.

PubMed

Jasemzadeh, Mehrnoosh; Khafaie, Morteza Abdullatif; Jaafarzadeh, Nematallah; Araban, Marzieh

2018-03-01

Health impact of exposure to air pollution is a public health concern. The aim of this study was to investigate an extended parallel process model (EPPM)-based mobile phone text message intervention for improving protective behaviors against air pollution among pregnant women. In this randomized controlled trial (IRCT2016102810804N8), 130 pregnant women were randomly assigned into either experimental or control groups. A valid and reliable questionnaire was used to collect data. Experimental group received mobile phone intervention on a daily basis for 2 months. Control group received usual care, only. Data were analyzed using SPSS 15 applying t test, chi-square, and Wilcoxon and Mann-Whitney U test. Although before intervention, there were no significant differences between different structures of EPPM (P > 0.05), after intervention, there were statistically significant differences between perceived severity, response efficacy, self-efficacy, and protective behaviors between two groups (P < 0.05). Implementing EPPM based-mobile phone intervention could promote protective behaviors against air pollution among pregnant women. The present study might be used as a framework for evidence-based health promotion regarding air pollution risk communication and self-care behaviors. IRCT2016102810804N8.

Who's afraid of national laws? Pesticide corporations use trade negotiations to avoid bans and undercut public health protections in Central America.

PubMed

Rosenthal, Erika

2005-01-01

The agrochemical industry is using trade agreements to block proposed bans on pesticides identified as the worst occupational health hazards by a multi-country illness surveillance program in Central America. Through privileged access to closed-door negotiations, industry inserted deregulatory mechanisms, including a regional pesticide registry that invalidates national laws, investors' rights protection, and increased intellectual property protections, into the draft Central American Customs Union and the Central American Free Trade Agreement. These agreements undermine health-based national pesticide registration requirements; weaken health ministries' role in pesticide control; block marketing of cheaper, less toxic pesticides; and have a chilling effect on future pesticide regulatory activity. So long as corporations have privileged access to the trade negotiations and civil society is excluded, the resulting agreements will benefit special interests at the expense of public health.

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

PubMed Central

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

2014-01-01

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

Understanding processes of risk and protection that shape the sexual and reproductive health of young women affected by conflict: the price of protection.

PubMed

Hutchinson, Aisha; Waterhouse, Philippa; March-McDonald, Jane; Neal, Sarah; Ingham, Roger

2017-01-01

It is assumed that knowing what puts young women at risk of poor sexual health outcomes and, in turn, what protects them against these outcomes, will enable greater targeted protection as well as help in designing more effective programmes. Accordingly, efforts have been directed towards mapping risk and protective factors onto general ecological frameworks, but these currently do not take into account the context of modern armed conflict. A literature overview approach was used to identify SRH related risk and protective factors specifically for young women affected by modern armed conflict. A range of keywords were used to identify academic articles which explored the sexual and reproductive health needs of young women affected by modern armed conflict. Selected articles were read to identify risk and protective factors in relation to sexual and reproductive health. While no articles explicitly identified 'risk' or 'protective' factors, we were able to extrapolate these through a thorough engagement with the text. However, we found that it was difficult to identify factors as either 'risky' or 'protective', with many having the capacity to be both risky and protective (i.e. refugee camps or family). Therefore, using an ecological model, six environments that impact upon young women's lives in contexts of modern armed conflict are used to illustrate the dynamic and complex operation of risk and protection - highlighting processes of protection and the 'trade-offs' between risks. We conclude that there are no simple formulaic risk/protection patterns to be applied in every conflict and post-conflict context. Instead, there needs to be greater recognition of the 'processes' of protection, including the role of 'trade-offs' (what we term as 'protection at a price'), in order to further effective policy and practical responses to improve sexual and reproductive health outcomes during or following armed conflict. Focus on specific 'factors' (such as 'female headed

History of US Presidential Assaults on Modern Environmental Health Protection

PubMed Central

Sellers, Christopher; Dillon, Lindsey; Ohayon, Jennifer Liss; Shapiro, Nicholas; Sullivan, Marianne; Bocking, Stephen; Brown, Phil; de la Rosa, Vanessa; Harrison, Jill; Johns, Sara; Kulik, Katherine; Lave, Rebecca; Murphy, Michelle; Piper, Liza; Richter, Lauren; Wylie, Sara

2018-01-01

The Trump administration has undertaken an assault on the Environmental Protection Agency (EPA), an agency critical to environmental health. This assault has precedents in the administrations of Ronald Reagan and George W. Bush. The early Reagan administration (1981–1983) launched an overt attack on the EPA, combining deregulation with budget and staff cuts, whereas the George W. Bush administration (2001–2008) adopted a subtler approach, undermining science-based policy. The current administration combines both these strategies and operates in a political context more favorable to its designs on the EPA. The Republican Party has shifted right and now controls the executive branch and both chambers of Congress. Wealthy donors, think tanks, and fossil fuel and chemical industries have become more influential in pushing deregulation. Among the public, political polarization has increased, the environment has become a partisan issue, and science and the mainstream media are distrusted. For these reasons, the effects of today’s ongoing regulatory delays, rollbacks, and staff cuts may well surpass those of the administrations of Reagan and Bush, whose impacts on environmental health were considerable. PMID:29698097

History of US Presidential Assaults on Modern Environmental Health Protection.

PubMed

Fredrickson, Leif; Sellers, Christopher; Dillon, Lindsey; Ohayon, Jennifer Liss; Shapiro, Nicholas; Sullivan, Marianne; Bocking, Stephen; Brown, Phil; de la Rosa, Vanessa; Harrison, Jill; Johns, Sara; Kulik, Katherine; Lave, Rebecca; Murphy, Michelle; Piper, Liza; Richter, Lauren; Wylie, Sara

2018-04-01

The Trump administration has undertaken an assault on the Environmental Protection Agency (EPA), an agency critical to environmental health. This assault has precedents in the administrations of Ronald Reagan and George W. Bush. The early Reagan administration (1981-1983) launched an overt attack on the EPA, combining deregulation with budget and staff cuts, whereas the George W. Bush administration (2001-2008) adopted a subtler approach, undermining science-based policy. The current administration combines both these strategies and operates in a political context more favorable to its designs on the EPA. The Republican Party has shifted right and now controls the executive branch and both chambers of Congress. Wealthy donors, think tanks, and fossil fuel and chemical industries have become more influential in pushing deregulation. Among the public, political polarization has increased, the environment has become a partisan issue, and science and the mainstream media are distrusted. For these reasons, the effects of today's ongoing regulatory delays, rollbacks, and staff cuts may well surpass those of the administrations of Reagan and Bush, whose impacts on environmental health were considerable.

[UV Protection Law. Enhancing the protection of minors against health risks from solaria].

PubMed

Riemer, M

2006-12-01

The article reports on a petition to the German Bundestag in the field of UV protection for persons under the age of 18 against the dangers of artificial sunbed tanning for cosmetic purposes. On 16 March 2006 the Parliament agreed to adopt the proposal of the author, after the Ministry of Environment announced it is working on a UV Protection Law for Germany. Furthermore the committee recommended the petition to the government and the parliamentary parties. The UV Protection Law is still in progress, and no draft has yet been published. Therefore, the author explains the difficulties in creating such law from a legal and a public health perspective, pointing out that the split of competence between the federation and the states poses difficulties. He concludes that the German Constitution would allow a sunbed prohibition for minors in public studios and explains why a complete prohibition for the adult population would be disproportionate and unconstitutional.

Access to health care and equal protection of the law: the need for a new heightened scrutiny.

PubMed

Mariner, W K

1986-01-01

Proposals to reduce national expenditures for health care under Medicare and other programs raise questions about the limits on legislative power to distribute health care benefits. The constitutional guarantee of equal protection has been a weak source of protection for the sick, largely because they fail to qualify for special scrutiny under traditional equal protection analysis. Recent decisions of the United States Supreme Court suggest that the Justices seek a newer, more flexible approach to reviewing claims of unequal protection. This Article examines the application of the equal protection guarantee to health-related claims. It argues that traditional equal protection analysis is too rigid and newer rationality review too imprecise to provide just eligibility determinations. The Article concludes that courts should subject claims of unequal protection in the health care context to heightened scrutiny, as health care plays a special role in assuring equality of opportunity.

An Adult Protective Services' view of collaboration with Mental Health Services.

PubMed

Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia

2009-10-01

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

Balancing Good Intentions: Protecting the Privacy of Electronic Health Information

ERIC Educational Resources Information Center

McClanahan, Kitty

2008-01-01

Electronic information is a vital but complex component in the modern health care system, fueling ongoing efforts to develop a universal electronic health record infrastructure. This innovation creates a substantial tension between two desirable values: the increased quality and utility of patient medical records and the protection of the privacy…

COMPUTATIONAL TOXICOLOGY: NEW APPROACHES TO IMPROVE ENVIRONMENTAL HEALTH PROTECTION

EPA Science Inventory

The mission of the U.S. Environmental Protection Agency is to safeguard public health and the environment from harmful effects that may be caused by exposure to pollutants in the air, water, soil and food.

Protection motivation theory and adolescent drug trafficking: relationship between health motivation and longitudinal risk involvement.

PubMed

Wu, Ying; Stanton, Bonita F; Li, Xiaoming; Galbraith, Jennifer; Cole, Matthew L

2005-03-01

To assess health protection motivation as explained by the constructs of protection motivation theory (PMT) and its association with drug trafficking over 2 years. The sample included 817 African American youth (13-16 years old) participating in an adolescent risk-reduction program. We developed an instrument measuring the level of health protection motivation (LHPM) using factor analysis. Changes in LHPM over time were examined among drug traffickers, abstainers, initiators, and nonrisk youths. In sum, 151 participants reported selling and/or delivering drugs during the study period. The significant inverse correlation between drug-trafficking intention and health protection motivation was consistent with PMT. Changes in LHPM were strongly associated with the dynamics of behavior over 2 years. Adolescent drug trafficking can be predicted by an overall level of health protection motivation. PMT and related theories should be considered in the design of drug-trafficking prevention intervention.

Observations of infection prevention and control practices in primary health care, Kenya.

PubMed

Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

2017-07-01

To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

AIDS-related health behavior: coping, protection motivation, and previous behavior.

PubMed

Van der Velde, F W; Van der Pligt, J

1991-10-01

The purpose of this study was to examine Rogers' protection motivation theory and aspects of Janis and Mann's conflict theory in the context of AIDS-related health behavior. Subjects were 84 heterosexual men and women and 147 homosexual men with multiple sexual partners; LISREL's path-analysis techniques were used to evaluate the goodness of fit of the structural equation models. Protection motivation theory did fit the data but had considerably more explanatory power for heterosexual than for homosexual subjects (49 vs. 22%, respectively). When coping styles were added, different patterns of findings were found among both groups. Adding variables such as social norms and previous behavior increased the explained variance to 73% for heterosexual subjects and to 44% for homosexual subjects. It was concluded that although protection motivation theory did fit the data fairly adequately, expanding the theory with other variables--especially those related to previous behavior--could improve our understanding of AIDS-related health behavior.

Financial protection from health spending in the Philippines: policies and progress.

PubMed

Bredenkamp, Caryn; Buisman, Leander R

2016-09-01

The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. © The Author 2016. Published by Oxford University Press

48 CFR 2052.235-71 - Safety, health, and fire protection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... performance of the work under this contract to protect the health and safety of its employees and of members... hazards to life and property. The contractor shall comply with all applicable health, safety, and fire... an order stopping all or any part of the work. Thereafter, a start work order for resumption of work...

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru

PubMed Central

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-01-01

Objective This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Design Population based-survey with a nested case–control study. Setting Morropon, a semiurban district located in Piura, northern Peru. Participants For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case–control study, only one participant, case or control, per household was included in the study. Primary and secondary outcome measures Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. Results The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. Conclusions People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions

Inclusion of persons with disabilities in systems of social protection: a population-based survey and case-control study in Peru.

PubMed

Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl

2016-08-26

This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. Population based-survey with a nested case-control study. Morropon, a semiurban district located in Piura, northern Peru. For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Protecting policy space for public health nutrition in an era of international investment agreements.

PubMed

Thow, Anne Marie; McGrady, Benn

2014-02-01

Philip Morris has recently brought claims against Australia (2011) and Uruguay (2010) under international investment agreements (IIAs). The claims allege that Philip Morris is entitled to compensation following the introduction of innovative tobacco packaging regulations to reduce smoking and prevent noncommunicable diseases (NCDs). Since tobacco control measures are often viewed as a model for public health nutrition measures, the claims raise the question of how investment law governs the latter. This paper begins to answer this question and to explain how governments can proactively protect policy space for public health nutrition in an era of expanding IIAs. The authors first consider the main interventions proposed to reduce diet-related NCDs and their intersection with investment in the food supply chain. They then review the nature of investment regimes and relevant case law and examine ways to maximize policy space for public health nutrition intervention within this legal context. As foreign investment increases across the food-chain and more global recommendations discouraging the consumption of unhealthful products are issued, investment law will increase in importance as part of the legal architecture governing the food supply. The implications of investment law for public health nutrition measures depend on various factors: the measures themselves, the terms of the applicable agreements, the conditions surrounding the foreign investment and the policies governing agricultural support. This analysis suggests that governments should adopt proactive measures--e.g. the clarification of terms and reliance on exceptions--to manage investment and protect their regulatory autonomy with respect to public health nutrition.

Protecting policy space for public health nutrition in an era of international investment agreements

PubMed Central

McGrady, Benn

2014-01-01

Abstract Philip Morris has recently brought claims against Australia (2011) and Uruguay (2010) under international investment agreements (IIAs). The claims allege that Philip Morris is entitled to compensation following the introduction of innovative tobacco packaging regulations to reduce smoking and prevent noncommunicable diseases (NCDs). Since tobacco control measures are often viewed as a model for public health nutrition measures, the claims raise the question of how investment law governs the latter. This paper begins to answer this question and to explain how governments can proactively protect policy space for public health nutrition in an era of expanding IIAs. The authors first consider the main interventions proposed to reduce diet-related NCDs and their intersection with investment in the food supply chain. They then review the nature of investment regimes and relevant case law and examine ways to maximize policy space for public health nutrition intervention within this legal context. As foreign investment increases across the food-chain and more global recommendations discouraging the consumption of unhealthful products are issued, investment law will increase in importance as part of the legal architecture governing the food supply. The implications of investment law for public health nutrition measures depend on various factors: the measures themselves, the terms of the applicable agreements, the conditions surrounding the foreign investment and the policies governing agricultural support. This analysis suggests that governments should adopt proactive measures – e.g. the clarification of terms and reliance on exceptions – to manage investment and protect their regulatory autonomy with respect to public health nutrition. PMID:24623907

HIV and Child Mental Health: A Case-Control Study in Rwanda

PubMed Central

Scorza, Pamela; Kanyanganzi, Frederick; Fawzi, Mary C. Smith; Sezibera, Vincent; Cyamatare, Felix; Beardslee, William; Stulac, Sara; Bizimana, Justin I.; Stevenson, Anne; Kayiteshonga, Yvonne

2014-01-01

BACKGROUND: The global HIV/AIDS response has advanced in addressing the health and well-being of HIV-positive children. Although attention has been paid to children orphaned by parental AIDS, children who live with HIV-positive caregivers have received less attention. This study compares mental health problems and risk and protective factors in HIV-positive, HIV-affected (due to caregiver HIV), and HIV-unaffected children in Rwanda. METHODS: A case-control design assessed mental health, risk, and protective factors among 683 children aged 10 to 17 years at different levels of HIV exposure. A stratified random sampling strategy based on electronic medical records identified all known HIV-positive children in this age range in 2 districts in Rwanda. Lists of all same-age children in villages with an HIV-positive child were then collected and split by HIV status (HIV-positive, HIV-affected, and HIV-unaffected). One child was randomly sampled from the latter 2 groups to compare with each HIV-positive child per village. RESULTS: HIV-affected and HIV-positive children demonstrated higher levels of depression, anxiety, conduct problems, and functional impairment compared with HIV-unaffected children. HIV-affected children had significantly higher odds of depression (1.68: 95% confidence interval [CI] 1.15–2.44), anxiety (1.77: 95% CI 1.14–2.75), and conduct problems (1.59: 95% CI 1.04–2.45) compared with HIV-unaffected children, and rates of these mental health conditions were similar to HIV-positive children. These results remained significant after controlling for contextual variables. CONCLUSIONS: The mental health of HIV-affected children requires policy and programmatic responses comparable to HIV-positive children. PMID:25049342

HIV and child mental health: a case-control study in Rwanda.

PubMed

Betancourt, Theresa; Scorza, Pamela; Kanyanganzi, Frederick; Fawzi, Mary C Smith; Sezibera, Vincent; Cyamatare, Felix; Beardslee, William; Stulac, Sara; Bizimana, Justin I; Stevenson, Anne; Kayiteshonga, Yvonne

2014-08-01

The global HIV/AIDS response has advanced in addressing the health and well-being of HIV-positive children. Although attention has been paid to children orphaned by parental AIDS, children who live with HIV-positive caregivers have received less attention. This study compares mental health problems and risk and protective factors in HIV-positive, HIV-affected (due to caregiver HIV), and HIV-unaffected children in Rwanda. A case-control design assessed mental health, risk, and protective factors among 683 children aged 10 to 17 years at different levels of HIV exposure. A stratified random sampling strategy based on electronic medical records identified all known HIV-positive children in this age range in 2 districts in Rwanda. Lists of all same-age children in villages with an HIV-positive child were then collected and split by HIV status (HIV-positive, HIV-affected, and HIV-unaffected). One child was randomly sampled from the latter 2 groups to compare with each HIV-positive child per village. HIV-affected and HIV-positive children demonstrated higher levels of depression, anxiety, conduct problems, and functional impairment compared with HIV-unaffected children. HIV-affected children had significantly higher odds of depression (1.68: 95% confidence interval [CI] 1.15-2.44), anxiety (1.77: 95% CI 1.14-2.75), and conduct problems (1.59: 95% CI 1.04-2.45) compared with HIV-unaffected children, and rates of these mental health conditions were similar to HIV-positive children. These results remained significant after controlling for contextual variables, there were no significant differences on mental health outcomes groups, reflecting a potential explanatory role of factors such as daily hardships, caregiver depression, and HIV-related stigma [corrected]. The mental health of HIV-affected children requires policy and programmatic responses comparable to HIV-positive children. Copyright © 2014 by the American Academy of Pediatrics.

Social capital and health-protective behavior intentions in an influenza pandemic.

PubMed

Chuang, Ying-Chih; Huang, Ya-Li; Tseng, Kuo-Chien; Yen, Chia-Hsin; Yang, Lin-hui

2015-01-01

Health-protective behaviors, such as receiving a vaccine, wearing a face mask, and washing hands frequently, can reduce the risk of contracting influenza. However, little is known about how social capital may influence health-protective behavior in the general population. This study examined whether each of the social capital dimensions (bonding, bridging, and linking) contributed to the intention to adopt any of the health-protective behaviors in an influenza pandemic. The data of this study were from the 2014 Taiwan Social Change Survey. A stratified, three-stage probability proportional-to-size sampling from across the nation, was conducted to select adults aged 20 years and older (N = 1,745). Bonding social capital was measured by the frequency of neighborly contact and support. Bridging social capital was measured based on association membership. Linking social capital was measured according to general government trust and trust in the government's capacity to counter an influenza pandemic. Binary logistic regressions were used to assess the multivariate associations between social capital and behavioral intention. The study results indicate that social capital may influence the response to influenza pandemic. Specifically, the intention to receive a vaccine and to wash hands more frequently were associated with the linking dimension and the bonding dimension of social capital, while the intention to wear a face mask was associated with all forms of social capital. The findings of this study suggest that government credibility and interpersonal networks may play a crucial role in health-protective behavior. This study provides new insights into how to improve the effectiveness of influenza prevention campaigns.

Patents and the obligation to protect health: examining the significance of human rights considerations in the protection of pharmaceutical patents.

PubMed

Owoeye, Olasupo Ayodeji

2014-06-01

This article discusses the human right to health in the context of patent protection and access to medicines. It considers the limitations in international human rights law, especially in relation to socioeconomic rights, that make it difficult for the right to health to be a potent justification for derogation from trade or intellectual property agreements. It concludes by taking the view that while the right to health may be somewhat unenforceable in international law, its close association with enforceable rights such as the right to life can be a legitimate basis for making maximum use of the flexibilities in the international intellectual property regime to protect public health. The article takes the view that trade and intellectual property agreements must be interpreted in a way that endeavours as much as possible to resolve any seeming inconsistency with the right to health.

Integrating Worksite Health Protection and Health Promotion: A Conceptual Model for Intervention and Research

PubMed Central

Sorensen, Glorian; McLellan, Deborah L.; Sabbath, Erika L.; Dennerlein, Jack T.; Nagler, Eve M.; Hurtado, David A.; Pronk, Nicolaas P.; Wagner, Gregory R.

2016-01-01

There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009–2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting’s conditions of work. PMID:27527576

Assessing different measures of population-level vaccine protection using a case-control study.

PubMed

Ali, Mohammad; You, Young Ae; Kanungo, Suman; Manna, Byomkesh; Deen, Jacqueline L; Lopez, Anna Lena; Wierzba, Thomas F; Bhattacharya, Sujit K; Sur, Dipika; Clemens, John D

2015-11-27

Case-control studies have not been examined for their utility in assessing population-level vaccine protection in individually randomized trials. We used the data of a randomized, placebo-controlled trial of a cholera vaccine to compare the results of case-control analyses with those of cohort analyses. Cases of cholera were selected from the trial population followed for three years following dosing. For each case, we selected 4 age-matched controls who had not developed cholera. For each case and control, GIS was used to calculate vaccine coverage of individuals in a surrounding "virtual" cluster. Specific selection strategies were used to evaluate the vaccine protective effects. 66,900 out of 108,389 individuals received two doses of the assigned regimen. For direct protection among subjects in low vaccine coverage clusters, we observed 78% (95% CI: 47-91%) protection in a cohort analysis and 84% (95% CI: 60-94%) in case-control analysis after adjusting for confounding factors. Using our GIS-based approach, estimated indirect protection was 52% (95% CI: 10-74%) in cohort and 76% (95% CI: 47-89%) in case control analysis. Estimates of total and overall effectiveness were similar for cohort and case-control analyses. The findings show that case-control analyses of individually randomized vaccine trials may be used to evaluate direct as well as population-level vaccine protection. Copyright © 2015. Published by Elsevier Ltd.

[The necessity of new approaches to the elaboration of the projects for the sanitary (mountainous sanitary) protection districts around the therapeutic and health-promotion facilities, health resorts and their natural medical resources].

PubMed

Razumov, A N; Adilov, V B

2015-01-01

The international experience gained during the past two centuries indicates that the most efficient and rational way to ensure the protection of the territories occupied by the therapeutic and health-promotion facilities, spa centres, and health resorts together with their natural medical resources is to set up sanitary (mountainous sanitary) protection districts or zones along the perimeter of these territories. Beginning from 2000, numerous changes and amendments have been annually introduced in the Russian legislation intended to ensure efficacious control over the rational exploitation of the territories of therapeutic and health-promotion value and their natural medical resources. These initiatives have negative effect on the activities of these organizations and the quality of the services they are expected to provide. Taken together these effects lead to the degradation of the spa and health resort business. Bearing in mind the current conditions for economic activities, it is proposed, in contrast to the former global approach, to envisage in the aforementioned projects the establishment of the sanitary (mountainous sanitary) protection districts or zones and determine their borders based on the results of the assessment of their potential for the protection of therapeutic factors and other valuable resources. Equally important is the maximum reduction of the areas of the second and third zones taking into account their relevant objective characteristics. In certain cases, the protective district may coincide with the second zone. As far as the federal health resorts and large territories of special health-promotion value are concerned, some of them may have two or more sanitary (mountainous sanitary) protection districts. Both the owners and the users of these territories should be provided the necessary and sufficient possibilities for the rational nature use at the grounds and in the adjacent water areas suitable for the development of health resort

Youth-Adult Connectedness:: A Key Protective Factor for Adolescent Health.

PubMed

Sieving, Renee E; McRee, Annie-Laurie; McMorris, Barbara J; Shlafer, Rebecca J; Gower, Amy L; Kapa, Hillary M; Beckman, Kara J; Doty, Jennifer L; Plowman, Shari L; Resnick, Michael D

2017-03-01

Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

ERIC Educational Resources Information Center

Duffy, Joe; Davidson, Gavin; Kavanagh, Damien

2016-01-01

There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

Veterinarians in Environmental Health: Opportunities for Veterinarians at the Environmental Protection Agency

EPA Science Inventory

The United States Environmental Protection Agency (EPA) was created in 1970 partially in response to widespread public concern about environmental degradation. The EPA mission is to protect human health and the environment and the Agency is tasked with enforcing our nation's envi...

45 CFR 164.520 - Notice of privacy practices for protected health information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... organized health care arrangement; (2) The joint notice meets the implementation specifications in paragraph... 45 Public Welfare 1 2011-10-01 2011-10-01 false Notice of privacy practices for protected health information. 164.520 Section 164.520 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE...

45 CFR 164.520 - Notice of privacy practices for protected health information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... organized health care arrangement; (2) The joint notice meets the implementation specifications in paragraph... 45 Public Welfare 1 2010-10-01 2010-10-01 false Notice of privacy practices for protected health information. 164.520 Section 164.520 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE...

Programming microphysiological systems for children's health protection (SEBM meeting)

EPA Science Inventory

Presentation: Programming microphysiological systems for children’s health protectionAuthors: Knudsen1 T, Klieforth2 B, and Slikker3 W Jr.1National Center for Computational Toxicology/EPA, Research Triangle Park NC2National Center for Environmental Research/EPA, Washington DC3Nat...

Workplace incivility and new graduate nurses' mental health: the protective role of resiliency.

PubMed

Laschinger, Heather K; Wong, Carol; Regan, Sandra; Young-Ritchie, Carol; Bushell, Pamela

2013-01-01

The aim of this study was to examine the relationships between coworker, physician, and supervisor workplace incivility and new graduate nurses' mental health and the protective role of personal resiliency. Positive interpersonal relationships in healthcare work environments are important for new graduate nurses' career transition and commitment. Workplace incivility threatens new graduate nurses' health and well-being. Personal resiliency helps employees to recover from negative stressors and may protect new nurses from the negative effects of workplace incivility. We surveyed 272 new graduate nurses in Ontario to explore the influence of 3 forms of workplace incivility and personal resiliency on new nurses' mental health. All sources of incivility were related to poor mental health. Results suggest that personal resiliency may protect nurses from the negative effects of incivility. New nurses are experiencing workplace incivility from a variety of sources in their work environments, which have detrimental effects on their workplace well-being.

Observations of infection prevention and control practices in primary health care, Kenya

PubMed Central

Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana

2017-01-01

Abstract Objective To assess compliance with infection prevention and control practices in primary health care in Kenya. Methods We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker’s and facility’s characteristics. Findings Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility’s characteristics (e.g. public or private, or level of specialization) and the health-care worker’s knowledge of, and training in, infection prevention and control practices. Conclusion The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required. PMID:28670015

Protective and control relays as coal-mine power-supply ACS subsystem

NASA Astrophysics Data System (ADS)

Kostin, V. N.; Minakova, T. E.

2017-10-01

The paper presents instantaneous selective short-circuit protection for the cabling of the underground part of a coal mine and central control algorithms as a Coal-Mine Power-Supply ACS Subsystem. In order to improve the reliability of electricity supply and reduce the mining equipment down-time, a dual channel relay protection and central control system is proposed as a subsystem of the coal-mine power-supply automated control system (PS ACS).

Collaboration between infection control and occupational health in three continents: a success story with international impact.

PubMed

Yassi, Annalee; Bryce, Elizabeth A; Breilh, Jaime; Lavoie, Marie-Claude; Ndelu, Lindiwe; Lockhart, Karen; Spiegel, Jerry

2011-11-08

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work.The products developed have been widely heralded as innovative and interactive, leading to their inclusion into "toolkits" used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational

Collaboration between infection control and occupational health in three continents: a success story with international impact

PubMed Central

2011-01-01

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between

Does the financial protection of health insurance vary across providers? Vietnam's experience.

PubMed

Sepehri, Ardeshir; Sarma, Sisira; Oguzoglu, Umut

2011-08-01

Using household panel data from Vietnam, this paper compares out-of-pocket health expenditures on outpatient care at a health facility between insured and uninsured patients as well as across various providers. In the random effects model, the estimated coefficient of the insurance status variable suggests that insurance reduces out-of-pocket spending by 24% for those with the compulsory and voluntary coverage and by about 15% for those with the health insurance for the poor coverage. However, the modest financial protection of the compulsory and voluntary schemes disappears once we control for time-invariant unobserved individual effects using the fixed effects model. Additional analysis of the interaction terms involving the type of insurance and health facility suggests that the overall insignificant reduction in out-of-pocket expenditures as a result of the insurance schemes masks wide variations in the reduction in out-of-pocket sending across various providers. Insurance reduces out-of-pocket expenditures more for those enrollees using district and higher level public health facilities than those using commune health centers. Compared to the uninsured patients using district hospitals, compulsory and voluntary insurance schemes reduce out-of-pocket expenditures by 40 and 32%, respectively. However, for contacts at the commune health centers, both the compulsory health scheme and the voluntary health insurance scheme schemes have little influence on out-of-pocket spending while the health insurance scheme for the poor reduces out-of-pocket spending by about 15%. Copyright © 2011 Elsevier Ltd. All rights reserved.

Are current guidelines for sun protection optimal for health? Exploring the evidence.

PubMed

Lucas, Robyn M; Neale, Rachel E; Madronich, Sasha; McKenzie, Richard L

2018-06-15

Exposure of the skin to ultraviolet (UV) radiation is the main risk factor for skin cancer, and a major source of vitamin D, in many regions of the world. Sun protection messages to minimize skin cancer risks but avoid vitamin D deficiency are challenging, partly because levels of UV radiation vary by location, season, time of day, and atmospheric conditions. The UV Index provides information on levels of UV radiation and is a cornerstone of sun protection guidelines. Current guidelines from the World Health Organization are that sun protection is required only when the UV Index is 3 or greater. This advice is pragmatic rather than evidence based. The UV Index is a continuous scale; more comprehensive sun protection is required as the UV Index increases. In addition, a wide range of UVA doses is possible with a UVI of 3, from which there may be health consequences, while full sun protection when the UVI is "moderate" (between 3 and 5) may limit vitamin D production. Finally, the duration of time spent in the sun is an essential component of a public health message, in addition to the intensity of ambient UV radiation as measured by the UV Index. Together these provide the dose of UV radiation that is relevant to both skin cancer genesis and vitamin D production. Further education is required to increase the understanding of the UV Index; messages framed using the UV Index need to incorporate the importance of duration of exposure and increasing sun protection with increasing dose of UV radiation.

An Optimized Integrator Windup Protection Technique Applied to a Turbofan Engine Control

NASA Technical Reports Server (NTRS)

Watts, Stephen R.; Garg, Sanjay

1995-01-01

This paper introduces a new technique for providing memoryless integrator windup protection which utilizes readily available optimization software tools. This integrator windup protection synthesis provides a concise methodology for creating integrator windup protection for each actuation system loop independently while assuring both controller and closed loop system stability. The individual actuation system loops' integrator windup protection can then be combined to provide integrator windup protection for the entire system. This technique is applied to an H(exp infinity) based multivariable control designed for a linear model of an advanced afterburning turbofan engine. The resulting transient characteristics are examined for the integrated system while encountering single and multiple actuation limits.

How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?

PubMed

Ritchie, Deborah Doreen; Amos, Amanda; Shaw, April; O'Donnell, Rachel; Semple, Sean; Turner, Steve; Martin, Claudia

2015-01-01

The aim is to extend understanding of the policy and practice discourses that inform the development of national tobacco control policy to protect children from secondhand smoke exposure (SHSE) in the home, particularly in a country with successful implementation of smoke-free public places legislation. The Scottish experience will contribute to the tobacco control community, particularly those countries at a similar level of tobacco control, as normalising discourses about protecting children from SHSE are becoming more widespread. Case study design using qualitative interviews and focus groups (FGs) with policy makers, health and childcare practitioners during which they were presented with the findings of the Reducing Families' Exposure to Secondhand Smoke (REFRESH) intervention and discussed the implications for their policy and practice priorities. Scotland, UK PARTICIPANTS: Qualitative interviews and FGs were conducted with 30 policy makers and practitioners who were purposively recruited. Participants accepted the harm of SHSE to children; however, action is limited by political expedience due to-the perception of a shift of the public health priority from smoking to alcohol, current financial constraints, more immediate child protection concerns and continuing unresolved ethical arguments. In a country, such as Scotland, with advanced tobacco control strategies, there continue to be challenges to policy and practice development in the more contentious arena of the home. Children's SHSE in their homes is unequivocally accepted as an important health priority, but it is not currently perceived to be a top public health priority in Scotland. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effects of mutual health organizations on use of priority health-care services in urban and rural Mali: a case-control study.

PubMed

Franco, Lynne Miller; Diop, François Pathé; Burgert, Clara R; Kelley, Allison Gamble; Makinen, Marty; Simpara, Cheick Hamed Tidiane

2008-11-01

To examine the effects of a community-based mutual health organization (MHO) on utilization of priority health services, financial protection of its members and inclusion of the poor and other target groups. Four MHOs were established in two districts in Mali. A case-control study was carried out in which household survey data were collected from 817 MHO member households, 787 non-member households in MHO catchment areas, and 676 control households in areas without MHOs. We compiled MHO register data by household for a 22-month period. Outcome measures included utilization of priority services, health expenditures and out-of-pocket payments. Independent variables included individual, household and community demographic, socioeconomic and access characteristics, as determined through a household survey in 2004. MHO members who were up to date on premium payments (controlling for education, distance to the nearest health facility and other factors) were 1.7 times more likely to get treated for fevers in modern facilities; three times more likely to take children with diarrhoea to a health facility and/or treat them with oral rehydration salts at home; twice as likely to make four or more prenatal visits; and twice as likely, if pregnant or younger than 5 years, to sleep under an insecticide-treated net (P < 0.10 or better in all cases). However, distance was also a significant negative predictor for the utilization of many services, particularly assisted deliveries. Household and individual enrolment in an MHO were not significantly associated with socioeconomic status (with the exception of the highest quintile), and MHOs seemed to provide some financial protection for their members. MHOs are one mechanism that countries strengthening the supply of primary care can use to increase financial access to - and equity in - priority health services.

Development of Protection and Control Unit for Distribution Substation

NASA Astrophysics Data System (ADS)

Iguchi, Fumiaki; Hayashi, Hideyuki; Takeuchi, Motohiro; Kido, Mitsuyasu; Kobayashi, Takashi; Yanaoka, Atsushi

The Recently, electronics and IT technologies have been rapidly innovated and have been introduced to power system protection & control system to achieve high reliability, maintainability and more functionality. Concerning the distribution substation application, digital relays have been applied for more than 10 years. Because of a number of electronic devices used for it, product cost becomes higher. Also, products installed during the past high-growth period will be at the end of lifetime and will be replaced. Therefore, replacing market is expected to grow and the reduction of cost is demanded. Considering above mentioned background, second generation digital protection and control unit as a successor is designed to have following concepts. Functional integration based on advanced digital technologies, Ethernet LAN based indoor communication network, cost reduction and downsizing. Pondering above concepts, integration of protection and control function is adopted in contrary to the functional segregation applied to the previous system in order to achieve one-unit concept. Also the adoption of Ethernet LAN for inter-unit communication is objective. This report shows the development of second-generation digital relay for distribution substation, which is equipped with control function and Ethernet LAN by reducing the size of auxiliary transformer unit and the same size as previous product is realized.

Does the National Health Insurance Scheme provide financial protection to households in Ghana?

PubMed

Kusi, Anthony; Hansen, Kristian Schultz; Asante, Felix A; Enemark, Ulrika

2015-08-15

Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting direct out-of-pocket health expenditures (OOPHE). The study examines the effect of the NHIS on OOPHE and how it protects households against catastrophic health expenditures. Data was obtained from a cross-sectional representative household survey involving 2,430 households from three districts across Ghana. All OOPHE associated with treatment seeking for reported illness in the household in the last 4 weeks preceding the survey were analysed and compared between insured and uninsured persons. The incidence and intensity of catastrophic health expenditures (CHE) among households were measured by the catastrophic health payment method. The relative effect of NHIS on the incidence of CHE in the household was estimated by multiple logistic regression analysis. About 36% of households reported at least one illness during the 4 weeks period. Insured patients had significantly lower direct OOPHE for out-patient and in-patient care compared to the uninsured. On financial protection, the incidence of CHE was lower among insured households (2.9%) compared to the partially insured (3.7%) and the uninsured (4.0%) at the 40% threshold. The incidence of CHE was however significantly lower among fully insured households (6.0%) which sought healthcare from NHIS accredited health facilities compared to the partially insured (10.1%) and the uninsured households (23.2%). The likelihood of a household incurring CHE was 4.2 times less likely for fully insured and 2.9 times less likely for partially insured households relative to being uninsured. The NHIS has however not completely eliminated OOPHE for the

Force Health Protection: the mission and political context of the longitudinal health record.

PubMed

Collmann, Jeff

2009-05-01

Drawing upon an extensive search of publically available literature and discussions at the "National Forum on the Future of the Defense Health Information System," this article documents the evolving mission and political context of the longitudinal health record (LHR) as an instrument for Force Health Protection (FHP). Because of the Gulf War syndrome controversy, the Department of Defense (DoD) launched an ambitious, complex series of programs designed to create a comprehensive, integrated defense health surveillance capability to assure FHP and keep faith with the American people. This "system of systems" includes individual component systems to perform specific functions such as disease surveillance, battlefield assessment, and patient care and consolidates these diverse types of information into centrally accessible archives that serve the interests of occupational health, preventive medicine, medical strategic planning, and longitudinal patient health care. After 25 years of effort and major accomplishments, progress toward a LHR remains uneven and controversy persists.

Measuring financial protection for health in families with chronic conditions in Rural China.

PubMed

Jiang, Chunhong; Ma, Jingdong; Zhang, Xiang; Luo, Wujin

2012-11-16

As the world's largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New Cooperative Medical Schemes. Given the

Measuring financial protection for health in families with chronic conditions in Rural China

PubMed Central

2012-01-01

Background As the world’s largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. Methods We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. Results An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. Conclusions There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New

Protecting our children's health: The ultimate government 'stimulus package'.

PubMed

Oliver, L Christine

2009-07-01

The Children's Environment and Health Action Plan for Europe has established four Regional Priority Goals (RPG) for the protection of the health of children. Hutter et al (JPHP 2009) have developed and tested an accessible method for addressing one aspect of RPG III: indoor and outdoor air pollution. The study provides an accessible method for use by communities to access effects of air pollution in and around the home on the respiratory health of children. This Commentary reviews that study, as well as other evidence in the scientific literature of effects of indoor and outdoor air pollution on children's respiratory health. In addition, this Commentary discusses the importance of air quality in schools to children's respiratory health and to school attendance and performance, citing supportive dat and urging action on this front.

To what extent can China’s near-term air pollution control policy protect air quality and human health? A case study of the Pearl River Delta region

NASA Astrophysics Data System (ADS)

Jiang, Xujia; Hong, Chaopeng; Zheng, Yixuan; Zheng, Bo; Guan, Dabo; Gouldson, Andy; Zhang, Qiang; He, Kebin

2015-10-01

Following a series of extreme air pollution events, the Chinese government released the Air Pollution Prevention and Control Action Plan in 2013 (China’s State Council 2013). The Action Plan sets clear goals for key regions (i.e. cities above the prefecture level, Beijing-Tianjin-Hebei Province, the Yangtze River Delta and the Pearl River Delta) and establishes near-term control efforts for the next five years. However, the extent to which the Action Plan can direct local governments’ activities on air pollution control remains unknown. Here we seek to evaluate the air quality improvement and associated health benefits achievable under the Action Plan in the Pearl River Delta (PRD) area from 2012 to 2017. Measure-by-measure quantification results show that the Action Plan would promise effective emissions reductions of 34% of SO2, 28% of NOx, 26% of PM2.5 (particulate matter less than 2.5 μm in diameter), and 10% of VOCs (volatile organic compounds). These emissions abatements would lower the PM2.5 concentration by 17%, surpassing the 15% target established in the Action Plan, thereby avoiding more than 2900 deaths and 4300 hospital admissions annually. We expect the implementation of the Action Plan in the PRD would be productive; the anticipated impacts, however, fall short of the goal of protecting the health of local residents, as there are still more than 33 million people living in places where the annual mean ambient PM2.5 concentrations are greater than 35 μg m-3, the interim target-3 of the World Health Organization (WHO). We therefore propose the next steps for air pollution control that are important not only for the PRD but also for all other regions of China as they develop and implement effective air pollution control policies.

US Centers for Disease Control and Prevention and Its Partners' Contributions to Global Health Security.

PubMed

Tappero, Jordan W; Cassell, Cynthia H; Bunnell, Rebecca E; Angulo, Frederick J; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca

2017-12-01

To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.

US Centers for Disease Control and Prevention and Its Partners’ Contributions to Global Health Security

PubMed Central

Cassell, Cynthia H.; Bunnell, Rebecca E.; Angulo, Frederick J.; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A.; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca

2017-01-01

To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world. PMID:29155656

Out-of-pocket expenditure and financial protection in the Chilean health care system-A systematic review.

PubMed

Koch, Kira Johanna; Cid Pedraza, Camilo; Schmid, Andreas

2017-05-01

Protection against financial risk due to medical spending is an explicit health guarantee within Chile's AUGE health reform. This paper seeks to analyze the degree to which out-of-pocket expenditure still expose Chilean households to financial catastrophe and impoverishment, and to explore inequalities in financial protection. A systematic literature review was conducted to identify empirical studies analyzing financial protection in Chile. The search included databases as well as grey literature, i.e. governmental and institutional webpages. The indicators are based on the conceptual framework of financial protection, as portrayed in the World Health Report 2013. We identify n=16 studies that fulfill the inclusion criteria. Empirical studies indicate that 4% of Chilean households faced catastrophic health expenditure defined as out-of-pocket expenditure exceeding 30% of household's capacity to pay, while less than 1% were pushed into poverty in 2012. In contrast to prior studies, recent data report that even publicly insured who should be fully protected from co-payments were affected by catastrophic health expenditure. Also in the private insurance system financial catastrophe is a common risk. Despite health reform efforts, financial protection is insufficient and varies to the disadvantage of the poor and vulnerable groups. More research is required to understand why current mechanisms are not as effective as expected and to enable according reforms of the insurance system. Copyright © 2017 Elsevier B.V. All rights reserved.

Financial risk protection from social health insurance.

PubMed

Barnes, Kayleigh; Mukherji, Arnab; Mullen, Patrick; Sood, Neeraj

2017-09-01

This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection. Results show that insurance reduces out-of-pocket costs, particularly in higher quantiles of the distribution. We find reductions in the frequency and amount of money borrowed for health reasons. Finally, we find that the value of financial risk reduction outweighs total per household costs of the insurance program by two to five times. Copyright © 2017. Published by Elsevier B.V.

30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., property, and the environment? (a) You must protect health, safety, property, and the environment by: (1... would have a significant effect on safety, health, or the environment; (2) If it is economically... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What must I do to protect health, safety...

30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

Code of Federal Regulations, 2012 CFR

2012-07-01

... the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing... would have a significant effect on safety, health, or the environment; (2) If it is economically... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What must I do to protect health, safety...

30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

Code of Federal Regulations, 2014 CFR

2014-07-01

... the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing... would have a significant effect on safety, health, or the environment; (2) If it is economically... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What must I do to protect health, safety...

30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

Code of Federal Regulations, 2013 CFR

2013-07-01

... the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing... would have a significant effect on safety, health, or the environment; (2) If it is economically... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What must I do to protect health, safety...

TREAT Reactor Control and Protection System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lipinski, W.C.; Brookshier, W.K.; Burrows, D.R.

1985-01-01

The main control algorithm of the Transient Reactor Test Facility (TREAT) Automatic Reactor Control System (ARCS) resides in Read Only Memory (ROM) and only experiment specific parameters are input via keyboard entry. Prior to executing an experiment, the software and hardware of the control computer is tested by a closed loop real-time simulation. Two computers with parallel processing are used for the reactor simulation and another computer is used for simulation of the control rod system. A monitor computer, used as a redundant diverse reactor protection channel, uses more conservative setpoints and reduces challenges to the Reactor Trip System (RTS).more » The RTS consists of triplicated hardwired channels with one out of three logic. The RTS is automatically tested by a digital Dedicated Microprocessor Tester (DMT) prior to the execution of an experiment. 6 refs., 5 figs., 1 tab.« less

76 FR 66927 - Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-28

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9484-1] Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... Avenue NW., Washington, DC 20460, (202) 564-2191, [email protected]epa.gov . SUPPLEMENTARY INFORMATION: The...

78 FR 65644 - Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9902-35-OA] Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... NW., Washington, DC 20460, (202) 564-2191 or [email protected]epa.gov . SUPPLEMENTARY INFORMATION: The...

Occupational Health for Health Care Providers

MedlinePlus

Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

National occupant protection use survey : controlled intersection study

DOT National Transportation Integrated Search

1995-05-01

In late 1994, NHTSA conducted the National Occupant Protection Use Survey : (NOPUS). NOPUS is composed of three separate studies: the moving traffic study : which provides information on overall shoulder belt use, the controlled : intersection study ...

Modifying attitude and intention toward regular physical activity using protection motivation theory: a randomized controlled trial.

PubMed

Mirkarimi, Kamal; Eri, Maryam; Ghanbari, Mohammad R; Kabir, Mohammad J; Raeisi, Mojtaba; Ozouni-Davaji, Rahman B; Aryaie, Mohammad; Charkazi, Abdurrahman

2017-10-30

We were guided by the Protection Motivation Theory to test the motivational interviewing effects on attitude and intention of obese and overweight women to do regular physical activity. In a randomized controlled trial, we selected using convenience sampling 60 overweight and obese women attending health centres. The women were allocated to 2 groups of 30 receiving a standard weight-control programme or motivational interviewing. All constructs of the theory (perceived susceptibility, severity, self-efficacy and response efficacy) and all anthropometric characteristics (except body mass index) were significantly different between the groups at 3 study times. The strongest predictors of intention to do regular physical exercise were perceived response efficacy and attitude at 2- and 6-months follow-up. We showed that targeting motivational interviewing with an emphasis on Protection Motivation Theory constructs appeared to be beneficial for designing and developing appropriate intervention to improve physical activity status among women with overweight and obesity.

Protecting nonlocality of multipartite states by feed-forward control

NASA Astrophysics Data System (ADS)

Li, Xiao-Gang; Zou, Jian; Shao, Bin

2018-06-01

Nonlocality is a useful resource in quantum communication and quantum information processing. In practical quantum communication, multipartite entangled states must be distributed between different users in different places through a channel. However, the channel is usually inevitably disturbed by the environment in quantum state distribution processing and then the nonlocality of states will be weakened and even lost. In this paper, we use a feed-forward control scheme to protect the nonlocality of the Bell and GHZ states against dissipation. We find that this protection scheme is very effective, specifically, for the Bell state, we can increase the noise threshold from 0.5 to 0.98, and for GHZ state from 0.29 to 0.96. And we also find that entanglement is relatively easier to be protected than nonlocality. For our scheme, protecting entanglement is equivalent to protecting the state in the case of Bell state, while protecting nonlocality is not.

The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes.

PubMed

Obermann, Konrad; Chanturidze, Tata; Glazinski, Bernd; Dobberschuetz, Karin; Steinhauer, Heiko; Schmidt, Jean-Olivier

2018-02-20

Managers and administrators in charge of social protection and health financing, service purchasing and provision play a crucial role in harnessing the potential advantage of prudent organization, management and purchasing of health services, thereby supporting the attainment of Universal Health Coverage. However, very little is known about the needed quantity and quality of such staff, in particular when it comes to those institutions managing mandatory health insurance schemes and purchasing services. As many health care systems in low- and middle-income countries move towards independent institutions (both purchasers and providers) there is a clear need to have good data on staff and administrative cost in different social health protection schemes as a basis for investing in the development of a cadre of health managers and administrators for such schemes. We report on a systematic literature review of human resources in health management and administration in social protection schemes and suggest some aspects in moving research, practical applications and the policy debate forward.

Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia's Experience.

PubMed

Rannan-Eliya, Ravindra P; Anuranga, Chamara; Manual, Adilius; Sararaks, Sondi; Jailani, Anis S; Hamid, Abdul J; Razif, Izzanie M; Tan, Ee H; Darzi, Ara

2016-05-01

Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources. Project HOPE—The People-to-People Health Foundation, Inc.

When does risk perception predict protection motivation for health threats? A person-by-situation analysis.

PubMed

Ferrer, Rebecca A; Klein, William M P; Avishai, Aya; Jones, Katelyn; Villegas, Megan; Sheeran, Paschal

2018-01-01

Although risk perception is a key concept in many health behavior theories, little research has explicitly tested when risk perception predicts motivation to take protective action against a health threat (protection motivation). The present study tackled this question by (a) adopting a multidimensional model of risk perception that comprises deliberative, affective, and experiential components (the TRIRISK model), and (b) taking a person-by-situation approach. We leveraged a highly intensive within-subjects paradigm to test features of the health threat (i.e., perceived severity) and individual differences (e.g., emotion reappraisal) as moderators of the relationship between the three types of risk perception and protection motivation in a within-subjects design. Multi-level modeling of 2968 observations (32 health threats across 94 participants) showed interactions among the TRIRISK components and moderation both by person-level and situational factors. For instance, affective risk perception better predicted protection motivation when deliberative risk perception was high, when the threat was less severe, and among participants who engage less in emotional reappraisal. These findings support the TRIRISK model and offer new insights into when risk perceptions predict protection motivation.

When does risk perception predict protection motivation for health threats? A person-by-situation analysis

PubMed Central

Klein, William M. P.; Avishai, Aya; Jones, Katelyn; Villegas, Megan; Sheeran, Paschal

2018-01-01

Although risk perception is a key concept in many health behavior theories, little research has explicitly tested when risk perception predicts motivation to take protective action against a health threat (protection motivation). The present study tackled this question by (a) adopting a multidimensional model of risk perception that comprises deliberative, affective, and experiential components (the TRIRISK model), and (b) taking a person-by-situation approach. We leveraged a highly intensive within-subjects paradigm to test features of the health threat (i.e., perceived severity) and individual differences (e.g., emotion reappraisal) as moderators of the relationship between the three types of risk perception and protection motivation in a within-subjects design. Multi-level modeling of 2968 observations (32 health threats across 94 participants) showed interactions among the TRIRISK components and moderation both by person-level and situational factors. For instance, affective risk perception better predicted protection motivation when deliberative risk perception was high, when the threat was less severe, and among participants who engage less in emotional reappraisal. These findings support the TRIRISK model and offer new insights into when risk perceptions predict protection motivation. PMID:29494705

78 FR 14790 - Notice of Meeting of the EPA Children's Health Protection Advisory Committee (CHPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9787-3] Notice of Meeting of the EPA Children's Health Protection Advisory Committee (CHPAC) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice [email protected]epa.gov . SUPPLEMENTARY INFORMATION: The meetings of the CHPAC are open to the public. The CHPAC...

76 FR 36918 - Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9322-9] Notice of Meeting of the EPA's Children's Health Protection Advisory Committee (CHPAC) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of..., USEPA, MC 1107T, 1200 Pennsylvania Avenue, NW., Washington, DC 20460, (202) 564-2191, [email protected]epa...

Perceived Barriers to Adherence to Tuberculosis Infection Control Measures among Health Care Workers in the Dominican Republic.

PubMed

Chapman, Helena J; Veras-Estévez, Bienvenido A; Pomeranz, Jamie L; Pérez-Then, Eddy N; Marcelino, Belkys; Lauzardo, Michael

2017-01-01

INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low. Identifying the causes of low adherence is a prerequisite to effective programming to reduce risk. OBJECTIVE Identify perceived barriers to adherence to tuberculosis infection control measures among health care workers in the Dominican Republic. METHODS During August 2014, a qualitative study was conducted in two tertiary-level hospitals in different regions of the Dominican Republic. A semi-structured interview guide of nine questions was developed, based on the scientific literature and with consensus of clinical experts. Nine semi-structured interviews were conducted with a purposive sample of seven physicians (five men, two women) and two baccalaureate nurses (both women) working in the emergency medicine, internal medicine or nursing departments of those institutions. Question topics included clinical experience of M. tuberculosis infection and disease; knowledge of disease transmission and preventive practices; clinical management strategies; and perceptions of effectiveness of directly observed treatment, short-course, and disease coping strategies. RESULTS Perceived barriers were described as: 1) sense of invincibility of health care workers; 2) personal beliefs of health care workers related to direct patient communication; 3) low provider-to-patient ratios in hospitals; 4) absence of tuberculosis isolation units for

Self management, joint protection and exercises in hand osteoarthritis: a randomised controlled trial with cost effectiveness analyses

PubMed Central

2011-01-01

Background There is limited evidence for the clinical and cost effectiveness of occupational therapy (OT) approaches in the management of hand osteoarthritis (OA). Joint protection and hand exercises have been proposed by European guidelines, however the clinical and cost effectiveness of each intervention is unknown. This multicentre two-by-two factorial randomised controlled trial aims to address the following questions: • Is joint protection delivered by an OT more effective in reducing hand pain and disability than no joint protection in people with hand OA in primary care? • Are hand exercises delivered by an OT more effective in reducing hand pain and disability than no hand exercises in people with hand OA in primary care? • Which of the four management approaches explored within the study (leaflet and advice, joint protection, hand exercise, or joint protection and hand exercise combined) provides the most cost-effective use of health care resources Methods/Design Participants aged 50 years and over registered at three general practices in North Staffordshire and Cheshire will be mailed a health survey questionnaire (estimated mailing sample n = 9,500). Those fulfilling the eligibility criteria on the health survey questionnaire will be invited to attend a clinical assessment to assess for the presence of hand or thumb base OA using the ACR criteria. Eligible participants will be randomised to one of four groups: leaflet and advice; joint protection (looking after your joints); hand exercises; or joint protection and hand exercises combined (estimated n = 252). The primary outcome measure will be the OARSI/OMERACT responder criteria combining hand pain and disability (measured using the AUSCAN) and global improvement, 6 months post-randomisation. Secondary outcomes will also be collected for example pain, functional limitation and quality of life. Outcomes will be collected at baseline and 3, 6 and 12 months post-randomisation. The main analysis will

National nanotechnology partnership to protect workers

NASA Astrophysics Data System (ADS)

Howard, John; Murashov, Vladimir

2009-10-01

Nanotechnology is predicted to improve many aspects of human life. By 2015, it is estimated to represent 3.1 trillion in manufactured goods. Data is emerging that exposure to nanomaterials may pose a health risk to workers. If the economic promise of nanotechnology is to be achieved, ways need to be found to protect nanotechnology workers now. The Occupational Safety and Health Act of 1970 (OSHAct) gave the responsibility to protect workers to the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) through research, standards adoption, and standards enforcement. Since 1980, adopting new occupational health standards has grown more complex. The increased complexity has greatly slowed efforts to adopt protective standards for toxic agents that are well-known to pose significant risks. The likelihood of rapidly adopting standards to protect workers from nanomaterials, whose risks are just emerging, seems even more unlikely. Use of the OSHAct's general duty clause to protect workers also seems uncertain at this time. In the interim, a national partnership led by NIOSH involving nanotech manufacturers and downstream users, workers, academic researchers, safety, and health practitioners is proposed. A National Nanotechnology Partnership would generate knowledge about the nature and the extent of worker risk, utilize that knowledge to develop risk control strategies to protect nanotechnology workers now, and provide an evidence base for NIOSH recommendations to OSHA for a nanotechnology program standard at a future date.

Integrated worker health protection and promotion programs: overview and perspectives on health and economic outcomes.

PubMed

Pronk, Nicolaas P

2013-12-01

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

38 CFR 17.91 - Protection of health-care eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of health-care eligibility. Any veteran whose entitlement to VA pension is terminated by reason of... reason of income from the veteran's employment. (b) A veteran who does not participate in a vocational... and medical services benefits only if the veteran's pension is terminated by reason of income from the...

The frontoparietal control system: A central role in mental health

PubMed Central

Cole, Michael W.; Repovs, Grega; Anticevic, Alan

2014-01-01

Recent findings suggest the existence of a frontoparietal control system consisting of ‘flexible hubs’ that regulate distributed systems (e.g., visual, limbic, motor) according to current task goals. A growing number of studies are reporting alterations of this control system across a striking range of mental diseases. We suggest this may reflect a critical role for the control system in promoting and maintaining mental health. Specifically, we propose that this system implements feedback control to regulate symptoms as they arise (e.g., excessive anxiety reduced via regulation of amygdala), such that an intact control system is protective against a variety of mental illnesses. Consistent with this possibility, recent results indicate that several major mental illnesses involve altered brain-wide connectivity of the control system, likely altering its ability to regulate symptoms. These results suggest that this ‘immune system of the mind’ may be an especially important target for future basic and clinical research. PMID:24622818

Enabling Technology to Advance Health-Protecting Individual Rights-Are We Walking the Talk?

NASA Astrophysics Data System (ADS)

Sharp, Crystal; Gwadry-Sridhar, Femida

The evolving structure and business of health care services and delivery need the functionality and capability offered by electronic health record (EHR) systems. By electronically diffusing the traditional patient record, however, this new model blurs the long-established medical data home, raising concerns about data ownership, confidentiality, access and individual rights. In 2008 the Lawson Health Research Institute began the process of instituting a robust health informatics and collaborative research infrastructure, now known as I-THINK Research. As data are migrated to the platform and policies are developed, we are forced to confront the complexity of issues around protection of individual rights. The paper presents, in a broader context, the main issues surrounding the privacy debate and the need for education, accountability and new legislation to help define and protect individual rights as new e-health business models emerge.

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

PubMed

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

2008-10-01

Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P < 0.01]. Similar findings were noted for financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P < 0.05; chi2 test). After controlling for covariates, publicly-insured families of CSHCN had significantly lower likelihood of financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of

Promoting and protecting the health of children and young people.

PubMed

Licence, K

2004-11-01

The health-related behaviours adopted by children and young people can have both immediate and long-term health effects. Health promotion interventions that target children and young people can lay the foundations of a healthy lifestyle that may be sustained into adulthood. This paper is based on a selective review of evidence relating to health promotion in childhood, carried out to support the external working group on the 'Healthy Child' module of the Children's National Service Framework. This is a selective review of mainly secondary research. It focuses on injury prevention, support for parenting and the promotion of good mental health, and promoting a healthy diet and physical activity amongst children and young people. In many areas, the quality of primary research into health promotion interventions aimed at children and young people is poor. Interventions are heterogeneous and not described in sufficient detail. Sample sizes tend to be small, and there are commonly problems of bias. Despite these difficulties, there is good evidence for a range of interventions, including (1) area road safety schemes; (2) combining a variety of approaches to the promotion of the use of safety equipment, including legislation and enforcement, loan/assisted purchase/giveaway schemes, education, fitting and maintenance of safety equipment; (3) school-based mental health promotion; (4) parenting support; (5) interventions that promote and facilitate 'lifestyle' activity for children, such as walking and cycling to school, and those that aim to reduce sedentary behaviours such as parent education to reduce the time children spend watching TV and using computers; and (6) controlling advertising of unhealthy food that is aimed at children. There are effective interventions to promote and protect the health of children and young people that require action across the five areas described in the Ottawa Charter. Health, social care and education services have a direct role in the

Worker rights and health protection for prostitutes: a comparison of The Netherlands, Germany, and Nevada.

PubMed

Seals, Maryann

2015-01-01

I analyze prostitution policy changes regarding worker rights and health protection for legal prostitutes in The Netherlands, Germany, and Nevada to determine whether the changes benefit the prostitutes. I critically analyze and compare laws, government policy briefs, advocacy studies, books, articles, and ethnographic studies. Problems were revealed in recognizing prostitution as legitimate work and in realization of health protection. Health and safety concerns exist in The Netherlands and Germany where policy does not mandate health requirements and condom usage. Nevada law requires safety precautions, health testing, and condom usage, resulting in no legal prostitutes testing positive for HIV.

Comparison of the caries-protective effect of fluoride varnish with treatment as usual in nursery school attendees receiving preventive oral health support through the Childsmile oral health improvement programme - the Protecting Teeth@3 Study: a randomised controlled trial.

PubMed

Wright, William; Turner, Stephen; Anopa, Yulia; McIntosh, Emma; Wu, Olivia; Conway, David I; Macpherson, Lorna M D; McMahon, Alex D

2015-12-18

The Scottish Government set out its policy on addressing the poor oral health of Scottish children in 2005. This led to the establishment of Childsmile, a national programme designed to improve the oral health of children in Scotland. One element of the programme promotes daily tooth brushing in all nurseries in Scotland (Childsmile Core). A second targeted component (Childsmile Nursery) offers twice-yearly application of fluoride varnish to children attending nurseries in deprived areas. Studies suggest that fluoride varnish application can reduce caries in both adult and child populations. This trial aims to explore the effectiveness and cost-effectiveness of additional preventive value fluoride varnish application compared to Childsmile Core. The Protecting Teeth@3 Study is an ongoing 2 year parallel group randomised treatment as usual controlled trial. Three-year-old children attending the ante pre-school year are randomised (1:1) to the intervention arm (fluoride varnish & treatment as usual) or the control arm (treatment as usual). Children in the intervention arm will have Duraphat® fluoride varnish painted on the primary tooth surfaces and will continue to receive treatment as usual: the core Childsmile Nursery intervention. Children in the treatment as usual arm will receive the same series of contacts, without the application of varnish and will also continue with the Childsmile Core intervention. Interventions are undertaken by Childsmile trained extended duty dental nurses at six-monthly intervals. Participants receive a baseline dental inspection in nursery and an endpoint inspection in Primary 1 at the age of 5 years old. We will use primary and secondary outcome measures to compare the effectiveness of Duraphat® fluoride varnish plus treatment as usual with treatment as usual only in preventing any further dental decay. We will also undertake a full economic evaluation of the trial. This study is registered at ClinicalTrials.gov. Number: NCT

Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection

PubMed Central

Nguyen, Kim Thuy; Khuat, Oanh Thi Hai; Pham, Duc Cuong; Khuat, Giang Thi Hong

2012-01-01

We applied an alternative conceptual framework for analyzing health insurance and financial protection grounded in the health capability paradigm. Through an original survey of 706 households in Dai Dong, Vietnam, we examined the impact of Vietnamese health insurance schemes on inpatient and outpatient health care access, costs, and health outcomes using bivariate and multivariable regression analyses. Insured respondents had lower outpatient and inpatient treatment costs and longer hospital stays but fewer days of missed work or school than the uninsured. Insurance reform reduced household vulnerability to high health care costs through direct reduction of medical costs and indirect reduction of income lost to illness. However, from a normative perspective, out-of-pocket costs are still too high, and accessibility issues persist; a comprehensive insurance package and additional health system reforms are needed. PMID:22698046

Deviant Peer Behavior and Adolescent Delinquency: Protective Effects of Inhibitory Control, Planning, or Decision Making?

PubMed

Hinnant, J Benjamin; Forman-Alberti, Alissa B

2018-05-09

We examined relations between adolescent perceptions of deviant peer behavior and delinquency as moderated by inhibitory control, planning, and decision making in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development at age 15 (N = 991). Adolescents reported perceptions of deviant peer behavior. Inhibitory control, planning, and decision making were assessed behaviorally. Delinquency was evaluated with a latent variable comprised of parent-guardian perceptions of adolescent delinquency and adolescent self-reports. Only inhibitory control moderated the relationship between deviant peer behavior and delinquency, showing that better inhibition protected against delinquency in contexts of high levels of adolescent perceptions of deviant peer behavior. Findings are discussed in the context of theories of adolescent delinquency and risk taking. © 2018 Society for Research on Adolescence.

Evaluation of a Wildfire Smoke Forecasting System as a Tool for Public Health Protection

PubMed Central

Brauer, Michael; Henderson, Sarah B.

2013-01-01

Background: Exposure to wildfire smoke has been associated with cardiopulmonary health impacts. Climate change will increase the severity and frequency of smoke events, suggesting a need for enhanced public health protection. Forecasts of smoke exposure can facilitate public health responses. Objectives: We evaluated the utility of a wildfire smoke forecasting system (BlueSky) for public health protection by comparing its forecasts with observations and assessing their associations with population-level indicators of respiratory health in British Columbia, Canada. Methods: We compared BlueSky PM2.5 forecasts with PM2.5 measurements from air quality monitors, and BlueSky smoke plume forecasts with plume tracings from National Oceanic and Atmospheric Administration Hazard Mapping System remote sensing data. Daily counts of the asthma drug salbutamol sulfate dispensations and asthma-related physician visits were aggregated for each geographic local health area (LHA). Daily continuous measures of PM2.5 and binary measures of smoke plume presence, either forecasted or observed, were assigned to each LHA. Poisson regression was used to estimate the association between exposure measures and health indicators. Results: We found modest agreement between forecasts and observations, which was improved during intense fire periods. A 30-μg/m3 increase in BlueSky PM2.5 was associated with an 8% increase in salbutamol dispensations and a 5% increase in asthma-related physician visits. BlueSky plume coverage was associated with 5% and 6% increases in the two health indicators, respectively. The effects were similar for observed smoke, and generally stronger in very smoky areas. Conclusions: BlueSky forecasts showed modest agreement with retrospective measures of smoke and were predictive of respiratory health indicators, suggesting they can provide useful information for public health protection. Citation: Yao J, Brauer M, Henderson SB. 2013. Evaluation of a wildfire smoke

Protecting health.

PubMed

Armour, Margaret-Ann; Linetsky, Asya; Ashick, Donna

2008-10-01

Water-soluble heavy metal salts injure health when they leach into water supplies. It is important that students who may later be employed in industries generating aqueous solutions of such salts are aware of the methods that can be used to recover the metal salt or transform it to non-health threatening products. The research was in the management of small quantities of hazardous wastes, such as are generated in school, college, and university teaching laboratories; in research laboratories; in industrial quality control and testing laboratories; and in small industries. Methods for the recovery of silver, nickel, and cobalt salts from relatively small volumes of aqueous solutions of their soluble salts were developed and tested. Where it was not practical to recover the metal salt, the practice has been to convert it to a water-insoluble salt, often the sulfide. This requires the use of highly toxic reagents. It was found that a number of heavy metal salts can be precipitated as the silicates, returning them to the form in which they are found in the natural ore. These salts show similar solubility properties to the sulfides in neutral, acidic, and basic aqueous solutions. The work has determined the conditions, quantities, and solution acidity that result in the most effective precipitation of the heavy metal salt. The concentration of the metal ions remaining in solution was measured by AA and ICP spectrometry. Specific methods have been developed for the conversion of salts of mercury and chromium to nonsoluble products.

[Children's health protection in the state political system].

PubMed

Baranov, A A; Iakovleva, T V; Lapin, Iu E

2011-01-01

The system of children's health protection in this country still lacks an adequate legal basis. Its improvement should be considered as a function of the state realized through legal regulation of public relations for the benefit of each child based on the legislatively fixed government policy in the sphere of children's health care. Such an approach may strengthen the role of this sphere in the intersectoral relations and implies the extension of pediatrics toward interaction with the spheres of politics and law. It reflects the understanding that physiological processes behind regulation of the functioning of the child's organism in the course of its development need an adequate support from the outside through regulation of public relations on behalf of children. The definition of state policy in the sphere of children's health care is proposed and its basic principles are considered.

14 CFR 25.865 - Fire protection of flight controls, engine mounts, and other flight structure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Design and Construction Fire Protection § 25.865 Fire protection of flight controls, engine mounts, and other flight structure. Essential flight controls, engine mounts, and other flight structures located in... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Fire protection of flight controls, engine...

14 CFR 25.865 - Fire protection of flight controls, engine mounts, and other flight structure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Design and Construction Fire Protection § 25.865 Fire protection of flight controls, engine mounts, and other flight structure. Essential flight controls, engine mounts, and other flight structures located in... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Fire protection of flight controls, engine...

14 CFR 25.865 - Fire protection of flight controls, engine mounts, and other flight structure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Design and Construction Fire Protection § 25.865 Fire protection of flight controls, engine mounts, and other flight structure. Essential flight controls, engine mounts, and other flight structures located in... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fire protection of flight controls, engine...

14 CFR 25.865 - Fire protection of flight controls, engine mounts, and other flight structure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Design and Construction Fire Protection § 25.865 Fire protection of flight controls, engine mounts, and other flight structure. Essential flight controls, engine mounts, and other flight structures located in... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Fire protection of flight controls, engine...

14 CFR 25.865 - Fire protection of flight controls, engine mounts, and other flight structure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Design and Construction Fire Protection § 25.865 Fire protection of flight controls, engine mounts, and other flight structure. Essential flight controls, engine mounts, and other flight structures located in... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Fire protection of flight controls, engine...

Awareness of Consumer Protection Act among dental health professionals in dental schools of Ghaziabad, India.

PubMed

Prasad, Sumanth; Menon, Ipseeta; Dhingra, Chandan; Anand, Richa

2013-12-01

The study aimed to assess the awareness of the Consumer Protection Act among dental health professionals in dental schools of Ghaziabad, India. A cross-sectional questionnaire survey was carried out on dental health professionals in dental schools of Ghaziabad, India. A total of 348 dental health professionals (170 males and 178 females) were surveyed, out of which 116 were MDS faculty, 45 were BDS faculty and 187 were pursuing post graduation. The questionnaire comprised of 24 questions about the awareness of consumer protection act. Statistical analysis was done using Chi-square test, student's t test and ANOVA. A total of 84.8% (n=295) reported to be aware of consumer protection act. Amongst them, MDS faculty showed more awareness as compared to BDS faculty and those pursuing post-graduation. Considering the present scenario, MDS faculty dental professionals have more awareness of consumer protection act compared to other dental professionals. So, we must upgrade our knowledge on consumer protection act at all levels of our profession and change our attitude by inculcating a practice to spread the message of consumer protection act for delivering quality dental care.

The Patient Protection and Affordable Care Act: opportunities for prevention and public health.

PubMed

Shaw, Frederic E; Asomugha, Chisara N; Conway, Patrick H; Rein, Andrew S

2014-07-05

The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Separation of functions in the System of Social Protection in Health, Mexico 2009: progress and challenges].

PubMed

González-Robledo, Luz María; Nigenda, Gustavo; González-Robledo, María Cecilia; Reich, Michael

2011-01-01

To evaluate advancements and challenges in the separation of functions within Mexico's System of Social Protection in Health. A 2009 evaluation study involving nine states and the National Commission for Social Protection in Health was carried out via semi-structured interviews with key actors and literature analysis. The main advancement has been the creation of the State Regimens for Social Protection in Health (REPSS in Spanish) which act as intermediaries between users and health service providers, making these state-level entities responsible for both managing financial resources and shaping and coordinating the health care delivery network. However, most of the REPSS studied were found to be in a state of inertia, leading to inadequate compliance with legally mandated functions. Normative, technical, political and managerial obstacles persist, impeding the successful separation of functions.

Ethical considerations in internet use of electronic protected health information.

PubMed

Polito, Jacquelyn M

2012-03-01

Caregivers, patients, and their family members are increasingly reliant on social network websites for storing, communicating, and referencing medical information. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule seeks balance by protecting the privacy of patients' health information and assuring that this information is available to those who need it to provide health care. Though federal and state governments have created laws and policies to safeguard patient privacy and confidentiality, the laws are inadequate against the rapid and innovative use of electronic health websites. As Internet use broadens access to information, health professionals must be aware that this information is not always secure. We must identify and reflect on medical ethics issues and be accountable for maintaining privacy for the patient.

Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk.

PubMed

O'Donnell, Melissa; Maclean, Miriam J; Sims, Scott; Morgan, Vera A; Leonard, Helen; Stanley, Fiona J

2015-12-01

Previous research shows that maternal mental illness is an important risk factor for child maltreatment. This study aims to quantify the relationship between maternal mental health and risk of child maltreatment according to the different types of mental health diagnoses. The study used a retrospective cohort of children born in Western Australia between 1990 and 2005, with deidentified linked data from routine health and child protection collections. Nearly 1 in 10 children (9.2%) of mothers with a prior mental health contact had a maltreatment allegation. Alternatively, almost half the children with a maltreatment allegation had a mother with a mental health contact. After adjusting for other risk factors, a history of mental health contacts was associated with a more than doubled risk of allegations (HR=2.64, 95% CI 2.50 to 2.80). Overall, all mental health diagnostic groups were associated with an increased risk of allegations. The greatest risk was found for maternal intellectual disability, followed by disorders of childhood and psychological development, personality disorders, substance-related disorders, and organic disorders. Maltreatment allegations were substantiated at a slightly higher rate than for the general population. Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Protecting unauthorized immigrant mothers improves their children's mental health.

PubMed

Hainmueller, Jens; Lawrence, Duncan; Martén, Linna; Black, Bernard; Figueroa, Lucila; Hotard, Michael; Jiménez, Tomás R; Mendoza, Fernando; Rodriguez, Maria I; Swartz, Jonas J; Laitin, David D

2017-09-08

The United States is embroiled in a debate about whether to protect or deport its estimated 11 million unauthorized immigrants, but the fact that these immigrants are also parents to more than 4 million U.S.-born children is often overlooked. We provide causal evidence of the impact of parents' unauthorized immigration status on the health of their U.S. citizen children. The Deferred Action for Childhood Arrivals (DACA) program granted temporary protection from deportation to more than 780,000 unauthorized immigrants. We used Medicaid claims data from Oregon and exploited the quasi-random assignment of DACA eligibility among mothers with birthdates close to the DACA age qualification cutoff. Mothers' DACA eligibility significantly decreased adjustment and anxiety disorder diagnoses among their children. Parents' unauthorized status is thus a substantial barrier to normal child development and perpetuates health inequalities through the intergenerational transmission of disadvantage. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Protecting health workers from infectious disease transmission: an exploration of a Canadian-South African partnership of partnerships.

PubMed

Yassi, Annalee; Zungu, Muzimkhulu; Spiegel, Jerry M; Kistnasamy, Barry; Lockhart, Karen; Jones, David; O'Hara, Lyndsay M; Nophale, Letshego; Bryce, Elizabeth A; Darwin, Lincoln

2016-03-31

Health workers are at high risk of acquiring infectious diseases at work, especially in low and middle-income countries (LMIC) with critical health human resource deficiencies and limited implementation of occupational health and infection control measures. Amidst increasing interest in international partnerships to address such issues, how best to develop such collaborations is being actively debated. In 2006, a partnership developed between occupational health and infection control experts in Canada and institutions in South Africa (including an institute with a national mandate to conduct research and provide guidance to protect health workers from infectious diseases and promote improved working conditions). This article describes the collaboration, analyzes the determinants of success and shares lessons learned. Synthesizing participant-observer experience from over 9 years of collaboration and 10 studies already published from this work, we applied a realist review analysis to describe the various achievements at global, national, provincial and hospital levels. Expectations of the various parties on developing new insights, providing training, and addressing service needs were examined through a micro-meso-macro lens, focusing on how each main partner organization contributed to and benefitted from working together. A state-of-the-art occupational health and safety surveillance program was established in South Africa following successful technology transfer from a similar undertaking in Canada and training was conducted that synergistically benefitted Northern as well as Southern trainees. Integrated policies combining infection control and occupational health to prevent and control infectious disease transmission among health workers were also launched. Having a national (South-South) network reinforced by the international (North-south) partnership was pivotal in mitigating the challenges that emerged. High-income country partnerships with experience in

Access control and privilege management in electronic health record: a systematic literature review.

PubMed

Jayabalan, Manoj; O'Daniel, Thomas

2016-12-01

This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

Exposure to mass media health information, skin cancer beliefs, and sun protection behaviors in a United States probability sample.

PubMed

Hay, Jennifer; Coups, Elliot J; Ford, Jennifer; DiBonaventura, Marco

2009-11-01

The mass media is increasingly important in shaping a range of health beliefs and behaviors. We examined the association among mass media health information exposure (general health, cancer, sun protection information), skin cancer beliefs, and sun protection behaviors. We used a general population national probability sample comprised of 1633 individuals with no skin cancer history (Health Information National Trends Survey, 2005, National Cancer Institute) and examined univariate and multivariate associations among family history of skin cancer, mass media exposure, skin cancer beliefs, and sun protection (use of sunscreen, shade seeking, and use of sun-protective clothing). Mass media exposure was higher in younger individuals, and among those who were white and more highly educated. More accurate skin cancer beliefs and more adherent sun protection practices were reported by older individuals, and among those who were white and more highly educated. Recent Internet searches for health or sun protection information were associated with sunscreen use. Study limitations include the self-report nature of sun protection behaviors and cross-sectional study design. We identify demographic differences in mass media health exposure, skin cancer beliefs, and sun protection behaviors that will contribute to planning skin cancer awareness and prevention messaging across diverse population subgroups.

Protecting unauthorized immigrant mothers improves their children’s mental health

PubMed Central

Hainmueller, Jens; Lawrence, Duncan; Martén, Linna; Black, Bernard; Figueroa, Lucila; Hotard, Michael; Jiménez, Tomás R.; Mendoza, Fernando; Rodriguez, Maria I.; Swartz, Jonas J.; Laitin, David D.

2018-01-01

The United States is embroiled in a debate about whether to protect or deport its estimated 11 million unauthorized immigrants, but the fact that these immigrants are also parents to more than 4 million U.S.-born children is often overlooked. We provide causal evidence of the impact of parents’ unauthorized immigration status on the health of their U.S. citizen children. The Deferred Action for Childhood Arrivals (DACA) program granted temporary protection from deportation to more than 780,000 unauthorized immigrants. We used Medicaid claims data from Oregon and exploited the quasi-random assignment of DACA eligibility among mothers with birthdates close to the DACA age qualification cutoff. Mothers’ DACA eligibility significantly decreased adjustment and anxiety disorder diagnoses among their children. Parents’ unauthorized status is thus a substantial barrier to normal child development and perpetuates health inequalities through the intergenerational transmission of disadvantage. PMID:28860206

Social capital and risk and protective behaviors: a global health perspective

PubMed Central

Kaljee, Linda M; Chen, Xinguang

2011-01-01

Social capital and health research has emerged as a focus of contemporary behavioral epidemiology, while intervention research is seeking more effective measures to increase health protective behaviors and decrease health-risk behaviors. In this review we explored current literature on social capital and health outcomes at the micro-, mesa-, and macro-levels with a particular emphasis on research that incorporates a social capital framework, and adolescent and young adult engagement in risk behaviors. These data indicate that across a broad range of socio-cultural and economic contexts, social capital can affect individuals’ risk for negative health outcomes and their engagement in risk behaviors. Further research is needed which should focus on differentiating and measuring positive and negative social capital within both mainstream and alternative social networks, assessing how social constructions of gender, ethnicity, and race – within specific cultural contexts – mediate the relationship between social capital and risk and/or protective behaviors. This new research should integrate the existing research within historical socioeconomic and political conditions. In addition, social capital scales need to be developed to be both culturally and developmentally appropriate for use with adolescents living in a diversity of settings. Despite the proliferation of social capital research, the concept remains underutilized in both assessment and intervention development for adolescents’ and young adults’ engagement in risk behaviors and their associated short- and long-term poor health outcomes. PMID:23243387

The efficacy of Protected Mealtimes in hospitalised patients: a stepped wedge cluster randomised controlled trial.

PubMed

Porter, Judi; Haines, Terry P; Truby, Helen

2017-02-07

Protected Mealtimes is an intervention developed to address the problem of malnutrition in hospitalised patients through increasing positive interruptions (such as feeding assistance) whilst minimising unnecessary interruptions (including ward rounds and diagnostic procedures) during mealtimes. This clinical trial aimed to measure the effect of implementing Protected Mealtimes on the energy and protein intake of patients admitted to the subacute setting. A prospective, stepped wedge cluster randomised controlled trial was undertaken across three hospital sites at one health network in Melbourne, Australia. All patients, except those receiving end-of-life care or not receiving oral nutrition, admitted to these wards during the study period participated. The intervention was guided by the British Hospital Caterers Association reference policy on Protected Mealtimes and by principles of implementation science. Primary outcome measures were daily energy and protein intake. The study was powered to determine whether the intervention closed the daily energy deficit between estimated intake and energy requirements measured as 1900 kJ/day in the pilot study for this trial. There were 149 unique participants, including 38 who crossed over from the control to intervention period as the Protected Mealtimes intervention was implemented. In total, 416 observations of 24-hour food intake were obtained. Energy intake was not significantly different between the intervention ([mean ± SD] 6479 ± 2486 kJ/day) and control (6532 ± 2328 kJ/day) conditions (p = 0.88). Daily protein intake was also not significantly different between the intervention (68.6 ± 26.0 g/day) and control (67.0 ± 25.2 g/day) conditions (p = 0.86). The differences between estimated energy/protein requirements and estimated energy/protein intakes were also limited between groups. The adjusted analysis yielded significant findings for energy deficit: (coefficient [robust 95% CI], p

[Health protection and health promotion in formal structures of executive county authorities and executive offices of municipalities having the county status].

PubMed

Nosko, Jan; Marcinkiewicz, Andrzej

2009-01-01

An analysis of the role of public administration in the Polish health system, essential for the effectiveness of health protection and health promotion, is a very important and urgent task faced by scholars. This issue also concerns the authorities of counties (powiaty) and municipalities having the county status (MHCS), and these structures were chosen as the subject of our study. The aim of the study was to analyze whether health related rules and regulations of these administrative structures comply with the requirements of relevant Polish legislation acts. The survey, performed in 2008, covered all the 378 counties and municipalities having the county status. On the basis of 171 Acts reviewed, a list of 11 groups of obligations and duties assigned to county and municipality units were prepared and used as a research tool. It was found that the provisions of the Health Care Institutions Act of 1991 were most evidently (87%) reflected in the rules and regulations of the studies structures; more than a half (57%) refer to prophylaxis and health promotion, however, the most important Act as far as health protection and health promotion are concerned, i.e., the Act of 2004 was reflected in only 11.6%. Also the presence of some outdated regulations was discovered. The results of the study may indicate that the mechanisms, by which the execution of legal regulations on health protection and health promotion tasks should be supervised, are insufficient.

Social protection strategies and health financing to safeguard reproductive health for the poor: making a case for Pakistan.

PubMed

Shaikh, Babar Tasneem; Mazhar, Arslan; Khan, Shahzad Ali; Hafeez, Assad

2011-01-01

Globally, a billion people cannot seek appropriate and timely healthcare because they are not covered under any social protection and health insurance system. Countries where government financing for health care is meagre, the situation is even worse. Pakistan with its slowly improving indicators of maternal and child health makes a classical case for instigating a social protection mechanism for the poor segments of population. The Government safety nets are unable to cater the large proportion of poor population. NGOs partially cover the rural areas where majority of the vulnerable population lives but need to expand their scope of work. Donors have presented variety of models and frameworks which were seldom considered in the concerned quarters. All stakeholders ought to strategise their plans to adopt and scale up the successful interventions (vouchers, cash transfers, micro-credits, community based insurance etc) which have been operating but on a very small scale or for other types of health services, but none for reproductive health care per se. Adoption of risk pooling mechanisms and provision of accessible and quality reproductive health services seems feasible through a meaningful and integrated public private partnership in the times to come.

49 CFR 192.461 - External corrosion control: Protective coating.

Code of Federal Regulations, 2012 CFR

2012-10-01

... protective coating, whether conductive or insulating, applied for the purpose of external corrosion control... or damage from supporting blocks. (e) If coated pipe is installed by boring, driving, or other...

49 CFR 192.461 - External corrosion control: Protective coating.

Code of Federal Regulations, 2014 CFR

2014-10-01

... protective coating, whether conductive or insulating, applied for the purpose of external corrosion control... or damage from supporting blocks. (e) If coated pipe is installed by boring, driving, or other...

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

PubMed Central

Pronk, Nicolaas P.

2014-01-01

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

Biological Control beneath the Feet: A Review of Crop Protection against Insect Root Herbivores.

PubMed

Kergunteuil, Alan; Bakhtiari, Moe; Formenti, Ludovico; Xiao, Zhenggao; Defossez, Emmanuel; Rasmann, Sergio

2016-11-29

Sustainable agriculture is certainly one of the most important challenges at present, considering both human population demography and evidence showing that crop productivity based on chemical control is plateauing. While the environmental and health threats of conventional agriculture are increasing, ecological research is offering promising solutions for crop protection against herbivore pests. While most research has focused on aboveground systems, several major crop pests are uniquely feeding on roots. We here aim at documenting the current and potential use of several biological control agents, including micro-organisms (viruses, bacteria, fungi, and nematodes) and invertebrates included among the macrofauna of soils (arthropods and annelids) that are used against root herbivores. In addition, we discuss the synergistic action of different bio-control agents when co-inoculated in soil and how the induction and priming of plant chemical defense could be synergized with the use of the bio-control agents described above to optimize root pest control. Finally, we highlight the gaps in the research for optimizing a more sustainable management of root pests.

Biological Control beneath the Feet: A Review of Crop Protection against Insect Root Herbivores

PubMed Central

Kergunteuil, Alan; Bakhtiari, Moe; Formenti, Ludovico; Xiao, Zhenggao; Defossez, Emmanuel; Rasmann, Sergio

2016-01-01

Sustainable agriculture is certainly one of the most important challenges at present, considering both human population demography and evidence showing that crop productivity based on chemical control is plateauing. While the environmental and health threats of conventional agriculture are increasing, ecological research is offering promising solutions for crop protection against herbivore pests. While most research has focused on aboveground systems, several major crop pests are uniquely feeding on roots. We here aim at documenting the current and potential use of several biological control agents, including micro-organisms (viruses, bacteria, fungi, and nematodes) and invertebrates included among the macrofauna of soils (arthropods and annelids) that are used against root herbivores. In addition, we discuss the synergistic action of different bio-control agents when co-inoculated in soil and how the induction and priming of plant chemical defense could be synergized with the use of the bio-control agents described above to optimize root pest control. Finally, we highlight the gaps in the research for optimizing a more sustainable management of root pests. PMID:27916820

Community violence, protective factors, and adolescent mental health: a profile analysis.

PubMed

Copeland-Linder, Nikeea; Lambert, Sharon F; Ialongo, Nicholas S

2010-01-01

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring, and parental involvement and to examine whether these profiles differentially predict adolescents' depressive symptoms and aggressive behavior. Three classes were identified-a vulnerable class, a moderate risk/medium protection class, and a moderate risk/high protection class. The classes differentially predicted depressive symptoms but not aggressive behavior for boys and girls. The class with the highest community violence exposure also had the lowest self-worth.

Ten Years of Addressing Children’s Health through Regulatory Policy at the U.S. Environmental Protection Agency

PubMed Central

Payne-Sturges, Devon; Kemp, Debra

2008-01-01

Background Executive Order (EO) 13045, Protection of Children From Environmental Health Risks and Safety Risks, directs each federal agency to ensure that its policies, programs, activities, and standards address disproportionate environmental health and safety risks to children. Objectives We reviewed regulatory actions published by U.S. Environmental Protection Agency (EPA) in the Federal Register from April 1998 through December 2006 to evaluate applicability of EO 13045 to U.S. EPA actions and consideration of children’s health issues in U.S. EPA rulemakings. Discussion Although virtually all actions discussed EO 13045, fewer than two regulations per year, on average, were subject to the EO requirement to evaluate children’s environmental health risks. Nonetheless, U.S. EPA considered children’s environmental health in all actions addressing health or safety risks that may disproportionately affect children. Conclusion The EO does not apply to a broad enough set of regulatory actions to ensure protection of children’s health and safety risks, largely because of the small number of rules that are economically significant. However, given the large number of regulations that consider children’s health issues despite not being subject to the EO, other statutory requirements and agency policies reach a larger set of regulations to ensure protection of children’s environmental health. PMID:19079726

30 CFR 250.107 - What must I do to protect health, safety, property, and the environment?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., property, and the environment? 250.107 Section 250.107 Mineral Resources MINERALS MANAGEMENT SERVICE... Performance Standards § 250.107 What must I do to protect health, safety, property, and the environment? (a) You must protect health, safety, property, and the environment by: (1) Performing all operations in a...

Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia

PubMed Central

Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

2016-01-01

Background Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Methods Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households’ out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Results Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Conclusion Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the

Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.

PubMed

Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

2016-01-01

Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal

Linking perceived control, physical activity, and biological health to memory change.

PubMed

Infurna, Frank J; Gerstorf, Denis

2013-12-01

Perceived control plays an important role for remaining cognitively fit across adulthood and old age. However, much less is known about the role of perceived control over and above common correlates of cognition, and possible factors that underlie such control-cognition associations. Our study examined whether perceived control was predictive of individual differences in subsequent 4-year changes in episodic memory, and explored the mediating role of physical activity and indicators of physical fitness, cardiovascular, and metabolic health for control-memory associations. To do so, we used longitudinal data from the nationwide Health and Retirement Study (HRS; N = 4,177; ages 30 to 97 years; 59% women). Our results show that perceiving more control over one's life predicted less memory declines, and this protective effect was similar in midlife and old age. We additionally observed that higher levels and maintenance of physical activity over 2 years, better pulmonary function, lower systolic blood pressure (SPB), lower hemoglobin A1c, and higher high-density lipoprotein cholesterol (HDL-C) also predicted less memory declines. Mediation analyses revealed that levels of, and 2-year changes in, physical activity, as well as levels of pulmonary function and hemoglobin A1c and HDL-C, each uniquely mediated control-memory change associations. Our findings illustrate that perceived control, physical activity, and indicators of physical fitness and cardiovascular and metabolic health moderate changes in memory, and add to the literature on antecedents of cognitive aging by conjointly targeting perceived control and some of its mediating factors. We discuss possible pathways underlying the role of control for memory change and consider future routes of inquiry to further our understanding of control-cognition associations in adulthood and old age. PsycINFO Database Record (c) 2013 APA, all rights reserved.

EPA Community Grants Available to Protect Public Health and the Environment in New England

EPA Pesticide Factsheets

The US Environmental Protection Agency is making grants available for New England communities to support EPA’s “Back-to-Basics” agenda to reduce environmental risks, protect and improve human health and improve the quality of life.

RCT: Module 2.07, Respiratory Protection, Course 8773

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

Internal dosimetry controls require the use of engineering controls to prevent the internal deposition of radioactive and nonradiological contaminants. However, when engineering and administrative controls are not available or feasible, respiratory protection may be necessary. The radiation control technician (RCT) should know and apply the considerations used in determining the respiratory protection equipment that is most appropriate for the job. The inappropriate use of or the use of the wrong respiratory protection equipment may result in undesirable health effects. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensivemore » Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.« less

Is the tobacco control movement misrepresenting the acute cardiovascular health effects of secondhand smoke exposure? An analysis of the scientific evidence and commentary on the implications for tobacco control and public health practice

PubMed Central

Siegel, Michael

2007-01-01

While chronic exposure to secondhand smoke has been well recognized as a cause of heart disease in nonsmokers, there has been recent speculation about the potential acute cardiovascular effects of transient exposure to secondhand smoke among nonsmokers; in particular, the possibility that such exposure could increase the risk of acute myocardial infarction even in an otherwise healthy nonsmoker. This paper reviews the claims being made by a number of anti-smoking and public health groups regarding the acute cardiovascular effects of secondhand smoke exposure among otherwise healthy adults, analyzes the validity of these claims based on a review of the scientific evidence, and discusses the implications of the findings for tobacco control and public health practice. Based on the analysis, it appears that a large number of anti-smoking organizations are making inaccurate claims that a single, acute, transient exposure to secondhand smoke can cause severe and even fatal cardiovascular events in healthy nonsmokers. The dissemination of inaccurate information by anti-smoking groups to the public in support of smoking bans is unfortunate because it may harm the tobacco control movement by undermining its credibility, reputation, and effectiveness. Disseminating inaccurate information also represents a violation of basic ethical principles that are a core value of public health practice that cannot and should not be sacrificed, even for a noble end such as protecting nonsmokers from secondhand smoke exposure. How the tobacco control movement responds to this crisis of credibility will go a long way towards determining the future effectiveness of the movement and its ability to continue to save lives and protect the public's health. PMID:17927828

Design of lightning protection for a full-authority digital engine control

NASA Technical Reports Server (NTRS)

Dargi, M.; Rupke, E.; Wiles, K.

1991-01-01

The steps and procedures are described which are necessary to achieve a successful lightning-protection design for a state-of-the-art Full-Authority Digital Engine Control (FADEC) system. The engine and control systems used as examples are fictional, but the design and verification methods are real. Topics discussed include: applicable airworthiness regulation, selection of equipment transient design and control levels for the engine/airframe and intra-engine segments of the system, the use of cable shields, terminal-protection devices and filter circuits in hardware protection design, and software approaches to minimize upset potential. Shield terminations, grounding, and bonding are also discussed, as are the important elements of certification and test plans, and the role of tests and analyses. Also included are examples of multiple-stroke and multiple-burst testing. A review of design pitfalls and challenges, and status of applicable test standards such as RTCA DO-160, Section 22, are presented.

Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents: associated risk and protective correlates.

PubMed

Spein, Anna Rita; Pedersen, Cecilia Petrine; Silviken, Anne Cathrine; Melhus, Marita; Kvernmo, Siv Eli; Bjerregaard, Peter

2013-01-01

Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Cross-sectional data were collected from "Well-being among Youth in Greenland" (WBYG) and "The Norwegian Arctic Adolescent Health Study" (NAAHS), conducted during 2003-2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with "very good" (NAAHS) and "very good/good" (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent-parent relationship). A majority of both Inuit (62%) and Sami (89%) youth reported "good" or "very good" SRH. The proportion of "poor/fair/not so good" SRH was three times higher among Inuit than Sami (38% vs. 11%, p≤0.001). Significantly more Inuit females than males reported "poor/fair" SRH (44% vs. 29%, p≤0.05), while no gender differences occurred among Sami (12% vs. 9%, p≤0.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit-Sami differences in SRH could partly be due to higher "risk" and lower "protective" correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs.

Ethics and data protection in human biomarker studies in environmental health.

PubMed

Casteleyn, Ludwine; Dumez, Birgit; Van Damme, Karel; Anwar, Wagida A

2013-08-01

Human biomarker studies in environmental health are essential tools to study the relationship between health and environment. They should ultimately contribute to a better understanding of environmentally induced adverse health effects and to appropriate preventive actions. To ensure the protection of the rights and dignity of study participants a complex legal and ethical framework is applied, consisting of several international directives, conventions, and guidelines, whether or not translated in domestic laws. Main characteristics of ethics and data protection in studies using biomarkers in the field of environmental health are summarized and current discussions on related questions and bottlenecks highlighted. In the current regulatory context, dominated by the protection of the individual study participant, difficulties are reported due to the different interpretation and implementation of the regulations of concern within and across borders. Advancement of consistency and compatibility is recommended and efforts are ongoing. An increasing demand for secondary use of data and samples poses additional challenges in finding a right balance between the individual rights of the study participants on the one hand and the common interest of, and potential benefit for the public or community at large on the other. Ethics committees could play a key role in assessing problems originating from the sometimes competing needs at individual and societal level. Building trust in science amongst (potential) study participants and within the community allows the inclusion of arguments from the societal perspective. This requires increased attention for respectful communication efforts. Striving for public participation in decision making processes may promote policy relevant research and the related translation of study results into action. Copyright © 2013 Elsevier GmbH. All rights reserved.

Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision.

PubMed

Pepper, Gillian V; Nettle, Daniel

2014-01-01

Prior evidence from the public health literature suggests that both control beliefs and perceived threats to life are important for health behaviour. Our previously presented theoretical model generated the more specific hypothesis that uncontrollable, but not controllable, personal mortality risk should alter the payoff from investment in health protection behaviours. We carried out three experiments to test whether altering the perceived controllability of mortality risk would affect a health-related decision. Experiment 1 demonstrated that a mortality prime could be used to alter a health-related decision: the choice between a healthier food reward (fruit) and an unhealthy alternative (chocolate). Experiment 2 demonstrated that it is the controllability of the mortality risk being primed that generates the effect, rather than mortality risk per se. Experiment 3 showed that the effect could be seen in a surreptitious experiment that was not explicitly health related. Our results suggest that perceptions about the controllability of mortality risk may be an important factor in people's health-related decisions. Thus, techniques for adjusting perceptions about mortality risk could be important tools for use in health interventions. More importantly, tackling those sources of mortality that people perceive to be uncontrollable could have a dual purpose: making neighbourhoods and workplaces safer would have the primary benefit of reducing uncontrollable mortality risk, which could lead to a secondary benefit from improved health behaviours.

Validation and Dimensionality of the Integration of Health Protection and Health Promotion Score: Evidence From the PULSE Small Business and VA Medical Center Surveys.

PubMed

Williams, Jessica A R; Schult, Tamara M; Nelson, Candace C; Cabán-Martinez, Alberto J; Katz, Jeffrey N; Wagner, Gregory R; Pronk, Nicolaas P; Sorensen, Glorian; McLellan, Deborah L

2016-05-01

To conduct validation and dimensionality analyses for an existing measure of the integration of worksite health protection and health promotion approaches. A survey of small to medium size employers located in the United States was conducted between October 2013 and March 2014 (N = 115). A survey of Department of Veterans Affairs (VA) administrative parents was also conducted from June to July 2014 (N = 140). Exploratory factor analysis (EFA) was used to determine the dimensionality of the Integration Score in each sample. Using EFA, both samples indicated the presence of one unified factor. The VA survey indicated that customization improves the relevance of the Integration Score for different types of organizations. The Integration Score is a valid index for assessing the integration of worksite health protection and health promotion approaches and is customizable based on industry. The Integration Score may be used as a single metric for assessing the integration of worksite health protection and health promotion approaches in differing work contexts.

Evaluation of a wildfire smoke forecasting system as a tool for public health protection.

PubMed

Yao, Jiayun; Brauer, Michael; Henderson, Sarah B

2013-10-01

Exposure to wildfire smoke has been associated with cardiopulmonary health impacts. Climate change will increase the severity and frequency of smoke events, suggesting a need for enhanced public health protection. Forecasts of smoke exposure can facilitate public health responses. We evaluated the utility of a wildfire smoke forecasting system (BlueSky) for public health protection by comparing its forecasts with observations and assessing their associations with population-level indicators of respiratory health in British Columbia, Canada. We compared BlueSky PM2.5 forecasts with PM2.5 measurements from air quality monitors, and BlueSky smoke plume forecasts with plume tracings from National Oceanic and Atmospheric Administration Hazard Mapping System remote sensing data. Daily counts of the asthma drug salbutamol sulfate dispensations and asthma-related physician visits were aggregated for each geographic local health area (LHA). Daily continuous measures of PM2.5 and binary measures of smoke plume presence, either forecasted or observed, were assigned to each LHA. Poisson regression was used to estimate the association between exposure measures and health indicators. We found modest agreement between forecasts and observations, which was improved during intense fire periods. A 30-μg/m3 increase in BlueSky PM2.5 was associated with an 8% increase in salbutamol dispensations and a 5% increase in asthma-related physician visits. BlueSky plume coverage was associated with 5% and 6% increases in the two health indicators, respectively. The effects were similar for observed smoke, and generally stronger in very smoky areas. BlueSky forecasts showed modest agreement with retrospective measures of smoke and were predictive of respiratory health indicators, suggesting they can provide useful information for public health protection.

78 FR 20004 - Protection of Stratospheric Ozone: Adjustments to the Allowance System for Controlling HCFC...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... Protection of Stratospheric Ozone: Adjustments to the Allowance System for Controlling HCFC Production... adjusting the allowance system controlling U.S. consumption and production of hydrochlorofluorocarbons... ``Protection of Stratospheric Ozone: Adjustments to the Allowance System for Controlling HCFC Production...

Sun exposure and protection behaviors among long-term melanoma survivors and non-cancer controls

PubMed Central

Vogel, Rachel Isaksson; Strayer, Lori G.; Engelman, Leah; Nelson, Heather H.; Blaes, Anne H.; Anderson, Kristin E.; Lazovich, DeAnn

2016-01-01

Introduction Melanoma is considered a generally preventable cancer, with excessive ultraviolet radiation (UVR) exposure being a strong causal factor. UVR exposure following a melanoma diagnosis can be modified to reduce risk of second primary melanomas. The goal of this study was to compare measures of UVR exposure and protection behaviors between long-term melanoma survivors and controls. Methods Participants from a previously conducted case-control study were recruited for a cross-sectional survey. Melanoma cases were 25–59 years old at diagnosis; controls were age and sex matched. Participants were asked about UVR exposure and protection measures used in the past year and comparisons between melanoma survivors and controls were conducted using logistic regression models, adjusting for potential confounders. Results A total of 726 (67.7%) long-term melanoma survivors and 657 (60.9%) controls completed the follow-up survey. Melanoma survivors were significantly less likely to report high sun exposure on a typical weekday (OR=0.72 [0.55–0.94]), sunburns (OR=0.40 [0.30–0.53]), or indoor tanning (OR=0.20 [0.09–0.44]) than controls; however high sun exposure on a typical weekend day was similar. Report of optimal sun protection behaviors were higher in melanoma survivors compared to controls. However, a few melanoma survivors reported indoor tanning, 10% reported intentionally seeking sun to tan, and 20% reported sunburns. Conclusion Although long term melanoma survivors reported healthier UVR exposure and protection behaviors compared to controls, a sizeable proportion still reported elevated sun exposure, sunburns, and suboptimal UVR protection behaviors. Impact Opportunities remain for improving sun protection to reduce future melanoma risk among melanoma survivors. PMID:28254810

CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management.

PubMed

Schillie, Sarah; Murphy, Trudy V; Sawyer, Mark; Ly, Kathleen; Hughes, Elizabeth; Jiles, Ruth; de Perio, Marie A; Reilly, Meredith; Byrd, Kathy; Ward, John W

2013-12-20

-HBs testing occurs greater than 2 months after vaccination. This guidance can assist clinicians, occupational health and student health providers, infection-control specialists, hospital and health-care training program administrators, and others in selection of an approach for assessing HBV protection for vaccinated HCP. This report emphasizes the importance of administering HepB vaccination for all HCP, provides explicit guidance for evaluating hepatitis B protection among previously vaccinated HCP (particularly those who were vaccinated in infancy or adolescence), and clarifies recommendations for postexposure management of HCP exposed to blood or body fluids.

The potential of dental-protective chewing gum in oral health interventions.

PubMed

Ly, Kiet A; Milgrom, Peter; Rothen, Marilynn

2008-05-01

The authors provide an overview of chewing gum as a delivery vehicle for dental-protective agents, highlighting xylitol and its potential application in caries-prevention programs for children. The authors reviewed selected clinical investigations and previous reviews associated with chewing gum containing substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol and their effects on reducing caries. They searched the MEDLINE database by using the key words "dental caries," "oral health," "calcium," "bicarbonate," "carbamide," "chlorhexidine," "fluoride" and "xylitol." Chewing gum is being used as a delivery vehicle for substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol to improve oral health and reduce caries. These substances exhibit properties that are protective of the oral environment and mediate common oral diseases. The debate for advocating xylitol use in caries prevention is advancing; however, chewing gum use by young schoolchildren in the United States is hindered by choking hazard concerns and lack of specific xylitol dosing recommendations. The use of chewing gum containing dental-protective substances, particularly xylitol, in caries-prevention programs can reduce the tooth decay epidemic. Chewing gum use by children in the school setting should be reconsidered.

Protection Motivation and Self-Efficacy: A Model of Health Enhancement.

ERIC Educational Resources Information Center

Stanley, Melinda A.

Protection motivation theory proposes that a perceived threat to health activates cognitive appraisals of the severity of the threatened event, the probability of its occurrence, and the efficacy of a coping response; a recent reformulation of the theory incorporates self-efficacy expectancy as a fourth mediating cognitive process. To test the…

Legal protection of public health through control over genetically modified food.

PubMed

Gutorova, Nataliya; Batyhina, Olena; Trotska, Maryna

2018-01-01

Introduction: Science is constantly being developed which leads to both positive and negative changes in public health and the environment. One of the results of scientific progress is introduction of food based on genetically modified organisms whose effects on human health, to date, remain scantily studied and are ambiguous. The aim: to determine how human health can be influenced by food production based on genetically modified organisms. Materials and methods: international acts, data of international organizations and conclusions of scientists have been examined and used in the study. The article also summarizes information from scientific journals and monographs from a medical and legal point of view with scientific methods. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. Conclusions: Genetically modified organisms are specific human-made organisms being a result of using modern biotechnology techniques. They have both positive and negative effects on human health and the environment. The main disadvantage is not sufficient study of them in various spheres of public life.

[Financial allocations in the System for Social Protection in Health in Mexico: challenges for strategic purchasing].

PubMed

González-Block, Miguel Ángel; Figueroa, Alejandro; García-Téllez, Ignacio; Alarcón, José

2016-01-01

The financial coordination of the System of Social Protection in Health (SPSS) was analyzed to assess its support to strategic purchasing. Official reports and surveys were analyzed. SPSS covers a capita of 2 765 Mexican pesos, equivalent to 0.9% of GDP. The Ministry of Health contributed 35% of the total, state governments 16.7% and beneficiaries 0.06%. The National Commission for Social Protection in Health received 48.3% of resources, allocating 38% to State Social Protection Schemes in Health and paying 7.4% of the total directly to providers.The state contribution is in deficit while family contributions tend not to be charged. SPSS has not built funds specialized in strategic purchasing, capable of transforming historical budgets.The autonomy of providers is key to reduce out-of-pocket spending through the supply of quality services.

IMPLEMENTATION OF DRUG ADDICTS RIGHT TO HEALTH PROTECTION (SEPARATE ASPECTS).

PubMed

Shevchuk, O; Rzhevska, O; Korop, O; Pyliuha, L

2018-03-01

The purpose of the research is to analyze specific problems of the realization of the right to protect the health of people who take narcotic drugs or psychotropic substances. To achieve this goal, statistics have been analyzed on the number of people using narcotic drugs or psychotropic substances (including drug-addicted children) placed on medical records and the number of their applications for medical care. It has been found out that people in this category often face a denial of medical care that causes extremely strong physical and mental suffering. The analysis of the understanding of the legal design of the «right to health care» in the scientific literature, national legislation and international legal documents was made. State institutions and local authorities providing «the right to health care» of people taking narcotic or psychotropic drugs are singled out. The absence of grounds for restricting the right to protect the health of people who take narcotic or psychotropic drugs who are not registered is justified. In the course of the research, it was found out that people who take narcotic drugs or psychotropic substances are more likely than other patients to need medical assistance and, when requesting the right to health care, face a number of problems that require immediate solution: incomplete provision of quality free medical care; unimplementation of rehabilitation programs for such categories of patients; the lack of the right of children who take narcotic drugs or psychotropic substances to make their own decisions at the age of 14 and apply to public health institutions for the treatment of drug addiction; violations of the continuity of SMT programs and their absence in penal institutions for drug dependent people. It was proposed to introduce a number of changes in the relevant normative legal acts.

Compliance with infection prevention and control in oral health-care facilities: a global perspective.

PubMed

Oosthuysen, Jeanné; Potgieter, Elsa; Fossey, Annabel

2014-12-01

Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control. © 2014 FDI World Dental Federation.

Social health insurance coverage and financial protection among rural-to-urban internal migrants in China: evidence from a nationally representative cross-sectional study

PubMed Central

Chen, Wen; Zhang, Qi; Renzaho, Andre M N; Zhou, Fangjing; Zhang, Hui; Ling, Li

2017-01-01

Introduction Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China. Methods Data from the ‘2014 National Internal Migrant Dynamic Monitoring Survey’ were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban resident-based basic medical insurance (URBMI)), and doubly insured (enrolled in both rural and urban schemes). Financial protection was defined as ‘the percentage of out-of-pocket (OOP) payments for the latest inpatient service during the past 12 months in the total household expenditure’. Results The uninsured rate of SHI and the NCMS, UEBMI/URBMI and double insurance coverage in rural-to-urban IMs was 17.3% (95% CI 16.9% to 17.7%), 66.6% (66.0% to 67.1%), 22.6% (22.2% to 23.0%) and 5.5% (5.3% to 5.7%), respectively. On average, financial protection indicator among uninsured, only NCMS insured, only URBMI/UEBMI insured and doubly insured participants was 13.3%, 9.2%, 6.2% and 5.8%, respectively (p=0.004). After controlling for confounding factors and adjusting the protection effect of private health insurance, compared with no SHI, the UEBMI/URBMI, the NCMS and double insurance could reduce the average percentage share of OOP payments by 33.9% (95% CI 25.5% to 41.4%), 14.1% (6.6% to 20.9%) and 26.8% (11.0% to 39.7%), respectively. Conclusion Although rural-to-urban IMs face barriers to accessing SHI schemes, our findings confirm the positive financial protection effect of SHI. Improving availability and portability of health insurance would

Interagency Collaboration between Child Protection and Mental Health Services: Practices, Attitudes and Barriers

ERIC Educational Resources Information Center

Darlington, Yvonne; Feeney, Judith A.; Rixon, Kylie

2005-01-01

Objective: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and…

45 CFR 164.502 - Uses and disclosures of protected health information: General rules.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Uses and disclosures of protected health information: General rules. 164.502 Section 164.502 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable...

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty, Utility, Fairness, and Accountability for Reasonableness

PubMed Central

Resnik, David B.; MacDougall, D. Robert; Smith, Elise M.

2018-01-01

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. PMID:29466133

Control use of data to protect privacy.

PubMed

Landau, Susan

2015-01-30

Massive data collection by businesses and governments calls into question traditional methods for protecting privacy, underpinned by two core principles: (i) notice, that there should be no data collection system whose existence is secret, and (ii) consent, that data collected for one purpose not be used for another without user permission. But notice, designated as a fundamental privacy principle in a different era, makes little sense in situations where collection consists of lots and lots of small amounts of information, whereas consent is no longer realistic, given the complexity and number of decisions that must be made. Thus, efforts to protect privacy by controlling use of data are gaining more attention. I discuss relevant technology, policy, and law, as well as some examples that can illuminate the way. Copyright © 2015, American Association for the Advancement of Science.

Halloysite clay nanotubes for controlled release of protective agents.

PubMed

Lvov, Yuri M; Shchukin, Dmitry G; Möhwald, Helmuth; Price, Ronald R

2008-05-01

Halloysite aluminosilicate nanotubes with a 15 nm lumen, 50 nm external diameter, and length of 800 +/- 300 nm have been developed as an entrapment system for loading, storage, and controlled release of anticorrosion agents and biocides. Fundamental research to enable the control of release rates from hours to months is being undertaken. By variation of internal fluidic properties, the formation of nanoshells over the nanotubes and by creation of smart caps at the tube ends it is possible to develop further means of controlling the rate of release. Anticorrosive halloysite coatings are in development and a self-healing approach has been developed for repair mechanisms through response activation to external impacts. In this Perspective, applications of halloysite as nanometer-scale containers are discussed, including the use of halloysite tubes as drug releasing agents, as biomimetic reaction vessels, and as additives in biocide and protective coatings. Halloysite nanotubes are available in thousands of tons, and remain sophisticated and novel natural nanomaterials which can be used for the loading of agents for metal and plastic anticorrosion and biocide protection.

SOURCE WATER PROTECTION: ITS ROLE IN CONTROLLING DISINFECTION BY-PRODUCTS (DBPS) AND MICROBIAL CONTAMINANTS

EPA Science Inventory

Passage of 1996 Safe Drinking Water Act Amendments (SDWAA) has focused the attention of wter utility managers and public health and regulatory officials on source water protection (SWP) and its role in protecting public water supplies. There is growing awareness that water treatm...

Cancer screening and health system resilience: keys to protecting and bolstering preventive services during a financial crisis.

PubMed

Martin-Moreno, Jose M; Anttila, Ahti; von Karsa, Lawrence; Alfonso-Sanchez, Jose L; Gorgojo, Lydia

2012-09-01

The aim of this paper is to elucidate the rationale for sustaining and expanding cost-effective, population-based screening services for breast, cervical and colorectal cancers in the context of the current financial crisis. Our objective is not only to promote optimal delivery of high-quality secondary cancer prevention services, but also to underline the importance of strengthening comprehensive cancer control, and with it, health system response to the complex care challenges posed by all chronic diseases. We focus primarily on issues surrounding planning, organisation, implementation and resources, arguing that given the growing cancer burden, policymakers have ample justification for establishing and expanding population-based programmes that are well-organised, well-resourced and well-executed. In a broader economic context of rescue packages, deficits and cutbacks to government entitlements, health professionals must intensify their advocacy for the protection of vital preventive health services by fighting for quality services with clear benefits for population health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.

The labor movement's role in gaining federal safety and health standards to protect America's workers.

PubMed

Weinstock, Deborah; Failey, Tara

2014-11-01

In the United States, unions sometimes joined by worker advocacy groups (e.g., Public Citizen and the American Public Health Association) have played a critical role in strengthening worker safety and health protections. They have sought to improve standards that protect workers by participating in the rulemaking process, through written comments and involvement in hearings; lobbying decision-makers; petitioning the Department of Labor; and defending improved standards in court. Their efforts have culminated in more stringent exposure standards, access to information about the presence of potentially hazardous toxic chemicals, and improved access to personal protective equipment-further improving working conditions in the United States.

Women in chronic pain: sense of control and encounters with health professionals.

PubMed

Skuladottir, Hafdis; Halldorsdottir, Sigridur

2008-07-01

An evolving theory on "women's sense of control while in chronic pain and the results of the quality of their encounters with health professionals" is introduced in this article. According to the theory, the main challenge of women in chronic pain is to maintain a sense of control of self and the pain to avoid demoralization, which is seen as a potential threat for all women in chronic pain. To retain a sense of control, women are challenged to learn to live with the pain and cope with the unpredictability and incurability of the pain. They are challenged to find meaning in their suffering, to create personal space, and to be self-protective as well as to keep a positive self-image and self-esteem while trying to live a "normal" life in dignity in spite of the pain and warding off isolation and demoralization. Health professionals are seen as potentially powerful people in the lives of women in chronic pain. Empowerment or disempowerment from them greatly influences whether women in chronic pain are demoralized or not.

Asbestos worker protection. Environmental Protection Agency (EPA). Final rule.

PubMed

2000-11-15

In this Final Rule, EPA is amending both the Asbestos Worker Protection Rule (WPR) and the Asbestos-in-Schools Rule. The WPR amendment protects State and local government employees from the health risks of exposure to asbestos to the same extent as private sector workers by adopting for these employees the Asbestos Standards of the Occupational Safety and Health Administration (OSHA). The WPR's coverage is extended to State and local government employees who are performing construction work, custodial work, and automotive brake and clutch repair work. This final rule cross-references the OSHA Asbestos Standards for Construction and for General Industry, so that future amendments to these OSHA standards are directly and equally effective for employees covered by the WPR. EPA also amends the Asbestos-in-Schools Rule to provide coverage under the WPR for employees of public local education agencies who perform operations, maintenance, and repair activities. EPA is issuing this final rule under section 6 of the Toxic Substances Control Act (TSCA).

Protecting children's rights in the collection of health and welfare data.

PubMed

Schenk, Katie; Murove, Tapfuma; Williamson, Jan

2006-01-01

Program managers and researchers promoting children's rights to health, education, and an adequate standard of living often gather data directly from children to assess their needs and develop responsive services. Gathering information within a participatory framework recognizing children's views contributes to protection of their rights. Extra precautions, however, are needed to protect children because of the vulnerabilities associated with their developmental needs. Using case studies of ethical challenges faced by program implementers and sociobehavioral researchers, this article explores ways in which data collection activities among children may affect their rights. We suggest ways in which rights-based principles may be used to derive safeguards to protect against unintentional harm and abuses, based on a multidisciplinary consultation with researchers and service providers.

Inequalities in financial risk protection in Bangladesh: an assessment of universal health coverage.

PubMed

Islam, Md Rashedul; Rahman, Md Shafiur; Islam, Zobida; Nurs, Cherri Zhang B; Sultana, Papia; Rahman, Md Mizanur

2017-04-04

Financial risk protection and equity are major components of universal health coverage (UHC), which is defined as ensuring access to health services for all citizens without any undue financial burden. We investigated progress towards UHC financial risk indicators and assessed variability of inequalities in financial risk protection indicators by wealth quintile. We further examined the determinants of different financial hardship indicators related to healthcare costs. A cross-sectional, three-stage probability survey was conducted in Bangladesh, which collected information from 1600 households from August to November 2011. Catastrophic health payments, impoverishment, and distress financing (borrowing or selling assets) were treated as financial hardship indicators in UHC. Poisson regression models were used to identify the determinants of catastrophic payment, impoverishment and distress financing separately. Slope, relative and concentration indices of inequalities were used to assess wealth-based inequalities in financial hardship indicators. The study found that around 9% of households incurred catastrophic payments, 7% faced distress financing, and 6% experienced impoverishing health payments in Bangladesh. Slope index of inequality indicated that the incidence of catastrophic health payment and distress financing among the richest households were 12 and 9 percentage points lower than the poorest households respectively. Multivariable Poisson regression models revealed that all UHC financial hardship indicators were significantly higher among household that had members who received inpatient care or were in the poorest quintile. The presence of a member with chronic illness in a household increased the risk of impoverishment by nearly double. This study identified a greater inequality in UHC financial hardship indicators. Rich households in Bangladesh were facing disproportionately less financial hardship than the poor ones. Households can be protected from

Protecting human health in a changing world: the role of social and economic development.

PubMed Central

Woodward, A.; Hales, S.; Litidamu, N.; Phillips, D.; Martin, J.

2000-01-01

The biological and physical environment of the planet is changing at an unprecedented rate as a result of human activity, and these changes may have an enormous impact on human health. One of the goals of human development is to protect health in the face of rapid environmental change, but we often fail to do this. The aim in this paper is to distinguish between socioeconomic aspects of development that are likely to be protective and those that are likely to increase vulnerability (the capacity for loss resulting from environmental change). Examples include climate change in the Pacific. We conclude that protecting human health in a changing world requires us to take steps to minimize harmful change wherever possible, and at the same time to be prepared for surprises. The goals of mitigation (reducing or preventing change) and adaptation (response to change) are not mutually exclusive. In fact, steps to make populations more resilient in the face of change are often similar to those that are needed to lighten the load on the environment. We need social policies that convert economic growth into human development. Wider application of sustainable development concepts is part of the solution. In particular, there is a need to promote health as an essential asset of poor and vulnerable populations. It is their key to productivity and to surviving shocks; it is also the key to achieving broader development goals such as universal education. For these reasons it is in the interests of all sectors--economic, social and environmental--to play their particular roles in protecting and improving health. PMID:11019463

Legal Protections in Public Accommodations Settings: A Critical Public Health Issue for Transgender and Gender-Nonconforming People.

PubMed

Reisner, Sari L; Hughto, Jaclyn M White; Dunham, Emilia E; Heflin, Katherine J; Begenyi, Jesse Blue Glass; Coffey-Esquivel, Julia; Cahill, Sean

2015-09-01

Since 2012, Massachusetts law has provided legal protections against discrimination on the basis of gender identity in employment, housing, credit, public education, and hate crimes. The law does not protect against discrimination based on gender identity in public accommodations settings such as transportation, retail stores, restaurants, health care facilities, and bathrooms. A 2013 survey of Massachusetts transgender and other gender minority adults found that in the past 12 months, 65% had experienced public accommodations discrimination since the law was passed. This discrimination was associated with a greater risk of adverse emotional and physical symptoms in the past 30 days. Nondiscrimination laws inclusive of gender identity should protect against discrimination in public accommodations settings to support transgender people's health and their ability to access health care. Gender minority people who are transgender or gender nonconforming experience widespread discrimination and health inequities. Since 2012, Massachusetts law has provided protections against discrimination on the basis of gender identity in employment, housing, credit, public education, and hate crimes. The law does not, however, protect against discrimination in public accommodations (eg, hospitals, health centers, transportation, nursing homes, supermarkets, retail establishments). For this article, we examined the frequency and health correlates of public accommodations discrimination among gender minority adults in Massachusetts, with attention to discrimination in health care settings. In 2013, we recruited a community-based sample (n = 452) both online and in person. The respondents completed a 1-time, electronic survey assessing demographics, health, health care utilization, and discrimination in public accommodations venues in the past 12 months. Using adjusted multivariable logistic regression models, we examined whether experiencing public accommodations discrimination in

40 CFR 26.1706 - Criteria and procedure for decisions to protect public health by relying on otherwise...

Code of Federal Regulations, 2011 CFR

2011-07-01

... protect public health by relying on otherwise unacceptable research. 26.1706 Section 26.1706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Ethical Standards for Assessing Whether To Rely on the Results of Human Research in EPA Actions § 26.1706 Criteria and procedure...

40 CFR 26.1706 - Criteria and procedure for decisions to protect public health by relying on otherwise...

Code of Federal Regulations, 2012 CFR

2012-07-01

... protect public health by relying on otherwise unacceptable research. 26.1706 Section 26.1706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Ethical Standards for Assessing Whether To Rely on the Results of Human Research in EPA Actions § 26.1706 Criteria and procedure...

40 CFR 26.1706 - Criteria and procedure for decisions to protect public health by relying on otherwise...

Code of Federal Regulations, 2010 CFR

2010-07-01

... protect public health by relying on otherwise unacceptable research. 26.1706 Section 26.1706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Ethical Standards for Assessing Whether To Rely on the Results of Human Research in EPA Actions § 26.1706 Criteria and procedure...

40 CFR 26.1706 - Criteria and procedure for decisions to protect public health by relying on otherwise...

Code of Federal Regulations, 2013 CFR

2013-07-01

... protect public health by relying on otherwise unacceptable research. 26.1706 Section 26.1706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Standards for Assessing Whether To Rely on the Results of Human Research in EPA Actions § 26.1706 Criteria and procedure for...

40 CFR 26.1706 - Criteria and procedure for decisions to protect public health by relying on otherwise...

Code of Federal Regulations, 2014 CFR

2014-07-01

... protect public health by relying on otherwise unacceptable research. 26.1706 Section 26.1706 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Standards for Assessing Whether To Rely on the Results of Human Research in EPA Actions § 26.1706 Criteria and procedure for...

The Impact of State Preemption of Local Smoking Restrictions on Public Health Protections and Changes in Social Norms

PubMed Central

Mowery, Paul D.; Babb, Steve; Hobart, Robin; Tworek, Cindy; MacNeil, Allison

2012-01-01

Introduction. Preemption is a legislative or judicial arrangement in which a higher level of government precludes lower levels of government from exercising authority over a topic. In the area of smoke-free policy, preemption typically takes the form of a state law that prevents communities from adopting local smoking restrictions. Background. A broad consensus exists among tobacco control practitioners that preemption adversely impacts tobacco control efforts. This paper examines the effect of state provisions preempting local smoking restrictions in enclosed public places and workplaces. Methods. Multiple data sources were used to assess the impact of state preemptive laws on the proportion of indoor workers covered by smoke-free workplace policies and public support for smoke-free policies. We controlled for potential confounding variables. Results. State preemptive laws were associated with fewer local ordinances restricting smoking, a reduced level of worker protection from secondhand smoke, and reduced support for smoke-free policies among current smokers. Discussion. State preemptive laws have several effects that could impede progress in secondhand smoke protections and broader tobacco control efforts. Conclusion. Practitioners and advocates working on other public health issues should familiarize themselves with the benefits of local policy making and the potential impact of preemption. PMID:22654921

Unresolved legal questions in cross-border health care in Europe: liability and data protection.

PubMed

van der Molen, I N; Commers, M J

2013-11-01

Directive 2011/24/EU was designed to clarify the rights of EU citizens in evaluating, accessing and obtaining reimbursement for cross-border care. Based on three regional case studies, the authors attempted to assess the added value of the Directive in helping clarify issues in to two key areas that have been identified as barriers to cross-border care: liability and data protection. Qualitative case study employing secondary data sources including research of jurisprudence, that set up a Legal framework as a base to investigate liability and data protection in the context of cross-border projects. By means of three case studies that have tackled liability and data protection hurdles in cross-border care implementation, this article attempts to provide insight into legal certainty and uncertainty regarding cross-border care in Europe. The case studies reveal that the Directive has not resolved core uncertainties related to liability and data protection issues within cross-border health care. Some issues related to the practice of cross-border health care in Europe have been further clarified by the Directive and some direction has been given to possible solutions for issues connected to liability and data protection. Directive 2011/24/EU is clearly a transposition of existing regulations on data protection and ECJ case law, plus a set of additional, mostly, voluntary rules that might enhance regional border cooperation. Therefore, as shown in the case studies, a practical and case by case approach is still necessary in designing and providing cross-border care. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Iranian Household Financial Protection against Catastrophic Health Care Expenditures

PubMed Central

Moghadam, M Nekoei; Banshi, M; Javar, M Akbari; Amiresmaili, M; Ganjavi, S

2012-01-01

Background: Protecting households against financial risks is one of objectives of any health system. In this regard, Iran’s fourth five year developmental plan act in its 90th article, articulated decreasing household’s exposure to catastrophic health expenditure to one percent. Hence, this study aimed to measure percentage of Iranian households exposed to catastrophic health expenditures and to explore its determinants. Methods: The present descriptive-analytical study was carried out retrospectively. Households whose financial contributions to the health system exceeded 40% of disposable income were considered as exposed to catastrophic healthcare expenditures. Influential factors on catastrophic healthcare expenditures were examined by logistic regression and chi-square test. Results: Of 39,088 households, 80 were excluded due to absence of food expenditures. 2.8% of households were exposed to catastrophic health expenditures. Influential factors on catastrophic healthcare were utilizing ambulatory, hospital, and drug addiction cessation services as well as consuming pharmaceuticals. Socioeconomics characteristics such as health insurance coverage, household size, and economic status were other determinants of exposure to catastrophic healthcare expenditures. Conclusion: Iranian health system has not achieved the objective of reducing catastrophic healthcare expenditure to one percent. Inefficient health insurance coverage, different fee schedules practiced by private and public providers, failure of referral system are considered as probable barriers toward decreasing households’ exposure to catastrophic healthcare expenditures. PMID:23193508

WASP (Write a Scientific Paper): Data protection, a guide for health researchers.

PubMed

Grech, Victor; Agius-Muscat, Hugo

2018-05-02

Data protection (DP) protects crucial and humane fundamentals - the respect of human rights, particularly protecting aspects of privacy and confidentiality for living and identifiable persons. DP is enshrined in legislation, and this paper will outline the duties of potential data controllers (researchers) when applying for access to data, when processing said data, and what to do with it at the end of the study. Copyright © 2018 Elsevier B.V. All rights reserved.

Risk and Protective Factors Associated with Health-Related Quality of Life Among Older Gay and Bisexual Men Living With HIV Disease

PubMed Central

Emlet, Charles A.

2013-01-01

Purpose: To identify risk and protective factors associated with mental and physical health-related quality of life, after controlling for key background characteristics, in a population of older gay and bisexual men living with HIV disease. Previous research examining quality of life among persons living with HIV rarely includes older adults. Design and Methods: Survey responses from 226 gay and bisexual men aged 50 and older, and living with HIV disease, which were part of the Caring and Aging with Pride study, were analyzed using multivariate linear regression models. Results: Findings reveal that comorbidity, limitations in activities, and victimization are significant risk factors for decreased physical and mental health-related quality of life. Stigma and HIV progression did not contribute to the overall outcome variables in multivariate models. Social support and self-efficacy serve as protective factors although social support was only significant with mental health-related quality of life. Implications: Comorbidity, functional limitations, and lifetime victimization are risks to quality of life among older gay and bisexual men with HIV disease. Self-efficacy and social support represent intrapersonal and interpersonal resources that can be enhanced through interventions to improve health-related quality of life. PMID:23355449

Prevention concept in industry: improvement in occupational safety and health protection--an empirical study.

PubMed

Ramsauer, F

2001-12-01

This prevention concept offers a contribution to the expansion of the set of instruments for occupational safety and health protection within workplace prevention. The concept involves the multilateral analysis of work conditions. The utilized instruments include a strategy group, a survey, a health issue round table, and an analysis of work demands, and lead to synergy effects at the results level. Employees are drawn into the analysis of work conditions and workplace design solutions for the improvement of the work situation. The prevention concept was tested in a large company and its application established in practice. It was accepted by all participants, and the comparison with the previous situation (defined only through the analysis of work demands) demonstrated a significant improvement in health protection.

Does the perception that God controls health outcomes matter for health behaviors?

PubMed

Karvinen, Kristina H; Carr, Lucas J

2014-04-01

The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.

Protecting children from myopia: a PMT perspective for improving health marketing communications.

PubMed

Lwin, May O; Saw, Seang-Mei

2007-01-01

This research examined the predictive utility of the protection motivation theory (PMT) model for myopia prevention amongst children. An integrative model for myopia prevention behavior of parents was first developed in the context of theory and survey instruments then refined using information gathered from two focus groups. Empirical data then was collected from parents of primary school children in Singapore, a country with one of the highest rates of myopia in the world, and analyzed using structural equation modeling (SEM). Our findings revealed that coping appraisal variables were more significantly associated with protection motivation, relative to threat appraisal variables. In particular, perceived self-efficacy was the strongest predictor of parental intention to enforce good visual health behaviors, while perceived severity was relatively weak. Health marketing communications and public policy implications are discussed.

[The systemic approach to the health protection in the workers of industrial enterprises].

PubMed

Oransky, I E; Razumov, A N; Fedorov, A A

This paper presents the results of the systemic approach to the protection of health and prophylaxis of disability in the workers of industrial enterprises. The leading role in the technologies of rehabilitation (both short-term and long-term one) is played by the natural and physical therapeutic factors. The priority in the implementation of the therapeutic and health-promoting measures is given to the treatment based on the spa and health resort facilities as well as the factory health centers.

The Role of Consumer-Controlled Personal Health Management Systems in the Evolution of Employer-Based Health Care Benefits.

PubMed

Jones, Spencer S; Caloyeras, John; Mattke, Soeren

2011-01-01

The passage of the Patient Protection and Affordable Care Act has piqued employers' interest in new benefit designs because it includes numerous provisions that favor cost-reducing strategies, such as workplace wellness programs, value-based insurance design (VBID), and consumer-directed health plans (CDHPs). Consumer-controlled personal health management systems (HMSs) are a class of tools that provide encouragement, data, and decision support to individuals. Their functionalities fall into the following three categories: health information management, promotion of wellness and healthy lifestyles, and decision support. In this study, we review the evidence for many of the possible components of an HMS, including personal health records, web-based health risk assessments, integrated remote monitoring data, personalized health education and messaging, nutrition solutions and physical activity monitoring, diabetes-management solutions, medication reminders, vaccination and preventive-care applications, integrated incentive programs, social-networking tools, comparative data on price and value of providers, telehealth consultations, virtual coaching, and an integrated nurse hotline. The value of the HMS will be borne out as employers begin to adopt and implement these emerging technologies, enabling further assessment as their benefits and costs become better understood.

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building

PubMed Central

Collin, Jeff; Amos, Amanda

2016-01-01

Introduction: Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Methods: Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. Results: An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance’s success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. Conclusions: The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. PMID:25634938

Tuberculosis infection control practices and associated factors among health care workers in health centers of West Gojjam zone, Northwest Ethiopia: a cross-sectional study.

PubMed

Tamir, Kassahun; Wasie, Belaynew; Azage, Muluken

2016-08-08

Tuberculosis (TB) remains a major global health problem. The emerging epidemic of multi- and extensively drug-resistant (M/XDR) TB further imperils health workers, patients and public health. Health facilities with inadequate infection control are risky environments for the emergence and transmission of TB. There was no study that presented data on infection control practices of health care workers. This study aimed to assess tuberculosis infection control practices and associated factors among health care workers in West Gojjam Zone, Northwest Ethiopia. Institution based quantitative cross-sectional study triangulated with qualitative observation and key informant interview was conducted. Six hundred sixty two health care workers were selected by multistage random sampling method. Self-administered structured questionnaire was used to collect quantitative data. Observation checklists and key informant interview guides were used to collect qualitative data. Quantitative data were entered in to Epi Info version 3.5.3 and analyzed using SPSS version 20. Odds ratio with 95 % confidence interval was used to identify factors associated with TB infection control practice of health care workers. Qualitative data were translated, transcribed, analyzed and triangulated with the quantitative findings. The proportion of proper TB infection control (TBIC) practices was 38 %. Qualitative data showed that administrative, environmental and personal respiratory protection control measures were not practiced well. Knowledge on the presence of TBIC plan [AOR = 4.25, 95 % CI: 2.46 - 7.35], knowledge on the presence of national guideline [AOR = 8.95, 95 % CI: 4.35 - 18.40] and working department of the health care workers were independent predictors of TBIC practices. The proportion of proper TBIC practices of health care workers was low. TBIC practices were determined by knowing the presence of TBIC plan and national guideline and working department. Hence, supportive

Advising patients about international travel. What they can do to protect their health and safety.

PubMed

Bratton, R L

1999-07-01

As international travel becomes increasingly common, primary care physicians are often asked for advice about travel-related health issues. Having a basic knowledge of both health and safety issues is essential. Pregnant women and patients with chronic medical conditions need to be aware of factors that can compromise their health during airline flights. All travelers need to know about required and recommended immunizations; prevention and treatment of jet lag, motion sickness, altitude sickness, food-borne illness, traveler's diarrhea, and sunburn; protection from insects and swimming hazards; how to obtain medical care in foreign countries; and how to protect themselves in the event of a crime or medical emergency.

Use and disclosure of health information and protection of patient privacy in Taiwan.

PubMed

Liu, Han-Hsi

2010-03-01

This paper examines Taiwan's current regulatory system for the use of healthcare information from the viewpoint of patient privacy protection. The author proposes a patient-centered, cooperative system centered on the "traffic light theory", as a solution to the potential conflict between the use of healthcare information and the protection of patient privacy. Taiwan, a country with a national healthcare insurance program and state-of-the-art electronic technology, takes a distinctive approach to the protection of patient privacy. On January 1st, 2004, the Bureau of National Health Insurance (BNHI) implemented a comprehensive embedded integrated circuit (IC) card, which puts the wide-ranging health information of its 22 million beneficiaries online to facilitate review of use and disclosure. It is well understood that healthcare information is of a personal and sensitive nature, demanding stringent privacy protection. Nevertheless, there is no denying the potential benefit of using personal health information (PHI) to achieve public good, especially in the area of cost containment. The comprehensive e-health system in Taiwan greatly facilitates copying, transmission, and use of PHI, but does the regulatory system provide enough safeguards for patient privacy? Because the law in Taiwan does not provide clear standards for the use and disclosure of healthcare information, healthcare providers are either too conservative or too aggressive. While most healthcare providers keep their oath of confidentiality, some rogue members severely abuse patient privacy. This paper proposes a "traffic-light system" to remedy this situation. Flashing yellow lights allow aggressive drivers to ignore others, while causing overly cautious drivers to be too hesitant. The author contends that clear standards should have been established for healthcare providers. Like car drivers, healthcare providers need red and green traffic signals. The law should indicate, through workable privacy

Influence of Cancer Worry on Four Cancer Related Health Protective Behaviors among a Nationally Representative Sample: Implications for Health Promotion Efforts.

PubMed

Amuta, Ann O; Mkuu, Rahma S; Jacobs, Wura; Ejembi, Agbenu Z

2017-03-01

The aims of this study were to assess what sociodemographic characteristics are associated with cancer worry and what the influence of cancer worry is on four cancer-related protective health behaviors. Data from the Health Information National Trends Survey (HINTS) (4th cycle of the 4th iteration) were used. Multiple regression models were used for all analyses. Behaviors analyzed were as follows: physical activity, diets, smoking, and routine medical screening. Demographics controls included participant age, income, body mass index (BMI), race/ethnicity, and education. N = 2630, Older participants (OR = .99, p < .001), participants with higher BMI (OR = 1.01, p = .017), females (OR = 1.39, p < .001), and highly educated participants were more likely to worry about cancer. Cancer worry was not a significant predictor of exercise, healthy eating, or cancer screening behaviors. However, participants who worried about cancer were more likely to be current smokers (RRR = 1.20, p < .001) compared to participants who never smoked. Although, worry is only an emotional influence on health behavior and may be short-lived, the influence of worry on health-related decision making is likely to be lasting even when the emotions are no longer present.

Community Violence, Protective Factors, and Adolescent Mental Health: A Profile Analysis

ERIC Educational Resources Information Center

Copeland-Linder, Nikeea; Lambert, Sharon F.; Ialongo, Nicholas S.

2010-01-01

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring,…

Breathe easy with proper respiratory protection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bidwell, J.

1996-05-01

Evaluating the need for respiratory protection in chemical process industries (CPI) plants and selecting the appropriate respirator involves several steps. The Occupational Safety and Health Administration (OSHA) general industry standard for respiratory protection (29 CFR 1910.134(b)) requires the employer to establish a program to help reduce exposures to occupational contaminants. When feasible, employers must eliminate contaminants by using engineering controls (such as general and local ventilation, enclosure or isolation, or substitution of a less-hazardous process or material). Establishing a respiratory protection program consists of four steps: (1) Identify respiratory hazards and concentrations; (2) Understand the contaminants` effects on workers` health;more » (3) Select appropriate respiratory protection; and (4) Train in proper respirator use and maintenance. Consult applicable state and OSHA requirements to ensure that your program satisfies these steps. Industrial respirator manufacturers can assist with on-site training and fit testing. The paper discusses these four steps, program guidelines, determination of the hazard, and styles of respirators.« less

Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

PubMed Central

van Osch, Liesbeth; Beenackers, Mariëlle; Reubsaet, Astrid; Lechner, Lilian; Candel, Math; de Vries, Hein

2009-01-01

Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572) and one on high-caloric snack consumption (N = 585) in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health risk behaviors. Future

Protecting health care workers from tuberculosis in China: a review of policy and practice in China and the United States.

PubMed

Chai, Shua J; Mattingly, Daniel C; Varma, Jay K

2013-01-01

Tuberculosis causes >1.7 million deaths worldwide each year and is frequently transmitted in hospitals. Outbreaks of multidrug-resistant tuberculosis have led to illness and death among health care workers (HCWs) in many countries. Some countries, such as the United States, implemented occupational health policies that substantially reduced tuberculosis rates among HCWs. Inadequate tuberculosis infection control in China may contribute to its high burden of tuberculosis and multidrug-resistant tuberculosis, which are both the second highest worldwide. Occupational health policies in China for tuberculosis control can be strengthened. We reviewed the development and content of tuberculosis infection control policies in the United States and China. Sources included published academic literature, Chinese Ministry of Health policies, US government agency reports, legal databases, personal observations of hospitals, review of internet discussion sites, and discussions with HCWs and health care and law experts. In the United States, slow acceptance of the tuberculosis problem in HCWs resulted in decades of inaction. Tuberculosis infection control policies, based mostly on expert opinion, were implemented only after tuberculosis resurged in the 1980s. Effective evidence-based policies were developed only after multiple cycles of policy implementation, evaluation and revision. These policies have now substantially reduced occupational tuberculosis. In China, tuberculosis has not been formally recognized as an occupational disease, and data regarding the burden in HCWs are sparse. Vagueness of current labour laws and suboptimal alignment of infection control authority and expertise result in varied and sometimes absent protection of HCWs against tuberculosis. Formal evaluations of occupational tuberculosis policies have not been reported. By collecting data on its current HCW tuberculosis burden and infection control practices, refining policies, continually evaluating its

Wireless Subsurface Microsensors for Health Monitoring of Thermal Protection Systems on Hypersonic Vehicles

NASA Technical Reports Server (NTRS)

Milos, Frank S.; Watters, David G.; Pallix, Joan B.; Bahr, Alfred J.; Huestis, David L.; Arnold, Jim (Technical Monitor)

2001-01-01

Health diagnostics is an area where major improvements have been identified for potential implementation into the design of new reusable launch vehicles in order to reduce life cycle costs, to increase safety margins, and to improve mission reliability. NASA Ames is leading the effort to develop inspection and health management technologies for thermal protection systems. This paper summarizes a joint project between NASA Ames and SRI International to develop 'SensorTags,' radio frequency identification devices coupled with event-recording sensors, that can be embedded in the thermal protection system to monitor temperature or other quantities of interest. Two prototype SensorTag designs containing thermal fuses to indicate a temperature overlimit are presented and discussed.

The patient protection and affordable care act: how will it affect private health insurance for cancer patients?

PubMed

Schwartz, Karyn; Claxton, Gary

2010-01-01

The Patient Protection and Affordable Care Act will make health coverage more available and affordable while also strengthening regulations on the scope of private health insurance coverage. Most of the law's key provisions take effect in 2014, at which time health insurers will be barred from charging more or denying coverage for individuals with a pre-existing condition. Also in 2014, qualifying individuals will receive subsidies to purchase private insurance through newly created health insurance exchanges. New rules related to caps on benefits and stronger rights to appeal insurance company decisions take effect in 2010. In 2014, all insurance policies sold to individuals and small groups will have to cover an essential benefits package defined by the federal government. Although many Patient Protection and Affordable Care Act provisions do not apply to all types of private coverage, overall the law will provide more protections to cancer patients and survivors in the private health insurance marketplace.

Mandatory reporting for child protection in health settings and the rights of parents with disabilities.

PubMed

Mudrick, Nancy R; Smith, Carrie Jefferson

2017-04-01

This commentary considers the intersection of mandatory reporting in health settings and the public child protection system's treatment of parents with disabilities. Its impetus is the August 2015 technical assistance document issued jointly by the U.S. departments of Justice (DOJ) and Health and Human Services (HHS) that affirms the applicability of the ADA and Section 504 to child protection system (CPS) processes. The DOJ/HHS document speaks to actions of state child protection agencies and courts, without addressing the first step, mandatory reporting. Nonetheless, there are implications for how mandated reporters understand child risk in the presence of disability, and health settings are one venue where mandated reports initiate. This commentary seeks to provide medical professionals with greater understanding of the CPS process and its intersection with disability rights. It concludes that mandatory reporter training must include ADA principles for addressing disability so parents are not unnecessarily reported for investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

Integrating community health workers within Patient Protection and Affordable Care Act implementation.

PubMed

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau

2015-01-01

The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural

Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

PubMed Central