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Sample records for health assessment document

  1. Assessment and documentation of sexual health issues of recent combat veterans seeking VHA care.

    PubMed

    Helmer, Drew A; Beaulieu, Gregory R; Houlette, Cheryl; Latini, David; Goltz, Heather H; Etienne, Samuel; Kauth, Michael

    2013-04-01

    Sexual health is an important aspect of human existence associated with disease and overall health. Despite these associations and the existence of medical treatments to improve sexual function, sexual health is often overlooked in health care. Recent combat veterans may be particularly vulnerable to sexual health issues due to their deployment-related health issues such as mental health conditions, prescription medications use, and psychosocial challenges. This study assesses the sexual health issues of recent combat veterans seeking care at a Veterans Affairs Medical Center (VAMC) documented in the primary care and mental health notes from the first 6 months of care. Documentation of sexual health issues in the progress notes (coded into categories), primary care vs. mental health care visit note, initial vs. follow-up visit notes, and templated vs. non-templated text. This is a retrospective chart review of the first 158 consecutive patients seen for an initial assessment in the VAMC post-deployment clinic. Medical records were reviewed and text of sexual health issues and relevant patient and care characteristics were abstracted and coded into variables. Almost 25% of patients had documented sexual health issues in the first 6 months of care. We coded 52 separate sexual health issues into 13 distinct categories. Overall, most sexual health issues were documented in mental health care notes, in non-templated text, and at follow-up visits. The use of templated text appeared to drive the documentation of low libido (the most common sexual health issue) in mental health care notes. Sexual health issues are prevalent in recent combat veterans seeking care at a VAMC, but patterns of documentation suggest that they may be under-reported or incompletely addressed. A more systematic and provider-initiated approach to assessment of sexual health may promote fuller discussion of sexual health issues and optimize management. © 2013 International Society for Sexual

  2. Standardised care plans for in hospital stroke care improve documentation of health care assessments.

    PubMed

    Pöder, Ulrika; Dahm, Marie Fogelberg; Karlsson, Nina; Wadensten, Barbro

    2015-10-01

    To compare stroke unit staff members' documentation of care in line with evidence-based guidelines pre- and postimplementation of a multi-professional, evidence-based standardised care plan for stroke care in the electronic health record. Rapid and effective measures for patients with stroke or suspected stroke can limit the extent of damage; it is imperative that patients be observed, assessed and treated in accordance with evidence-based practice in hospital. Quantitative, comparative. Structured retrospective health record reviews were made prior to (n 60) and one and a half years after implementation (n 60) of a multi-professional evidence-based standardised care plan with a quality standard for stroke care in the electronic health record. Significant improvements were found in documentation of assessed vital signs, except for body temperature, Day 1 post compared with preimplementation. Documentation frequency regarding body temperature Day 1 and blood pressure and pulse Day 2 decreased post compared with preimplementation. Improvements were also detected in documented observations of patients' micturition capacity, swallowing capacity and mouth status and the proportion of physiotherapist-documented aid assessments. Observations of blood glucose, mobilisation ability and speech and communication ability were unchanged. An evidence-based standardised care plan in an electronic health record assists staff in improving documentation of health status assessments during the first days after a stroke diagnosis. Use of a standardised care plan seems to have the potential to help staff adhere to evidence-based patient care and, thereby, to increase patient safety. © 2015 John Wiley & Sons Ltd.

  3. Methodological guidance documents for evaluation of ethical considerations in health technology assessment: a systematic review.

    PubMed

    Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; Campbell, Kaitryn; Goeree, Ron

    2014-04-01

    Despite the advances made in the development of ethical frameworks for health technology assessment (HTA), there is no clear agreement on the scope and details of a practical approach to address ethical aspects in HTA. This systematic review aimed to identify existing guidance documents for incorporation of ethics in HTA to provide an overview of their methodological features. The review identified 43 conceptual frameworks or practical guidelines, varying in their philosophical approach, structure, and comprehensiveness. They were designed for different purposes throughout the HTA process, ranging from helping HTA-producers in identification, appraisal and analysis of ethical data to supporting decision-makers in making value-sensitive decisions. They frequently promoted using analytical methods that combined normative reflection with participatory approaches. The choice of a method for collection and analysis of ethical data seems to depend on the context in which technology is being assessed, the purpose of analysis, and availability of required resources.

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

    PubMed

    Ford, Heath; Trent, Shane; Wickizer, Stephen

    2016-03-25

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

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

    PubMed Central

    Trent, Shane; Wickizer, Stephen

    2016-01-01

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

  6. Assessment of text documentation accompanying uncoded diagnoses in computerized health insurance claims in Japan.

    PubMed

    Tanihara, Shinichi

    2015-01-01

    Uncoded diagnoses in health insurance claims (HICs) may introduce bias into Japanese health statistics dependent on computerized HICs. This study's aim was to identify the causes and characteristics of uncoded diagnoses. Uncoded diagnoses from computerized HICs (outpatient, inpatient, and the diagnosis procedure-combination per-diem payment system [DPC/PDPS]) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010 were analyzed. The text documentation accompanying the uncoded diagnoses was used to classify diagnoses in accordance with the International Classification of Diseases-10 (ICD-10). The text documentation was also classified into four categories using the standard descriptions of diagnoses defined in the master files of the computerized HIC system: 1) standard descriptions of diagnoses, 2) standard descriptions with a modifier, 3) non-standard descriptions of diagnoses, and 4) unclassifiable text documentation. Using these classifications, the proportions of uncoded diagnoses by ICD-10 disease category were calculated. Of the uncoded diagnoses analyzed (n = 363 753), non-standard descriptions of diagnoses for outpatient, inpatient, and DPC/PDPS HICs comprised 12.1%, 14.6%, and 1.0% of uncoded diagnoses, respectively. The proportion of uncoded diagnoses with standard descriptions with a modifier for Diseases of the eye and adnexa was significantly higher than the overall proportion of uncoded diagnoses among every HIC type. The pattern of uncoded diagnoses differed by HIC type and disease category. Evaluating the proportion of uncoded diagnoses in all medical facilities and developing effective coding methods for diagnoses with modifiers, prefixes, and suffixes should reduce number of uncoded diagnoses in computerized HICs and improve the quality of HIC databases.

  7. Health Assessment Document for 1,3-Butadiene (External Review Draft)

    EPA Science Inventory

    This risk assessment of 1,3-butadiene, a gas used commercially in the production of various resins and plastics, concludes that 1,3-butadiene is a known human carcinogen, based on three types of evidence: 1) excess leukemias in workers occupationally exposed to 1,3-butadiene (by ...

  8. Health Assessment Document for 1,3-Butadiene (External Review Draft)

    EPA Science Inventory

    This risk assessment of 1,3-butadiene, a gas used commercially in the production of various resins and plastics, concludes that 1,3-butadiene is a known human carcinogen, based on three types of evidence: 1) excess leukemias in workers occupationally exposed to 1,3-butadiene (by ...

  9. Documents for Recommended Toxicity Equivalency Factors for Human Health Risk Assessments of Dioxin and Dioxin-Like Compounds

    EPA Pesticide Factsheets

    This document describes the U.S. Environmental Protection Agency’s (U.S. EPA’s) updated approach for evaluating the human health risks from exposures to environmental media containing dioxin-like compounds (DLCs).

  10. Annex II technical documentation assessed.

    PubMed

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

    2005-12-01

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

  11. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT ...

    EPA Pesticide Factsheets

    Health and Environmental Effects Documents (HEEDS) are prepared for the Office of Solid Waste and Emergency Response (OSWER). This document series is intended to support listings under the Resource Conservation and Recovery Act (RCRA) as well as to provide health-related limits and goals for emergency and remedial actions under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA). Both published literature and information obtained from Agency Program Office files are evaluated as they pertain to potential human health, aquatic life and environmental effects of hazardous waste constituents. Several quantitative estimates are presented provided sufficient data are available. For systemic toxicants, these include Reference Doses (RfDs) for chronic and subchronic exposures for both the inhalation and oral exposures. In the case of suspected carcinogens, RfDs may not be estimated. Instead, a carcinogenic potency factor, or q1*, is provided. These potency estimates are derived for both oral and inhalation exposures where possible. In addition, unit risk estimates for air and drinking water are presented based on inhalation and oral data, respectively. Reportable quantities (RQs) based on both chronic toxicity and carcinogenicity are derived. The RQ is used to determine the quantity of a hazardous substance for which notification is required in the event of a release as specified under CERCLA.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  14. Health Information Technology Evaluation Framework (HITREF) Comprehensiveness as Assessed in Electronic Point-of-Care Documentation Systems Evaluations.

    PubMed

    Sockolow, Paulina S; Bowles, Kathryn H; Rogers, Michelle

    2015-01-01

    We assessed the Health Information Technology (HIT) Reference-based Evaluation Framework (HITREF) comprehensiveness in two HIT evaluations in settings different from that in which the HITREF was developed. Clinician satisfaction themes that emerged from clinician interviews in the home care and the hospital studies were compared to the framework components. Across both studies, respondents commented on 12 of the 20 HITREF components within 5 of the 6 HITREF concepts. No new components emerged that were missing from the HITREF providing evidence that the HITREF is a comprehensive framework. HITREF use in a range of HIT evaluations by researchers new to the HITREF demonstrates that it can be used as intended. Therefore, we continue to recommend the HITREF as a comprehensive, research-based HIT evaluation framework to increase the capacity of informatics evaluators' use of best practice and evidence-based practice to support the credibility of their findings for fulfilling the purpose of program evaluation.

  15. Advanced Materials Laboratory hazards assessment document

    SciTech Connect

    Barnett, B.; Banda, Z.

    1995-10-01

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

  16. Assessing and documenting fluid balance.

    PubMed

    Pinnington, Sarah; Ingleby, Sarah; Hanumapura, Prasanna; Waring, Deryn

    2016-12-07

    Concerns about inadequate patient hydration and suboptimal monitoring of fluid balance have been documented in recent reports. The Fluid Balance Improvement Project at Central Manchester University Hospitals NHS Foundation Trust was undertaken to identify risk factors influencing hydration and to implement a revised process to manage these risks, resulting in the development of a hydration pathway. This new approach to monitoring patient hydration, together with staff education and support, has resulted in improved compliance with fluid balance monitoring standards, as well as significant improvements in identifying patients at risk of dehydration, and an increase in patients with acute kidney injury commencing appropriate fluid balance monitoring.

  17. The psychiatric inpatient physical health assessment sheet (PIPHAS): a useful tool to improve the speed, efficiency, and documentation of physical examination in new psychiatric inpatients.

    PubMed

    Pettipher, Alexander; Ovens, Richard

    2015-01-01

    There is increased morbidity and mortality among patients suffering from mental illness. This is believed to be multi-factorial. Poor access to healthcare, the stigma of mental illness, reduced clinic attendance, lifestyle factors, and side effects of medications are cited as possible contributing factors. It is therefore vital to perform a physical examination to identify previously undiagnosed conditions during the admission of a psychiatric inpatient. The Royal College of Psychiatrists recommends that all patients admitted to a psychiatric hospital should receive a full physical examination on admission, or within twenty-four hours of admission. A snapshot audit was carried out at Prospect Park Hospital in Reading, which highlighted that The Royal College of Psychiatrist's recommendation, along with Trust guidelines regarding physical examination were not being met, with only 78 out of 111 patients (70.3%) undergoing an examination during their admission. In addition to this, examinations were often poorly documented and not covering all examination domains. A psychiatric inpatient physical health assessment sheet (PIPHAS) was designed and introduced, providing a quick and standardised approach to the documentation of a physical examination. After the intervention was put into practice, its impact was assessed by performing a retrospective review of the admission clerking notes of the next 100 admissions to Prospect Park Hospital. Following the introduction of the PIPHAS form there was an increase in the number of patients undergoing physical examination on admission to hospital (75 out of 100 patients, 75%). There was also an increase in the thorough documentation of all examination domains (e.g. respiratory examination) for patients that had a completed PIPHAS form scanned within their medical records. This quality improvement project demonstrates that the PIPHAS form is a useful tool to improve the speed, efficiency, and documentation of a thorough physical

  18. Survey of state health information exchanges regarding inclusion of Continuity of Care Documents for long-term post-acute care (LTPAC) patient assessment.

    PubMed

    Hassol, Andrea; Goodman, Laura; Younkin, Jim; Honicker, Mary; Chaundy, Kimberly; Walker, James M

    2014-01-01

    This study aimed to measure awareness and interest among state health information exchanges (HIEs) in a tool that translates long-term post-acute care (LTPAC) patient assessment information to a Continuity of Care Document (CCD) format for sharing; whether any state HIEs currently integrate patient information from LTPAC providers; and the anticipated benefits and barriers to using such a tool. The study consisted of an online survey of state HIEs. Responses were received from representatives of 29 of the 51 HIEs (57 percent). Eleven of the 29 respondents (38 percent) were aware of the LTPAC-to-CCD translation tool, and 24 (83 percent of respondents) were interested in it or felt LTPAC providers in their state would be interested. Twenty-one of the 24 interested respondents (88 percent) indicated a desire for more information about this technology. Skilled nursing facilities and home health agencies receive no incentives for adoption of electronic health record systems and are not commonly included in HIEs. These organizations do, however collect extensive structured data about their patients (Minimum Data Set for nursing facilities, Outcome and Assessment Information Set for home health agencies) and transmit the data electronically to the Centers for Medicare and Medicaid Services (CMS). A tool is now available that will intercept the transmissions to CMS, transform content extracted from patient assessments into CCDs, and send the CCDs to a designated HIE. Responding HIEs reported almost no experience exchanging patient assessment information from LTPAC providers. Anticipated benefits include safer care transitions; anticipated barriers include information technology constraints in LTPAC settings.

  19. Survey of State Health Information Exchanges Regarding Inclusion of Continuity of Care Documents for Long-Term Post-Acute Care (LTPAC) Patient Assessment

    PubMed Central

    Hassol, Andrea; Goodman, Laura; Younkin, Jim; Honicker, Mary; Chaundy, Kimberly; Walker, James M.

    2014-01-01

    Objectives This study aimed to measure awareness and interest among state health information exchanges (HIEs) in a tool that translates long-term post-acute care (LTPAC) patient assessment information to a Continuity of Care Document (CCD) format for sharing; whether any state HIEs currently integrate patient information from LTPAC providers; and the anticipated benefits and barriers to using such a tool. Materials and Methods The study consisted of an online survey of state HIEs. Results Responses were received from representatives of 29 of the 51 HIEs (57 percent). Eleven of the 29 respondents (38 percent) were aware of the LTPAC-to-CCD translation tool, and 24 (83 percent of respondents) were interested in it or felt LTPAC providers in their state would be interested. Twenty-one of the 24 interested respondents (88 percent) indicated a desire for more information about this technology. Discussion Skilled nursing facilities and home health agencies receive no incentives for adoption of electronic health record systems and are not commonly included in HIEs. These organizations do, however collect extensive structured data about their patients (Minimum Data Set for nursing facilities, Outcome and Assessment Information Set for home health agencies) and transmit the data electronically to the Centers for Medicare and Medicaid Services (CMS). A tool is now available that will intercept the transmissions to CMS, transform content extracted from patient assessments into CCDs, and send the CCDs to a designated HIE. Conclusion Responding HIEs reported almost no experience exchanging patient assessment information from LTPAC providers. Anticipated benefits include safer care transitions; anticipated barriers include information technology constraints in LTPAC settings. PMID:25593573

  20. Assessment and documentation of non-healing, chronic wounds in inpatient health care facilities in the Czech Republic: an evaluation study.

    PubMed

    Pokorná, Andrea; Leaper, David

    2015-04-01

    The foundation of health care management of patients with non-healing, chronic wounds needs accurate evaluation followed by the selection of an appropriate therapeutic strategy. Assessment of non-healing, chronic wounds in clinical practice in the Czech Republic is not standardised. The aim of this study was to analyse the methods being used to assess non-healing, chronic wounds in inpatient facilities in the Czech Republic. The research was carried out at 77 inpatient medical facilities (8 university/faculty hospitals, 63 hospitals and 6 long- term hospitals) across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The results of this research have corroborated the suspicion of inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of a wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were significantly improved when a consultant for wound healing was present (P = 0·047). The same applied to facilities possessing a certificate of quality issued by the Czech Wound Management Association (P = 0·010). In conclusion, an effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of a 'non-healing, chronic wound assessment' algorithm. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  1. Kauai Test Facility hazards assessment document

    SciTech Connect

    Swihart, A

    1995-05-01

    The Department of Energy Order 55003A requires facility-specific hazards assessment be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Kauai Test Facility, Barking Sands, Kauai, Hawaii. The Kauai Test Facility`s chemical and radiological inventories were screened according to potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distance to the Early Severe Health Effects threshold is 4.2 kilometers. The highest emergency classification is a General Emergency at the {open_quotes}Main Complex{close_quotes} and a Site Area Emergency at the Kokole Point Launch Site. The Emergency Planning Zone for the {open_quotes}Main Complex{close_quotes} is 5 kilometers. The Emergency Planning Zone for the Kokole Point Launch Site is the Pacific Missile Range Facility`s site boundary.

  2. Checklist clerking document improves health promotion among medical admissions

    PubMed Central

    Cousins, Sarah

    2013-01-01

    Health promotion, as defined by the Ottawa Charter (1) is the ‘process of enabling people to increase control over, and to improve their health’. Four life style risk factors: smoking, alcohol, obesity and physical activity are recognised as leading to health inequalities. These factors have implications at an individual, community and national level and the burden of disease has large cost implications for the NHS and country as a whole. Therefore the assessment of these risk factors, and the provision of good health promotion assist to address these problems. A pilot and initial audit demonstrated that assessment for the key life style risk factors and the provision of health promotion was poor. This quality improvement audit developed an easy to use, checklist based, amended clerking document. This improved both assessment and provision of health promotion and will be carried forward to influence the designing of a new clerking document. PMID:26734175

  3. PUREX Deactivation Health and Safety documentation

    SciTech Connect

    Dodd, E.N. III

    1995-01-01

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

  4. Representing nursing assessment documentation with ICNP.

    PubMed

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

    2008-11-06

    The purpose of this study was to identify key concepts and semantic relations necessary to represent standardized and local patient assessment items in an electronic documentation system and to evaluate the degree to which coverage of both are represented by ICNP. A total of 805 unique assessment concepts were identified. Forty-three percent had exact matches in ICNP, and an additional 20% had matches in the ICNP classified as narrower, broader or other.

  5. W-320 Department of Health documentation

    SciTech Connect

    Bailey, J.W.

    1998-08-07

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

  6. Advantages of coordinated school health portfolios: documenting and showcasing achievements.

    PubMed

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

    2013-04-01

    Thirteen school district teams from Michigan and Indiana participated in the Michiana Coordinated School Health Leadership Institute with the intent of Coordinated School Health Program (CSHP) implementation. The purpose of this study was to determine if portfolios served as an effective approach for documenting teams' accomplishments and health programming efforts. Data were gathered through a combined survey/interview process and portfolio analysis. The survey was developed by the Institute's core team of experts and designed to assess the Institute's goals and objectives. Interviews elicited greater detail pertaining to survey questions. Content analysis yielded a detailed and descriptive summary of each team's portfolio. Portfolios proved useful for providing rich descriptions and artifacts documenting each team's process and progress toward achieving CSHP. They were not limited to the 12 required Michiana categories and contained additional items related to other aspects of health programming. Portfolios also served as a record-keeping and CSHP marketing tool. This study demonstrates the advantages of portfolios for documenting the process of CSHP development and implementation and teams' health programming efforts. The portfolios provided evidence of team achievements related to Institute goals and objectives-those that included greater documentation were indicative of fuller implementation. Teams with portfolios that used both categorical and scrapbook formats provided richer portrayals of successes to a broader variety of audiences. © 2013, American School Health Association.

  7. Review of the acrylamide health criteria document. Final report

    SciTech Connect

    Not Available

    1988-07-19

    The Drinking Water Subcommittee of the Science Advisory Board's Environmental Health Committee completed its review of the Drinking Water Health Criteria Document for Acrylamide. The Subcommittee made the following conclusions and recommendations: because it was performed for two full years, the Johnson Study should be used in setting the standard; the final assessment of the carcinogenic potential should await the results of the current bioassay, the ability of acrylamide to produce heritable germ-cell mutations should be given emphasis in the risk-assessment process; the health implications of products formed from acrylamide as a result of chlorination and oxidation processes are potentially serious and must be considered in the document; and the potential effects of pH and metal ions in water should be addressed.

  8. Comparison of AIHA ISO 9001-based occupational health and safety management system guidance document with a manufacturer's occupational health and safety assessment instrument.

    PubMed

    Dyjack, D T; Levine, S P; Holtshouser, J L; Schork, M A

    1998-06-01

    Numerous manufacturing and service organizations have integrated or are considering integration of their respective occupational health and safety management and audit systems into the International Organization for Standardization-based (ISO) audit-driven Quality Management Systems (ISO 9000) or Environmental Management Systems (ISO 14000) models. Companies considering one of these options will likely need to identify and evaluate several key factors before embarking on such efforts. The purpose of this article is to identify and address the key factors through a case study approach. Qualitative and quantitative comparisons of the key features of the American Industrial Hygiene Association ISO-9001 harmonized Occupational Health and Safety Management System with The Goodyear Tire & Rubber Co. management and audit system were conducted. The comparisons showed that the two management systems and their respective audit protocols, although structured differently, were not substantially statistically dissimilar in content. The authors recommend that future studies continue to evaluate the advantages and disadvantages of various audit protocols. Ideally, these studies would identify those audit outcome measures that can be reliably correlated with health and safety performance.

  9. [Formal quality assessment of informed consent documents in 9 hospitals].

    PubMed

    Calle-Urra, J E; Parra-Hidalgo, P; Saturno-Hernández, P J; Martínez-Martínez, M J; Navarro-Moya, F J

    2013-01-01

    Informed consent forms are very important in the process of medical information. The aim of this study is to design reliable formal quality criteria of these documents and their application in the evaluation of those used in the hospitals of a regional health service. Criteria have been designed from the analysis of existing regulations, previous studies and consultation with key experts. The interobserver concordance was assessed using the kappa index. Criteria evaluation was performed on 1425 documents of 9 hospitals. A total of 19 criteria used in the evaluation of the quality of informed consent forms have been obtained. Kappa values were higher than 0,60 in 17 of them and higher than 0,52 in the other 2. The average number of defects per document was 7.6, with a high-low ratio among hospitals of 1.84. More than 90% of the documents had defects in the information on consequences and contraindications, and in about 90% it did not mention the copy to the patient. More than 60% did not comply with stating the purpose of the procedure, a statement of having understood and clarified doubts, and the treatment options. A tool has been obtained to reliably assess the formal quality of the informed consent forms. The documents assessed have a wide margin for improvement related to giving a copy to the patient, and some aspects of the specific information that patients should receive. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

  10. Transmission line environmental assessment guidance document

    SciTech Connect

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

    1994-01-01

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

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

    PubMed

    Horton, David

    2015-01-01

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

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

    PubMed Central

    Horton, David

    2015-01-01

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

  13. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT FOR 1,3-BUTADIENE

    EPA Science Inventory

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

  14. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT FOR 1,3-BUTADIENE

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  17. Quality of Nursing Documentation: Paper-Based Health Records versus Electronic-Based Health Records.

    PubMed

    Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam Hasan

    2017-10-05

    To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process, and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organized within the system known as the Electronic Health Records (EHRs). Nursing documentation must be completed at the highest standards, in order to ensure the safety and quality of health care services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus EHRs) is more qualified. A retrospective, descriptive, comparative design was utilized to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing Audit Instrument. The sample size consisted of 434 records for both paper-based health records and EHRs from medical and surgical wards. EHRs were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than EHRs. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process, and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nurses practice to improve the quality of nursing care and patients' outcomes. This article is protected by copyright

  18. Emergency Response Capability Baseline Needs Assessment - Requirements Document

    SciTech Connect

    Sharry, John A.

    2016-10-04

    This document was prepared by John A. Sharry, LLNL Fire Marshal and LLNL Division Leader for Fire Protection and reviewed by LLNL Emergency Management Department Head James Colson. The document follows and expands upon the format and contents of the DOE Model Fire Protection Baseline Capabilities Assessment document contained on the DOE Fire Protection Web Site, but only addresses emergency response.

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2015-06-01

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

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

    SciTech Connect

    Banda, Z.; Barnett, B.

    1994-10-01

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

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

    SciTech Connect

    Swihart, A.

    1994-12-01

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

  3. Simulation Technology Laboratory Building 970 hazards assessment document

    SciTech Connect

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

    1994-11-01

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

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

    PubMed

    Broach, Debra

    2015-04-01

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

  5. Exposure assessment of upper limb repetitive movements: a consensus document developed by the Technical Committee on Musculoskeletal Disorders of International Ergonomics Association (IEA) endorsed by International Commission on Occupational Health (ICOH).

    PubMed

    Colombini, D; Occhipinti, E; Delleman, N; Fallentin, N; Kilbom, A; Grieco, A

    2001-01-01

    This consensus document intends to supply a set of definitions, criteria and procedures useful to describe and, wherever possible, to assess the work conditions that can represent a physical overload for the upper limbs. The document is aimed at all the operators, i.e. occupational doctors but mainly technicians, who are, involved in risk exposure assessment and management. The document intends to provide methods and procedures easily applicable in the field, possibly not requiring sophisticated instrumentation and when possible based on observation procedures. The proposed methods shall be based as far as possible on knowledge and data from scientific literature: should they be contradictory or deficient, reference will be made to standards or pre-standards issued by national and international agencies and bodies, with the experience of researchers involved and common sense. In this regard, it is to be emphasized that the potential users increasingly demand an easily applicable method for description and assessment of work with repetitive movements. The group intends to give a response even if there are still uncertainties from a strictly scientific standpoint: however the group commits itself to perform subsequent validations especially of as yet unconsolidated issues. This document focuses specifically on identification of risk factors and describes some of the methods that have been developed for evaluating them. There is a rapidly developing body of literature on job analysis and not yet agreement on a single best way to analyze jobs. Professional judgement is required to select the appropriate methods. Analysis and design of jobs should to be integrated into an ongoing ergonomics program that includes management commitment, training, health surveillance, and medical case management. In summing up this report, space must be given to the check lists that are so often seen in the medical press, although this is not the occasion to propose a detailed analytical

  6. Using Reflection Documents to Assess Student Learning

    ERIC Educational Resources Information Center

    Powell, Larkin A.

    2009-01-01

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

  7. Using Reflection Documents to Assess Student Learning

    ERIC Educational Resources Information Center

    Powell, Larkin A.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  9. Collaborative Documentation in Mental Health: Applications to Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Sheehan, Lindsay; Lewicki, Todd

    2016-01-01

    Purpose: In this article, the emerging practice of collaborative documentation (CD) in community mental health care and its applications to rehabilitation counseling were explored. CD has the potential to promote greater client empowerment, clinical transparency, and documentation efficiency and quality; however, the CD process is not well…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  11. Collaborative Documentation in Mental Health: Applications to Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Sheehan, Lindsay; Lewicki, Todd

    2016-01-01

    Purpose: In this article, the emerging practice of collaborative documentation (CD) in community mental health care and its applications to rehabilitation counseling were explored. CD has the potential to promote greater client empowerment, clinical transparency, and documentation efficiency and quality; however, the CD process is not well…

  12. 75 FR 72829 - Los Alamos Historical Document Retrieval and Assessment (LAHDRA) Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Los Alamos Historical Document Retrieval and... Los Alamos Historical Document Retrieval and Assessment (LAHDRA)Project. Time and Date: 5 p.m.-7...

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

    SciTech Connect

    Not Available

    1988-05-09

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  16. Assessing the long-term health impact of Q-fever in the Netherlands: a prospective cohort study started in 2007 on the largest documented Q-fever outbreak to date

    PubMed Central

    2012-01-01

    Background Between 2007 and 2011, the Netherlands experienced the largest documented Q-fever outbreak to date with a total of 4108 notified acute Q-fever patients. Previous studies have indicated that Q-fever patients may suffer from long-lasting health effects, such as fatigue and reduced quality of life. Our study aims to determine the long-term health impact of Q-fever. It will also compare the health status of Q-fever patients with three reference groups: 1) healthy controls, 2) patients with Legionnaires’ disease and 3) persons with a Q-fever infection but a-specific symptoms. Methods/design Two groups of Q-fever patients were included in a prospective cohort study. In the first group the onset of illness was in 2007–2008 and participation was at 12 and 48 months. In the second group the onset of illness was in 2010–2011 and participation was at 6 time intervals, from 3 to 24 months. The reference groups were included at only one time interval. The subjective health status, fatigue status and quality of life of patients will be assessed using two validated quality of life questionnaires. Discussion This study is the largest prospective cohort study to date that focuses on the effects of acute Q-fever. It will determine the long-term (up to 4 years) health impact of Q-fever on patients and compare this to three different reference groups so that we can present a comprehensive assessment of disease progression over time. PMID:23110336

  17. 7 CFR 1260.313 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... to give the producer from whom the collecting person collected an assessment written evidence of payment of the Beef Promotion and Research Assessments. Such written evidence serving as a receipt shall... 7 Agriculture 10 2010-01-01 2010-01-01 false Document evidencing payment of assessments....

  18. Laboratory Biosafety and Biosecurity Risk Assessment Technical Guidance Document

    SciTech Connect

    Astuto-Gribble, Lisa M; Caskey, Susan Adele

    2014-07-01

    The purpose of this document is threefold: 1) to describe the laboratory bio safety and biosecurity risk assessment process and its conceptual framework; 2) provide detailed guidance and suggested methodologies on how to conduct a risk assessment; and 3) present some practical risk assessment process strategies using realistic laboratory scenarios.

  19. Health and environmental effects document for direct coal liquefaction - 1981.

    SciTech Connect

    Mellinger, P.J.; Wilson, B.W.; Mahlum, D.D.; Sever, L.E.; Olsen, A.R.

    1982-09-01

    This document presents initial estimates of potential human health effects from inhalation of nonmethane hydrocarbons (NMHC) that may be released from a future hypothetical industry producing about 600,000 bb1/day of synthetic fuel by direct liquefaction of coal. The assessment approach starts wth general assumptions that are then refined in a tiered sequence that considers available epidemiological, environmental and chemical data. The uncertainties involved in such an evaluation have been quantified where possible at this early stage of health risk analysis. Many surrogate data bases were considered for application to coal liquefaction including coke oven, British gas retort, roofing tar and asphalts, and cigarette smoke. The coke oven data base was selected for this assessment because the chemical and physical nature of coke oven emissions are judged to more closely approximate potential coal liquefaction emissions. Utilizing the extensive epidemiological data base for coke oven workers as a surrogate model, health effects from release of coal liquefaction NMHC may be quantified. This method results in estimates of about 1 x 10/sup -3/ excess cancer deaths/yr to an industrial work force of 7800 persons and 5 x 10/sup -2/ excess cancer deaths/yr in the U.S. population as a whole from NMHC that boil above 600/sup 0/F. Sources of uncertainty in the estimates are listed. Using these uncertainties, it is estimated that from 2 x 10/sup -4/ to 5 x 10/sup -3/ lung cancer deaths/yr may occur in the industrial work force and from 1 x 10/sup -2/ to 2.5 x 10/sup -1/ lung cancer deaths/yr in the U.S. population as a whole. On an individual basis, the excess lifetime risk to occupationally exposed workers is estimated to be 500 times greater than to members of the U.S. public.

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

    PubMed

    Mandel, Lene; Worm, Lise

    2007-01-01

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

  1. Routine dyspnea assessment and documentation: Nurses' experience yields wide acceptance.

    PubMed

    Baker, Kathy M; DeSanto-Madeya, Susan; Banzett, Robert B

    2017-01-01

    Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and documentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation is the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by nurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients upon admission and once per shift throughout their hospitalization. A year after dyspnea measurement was implemented we explored nurses' approach to dyspnea assessment, their perception of patient response, and their perception of the utility and burden of dyspnea measurement. We obtained feedback from nurses using a three-part assessment of practice: 1) a series of recorded focus group interviews with nurses, 2) a time-motion observation of nurses performing routine dyspnea and pain assessment, and 3) a randomized, anonymous on-line survey based, in part, on issues raised in focus groups. Ninety-four percent of the nurses surveyed reported administering the dyspnea assessment is "easy" or "very easy". None of the nurses reported that assessing dyspnea negatively impacted workflow and many reported that it positively improved their practice by increasing their awareness. Our time-motion data showed dyspnea assessment and documentation takes well less than a minute. Nurses endorsed the importance of routine measurement and agreed that most patients were able to provide a meaningful rating of their dyspnea. Nurses found the patient report very useful, and used it in conjunction with observed signs to respond to changes in a patient's condition. In this study, we have demonstrated that routine dyspnea assessment and documentation was widely accepted by the nurses at our institution. Our nurses fully incorporated routine dyspnea assessment and documentation into their practice and felt that it improved patient-centered care.

  2. Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.

    PubMed

    Walker, Evan; McMahan, Ryan; Barnes, Deborah; Katen, Mary; Lamas, Daniela; Sudore, Rebecca

    2017-09-21

    Documenting patients' advance care planning wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about advance care planning documentation practices in the electronic health record. Describe advance care planning documentation practices and the accessibility of documented discussions in the electronic health record. Participants were primary care patients at the San Francisco VA Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions. In this cross-sectional study, we assessed the prevalence of advance care planning documentation, including any legal forms/orders and discussions in the prior five years. We also determined accessibility of discussions (i.e., accessible centralized posting vs. inaccessible free-text in progress notes). The mean age of 414 participants was 71 years (SD ±8), 9% were women, 43% were non-white, and 51% had documented advance care planning including 149 (36%) with forms/orders and 138 (33%) with discussions. Seventy-four participants (50%) with forms/orders lacked accompanying explanatory documentation. Most (55%) discussions were not easily accessible, including 70% of those documenting changes in treatment preferences from prior forms/orders. Half of chronically ill, older participants had documented advance care planning, including one third with documented discussions. However, half of the patients with completed legal forms/orders had no accompanying documented explanatory discussions, and the majority of documented discussions were not easily accessible, even when wishes had changed. Ensuring that patients' preferences are documented and easily accessible is an important patient safety and quality improvement target to ensure patients' wishes are honored. Copyright © 2017. Published by Elsevier Inc.

  3. Simplifying documentation while approaching site closure: integrated health & safety plans as documented safety analysis

    SciTech Connect

    Brown, Tulanda

    2003-06-01

    At the Fernald Closure Project (FCP) near Cincinnati, Ohio, environmental restoration activities are supported by Documented Safety Analyses (DSAs) that combine the required project-specific Health and Safety Plans, Safety Basis Requirements (SBRs), and Process Requirements (PRs) into single Integrated Health and Safety Plans (I-HASPs). By isolating any remediation activities that deal with Enriched Restricted Materials, the SBRs and PRs assure that the hazard categories of former nuclear facilities undergoing remediation remain less than Nuclear. These integrated DSAs employ Integrated Safety Management methodology in support of simplified restoration and remediation activities that, so far, have resulted in the decontamination and demolition (D&D) of over 150 structures, including six major nuclear production plants. This paper presents the FCP method for maintaining safety basis documentation, using the D&D I-HASP as an example.

  4. Comparison of health policy documents of European cities: are they oriented to reduce inequalities in health?

    PubMed

    Borrell, Carme; Morrison, Joana; Burstrom, Bo; Pons-Vigués, Mariona; Hoffmann, Rasmus; Gandarillas, Ana; Martikainen, Pekka; Domínguez-Berjón, M Felicitas; Tarkiainen, Lasse; Díez, Elia

    2013-01-01

    Health policies are specified in documents that contain values, objectives, strategies, and interventions to be implemented. The objective of our study was to analyse health policy documents of six European cities and one county council published around 2010 to determine (i) how cities conceptualize health inequalities, and (ii) what strategies are proposed to reduce them. We performed a qualitative document analysis. We selected Health or Health Inequalities policy documents and analysed the following aspects: general characteristics of the document, inclusion and definition of health inequalities, promotion of good governance and participation, number of objectives, and evaluation. We also described specific objectives. Rotterdam, London, and Stockholm use a conceptual framework. Two of them define health inequalities as a social gradient. Intersectoral action, participation, and evaluation are included in most documents. Interventions focus mainly on the socioeconomic context.

  5. Research Notes - Openness and Evolvability - Documentation Quality Assessment

    DTIC Science & Technology

    2016-08-01

    4 2.1.8 Any issues with spelling, grammar or punctuation? ......................... 4 2.1.9 Any issues with sentence structure...considered later in the overall document quality assessment. 2.1.8 Any issues with spelling, grammar or punctuation? Read randomly selected...paragraphs drawn from a cross-section of the document and judge the accuracy of the document’s spelling, grammar and punctuation. Incorrect punctuation or

  6. Health-assessment document for vermiculite

    SciTech Connect

    Not Available

    1991-09-01

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

  7. Health effects of risk-assessment categories

    SciTech Connect

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

    1983-10-01

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

  8. Enhancing problem list documentation in electronic health records using two methods: the example of prior splenectomy.

    PubMed

    McEvoy, Dustin; Gandhi, Tejal K; Turchin, Alexander; Wright, Adam

    2017-07-28

    Quality improvement professionals often choose between patient-specific interventions, like clinical decision support (CDS), and population-based interventions, like registries or care management. In this paper, we explore the synergy of these two strategies, targeting the problem of procedure documentation for patients with a history of splenectomy. We developed a population health documentation (PHD) intervention and a CDS intervention to improve splenectomy documentation within our electronic health record. Rates of splenectomy documentation were collected before and after the implementation of both interventions to assess their impact on the rate of procedure documentation. Both the PHD and CDS interventions led to statistically significant (p<0.001) increases in the baseline rate of splenectomy documentation of 27.4 documentations per month. During the PHD intervention, 444.7 splenectomies were documented per month, while 40.8 splenectomies per month were documented during the CDS intervention. Both approaches were successful, with the PHD intervention leading to a larger number of incremental procedure documentations, in batches, and the CDS intervention augmenting procedure documentation on an ongoing basis. Our results suggest that population health and CDS strategies complement each other and, where possible, should be used in conjunction. PHD and CDS strategies may best be used in conjunction to create a symbiotic relationship in which current problem and procedure documentation gaps are closed using PHD strategies, while new gaps are prevented through ongoing CDS interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Electronic health record systems in ophthalmology: impact on clinical documentation.

    PubMed

    Sanders, David S; Lattin, Daniel J; Read-Brown, Sarah; Tu, Daniel C; Wilson, David J; Hwang, Thomas S; Morrison, John C; Yackel, Thomas R; Chiang, Michael F

    2013-09-01

    To evaluate quantitative and qualitative differences in documentation of the ophthalmic examination between paper and electronic health record (EHR) systems. Comparative case series. One hundred fifty consecutive pairs of matched paper and EHR notes, documented by 3 attending ophthalmologist providers. An academic ophthalmology department implemented an EHR system in 2006. Database queries were performed to identify cases in which the same problems were documented by the same provider on different dates, using paper versus EHR methods. This was done for 50 consecutive pairs of examinations in 3 different diseases: age-related macular degeneration (AMD), glaucoma, and pigmented choroidal lesions (PCLs). Quantitative measures were used to compare completeness of documenting the complete ophthalmologic examination, as well as disease-specific critical findings using paper versus an EHR system. Qualitative differences in paper versus EHR documentation were illustrated by selecting representative paired examples. (1) Documentation score, defined as the number of examination elements recorded for the slit-lamp examination, fundus examination, and complete ophthalmologic examination and for critical clinical findings for each disease. (2) Paired comparison of qualitative differences in paper versus EHR documentation. For all 3 diseases (AMD, glaucoma, PCL), the number of complete examination findings recorded was significantly lower with paper than the EHR system (P ≤ 0.004). Among the 3 individual examination sections (general, slit lamp, fundus) for the 3 diseases, 5 of the 9 possible combinations had significantly lower mean documentation scores with paper than EHR notes. For 2 of the 3 diseases, the number of critical clinical findings recorded was significantly lower using paper versus EHR notes (P ≤ 0.022). All (150/150) paper notes relied on graphical representations using annotated hand-drawn sketches, whereas no (0/150) EHR notes contained drawings. Instead

  10. Harnessing the power of student health data: Selecting, using, and implementing electronic school health documentation systems.

    PubMed

    Johnson, Kathleen H; Guthrie, Sharon

    2012-01-01

    School nurses manage an immense amount of student health information, making electronic documentation systems essential to provide effective care for students. This article describes the elements of and rationale for using an electronic documentation system, the use of standardized nursing languages, and strategies for successfully implementing an electronic documentation system.

  11. 7 CFR 1260.313 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Document evidencing payment of assessments. 1260.313 Section 1260.313 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF...

  12. Pedagogical Voyeurism: Dialogic Critique of Documentation and Assessment of Learning

    ERIC Educational Resources Information Center

    Matusov, Eugene; Marjanovic-Shane, Ana; Meacham, Sohyun

    2016-01-01

    We challenge a common emphasis on documentation and assessment of learning for providing good education: from the mainstream of neoliberal accountability movement to the progressive Reggio Emilia schools. We develop these arguments through discussing: 1) immeasurableness of education and learning, 2) students' ownership/authorship of education and…

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

    SciTech Connect

    Daniels, J

    2007-10-01

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

  14. Documentation.

    ERIC Educational Resources Information Center

    Burt, Lorna; Lewandowski, Carol

    This workbook, designed for workplace literacy courses, contains materials for a course on documentation. The six sessions of the course cover the following topics: (1) general principles of procedure writing; (2) principles of clear communication (clarity, audience, visuals) and identification of systems types, accounts, and customer requests;…

  15. Developing an Interface to Order and Document Health Education Videos in the Electronic Health Record.

    PubMed

    Wojcik, Lauren

    2015-01-01

    Transitioning to electronic health records (EHRs) provides an opportunity for health care systems to integrate educational content available on interactive patient systems (IPS) with the medical documentation system. This column discusses how one hospital simplified providers' workflow by making it easier to order educational videos and ensure that completed education is documented within the medical record. Integrating the EHR and IPS streamlined the provision of patient education, improved documentation, and supported the organization in meeting core requirements for Meaningful Use.

  16. Wildlife resource trends in the United States: A technical document supporting the 2000 RPA Assessment

    Treesearch

    Curtis H. Flather; Stephen J. Brady; Michael S. Knowles

    1999-01-01

    This report documents trends in wildlife resources for the nation as required by the Renewable Resources Planning Act (RPA) of 1974. The report focuses on recent historical trends in wildlife as one indicator of ecosystem health across the United States and updates wildlife trends presented in previous RPA Assessments. The report also shows short- and long-term...

  17. Development and implementation of an educational support process for electronic nursing admission assessment documentation.

    PubMed

    Evatt, Manjulata; Ren, Dianxu; Tuite, Patricia; Reynolds, Colleen; Hravnak, Marilyn

    2014-01-01

    Educating nurses in use of the electronic health record nursing admission assessment using e-learning alone may not yield best results. Use of a hybrid instructional method of e-learning followed by a brief (20-minute) slide presentation with face-to-instruction significantly improved nursing documentation.

  18. Onboard System Health Assessment

    NASA Technical Reports Server (NTRS)

    Barry, Tom; Cunningham, Harry

    1990-01-01

    Viewgraphs and discussion of onboard system health assessment are presented. Success of the space station program will be measured by how well it addresses the basic requirements for (1) maintaining the orbiting Space Station Freedom fully operational for its projected life of thirty years, and (2) the cost-effective execution of the overall space station program. Onboard system health assessment must provide complete and thorough testing capabilities along with effective associated redundancy/fault management.

  19. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

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

  20. The World Health Organization’s Safe Abortion Guidance Document

    PubMed Central

    Van Look, Paul F. A.; Cottingham, Jane

    2013-01-01

    We discuss the history of the World Health Organization’s (WHO’s) development of guidelines for governments on providing safe abortion services, which WHO published as Safe Abortion: Technical and Policy Guidance for Health Systems in 2003 and updated in 2012. We show how the recognition of the devastating impact of unsafe abortion on women’s health and survival, the impetus of the International Conference on Population and Development and its five-year follow-up, and WHO’s progressive leadership at the end of the century enabled the organization to elaborate guidance on providing safe abortion services. Guideline formulation involved extensive review of published evidence, an international technical expert meeting to review the draft document, and a protracted in-house review by senior WHO management. PMID:23409886

  1. CP-50 calibration facility radiological safety assessment document

    SciTech Connect

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

    1980-03-01

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

  2. Health Effects Assessment for Carbon Tetrachloride (1986)

    EPA Science Inventory

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

  3. RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

    EPA Science Inventory

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

  4. Health Effects Assessment for Carbon Tetrachloride (1986)

    EPA Science Inventory

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

  5. RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

    EPA Science Inventory

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

  6. Health equity impact assessment.

    PubMed

    Povall, Susan L; Haigh, Fiona A; Abrahams, Debbie; Scott-Samuel, Alex

    2014-12-01

    The World Health Organization's Commission on Social Determinants of Health has called for 'health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, 'downstream' factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

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

  8. Document Level Assessment of Document Retrieval Systems in a Pairwise System Evaluation

    ERIC Educational Resources Information Center

    Rajagopal, Prabha; Ravana, Sri Devi

    2017-01-01

    Introduction: The use of averaged topic-level scores can result in the loss of valuable data and can cause misinterpretation of the effectiveness of system performance. This study aims to use the scores of each document to evaluate document retrieval systems in a pairwise system evaluation. Method: The chosen evaluation metrics are document-level…

  9. A New Measure of Assessing Document Complexity: The PMOSE/IKIRSCH Document Readability Formula.

    ERIC Educational Resources Information Center

    Mosenthal, Peter B.; Kirsch, Irwin S.

    1998-01-01

    Describes the PMOSE/IKIRSCH document readability formula, which provides a measure of document complexity (looking at structure and density) of a wide array of different document types (including lists, schedules, tables, graphs, charts, indexes, time lines, maps, calendars, and forms). Discusses implications of the formula in terms of document…

  10. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

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

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

    SciTech Connect

    Banda, Z.; Wood, C.L.

    1995-08-01

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

  12. Advanced Manufacturing Processes Laboratory Building 878 hazards assessment document

    SciTech Connect

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

    1994-07-01

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

  13. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    PubMed

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

  14. Health and environmental effects document for batteries: 1980

    SciTech Connect

    Not Available

    1980-11-01

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

  15. Area 5 Radioactive Waste Management Site Safety Assessment Document

    SciTech Connect

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

    1980-02-01

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

  16. Documenting Matured Science: The BACC-Type Assessment Reports

    NASA Astrophysics Data System (ADS)

    Reckermann, M.; Omstedt, A. T.

    2016-12-01

    The BACC-type reports (BALTEX and Baltic Earth Assessment of Climate Change for the Baltic Sea region, BACC 2008 and BACC II 2015) represent an approach to assessing and making available current knowledge on regional climate change and its regional impacts on the physical, biogeochemical and biological environment (ecosystems, socio-economic sphere). The BACC assessments have originated in the BALTEX scientific research community (now Baltic Earth) and are coordinated by the International Baltic Earth Secretariat. The assessments are produced by teams of scientists from the region, led by lead authors who recruit experts from relevant topics to contribute. The report of 2015 was compiled by a different group of authors as 2008 to warrant independence of personal opinions and bias. The process is not externally funded and completely based on published scientific evidence, and not biased by political or economic interest groups. The BACC-type reports aim to bring together consolidated knowledge that has broad consensus in the scientific community, but also acknowledging issues for which contradicting opinions are found in the literature, so that no consensus can be reached ("consensus on dissensus"). An international steering committee is responsible for overlooking the process, and all manuscripts are anonymously peer-reviewed by independent international experts. Outreach to stakeholders and the public is an inherent aspect of this approach to document mature science. For the Baltic Sea, there is a close collaboration with HELCOM, the intergovernmental Baltic Marine Environment Protection Commission and the major regional science-policy interface in the Baltic Sea region. A summary for non-scientists was produced for the first BACC report and is in preparation for the second. Other BACC-type reports published are the climate report for the greater Hamburg area (published in 2011), and the NOSCCA report (North Sea Climate Change Assessment), published in 2016.

  17. Natural Language Processing to Assess Documentation of Features of Critical Illness in Discharge Documents of Acute Respiratory Distress Syndrome Survivors.

    PubMed

    Weissman, Gary E; Harhay, Michael O; Lugo, Ricardo M; Fuchs, Barry D; Halpern, Scott D; Mikkelsen, Mark E

    2016-09-01

    Transitions to outpatient care are crucial after critical illness, but the documentation practices in discharge documents after critical illness are unknown. To characterize the rates of documentation of various features of critical illness in discharge documents of patients diagnosed with acute respiratory distress syndrome (ARDS) during their hospital stay. We used natural language processing tools to build a keyword-based classifier that categorizes discharge documents by presence of terms from four groups of keywords related to critical illness. We used a multivariable modified Poisson regression model to infer patient- and hospital-level characteristics associated with documentation of relevant keywords. A manual chart review was used to validate the accuracy of the keyword-based classifier, and to assess for ARDS documentation during the hospital stay. Of 815 discharge documents, ARDS was identified in only 111 (13%). Mechanical ventilation was identified in 770 (92%) and intensive care unit (ICU) admission in 693 (83%) of discharge documents. Symptoms or recommendations related to post-intensive care syndrome were included in 306 (38%) of discharge documents. Patient age (older; relative risk [RR] = 0.97/yr, 95% confidence interval [CI] = 0.96-0.98) and higher PaO2:FiO2 (decreasing illness severity; RR = 0.96/10-unit increment, 95% CI = 0.93-0.98) were associated with decreased documentation of ARDS. Being discharged from a surgical (RR = 0.33, 95% CI = 0.22-0.50) compared with a medicine service was also associated with decreased rates of ARDS documentation. The manual chart review revealed 98% concordance between ARDS documentation in the discharge summary and during the hospital stay. Accuracy of the document classifier was 100% for ARDS and mechanical ventilation, 98% for ICU admission, and 95% for symptoms of post-intensive care syndrome. In the discharge documents of survivors of ARDS, ARDS itself is rarely mentioned, but

  18. Hanford patrol firing range complex safety assessment document

    SciTech Connect

    BENDIXSEN, R.B.

    2001-09-19

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

  19. Obesity perceptions and documentation among primary care clinicians at a rural academic health center.

    PubMed

    Aleem, Sohaib; Lasky, Rosalind; Brooks, W Blair; Batsis, John A

    2015-01-01

    Obesity recognition in primary care is important to address the epidemic. We aimed to evaluate primary care clinician-reported documentation, management practices, beliefs and attitudes toward obesity compared to body mass index (BMI) calculation, obesity prevalence and actual documentation of obesity as an active problem in electronic health record in a rural academic center. Our target population for previously validated clinician survey was 56 primary care providers working at 3 sites. We used calendar year 2012 data for assessment of baseline system performance for metrics of documentation of BMI in primary care visits, and proportion of visits in patients with obesity with obesity as a problem. Standard statistical methods assessed the data. Survey response rate was 91%. Average age of respondents was 48.9 years and 62.7% were females. 72.5% clinicians reported having normal BMI. The majority of clinicians reported regularly documenting obesity as an active problem, and utilized motivational interviewing and basic good nutrition and healthy exercise. Clinicians identified lack of discipline and exercise time, access to unhealthy food and psychosocial issues as major barriers. Most denied disliking weight loss discussion or patients taking up too much time. In 21,945 clinic visits and 11,208 annual preventive care visits in calendar year 2012, BMI was calculated in 93% visits but obesity documentation as an active problem only 27% of patients meeting BMI criteria for obesity. Despite high clinician-reported documentation of obesity as an active problem, actual obesity documentation rates remained low in a rural academic medical center. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  20. Lifetime health outcomes of breast-feeding: a comparison of the policy documents of five European countries.

    PubMed

    Martin-Bautista, Elena; Gage, Heather; von Rosen-von Hoewel, Julia; Jakobik, Viktoria; Laitinen, Kirsi; Schmid, Martina; Morgan, Jane; Williams, Peter; Decsi, Tamas; Campoy, Cristina; Koletzko, Berthold; Raats, Monique

    2010-10-01

    To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months. Documentary review and analysis. Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain). Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted. Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24.1 % mentioned general health effects, 32.5 % protection against infections, 31.5 % long-term conditions (e.g. diabetes, CVD) and 11.8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements. Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.

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

    SciTech Connect

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

    1981-12-04

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

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

    ERIC Educational Resources Information Center

    Lindstrom, Jennifer H.; Lindstrom, Will

    2011-01-01

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

  3. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... planning document requirements (HIT PAPD). 495.336 Section 495.336 Public Health CENTERS FOR MEDICARE... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

  4. Public health human resources: a comparative analysis of policy documents in two Canadian provinces

    PubMed Central

    2014-01-01

    Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

  5. Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

    PubMed

    Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

    2014-02-24

    Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

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

    SciTech Connect

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

    1983-11-30

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

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

    SciTech Connect

    Anthony F. Gallegos; Gilbert J. Gonzales

    1999-06-01

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

  8. Assessing Usage Patterns of Electronic Clinical Documentation Templates

    PubMed Central

    Vawdrey, David K.

    2008-01-01

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

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

    PubMed

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

    2016-03-01

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

  10. Framework for Human Health Risk Assessment to Inform Decision Making

    EPA Pesticide Factsheets

    The purpose of this document is to describe a Framework for conducting human health risk assessments that are responsive to the needs of decision‐making processes in the U.S. Environmental Protection Agency (EPA).

  11. Health Effects Assessment for Carbon Tetrachloride (Updated 1989)

    EPA Science Inventory

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

  12. Health Effects Assessment for Carbon Tetrachloride (Updated 1989)

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Farri, Oladimeji Feyisetan

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Farri, Oladimeji Feyisetan

    2012-01-01

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

  15. Evaluating current automatic de-identification methods with Veteran's health administration clinical documents.

    PubMed

    Ferrández, Oscar; South, Brett R; Shen, Shuying; Friedlin, F Jeffrey; Samore, Matthew H; Meystre, Stéphane M

    2012-07-27

    The increased use and adoption of Electronic Health Records (EHR) causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI), which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act "Safe Harbor" method.This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA) clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. We installed and evaluated five text de-identification systems "out-of-the-box" using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique 'PHI' category. Performance of the systems was assessed using recall (equivalent to sensitivity) and precision (equivalent to positive predictive value) metrics, as well as the F(2)-measure. Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest "out-of-the-box" F(2)-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F(2)-measure to 79% with partial matches. The "out-of-the-box" evaluation of text de

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

    PubMed Central

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Herrick, Clare

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Herrick, Clare

    2010-01-01

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

  19. Resident Documentation of Social Determinants of Health: Effects of a Teaching Tool in the Outpatient Setting.

    PubMed

    Patel, Milani; Bathory, Eleanor; Scholnick, Jenna; White-Davis, Tanya; Choi, Jaeun; Braganza, Sandra

    2017-09-01

    Social determinants of health (SDH) significantly affect the health of children and thus, screening is important in pediatric primary care. We assessed the use of a formal social history taking tool after a 2-phase intervention. The first phase (P1) was a teaching module describing SDH and community resources and the second phase (P2) consisted of visual reminders to use the tool. Patient charts (n = 322) were reviewed pre- and postintervention. Residents had higher documentation rates of Women, Infants, and Children (WIC) program use and housing subsidies at post-P1 and at post-P(1 + 2) (WIC, P = .01 and P = .03, respectively; housing, P = .02 and P = .04, respectively), and higher documentation rates of food stamp utilization at post-P(1 + 2) ( P = .04), as compared with baseline. Implementation of a simple teaching tool in the outpatient setting enabled residents to document income benefits and housing. Further studies should be done to evaluate effective teaching methods to elicit other important SDH.

  20. Standardizing documentation for postoperative nausea and vomiting in the electronic health record.

    PubMed

    DeBlieck, Conni; LaFlamme, Anne Fishman; Rivard, Mary Jane; Monsen, Karen A

    2013-10-01

    Postoperative nausea and vomiting (PONV) remains a common postoperative complication that causes patient discomfort and increases health care costs. Clinicians use the American Society of PeriAnesthesia Nurses (ASPAN) guideline to help prevent and treat PONV. However, the lack of standardized terminology in the electronic health record (EHR) and the lack of clinical decision support tools make it difficult for clinicians to document guideline implementation and to determine the effects of nursing care on PONV. To address this, we created a concept map of the Perioperative Nursing Data Set (PNDS) that illustrates the relationship between elements of this standardized nursing terminology and the ASPAN guideline, using the Systematized Nomenclature of Medicine-Clinical Terms multidisciplinary terminology to fill any gaps. This mapping results in a standardized dataset specific to PONV for use in an EHR, which links nursing care to nursing diagnoses, interventions, and outcomes. The mapping and documentation in the EHR also allows standardized data collection for research, evaluation, and benchmarking, which makes perioperative nursing care of patients who are at risk for or experiencing PONV measureable and visible. Distributing this information to perioperative and perianesthesia nursing personnel, in addition to implementing risk assessment tools for PONV and clinical support alerts in electronic documentation systems, will help support implementation of the PONV clinical practice guideline in the EHR.

  1. 75 FR 2145 - Draft Guidance for Industry on Tobacco Health Document Submission; Availability; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Tobacco Health Document... entitled ``Tobacco Health Document Submission.'' The notice published with an inadvertent error in the... CONTACT: May Nelson, Center for Tobacco Products, Food and Drug Administration, 9200 Corporate...

  2. 75 FR 20606 - Guidance for Industry on Tobacco Health Document Submission; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Tobacco Health Document Submission... Administration (FDA) is announcing the availability of a guidance entitled ``Tobacco Health Document Submission... the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act). DATES: Submit written...

  3. Architecture and Assessment: Privacy Preserving Biometrically Secured Electronic Documents

    DTIC Science & Technology

    This document explores an application which uses biometrics to secure electronic travel authorizations granted to foreign passport holders wishing to...TA) system in which foreign passport holders obtain electronic credentials which permit entry to Canada. This b-TA can be seen as a privacy preserving

  4. Community mental health care: documenting the role of the nurse.

    PubMed

    Zeeman, Zenith; Chapman, Rose; Wynaden, Dianne; McGowan, Sunita; Lewis, Mark; Austin, John; Finn, Michael

    2002-04-01

    In Australia, the process of deinstitutionalisation has resulted in the closure or downsizing of many large stand-alone psychiatric hospitals. The aim of modern community mental health care is to provide treatment and rehabilitation for people, who have a mental illness, in their local community. This aim is supported by the Australian National Mental Health Strategy that outlines the importance of health professionals, carers, and consumers working together to obtain the best therapeutic outcomes. This study was undertaken to obtain information regarding the current role of the community mental health nurse (CMHN). All community mental health nurses working in the Adult Program at the Directorate of Mental Health Services, Fremantle Hospital and Health Service in Western Australia participated in the study. The study was completed in November 2000. The results showed that the CMHNs' role focused on six main areas. These areas included the day-to-day management of clients, working with carers and their families; crisis work for both existing andfirst time contacts; as well as liaison and advocacy work. Thefinding of this study demonstrate CMHN's work most often with acutely ill and psychotic patients and theirfamilies. Therefore, CMHN's play a pivotal role in promoting and sustaining the philosophy of community mental health care. In addition, the liaison work within the community completed by CMHN's is vital to address the mental health needs of the community and to reduce the stigma associated with mental illness. The documentedfindings of this study provide challengesfor thefurther expansion of the CMHN's role and the development of best practice initiatives in community mental health care.

  5. New Mexico Community Health Councils: Documenting Contributions to Systems Changes.

    PubMed

    Sánchez, Victoria; Andrews, Mark L; Carrillo, Christina; Hale, Ron

    2015-01-01

    Coalition research has shifted from delineating structures and processes to identifying intermediate, systems changes (e.g., changes in policies) that contribute to longterm community health improvement. The University of New Mexico, the New Mexico Department of Health, and community health councils entered a multiyear participatory evaluation process to answer: What actions did health councils take that led to improving health through intermediate, systems changes? The evaluation system was created over several phases through an iterative, participatory process. Data were collected for councils' health priority areas (e.g., substance abuse) from 2009 to 2011. Twenty-three community health councils participated. Intermediate systems changes were measured: 1) networking and partnering, 2) joint planning of strategies, programs, and services, 3) leveraging resources, and 4) policy initiatives. Health councils reported data for each intermediate outcome by health priority area. Data showed councils identified local public health priorities and addressed those priorities through strengthening networks and partnerships, which lead to the creation and enhancement of strategies, services, and programs. Data also showed councils influenced policies in several ways (e.g., developing policy, identifying new policy, or sponsoring informational forums). Additionally, data showed councils leveraged $1.10 for every dollar invested by the state. When funding was suspended in July 2010, data showed dramatic decreases in activity levels from 2010 to 2011. The data demonstrate the feasibility and utility of an Internet-based system designed to gather intermediate systems changes evaluation data. This process is a model for similar efforts to capture common outcomes across diverse coalitions and partnerships.

  6. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation advance planning document requirements (HIT IAPD). 495.338 Section 495.338 Public Health CENTERS FOR... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to...

  7. Assessing Instructional Documents: A Comparison of Writing Faculty, Engineering Faculty and Workplace Technical Communicator Practices.

    ERIC Educational Resources Information Center

    Napierkowski, Harriet

    A study examined the assessment of instructional documents written by undergraduate engineering students in a 300-level technical writing course. The six documents were independently ranked by nine readers--three writing faculty, three engineering faculty, and three technical writing professionals. Besides ranking the documents, the nine readers…

  8. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

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

  9. XML and its impact on content and structure in electronic health care documents.

    PubMed Central

    Sokolowski, R.; Dudeck, J.

    1999-01-01

    Worldwide information networks have the requirement that electronic documents must be easily accessible, portable, flexible and system-independent. With the development of XML (eXtensible Markup Language), the future of electronic documents, health care informatics and the Web itself are about to change. The intent of the recently formed ASTM E31.25 subcommittee, "XML DTDs for Health Care", is to develop standard electronic document representations of paper-based health care documents and forms. A goal of the subcommittee is to work together to enhance existing levels of interoperability among the various XML/SGML standardization efforts, products and systems in health care. The ASTM E31.25 subcommittee uses common practices and software standards to develop the implementation recommendations for XML documents in health care. The implementation recommendations are being developed to standardize the many different structures of documents. These recommendations are in the form of a set of standard DTDs, or document type definitions that match the electronic document requirements in the health care industry. This paper discusses recent efforts of the ASTM E31.25 subcommittee. PMID:10566338

  10. How Comprehensively Is Evidence-Based Practice Represented in Australian Health Professional Accreditation Documents? A Systematic Audit.

    PubMed

    McEvoy, Maureen P; Crilly, Mike; Young, Taryn; Farrelly, Jane; Lewis, Lucy Kate

    2016-01-01

    PHENONENON: In many developed countries, accreditation documents, which reflect the practice standards of health professions, form the basis for evaluation of education programs for meeting the requirements for registration. The 2005 Sicily statement proposed a 5-step model of training in evidence-based practice (ask, access, appraise, apply, and assess). A key recommendation was that evidence-based practice should be incorporated into entry-level health professional training and registration. No previous research has assessed the extent to which this has occurred. We undertook a systematic audit of the accreditation documents for the registered health professions in Australia. The 11 health professional disciplines included in the audit were medicine, nursing and midwifery, pharmacy, physiotherapy, dentistry, psychology, occupational therapy, optometry, podiatry, osteopathy, and chiropractic. Two investigators independently identified the occurrence of the term evidence that related to "evidence-based practice" and the occurrences of terms related to the 5 steps in the accreditation documents. Occurrence of the term evidence as it relates specifically to "evidence-based practice" ranged from 0 (pharmacy, dentistry and occupational therapy) to 8 (physiotherapy) in the accreditation documents. Overall, there were 77 occasions when terms relating to any of the 5 steps of evidence-based practice were used across all 11 accreditation documents. All 5 steps were included in the physiotherapy and psychology documents; 4 steps in medicine and optometry; 3 steps in pharmacy; 2 steps each in documents for chiropractic, osteopathy, and podiatry; and 1 step for nursing. There was no inclusion of terms relating to any of the 5 steps in the dentistry and occupational therapy documents. Insights: Terminology relating explicitly to evidence-based practice and to the 5 steps of evidence-based practice appears to be lacking in the accreditation documents for health professions

  11. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  12. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  13. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  14. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  15. 7 CFR 1220.314 - Document evidencing payment of assessments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

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

  17. Health Impact Assessment: Linking Public Health to ...

    EPA Pesticide Factsheets

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  18. Educational Programming in Mental Health/Retardation Facilities. Report of the Mental Health and Retardation to the Governor and the General Assembly of Virginia. Senate Document No. 7.

    ERIC Educational Resources Information Center

    Virginia State General Assembly, Richmond. Joint Legislative Audit and Review Commission.

    This document presents data on three studies requested by Virginia State Senate Joint Resolution No. 148 and carried out by the Virginia Department of Mental Health and Mental Retardation in cooperation with other agencies. The three studies included in the report are: (1) an assessment of the appropriateness of housing young adults (ages 18-22)…

  19. Health impact assessment in Korea

    SciTech Connect

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

    2011-07-15

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

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

    PubMed Central

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

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

  2. 76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... availability of the human health assessment, along with all supporting documents, and commenced a 60-day public..., Gharda Chemicals Limited, Agricultural Retailers Association, California Citrus Mutual, California Grape...

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    EPA Science Inventory

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

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

    PubMed Central

    Yehia, Baligh R.

    2015-01-01

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

  8. NUCDAM (Nuclear Damage Assessment Module) Control Document. Volume 1

    DTIC Science & Technology

    1984-06-19

    NOSC. Nuclear Damage Assessment BGTCSF NUCDAM Tactical Engagement Training Tactical Nuclear Weapon NWISS - 20 ABSTRACT (Continue on reverse aide it...the configuration management plan by which changes to NUCDAM are initiated. U) DD IFORM 1473 EDITION or INOV SS IS OBSOLETEU UNCLASSIFIED TABLE OF...5I 3.2 NUCDAM Module ...... .. ... ....... 7 3.3 Nuclear Environments.. ........... 9 3.4 Unit OATs.......................... 9 3.5 Damage Environments

  9. Harmonization of criteria documents for standard setting in occupational health: a report of a workshop.

    PubMed

    Zielhuis, R L; Noordam, P C; Maas, C L; Kolk, J J; Illing, H P

    1991-06-01

    The paper presents the most important points of the discussion, recommendations, and conclusions of a workshop on harmonization of criteria documents (CDs) for standard setting in occupational health, with emphasis on standard setting in the European Community (EC). The objectives were to achieve harmonized CDs and to develop a mechanism for international cooperation. The discussion focused on three broad topics: contents of CDs; collection, assessment, and evaluation of data; and procedures for the preparation and exchange of CDs on specific chemicals. Annex A on the various procedures for standard setting by EC Member States, countries outside the EC, and international organizations and Annex B on the proposed contents of the CDs are also included.

  10. Digital imaging technology assessment: Digital document storage project

    NASA Technical Reports Server (NTRS)

    1989-01-01

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

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

    SciTech Connect

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

    1981-11-24

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

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

    PubMed

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

    2016-03-01

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

  13. Assessing Your Weight and Health Risk

    MedlinePlus

    ... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

  14. Documentation of sexual partner gender is low in electronic health records: observations, predictors, and recommendations to improve population health management in primary care.

    PubMed

    Nguyen, Giang T; Yehia, Baligh R

    2015-06-01

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

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

    ERIC Educational Resources Information Center

    Suarez, Stephanie Cox; Daniels, Karen J.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Suarez, Stephanie Cox; Daniels, Karen J.

    2009-01-01

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

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

    SciTech Connect

    1995-01-01

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

  18. To what extent do Australian child and youth health policies address the social determinants of health and health equity?: a document analysis study.

    PubMed

    Phillips, Clare; Fisher, Matt; Baum, Fran; MacDougall, Colin; Newman, Lareen; McDermott, Dennis

    2016-06-15

    There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is 'middle of the road' when compared to other OECD countries. To date, there have been no systematic analyses of Australian child/youth health policies with a social determinants and health equity focus and this study aimed to contribute to addressing this gap. Document analysis of seventeen strategic level child/youth health policies across Australia used an a priori coding framework specifically developed to assess the extent to which health departments address the social determinants of child/youth health and health equity. Policies were selected from a review of all federal and state/territory strategic health department policies dated between 2008 and 2013. They were included if the title of the policy addressed children, youth, paediatric health or families directly. We also included whole of government policies that addressed child/youth health issues and linked to the health department, and health promotion policies with a chapter or extensive section dedicated to children. Australian child/youth health policies address health inequities to some extent, with the best examples in Aboriginal or child protection policies, and whole of government policies. However, action on the social determinants of child/youth health was limited. Whilst all policies acknowledge the SDH, strategies were predominantly about improving health services delivery or access to health services. With some exceptions, the policies that appeared to address important SDH, such as early childhood development and healthy settings, often took a narrow view of the evidence and drifted back to focus on the individual. This research highlights

  19. Safety assessment document for the Dynamic Test Complex B854

    SciTech Connect

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

    1981-12-11

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

  20. An assessment of forest ecosystem health in the Southwest

    Treesearch

    Cathy W. Dahms; Brian W. Geils

    1997-01-01

    This report documents an ecological assessment of forest ecosystem health in the Southwest. The assessment focuses at the regional level and mostly pertains to lands administered by the National Forest System. Information is presented for use by forest and district resource managers as well as collaborative partners in the stewardship of Southwestern forests. The...

  1. Evaluation of health assessment skills.

    PubMed

    Wilbur, J

    1989-01-01

    This article presents the reliability and validity data on a checklist used to evaluate health assessment skills. In 1982, the nurse practitioner faculty at a large midwestern university acknowledged that health assessment skills were basic to the preparation of all nurses and made the decision to require these skills for entry into the graduate program. Because of the varying ways in which health assessment skills are acquired, the faculty saw the need to standardize the expected level of performance. An objective, three-page instrument to measure student competence in performing and recording a health history and physical examination for a client of any age is administered prior to beginning the nurse practitioner sequence of courses. The 91 objective items for this instrument are based on the traditional outline for writing up a client history and physical examination. Criteria for the items are located in an accompanying manual. The student achieves a "Yes" rating on an item if all the components of the item are performed and written according to the criteria. Reliability of the tool was assessed by 12 faculty members who participated in a simulated evaluation. The tool has been used to evaluate the skills of 165 nurses. Of these, 149 nurses were enrolled in a continuing education course, and 16 nurses tested out of a health assessment course.

  2. 75 FR 22812 - Guidance for Industry on Tobacco Health Document Submission; Availability; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Guidance for Industry on Tobacco Health Document Submission... April 20, 2010 (75 FR 20606). The notice announced the availability of a guidance entitled...

  3. Process documentation of health education interventions for school children and adolescent girls in rural India.

    PubMed

    Dongre, Amol R; Deshmukh, Pradeep R; Garg, Bishan S

    2009-05-01

    To undertake process documentation (PD) of two health education interventions for tribal school children (6-14 years) and adolescent girls (12-19 years) in rural central India. The present participatory process documentation exercise was undertaken at Kasturba Rural Health Training Center, (KRHTC), Anji, which is a field practice area of the Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The various steps identified for process documentation were decided after reviewing the monthly and annual reports of KRHTC, training reports, published research papers, flipbooks and daily diaries of health educators. In order to get the health educators' perceptions, a free listing and pile sort exercise on the domain of 'perceived advantages of the present approach' was undertaken, followed by a semi-structured Focus Group Discussion (FGD) with the educators. A two-dimensional scaling and hierarchical cluster analysis was completed with the pile sort data to get the collective picture of perceived advantages. The health education interventions were need-based, focusing on a target audience. The approach was community-based and has the potential to stimulate an action-experience-learning cycle of health educators and community members by stimulating their creative potential. The health educators found locally-developed handmade flipbooks with relevant messages and culturally sensitive pictures to be facilitating factors. The present study provided process documentation of two health education interventions which could be useful to both governmental and non-governmental organizations working in resource poor rural settings of developing countries.

  4. Air Quality Modeling Technical Support Document for the 2015 Ozone NAAQS Preliminary Interstate Transport Assessment

    EPA Pesticide Factsheets

    In this technical support document (TSD) EPA describes the air quality modeling performed to support the 2015 ozone National Ambient Air Quality Standards (NAAQS) preliminary interstate transport assessment Notice of Data Availability (NODA).

  5. 43 CFR 11.90 - What documentation must the authorized official prepare after completing the assessment?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false What documentation must the authorized official prepare after completing the assessment? 11.90 Section 11.90 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE DAMAGE ASSESSMENTS Post-Assessment Phase § 11.90...

  6. 43 CFR 11.90 - What documentation must the authorized official prepare after completing the assessment?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false What documentation must the authorized official prepare after completing the assessment? 11.90 Section 11.90 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE DAMAGE ASSESSMENTS Post-Assessment Phase § 11.90 What...

  7. 43 CFR 11.90 - What documentation must the authorized official prepare after completing the assessment?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true What documentation must the authorized official prepare after completing the assessment? 11.90 Section 11.90 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE DAMAGE ASSESSMENTS Post-Assessment Phase § 11.90 What...

  8. 43 CFR 11.90 - What documentation must the authorized official prepare after completing the assessment?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What documentation must the authorized official prepare after completing the assessment? 11.90 Section 11.90 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE DAMAGE ASSESSMENTS Post-Assessment Phase § 11.90...

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

    PubMed Central

    Chalmers, M.

    1988-01-01

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

  10. Health technology assessment in Malaysia.

    PubMed

    Sivalal, Sadasivan

    2009-07-01

    Malaysia, as a rapidly developing country, has been facing tremendous pressures in its attempts to maximize scarce resources. Despite this problem, Malaysia has made great strides in developing its health services, and has successfully provided good access to the population to healthcare services, reduced the incidence of many communicable diseases, and improved life expectancies and other global indices of health care, some of which are comparable to that of developed countries. The Health Technology Assessment (HTA) Unit was set up in Malaysia in August 1995 in the Ministry of Health Malaysia and has since grown tremendously in size and resources. To date, forty-three in-depth assessments have been carried out, and the recommendations of these assessments were subsequently implemented. In addition, approximately 140 rapid assessment reports were produced in response to requests from policy and decision makers. HTA has been able to provide input into formulation of national and Ministry of Health Malaysia policies, and provide a basis for clinical practice guidelines development, input into purchasing decisions, regulation of drugs, as well as advertisements related to health. A major challenge is sustainability of the program, to be able to have trained personnel competent to take on the demanding tasks of assessments and the sustained efforts that are required. In addition, there need to be constant efforts to create awareness of the utility of HTA so that its services are used and its full potential realized. The scope of services may also need to be expanded to include an early warning system. Malaysia has successfully implemented a health technology program that has had major impact on policy formulation and decision making at various levels. Challenges may be faced in sustaining and developing the program further.

  11. Resource document on the use of restraint and seclusion in correctional mental health care.

    PubMed

    Metzner, Jeffrey L; Tardiff, Kenneth; Lion, John; Reid, William H; Recupero, Patricia Ryan; Schetky, Diane H; Edenfield, Bruce M; Mattson, Marlin; Janofsky, Jeffrey S

    2007-01-01

    This resource document discusses the use of seclusion or restraint for purposes of mental health intervention in correctional facilities. Correctional mental health standards essentially state that seclusion or restraint, when used for health care purposes, should be implemented in a manner consistent with current community practice. The community practice was significantly impacted and revised during July 1999, after the Health Care Financing Administration defined rules for the use of seclusion and restraint in facilities that participate in Medicare and Medicaid. Since few correctional facilities are Medicare or Medicaid participants, these rules had little impact on the use of seclusion or restraint for mental health care purposes in correctional systems. Consequently, many correctional health care systems have not developed policies, procedures, or practices that are consistent with current community practice. This document provides guidance in remedying such problems, with a focus on areas relevant to timeframes, settings, and monitoring.

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

    SciTech Connect

    1996-12-01

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

  13. The development of health technology assessment.

    PubMed

    Banta, David

    2003-02-01

    The field of health technology assessment (HTA) is still relatively new, but it has shown remarkable growth over the last decade, having spread first from the United States to Europe, and now to the entire world. HTA seeks to couple evidence with decision-making, and thus has similarities to evidence-based health care and evidence-based policy-making. The early history of HTA, beginning around 1975, reveals a first period of synthesising available evidence-principally that dealing with efficacy and cost-effectiveness of health care interventions-so as to put it in a format helpful to health policy-makers, especially those in national governments. From 1985 or so, the focus of the second period was on seeking more effective links with these policy-makers, particularly in Europe. The most recent period, beginning in the late 1990s, has been increasingly devoted to more effective dissemination and implementation in order to influence administrators and clinicians. While early assessments tended to focus on large, expensive, machine-based technologies, the scope has gradually widened to include smaller technologies, 'softer' technologies (such as counselling), and health care needs. Actual assessments have also taken on broader issues, such as organisational, social, and ethical implications. In the Member States of the European Union (EU), HTA activities are increasingly visible, and almost all now have a national focus for HTA associated with the Ministry of Health or its equivalent. Central and Eastern European countries are also developing HTA activities. Most recently, HTA has been highlighted by health policy documents from the European Commission. It seems likely that HTA will in the future be institutionalised in some form as part of EU activities.

  14. Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings.

    PubMed

    Lavin, Mary Ann; Harper, Ellen; Barr, Nancy

    2015-04-14

    The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made. In this article, we describe the experiential-reflective reasoning and action model used to understand staff nurses' perspectives, share committee reflections and recommendations for improving both documentation and documentation technology, and conclude by encouraging nurses to develop their documentation and informatics skills. Nursing issues include medication safety, documentation and standards of practice, and EHR efficiency. IT concerns include interoperability, vendors, innovation, nursing voice, education, and collaboration.

  15. Health technology assessment in Greece.

    PubMed

    Liaropoulos, L; Kaitelidou, D

    2000-01-01

    In 1983 a health reform aimed to assure universal coverage and equity in the distribution of services in Greece. The reform implied state responsibility for the financing and delivery of services and a reduction of the private sector. The model was a Bismarckian scheme for social insurance. However, healthcare delivery remains fragmented and uncoordinated and the private sector is getting stronger. The dominant payment system is fee-for-service for the private sector and administered prices and salaries for public hospitals and social insurance funds. The many insurers have their own eligibility requirements, validation procedures, etc. Coverage of services by social security funds, probably among the most comprehensive in Europe, is determined more on historical and political grounds than on efficiency or cost-effectiveness. The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management, poor incentives in the public sector, open-ended financing, inefficient use of hospital beds, and lack of cost-effectiveness. There are no specific legal provisions for the control of health technology. Technologies are introduced without standards or formal consideration of needs. There are no current efforts to control health technology in Greece. However, health technology assessment (HTA) has gained increasing visibility. In 1997 a law provided for a new government agency responsible for quality control, economic evaluation of health services, and HTA. The hope is that the new law may introduce evaluation and assessment elements into health policy formulation and assure that cost effectiveness, quality, and appropriate use of health technology will receive more attention.

  16. Systemwide Initiative Documents Robust Health Screening for Adults With Intellectual Disability.

    PubMed

    Brown, Marisa; Jacobstein, Diane; Yoon, Irene Seyoung; Anthony, Bruno; Bullock, Kim

    2016-10-01

    It is well documented that adults with intellectual disability (ID) experience higher rates of a series of health conditions compared to their peers without disability. These health conditions include cardiovascular disease, obesity, diabetes, gastrointestinal disorders, and psychiatric and behavioral disorders. With life expectancy approximating the general population, adults with ID are also now experiencing health conditions related to aging, further increasing their risk for diminished function and well-being. This increased morbidity poses new challenges in geriatric healthcare planning for this population. Relatively simple health prevention practices, such as the implementation of a health screening tool, can substantially increase disease detection and clinical activities directed toward improved health outcomes for people with ID. This study examines data collected from the District of Columbia Developmental Disabilities Administration's (DC DDA's) health screening component of its Health and Wellness Standards. Findings are presented, along with recommendations and implications for improving preventive health screening practices in the ID population.

  17. Assessment and documentation of patients' nutritional status: perceptions of registered nurses and their chief nurses.

    PubMed

    Persenius, Mona Wentzel; Hall-Lord, Marie-Louise; Bååth, Carina; Larsson, Bodil Wilde

    2008-08-01

    To study, within municipal care and county council care, (1) chief nurses' and registered nurses' perceptions of patient nutritional status assessment and nutritional assessment/screening tools, (2) registered nurses' perceptions of documentation in relation to nutrition and advantages and disadvantages with a documentation model. Chief nurses and registered nurses have a responsibility to identify malnourished patients and those at risk of malnutrition. In this descriptive study, 15 chief nurses in municipal care and 27 chief nurses in county council care were interviewed by telephone via a semi-structured interview guide. One hundred and thirty-one registered nurses (response rate 72%) from 14 municipalities and 28 hospital wards responded to the questionnaire, all in one county. According to the majority of chief nurses and registered nurses, only certain patients were assessed, on admission and/or during the stay. Nutritional assessment/screening tools and nutritional guidelines were seldom used. Most of the registered nurses documented nausea/vomiting, ability to eat and drink, diarrhoea and difficulties in chewing and swallowing, while energy intake and body mass index were rarely documented. However, the majority documented their judgement about the patient's nutritional condition. The registered nurses perceived the VIPS model (Swedish nursing documentation model) as a guideline as well as a model obstructing the information exchange. Differences were found between nurses (chief nurses/registered nurses) in municipal care and county council care, but not between registered nurses and their chief nurses. All patients are not nutritionally assessed and important nutritional parameters are not documented. Nutritionally compromised patients may remain unidentified and not properly cared for. Assessment and documentation of the patients' nutritional status should be routinely performed in a more structured way in both municipal care and county council care

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

    PubMed Central

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

    2016-01-01

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

  19. Sensor based soil health assessment

    USDA-ARS?s Scientific Manuscript database

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

  20. Accuracy and speed of electronic health record versus paper-based ophthalmic documentation strategies.

    PubMed

    Chan, Patrick; Thyparampil, Preeti J; Chiang, Michael F

    2013-07-01

    To compare accuracy and speed of keyboard and mouse electronic health record (EHR) documentation strategies with those of a paper documentation strategy. Prospective cohort study. Three documentation strategies were developed: (1) keyboard EHR, (2) mouse EHR, and (3) paper. Ophthalmology trainees recruited for the study were presented with 5 clinical cases and documented findings using each strategy. For each case-strategy pair, findings and documentation time were recorded. Accuracy of each strategy was calculated based on sensitivity (fraction of findings in actual case that were documented by subject) and positive ratio (fraction of findings identified by subject that were present in the actual case). Twenty subjects were enrolled. A total of 258 findings were identified in the 5 cases, resulting in 300 case-strategy pairs and 77 400 possible total findings documented. Sensitivity was 89.1% for the keyboard EHR, 87.2% for mouse EHR, and 88.6% for the paper strategy (no statistically significant differences). The positive ratio was 99.4% for the keyboard EHR, 98.9% for mouse EHR, and 99.9% for the paper strategy (P < .001 for mouse EHR vs paper; no significant differences between other pairs). Mean ± standard deviation documentation speed was significantly slower for the keyboard (2.4 ± 1.1 seconds/finding) and mouse (2.2 ± 0.7 seconds/finding) EHR compared with the paper strategy (2.0 ± 0.8 seconds/finding). Documentation speed of the mouse EHR strategy worsened with repetition. No documentation strategy was perfectly accurate in this study. Documentation speed for both EHR strategies was slower than with paper. Further studies involving total physician time requirements for ophthalmic EHRs are required. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Brentwood Community Health Care Assessment

    PubMed Central

    Goodman, Melody S.; Gonzalez, Maria; Gil, Sandra; Si, Xuemei; Pashoukos, Judith L.; Stafford, Jewel D.; Ford, Elsa; Pashoukos, Dennis A.

    2015-01-01

    Background The Community Alliance for Research Empowering Social Change (CARES) is an academic–community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. Objectives The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. Methods Using CBPR approaches, the community–academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. Results Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. Conclusions We describe the community–academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County’s most vulnerable communities. PMID:24859100

  2. Health technology assessment in osteoporosis.

    PubMed

    Hiligsmann, Mickael; Kanis, John A; Compston, Juliet; Cooper, Cyrus; Flamion, Bruno; Bergmann, Pierre; Body, Jean-Jacques; Boonen, Steven; Bruyere, Olivier; Devogelaer, Jean-Pierre; Goemaere, Stefan; Kaufman, Jean-Marc; Rozenberg, Serge; Reginster, Jean-Yves

    2013-07-01

    We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.

  3. Early health assessment of refugees.

    PubMed

    Benson, Jill; Smith, Mitchell M

    2007-01-01

    This is the first in a series of articles looking at refugee health in Australian general practice. Each year approximately 13,000 refugees settle in Australia, mostly from countries with minimal public and personal health resources. They may present in a very different manner to the rest of the population and are at risk of unfamiliar and complex illnesses. Their health care can be difficult and time consuming and the general practitioners who supply this care need support, guidance and adequate remuneration. The new Medicare Benefits Schedule item numbers 714 and 716 are an acknowledgment by the Australian government of these concerns of community GPs who are seeing refugees for their initial health assessments. This article discusses, in the context of the new item number, some of the broader issues that are important when seeing refugees for the first time.

  4. BASINs 4.0 Climate Assessment Tool (CAT): Supporting Documentation and User's Manual (Final Report)

    EPA Science Inventory

    EPA announced the availability of the report, BASINS 4.0 Climate Assessment Tool (CAT): Supporting Documentation and User's Manual. This report was prepared by the EPA's Global Change Research Program (GCRP), an assessment-oriented program, that sits within the Office of R...

  5. BASINs 4.0 Climate Assessment Tool (CAT): Supporting Documentation and User's Manual (Final Report)

    EPA Science Inventory

    EPA announced the availability of the report, BASINS 4.0 Climate Assessment Tool (CAT): Supporting Documentation and User's Manual. This report was prepared by the EPA's Global Change Research Program (GCRP), an assessment-oriented program, that sits within the Office of R...

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

    SciTech Connect

    Annette L. Schafer; A. Jeffrey Sondrup

    2013-11-01

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

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

    SciTech Connect

    Browne, E.T.

    1981-03-01

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

  8. Health assessment document for hydrogen sulfide: review draft

    SciTech Connect

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

    1986-08-01

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

  9. Health Assessment Document for Carbon Tetrachloride (Final Report, 1984)

    EPA Science Inventory

    Carbon tetrachloride (CC14) is a haloalkane with a wide range of industrial and chemical applications. Its presence in the atmosphere and in water appears to be of anthropogenic origin. It is readily absorbed through the lung, gastrointestinal tract and skin and, therefore, poses...

  10. Health Assessment Document for Carbon Tetrachloride (Final Report, 1984)

    EPA Science Inventory

    Carbon tetrachloride (CC14) is a haloalkane with a wide range of industrial and chemical applications. Its presence in the atmosphere and in water appears to be of anthropogenic origin. It is readily absorbed through the lung, gastrointestinal tract and skin and, therefore, poses...

  11. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements

    PubMed Central

    Citty, Sandra W.; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  12. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    PubMed

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

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

    ERIC Educational Resources Information Center

    Jensen, Tracey A.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Jensen, Tracey A.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Luk, Alice; Aslani, Parisa

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Luk, Alice; Aslani, Parisa

    2011-01-01

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

  17. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  18. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  19. The Pollutant Hazard Assessment System Version 3: Documentation and Users Manual

    DTIC Science & Technology

    1993-03-15

    necessary and identify by block number) FIELD GROUP SUB-GROUP Risk Assessment Baseline Assessments BASIC 12 05 Public Health Superfund 24 07 Environmental...is designed for general use in risk assessments, such as the "baseline assessment" detailed in the most recent Risk Assessment Guidance for Superfund ...conform to U.S. Environmental Protection Agency (EPA) Superfund risk assessment guidance2 ’ 3 . The system structure is reviewed in Section 3. Sections 4

  20. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  1. Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards.

    PubMed

    Bergh, Ingrid H E; Johansson, Anna; Bratt, Annelie; Ekström, Anette; Mårtensson, Lena B

    2015-06-01

    A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  2. Computer-based documentation: effects on parent-provider communication during pediatric health maintenance encounters.

    PubMed

    Johnson, Kevin B; Serwint, Janet R; Fagan, Lawrence A; Thompson, Richard E; Wilson, Modena E H; Roter, Debra

    2008-09-01

    The goal was to investigate the impact of a computer-based documentation tool on parent-health care provider communication during a pediatric health maintenance encounter. We used a quasiexperimental study design to compare communication dynamics between clinicians and parents/children in health maintenance visits before and after implementation of the ClicTate system. Before ClicTate use, paper forms were used to create visit notes. The children examined were documentation visits were slightly longer than control visits (32 vs 27 minutes). With controlling for visit length, the amounts of conversation were similar during control and computer-based documentation visits. Computer-based documentation visits were associated with a greater proportion of open-ended questions (28% vs 21%), more use of partnership strategies, greater proportions of social and positive talk, and a more patient-centered interaction style but fewer orienting and transition phrases. The introduction of ClicTate into the health maintenance encounter positively affected several aspects of parent-clinician communication in a pediatric clinic setting. These results support the integration of computer-based documentation into primary care pediatric visits.

  3. The impact of immigration detention on the mental health of torture survivors is poorly documented--a systematic review.

    PubMed

    Storm, Tania; Engberg, Marianne

    2013-11-01

    Torture has enduring mental and physical health consequences for survivors. Detention of asylum seekers is an integrated part of the immigration systems in many countries. Among the asylum seekers are vulnerable groups such as survivors of torture and severely traumatized refugees. The aim of the present study is to review the scientific evidence on the mental health consequences of immigration detention for adult survivors of torture. The review was conducted according to a modified version of the PRISMA guidelines. A systematic search was made in: PubMed (Medline), PsychINFO, PILOTS and IBSS, and reference lists were screened. The search yielded 241 results and two records came from additional sources. A total of 15 studies were included. Merely two case studies focused on survivors of torture. Both reported severe effects of detention on the detainees' mental health. High levels of psychological problems were found in studies identifying torture survivors among the asylum seekers. The impact of detention on the mental health of torture survivors is poorly documented, and the available data are insufficient to allow analysis of any specific effects. The studies do report severe mental health issues among detained torture survivors. In general, serious mental health problems are found among the detainees and formerly detained asylum seekers. Systematically identifying torture survivors and other vulnerable groups, and assessing and monitoring mental health issues is crucial. The health risks that detention may pose to the wellbeing of each individual should be carefully considered.

  4. Documentation of person-centred health plans for patients with acute coronary syndrome.

    PubMed

    Jansson, Inger; Fors, Andreas; Ekman, Inger; Ulin, Kerstin

    2017-06-01

    Personalised care planning is argued for but there is a need to know more about what the plans actually contain. To describe the content of person-centred health, plans documented at three healthcare levels for patients with acute coronary syndrome. Patients with acute coronary syndrome aged under 75 years and admitted to two coronary care units at a university hospital were enrolled in the study. This retrospective descriptive study documented 89 person-centred health plans at three healthcare levels: hospital, outpatient and primary care. In total, 267 health plans were reviewed and a quantitative content analysis conducted. The health plans included commonly formulated goals, patients' own resources and support needed. The health plan goals were divided into three categories: lifestyle changes, illness management and relational activities. The most frequently reported goal for better health was increased physical activity, followed by social life/leisure activities and return to paid professional work. In order to reach the goals, patients identified three ways: own resources, family and social support and healthcare system, in total three categories. The most frequently reported own capability was self-motivation. Spouses and children were important sources of family and social support. The most frequently reported healthcare support was cardiac rehabilitation. In traditional care and treatment plans devised by health professionals, patient goals often comprise behavioural changes. When patients identify their own goals and resources with the help of professionals, they include maintaining social relations and being able to return to important activities such as work.

  5. A systematic method to document population-level nursing interventions in an electronic health system.

    PubMed

    Baisch, Mary Jo

    2012-01-01

    Many public health electronic health systems lack the specificity to distinguish between individual- and population-based levels of care provided by public health nurses. Data that describe the broad scope of the everyday practice of public health nurses are critical to providing evidence of their effectiveness in promoting community health, which may not be fully appreciated in an arena of scarce resources. This article describes a method to document population-based nursing practice by adding population-based interventions to the nursing taxonomy underlying an electronic health information system. These interventions, derived from the Intervention Wheel, were incorporated into the Omaha System taxonomy, the conceptual framework for the Automated Community Health Information System (ACHIS), which is a longstanding data system used to capture nursing practice in community nursing centers. This article includes a description of the development and testing of the system's ability to capture the practice of the district public health nurse model. This method of adapting an existing data system to capture population-based interventions could be replicated by public health administrators interested in better evaluating the processes and outcomes of public health nursing and other public health professionals.

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

    SciTech Connect

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

    1994-12-21

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

  7. Nystagmus Assessments Documented by Emergency Physicians in Acute Dizziness Presentations: A Target for Decision Support?

    PubMed Central

    Kerber, Kevin A.; Morgenstern, Lewis B.; Meurer, William J.; McLaughlin, Thomas; Hall, Pamela A.; Forman, Jane; Fendrick, A. Mark; Newman-Toker, David E.

    2011-01-01

    Objectives Dizziness is a common presenting complaint to the emergency department (ED), and emergency physicians (EPs) consider these presentations a priority for decision support. Assessing for nystagmus and defining its features are important steps for any acute dizziness decision algorithm. The authors sought to describe nystagmus documentation in routine ED care to determine if nystagmus assessments might be an important target in decision support efforts. Methods Medical records from ED visits for dizziness were captured as part of a surveillance study embedded within an ongoing population-based cohort study. Visits with documentation of a nystagmus assessment were reviewed and coded for presence or absence of nystagmus, ability to draw a meaningful inference from the description, and coherence with the final EP diagnosis when a peripheral vestibular diagnosis was made. Results Of 1,091 visits for dizziness, 887 (81.3%) documented a nystagmus assessment. Nystagmus was present in 185 out of 887 (20.9%) visits. When nystagmus was present, no further characteristics were recorded in 48 of the 185 visits (26%). The documentation of nystagmus (including all descriptors recorded) enabled a meaningful inference about the localization or cause in only 10 of the 185 (5.4%) visits. The nystagmus description conflicted with the EP diagnosis in 113 (80.7%) of the 140 visits that received a peripheral vestibular diagnosis. Conclusions Nystagmus assessments are frequently documented in acute dizziness presentations, but details do not generally enable a meaningful inference. Recorded descriptions usually conflict with the diagnosis when a peripheral vestibular diagnosis is rendered. Nystagmus assessments might be an important target in developing decision support for dizziness presentations. PMID:21676060

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

    PubMed Central

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

    2006-01-01

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

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

    PubMed

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

    2006-06-01

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

  10. CHANGING HEALTH TECHNOLOGY ASSESSMENT PARADIGMS?

    PubMed

    Husereau, Don; Henshall, Chris; Sampietro-Colom, Laura; Thomas, Sarah

    2016-01-01

    Health technology assessment (HTA) has to innovate to best support changing health system environments and to help provide access to valuable innovation under fiscal constraint. Issues associated with changing HTA paradigms were identified through scoping and explored through deliberation at a meeting of industry and HTA leaders. Five broad areas of change (engagement, scientific dialogue, research prioritization, adaptive approaches, and real world data) were identified. The meeting focused on two themes derived from these: re-thinking scientific dialogue and multi-stakeholder engagement, and re-thinking value, affordability, and access. Earlier and ongoing engagement to steer the innovation process and help achieve appropriate use across the technology lifecycle was perceived as important but would be resource intensive and would require priority setting. Patients need to be involved throughout, and particularly at the early stages. Further discussion is needed on the type of body best suited to convening the dialogue required. There was agreement that HTA must continue to assess value, but views differed on the role that HTA should play in assessing affordability and on appropriate responses to challenges around affordability. Enhanced horizon scanning could play an important role in preparing for significant future investments. Early and ongoing multi-stakeholder engagement and revisiting approaches to valuing innovation are required. Questions remain as to the most appropriate role for HTA bodies. Changing HTA paradigms extend HTA's traditional remit of being responsive to decision-makers demands to being more proactive and considering whole system value.

  11. The Pollution Hazard Assessment System Version 20: Documentation and Users Manual

    DTIC Science & Technology

    1991-03-15

    block number) FIELD GROUP SUB-ROUP Risk Assessment BASIC -- Public Health Baseline Assessments Environmental Effects Su r und 19. ABSTRACT (Continue...universal in application. PHAS20 lets the user incorporate information about potential effects to indigenous biota in the environment so that the assessment...PHAS20 health- effects related concepts and operational instructions. Appendix A presents a glossary of terms and data identifications. Appendix B

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

    SciTech Connect

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

    2006-01-15

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

  13. Developing Authentic, Performance-Based Assessment Tools for Eighth Graders To Document Language Arts Achievement.

    ERIC Educational Resources Information Center

    James, Darlene K.

    This practicum was designed to develop performance-based assessment tools to document language arts achievement for use in eighth-grade language arts classes. Two eighth grade language arts classes (55 students) participated in the program for an entire school year, maintaining a writing portfolio and a record-keeping portfolio. A video portfolio…

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

    ERIC Educational Resources Information Center

    Medina, Muriel; And Others

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

  15. Documenting the Assessment of Institutional Effectiveness at Community Colleges in Ohio

    ERIC Educational Resources Information Center

    Zahler, Megan M.

    2013-01-01

    The community college of today confronts decreased state funding, increased demand, and increased calls for accountability. In this highly competitive environment, community colleges are required to document the assessment of institutional effectiveness to satisfy state accountability systems and regional accreditation standards. The purpose of…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  17. Health technology assessment in Mexico.

    PubMed

    Gómez-Dantés, Octavio; Frenk, Julio

    2009-07-01

    The history of health technology assessment (HTA) in Mexico is examined, starting with the efforts to incorporate this topic into the policy agenda and culminating with the recent creation of a specialized public agency. Information was gathered through a bibliographic search and interviews with actors involved in HTA in Mexico. HTA efforts were developed in Mexico since the mid-1980s with the participation both of academics and of policy makers, a relationship that eventually led to the creation of the Center for Technological Excellence within the Ministry of Health. Institutionalization of HTA in resource-constrained settings requires the development of a critical mass of researchers involved in this field, the implementation of information efforts, and the establishment of strong relationships between HTA experts and policy makers.

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

    PubMed

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

    2015-05-31

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

  19. Human Health, Environmental and Economic Assessments

    EPA Pesticide Factsheets

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  20. Falling through the Coverage Cracks: How Documentation Status Minimizes Immigrants' Access to Health Care.

    PubMed

    Joseph, Tiffany D

    2017-10-01

    Recent policy debates have centered on health reform and who should benefit from such policy. Most immigrants are excluded from the 2010 Affordable Care Act (ACA) due to federal restrictions on public benefits for certain immigrants. But, some subnational jurisdictions have extended coverage options to federally ineligible immigrants. Yet, less is known about the effectiveness of such inclusive reforms for providing coverage and care to immigrants in those jurisdictions. This article examines the relationship between coverage and health care access for immigrants under comprehensive health reform in the Boston metropolitan area. The article uses data from interviews conducted with a total of 153 immigrants, health care professionals, and immigrant and health advocacy organization employees under the Massachusetts and ACA health reforms. Findings indicate that respondents across the various stakeholder groups perceive that immigrants' documentation status minimizes their ability to access health care even when they have health coverage. Specifically, respondents expressed that intersecting public policies, concerns that using health services would jeopardize future legalization proceedings, and immigrants' increased likelihood of deportation en route to medical appointments negatively influenced immigrants' health care access. Thus, restrictive federal policies and national-level anti-immigrant sentiment can undermine inclusive subnational policies in socially progressive places. Copyright © 2017 by Duke University Press.

  1. Using Computer Agents to Explain Medical Documents to Patients with Low Health Literacy

    PubMed Central

    Bickmore, Timothy W.; Pfeifer, Laura M.; Paasche-Orlow, Michael K.

    2009-01-01

    Objective Patients are commonly presented with complex documents that they have difficulty understanding. The objective of this study was to design and evaluate an animated computer agent to explain research consent forms to potential research participants. Methods Subjects were invited to participate in a simulated consent process for a study involving a genetic repository. Explanation of the research consent form by the computer agent was compared to explanation by a human and a self-study condition in a randomized trial. Responses were compared according to level of health literacy. Results Participants were most satisfied with the consent process and most likely to sign the consent form when it was explained by the computer agent, regardless of health literacy level. Participants with adequate health literacy demonstrated the highest level of comprehension with the computer agent-based explanation compared to the other two conditions. However, participants with limited health literacy showed poor comprehension levels in all three conditions. Participants with limited health literacy reported several reasons, such as lack of time constraints, ability to re-ask questions, and lack of bias, for preferring the computer agent-based explanation over a human-based one. Conclusion Animated computer agents can perform as well as or better than humans in the administration of informed consent. Practice Implications Animated computer agents represent a viable method for explaining health documents to patients. PMID:19297116

  2. Medical student documentation in electronic health records: a collaborative statement from the Alliance for Clinical Education.

    PubMed

    Hammoud, Maya M; Dalymple, John L; Christner, Jennifer G; Stewart, Robyn A; Fisher, Jonathan; Margo, Katherine; Ali, Imran I; Briscoe, Gregory W; Pangaro, Louis N

    2012-01-01

    The electronic health record (EHR) is an important advancement in health care. It facilitates improvement of health care delivery and coordination of care, but it creates special challenges for student education. This article represents a collaborative effort of the Alliance for Clinical Education (ACE), a multidisciplinary group formed in 1992. ACE recognizes the importance of medical student participation in patient care including the ability of documentation. This article proposes guidelines that can be used by educators to establish expectations on medical student documentation in EHRs. To provide the best education for medical students in the electronic era, ACE proposes to use the following as practice guidelines for medical student documentation in the EHR: (a) Students must document in the patient's chart and their notes should be reviewed for content and format, (b) students must have the opportunity to practice order entry in an EHR--in actual or simulated patient cases--prior to graduation, (c) students should be exposed to the utilization of the decision aids that typically accompany EHRs, and (d) schools must develop a set of medical student competencies related to charting in the EHR and state how they would evaluate it. This should include specific competencies to be documented at each stage, and by time of graduation. In addition, ACE recommends that accreditation bodies such as the Liaison Committee for Medical Education utilize stronger language in their educational directives standards to ensure compliance with educational principles. This will guarantee that the necessary training and resources are available to ensure that medical students have the fundamental skills for lifelong clinical practice. ACE recommends that medical schools develop a clear set of competencies related to student in the EHR which medical students must achieve prior to graduation in order to ensure they are ready for clinical practice.

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

    PubMed

    Sadoughi, Farahnaz; Azadi, Tania; Azadi, Tannaz

    2016-01-01

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

  4. Developing and implementing an interoperable document-based electronic health record.

    PubMed

    Campos, Fernando; Plazzotta, Fernando; Luna, Daniel; Baum, Analia; de Quirós, Fernán González Bernaldo

    2013-01-01

    Health information exchange ensuring its authenticity and integrity is not a simple task. Many institutions have implemented different solutions to perform this exchange using partial or summary information, and rarely include metadata that establish the context in which they performed the primary data capture. In this setting, we proposed the creation of an alternative architecture, parallel, yet integrated with a traditional electronic health record, based on the relational data model. We used a clinical documents standard, the CDA, whose architecture allows having a scalable document-based electronic clinical data repository, plausible to be shared with the patient, other institutions, other healthcare professionals or funders, with secure and controlled access and that remains unchanged over time. Furthermore, in addition to achieving this redundant clinical data repository, it was possible to reduce printing charts thanks to the portability that this standard allows.

  5. Quantitative health impact assessment: current practice and future directions

    PubMed Central

    Veerman, J; Barendregt, J; Mackenbach, J

    2005-01-01

    Study objective: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. Design: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health (exposure impact assessment) and (2) methods used to quantify health outcomes resulting from changes in exposure to determinants (outcome assessment). Main results: Of 98 prospective HIA studies, 17 reported quantitative estimates of change in exposure to determinants, and 16 gave quantified health outcomes. Eleven (categories of) determinants were quantified up to the level of health outcomes. Methods for exposure impact assessment were: estimation on the basis of routine data and measurements, and various kinds of modelling of traffic related and environmental factors, supplemented with experts' estimates and author's assumptions. Some studies used estimates from other documents pertaining to the policy. For the calculation of health outcomes, variants of epidemiological and toxicological risk assessment were used, in some cases in mathematical models. Conclusions: Quantification is comparatively rare in HIA. Methods are available in the areas of environmental health and, to a lesser extent, traffic accidents, infectious diseases, and behavioural factors. The methods are diverse and their reliability and validity are uncertain. Research and development in the following areas could benefit quantitative HIA: methods to quantify the effect of socioeconomic and behavioural determinants; user friendly simulation models; the use of summary measures of public health, expert opinion and scenario building; and empirical research into validity and reliability. PMID:15831683

  6. Health search engine with e-document analysis for reliable search results.

    PubMed

    Gaudinat, Arnaud; Ruch, Patrick; Joubert, Michel; Uziel, Philippe; Strauss, Anne; Thonnet, Michèle; Baud, Robert; Spahni, Stéphane; Weber, Patrick; Bonal, Juan; Boyer, Celia; Fieschi, Marius; Geissbuhler, Antoine

    2006-01-01

    After a review of the existing practical solution available to the citizen to retrieve eHealth document, the paper describes an original specialized search engine WRAPIN. WRAPIN uses advanced cross lingual information retrieval technologies to check information quality by synthesizing medical concepts, conclusions and references contained in the health literature, to identify accurate, relevant sources. Thanks to MeSH terminology [1] (Medical Subject Headings from the U.S. National Library of Medicine) and advanced approaches such as conclusion extraction from structured document, reformulation of the query, WRAPIN offers to the user a privileged access to navigate through multilingual documents without language or medical prerequisites. The results of an evaluation conducted on the WRAPIN prototype show that results of the WRAPIN search engine are perceived as informative 65% (59% for a general-purpose search engine), reliable and trustworthy 72% (41% for the other engine) by users. But it leaves room for improvement such as the increase of database coverage, the explanation of the original functionalities and an audience adaptability. Thanks to evaluation outcomes, WRAPIN is now in exploitation on the HON web site (http://www.healthonnet.org), free of charge. Intended to the citizen it is a good alternative to general-purpose search engines when the user looks up trustworthy health and medical information or wants to check automatically a doubtful content of a Web page.

  7. Global Nursing Issues and Development: Analysis of World Health Organization Documents.

    PubMed

    Wong, Frances Kam Yuet; Liu, Huaping; Wang, Hui; Anderson, Debra; Seib, Charrlotte; Molasiotis, Alex

    2015-11-01

    To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Qualitative content analysis. Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health. © 2015 Sigma Theta Tau International.

  8. Improving visual assessment documentation in patients with periorbital trauma through an eye assessment teaching session and a proforma sticker

    PubMed Central

    Myuran, Tharsika

    2017-01-01

    Up to 30% of patients who have periorbital trauma will have ocular injury with devastating consequences if missed. All staff working with acutely injured Oral and Maxillofacial Surgery (OMFS) patients should be competent in a basic eye examination with documentation of visual acuity, gross visual fields, eye movements, diplopia, and pupillary responses at a minimum. As a standard we adapted guidance published by the Emergency Care Institute New South Wales to assess the documentation of the eye examination in OMFS patients at King's College Hospital with any periorbital injury. After initial assessment we presented the data in the departmental audit meeting, then gave a detailed teaching session to junior doctors and introduced an ‘eye exam’ proforma sticker designed to act as an aide memoir. At baseline, 38 eye assessments across all clinical environments and by all seniority of clinician were assessed at random. Of these, 41% of these had visual acuity documented, 5% visual fields, 47% pupils, and 83% movements. After presentation of data, reaudit showed progress to 81%, 0%, 94%, and 100% respectively. Following the teaching session reaudit showed final progression to 83%, 46%, 83%, and 100%. Teaching sessions and use of an eye sticker proforma has been shown to improve rates of documentation of the eye exam for those OMFS patients presenting with periorbital injuries. PMID:28123747

  9. Incremental adoption of information security in health-care organizations: implications for document management.

    PubMed

    Lorence, Daniel P; Churchill, Richard

    2005-06-01

    The incremental adoption of electronic media in U.S. health care has created increased risk of security and privacy violations in provider organizations. Protective regulatory efforts have been proposed to address ineffective security of patient information, with severe noncompliance penalties. Using data from a nationwide survey of health information managers, this study examines how industry-wide knowledge management trends may influence the degree of security program adoption in health-care organizations. Results suggest that significant nonadoption of mandated security measures continues to occur across the health-care industry. Paper-based systems still prevail, and computerized settings tend to have less security measures. Implications for document management and knowledge policy are discussed.

  10. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and public health and safety documentation regarding any gaming place, facility, or location where... FACILITY LICENSE NOTIFICATIONS, RENEWALS, AND SUBMISSIONS § 559.7 May the Chairman request Indian lands or environmental and public health and safety documentation regarding any gaming place, facility, or location where...

  11. Screening and Assessment for Physical and Mental Health Issues That Impact TANF Recipients' Ability To Work.

    ERIC Educational Resources Information Center

    Kramer, Fredrica D.

    2001-01-01

    This document examines screening and assessment for physical and mental health conditions that impact Temporary Assistance for Needy Families (TANF) recipients' ability to work. The document begins by defining screening and assessment and discussing their relevance for agencies serving TANF recipients. The next section answers policy questions…

  12. Evaluation of community health assessment in Kansas.

    PubMed

    Curtis, Denice C

    2002-07-01

    This article evaluates the status of community health assessment in Kansas. It describes community characteristics associated with community health assessment completion, factors contributing to success, as well as barriers and limitations that prevented Kansas communities from initiating a community health assessment or completing the process. Survey findings show that certain community characteristics such as interagency cooperation, history of success at problem solving, and shared decision-making power are strongly associated with completion of a community health assessment. Results also indicate that factors such as lack of leadership, money, and time as well as poor functioning coalitions may hinder the completion of community health assessment.

  13. Evidence-based risk assessment and recommendations for physical activity clearance: Consensus Document 2011.

    PubMed

    Warburton, Darren E R; Gledhill, Norman; Jamnik, Veronica K; Bredin, Shannon S D; McKenzie, Don C; Stone, James; Charlesworth, Sarah; Shephard, Roy J

    2011-07-01

    The Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) are internationally known preparticipation screening tools developed on the basis of expert opinion. The primary purposes of this consensus document were to seek evidence-based support for the PAR-Q and PARmed-X forms, to identify whether further revisions of these instruments are warranted, to determine how people responding positively to questions on the PAR-Q can be safely cleared without medical referral, and to develop exercise clearance procedures appropriate for various clinical conditions across the human lifespan. Seven systematic reviews were conducted, examining physical-activity-related risks and effective risk-stratification procedures for various prevalent chronic conditions. An additional systematic review assessed the risks associated with exercise testing and training of the general population. Two gap areas were identified and evaluated systematically: the role of the qualified exercise professional and the requisite core competencies required by those working with various chronic conditions; and the risks associated with physical activity during pregnancy. The risks associated with being physically inactive are markedly higher than transient risks during and following an acute bout of exercise in both asymptomatic and symptomatic populations across the lifespan. Further refinements of the PAR-Q and the PARmed-X (including online versions of the forms) are required to address the unique limitations imposed by various chronic health conditions, and to allow the inclusion of individuals across their entire lifespan. A probing decision-tree process is proposed to assist in risk stratification and to reduce barriers to physical activity. Qualified exercise professionals will play an essential role in this revised physical activity clearance process.

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

    NASA Astrophysics Data System (ADS)

    Nayef, Nibal; Ogier, Jean-Marc

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Who has used internal company documents for biomedical and public health research and where did they find them?

    PubMed

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

    2014-01-01

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

  17. From documenting to eliminating disparities in mental health care for Latinos.

    PubMed

    López, Steven R; Barrio, Concepcion; Kopelowicz, Alex; Vega, William A

    2012-10-01

    The U.S. Surgeon General's report Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 2001) identified significant disparities in mental health care for Latinos and recommended directions for future research and mental health services. We update that report by reviewing five groundbreaking research projects on the mental health of Latinos that were published since 2001. National studies of adults and children, longitudinal designs, and analyses of Latino subgroups characterize these investigations. Despite the increasing sophistication of disparities research, these landmark studies, as well as the research in the supplemental report, can be characterized as documenting disparities in care. We argue that the next wave of research should give greater attention to reducing and eliminating disparities. Accordingly, we apply Rogler and Cortes's (1993) framework of pathways to care to the study of Latinos with schizophrenia. Specifically, we draw on research regarding the recognition of illness, social networks (families) and their association with the course of illness, and interventions. We illustrate examples at each pathway that have the potential to reduce disparities. We argue that implementing interventions synchronously across multiple pathways has considerable potential to reduce and eventually eliminate disparities in mental health care.

  18. Improving health care proxy documentation using a web-based interview through a patient portal

    PubMed Central

    Crotty, Bradley H; Kowaloff, Hollis B; Safran, Charles; Slack, Warner V

    2016-01-01

    Objective Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). Methods We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. Results From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45–67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. Conclusions Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient’s HCP information is both feasible and useful. PMID:26568608

  19. Simulated Engineer Assessment of the Communications Zone Model (SEAC) (Documentation and Users Manual)

    DTIC Science & Technology

    1988-06-01

    job . It would be relatively easy to include such information in the model and indicate how such supplies were consumed, by time , and by location. And...Use available data as much as possible. 2. Systemic - Use a time - dependent , process-oriented modeling approach. -Employ good software engineering...TITLE ( Include Security Classification) SIMULATED ENGINEER ASSESSMENT OF THE COMMUNICATIONS ZONE MODEL (SEAC) (Documentation and Users Manual) (U) 12

  20. Othering the Chronically Ill: A Discourse Analysis of New Zealand Health Policy Documents.

    PubMed

    Walton, Jo Ann; Lazzaro-Salazar, Mariana

    2016-01-01

    It is widely recognized that chronic illnesses pose significant challenges for health care systems around the world. In response, most governments have set health policies in order to manage (or better, reduce) demand and improve the health of their populations. A discourse analysis of four policy documents that shape these strategies in New Zealand reveals that the policies construct the chronically ill as "others," that is, as deviant or different from the "normal" population. The discourse further serves to blame the chronically ill both for being sick, and for placing a serious financial burden on society. We identify problems that arise from this discourse. They relate to (a) the fact that chronic illnesses are so prevalent, (b) the fallacy of categorizing all chronic illnesses as the same,

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

    PubMed

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

    2013-01-01

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

  2. Promoting Health Literacy through the Health Education Assessment Project

    ERIC Educational Resources Information Center

    Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

    2007-01-01

    Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

  3. Promoting Health Literacy through the Health Education Assessment Project

    ERIC Educational Resources Information Center

    Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

    2007-01-01

    Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

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

    SciTech Connect

    Sharry, J A

    2009-12-30

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

  5. Documentation of advance directives among home health and hospice patients: United States, 2007.

    PubMed

    Resnick, Helaine E; Hickman, Susan; Foster, Gregory L

    2012-02-01

    This report provides nationally representative data on documentation of advance directives (ADs) among home health (HH) and hospice patients. Advance directives were recorded for 29% of HH patients and 90% of hospice discharges. Among HH patients, increasing age and use of assistive devices were associated with greater odds of having an AD, while being Hispanic or black (relative to white) and enrolled in Medicaid decreased the odds of having ADs. Among hospice discharges, being enrolled in Medicare and having 4 or 5 activities of daily living (ADL) limitations were associated with higher odds of ADs while depression, use of emergency services, and being black (relative to White) were associated with lower odds. Even after adjustment for potentially confounding factors, racial differences persist in AD documentation in both care settings.

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

    PubMed

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

    2013-01-01

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

  7. Assessing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Cuff, Patricia A.

    2014-01-01

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

  8. Assessing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Cuff, Patricia A.

    2014-01-01

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

  9. Documenting the use of computers in Swedish Health Care up to 1980.

    PubMed

    Peterson, H E; Lundin, P

    2011-01-01

    This paper describes a documentation project to create, collect and preserve previously unavailable sources on informatics in Sweden (including health care as one of 16 subgroups), and making them available on the Web. Time was critical as the personal documentation and artifacts of early pioneers could be irretrievably lost. The criteria for participation were that a person had developed a system in a clinical environment which was used by others prior to 1980. Participants were interviewed and asked for early documentation such as notes, minutes from meetings, drawings, test results and early models - together with related artifacts. The approach included traditional oral history interviews, collection of autobiographies and new self-structuring and time saving methods, such as witness seminars and an Internet-based repository of their recollections (the Writers' Web). The combination of methods obtained new information on system errors, and challenges in reaching the goals due partly to inadequacies of the early technology, and partly to the insufficient understanding of the complexity of the many problems which needed to be solved before a useful electronic patient record could be realized. A very important result was the development of a method to collect information in an easier, faster and much less expensive way than using the traditional scientific method, and still reach results that are qualitative and quantitative for the purpose of documenting the early period of computer-based health care technology. The witness seminars and the Writers' Web yielded especially large amounts of hitherto-unknown information. With all material in one database available to everyone on the Web, it is accessed very frequently - especially by students, researchers, journalists and teachers. Study of the materials explains and clarifies the reasons behind the delays and difficulties that have been encountered in developing electronic patient records, as described in an

  10. Impact of electronic documentation on Pap screening rates in an urban health center.

    PubMed

    Khullar, Karishma; Peitzmeier, Sarah; Koffman, Rachel; Potter, Jennifer

    2014-06-01

    Providers and non-physician staff in primary care settings have reported barriers to full electronic health record (EHR) utilization. This study evaluates the effectiveness of EHR use for accurately documenting cervical cancer screening in a community healthcare setting, and proposes strategies to improve documentation. An electronic query generated data on average-risk patients aged 21-64 who had a medical visit at Fenway Health in 2012 and were overdue for a Papanicolaou (Pap) test according to the 2012 American Society for Colposcopy and Cervical Pathology guidelines. We then conducted a manual review of these records to determine the accuracy of EHR documentation. Of a total 5,279 patients, the electronic query classified 2,982 (56.5%) as up-to-date (UTD) for a Pap and 2,297 patients (43.5%) as overdue. Upon manual review, 65 (2.2%) patients thought to be UTD were actually overdue. Of those 2,297 patients classified by the query as overdue, 816 (35.5%) were reclassified as UTD due to evidence of a recent Pap in their chart that was not extractable by electronic query and 208 (9.1%) were ineligible for a Pap; only 1,272 patients (55.4%) of the 2,297 classified by the query were truly overdue. The cervical cancer screening rate indicated by electronic query was 56.5 %; after manual review, the adjusted rate was 73.6%. Overall, 1,090 patients (20.6%) were misclassified by the query. Inefficient EHR use can have serious implications for clinical practice and performance measures. Primary care practices need to develop mechanisms to capture outside medical records and create a team-based approach to facilitate accurate EHR documentation.

  11. Mental health problems in undocumented and documented migrants: a survey study.

    PubMed

    Teunissen, Erik; van den Bosch, Laura; van Bavel, Eric; van den Driessen Mareeuw, Francine; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2014-10-01

    Undocumented migrants (UM) frequently report mental health problems. It is unknown to what extent these migrants seek help for these problems in general practice and how these issues are explored, discussed, registered and treated by GPs. To gain insight in the registration and treatment of mental health problems in general practice of UM compared to documented migrants (DM). A survey study of general practice patient records of UM and DM in nine general practices in the Netherlands. Consultation rates, registration of mental health problems, prescription of psychotropic medication and referrals to mental health care institutions of UM and DM patients were compared. A total of 541 migrants were included (325 UM and 216 DM). UM consulted a GP significantly less than DM (3.1 versus 4.9 times per year). Only 20.6% of the UM had at least one mental health problem diagnosis registered compared to 44.0% of the DM. In both groups, ~10% mentioned at least one main mental health complaint during the consultation that was not coded in the record. No significant differences were found in the prescription of psychotropic medication between the two groups. UM were referred less to mental health care institutions but more often to psychiatrists than to psychologists. UM had less consultations with their GP, and in these consultations, less mental health problems were registered. UM were referred less to psychologists but more often to psychiatrists. GPs are advised to explore and register mental health problems more actively in UM. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Manitoba Health Assessment Program 1982. Final Report.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    Test results and interpretations, conclusions, and recommendations are presented from the Health Assessment Program conducted in the Manitoba public schools in 1982. Chapter I provides an overview and highlights the health assessment and major findings of fifth and tenth grade student assessments. Major findings of the teacher and administrator…

  13. Human Health Risk Assessment Strategic Research Action Plan 2012-2016

    EPA Pesticide Factsheets

    This document outlines the strategic plan for EPA’s Human Health Risk Assessment research efforts, and how they support and are integrated into the overall research portfolio of the Agency’s Office of Research and Development.

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

    PubMed Central

    Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

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

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

    PubMed

    Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen; Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

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

  16. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

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

  17. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

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

  18. Defense Health Care: Post-Deployment Health Reassessment Documentation Needs Improvement

    DTIC Science & Technology

    2009-11-01

    identified a number of potential problems that may pose risks to the PDHRA program objective and to the welfare and safety of Reserve component...Servicemembers deployed to Iraq and Afghanistan have engaged in intense and prolonged combat, placing them at risk for developing various physical and...peers, typically transition back to civilian life after their deployments. They may be particularly at risk for developing mental health conditions

  19. OASIS skin and wound integumentary assessment items: applying the WOCN guidance document.

    PubMed

    Baranoski, Sharon; Thimsen, Kathi

    2003-03-01

    This supplement provides home care nurses, therapists, and clinical managers a tool for understanding of how the Wound, Ostomy, and Continence Nurses (WOCN) Guidance Document on OASIS Skin and Wound Status M0 Items 2001 should be used. The supplement is a pictorial guide that clarifies definitions by linking them to photos using the skin integrity OASIS M0 items as an outline. The additional visual cues enable the clinician to clearly observe subtle characteristics that lead to a more reliable OASIS score and appropriate reimbursement by choosing the correct Home Health Resource Group (HHRG).

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

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

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

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

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

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

  2. Revised Human Health Risk Assessment on Chlorpyrifos

    EPA Pesticide Factsheets

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  3. [Spanish articles about quality evaluation of documents and clinic and health information systems (1983-1992)].

    PubMed

    Abad García, M F; Aleixandre Benavent, R; Peris Bonet, R

    1996-01-01

    To analize the number, characteristics and content of the articles on quality evaluation of health records and information systems published by Spanish authors in biomedical journals (1983-1992). Sources were IME and MEDLINE databases, journal summaries and bibliographies from the retrieved items. Originals or review articles and communications were included. Variables analyzed were: publication date; kind of document; coauthorship number; authors/items ratio; institutions where the authors work; journal of publication. The content analysis included the main aspects studied and the kind of document or system investigated. 87 documents were retrieved, 74 being original papers and 13 communications. Along the period a gradual growth was observed and a maximum was reached in 1991 with 18 items. The total number of authors was 370, 5 authors with three or more items. The maximum number of items per author was 6. The ratio authors/items was 4.1. The most productive institutions were hospitals and governmental centers. Twenty four different journals were identified, 5 publishing the 74.4% of papers. 61 (82.4%) of the 74 articles correspond to evaluative research and 13 (17.6%) dealt with questions related with quality but were not evaluative researches. The questions more frequently evaluated in the 61 articles were the completeness of data in clinical records (22 articles); the accuracy of data recorded in the documents used for death certification (7 articles) and the accuracy of data recorded in the Hospital Patient's Logbook (5 articles). An increase of scientific production in this field and its concentration in a reduced number of magazines has taken place in Spain in the past few years of study. The content in most of the articles is about formal aspects of clinic and sanitary information.

  4. Impact of Homecare Electronic Health Record on Timeliness of Clinical Documentation, Reimbursement, and Patient Outcomes

    PubMed Central

    Bowles, K. H.; Adelsberger, M. C.; Chittams, J. L.; Liao, C.

    2014-01-01

    Summary Background Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have adopted point-of-care EHRs. Yet, relatively little is known about the growing use of homecare EHRs. Objective Researchers compared workflow, financial billing, and patient outcomes before and after implementation to evaluate the impact of a homecare point-of-care EHR. Methods The design was a pre/post observational study embedded in a mixed methods study. The setting was a Philadelphia-based homecare agency with 137 clinicians. Data sources included: (1) clinician EHR documentation completion; (2) EHR usage data; (3) Medicare billing data; (4) an EHR Nurse Satisfaction survey; (5) clinician observations; (6) clinician interviews; and (7) patient outcomes. Results Clinicians were satisfied with documentation timeliness and team communication. Following EHR implementation, 90% of notes were completed within the 1-day compliance interval (n = 56,702) compared with 30% of notes completed within the 7-day compliance interval in the pre-implementation period (n = 14,563; OR 19, p <. 001). Productivity in the number of clinical notes documented post-implementation increased almost 10-fold compared to pre-implementation. Days to Medicare claims fell from 100 days pre-implementation to 30 days post-implementation, while the census rose. EHR implementation impact on patient outcomes was limited to some behavioral outcomes. Discussion Findings from this homecare EHR study indicated clinician EHR use enabled a sustained increase in productivity of note completion, as well as timeliness of documentation and billing for reimbursement with limited impact on improving patient outcomes. As EHR adoption increases to better meet the needs of the growing

  5. Evaluation of the assessment and documentation of chronic wounds in residential social care in the Czech Republic.

    PubMed

    Saibertová, S; Pokorná, A

    2016-11-02

    Accurate evaluation of non-healing, chronic wounds followed by the selection of an appropriate therapeutic strategy is a must for the foundation of health-care management. Assessment of non-healing chronic wounds in clinical practice in the Czech Republic is not standardised in acute care settings or in residential social care facilities. The aim of the study was to analyse the methods being used to assess non-healing, chronic wounds in residential social services in the Czech Republic, where more patients with chronic wounds are present because of the increasing incidence of wounds in old age. The research was carried out at 66 residential social care institutions across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The same methodology was used in previous work which has been done in acute care settings in 2013. The results of this research have corroborated the inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to the evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of the wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were improved when a consultant for wound healing was present. An effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of 'non-healing, chronic wound assessment' algorithm.

  6. Clinical documentation of dental care in an era of electronic health record use.

    PubMed

    Tokede, Oluwabunmi; Ramoni, Rachel B; Patton, Michael; Da Silva, John D; Kalenderian, Elsbeth

    2016-09-01

    Although complete and accurate clinical records do not guarantee the provision of excellent dental care, they do provide an opportunity to evaluate the quality of care provided. However, a lack of universally accepted documentation standards, incomplete record-keeping practices, and unfriendly electronic health care record (EHR) user interfaces are factors that have allowed for persistent poor dental patient record keeping. Using 2 different methods-a validated survey, and a 2-round Delphi process-involving 2 appropriately different sets of participants, we explored what a dental clinical record should contain and the frequency of update of each clinical entry. For both the closed-ended survey questions and the open-ended Delphi process questions, respondents had a significant degree of agreement on the "clinical entry" components of an adequate clinical record. There was, however, variance on how frequently each of those clinical entries should be updated. Dental providers agree that complete and accurate record keeping is essential and that items such as histories, examination findings, diagnosis, radiographs, treatment plans, consents, and clinic notes should be documented. There, however, does not seem to be universal agreement how frequently such items should be recorded. As the dental profession moves towards prevalent use of electronic health care records, the issue of standardization and interoperability becomes ever more pressing. Settling issues of standardization, including record documentation, must begin with guideline-creating dental professional bodies, who need to clearly define and disseminate what these standards should be and everyday dentists who will ultimately ensure that these standards are met and kept. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. A short history of health technology assessment in Germany.

    PubMed

    Perleth, Matthias; Gibis, Bernhard; Göhlen, Britta

    2009-07-01

    To provide an overview of the development of health technology assessment (HTA) in Germany since the 1990s. Analysis of key documents (e.g. literature, laws, and other official documentation) and personal experiences. Health technology assessment (HTA) entered the political agenda in Germany only in the mid-1990s, basically as the result of a top-down approach toward more efficiency in health care, but with a strong impetus of an evidence-based medicine movement. Accordingly, HTA became part of several healthcare reform laws since 1997, which led to the establishment of the Federal Joint Committee (G-BA) and the Institute for Quality and Efficiency in Health Care (IQWiG) in 2004. This tandem construction aims at using evidence in decision-making processes for coverage and other decisions. These developments have led to a considerable impact of HTA in Germany. In addition, a broad spectrum of activities at universities and in other organizations, such as the German Institute for Medical Documentation and Information (DIMDI), can be observed that contribute to both teaching and research in HTA. German researchers in the field of HTA are actively involved in international projects, such as EUNetHTA, and contribute to scientific conferences and journals.

  8. 78 FR 70040 - Draft Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... AGENCY Draft Integrated Science Assessment for Nitrogen Oxides--Health Criteria AGENCY: Environmental... for Nitrogen Oxides--Health Criteria'' (EPA/600/R-13/202). The draft document was prepared by the... nitrogen dioxide (NO 2 ). The Integrated Science Assessment (ISA), in conjunction with additional technical...

  9. [Health technology assessment: II. Cost effectiveness analysis].

    PubMed

    Secoli, Silvia Regina; Nita, Marcelo Eidi; Ono-Nita, Suzane Kioko; Nobre, Moacyr

    2010-01-01

    New health technologies have made an impact in clinical and economic outcomes. Therefore, research methodologies that allow to evaluate the efficiency of these new technologies such as cost-effectiveness analysis are necessary. Cost-effectiveness analysis assess the value of health care interventions or drugs, the technology. Cost-effectiveness analysis is also deemed a determinant of modern health care practice, because the therapeutic options available at public (SUS) or private health care system must go through a formal health technology assessment in Brazil; thus, both the health care system and the health care professionals have to reevaluate the clinical consequences and costs of their actions to assure that the most efficient technologies are the one used in the practice. In this second article about health technology assessment we review the concepts of cost-effectiveness analysis, the steps involved in performing such analysis, and the criteria most frequently used to critically review the results.

  10. Report: EPA Is Documenting How It Addresses Time-Critical Public Health Risks Under Its Superfund Authority

    EPA Pesticide Factsheets

    Report #16-P-0059, December 9, 2015. We found that the EPA can provide documentation that imminent and substantial endangerment threats to public health at Superfund time-critical removal sites have been addressed.

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

    NASA Technical Reports Server (NTRS)

    CLement, Bethany M.

    2011-01-01

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

  12. Readiness Assessment of Electronic Health Records Implementation

    PubMed Central

    Ajami, Sima; Ketabi, Saeedeh; Isfahani, Sakineh Saghaeiannejad; Heidari, Asieh

    2011-01-01

    Introduction: During the past 20 years, with huge advances in information technology and particularly, in the areas of health, various forms of electronic records have been discussed, designed or implemented. Although making health records automatically has many advantages but unfortunately in some cases, creation of an Electronic Health Record (EHR) system seems to be complicated. E-health (Electronic health) readiness assessment, as a part of the assessment before implementation is considered essential and prior to implementation. Readiness assessment aims to evaluate preparedness of each organizational component. This process can lead to the correct decision making. Therefore, identifying areas and requirements for such an assessment is so essential. Using the results of this assessment can identify deficiencies in the existing electronic health records to plan their strategies. The aim of this study was first; to show the situation of readiness assessment in EHR implementation roadmap, second, to recognize requirements associated with electronic readiness assessment and main areas of EHR readiness assessment. Results and discussion: This study reviewed the literature on EHR readiness assessment with the help of library and also searches engines available at Google. For our searches, we employed the following keywords and their combinations: readiness, assessment, implementation, Electronic Health Record (EHR), Information Technology, road map in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 45 of them were selected based on their relevancy. PMID:23407861

  13. Automated utility assessment of global health.

    PubMed

    Nease, R F; Tsai, R; Hynes, L M; Littenberg, B

    1996-02-01

    The objective of this study was to characterize the performance of an automated utility assessment instrument for measuring preferences for overall health. The study population consisted of 83 subjects recruited from the cafeteria of a large tertiary care hospital. We assessed utilities for current health relative to perfect health and death using the rating scale, time tradeoff and standard gamble metrics. To validate the instrument, we compared utilities with the General Health subscale of the SF-36 Health Survey instrument, satisfaction with current health, and degree of bother due to current health. We evaluated interview failure rate based on irrational orderings of two practice assessments (monocular and binocular blindness) or inability to complete the interview. As expected, utility for overall health was statistically significantly associated with the General Health subscale score and measures of satisfaction with current health and degree of bother. There is substantial variation in utilities among patients with similarly severe overall health, and substantial overlap in utilities among subjects with different levels of overall health. The failure rate in the study was acceptable (9.6%). Automated assessment of utility for overall health provides a feasible means for estimating individual preferences.

  14. Guidelines for condensed documentation of a probabilistic risk assessment. Final report

    SciTech Connect

    Dewailly, J.

    1999-01-01

    A desire to ``codify`` practices for the preparation and use of Probabilistic Risk Assessments (PRAs) is emerging in France. EDF has set itself the objective of developing PRAs that are representative of each nuclear power plant series in operation, that will produce standard results (core damage frequency, ranking of risk components, etc.), that meet the requirements of applications, and that use common tools. As PRA applications develop, it becomes even more important to ensure a consistent documentation of the PRA models for the application at hand. An important issue here is the turnover of engineers at utilities. As engineers move in and out of the utility or even the PRA group, the memory of the hidden assumptions in the PRA models must be captured reliably. That is, it must be captured in a framework that allows easy retrieval by staff who may never have participated in the original development. Condensed documentation of the main strategic choices and technical assumptions greatly facilitates the appropriation of PRA models and their use for applications. The purpose of this report is to outline four sections of the PRA condensed documentation (Sequence Development, System Analysis, Component Reliability data, Initiating Events). Each section is illustrated in its companion appendix.

  15. The National Library of Kosovo "PJETËR Bogdani" Rapid Condition Assessment and Documentation

    NASA Astrophysics Data System (ADS)

    Eppich, R.; Ramku, B.; Binakaj, N.

    2017-08-01

    The National Library of Kosovo "Pjetër Bogdani" is a symbol of Prishtina, Kosovo and the quest for knowledge. It is simultaneously an icon of modernity and symbol of the past. Unfortunately, it suffered through the Kosovo war and neglect in times of economic difficulty. It was also unfortunately featured in the British newspaper The Telegraph in their travel section: "One of the worl&dacute;s 30 ugliest buildings?" In late 2015 the Kosovo Architectural Foundation, a non-profit dedicated to spirit of creating and preserving unique architecture, became concerned with the reputation and condition of the Library and contacted the Kosovo Ministry of Culture, visited the site and initiated a project to raise awareness and document this modern masterpiece. The Getty Foundation and their Keeping it Modern grant program awarded funding for initial condition assessment, documentation, capacity building and investigations. This paper discusses the project to document and improve the image and awareness of this important structure and set priorities for its future.

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

    SciTech Connect

    Not Available

    1992-12-01

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

  17. Health Economic Assessment: A Methodological Primer

    PubMed Central

    Simoens, Steven

    2009-01-01

    This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments. PMID:20049237

  18. Alabama Allied Health Needs Assessment Study.

    ERIC Educational Resources Information Center

    Morris, Libby V.

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

  19. The West Virginia Health Education Assessment Project

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  20. The West Virginia Health Education Assessment Project

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  1. Findings from ATSDR's Health Assessments.

    ERIC Educational Resources Information Center

    Susten, Allan S.

    1992-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. The contribution of health technology assessment, health needs assessment, and health impact assessment to the assessment and translation of technologies in the field of public health genomics.

    PubMed

    Rosenkötter, N; Vondeling, H; Blancquaert, I; Mekel, O C L; Kristensen, F B; Brand, A

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation.

  4. Implementation of an Evidence Based Guideline for Assessment and Documentation of the Civil Commitment Process.

    PubMed

    Perrigo, Tabitha L; Williams, Kimberly A

    2016-11-01

    The purpose of this quality improvement project was to implement an evidence-based practice guideline for assessment and documentation of the civil commitment process. Participants included six civil commitment examiners who conduct court ordered psychiatric evaluations at two crisis intervention centers in rural area of southeaster state. Data collection was conducted utilizing a chart audit tool both pre and post intervention of 100 civil commitment evaluations. The intervention included the development of an evidenced based form for documentation of civil commitment evaluations and a one on one educational training session was conducted for each participant. Descriptive statistics (t test) was utilized to analyze the data collected. The project demonstrated a significant increase as 25.5 % of evaluations contained the America Psychiatric Association's recommended 11 domains of assessment prior to implementation compared to 65.6 % (p value = 0.018) post implementation. Moreover, participants with family practice training showed an increase in commitment rates from 60 to 77.3 % (p value = 0.066). Whereas, psychiatric trained participants showed a decrease from 83.75 to 77.66 % (p value = 0.38). Demonstrating that court ordered evaluations guided by a standardized form based on evidence affected examiners recommendations for commitments.

  5. A scalable climate health justice assessment model.

    PubMed

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

    2015-05-01

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

  6. A scalable climate health justice assessment model

    PubMed Central

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

    2014-01-01

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

  7. Chemical Risk Assessment: Traditional vs Public Health ...

    EPA Pesticide Factsheets

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  8. The West Virginia Health Education Assessment Project.

    PubMed

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

    2005-08-01

    Well-designed school health education should provide students with the knowledge and skills to prevent the health risk behaviors most responsible for the major causes of morbidity and mortality. This paper reports the methodology and findings of a West Virginia statewide health education assessment initiative and describes how the findings are used to design professional development training for school health educators. Selected response items from the State Collaborative on Assessment and Student Standards, Health Education Assessment Project were used to develop a 40-item assessment instrument for 6 health education content areas. In West Virginia, 51 counties and 242 schools were recruited (county response rate = 93%; school response rate = 53%); 17,549 students were tested in grades 6, 8, and high school health education classes. Mean total scores by grade were 30.61 (grade 6), 26.55 (grade 8), and 26.53 (high school), indicating a slight decline in scores as grade level increased. Females in each grade level scored higher on total Health Education Assessment Project (HEAP) scores and subtest scores than males. The results suggest notable differences across grade levels. High school students failed to meet the standard on any health education content areas, indicating the need for enhanced knowledge and skill development. During professional development training, HEAP scores were examined in the context of results from the West Virginia Youth Risk Behavior Survey to underscore the importance of providing quality skills-based health education in West Virginia schools.

  9. Assessment of the quality of clinical documentation in India's JSY cash transfer program for facility births in Madhya Pradesh.

    PubMed

    Chaturvedi, Sarika; Randive, Bharat; Raven, Joanna; Diwan, Vishal; De Costa, Ayesha

    2016-02-01

    To gain insight into the quality of care in facilities implementing the Janani Suraksha Yojana (JSY) cash transfer program in Madhya Pradesh, India, by reviewing the level of documentation in the clinical records of women who delivered. The present retrospective, descriptive study reviewed case records of women who delivered at 73 primary, secondary, and tertiary level facilities in three districts of Madhya Pradesh between 2012 and 2013. Twenty elements of care were assessed encompassing clinical history and admission details, care during delivery and postnatal period, and discharge details. A total of 1239 records were reviewed. The extent of documentation varied among the elements assessed-e.g. 24 (1.9%) records documented advice at discharge, 171 (13.8%) documented postnatal blood pressure, 437 (35.3%) documented fetal heart rate, and 1220 (98.5%) documented admission date. The extent of documentation was better at higher level facilities. The quality of clinical documentation in the JSY program was found to be unacceptably poor in Madhya Pradesh. Improving staff skills and practices in clinical documentation and record keeping will be required to enable clinical processes to be assessed and quality of care to be improved. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  10. NCBI Bookshelf: books and documents in life sciences and health care.

    PubMed

    Hoeppner, Marilu A

    2013-01-01

    Bookshelf (http://www.ncbi.nlm.nih.gov/books/) is a full-text electronic literature resource of books and documents in life sciences and health care at the National Center for Biotechnology Information (NCBI). Created in 1999 with a single book as an encyclopedic reference for resources such as PubMed and GenBank, it has grown to its current size of >1300 titles. Unlike other NCBI databases, such as GenBank and Gene, which have a strict data structure, books come in all forms; they are diverse in publication types, formats, sizes and authoring models. The Bookshelf data format is XML tagged in the NCBI Book DTD (Document Type Definition), modeled after the National Library of Medicine journal article DTDs. The book DTD has been used for systematically tagging the diverse data formats of books, a move that has set the foundation for the growth of this resource. Books at NCBI followed the route of journal articles in the PubMed Central project, using the PubMed Central architectural framework, workflows and processes. Through integration with other NCBI molecular databases, books at NCBI can be used to provide reference information for biological data and facilitate its discovery. This article describes Bookshelf at NCBI: its growth, data handling and retrieval and integration with molecular databases.

  11. NCBI Bookshelf: books and documents in life sciences and health care

    PubMed Central

    Hoeppner, Marilu A.

    2013-01-01

    Bookshelf (http://www.ncbi.nlm.nih.gov/books/) is a full-text electronic literature resource of books and documents in life sciences and health care at the National Center for Biotechnology Information (NCBI). Created in 1999 with a single book as an encyclopedic reference for resources such as PubMed and GenBank, it has grown to its current size of >1300 titles. Unlike other NCBI databases, such as GenBank and Gene, which have a strict data structure, books come in all forms; they are diverse in publication types, formats, sizes and authoring models. The Bookshelf data format is XML tagged in the NCBI Book DTD (Document Type Definition), modeled after the National Library of Medicine journal article DTDs. The book DTD has been used for systematically tagging the diverse data formats of books, a move that has set the foundation for the growth of this resource. Books at NCBI followed the route of journal articles in the PubMed Central project, using the PubMed Central architectural framework, workflows and processes. Through integration with other NCBI molecular databases, books at NCBI can be used to provide reference information for biological data and facilitate its discovery. This article describes Bookshelf at NCBI: its growth, data handling and retrieval and integration with molecular databases. PMID:23203889

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

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

  13. Using portfolios to assess student performance in school health education.

    PubMed

    Cleary, M J

    1993-11-01

    Outcome-based education is a topic of growing interest in educational circles today. More performance-oriented than traditional learning approaches, outcome-based education requires students to demonstrate what they know and what they can do. Because of this emphasis, outcome-based curricula will require new methods to assess student achievement. One approach is the portfolio, a repository that enables students to document authentic examples of academic work and presentations as well as nonschool accomplishments. The possibility of using portfolio-based assessment as a viable mechanism to promote comprehensive school health education is examined. Practical recommendations concerning portfolio development and evaluation are offered.

  14. Urban ecosystem health assessment: a review.

    PubMed

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

    2010-05-15

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

  15. Developing Technical Documentation Standards for NOHIMS (Navy Occupational Health Information Management System)

    DTIC Science & Technology

    1985-01-01

    Information Management System (NOHIMS) uses the Massachusetts General Hospital Utility Multi-Programming System (MUMPS) language, which is dynamic in nature, it was felt that new technical documentation standards had to be developed to accommodate its flexibility. This paper describes a transactional approach to documentating the NOHIMS system. Examples of documentation worksheets, as well as a diagram depicting the levels of documentation and their relationship to the transaction center, are provided. This method of documentation may be advantageous for others who are

  16. Occupational health policies on risk assessment in Japan.

    PubMed

    Horie, Seichi

    2010-09-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  17. Assessment of health risks of policies

    SciTech Connect

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

    2014-09-15

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  20. Application of HL7/LOINC Document Ontology to a University-Affiliated Integrated Health System Research Clinical Data Repository

    PubMed Central

    Wang, Yan; Pakhomov, Serguei; Dale, Justin L.; Chen, Elizabeth S.; Melton, Genevieve B.

    2014-01-01

    Fairview Health Services is an affiliated integrated health system partnering with the University of Minnesota to establish a secure research-oriented clinical data repository that includes large numbers of clinical documents. Standardization of clinical document names and associated attributes is essential for their exchange and secondary use. The HL7/LOINC Document Ontology (DO) was developed to provide a standard representation of clinical document attributes with a multi-axis structure. In this study, we evaluated the adequacy of DO to represent documents in the clinical data repository from legacy and current EHR systems across community and academic practice sites. The results indicate that a large portion of repository data items can be mapped to the current DO ontology but that document attributes do not always link consistently with DO axes and additional values for certain axes, particularly “Setting” and “Role” are needed for better coverage. To achieve a more comprehensive representation of clinical documents, more effort on algorithms, DO value sets, and data governance over clinical document attributes is needed. PMID:25954591

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

    SciTech Connect

    Biebesheimer, E., Westinghouse Hanford Co.

    1996-09-30

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

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

    SciTech Connect

    Not Available

    1992-05-01

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

  3. Assessing research productivity in an oncology research institute: the role of the documentation center.

    PubMed Central

    Ugolini, D; Bogliolo, A; Parodi, S; Casilli, C; Santi, L

    1997-01-01

    An evaluation method used to assess the quality of research productivity and to provide priorities for budget allocation purposes is presented. This method, developed by a working group of the National Institute for Research on Cancer (IST), Genoa, Italy, is based on the partitioning of categories of the Science Citation Index and Journal Citation Reports (SCI-JCR) into deciles, which normalizes journal impact factors in order to gauge the quality of the productivity. A second parameter related to the number of staff of each institute department co-authoring a given paper has been introduced in order to guide departmental budget allocations. The information scientists of the IST Documentation Center who participated in the working group played a pivotal role in developing the computerized database of publications, providing and analyzing data, supplying and evaluating literature on the topic, and placing international bibliographic databases at the working group's disposal. PMID:9028569

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

    PubMed

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

    2007-12-01

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

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

    PubMed

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

    2016-02-01

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

  6. Health Risk Assessments for Alumina Refineries

    PubMed Central

    Coffey, Patrick S.

    2014-01-01

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

  7. Health risk assessments for alumina refineries.

    PubMed

    Donoghue, A Michael; Coffey, Patrick S

    2014-05-01

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

  8. Assessing Human Health Risk from Pesticides

    EPA Pesticide Factsheets

    EPA protects human health and the environment by evaluating the risk associated with pesticides before allowing them to be used in the United States. Learn about the tools and processes used in risk assessment for pesticides.

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

    PubMed Central

    Habibi, Roojin; Lexchin, Joel

    2014-01-01

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

  10. Using informatics-enabled quality improvement techniques to meet health record documentation requirements in radiology reports.

    PubMed

    Prevedello, Luciano M; Farkas, Cameron; Dufault, Allen; Damiano, Maria; Doubilet, Peter; Khorasani, Ramin

    2013-08-01

    Medicare requires documented teaching physician involvement (attestation) in trainee-generated radiology reports. Automated attestation statement insertion in reports expedites the process but does not comply with requirements for active attestation. We evaluated an informatics-enabled quality improvement (QI) intervention to improve health record documentation requirements for active attestation. Institutional review board approval was not needed for this QI project performed in a 776-bed tertiary/quaternary teaching hospital. The intervention consisted of (1) policy requiring staff radiologists to actively attest to trainee-generated reports by personally activating a "macro" in the reporting system and (2) a semiautomated process to detect reports missing attestation; radiologists received daily e-mail reminders until the attestation statement was inserted. A random sample of 600 of 123,561 trainee-generated radiology reports created 17 months after the intervention (May 2011) was manually reviewed to determine attestation policy adherence. The number of attestation statements added in response to reminders throughout the entire study period was also evaluated. Trend analysis of the number of report addenda containing solely the attestation statement (proxy for missing initial attestation) was performed. Of 600 reports, 594 (99%) contained the attestation statement. Monthly attestations in response to email notifications decreased from 585 to 227 by the sixth month, a 2.6-fold reduction (P < .01). No significant trend was observed the following year, indicating a sustained effect. Informatics-enabled QI techniques resulted in 99% adherence to our teaching physician attestation policy with sustained results. Similar approaches may help improve adherence to other mandated performance measures in radiology reports. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  11. Office for prevention and health services assessment

    NASA Astrophysics Data System (ADS)

    Wright, James A.

    1994-12-01

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

  12. Health Security Intelligence: Assessing the Nascent Public Health Capability

    DTIC Science & Technology

    2012-03-01

    construction and other environmental changes; write technical proposals ; and give presentations to managers and regulators (U.S. Department of...environments, contacts within the first response community at the SLTT level, experience writing reports , making educated assessments and deciding on...Lauren Wolllman THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this

  13. Health impact assessment of active transportation: A systematic review.

    PubMed

    Mueller, Natalie; Rojas-Rueda, David; Cole-Hunter, Tom; de Nazelle, Audrey; Dons, Evi; Gerike, Regine; Götschi, Thomas; Int Panis, Luc; Kahlmeier, Sonja; Nieuwenhuijsen, Mark

    2015-07-01

    Walking and cycling for transportation (i.e. active transportation, AT), provide substantial health benefits from increased physical activity (PA). However, risks of injury from exposure to motorized traffic and their emissions (i.e. air pollution) exist. The objective was to systematically review studies conducting health impact assessment (HIA) of a mode shift to AT on grounds of associated health benefits and risks. Systematic database searches of MEDLINE, Web of Science and Transportation Research International Documentation were performed by two independent researchers, augmented by bibliographic review, internet searches and expert consultation to identify peer-reviewed studies from inception to December 2014. Thirty studies were included, originating predominantly from Europe, but also the United States, Australia and New Zealand. They compromised of mostly HIA approaches of comparative risk assessment and cost-benefit analysis. Estimated health benefit-risk or benefit-cost ratios of a mode shift to AT ranged between -2 and 360 (median=9). Effects of increased PA contributed the most to estimated health benefits, which strongly outweighed detrimental effects of traffic incidents and air pollution exposure on health. Despite different HIA methodologies being applied with distinctive assumptions on key parameters, AT can provide substantial net health benefits, irrespective of geographical context. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. An Assessment of Environmental Health Needs

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

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

  15. Sensor data fusion for soil health assessment

    USDA-ARS?s Scientific Manuscript database

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

  16. Content Assessment of Selected College Health Textbooks.

    ERIC Educational Resources Information Center

    Huetteman, Julie Doidge

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

  17. Content Assessment of Selected College Health Textbooks.

    ERIC Educational Resources Information Center

    Huetteman, Julie Doidge

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

  18. [Approaches for assessing forest ecosystem health].

    PubMed

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

    2003-06-01

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

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

    PubMed

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

    2015-01-01

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

  20. Smart Sensors Assess Structural Health

    NASA Technical Reports Server (NTRS)

    2010-01-01

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

  1. 78 FR 26026 - Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... AGENCY Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides--Health... Science Assessment for Nitrogen Oxides--Health Criteria.'' The draft document was prepared by the National... review of the primary (health-based) national ambient air quality standards (NAAQS) for nitrogen dioxide...

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

    SciTech Connect

    Not Available

    1992-02-28

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

  3. Assessment of Rural Health Research. Executive Summary.

    ERIC Educational Resources Information Center

    Control Data Corp., Arlington, VA. Professional Services Div.

    Culminating a 6-month assessment effort by Control Data Corporation's (CDC) Engineering Management Operations (EMO), the report was prepared to help meet the Department of Agriculture's need for an assessment of (1) rural health care services research as a whole and (2) the knowledge contained in that research. The CDC "Final Report" was presented…

  4. Prevalence of food allergies and intolerances documented in electronic health records.

    PubMed

    Acker, Warren W; Plasek, Joseph M; Blumenthal, Kimberly G; Lai, Kenneth H; Topaz, Maxim; Seger, Diane L; Goss, Foster R; Slight, Sarah P; Bates, David W; Zhou, Li

    2017-05-23

    Food allergy prevalence is reported to be increasing, but epidemiological data using patients' electronic health records (EHRs) remain sparse. We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. Using allergy data from a large health care organization's EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. We examined the prevalence of reactions that were potentially IgE-mediated and anaphylactic. Data were validated using radioallergosorbent test and ImmunoCAP results, when available, for patients with reported peanut allergy. Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 ± 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P < .001) and Asians (4.3% vs 3.6%; P < .001). The most common food allergen groups were shellfish (0.9%), fruit or vegetable (0.7%), dairy (0.5%), and peanut (0.5%). Of the 103,659 identified reactions to foods, 48.1% were potentially IgE-mediated (affecting 50.8% of food allergy or intolerance patients) and 15.9% were anaphylactic. About 20% of patients with reported peanut allergy had a radioallergosorbent test/ImmunoCAP performed, of which 57.3% had an IgE level of grade 3 or higher. Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR's allergy module has the potential to be used for clinical and epidemiological research. The spectrum of severity observed with food allergy highlights the critical need for more allergy evaluations. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

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

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

  7. [An optimised assessment of "severely injured patients" for the documentation of road traffic accident black spots].

    PubMed

    Sellei, R M; Lank, C; Becher, T; Knobe, M; Rüger, M; Spies, C K G; Schmitt, T; Peters, J; Erli, H J

    2011-06-01

    The success of traffic safety improvement strategies is based on documentation. Analysis and remedy of accident black spots in addition to improvements in automobile production involve the work of traffic engineers, politicians, traffic regulations, police, and medical care. To create priorities, the traffic statistics differentiate accidents in a 3-class system in relation to severe accidents: slightly injured, severely injured and fatally injured (death). This study assesses the validity of the existing classification of "severely injured" compared with the actual injury severity. We analysed accidents resulting in 182 "severely injured" people in one year in a city model. A synchronisation of anonymous police documentation with the medical notes of admitted casualties which were validated by established trauma scores and medical classification was undertaken. A correlation analysis of length of stay should give indications of the actual injury severity. The study group showed a ubiquitous range of age, sex and injuries despite a relatively low case number. The range of MAIS, ISS and NACA index scores shows the inhomogeneity of the people classified as "severely injured". 70 % of the study group revealed ISS < 16 which means that they are not polytraumatised patients. The correlation analysis according to Spearman certifies the validity of these scores (r MAIS/NACA = 0.645 and r ISS/NACA = 0.592). The further differentiation on the basis of MAIS, ISS and NACA showed that 51 % of the study group should be classified as slightly injured and 83 % of these were discharged in less than 5 days. This study shows that the traffic safety classification of "severely injured" people is not sufficient and most severely injured people are not even approximately recorded. We propose that a new continuous link system between police and medical data will be inevitable for future improvements in traffic safety. The use of established trauma scores and a

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

    SciTech Connect

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

    2009-09-15

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

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

    SciTech Connect

    1993-09-02

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

  10. National Assessment of Clinical Education of Allied Health Manpower: Volume III, Monographs.

    ERIC Educational Resources Information Center

    Booz Allen and Hamilton, Inc., Washington, DC.

    The document is the third volume of a four-part report of a study conducted to evaluate and assess the state of allied health manpower clinical education and training. Four monographs focus on important issues related to clinical education as a major factor in the training of allied health manpower. In "A Critical Analysis of Methods of Ensuring…

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

    PubMed

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

    2014-01-01

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

  12. Leveraging electronic health record documentation for Failure Mode and Effects Analysis team identification

    PubMed Central

    Carson, Matthew B; Lee, Young Ji; Benacka, Corrine; Mutharasan, R. Kannan; Ahmad, Faraz S; Kansal, Preeti; Yancy, Clyde W; Anderson, Allen S; Soulakis, Nicholas D

    2017-01-01

    Objective: Using Failure Mode and Effects Analysis (FMEA) as an example quality improvement approach, our objective was to evaluate whether secondary use of orders, forms, and notes recorded by the electronic health record (EHR) during daily practice can enhance the accuracy of process maps used to guide improvement. We examined discrepancies between expected and observed activities and individuals involved in a high-risk process and devised diagnostic measures for understanding discrepancies that may be used to inform quality improvement planning. Methods: Inpatient cardiology unit staff developed a process map of discharge from the unit. We matched activities and providers identified on the process map to EHR data. Using four diagnostic measures, we analyzed discrepancies between expectation and observation. Results: EHR data showed that 35% of activities were completed by unexpected providers, including providers from 12 categories not identified as part of the discharge workflow. The EHR also revealed sub-components of process activities not identified on the process map. Additional information from the EHR was used to revise the process map and show differences between expectation and observation. Conclusion: Findings suggest EHR data may reveal gaps in process maps used for quality improvement and identify characteristics about workflow activities that can identify perspectives for inclusion in an FMEA. Organizations with access to EHR data may be able to leverage clinical documentation to enhance process maps used for quality improvement. While focused on FMEA protocols, findings from this study may be applicable to other quality activities that require process maps. PMID:27589944

  13. Content and Quality of Free-Text Occupation Documentation in the Electronic Health Record.

    PubMed

    Aldekhyyel, Ranyah; Chen, Elizabeth S; Rajamani, Sripriya; Wang, Yan; Melton, Genevieve B

    2016-01-01

    Recent recommendations for capturing social and behavioral information in electronic health record (EHR) systems for downstream applications, including research, highlight the need to better represent patient occupation. The objectives of this study were to characterize the content and quality of EHR social history module free-text occupation documentation. After developing categorization schemas, occupation entries with frequencies >5 (n=2,336) and a random sample of those with frequencies ≤5 (n=381) were analyzed. The information contained in the 2,336 entries fell into five groups: occupation (84.7%), occupation details (20.6%), employment status (2.5%), not in labor force (21.6%), and other (2.5%). Quality issues included use of acronyms/abbreviations (9.1%) and misspellings (1.6%). In comparison, quality issues with the 381 entries were: other (29.1%), acronyms/abbreviations (19.0%), and misspellings (9.0%). These findings suggest the need for EHR user training, system enhancements, and content standardization to support use of occupational information for clinical care and research.

  14. Content and Quality of Free-Text Occupation Documentation in the Electronic Health Record

    PubMed Central

    Aldekhyyel, Ranyah; Chen, Elizabeth S.; Rajamani, Sripriya; Wang, Yan; Melton, Genevieve B.

    2016-01-01

    Recent recommendations for capturing social and behavioral information in electronic health record (EHR) systems for downstream applications, including research, highlight the need to better represent patient occupation. The objectives of this study were to characterize the content and quality of EHR social history module free-text occupation documentation. After developing categorization schemas, occupation entries with frequencies >5 (n=2,336) and a random sample of those with frequencies ≤5 (n=381) were analyzed. The information contained in the 2,336 entries fell into five groups: occupation (84.7%), occupation details (20.6%), employment status (2.5%), not in labor force (21.6%), and other (2.5%). Quality issues included use of acronyms/abbreviations (9.1%) and misspellings (1.6%). In comparison, quality issues with the 381 entries were: other (29.1%), acronyms/abbreviations (19.0%), and misspellings (9.0%). These findings suggest the need for EHR user training, system enhancements, and content standardization to support use of occupational information for clinical care and research. PMID:28269929

  15. Promoting health literacy through the health education assessment project.

    PubMed

    Marx, Eva; Hudson, Nancy; Deal, Tami B; Pateman, Beth; Middleton, Kathleen

    2007-04-01

    The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is to describe the extensive ongoing development of the SCASS-HEAP and its benefits for important stakeholders in health and education. A review of the products from the first decade of the SCASS-HEAP was undertaken. The SCASS-HEAP supports a comprehensive systems approach to helping educators focus effectively on the most important skills and issues in child and adolescent health and gives health education a place at the school reform table, providing visibility and credibility and promoting the essential links between health and learning. State education agencies and school districts can use SCASS-HEAP materials for assessment and, perhaps more importantly, to help teachers modify and improve instruction at the classroom level for increased student learning.

  16. Prospective evaluation of inappropriate unable-to-assess CAM-ICU documentations of critically ill adult patients.

    PubMed

    Terry, Kimberly J; Anger, Kevin E; Szumita, Paul M

    2015-01-01

    Delirium occurs in the intensive care unit and identification is often performed using a validated assessment tool such as the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) patients. The CAM-ICU has three ratings: positive, negative, and unable to assess (UTA). Patients may often be assigned UTA when it is inappropriate given the level of sedation or medical condition. The purpose of this study is to evaluate the rate of inappropriate UTA CAM-ICU documentations. A single-center prospective observational analysis was performed evaluating CAM-ICU documentations from October 27, 2014, to December 26, 2014. Patients admitted to the medical and surgical ICU were included and excluded if admitted to the ICU for less than 24 h. CAM-ICU assessments were performed per institutional guidelines using CAM-ICU scoring as validated in literature. CAM-ICU patient documentations were recorded as positive, negative, UTA, or not assessed. Patients with an appropriate UTA documentation were deeply sedated, non-English speaking, or not medically able to participate in the assessment. The major endpoint assessed rates of inappropriate UTA CAM-ICU documentations. Minor endpoints evaluated adherence to CAM-ICU documentations and use of pharmacologic agents for symptoms of delirium. Sixty-one patients were identified with 45 (74 %) medical, 16 (26 %) surgical, of which 27 (44.3 %) were mechanically ventilated. There were 116 UTA documentations with 35 (30.2 %) identified as inappropriate. Of the 906 identified CAM-ICU documentation opportunities, adherence was 439 (48.5 %). Overall, 18 (29.5 %) of the 61 patients were administered pharmacologic agents for delirium management and 5 (27.7 %) had a positive CAM-ICU documented within 24 h. Rates of inappropriate UTA CAM-ICU documentations may be significantly higher than reported in literature. Additional research is needed to identify an acceptable rate of inappropriate UTA CAM-ICU assessments and its clinical impact

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

    PubMed

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

    2013-01-01

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

  18. Health Technology Assessment in the UK.

    PubMed

    Raftery, James; Powell, John

    2013-10-12

    In this Review, we discuss the UK's Health Technology Assessment programme, which is 20 years old in 2013. We situate the programme in the context of the UK landscape for evidence-based medicine, including in relation to the National Institute for Health and Care Excellence and as guidance to the National Health Service. We identify features that might be of value to other health systems as they confront the challenges of rapid innovation and rising costs. We use examples of recent studies to show the strengths and weaknesses of the programme. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    SciTech Connect

    Not Available

    1993-11-01

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

  20. 76 FR 58509 - Release of Risk and Exposure Assessment Planning Document for the Review of the National Ambient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... Air Quality Standards for Lead AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... Ambient Air Quality Standards for Lead: Risk and Exposure Assessment Planning Document (REA Planning... external review draft of the Integrated Science Assessment (ISA) for this review (Lead Integrated Science...

  1. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

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

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

    PubMed

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

    2016-06-01

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

  3. Assessing entrepreneurship in governmental public health.

    PubMed

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  4. Assessing Entrepreneurship in Governmental Public Health

    PubMed Central

    Wasserman, Jeffrey; Wu, Helen W.; Lauer, Johanna R.

    2015-01-01

    Objectives. We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Methods. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Results. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Conclusions. Ongoing PHE activity has the potential to reduce LHDs’ reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs’ current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative. PMID:25689182

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

    PubMed

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

    2016-05-04

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

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

    PubMed Central

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

    2016-01-01

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

  7. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    PubMed Central

    2011-01-01

    Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Methods Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP) was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend). Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p < 0.001). Also, documentation of repeated assessment was more frequent for low RTS categories of GCS, RR, and SBP (All: p < 0.001). Mechanism of injury was documented in 80% of cases by ground and 92% of cases by air ambulance. Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our

  8. Faculty perceptions of student documentation skills during the transition from paper-based to electronic health records systems.

    PubMed

    Mahon, Pamela Young; Nickitas, Donna M; Nokes, Kathleen M

    2010-11-01

    Nursing faculty perceptions of teaching undergraduate nursing students documentation skills using either paper-based or electronic health record systems were explored in this study. Twenty-five nursing faculty in a large urban public school of nursing were interviewed using a 13-item survey questionnaire. Responses were analyzed using the constant comparative method, and four major themes arose: teaching strategies; learning from experts; road from novice to expert; and legal, ethical, and institutional issues. Results demonstrate how faculty overcome myriad obstacles encountered while teaching clinical documentation processes. Self-efficacy theory, with its emphasis on knowledge, skills, and social context, describes how faculty are modeling behaviors necessary to succeed during this transition from paper to electronic documentation. The school of nursing is integrating the findings from this research to further informatics integration across the curricula, and ongoing research is planned to investigate issues of self-efficacy and student and clinical staff perceptions of teaching-learning clinical documentation.

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

    NASA Astrophysics Data System (ADS)

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

    2013-02-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

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

    PubMed

    Sharma, Jayendra

    2016-07-01

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

  12. 25 CFR 559.7 - May the Chairman request Indian lands or environmental and public health and safety documentation...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  13. Reliability assessment of home health care services.

    PubMed

    Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas

    2007-01-01

    In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN).

  14. How accessible was information about H1N1 flu? Literacy assessments of CDC guidance documents for different audiences.

    PubMed

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

    2011-01-01

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

  15. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  16. Assessing health impact assessment: multidisciplinary and international perspectives

    PubMed Central

    Krieger, N; Northridge, M; Gruskin, S; Quinn, M; Kriebel, D; Davey, S; Bassett, M; Rehkopf, D; Miller, C

    2003-01-01

    Health impact assessment (HIA) seeks to expand evaluation of policy and programmes in all sectors, both private and public, to include their impact on population health. While the idea that the public's health is affected by a broad array of social and economic policies is not new and dates back well over two centuries, what is new is the notion—increasingly adopted by major health institutions, such as the World Health Organisation (WHO) and the United Kingdom National Health Services (NHS)—that health should be an explicit consideration when evaluating all public policies. In this article, it is argued that while HIA has the potential to enhance recognition of societal determinants of health and of intersectoral responsibility for health, its pitfalls warrant critical attention. Greater clarity is required regarding criteria for initiating, conducting, and completing HIA, including rules pertaining to decision making, enforcement, compliance, plus paying for their conduct. Critical debate over the promise, process, and pitfalls of HIA needs to be informed by multiple disciplines and perspectives from diverse people and regions of the world. PMID:12933768

  17. Using health technology assessment for informing coverage decisions in Thailand.

    PubMed

    Mohara, Adun; Youngkong, Sitaporn; Velasco, Román Pérez; Werayingyong, Pitsaphun; Pachanee, Kumaree; Prakongsai, Phusit; Tantivess, Sripen; Tangcharoensathien, Viroj; Lertiendumrong, Jongkol; Jongudomsuk, Pongpisut; Teerawattananon, Yot

    2012-03-01

    This article aims to illustrate and critically analyze the results from the 1-year experience of using health technology assessment (HTA) in the development of the Thai Universal Coverage health benefit package. We review the relevant documents and give a descriptive analysis of outcomes resulting from the development process in 2009-2010. Out of 30 topics nominated by stakeholders for prioritization, 12 were selected for further assessment. A total of five new interventions were recommended for inclusion in the benefit package based on value for money, budget impact, feasibility and equity reasons. Different stakeholders have diverse interests and capabilities to participate in the process. In conclusion, HTA is helpful for informing coverage decisions for health benefit packages because it enhances the legitimacy of policy decisions by increasing the transparency, inclusiveness and accountability of the process. There is room for improvement of the current use of HTA, including providing technical support for patient representatives and civic groups, better communication between health professionals, and focusing more on health promotion and disease prevention.

  18. Mental health assessment of rape offenders.

    PubMed

    Sarkar, Jaydip

    2013-07-01

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

  19. Mental health assessment of rape offenders

    PubMed Central

    Sarkar, Jaydip

    2013-01-01

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Sum, Paul E.; Light, Steven Andrew

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  7. Historical development of health technology assessment in Thailand.

    PubMed

    Teerawattananon, Yot; Tantivess, Sripen; Yothasamut, Jomkwan; Kingkaew, Pritaporn; Chaisiri, Kakanang

    2009-07-01

    This study aims to review the development of health technology assessment (HTA), including the socioeconomic context, outputs, and policy utilization in the Thai setting. This study was conducted through extensive document reviews including these published in both domestic and international literature. Evidence suggests that contextual elements of the health system, especially the country's economic status and health financing reforms, as well as their effects on government budgeting for medical and public health services, played an important role in the increasing needs and demands for HTA information among policy makers. In the midst of substantial economic growth during the years 1982 to 1996, several studies reported the rapid diffusion and poor distribution of health technologies, and inequitable access to high-cost technology in public and private hospitals. At the same time, economic analysis and its underpinning concept of efficiency were suggested by groups of scholars and health officials to guide national policy on the investment in health technology equipment. Related research and training programs were subsequently launched. However, none of these HTA units could be institutionalized into national bodies. From 1997 to 2005, an economic recession, followed by the introduction of a universal health coverage plan, triggered the demands for effective measures for cost containment and prioritization of health interventions. This made policy makers and researchers at the Ministry of Public Health (MOPH) pay increasing attention to economic appraisals, and several HTA programs were established in the Ministry. Despite the rising number of Thai health economic publications, a major problem at that period involved the poor quality of studies. Since 2006, economic recovery and demands from different interests to include expensive technologies in the public health benefit package have been crucial factors promoting the role of HTA in national policy decisions

  8. Use of electronic health record structured text and its payoffs. The approach and barriers to using structured text in EHR to document care encounters.

    PubMed

    Benge, James; Beach, Thomas; Gladding, Connie; Maestas, Gail

    2008-01-01

    The Military Health System (MHS) deployed its electronic health record (EHR), AHLTA to Military Treatment Facilities (MTFs) around the world. This paper focuses on the approach and barriers to using structured text in AHLTA to document care encounters and illustrates the direct correlation between the use of structured text and achievement of expected benefits. AHLTA uses commercially available products, a health data dictionary and standardized medical terminology, enabling the capture of structured computable data. With structured text stored in the AHLTA Clinical Data Repository (CDR), the MHS has seen a return on its EHR investment with improvements in the accuracy and completeness of coding and the documentation of care provided. Determining the aspects of documentation where structured text is most beneficial, as well as the degree of structured text needed has been a significant challenge. This paper describes how the economic value framework aligns the enterprise strategic objectives with the EHR investment features, performance metrics and expected benefits. The framework analyses focus on return on investment calculations, baseline assessment and post-implementation benefits validation. Cost avoidance, revenue enhancements and operational improvements, such as evidence-based medicine and medical surveillance can be directly attributed to use structured text.

  9. Assessing the misrepresentation of health problems.

    PubMed

    Lanyon, Richard I

    2003-08-01

    Although respondent misrepresentation in many areas of psychological testing has been widely studied, little is available for evaluating misrepresentation during health-related psychological assessments. In this article, I report the empirical development and validation of such scales for 2 screening inventories: the Psychological Screening Inventory (the HPO scale; Lanyon, 1970, 1978) and the Multidimensional Health Profile (the HPE scale; Ruehlman, Lanyon, & Karoly, 1998a, 1998b, 1999). In each case, judges were asked to simulate the misrepresentation of health problems. Items were selected whose frequencies differed from normal responding; these items were screened for marked content irrelevance and further refined using data from additional respondents. Validation data showed that for both scales the group means for persons with genuine health problems were up to 1 SD above the normative mean, and the means for suspected and actual simulators were about 2 SDs higher than the health-problem groups.

  10. New approaches in human health risk assessment

    PubMed Central

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu). PMID:27974141

  11. National Built Environment Health Impact Assessment Model ...

    EPA Pesticide Factsheets

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

  12. National Built Environment Health Impact Assessment Model ...

    EPA Pesticide Factsheets

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

  13. Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY).

    PubMed

    Darcy, L; Enskär, K; Granlund, M; Simeonsson, R J; Peterson, C; Björk, M

    2015-05-01

    Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence. The ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young children's health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer. © 2014 John Wiley & Sons Ltd.

  14. Interlending and document supply trends in NHS North West health libraries 2003/2004 to 2006/2007.

    PubMed

    Glover, Steven William; Addison, John; Gleghorn, Colette; Aalai, Elham; Annis, Shan

    2009-03-01

    The Library and Information for Health Network North West (LIHNN) represents health libraries in Cheshire, Cumbria, Greater Manchester, Isle of Man, Lancashire, Merseyside and Wirral. LIHNN members take part in a regional co-operative network supporting interlending and document supply. Data were analysed over a 4-year period to identify trends and patterns. In addition, a literature review was conducted to compare trends seen in NHS libraries to those trends seen in other sectors and in other countries. RESULTS/TRENDS: Between 2003/2004 and 2006/2007 there was a significant drop in document supply activity reported by NHS North West libraries from 59 321 to 37 134 copies, representing a fall of 37.4%. During the same period, lending between libraries stayed constant. The NHS supplies a significant number of documents to its users and it is investigating a number of options to increase efficiencies. The observed fall in document supply activity has been reported in several sectors and has been attributed to a number of cofactors. Although the fall in document supply activity is expected to continue, a critical mass of information is likely to remain behind subscription barriers and this, in turn, will necessitate supply from external sources.

  15. Occupational Health Policies on Risk Assessment in Japan

    PubMed Central

    2010-01-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations. PMID:22953159

  16. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  19. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  1. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  2. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  3. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  4. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  6. Health technology assessment and thyroid surgery.

    PubMed

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

    2013-01-01

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

  7. Health technology assessment and thyroid surgery

    PubMed Central

    LUCCHINI, R.; SANGUINETTI, A.; MONACELLI, M.; TRIOLA, R.; AVENIA, S.; CONTI, C.; SANTOPRETE, S.; AVENIA, N.

    2013-01-01

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

  8. Advanced Health Assessment in Nurse Practitioner Programs.

    ERIC Educational Resources Information Center

    Kelley, Frances J.; Kopac, Catharine

    2001-01-01

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

  9. Watershed Health Assessment Tools Investigating Fisheries

    EPA Science Inventory

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

  10. Health Risk Assessment of Chemical Mixtures | Science ...

    EPA Pesticide Factsheets

    The implementation of Superfund requires a methodology for estimating health risk from multi-chemical contamination at ambient levels. Most often, the chemical composition of these mixtures is poorly characterized, exposure data are uncertain and toxicologic data on the known components of the mixture are limited. However, a potential human health hazard may exist and the U.S.EPA, state and local governments need to be able to assess the total hazard in order to make decisions on appropriate action. This report describes a procedure for assessing the risks from chemical mixtures that includes options when different kinds of data are available. Good-quality information on the mixture of concern or a similar mixture should always be used. Less desirable, but still useful approach, is to utilize data on components and their interactions. The quality of exposure and toxicity data must be determined and the uncertainties involved in each risk assessment must be thoroughly discussed. ater contamination is briefly discussed since it is of vital concern as the primary exposure medium for chemical mixtures. The methodology for estimating the human health risk from single chemicals, both carcinogens and systemic toxicants, is reviewed as it forms the basis for the assessment of mixtures. The Implementation of Superfund requires a methodology for estimating health risk from multi-chemical contamination at ambient levels. Most often, the chemical composition of these mix

  11. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

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

  12. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

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

  13. Watershed Health Assessment Tools Investigating Fisheries

    EPA Science Inventory

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

  14. Documenting organisational development in general practice using a group-based assessment method: the Maturity Matrix.

    PubMed

    Eriksson, Tina; Siersma, Volkert Dirk; Løgstrup, Louise; Buch, Martin Sandberg; Elwyn, Glyn; Edwards, Adrian

    2010-10-01

    The Maturity Matrix (MM) comprises a formative evaluation instrument for primary care practices to self-assess their degree of organisational development in a group setting, guided by an external facilitator. The practice teams discuss organisational development, score their own performance and set improvement goals for the following year. The objective of this project was to introduce a translated and culturally adapted version of the MM in Denmark, to test its feasibility, to promote and document organisational change in general practices and to analyse associations between the recorded change(s) and structural factors in practices and the factors associated with the MM process. MM was used by general practices in three counties in Denmark, in two assessment sessions 1 year apart. First rounds of MM visits were carried out in 2006-2007 in 60 practice teams (320 participants (163 GPs, 157 staff)) and the second round in 2007-2008. A total of 48 practice teams (228 participants (117 GPs; 111 staff) participated in both sessions. The MM sessions were the primary intervention. Moreover, in about half of the practices, the facilitator reminded practice teams of their goals by sending them the written report of the initial session and contacted the practices regularly by telephone reminding them of the goals they had set. Those practice teams had password-protected access to their own and benchmark data. Where the minimum possible is 0 and maximum possible is 8, the mean overall MM score increased from 4.4 to 5.3 (difference=0.9, 95%, CI 0.76 to 1.06) from first to second sessions, indicating that development had taken place as measured by this group-based self-evaluation method. There was some evidence that lower-scoring dimensions were prioritised and more limited evidence that the prioritisation and interventions between meetings were helpful to achieve changes. This study provides evidence that MM worked well in general practices in Denmark. Practice teams appeared

  15. Lifestyle Assessment: Helping Patients Change Health Behaviors

    PubMed Central

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

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

  16. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  17. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  18. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  19. Analysis of Prehospital Documentation of Injury-Related Pain Assessment and Analgesic Administration on the Contemporary Battlefield.

    PubMed

    Gerhardt, Robert T; Reeves, Patrick T; Kotwal, Russ S; Mabry, Robert L; Robinson, John B; Butler, Frank

    2016-01-01

    In addition to life-saving interventions, the assessment of pain and subsequent administration of analgesia are primary benchmarks for quality emergency medical services care which should be documented and analyzed. Analyze US combat casualty data from the Department of Defense Trauma Registry (DoDTR) with a primary focus on prehospital pain assessment, analgesic administration and documentation. Retrospective cohort study of battlefield prehospital and hospital casualty data were abstracted by DoDTR from available records from 1 September 2007 through 30 June 2011. Data included demographics; injury mechanism; prehospital and initial combat hospital pain assessment documented by standard 0-to-10 numeric rating scale; analgesics administered; and survival outcome. Records were available for 8,913 casualties (median ISS of 5 [IQR 2 to 10]; 98.7% survived). Prehospital analgesic administration was documented for 1,313 cases (15%). Prehospital pain assessment was recorded for 581 cases (7%; median pain score 6 [IQR 3 to 8]), hospital pain assessment was recorded for 5,007 cases (56%; median pain score5 [CI95% 3 to 8]), and 409 cases (5%) had both prehospital and hospital pain assessments that could be paired. In this paired group, 49.1% (201/409) had alleviation of pain evidenced by a decrease in pain score (median 4,, IQR 2 to 5); 23.5% (96/409) had worsening of pain evidenced by an increase in pain score (median 3, CI95 2.8 to 3.7, IQR 1 to 5); 27.4% (112/409) had no change; and the overall difference was an average decrease in pain score of 1.1 (median 0, IQR 0 to 3, p < 0.01). Time-series analysis showed modest increases in prehospital and hospital pain assessment documentation and prehospital analgesic documentation. Our study demonstrates that prehospital pain assessment, management, and documentation remain primary targets for performance improvement on the battlefield. Results of paired prehospital to hospital pain scores and time-series analysis demonstrate

  20. "Notable Documents."

    ERIC Educational Resources Information Center

    Government Publications Review, 1990

    1990-01-01

    This annotated bibliography lists 569 documents from local, state, provincial, and national governments and from international organizations that have been selected on the basis of their reference value and/or subject coverage. Topics covered include health sciences, business and economics, government and politics, social problems, education,…

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

    PubMed

    1992-02-14

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

  2. Rangeland resource trends in the United States: A technical document supporting the 2000 USDA Forest Service RPA Assessment

    Treesearch

    John E. Mitchell

    2000-01-01

    This report documents trends in America's rangelands as required by the Renewable Resources Planning Act of 1974. The Forest Service has conducted assessments of the rangeland situation for 30 years. Over this period, rangeland values and uses have gradually shifted from concentrating upon forage production and meeting increasing demand for red meat to a more...

  3. A Question of Authenticity: The Document-Based Question as an Assessment of Students' Knowledge of History

    ERIC Educational Resources Information Center

    Grant, S. G.; Gradwell, Jill M.; Cimbricz, Sandra K.

    2004-01-01

    In this article we consider the extent to which the Document-Based Question (DBQ) on the New York State Global History and Geography exam represents an authentic task. The DBQ seems like a significant step toward authenticity, especially when compared with traditional forced-choice assessments. Drawing on the characteristics of authentic tasks as…

  4. Assessment and Accountability in Higher Education. Proceedings Document (Sante Fe, New Mexico, December 5-7, 1989). ECS Working Papers.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO.

    The conference reported in this document was attended by representatives of seven states (Florida, Illinois, New Jersey, New Mexico, Tennessee, Virginia, and Washington). Participants focused on three key questions: (1) what are the issues and objectives behind assessment in each state? (2) what can be done regarding the implementation of…

  5. Assessing and Acknowledging Learning through Non-Accredited Community Adult Language, Literacy and Numeracy Programs: Support Document

    ERIC Educational Resources Information Center

    Dymock, Darryl; Billett, Stephen

    2008-01-01

    This Support Document was produced by the authors based on their research for the report, "Assessing and Acknowledging Learning through Non-Accredited Community Adult Language, Literacy and Numeracy Programs," and is an added resource for further information. There were five phases of this project: Phase 1 comprised further interrogation…

  6. Health on the Net Foundation: assessing the quality of health web pages all over the world.

    PubMed

    Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

    2007-01-01

    The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.

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

    PubMed Central

    Lock, K.; McKee, M.

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  9. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

    PubMed

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

    2014-05-01

    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P < .001). This improved to baseline levels by the late EHR period (46%, P = .28), although POTD in the cataract group remained worse than at baseline (64%, P < .001). There was a worsening in absolute mean documentation time in the early EHR period (16.7 minutes) vs paper baseline (7.5 minutes) (P < .001). This improved in the late EHR period (9.2 minutes) but remained worse than in the paper baseline (P < .001). While cataract procedures required more

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

    PubMed

    Leino, Antti

    2002-01-01

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

  11. Lake ecosystem health assessment: indicators and methods.

    PubMed

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

    2001-09-01

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

  12. Conceptual modeling for Prospective Health Technology Assessment.

    PubMed

    Gantner-Bär, Marion; Djanatliev, Anatoli; Prokosch, Hans-Ulrich; Sedlmayr, Martin

    2012-01-01

    Prospective Health Technology Assessment (ProHTA) is a new and innovative approach to analyze and assess new technologies, methods and procedures in health care. Simulation processes are used to model innovations before the cost-intensive design and development phase. Thus effects on patient care, the health care system as well as health economics aspects can be estimated. To generate simulation models a valid information base is necessary and therefore conceptual modeling is most suitable. Project-specifically improved methods and characteristics of simulation modeling are combined in the ProHTA Conceptual Modeling Process and initially implemented for acute ischemic stroke treatment in Germany. Additionally the project aims at simulation of other diseases and health care systems as well. ProHTA is an interdisciplinary research project within the Cluster of Excellence for Medical Technology - Medical Valley European Metropolitan Region Nuremberg (EMN), which is funded by the German Federal Ministry of Education and Research (BMBF), project grant No. 01EX1013B.

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

    PubMed

    1998-12-01

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

  14. Untapped potential of health impact assessment.

    PubMed

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

    2013-04-01

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

  15. Untapped potential of health impact assessment

    PubMed Central

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

    2013-01-01

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

  16. Assessment of Public Health Infrastructure to Determine Public Health Preparedness

    DTIC Science & Technology

    2006-03-01

    62 Confirmed Positive 39 92 42 Residences Abated 40 92 43 Rabies and Zoonosis Control 2 Animal Bite Investigation3 1,280 … … Pets...Shops Inspected 9 9 100 Notes: 1 LHER: Local Health Evaluation Report 2 Zoonosis : Diseases transmitted from animals to humans 3 Number of...5,984 5,984 Childhood Lead Poisoning Risk assessments 2 466 932 Residences abated 8 40 320 Rabies and Zoonosis Control 2 Animal

  17. A content analysis of Health Technology Assessment programs in Latin America.

    PubMed

    Arellano, Luis E; Reza, Mercedes; Blasco, Juan Antonio; Andradas, Elena

    2009-10-01

    Health Technology Assessment (HTA) is a relatively new concept in Latin America (LA). The objectives of this exploratory study were to identify HTA programs in LA, review HTA documents produced by those programs, and assess the extent to which HTA aims are being achieved. An electronic search through two databases was performed to identify HTA programs in LA. A content analysis was performed on HTA documents (n = 236) produced by six programs between January 2000 and March 2007. Results were analyzed by comparing document content with the main goals of HTA. The number of HTA documents increased incrementally during the study period. The documents produced were mostly short HTA documents (82 percent) that assessed technologies such as drugs (31 percent), diagnostic and/or screening technologies (18 percent), or medical procedures (18 percent). Two-thirds (66 percent) of all HTA documents addressed issues related to clinical effectiveness and economic evaluations. Ethical, social, and/or legal issues were rarely addressed (<1 percent). The two groups most often targeted for dissemination of HTA information were third-party payers (55 percent) or government policy makers (41 percent). This study showed that while HTA programs in LA have attempted to address the main goals of HTA, they have done so through the production of short documents that focus on practical high-technology areas of importance to two specific target groups. Clinical and economic considerations still take precedence over ethical, social, and/or legal issues. Thus, an integrated conceptual framework in LA is wanting.

  18. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... project. (h) An estimate of prospective cost distribution to the various State and Federal funding sources...) A personnel resource statement indicating availability of qualified and adequate staff, including a... implementation advance planning document activity costs, including but not limited to the following: (1) The cost...

  19. Use of the community assessment for public health emergency response to conduct community health assessments for public health accreditation.

    PubMed

    Conley, Ashley M; Vagi, Sara; Horney, Jennifer A

    2014-01-01

    A community health assessment (CHA) is a collaborative process of collecting and analyzing data to learn about the health status of a community. Community health assessments are also a requirement of public health accreditation for state and local health departments and of the Affordable Care Act for nonprofit hospitals. One element of a CHA is primary data collection. This article describes the use of the Community Assessment for Public Health Emergency Response (CASPER) method for primary data collection to meet public health accreditation requirements in 2 case study communities--Nashua, New Hampshire, and Davidson County, North Carolina; CASPER is a flexible and efficient method for the collection of population-based primary data in an urban or rural setting.

  20. Health Impact Assessment of Urban Development Project

    PubMed Central

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

    2016-01-01

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

  1. Health impact assessment of liquid biofuel production.

    PubMed

    Fink, Rok; Medved, Sašo

    2013-01-01

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

  2. Implementing 10 CFR 830 at the FEMP Silos: Nuclear Health and Safety Plans as Documented Safety Analysis

    SciTech Connect

    Fisk, Patricia; Rutherford, Lavon

    2003-06-01

    The objective of the Silos Project at the Fernald Closure Project (FCP) is to safely remediate high-grade uranium ore residues (Silos 1 and 2) and metal oxide residues (Silo 3). The evolution of Documented Safety Analyses (DSAs) for these facilities has reflected the changes in remediation processes. The final stage in silos DSAs is an interpretation of 10 CFR 830 Safe Harbor Requirements that combines a Health and Safety Plan with nuclear safety requirements. This paper will address the development of a Nuclear Health and Safety Plan, or N-HASP.

  3. Ethical perspectives on health technology assessment.

    PubMed

    ten Have, Henk

    2004-01-01

    This study analyses why ethical aspects play a minor role in health technology assessment (HTA) studies, even when comprehensive approaches of technology assessment are advocated. Technology is often regarded as a value-neutral tool. At the same time, bioethics is dominated by an engineering model. Ethical contributions to evaluation of medical technology should go beyond issues of application in clinical practice and focus also on the definition of problems, the demarcation of technical and nontechnical issues, and the morally problematic implications of technologies.

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

    ERIC Educational Resources Information Center

    Yaruss, J. Scott; Quesal, Robert W.

    2006-01-01

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

  5. Health technology assessment. Findings from the Section on Assessing Information Technologies for Health.

    PubMed

    Ammenwerth, E

    2006-01-01

    To summarize current excellent research in the field of health technology assessment. Synopsis of the articles selected for the IMIA Yearbook 2006. Five excellent articles representing the research in four different nations were selected for the IMIA Yearbook 2006 from three international peer reviewed journals. The best paper selection for the Yearbook section 'Assessing Information Technologies for Health' presents papers evaluating the benefit and side-effects of information technology in various settings. They clearly indicate that benefit of IT in health care can be achieved when the systems are appropriately designed, implemented and operated. Besides the presented quantitative studies, also qualitative study designs are of value to find unintended effects of IT, or to better explain found effects. IT evaluation supports a reflective practice on how health informatics influences health care, enabling the emergence of an evidence-based health informatics.

  6. The role of health impact assessment in advancing sustainable development in Latin America and the Caribbean.

    PubMed

    Drewry, Jonathan; Kwiatkowski, Roy

    2015-04-01

    The World Health Organization's (WHO's) Commission on Social Determinants of Health formally adopted Health Impact Assessment (HIA) more than a decade ago as a promising concept to address underlying health issues. Latin America and the Caribbean (LAC) remains one of the regions of the world with minimal application of HIA in public programs and policies. This special report documents the need for public mechanisms to incorporate HIA, the benefits from its application, and steps to promote its use. The authors discuss the role of HIA in the sustainable development of IAC to address social determinants of health.

  7. [Equity in health and health technology assessment in Chile].

    PubMed

    Espinoza, Manuel Antonio; Cabieses, Báltica

    2014-01-01

    Equity has been recognized as one of the driving principles of many health systems in the world. In Latin America, Chile has led the explicit inclusion of equity in their health policies, which is reflected in its recent health reform. On the other hand, Chile faces the challenge of defining and implementing a policy for health technology assessment (HTA), which should be consistent with the equity principles that underlie the Chilean national health system. This paper reviews the equity concept emphasizing the relevance of socioeconomic inequalities. Furthermore, it examines how international HTA agencies have explicitly included this element in the evaluation and decision processes. It presents the English case, which highlights the elements of procedural justice rather than adopting a normative position regarding equity. Finally, it examines the methods that have been developed aiming to make explicit consideration of equity in HTA. It concludes that the methodological development to incorporate equity elements with empirical basis is recent and limited. The consideration of equity is, in most of the cases, left to the instances of deliberative participation.

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

    SciTech Connect

    Hoffman, J.S.

    1987-12-01

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

  9. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  10. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  11. Applying Multiple Methods to Assess the Readability of a Large Corpus of Medical Documents

    PubMed Central

    Wu, Danny T.Y.; Hanauer, David A.; Mei, Qiaozhu; Clark, Patricia M.; An, Lawrence C.; Lei, Jianbo; Proulx, Joshua; Zeng-Treitler, Qing; Zheng, Kai

    2017-01-01

    Medical documents provided to patients at the end of an episode of care, such as discharge summaries and referral letters, serve as an important vehicle to convey critical information to patients and families. Increasingly, healthcare institutions are also experimenting with granting patients direct electronic access to other types of clinical narratives that are not typically shared unless explicitly requested, such as progress notes. While these efforts have great potential to improve information transparency, their value can be severely diminished if patients are unable to read and thus unable to properly interpret the medical documents shared to them. In this study, we approached the problem by contrasting the ‘readability’ of two types of medical documents: referral letters vs. other genres of narrative clinician notes not explicitly intended for direct viewing by patients. To establish a baseline for comparison, we also computed readability scores of MedlinePlus articles—exemplars of fine patient education materials carefully crafted for lay audiences. We quantified document readability using four different measures. Differences in the results obtained through these measures are also discussed. PMID:23920636

  12. A System for Assessing and Documenting the Experience of Pre/Inservice Teachers. 1983 Update.

    ERIC Educational Resources Information Center

    Spillman, Russell J.; And Others

    A panel discussion was held on the Student Information System (SIS) established at Ohio State University. The SIS was designed to: (1) document student experiences; (2) diagnose student progress in programs in order to fulfill general student advising and counseling functions; (3) collect data on students and programs for evaluation purposes; and…

  13. Women's self-assessed personal health resources.

    PubMed

    Malterud, K; Hollnagel, H

    1997-12-01

    To contribute to the development of a resource-oriented medical language by identifying self-assessed personal health resources in women. Key questions were developed to invite the patient to tell the general practitioner about such resources. Patients' answers were audiotaped and analysed qualitatively according to Giorgi's phenomenological approach. The theoretical frame of reference included salutogenesis, patient-centredness, and gender perspectives. Two female general practitioners and their consultations. 37 consecutive female patients aged 24-85 years. Common aspects of personal qualities and strategies considered by women as their health resources. The material unveiled health resources related to 1) internal strength mobilized by external strain, 2) interactive networks within and outside the family, 3) lifestyle practices, 4) physical and social activity, 5) acceptance and facilitation of the natural course of Disease, and 6) constitution. Female patients have explicit and intelligible ideas about their self-assessed personal health resources, which can be identified and mobilized by the general practitioner and form part of potentially empowering strategies in medical practice.

  14. Teaching health assessment in the virtual classroom.

    PubMed

    Lashley, Mary

    2005-08-01

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

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

    SciTech Connect

    1995-12-11

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

  16. Risk assessment and toxicology databases for health effects assessment

    SciTech Connect

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

    1990-12-31

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

  17. Quantifying Selection Bias in National Institute of Health Stroke Scale Data Documented in an Acute Stroke Registry.

    PubMed

    Thompson, Michael P; Luo, Zhehui; Gardiner, Joseph; Burke, James F; Nickles, Adrienne; Reeves, Mathew J

    2016-05-01

    As a measure of stroke severity, the National Institutes of Health Stroke Scale (NIHSS) is an important predictor of patient- and hospital-level outcomes, yet is often undocumented. The purpose of this study is to quantify and correct for potential selection bias in observed NIHSS data. Data were obtained from the Michigan Stroke Registry and included 10 262 patients with ischemic stroke aged ≥65 years discharged from 23 hospitals from 2009 to 2012, of which 74.6% of patients had documented NIHSS. We estimated models predicting NIHSS documentation and NIHSS score and used the Heckman selection model to estimate a correlation coefficient (ρ) between the 2 model error terms, which quantifies the degree of selection bias in the documentation of NIHSS. The Heckman model found modest, but significant, selection bias (ρ=0.19; 95% confidence interval: 0.09, 0.29; P<0.001), indicating that because NIHSS score increased (ie, strokes were more severe), the probability of documentation also increased. We also estimated a selection bias-corrected population mean NIHSS score of 4.8, which was substantially lower than the observed mean NIHSS score of 7.4. Evidence of selection bias was also identified using hospital-level analysis, where increased NIHSS documentation was correlated with lower mean NIHSS scores (r=-0.39; P<0.001). We demonstrate modest, but important, selection bias in documented NIHSS data, which are missing more often in patients with less severe stroke. The population mean NIHSS score was overestimated by >2 points, which could significantly alter the risk profile of hospitals treating patients with ischemic stroke and subsequent hospital risk-adjusted outcomes. © 2016 American Heart Association, Inc.

  18. 2008 Final Report: Integrated Science Assessment for Oxides of Nitrogen – Health Criteria

    EPA Science Inventory

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

  19. Heart Check: The Development and Evolution of an Organizational Heart Health Assessment.

    ERIC Educational Resources Information Center

    Golaszewski, Thomas; Fisher, Brian

    2002-01-01

    Documented the development, testing, and application of an organizational assessment tool for measuring employer support for heart health. The Heart Check inventory measured such factors as organizational foundations, administrative supports, stress management, and screening services. Data on diverse worksites throughout New York State indicated…

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

    EPA Science Inventory

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

  1. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (Final Report, Jul 2008)

    EPA Science Inventory

    The Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard f...

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

    EPA Science Inventory

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

  3. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (First External Review Draft, Sep 2007)

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  5. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (Second External Review Draft, May 2008)

    EPA Science Inventory

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

  6. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (Final Report, Jul 2008)

    EPA Science Inventory

    The Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard f...

  7. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (External Review Draft, Nov 2015)

    EPA Science Inventory

    EPA announced the availability of the external review draft of the Integrated Science Assessment for Sulfur Oxides– Health Criteria for public comment and independent peer review in a November 24, 2015 Federal Register Notice. This draft document provides EPA’s evaluati...

  8. National Assessment of Clinical Education of Allied Health Manpower: Volume IV: Bibliography.

    ERIC Educational Resources Information Center

    Booz Allen and Hamilton, Inc., Washington, DC.

    The document is the last volume of a four-part report of a study conducted to evaluate and assess the national state of clinical education and training of allied health manpower. It presents a bibliography of all significant clinical education materials, documentary materials and ongoing studies, through August 30, 1973 but after 1965. The…

  9. Heart Check: The Development and Evolution of an Organizational Heart Health Assessment.

    ERIC Educational Resources Information Center

    Golaszewski, Thomas; Fisher, Brian

    2002-01-01

    Documented the development, testing, and application of an organizational assessment tool for measuring employer support for heart health. The Heart Check inventory measured such factors as organizational foundations, administrative supports, stress management, and screening services. Data on diverse worksites throughout New York State indicated…

  10. Missouri Assessment Program (MAP), Spring 2000: High School Health/Physical Education, Released Items, Grade 9.

    ERIC Educational Resources Information Center

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

    This document presents 10 released items from the Health/Physical Education Missouri Assessment Program (MAP) test given in the spring of 2000 to ninth graders. Items from the test sessions include: selected-response (multiple choice), constructed-response, and a performance event. The selected-response items consist of individual questions…

  11. Missouri Assessment Program (MAP), Spring 2000: Elementary Health/Physical Education, Released Items, Grade 5.

    ERIC Educational Resources Information Center

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

    This document presents 10 released items from the Health/Physical Education Missouri Assessment Program (MAP) test given in the spring of 2000 to fifth graders. Items from the test sessions include: selected-response (multiple choice), constructed-response, and a performance event. The selected-response items consist of individual questions…

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  14. 2008 Final Report: Integrated Science Assessment for Oxides of Nitrogen – Health Criteria

    EPA Science Inventory

    The Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard f...

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

    EPA Science Inventory

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

  16. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (External Review Draft, Nov 2015)

    EPA Science Inventory

    EPA announced the availability of the external review draft of the Integrated Science Assessment for Sulfur Oxides– Health Criteria for public comment and independent peer review in a November 24, 2015 Federal Register Notice. This draft document provides EPA’s evaluati...

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2015-10-01

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

  20. [An assessment of fiscal space for public health in Peru].

    PubMed

    Matus-López, Mauricio; Toledo, Lorena Prieto; Pedraza, Camilo Cid

    2016-08-01

    Objective To assess the fiscal space for public health in Peru so as to attain the goal of raising health spending to 6% of gross domestic product, as agreed upon by member countries of the Pan American Health Organization in 2014. Methods The main sources of fiscal space were identified by means of a thorough literature review. Technical feasibility was determined from statistics and national and international surveys and by reviewing various documents and official reports. Political feasibility was ascertained by studying policy guidelines. Results The sources showing the greatest technical and political feasibility are economic growth, a broadening of the personal income tax base, and an increase in tobacco-specific taxes. Decreasing informality in the job market and increasing contributory coverage are considered to be less politically feasible, but there is ample technical space for these measures. Conclusions There is enough fiscal space to allow for an increase in public health spending. Nevertheless, the 6% target will be reached only if the timeline is extended, tax revenues are increased, and informality in the job market is reduced.

  1. Climate for evidence informed health system policymaking in Cameroon and Uganda before and after the introduction of knowledge translation platforms: a structured review of governmental policy documents.

    PubMed

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2015-01-01

    There is a scarcity of empirical data on African country climates for evidence-informed health system policymaking (EIHSP) to backup the longstanding reputation that research evidence is not valued enough by health policymakers as an information input.Herein, we assess whether and how changes have occurred in the climate for EIHSP before and after the establishment of two Knowledge Translation Platforms housed in government institutions in Cameroon and Uganda since 2006. We merged content analysis techniques and policy sciences analytical frameworks to guide this structured review of governmental policy documents geared at achieving health Millennium Development Goals. We combined i) a quantitative exploration of the usage statistics of research-related words and constructs, citations of types of evidence, and budgets allocated to research-related activities; and (ii) an interpretive exploration using a deductive thematic analysis approach to uncover changes in the institutions, interests, ideas, and external factors displaying the country climate for EIHSP. Descriptive statistics compared quantitative data across countries during the periods 2001-2006 and 2007-2012. We reviewed 54 documents, including 33 grants approved by global health initiatives. The usage statistics of research-related words and constructs showed an increase over time across countries. Varied forms of data, information, or research were instrumentally used to describe the burden and determinants of poverty and health conditions. The use of evidence syntheses to frame poverty and health problems, select strategies, or forecast the expected outcomes has remained sparse over time and across countries. The budgets for research increased over time from 28.496 to 95.467 million Euros (335%) in Cameroon and 38.064 to 58.884 million US dollars (155%) in Uganda, with most resources allocated to health sector performance monitoring and evaluation. The consistent naming of elements pertaining to the

  2. 30 CFR 218.41 - Assessments for failure to submit payment of same amount as Form MMS-2014 or bill document or to...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... documents remitted to MMS for an Indian tribe or allottee. If the payment is made by EFT, the reporter/payor... same amount as Form MMS-2014 or bill document or to provide adequate information. 218.41 Section 218.41... Assessments for failure to submit payment of same amount as Form MMS-2014 or bill document or to provide...

  3. Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting.

    PubMed

    Gardiner, Paula; Filippelli, Amanda C; Kabbara, Karim; Lin, Steven C; Sadikova, Ekaterina; Kaptchuk, Ted J; Kemper, Kathi

    2015-10-01

    Little is known about the feasibility of online education in improving communication and documentation of dietary supplements (DS) among clinicians. This prospective educational study included clinicians at an urban teaching hospital. The curriculum included video streams, didactics, and interactive case presentations to discuss (1) DS safety and effectiveness, (2) cultural competency, (3) managing DS in a hospital setting, and (4) DS adverse events. Participants were surveyed, at baseline and after training, about DS knowledge, confidence, communication, and documentation practices. Thirty-nine of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean DS knowledge test score increased after the curriculum (p < 0.0001), and the clinician confidence score also increased (p < 0.0001). Most (82%) participants reported that curriculum changed their use of evidence-based resources (p = 0.01). There was a change in the indications for symptom management (p = 0.05) and gastrointestinal/digestive health issues (p = 0.03). There were statistically significant increases in the frequency of asking patients about DS use during discharge (p = 0.01), and 82% responded that the curriculum changed their DS documentation. An online curriculum is an effective tool for presenting DS education to clinicians with the goal of improving clinicians' knowledge, confidence, and documentation practices about DS.

  4. Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting

    PubMed Central

    Filippelli, Amanda C.; Kabbara, Karim; Lin, Steven C.; Sadikova, Ekaterina; Kaptchuk, Ted J.; Kemper, Kathi

    2015-01-01

    Abstract Background: Little is known about the feasibility of online education in improving communication and documentation of dietary supplements (DS) among clinicians. Methods: This prospective educational study included clinicians at an urban teaching hospital. The curriculum included video streams, didactics, and interactive case presentations to discuss (1) DS safety and effectiveness, (2) cultural competency, (3) managing DS in a hospital setting, and (4) DS adverse events. Participants were surveyed, at baseline and after training, about DS knowledge, confidence, communication, and documentation practices. Results: Thirty-nine of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean DS knowledge test score increased after the curriculum (p < 0.0001), and the clinician confidence score also increased (p < 0.0001). Most (82%) participants reported that curriculum changed their use of evidence-based resources (p = 0.01). There was a change in the indications for symptom management (p = 0.05) and gastrointestinal/digestive health issues (p = 0.03). There were statistically significant increases in the frequency of asking patients about DS use during discharge (p = 0.01), and 82% responded that the curriculum changed their DS documentation. Conclusion: An online curriculum is an effective tool for presenting DS education to clinicians with the goal of improving clinicians' knowledge, confidence, and documentation practices about DS. PMID:26270001

  5. Future scenarios: a technical document supporting the Forest Service 2010 RPA Assessment

    Treesearch

    . USDA Forest Service.

    2012-01-01

    The Forest and Rangeland Renewable Resources Planning Act of 1974 (RPA) mandates a periodic assessment of the conditions and trends of the Nation's renewable resources on forests and rangelands. The RPA Assessment includes projections of resource conditions and trends 50 years into the future. The 2010 RPA Assessment used a set of future scenarios to provide a...

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

    PubMed Central

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

    2012-01-01

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

  7. Workflow viewpoints: Analysis of nursing workflow documentation in the electronic health record.

    PubMed

    Whittenburg, Luann

    2010-01-01

    This article amplifies the emphasis on organizational workflow reignited by the Institute of Medicine reports on healthcare quality. The analysis of nursing workflow is central to understanding the power of technology to modify the fundamental constructs of nursing practice. The aim is to understand the evolution of nursing workflow and the concept of workflow from the management and computer science perspectives used in electronic health records and computerized provider order entry. The understanding of the workflow models within health information disciplines may improve the model of nursing workflow underlying the implementation of electronic health record systems. The article follows the Walker and Avant evolutionary method of concept analysis.

  8. Real-world evaluation of the Resident Assessment Instrument-Mental Health assessment system.

    PubMed

    Urbanoski, Karen A; Mulsant, Benoit H; Willett, Peggie; Ehtesham, Sahar; Rush, Brian

    2012-11-01

    We evaluated the Resident Assessment Instrument-Mental Health (RAI-MH) assessment platform at a large psychiatric hospital in Ontario during the 3 years following its provincially mandated implementation in 2005. Our objectives were to document and consider changes over time in front-line coding practices and in indicators of data quality. Structured interviews with program staff were used for preliminary information-gathering on front-line coding practices. A retrospective data review of assessments conducted from 2005 to 2007 examined 5 quantitative indicators of data quality. There is evidence of improved data quality over time; however, low scores on the outcome scales highlight potential shortcomings in the assessment system's ability to support outcome monitoring. There was variability in implementation and performance across clinical programs. This evaluation suggests that the RAI-MH-based assessment platform may be better suited to longer-term services for severely impaired clients than to short-term, highly specialized services. In particular, the suitability of the RAI-MH for hospital-based addictions care should be re-examined. Issues of staff compliance and motivation and problems with assessment system performance would be highly entwined, making it inappropriate to attempt to allocate responsibility for areas of less than optimal performance to one or the other. The ability of the RAI-MH to perform well on clinical front lines is, in any case, essential for it to meet its objectives. Continued evaluation of this assessment platform should be a priority for future research.

  9. Pain Assessment in INTensive care (PAINT): an observational study of physician-documented pain assessment in 45 intensive care units in the United Kingdom.

    PubMed

    Kemp, H I; Bantel, C; Gordon, F; Brett, S J; Laycock, H C

    2017-06-01

    Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients' records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the South-East of England. Data were collected from 750 patients, reflecting the practice of 362 physicians. Nearly two-thirds of patients (n = 475, 64.5%, 95%CI 60.9-67.8%) received no physician-documented pain assessment during the 24-h study period. Just under one-third (n = 215, 28.6%, 95%CI 25.5-32.0%) received no nursing-documented pain assessment, and over one-fifth (n = 159, 21.2%, 95%CI 19.2-23.4)% received neither a doctor nor a nursing pain assessment. Two of the 45 ICUs used validated behavioural pain assessment tools. The likelihood of receiving a physician pain assessment was affected by the following factors: the number of nursing assessments performed; whether the patient was admitted as a surgical patient; the presence of tracheal tube or tracheostomy; and the length of stay in ICU. Physician-documented pain assessments in the majority of participating ICUs were infrequent and did not utilise recommended behavioural pain assessment tools. Further research to identify factors influencing physician pain assessment behaviour in ICU, such as human factors or cultural attitudes, is urgently needed. © 2017 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland.

  10. Document Monitor

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The charters of Freedom Monitoring System will periodically assess the physical condition of the U.S. Constitution, Declaration of Independence and Bill of Rights. Although protected in helium filled glass cases, the documents are subject to damage from light vibration and humidity. The photometer is a CCD detector used as the electronic film for the camera system's scanning camera which mechanically scans the document line by line and acquires a series of images, each representing a one square inch portion of the document. Perkin-Elmer Corporation's photometer is capable of detecting changes in contrast, shape or other indicators of degradation with 5 to 10 times the sensitivity of the human eye. A Vicom image processing computer receives the data from the photometer stores it and manipulates it, allowing comparison of electronic images over time to detect changes.

  11. [Indirect costs in health technology assessment].

    PubMed

    Jakubczyk, Michał; Wrona, Witold; Macioch, Tomasz; Golicki, Dominik; Niewada, Maciej; Hermanowski, Tomasz

    2010-01-01

    In the health technology assessment it is crucial to define the perspective of the analysis. When the societal perspective is chosen it is necessary to include all the costs incurred by the society, also the costs of lost productivity resulting from absence of sick employees from work or their reduced efficiency at work. The aim of this article is to present the notion of indirect costs, their importance in health technology assessment and the methods of calculation. The economic literature has been reviewed for the state of knowledge on indirect costs. Three methods of calculation are described: human capital method, friction cost method or health state valuation. Indirect costs in Western European countries can amount to more than half of total costs attributed to the illness and its treatment. In the literature there is no consensus regarding the proper method of indirect costs calculation. It is necessary to conduct further theoretical and empirical research in the area of indirect costs and enhance discussion among Polish pharmacoeconomists.

  12. Documenting good practices: scaling up the youth friendly health service model in Colombia.

    PubMed

    Huaynoca, Silvia; Svanemyr, Joar; Chandra-Mouli, Venkatraman C; Moreno Lopez, Diva Jeaneth

    2015-09-18

    Young people make up for 24.5 % of Latin America's population. Inadequate supply of specific and timely sexual and reproductive health (SRH) services and sexuality education for young people increases their risk of sexual and reproductive ill health. Colombia is one of the few countries in Latin America that has implemented and scaled up specific and differentiated health and SRH services-termed as its Youth Friendly Health Services (YFHS) Model. To provide a systematic description of the crucial factors that facilitated and hindered the scale up process of the YFHS Model in Colombia. A comprehensive literature search on SRH services for young people and national efforts to improve their quality of care in Colombia and neighbouring countries was carried out along with interviews with a selection of key stakeholders. The information gathered was analysed using the World Health Organization-ExpandNet framework (WHO-ExpandNet). In 7 years (2007-2013) of the implementation of the YFHS Model in Colombia more than 800 clinics nationally have been made youth friendly. By 2013, 536 municipalities in 32 departments had YFHS, resulting in coverage of 52 % of municipalities offering YHFS. The analysis using the WHO-ExpandNet framework identified five elements that enabled the scale up process: Clear policies and implementation guidelines on YFHS, clear attributes of the user organization and resource team, establishment and implementation of an inter-sectoral and interagency strategy, identification of and support to stakeholders and advocates of YFHS, and solid monitoring and evaluation. The elements that limited or slowed down the scale up effort were: Insufficient number of health personnel trained in youth health and SRH, a high turnover of health personnel, a decentralized health security system, inadequate supply of financial and human resources, and negative perceptions among community members about providing SRH information and services to young people. Colombia

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

    PubMed

    Kiefer, Stephan; Schäfer, Michael; Rauch, Jochen

    2012-01-01

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

  14. Mapping the route to medication therapy management documentation and billing standardization and interoperabilility within the health care system: meeting proceedings.

    PubMed

    Millonig, Marsha K

    2009-01-01

    To convene a diverse group of stakeholders to discuss medication therapy management (MTM) documentation and billing standardization and its interoperability within the health care system. More than 70 stakeholders from pharmacy, health information systems, insurers/payers, quality, and standard-setting organizations met on October 7-8, 2008, in Bethesda, MD. The American Pharmacists Association (APhA) organized the invitational conference to facilitate discussion on strategic directions for meeting current market need for MTM documentation and billing interoperability and future market needs for MTM integration into electronic health records (EHRs). APhA recently adopted policy that specifically addresses technology barriers and encourages the use and development of standardized systems for the documentation and billing of MTM services. Day 1 of the conference featured six foundational presentations on health information technology (HIT) trends, perspectives on MTM from the profession and the Centers for Medicare & Medicaid Services, health care quality and medication-related outcome measures, integrating MTM workflow in EHRs, and the current state of MTM operalization in practice. After hearing presentations on day 1 and having the opportunity to pose questions to each speaker, conference participants were divided into three breakout groups on day 2. Each group met three times for 60 minutes each and discussed five questions from the perspective of a patient, provider, or payer. Three facilitators met with each of the groups and led discussion from one perspective (i.e., patient, provider, payer). Participants then reconvened as a complete group to participate in a discussion on next steps. HIT is expected to assist in delivering safe, effective, efficient, coordinated care as health professionals strive to improve the quality of care and outcomes for individual patients. The pharmacy profession is actively contributing to quality patient care through MTM services

  15. Health Risk Assessment Approach for 2,3,7,8 ...

    EPA Pesticide Factsheets

    2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is one of the most toxic and environmentally stable pollutants. In addition to various toxic effects, TCDD has been found to cause teratogenic, fetocidal, reproductive and carcinogenic effects in animals. In humans it adversely affects various organ systems and is probably carcinogenic as well. The report documents the methodologies utilized by the United States Environmental Protection Agency in its development of health risk assessment from exposure to TCDD. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is one of the most toxic and environmentally stable pollutants. In addition to various toxic effects, TCDD has been found to cause teratogenic, fetocidal, reproductive and carcinogenic effects in animals. In humans it adversely affects various organ systems and is probably carcinogenic as well.

  16. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    PubMed

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network.

  17. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context

    PubMed Central

    Gibaud, Bernard; Le Bouquin Jeannès, Régine

    2016-01-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners’ information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network. PMID:27222729

  18. Implementation of a standards-based anaesthesia record compliant with the health level 7 (HL7) clinical document architecture (CDA).

    PubMed

    Hurrell, M J; Monk, T G; Nicol, A; Norton, A N; Reich, D L; Walsh, J L

    2012-08-01

    With the increasing use of anaesthesia information management systems (AIMS) there is the opportunity for different institutions to aggregate and share information both nationally and internationally. Potential uses of such aggregated data include outcomes research, benchmarking and improvement in clinical practice and patient safety. However, these goals can only be achieved if data contained in records from different sources are truly comparable and there is semantic inter-operability. This paper describes the development of a standard terminology for anaesthesia and also a Domain Analysis Model and implementation guide to facilitate a standard representation of AIMS records as extensible markup language documents that are compliant with the Health Level 7 Version 3 clinical document architecture. A representation of vital signs that is compliant with the International Standards Organization 11073 standard is also discussed.

  19. Developing tools for health impact assessment in environmental impact assessment in Thailand.

    PubMed

    Hengpraprom, Sarunya; Sithisarankul, Pornchai

    2011-04-01

    The purpose of this research was to develop tools applicable to the Health Impact Assessment (HIA) in Environmental Impact Assessment (EIA) in a Thai context. The relevant documents and articles were extensively reviewed, analyzed, and drafted. The first draft was presented to a research advisory committee for their review, and the recommended changes were subsequently made. The second draft was then presented to respondents from 6 groups of key stakeholders-expert review committees under the Office of Natural Resources and Environmental Policy and Planning (ONREPP), EIA registered consulting firms, non-government organizations, members of the ONREPP, local government organizations, and government organizations responsible for issuing permission to the proposed projects. Their commentary and recommendation were considered, and modifications were made as necessary. The third draft was finally reviewed by the research advisory committee before the tryout step. The final revised version is presented in this paper.

  20. Health Impact Assessment of Urban Waterway Decisions

    PubMed Central

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

    2014-01-01

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

  1. Assessing Hmong Farmers’ Safety and Health

    PubMed Central

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

    2014-01-01

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

  2. Miniature Biosensor with Health Risk Assessment Feedback

    NASA Technical Reports Server (NTRS)

    Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

    2016-01-01

    Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

  3. Economic assessment of animal health performance.

    PubMed

    Galligan, David

    2006-03-01

    This article describes the fundamental principles of economic assessment of animal health performance in the modem animal production environment. Animal production is a complex system of combined inputs (eg, physical inputs, managerial decision choices) into a production process that produces products valued by society. Perturbations to this system include disease processes and management inefficiencies. Economic valuation of these perturbations must account for the marginal changes in revenues and cost, the time dimensions of occurrence, the inherent risk characteristics of biologic systems, and any opportunity value that exists that allows management to intervene within the process and make economically influencing decisions. It has been recognized that improving animal health can play a major role in achieving efficient and economically rewarding production.

  4. Assessing Hmong farmers' safety and health.

    PubMed

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

    2014-05-01

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

  5. [Assessment of quality of pre- and postoperative information documents about carpal tunnel syndrome].

    PubMed

    Facca, S; Sauleau, E; Robert, E; Gouzou, S; Clavert, P; Liverneaux, P

    2014-02-01

    Before surgery for carpal tunnel syndrome, oral patient information is partially understood and accepted. The objective of this study was to perform a documentation for patients, as recommended by the High Authority in Healthcare (HAS), then to compare the effectiveness of oral information. Our series included 37 patients who received the same information: preoperative shower, pathophysiology, and postoperative instructions. The first 18 (group 1) received only oral information. The following 19 (group 2) received oral, written and visual information. The information in Group 2 followed the methodology of McClune: promoter (Department of Hand Surgery), organizing committee (two teachers from the School of Decorative Arts, two teachers of the School of Medicine), group work (five art students, five medical students), panel of experts (three surgeons, two occupational therapists, one physiotherapist). Four documents were developed: a booklet, a diagram, an animation, a poster. Satisfaction was higher in group 2. Understanding and memorization were better in group 2. Fifty-six percent of patients in group 1 would have liked a paper, 12.5% videos, none went on the Internet. Twelve and a half percent of the patients in group 2 went on the Internet, 18.8% would have liked videos. Our results show that in terms of carpal tunnel syndrome, the written and visual information materials for patients significantly improve the efficacy of oral information. These documents may be extended to other pathologies in Hand Surgery. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. An assessment strateqy whose time has come for documenting competency in dental education and beyond.

    PubMed

    Gadbury-Amyot, Cynthia C

    2010-01-01

    The Institute of Medicine report on dental education in the mid-1990s called specific attention to the need for authentic assessment of student progress and outcomes. This corresponded with the advent of competency-based dental education, resulting in recognition of the need for new methods to assess dental students knowledge, skills, and values in the context of beginning independent dental practice. The portfolio approach to assessment uses a rich collection of cumulative evidence from multiple sources in ways that address this need. Because students take some responsibility for maintaining their portfolios, the competency of reflective critical thinking can also be assessed by means of portfolios.

  7. Baseline assessment of public health informatics competencies in two Hudson Valley health departments.

    PubMed

    Cunningham, Diana J; Ascher, Marie T; Viola, Deborah; Visintainer, Paul F

    2007-01-01

    Information technology has the capability to improve the way public health is practiced. Realization of this potential is possible only with a workforce ready to utilize these technologies. This project team assessed informatics competencies of employees in two county departments of health. The goal was to determine the status quo in terms of informatics competencies by surveying current levels of proficiency and relevance, and identify areas of needed training. A survey was adapted from the recommendations of a Working Group document by the Centers for Disease Control and Prevention and administered to all employees in the two health departments. Respondents evaluated proficiency and relevance for each of 26 recommended competencies. A gap score was generated between these two measures; results were compared to the recommendations of the Working Group. The following data for each job level are presented: mean gap scores by competency class; the percentage of respondents demonstrating a gap in the competencies reported to be most relevant; and the percentage of respondents meeting the target recommendations of the Working Group. The percentage of respondents who reached the targets was low in higher-level staff. And overall, employees reported low levels of relevance for most of the competencies. The average public health employee does not feel that prescribed informatics competencies are relevant to their work. Before the public health system can take advantage of information technology, relevant employee skills should be identified or developed. There needs to be a shift in thinking that will recognize the promise of information technology in everyday work.

  8. Managing Air Quality - Human Health, Environmental and Economic Assessments

    EPA Pesticide Factsheets

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  9. Using rangeland health assessment to inform successional management

    USDA-ARS?s Scientific Manuscript database

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

  10. Antimicrobial Exposure Assessment Task Force II (AEATF II) Volume 5: Governing Document for a Multi-Year Antimicrobial Chemical Exposure Monitoring Program (interim draft document with changes)

    EPA Pesticide Factsheets

    This document describes the overall scope of the AEATF II program, demonstrates the need for additional human exposure monitoring data and explains the proposed methodology for the exposure monitoring studies proposed for conduct by the AEATF II.

  11. AIR QUALITY CRITERIA DOCUMENT(S) FOR LEAD

    EPA Science Inventory

    This collection of documents intend to assess the latest scientific information on the health and environmental fate and effects of lead to provide scientific bases for periodic review and possible revision of the National Ambient Air Quality Standards (NAAQS) for lead.

  12. Environmental, health and safety assessment of photovoltaics

    NASA Technical Reports Server (NTRS)

    Rose, E. C.

    1983-01-01

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

  13. Mobile technology for mental health assessment.

    PubMed

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

    2016-06-01

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

  14. Mobile technology for mental health assessment

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2013-06-01

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

  16. Exploring the (Un-) Usefulness of Mandatory Assessment Documents in Primary Technology

    ERIC Educational Resources Information Center

    Hartell, Eva

    2014-01-01

    Every student in the Swedish compulsory school system is entitled to information regarding their progress in all school subjects given. In 2008, a mandatory assessment tool, called the individual development plan (IDP) with written assessment, was introduced by the Government. The statutory purpose was to provide teachers with a formative…

  17. BASINS 4.0 CLIMATE ASSESSMENT TOOL (CAT): SUPPORTING DOCUMENTATION AND USER'S MANUAL (FINAL REPORT)

    EPA Science Inventory

    The U.S. Environmental Protection Agency’s Global Change Research Program (GCRP) is an assessment-oriented program within the Office of Research and Development that focuses on assessing how potential changes in climate and other global environmental stressors may impact water qu...

  18. Accuracy Assessment of Point Clouds Geo-Referencing in Surveying and Documentation of Historical Complexes

    NASA Astrophysics Data System (ADS)

    Fryskowska, A.

    2017-05-01

    Terrestrial Laser Scanning (TLS) technique is widely used for documentation and preservation of historical sites by for example creating three-dimensional (3-D) digital models or vectorial sketches. In consequence, a complex, complete, detail and accurate documentation of historical structure is created. It is very crucial when it comes about modern digital culture. If we acquire TLS data of once particular structure usually we do it in local coordinate system of scanner. Nevertheless when measurements are conducted for complex of several historical buildings or monuments (i.e. castle ruins, building of narrow streets of the Old Towns), the registration of point clouds into a common, global coordinate system is one of the critical steps in TLS data processing. Then we have integrate data with different accuracy level. Inner accuracy of local coordinate system (scanner system) is usually thrice higher than for global coordinate systems measurement. The paper describes the geometric quality of the direct georeferencing in post-processing, considering surveying points. Then, an analysis of factors affecting registration accuracy is proposed. Finally, an improvement of direct georeferencing technique is presented and examined. Furthermore, registered data and chosen orientation methods have been compared to each other.

  19. A critical review of population health literacy assessment.

    PubMed

    Guzys, Diana; Kenny, Amanda; Dickson-Swift, Virginia; Threlkeld, Guinever

    2015-03-04

    Defining health literacy from a public health perspective places greater emphasis on the knowledge and skills required to prevent disease and for promoting health in everyday life. Addressing health literacy at the community level provides great potential for improving health knowledge, skills and behaviours resulting in better health outcomes. Yet there is a notable absence of discussion in the literature of what a health literate population looks like, or how this is best assessed. The emphasis in assessing health literacy has predominantly focused on the functional health literacy of individuals in clinical settings. This review examines currently available health literacy assessment tools to identify how well suited they are in addressing health literacy beyond clinical care settings and beyond the individual. Although public health literature appears to place greater emphasis on conceptualizing critical health literacy, the focus continues to remain on assessing individuals, rather than on health literacy within the context of families, communities and population groups. When a population approach is adopted, an aggregate of individual health literacy assessment is generally used. Aggregation of individual health literacy fails to capture the dynamic and often synergistic relationships within communities, and fails to reflect societal influences on health knowledge, beliefs and behaviours. We hypothesise that a different assessment framework is required to adequately address the complexities of community health literacy. We assert that a public health approach, founded on health promotion theories provides a useful scaffold to assess the critical health literacy of population groups. It is proposed that inclusion of community members in the research process is a necessary requirement to coproduce such an appropriate assessment framework. We contend that health literacy assessment and potential interventions need to shift to promoting the knowledge and skills

  20. Health Impact Assessments and Extreme Weather-Challenges for Environmental Health.

    PubMed

    Kintziger, Kristina; Ortegren, Jason; DuClos, Chris; Jordan, Melissa; Smith, Talia; Foglietti, Rebecca; Merritt, Robert; Donado, Louviminda

    The Florida Department of Health, Environmental Public Health Tracking Program, in collaboration with the Escambia County Health Department and the University of West Florida, used the Health Impact Assessment Framework to examine adverse health outcomes that may be related to an extreme flood event in Pensacola, Florida (Escambia County) during April 29 to May 3, 2014. In this 2014 flood event, portions of Pensacola received more than 15.5 in of rain in a single day. Infrastructure impacts from this extreme event included destroyed bridges and roads and the failure of many sewage lift stations. To determine whether there were associated increases in injury, illness, and death, data on reportable diseases, hospitalizations, emergency department (ED) visits, and deaths that occurred during the impact period in 2014 were compared with a control period in 2008. We used an ecological design to compare impact and control periods and examined the proportion of hospitalizations, ED visits, and deaths potentially attributable to the extreme flood event. The results of this comparison were mixed, with some Escambia County zip codes showing increased hospitalizations and ED visits, and some zip codes showing a decrease. However, countywide, there were increases in the proportion of both injury- and respiratory-related hospitalizations and ED visits during the impact period. It is challenging to characterize human health impacts from natural disasters such as extreme floods. Still, it is believed that specific policy changes could result in fewer health impacts during future flood events. For example, this study recommended raising the electric panels on lift stations above the flood elevation to keep them operational during extreme rainfall events. For more maps and tables, consult the complete project report available online at http://www.floridatracking.com/HealthTrackFL/document/Escambia_HIA_Report.pdf.