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Sample records for health integrating radiative

  1. RADIATION INTEGRATOR

    DOEpatents

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

    1959-02-17

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

  2. Healthful radiation.

    PubMed

    Agard, E T

    1997-01-01

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

  3. Healthful radiation

    SciTech Connect

    Agard, E.T.

    1997-01-01

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

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

    SciTech Connect

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

    2014-07-15

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

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

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  6. Radiation and health*

    PubMed Central

    Lindell, B.

    1987-01-01

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

  7. Radiation and Health

    NASA Astrophysics Data System (ADS)

    Evans, Albert; Blanchard, Karen

    2007-10-01

    This is a shortened version of the Science Teachers' Workshop offered free of charge to primary and secondary teachers at a location of their choice, covering fundamentals of nuclear radiation, natural and man-made sources of radiation, biological effects and risks to health, radioactive waste management, and radiation safety management and regulation. The course includes a hands-on demonstration of use of Geiger Counters, which are given without cost to participants for use in their classes. A CD and notebook of class material are issued to each student. Lunch will be provided.

  8. Radiation and Health

    NASA Astrophysics Data System (ADS)

    Evans, Albert E.

    2008-03-01

    This is a shortened version of the Science Teachers' Workshop offered free of charge to primary and secondary teachers at a location of their choice, covering fundamentals of nuclear radiation, natural and man-made sources of radiation, biological effects and risks to health, radioactive waste management, and radiation safety management and regulation. The course includes a hands-on demonstration of use of Geiger Counters, which are given without cost to participants for use in their classes. A CD and notebook of class material are issued to each student. Lunch will be provided. Limited to 20 participants.

  9. Radiation health research, 1986 - 1990

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  10. Environmental integrity, racism, health.

    PubMed

    Westra, L

    1996-05-17

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

  11. A contemporary case study illustrating the integration of health information technologies into the organisation and clinical practice of radiation oncology.

    PubMed

    Miller, Alexis Andrew; Phillips, Aaron K

    2006-01-01

    The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess, also known as the Siemens LANTIS) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred. The difficulties that were faced, which included procedural re-design, management of change, removal of paper, implementation cost, integration with the HIS, quality assurance and datasets, are highlighted along with the local solutions developed to overcome these problems.

  12. Integrated structural health monitoring.

    SciTech Connect

    Farrar, C. R.

    2001-01-01

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

  13. Real Time Radiation Exposure And Health Risks

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  14. Integral Radiator and Storage Tank

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  15. Integrated health programmes.

    PubMed

    Knowles, J

    1995-04-01

    Over a period of 10 years, a hospital in rural Africa slowly built an integrated primary and secondary health care program to the point where it has more than 40 elements. In its initial stage (1982-84), hospital staff and community participants were trained, the number of mobile clinics was increased, community participation was sought, and health education was emphasized. During 1985-86, 92 village health committees were organized with 70 trained Village Health Workers (VHWs). This led to a rapid increase in vaccination rates, the use of oral rehydration therapy, and training of traditional birth attendants. In 1987-88, 14 VHW were trained to use basic medical kits and distribute medicines. By 1990, 18,000 of the 72,000 outpatient treatments were administered by VHWs. In 1987, the hospital made a community diagnosis and increased the size of its advisory board (which became 60% female). Because the community identified food, water, and poverty as its priorities, the hospital took steps to improve the food supply, the water supply, and the financial position of the women. In 1989-90, the primary health care (PHC) project added the components of family planning, a weaning food production unit, food coupons, food for work, grain banks, a trust fund, literacy classes, health stamps, a mobile malnutrition clinic, subsidized fertilizer and seed, low-cost care for victims of AIDS, new malaria treatment schedules, and a housing association. The PHC program has resulted in a reduction in under-five deaths from the national average of 330/1000 to 145/1000 (other areas have reduced deaths to 270-300/1000. The program is also becoming increasingly cost-effective, costing about 6 pounds per capita over 10 years for a population of 50,000. Country-wide implementation of the PHC program would require only 30% of the present health budget.

  16. The NASA Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Schimmerling, W.

    1991-01-01

    The NASA program for determining the impact of cosmic radiation on health is described in terms of its long-term goal of reducing the uncertainty of radiation-model prediction to +/- 25 percent by 2010. The Space Radiation Health Program (SRHP) is intended to address fundamental issues for establishing a scientific basis for human radiation protection: (1) the prediction of the probability of biological effects from radiation; (2) the reduction of uncertainty in predicted highly charged energetic particles; and (3) the characterization of background flux from Galactic cosmic rays. Another key objective is to develop related technologies for ground- and space-based solar monitoring to predict events involving solar energetic particles. Although substantial uncertainties are involved in the prediction of such events, the SRHP is essential for determining crucial variables related to launching mass and humans into orbit.

  17. Space radiation health program plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  18. The NASA Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Schimmerling, Walter

    1991-01-01

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

  19. An Integrative Approach to Health

    PubMed Central

    HARRIS, KATHLEEN MULLAN

    2010-01-01

    In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental, and physical well-being; for studying health among the young as an important marker for future health and well-being across the life course; and for understanding health disparities among the young as both causes and consequences of social stratification. An integrative approach bridges biomedical sciences with social and behavioral sciences by understanding the linkages between social, behavioral, psychological, and biological factors in health. It is furthermore vital that integration occur in all steps of the research process: in theory, design, data collection, and analysis. I use the National Longitudinal Study of Adolescent Health, or Add Health, as an example of an integrative approach to health and of the importance of adolescence and the transition to adulthood years for setting health trajectories into adulthood. Evidence is also presented on the linkages between health trajectories during adolescence and the transition to adulthood and social stratification in adulthood. PMID:20355681

  20. [Health effects of ultraviolet radiation].

    PubMed

    Ohnaka, T

    1993-01-01

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

  1. Solar radiation and human health

    NASA Astrophysics Data System (ADS)

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

    2011-06-01

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

  2. Intelligent Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2012-01-01

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

  3. [Health disorders caused by radiation].

    PubMed

    Frischauf, H

    1984-01-01

    The rapid development and distribution of radiation sources has given rise to an "Energy Pollution" paralleling the chemical contamination of the environment. It has become necessary to establish limits for the "non-ionizing radiation" as well as for the ionizing radiation to which attention has been given for a long time. The non-ionizing radiation now includes the non-ionizing electromagnetic waves - radio frequency, micro waves, optical radiation - and ultrasound. Specific effects of these different radiation qualities caused by variation in biochemical and biophysical characteristics of tissues as well as the related biological changes and the mechanism of radiation effects are discussed shortly. Some commonly occurring radiation sources are quoted.

  4. Valuing ecosystem integrity and health

    SciTech Connect

    Rolston, H. III

    1995-12-31

    There is widespread concern for valuing ecosystem integrity and health, in Congressional legislation, in policy for ecosystem management, sustainable development, and environmental quality. Both integrity and health are combined fact-value words that significantly mix science and advocacy. Science orients policy, though policy also orients science. Recent ecological science raises questions about the mix of stability and historical change in ecosystems, about how structure and process combine to form biotic communities, about order and disorder in natural systems, and the scales on which these occur. Concern for sustainable development mixes the concern for a sustainable biosphere. Ecosystem integrity and health require much restoration of degraded environments, but restoration goals also mix science and values. A traditional attitude toward nature as resources to be for several centuries, is being challenged by an attitude toward nature as resources to be managed by sound scientific management, increasingly successful for several centuries, is being challenged by an attitude of responsibility for harmonizing culture with nature. This will require an unprecendented mix of science, ethics, and policy in the century ahead. It would be a tragic failure of human culture, especially of modern scientifically advanced culture, if it were further to degrade the integrity, health, and biodiversity achieved over many millennia, leaving a still more depauperate Earth. Homo sapiens, improverishing people and the planet, would not be the {open_quotes}wise{close_quotes} species at all.

  5. Integrated Solar Concentrator and Shielded Radiator

    NASA Technical Reports Server (NTRS)

    Clark, David Larry

    2010-01-01

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

  6. Integrator Circuitry for Single Channel Radiation Detector

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

  7. Radiation Safety among Workers in Health Services.

    PubMed

    Jones, Eric; Mathieson, Kathleen

    2016-05-01

    The purpose of this study was to survey health service workers regarding their radiation safety knowledge and practice. Participants were health service workers (n = 721) who received an anonymous online survey by email to test their radiation safety knowledge. A knowledge test of 15 questions was completed by 412 respondents. The overall average percent correct was 77.9%. Health physicists/medical physicists had the highest average percent score (93.5%), while physician assistants scored the lowest (60.0%). Of all the respondents, only 64.0% reported they participated in periodic radiation safety training at their place of employment. The most common topic selected where participants wanted additional training was in biological effects of radiation (41.0%). In conclusion, radiation safety training and education needs to be developed and planned effectively. Areas or specialties with poor radiation safety knowledge need to be addressed with corresponding safety measures. PMID:27023151

  8. An integrated radiation physics computer code system.

    NASA Technical Reports Server (NTRS)

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

    1972-01-01

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

  9. Health Effects of UV Radiation

    MedlinePlus

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  10. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.; Patel, Zarana S.; Simonsen, Lisa C.

    2014-01-01

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

  11. Ultraviolet Radiation: Human Exposure and Health Risks.

    ERIC Educational Resources Information Center

    Tenkate, Thomas D.

    1998-01-01

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

  12. Progress in radiation immune thermionic integrated circuits

    SciTech Connect

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

    1985-08-01

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

  13. Space radiation health research, 1991-1992

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  14. Space radiation health: a brief primer.

    PubMed

    Todd, Paul

    2003-06-01

    The goals of space radiation health research are to understand qualitatively and quantitatively the ionizing radiations present in the space environment, identify qualitatively and quantitatively the risks associated with these radiations, and discover countermeasures to mitigate these risks. The articles that follow address each of these three components of space radiation health research. This article introduces the basic science and definitions underlying radiation health research and protection. Space radiations consist of energetic protons from the sun, protons and electrons from the sun that are trapped in the Earth's magnetic field, and cosmic rays that include energetic nuclei of H, He, C, N, O and Fe atoms. The risks presented to space travelers by these radiations include cancer due to protons and cosmic-ray exposure, immune failure due to high-dose solar proton storms, and possible neurological effects caused by single tracks of cosmic-ray heavy nuclei. Potential countermeasures include shielding, medication consisting of radical scavengers, anti-oxidant consumption, cytokines, and cell transplants. PMID:12959125

  15. Health effects of prenatal radiation exposure.

    PubMed

    Williams, Pamela M; Fletcher, Stacy

    2010-09-01

    Pregnant women are at risk of exposure to nonionizing and ionizing radiation resulting from necessary medical procedures, workplace exposure, and diagnostic or therapeutic interventions before the pregnancy is known. Nonionizing radiation includes microwave, ultrasound, radio frequency, and electromagnetic waves. In utero exposure to nonionizing radiation is not associated with significant risks; therefore, ultrasonography is safe to perform during pregnancy. Ionizing radiation includes particles and electromagnetic radiation (e.g., gamma rays, x-rays). In utero exposure to ionizing radiation can be teratogenic, carcinogenic, or mutagenic. The effects are directly related to the level of exposure and stage of fetal development. The fetus is most susceptible to radiation during organogenesis (two to seven weeks after conception) and in the early fetal period (eight to 15 weeks after conception). Noncancer health effects have not been detected at any stage of gestation after exposure to ionizing radiation of less than 0.05 Gy (5 rad). Spontaneous abortion, growth restriction, and mental retardation may occur at higher exposure levels. The risk of cancer is increased regardless of the dose. When an exposure to ionizing radiation occurs, the total fetal radiation dose should be estimated and the mother counseled about the potential risks so that she can make informed decisions about her pregnancy management.

  16. Biological countermeasures in space radiation health

    NASA Technical Reports Server (NTRS)

    Kennedy, Ann R.; Todd, Paul

    2003-01-01

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

  17. Biological countermeasures in space radiation health.

    PubMed

    Kennedy, Ann R; Todd, Paul

    2003-06-01

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

  18. Biological countermeasures in space radiation health.

    PubMed

    Kennedy, Ann R; Todd, Paul

    2003-06-01

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

  19. [Integration of the delivery of health services].

    PubMed

    Frenk, J

    1992-01-01

    In Mexico the Constitution defines the right to health care as a social right and, as such, confers to the state the guiding role in the access of the population to health services. Unfortunately, this constitutional principle has not been fully met. One of the reasons for this is the fragmentation of public action in health and the continuous postponement of the integration of health services. In this paper the conceptual and practical limits of integration of health services are discussed, using as starting point a brief diagnosis of inequity and fragmentation of the health system in Mexico. The doctrinaire principles of integration are also described, as well as its practical advantages and disadvantages. Finally, a typology of forms of integration and previous integration experiences in Mexico are discussed. In the concluding remarks the integration prospects for Mexico are analyzed. PMID:1411782

  20. Space Radiation and its Associated Health Consequences

    NASA Technical Reports Server (NTRS)

    Wu, Honglu

    2007-01-01

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

  1. Radiation, chemicals, and occupational health research

    SciTech Connect

    Turner, J.E.

    1984-01-01

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

  2. Has radiation protection become a health hazard?

    SciTech Connect

    Rockwell, T.

    1996-12-31

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

  3. Benefits of radiation processing to public health

    NASA Astrophysics Data System (ADS)

    Kampelmacher, E. H.

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

  4. Integrative Metabolic Signatures for Hepatic Radiation Injury

    PubMed Central

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

    2015-01-01

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

  5. [Health integration processes: challenges for MERCOSUR in the health field].

    PubMed

    Sánchez, Delia M

    2007-01-01

    This paper describes the institutional background in Latin American integration in both the economy and health, and proposes a systematization of possible health integration modalities. Facilitating and inhibiting factors for integration according to each modality are identified, and their feasibility is discussed in the present context. The structure and functioning of MERCOSUR health structures (Ministerial Meeting and Sub-group 11) are briefly described, as well as the advances achieved to date, reflecting on the possible causes of uneven progress in different areas.

  6. Potential health effects of space radiation

    NASA Technical Reports Server (NTRS)

    Yang, Chui-Hsu; Craise, Laurie M.

    1993-01-01

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

  7. Final Report: Radiation Health Technology Curriculum.

    ERIC Educational Resources Information Center

    Marshall, Dwight A.; Hunt, Hiram M.

    This report describes all aspects of a radiation health technology program at a lower-division college level. Such a program must include certain basic courses, plus supplementary ones to meet the needs of local employers. To implement and sustain a curriculum, the college must (1) determine the need for it, (2) establish its objectives, (3)…

  8. Medical Physicists and Health Physicists: Radiation Occupations

    ERIC Educational Resources Information Center

    LaPointe, Jeffrey

    2011-01-01

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

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

    SciTech Connect

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

    1983-03-01

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

  10. Integral -tracking extreme radiation across the Universe

    NASA Astrophysics Data System (ADS)

    2002-10-01

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

  11. Integrating reproductive health: myth and ideology.

    PubMed Central

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

    1999-01-01

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

  12. Integrating health law and health policy: a European perspective.

    PubMed

    Legemaate, Johan

    2002-05-01

    Health law is intended to create an environment in which the promotion of health goes hand in hand with the protection of individual rights and the general principles of equality and justice. Over the years, the importance of health law has grown, both at national and international level. As health and human rights are closely interlinked, it is important to integrate health law and health policy. It is to be expected that, especially in Europe, the impact of health law on health policy-making will increase as a result of several developments, e.g. the internationalization of health care and health policy, the issue of consumer protection and the legalization of society. This requires a strategy to stimulate the fruitful relationship between health policy and health law. The most important components of this strategy are discussed.

  13. Health systems integration: state of the evidence

    PubMed Central

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

    2009-01-01

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

  14. Exposure to UV radiation and human health

    NASA Astrophysics Data System (ADS)

    Kimlin, Michael G.

    2005-08-01

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

  15. Method for analyzing radiation sensitivity of integrated circuits

    NASA Technical Reports Server (NTRS)

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

    1979-01-01

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

  16. Combating health care fragmentation through integrated health services delivery networks

    PubMed Central

    Ramagem, Caroline; Urrutia, Soledad; Griffith, Tephany; Cruz, Mario; Fabrega, Ricardo; Holder, Reynaldo; Montenegro, Hernán

    2011-01-01

    Introduction Despite existing initiatives to integrate health services in the Americas Health Care fragmentation remains a significant challenge. Excessive fragmentation leads to difficulties in access to services, delivery of services of poor technical quality, inefficient use of resources, increases in production costs, and low user satisfaction. To address this problem, the Pan American Health Organization (PAHO) has launched the Integrated Health Services Delivery Networks (IHSDN) Initiative to support the development of more accessible, equitable and efficient health care models in the Region [1]. Theory/conceptual framework IHSDN are defined as a network of organizations that provides, or makes arrangements to provide, equitable, comprehensive, and integrated health services to a defined population and is willing to be held accountable for its clinical and economic outcomes and the health status of the population served. IHSDN require 14 essential attributes for their adequate operation grouped according to four principal domains: model of care, governance and strategy, organization and management, and financial allocation and incentives [1]. Methods An extensive literature review, expert meetings and country consultations (national, subregional and regional) in the Americas resulted in a set of consensus-based essential attributes and policy options for implementing IHSDN. Results and conclusions The research and evidence on health services integration remains limited; however, several studies suggest that IHSDN could improve health systems performance. Principal lessons learned include: i) integration processes are difficult, complex and long term; ii) integration requires extensive systemic changes and a commitment by health workers, health service managers and policymakers; and iii) multiple modalities and degrees of integration can coexist within a single system. The public policy objective is to propose a design that meets each system’s specific

  17. [Changing structures--Integrating health].

    PubMed

    Plaumann, M; Lehmann, F; Pawils, S; Walter, U

    2015-09-01

    Changes in (municipal) structures for the improvement of health are often required but, in contrast to behavioural measures, less frequently implemented and scientifically evaluated. Results on this subject for Germany are scarce. In recent years, municipal prevention and health promotion programmes received new impetus from the expansion of the German "Early Assistance" initiative. Early assistance programmes to help children grow up healthy initiated municipal processes such as the establishment of networks between health services and youth welfare services, prevention chains and nationwide initiatives. This has moved issues such as equal opportunities for health into the centre of politically driven structural development efforts. Neighbourhood management groups and municipal round tables on prevention-specific topics etc. have been established throughout Germany. Regarding this structural development, 6 projects from the field of prevention research give a good indication as to how the structure of municipal concepts can be effectively implemented.

  18. Integral -tracking extreme radiation across the Universe

    NASA Astrophysics Data System (ADS)

    2002-10-01

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

  19. INTERCONNECTIONS BETWEEN HUMAN HEALTH AND ECOLOGICAL INTEGRITY

    EPA Science Inventory

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

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

    PubMed

    Goldman, M

    1997-12-01

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

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

    PubMed Central

    Goldman, M

    1997-01-01

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

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

    PubMed

    Goldman, M

    1997-12-01

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

  3. Health Impacts from Acute Radiation Exposure

    SciTech Connect

    Strom, Daniel J.

    2003-09-30

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

  4. Integrating homoeopathy in health systems.

    PubMed Central

    Poitevin, B.

    1999-01-01

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

  5. Integrated System Health Management Development Toolkit

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

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

  6. Integrating Nutrition into Health Education.

    ERIC Educational Resources Information Center

    German, Mary Jane; And Others

    1980-01-01

    A nutrition unit developed for inclusion in the high school health education curriculum contains a training packet that provides information about how best to implement the unit. Three major topics form the core of the nutrition unit: nutrient needs, qualitative evaluation of foods, and weight control. (JN)

  7. An Integrated Approach for Gear Health Prognostics

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

  8. Emerging Radiation Health-Risk Mitigation Technologies

    NASA Astrophysics Data System (ADS)

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

    2004-02-01

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

  9. Emerging Radiation Health-Risk Mitigation Technologies

    SciTech Connect

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

    2004-02-04

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

  10. Impaired skin integrity related to radiation therapy

    SciTech Connect

    Ratliff, C.

    1990-09-01

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

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

    PubMed

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

    2014-10-01

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

  12. The integration of biodiversity into One Health.

    PubMed

    Romanelli, C; Cooper, H D; de Souza Dias, B F

    2014-08-01

    A better understanding of the links between biodiversity, health and disease presents major opportunities for policy development, and can enhance our understanding of how health-focused measures affect biodiversity, and conservation measures affect health. The breadth and complexity of these relationships, and the socio-economic drivers by which they are influenced, in the context of rapidly shifting global trends, reaffirm the need for an integrative, multidisciplinary and systemic approach to the health of people, livestock and wildlife within the ecosystem context. Loss of biodiversity, habitat fragmentation and the loss of natural environments threaten the full range of life-supporting services provided by ecosystems at all levels of biodiversity, including species, genetic and ecosystem diversity. The disruption of ecosystem services has direct and indirect implications for public health, which are likely to exacerbate existing health inequities, whether through exposure to environmental hazards or through the loss of livelihoods. One Health provides a valuable framework for the development of mutually beneficial policies and interventions at the nexus between health and biodiversity, and it is critical that One Health integrates biodiversity into its strategic agenda.

  13. Capitated contracting of integrated health provider organizations.

    PubMed

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

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

  14. Capitated contracting of integrated health provider organizations.

    PubMed

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

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2010-02-01

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

  17. Vertical Integration Spurs American Health Care Revolution.

    ERIC Educational Resources Information Center

    Phillips, Richard C.

    1986-01-01

    Under new "managed health care systems," the classical functional separation of risk taker, claims payor, and provider are vertically integrated into a common entity. This evolution should produce a competitive environment with medical care rendered to all Americans on a more cost-effective basis. (CJH)

  18. Ultraviolet radiation and health: friend and foe.

    PubMed

    Lucas, Robyn M; Ponsonby, Anne-Louise

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

  19. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

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

  20. Radiation-hardened transistor and integrated circuit

    DOEpatents

    Ma, Kwok K.

    2007-11-20

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

  1. Integrating health and environmental impact analysis.

    PubMed

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

    2015-10-01

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

  2. Integrated Theory of Health Behavior Change

    PubMed Central

    RYAN, POLLY

    2009-01-01

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

  3. Outcome mapping for health system integration

    PubMed Central

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

    2013-01-01

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

  4. Frequency Integrated Radiation Models for Absorbing and Scattering Media

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  5. NASA Space Radiation Program Integrative Risk Model Toolkit

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  6. Using MACSYMA to drive numerical methods to computer radiation integrals

    SciTech Connect

    Clark, B.A.

    1986-01-01

    Because the emission of thermal radiation is characterized by the Planck emission spectrum, a multigroup solution of the thermal-radiation transport equation demands the calculation of definite integrals of the Planck spectrum. In the past, many approximate methods have been used with varying degrees of accuracy and efficiency. This paper describes how a symbolic algebra package, in this case MACSYMA is used to develop new methods for accurately and efficiently evaluating multigroup Planck integrals. The advantage of using a symbolic algebra package is that the job of developing the new methods is accomplished more efficiently.

  7. Making Technology Ready: Integrated Systems Health Management

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2016-03-01

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

  10. Analysis of integrated video and radiation data

    SciTech Connect

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

    1995-07-01

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

  11. W3 - Radiation and Health: A Workshop for Science Educators

    NASA Astrophysics Data System (ADS)

    Krieger, Kenneth

    2009-04-01

    This workshop covers nuclear science and technology topics suitable for science teachers to use in grade 4-12 classes. Subjects included are Fundamentals of Radiation, Exposure to natural and man-made Radiation, Cellular Biology and Radiation Effects, Radioactive Waste Management, Health Physics and Radiation Physics, and Career possibilities in Nuclear Technology. Schools of participants will receive a working Geiger Counter. Lunch will be served. Workshop presenter is a TEA-approved CPE Provider.

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

    PubMed Central

    2013-01-01

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

  13. Estimation of health risks from radiation exposures

    SciTech Connect

    Randolph, M.L.

    1983-08-01

    An informal presentation is given of the cancer and genetic risks from exposures to ionizing radiations. The risks from plausible radiation exposures are shown to be comparable to other commonly encountered risks.

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

    PubMed

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

    2016-01-01

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

  15. Challenges of Systematic Reviewing Integrative Health Care

    PubMed Central

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

    2013-01-01

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

  16. Synchronised integrated online e-health profiles.

    PubMed

    Liang, Jian; Iannella, Renato; Sahama, Tony

    2011-01-01

    Web-based social networking applications have become increasingly important in recent years. The current applications in the healthcare sphere can support the health management, but to date there is no patient-controlled integrator. This paper proposes a platform called Multiple Profile Manager (MPM) that enables a user to create and manage an integrated profile that can be shared across numerous social network sites. Moreover, it is able to facilitate the collection of personal healthcare data, which makes a contribution to the development of public health informatics. Here we want to illustrate how patients and physicians can be benefited from enabling the platform for online social network sites. The MPM simplifies the management of patients' profiles and allows health professionals to obtain a more complete picture of the patients' background so that they can provide better health care. To do so, we demonstrate a prototype of the platform and describe its protocol specification, which is an XMPP (Extensible Messaging and Presence Protocol) [1] extension, for sharing and synchronising profile data (vCard²) between different social networks. PMID:21893917

  17. Investigation of radiation effects on semiconductor devices and integrated circuits

    NASA Astrophysics Data System (ADS)

    Shanfield, Zef; Srour, Joseph R.; Moriwaki, Melvin; Kitazaki, Kerry S.; Hartmann, Robert A.

    1988-09-01

    Results of a study of radiation effects on electronic materials, devices, and integrated circuits are presented in this report. Emphasis was placed on determining the underlying mechanisms responsible for observed radiation effects with a view toward gaining understanding of value in the development of radiation-hardened devices. Measurements and analyses were made of the effects of single energetic neutrons and protons on silicon integrated circuits. In addition, a detailed description is given of the effects of radiation-induced displacement damage on device depletion regions. Single event upset studies included charge collection and transient current measurements on Si and GaAs devices following a single alpha-particle strike. The angular dependence of charge funneling was also investigated. The mechanisms of ionizing radiation effects on Si MOS devices were explored in detail using the thermally stimulated current technique and other measurement approaches. Data obtained by several techniques show that use of the radiation-induced shift of the capacitance-voltage curve at midgap is not generally valid for determining oxide trapped charge.

  18. The Effects of Space Radiation on Linear Integrated Circuit

    NASA Technical Reports Server (NTRS)

    Johnston, A.

    2000-01-01

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

  19. Securing Health Sensing Using Integrated Circuit Metric

    PubMed Central

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

    2015-01-01

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

  20. Securing health sensing using integrated circuit metric.

    PubMed

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

    2015-10-20

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

  1. Integrated Systems Health Management for Intelligent Systems

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

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

  2. Integrating Behavioral Health into Primary Care.

    PubMed

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

    2016-04-01

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

  3. Rocket Testing and Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

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

  4. Rethinking global health research: towards integrative expertise

    PubMed Central

    MacLachlan, Malcolm

    2009-01-01

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

  5. Occupational health effects of nonionizing radiation

    SciTech Connect

    Yost, M.G. )

    1992-07-01

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

  6. Integration of mental health into priority health service delivery platforms: maternal and child health services.

    PubMed

    Rahman, A

    2015-09-28

    Maternal and child health (MCH) programmes are the most logical and appropriate platforms for integration of mental health care in an equitable, accessible and holistic manner. Such integration has the potential to improve both mental and physical health synergistically. Key steps to successful integration include a) recognition, at the highest international and national policy forums, that mental health and well-being is a generic component of MCH that does not compete with MCH programmes but instead complements them; b) tailoring the training and supervision of MCH and primary care personnel so they can recognize and assist in the management of common maternal and child mental health problems, recognizing that this, in turn, will enable them to be more effective health-care workers; c) adapting effective interventions to local contexts; and d) investing in implementation research so that these approaches are refined and scaled-up, leading to improved outcomes for all MCH programmes.

  7. Radiation Testing and Evaluation Issues for Modern Integrated Circuits

    NASA Technical Reports Server (NTRS)

    LaBel, Kenneth A.; Cohn, Lew M.

    2005-01-01

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

  8. Radiation damage in MOS integrated circuits, Part 1

    NASA Technical Reports Server (NTRS)

    Danchenko, V.

    1971-01-01

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

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

    PubMed

    Laugesen, Miriam J; France, George

    2014-07-01

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

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

    SciTech Connect

    Not Available

    1986-01-01

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

  11. Radiation and health risks: a bioethical perspective

    SciTech Connect

    Maxey, M.N.

    1983-03-01

    The author suggests that radiation and radioactivity have acquired a set of attributes that tend almost inevitably to intensify public alarm as public concern over nuclear energy and nuclear weapons has escalated. She discusses the moral argument that widespread use of radioactive substances seems tantamount to an immoral violation of human rights no matter what the benefits might be. (KRM)

  12. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

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

    2012-05-18

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

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

    EPA Science Inventory

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

  14. Integrating the revenue cycle for improved health system performance.

    PubMed

    Colton, Ben; Davis, Andrew

    2015-01-01

    Three integrated revenue cycle models reflect the various levels of integration a health system'might find desirable or feasible based on its current circumstances and environment: Model A: A single health system executive provides oversight, but physician and hospital revenue cycles are managed separately. Model B: A single health system leader provides oversight, with a functional framework for management at the director level. Model C: Integration is complete for all processes.

  15. Integrating the revenue cycle for improved health system performance.

    PubMed

    Colton, Ben; Davis, Andrew

    2015-01-01

    Three integrated revenue cycle models reflect the various levels of integration a health system'might find desirable or feasible based on its current circumstances and environment: Model A: A single health system executive provides oversight, but physician and hospital revenue cycles are managed separately. Model B: A single health system leader provides oversight, with a functional framework for management at the director level. Model C: Integration is complete for all processes. PMID:26665989

  16. Monolithic Integrated Radiation Sensor Using Stimulated Luminescence From Alumina

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

  17. Elements of an integrated health monitoring framework

    NASA Astrophysics Data System (ADS)

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

    2003-07-01

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

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

    PubMed

    Shevchenko, V A

    1997-01-01

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

  19. Integrated Systems Health Management for Space Exploration

    NASA Technical Reports Server (NTRS)

    Uckun, Serdar

    2005-01-01

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

  20. Health protection: Toxic agent and radiation control.

    PubMed

    1983-01-01

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

  1. Technology Maturation of Integrated System Health Management

    NASA Astrophysics Data System (ADS)

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

    2008-01-01

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

  2. Workplace mental health: developing an integrated intervention approach

    PubMed Central

    2014-01-01

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

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

    SciTech Connect

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

    2015-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2005-04-01

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

  5. 78 FR 78965 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such radiation doses may have endangered the health...

  6. 78 FR 78963 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such radiation doses may have endangered the health...

  7. Integration of health care information systems.

    PubMed

    Cuddeback, J K

    1993-03-01

    Information is at the core of an effective response to virtually all of the new demands that health care institutions will face in the 1990s. New information that is differently organized, more timely, and more conveniently available will facilitate new interactions within the institution. The consistent theme of the new systems requirements introduced by CQI is tighter connection to the processes of patient care and integration of systems and data as those processes cross traditional organizational boundaries. Even the billing requirements are pushing in the same direction. Ironically, the dinosaurs descended from billing systems do not even perform very well as billing systems today, because payers want more clinical detail, in addition to information at very specific points during the patient-care process. This new management model changes our view of our systems. Instead of systems designed to create an after-the-fact record of patient care, we need to think in terms of systems that are part of the patient-care process. This is essential for the continuous monitoring and--when the process gets out of control--rapid intervention that are an intrinsic part of the process in the CQI model. Of course, these systems also produce a complete record as a by-product, but that is not their primary objective. These demands will test the capacities of many of our existing systems and will require the replacement of others. Like all complex processes, however, systems development is performed one step at a time. Each step is taken within the context of an overall goal but also presents an opportunity for learning. CQI is a new management model, and the system requirements are far from clear. Hence, we are likely to need a little continuous improvement in the systems, too.

  8. Management of ionizing radiation injuries and illnesses, Part 3: Radiobiology and health effects of ionizing radiation.

    PubMed

    Christensen, Doran M; Livingston, Gordon K; Sugarman, Stephen L; Parillo, Steven J; Glassman, Erik S

    2014-07-01

    Ionizing radiation exposure can induce profound changes in intracellular components, potentially leading to diverse health effects in exposed individuals. Any cellular component can be damaged by radiation, but some components affect cellular viability more profoundly than others. The ionization caused by radiation lasts longer than the initial inciting incident, continuing as 1 ionization incident causes another. In some cases, damage to DNA can lead to cellular death at mitosis. In other cases, activation of the genetic machinery can lead to a genetic cascade potentially leading to mutations or cell death by apoptosis. In the third of 5 articles on the management of injuries and illnesses caused by ionizing radiation, the authors provide a clinically relevant overview of the pathophysiologic process associated with potential exposure to ionizing radiation.

  9. 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...

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

    SciTech Connect

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

    2015-05-15

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

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

    PubMed

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

    2015-11-01

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

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

    ERIC Educational Resources Information Center

    Killien, Marcia

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

    Kim, Yungwook

    2016-02-01

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

  15. 76 FR 52329 - Advisory Board on Radiation and Worker Health: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

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

  16. Integrated Crew Health Care System for Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2007-01-01

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

  17. Radiation and Health Technology Laboratory Capabilities

    SciTech Connect

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

    2005-07-09

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

  18. Radiation and Health Technology Laboratory Capabilities

    SciTech Connect

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

    2003-07-15

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

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

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

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

  20. Integrated beta and gamma radiation dose calculations for the ferrocyanide waste tanks

    SciTech Connect

    Parra, S.A.

    1994-11-30

    This report contains the total integrated beta and gamma radiation doses in all the ferrocyanide waste tanks. It also contains estimated gamma radiation dose rates for all single-shell waste tanks containing a liquid observation well.

  1. Integration of Basic Sciences in Health's Courses

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. A revisionist view of the integrated academic health center.

    PubMed

    Rodin, Judith

    2004-02-01

    Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2015-08-01

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

  5. Integration mechanisms and hospital efficiency in integrated health care delivery systems.

    PubMed

    Wan, Thomas T H; Lin, Blossom Yen-Ju; Ma, Allen

    2002-04-01

    This study analyzes integration mechanisms that affect system performances measured by indicators of efficiency in integrated delivery systems (IDSs) in the United States. The research question is, do integration mechanisms improve IDSs' efficiency in hospital care? American Hospital Association's Annual Survey (1998) and Dorenfest's Survey on Information Systems in Integrated Healthcare Delivery Systems (1998) were used to conduct the study, using IDS as the unit of analysis. A covariance structure equation model of the effects of system integration mechanisms on IDS performance was formulated and validated by an empirical examination of IDSs. The study sample includes 973 hospital-based integrated health care delivery systems operating in the United States, carried in the list of Dorenfests Survey on Information Systems in Integrated Health care Delivery Systems. The measurement indicators of system integration mechanisms are categorized into six related domains: informatic integration, case management, hybrid physician-hospital integration, forward integration, backward integration, and high tech medical services. The multivariate analysis reveals that integration mechanisms in system operation are positively correlated and positively affect IDSs' efficiency. The six domains of integration mechanisms account for 58.9% of the total variance in hospital performance. The service differentiation strategy such as having more high tech medical services have much stronger influences on efficiency than other integration mechanisms do. The beneficial effects of integration mechanisms have been realized in IDS performance. High efficiency in hospital care can be achieved by employing proper integration strategies in operations.

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

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

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

    SciTech Connect

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

    2013-06-01

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

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

    PubMed

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

    2011-01-01

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

  9. Integrating mental health into primary health care in Zambia: a care provider's perspective

    PubMed Central

    2010-01-01

    Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka) and one rural setting (Mumbwa). Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia. PMID:20653981

  10. Integrating Social Theory Into Public Health Practice

    PubMed Central

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

    2005-01-01

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

  11. Integrating mental health and social development in theory and practice.

    PubMed

    Plagerson, Sophie

    2015-03-01

    In many low and middle income countries, attention to mental illness remains compartmentalized and consigned as a matter for specialist policy. Despite great advances in global mental health, mental health policy and practice dovetail only to a limited degree with social development efforts. They often lag behind broader approaches to health and development. This gap ignores the small but growing evidence that social development unavoidably impacts the mental health of those affected, and that this influence can be both positive and negative. This article examines the theoretical and practical challenges that need to be overcome for a more effective integration of social development and mental health policy. From a theoretical perspective, this article demonstrates compatibility between social development and mental health paradigms. In particular, the capability approach is shown to provide a strong framework for integrating mental health and development. Yet, capability-oriented critiques on 'happiness' have recently been applied to mental health with potentially detrimental outcomes. With regard to policy and practice, horizontal and vertical integration strategies are suggested. Horizontal strategies require stronger devolution of mental health care to the primary care level, more unified messages regarding mental health care provision and the gradual expansion of mental health packages of care. Vertical integration refers to the alignment of mental health with related policy domains (particularly the social, economic and political domains). Evidence from mental health research reinforces aspects of social development theory in a way that can have tangible implications on practice. First, it encourages a focus on avoiding exclusion of those affected by or at risk of mental illness. Secondly, it underscores the importance of the process of implementation as an integral component of successful policies. Finally, by retaining a focus on the individual, it seeks to

  12. Community Dental Health Promotion for Children: Integrating Applied Behavior Analysis and Public Health.

    ERIC Educational Resources Information Center

    Kramer, Kathryn D.; Geller, E. Scott

    1987-01-01

    The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…

  13. An integrated cattle health monitoring system.

    PubMed

    Smith, Kevin; Martinez, Angel; Craddolph, Roland; Erickson, Howard; Andresen, Daniel; Warren, Steve

    2006-01-01

    Clinical techniques for monitoring live stock health are insufficient, as they provide only sporadic information and require too much resource investment in terms of time and veterinary expertise. A sophisticated system capable of continuously assessing the health of individual animals, aggregating these data, and reporting the results to owners and regional authorities could provide tremendous benefit to the livestock industry. Such a system would not only improve individual animal health, but it would help to identify and pre vent widespread disease, whether it originated from natural causes or from biological attacks. This paper presents results from a prototype telemonitoring system that utilizes wearable technology to provide continuous animal health data. The infrastructure, hardware, software, and representative physiological measurements are presented.

  14. 76 FR 54775 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

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

  15. 78 FR 38346 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health... facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is a reasonable likelihood that such radiation doses may have endangered...

  16. Promoting Access Through Integrated Mental Health Care Education.

    PubMed

    Kverno, Karan

    2016-01-01

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

  17. Integrating Human and Ecosystem Health Through Ecosystem Services Frameworks.

    PubMed

    Ford, Adriana E S; Graham, Hilary; White, Piran C L

    2015-12-01

    The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health.

  18. Promoting Access Through Integrated Mental Health Care Education.

    PubMed

    Kverno, Karan

    2016-01-01

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

  19. Promoting Access Through Integrated Mental Health Care Education

    PubMed Central

    Kverno, Karan

    2016-01-01

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Farina, Joseph; Frechette, Michael

    1979-01-01

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

  2. Internal and external auditing in health systems: an integrative approach.

    PubMed

    Mersel, Elie P; Mor-Yosef, Shlomo; Shapira, Shmuel C

    2005-01-01

    Traditionally, auditors are apprehensive when it comes to auditing clinical decisions. A novel model might lead to better integration of auditors into the core activities of health system medical care, while creating common interests among all participants in the process.

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

    PubMed

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

    2015-01-01

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

  4. Health literacy and public health: A systematic review and integration of definitions and models

    PubMed Central

    2012-01-01

    Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings. PMID:22276600

  5. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  6. Health-related research on older inmates: an integrative review.

    PubMed

    Loeb, Susan J; Abudagga, Azza

    2006-12-01

    The literature on older inmates' health is fragmented and insufficiently developed. In this integrative review, 21 research articles on health and older inmates were identified, critiqued, and synthesized to determine: the minimum age criterion most commonly used; health-related variables explored; health status; the health impact of incarceration; and aging-specific policies, programs, and facilities. Age 50 and older was used most often. The top three health variables were psychiatric conditions, physical illnesses, and substance abuse. Self-reports of health status varied across studies; however, inmates consistently reported health declines since incarceration. Older inmates' health needs appear often to be left unmet. Nursing investigations are needed leading to practice innovations to enhance prisoners' self-management to reduce disease burden and fiscal and societal costs. PMID:17131280

  7. Radiation is not always harmful to human health

    SciTech Connect

    Thomas, R.G.

    1995-12-31

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

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

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

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

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

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

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

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

    ERIC Educational Resources Information Center

    Hill, Graham L.; Mageean, Pauline

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

  11. An Integrated Approach for Supervising Mental Health Counseling Interns.

    ERIC Educational Resources Information Center

    Nelson, Mark D.; Johnson, Patrick; Thorngren, Jill M.

    2000-01-01

    Proposes an approach for supervising mental health counseling interns that integrates the developmental model of Littrell, Lee-Borden, and Lorenz, and Bernard's discrimination model. This approach integrates supervisor role, intern skills, and stages of the supervision process. It provides a practical tool for conceptualizing and implementing the…

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

    ERIC Educational Resources Information Center

    Hall, Bob; Mageean, Pauline

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    SciTech Connect

    Vătăsescu, Mihaela

    2015-03-10

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

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

    ERIC Educational Resources Information Center

    Patterson, Sheila M.; Graf, Helen M.

    2000-01-01

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

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

    ERIC Educational Resources Information Center

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

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

  17. Social Integration and Health Behavioral Change in San Luis, Honduras

    ERIC Educational Resources Information Center

    McQuestion, Michael J.; Calle, Ana Quijano; Drasbek, Christopher; Harkins, Thomas; Sagastume, Lourdes J.

    2010-01-01

    This study explores the effects of social integration on behavioral change in the course of an intensive, community-based public health intervention. The intervention trained volunteers and mobilized local organizations to promote 16 key family health practices in rural San Luis, Honduras, during 2004 to 2006. A mixed methods approach is used.…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  19. Social Integration and Mental Health of the Aged.

    ERIC Educational Resources Information Center

    Deimling, Gary T.; Harel Zev

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

  20. Social Integration and the Mental Health of Black Adolescents

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  1. Health charities, unethical research and organizational integrity.

    PubMed

    Brehany, John

    2005-01-01

    Organizations, particularly Catholic hospitals, schools and social service agencies, should re-examine their relationships to health and medical charities promoting unethical research such as human embryonic stem cell research and therapeutic cloning. Part 6 of the Ethical and Religious Directives provides a helpful framework for ethical analysis and action.

  2. Social integration and the mental health of Black adolescents

    PubMed Central

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

    2014-01-01

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

  3. An Integrated Multi-Omic Approach to Assess Radiation Injury on the Host-Microbiome Axis.

    PubMed

    Goudarzi, Maryam; Mak, Tytus D; Jacobs, Jonathan P; Moon, Bo-Hyun; Strawn, Steven J; Braun, Jonathan; Brenner, David J; Fornace, Albert J; Li, Heng-Hong

    2016-09-01

    Medical responders to radiological and nuclear disasters currently lack sufficient high-throughput and minimally invasive biodosimetry tools to assess exposure and injury in the affected populations. For this reason, we have focused on developing robust radiation exposure biomarkers in easily accessible biofluids such as urine, serum and feces. While we have previously reported on urine and serum biomarkers, here we assessed perturbations in the fecal metabolome resulting from exposure to external X radiation in vivo. The gastrointestinal (GI) system is of particular importance in radiation biodosimetry due to its constant cell renewal and sensitivity to radiation-induced injury. While the clinical GI symptoms such as pain, bloating, nausea, vomiting and diarrhea are manifested after radiation exposure, no reliable bioindicator has been identified for radiation-induced gastrointestinal injuries. To this end, we focused on determining a fecal metabolomic signature in X-ray irradiated mice. There is overwhelming evidence that the gut microbiota play an essential role in gut homeostasis and overall health. Because the fecal metabolome is tightly correlated with the composition and diversity of the microorganism in the gut, we also performed fecal 16S rRNA sequencing analysis to determine the changes in the microbial composition postirradiation. We used in-house bioinformatics tools to integrate the 16S rRNA sequencing and metabolomic data, and to elucidate the gut integrated ecosystem and its deviations from a stable host-microbiome state that result from irradiation. The 16S rRNA sequencing results indicated that radiation caused remarkable alterations of the microbiome in feces at the family level. Increased abundance of common members of Lactobacillaceae and Staphylococcaceae families, and decreased abundances of Lachnospiraceae, Ruminococcaceae and Clostridiaceae families were found after 5 and 12 Gy irradiation. The metabolomic data revealed statistically

  4. Integration of mother and child health services in Ethiopia.

    PubMed

    Walley, J D; McDonald, M

    1991-01-01

    In Wollo region of Ethiopia, various non-governmental officers have been working closely with each other and with the Regional Health Department to implement the policy of daily integrated mother and child health services. The record cards, registers, procedures and training courses of the separate 'vertically' organized services were brought together to enable the development of a model integrated service. There were improvements in accessibility, acceptability and output of the services. The system was evaluated by a joint Ministry of Health and UNICEF team, and was adopted for use in the rest of Ethiopia.

  5. Integration of spirituality into health care practice by nurse practitioners.

    PubMed

    Treloar, L L

    2000-07-01

    Although conceptualizations of mind, body, and spirit are ancient, spiritual aspects have not been readily integrated into health care. Western medicine's mechanistic model, with its "fix-broken-parts" paradigm, focuses on the physical body, with occasional consideration given to emotional and mental aspects. One's view of self in relation to a Supreme Being, and one's existence and purpose for life is central to health at all levels, e.g., spiritual, physical, emotional, and cognitive. The purpose of this article is to describe the role that nurse practitioners can and should take with patients and their families in integrating spirituality into health care practice.

  6. Integrating emergency services in an urban health system.

    PubMed

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

    2000-03-01

    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  7. Integrated Systems Health Management (ISHM) Toolkit

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

  8. Electromagnetic radiation and health risks: Cell phones and microwave radiation in New Zealand

    SciTech Connect

    Smith, I.

    1996-07-01

    Presently the public is concerned over the proliferation of cellphone repeater sites around the cities of New Zealand and whether they pose a risk to health. The debate continued for some weeks over the proposal to erect a cellphone repeater in a school yard. The issues that came out of that debate are profiled in this paper -- environmental health professionals need to be able to communicate well-judged advice to their employers. Cellular phone networks use relatively low-powered transmitters to restrict coverage to a circumscribed locality and thereby enable particular carrier frequencies to be used simultaneously at different cell sites in the same general area. Compared with TV and radio broadcasting, the radiation power levels near cell sites are therefore relatively small. Broadcast transmission antennae are designed to confine the radiation so that it doesn`t go in directions where it is not required or not wanted.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    SciTech Connect

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

    2015-05-01

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

  12. Integration of health care organizations: using the power strategies of horizontal and vertical integration in public and private health systems.

    PubMed

    Thaldorf, Carey; Liberman, Aaron

    2007-01-01

    Integration in health care attempts to provide all elements in a seamless continuum of care. Pressures influencing development of system-wide integration primarily come from unsustainable cost increases in the United States over the later part of the 20th century and the early 21st century. Promoters of health care integration assume that it will lead to increased effectiveness and quality of care while concurrently increasing cost-effectiveness and possibly facilitating cost savings. The primary focus of this literature review is on the Power Strategies of Horizontal and Vertical Integration. The material presented suggests that vertical integration is most effective in markets where the partners involved are larger and dominant in the regions they serve. The research has also found that integrating health care networks had little or no significant effect on improving overall organizational efficiencies or profits. Capital investment in information technologies still is cost prohibitive and outweighs its benefits to integration efficiencies in the private sector; however, there are some indications of improvements in publicly provided health care. Further research is needed to understand the reasons the public sector has had greater success in improving effectiveness and efficiency through integration than the private sector.

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

    PubMed

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

    2010-06-01

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

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

    SciTech Connect

    Fabrikant, J.I,

    1980-11-01

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

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

    PubMed

    Holick, Michael F

    2016-03-01

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

  16. Preventing risk and promoting resilience in radiation health.

    PubMed

    Kurth, Margaret H; Linkov, Igor

    2016-10-01

    Because risk assessment is fundamentally deficient in the face of unknown or unforeseeable events and disasters such as occurred in 2011 at the Fukushima Daiichi Nuclear Power Station in Japan, resilience thinking, which focuses on the ability of both natural and human-made systems to prepare for, absorb, and recover from an adverse event and to adapt to new conditions is an important additional consideration in decision making. Radiation contamination is an impediment to most critical functions of a community; resilience planning considers how those critical functions will be maintained in the event that radiation contamination does occur. Therefore, planning should begin with resilience-based thinking and should be complemented with risk assessment-based tools. Integr Environ Assess Manag 2016;12:677-679. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  17. Preventing risk and promoting resilience in radiation health.

    PubMed

    Kurth, Margaret H; Linkov, Igor

    2016-10-01

    Because risk assessment is fundamentally deficient in the face of unknown or unforeseeable events and disasters such as occurred in 2011 at the Fukushima Daiichi Nuclear Power Station in Japan, resilience thinking, which focuses on the ability of both natural and human-made systems to prepare for, absorb, and recover from an adverse event and to adapt to new conditions is an important additional consideration in decision making. Radiation contamination is an impediment to most critical functions of a community; resilience planning considers how those critical functions will be maintained in the event that radiation contamination does occur. Therefore, planning should begin with resilience-based thinking and should be complemented with risk assessment-based tools. Integr Environ Assess Manag 2016;12:677-679. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. PMID:27447754

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

    SciTech Connect

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

    2013-08-08

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

  19. UV index forecasts and measurements of health-effective radiation.

    PubMed

    Feister, Uwe; Laschewski, Gudrun; Grewe, Rolf-Dieter

    2011-01-10

    While erythemal irradiance as a potentially damaging effect to the skin has been extensively studied and short-term forecasts have been issued to the public to reduce detrimental immediate and long-term effects such as sunburn and skin cancer by overexposure, beneficial effects to human health such as vitamin D(3) production by UV radiation and melatonin suppression by blue visible light have attained more and more attention, though both of them have not become part of forecasting yet. Using 4years of solar radiation data measured at the mid-latitude site Lindenberg (52°N), and forecast daily maximum UV index values, an overall good correspondence has been found. The data base of solar UV radiation and illuminance has also been used to analyze effects of clouds and aerosols on the effective irradiance. Optically thick clouds can strongly modify the ratios between erythemal and vitamin D(3) effective irradiance such that direct radiative transfer modeling of the latter in future UV forecasts should be preferably used. If parameterizations of vitamin D(3) effective irradiance from erythemal irradiance are used instead, the optical cloud depth would have to be taken into account to avoid an overestimation of vitamin D(3) with parameterizations neglecting cloud optical depth. Particular emphasis for the beneficial effects has been laid in our study on low exposure. Daily doses of solar irradiation for both vitamin D(3) and melatonin suppression do not reach minimum threshold doses even with clear sky and unobstructed horizon during the winter months.

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

    SciTech Connect

    Morgan, Richard K.

    2011-07-15

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

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

    PubMed

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

    2010-03-01

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

  2. Toward the Integration of Education and Mental Health in Schools

    PubMed Central

    Hoagwood, Kimberly E.; Kutash, Krista; Seidman, Edward

    2010-01-01

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

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

    PubMed

    Bernhardt, J H

    2005-01-01

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

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

    PubMed

    Bernhardt, J H

    2005-01-01

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

  5. 76 FR 16776 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

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

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

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

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

  7. Integration of targeted health interventions into health systems: a conceptual framework for analysis.

    PubMed

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-03-01

    The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

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

    PubMed

    Thompson, Michael; Checkley, Joseph

    2006-01-01

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

  9. Integration: a synergistic approach to health/wellness.

    PubMed

    Roca, H J; Imes, S

    2001-01-01

    Integration is defined as the weaving of new possibilities, new alternatives, and new options into a cloak of security where concepts of health or wellness are actualized. In integration, the mind, body, and soul are open to explore and embrace these new possibilities, alternatives, and options. The authors believe the process of integration, and thus health, is enhanced via synergy; particularly the synergy created by the provider/individual relationship. Health care is an outcome or the culmination of a variety of modalities identified, explored, and celebrated by the individual seeking health/wellness and the primary care practitioner coordinating care. In the quest to provide individuals with the health care they seek, practitioners are encouraged to take note of the lessons taught by alternative and complementary health care practitioners. Individuals want to be heard. They are seeking effective, low cost interventions that are as natural as possible. Reiki, meditation, biofeedback, massage, botanicals, healing touch, ayurveda, and aromatherapy represent some of the healing modalities and complementary therapies to explore for integration.

  10. Radiation impacts on human health: certain, fuzzy, and unknown.

    PubMed

    Shore, Roy E

    2014-02-01

    The atomic bomb and other studies have established with certainty that moderate-to-high doses of radiation cause many types of solid cancer and leukemia. Moving down the dose range to the vicinity of 100-200 mSv, the risks become fuzzy and then unknown at low doses on the order of 10-20 mSv. Nor have low-dose experimental studies provided definitive answers: some have suggested there may be adverse biological effects in the range of 5-50 mSv, while others support a "no risk" interpretation. Epidemiologic data contain intrinsic "noise" (variation by known and unknown factors related to genetics, lifestyle, other environmental exposures, sociodemographics, diagnostic accuracy, etc.) so are generally too insensitive to provide compelling answers in the low-dose range. However, there have been recent provocative reports regarding risk from relatively low-dose occupational and medical radiation exposures that warrant careful consideration. Summaries of the largest studies with low-dose or low dose-rate radiation exposure provide suggestive evidence of risk for solid cancer and stronger evidence for leukemia risk. Recently, interest in health endpoints other than cancer also has risen sharply, in particular the degree of cardiovascular and cataract risk following doses under 1 Sv. Data regarding cardiovascular disease are limited and fuzzy, with suggestions of inconsistencies, and the risk at low doses is essentially unknown. The evidence of cataract risk after low dose-rate exposures among those conducting interventional medical radiological procedures is becoming strong. The magnitude of radiation impacts on human health requires fuller documentation, especially for low-dose or low dose-rate exposures. From the epidemiologic vantage point, this will require longer observation of existing irradiated cohorts and development of new informative cohorts, improved accuracy in dose assessments, more attention to confounding variables, and more biosamples from irradiated

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

    NASA Astrophysics Data System (ADS)

    Heisler, Gordon M.

    2005-08-01

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

  12. [Health promotion and computer science in radiation protection].

    PubMed

    Pennarola, R; Porzio, G; Cavaliere, L

    2007-01-01

    An automatic system of clinical-diagnostic information has been applied to workers exposed to ionising radiation at the University of Naples Federico II with reference to the last 5 years. For every person exposed a computerized case sheet was elaborated recording clinical, biological, dosimetric and other preventive data. In the localized risk, capillaroscopic monitoring was used. This research has highlighted the role of medical surveillance in developing health promotion criteria and the planning of the interventions with the complete control of all data in real time.

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

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

    SciTech Connect

    Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

    1993-12-01

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

  15. Modeling the Early Annihilation Radiation Spectrum from INTEGRAL/SPI

    NASA Astrophysics Data System (ADS)

    Guessoum, N.; Jean, P.; Knödlseder, J.; Lonjou, V.; von Ballmoos, P.; Weidenspointer, G.

    2004-10-01

    We undertake to model the spectrum of the galactic annihilation radiation, using the preliminary data obtained by INTEGRAL/SPI (Jean et al. 2003; Jean et al. 2004; Lonjou et al. 2004). We use the general line spectroscopy approach developed by Guessoum et al. (1991), where the interstellar medium (ISM) is divided into 5 phases: cold, warm neutral, warm ionized, and hot, in addition to a dust grain fraction, each characterized by proper physical parameters. Each phase presents us with particular positron annihilation processes, rates, and line widths. Best- fitting the model spectrum to the SPI data (through a chi-square minimization approach) then allows us to obtain "best values" for the ISM phase fractions (density times filling factor) along with uncertainties. Noting that the (astrophysical) line width determined by SPI (3.0 ± 0.5 keV in the first set of data and 2.7 ± 0.3 keV in the most recent analysis; Lonjou et al. 2004) is rather significantly larger than the value derived by the TGRS measurements (Harris et al. 1998), i.e. 1.8 ± 0.5 keV, we submitted the TGRS data to the same analysis. We should also note, however, that the width of the line obtained from the previous Germanium-detector observation missions, namely GRIS and HEXAGONE, were 2.5±0.4 keV ("weighted mean" from 3 observation campaigns; (Leventhal et al. 1993) and 2.66±0.6 keV (Durouchoux et al. 1993), respectively. The results suggest annihilation in a medium that is warmer or hotter (more fully ionized) and quite devoid of grains, compared to the dustier and hotter (overall) medium suggested by the SPI data. We briefly discuss these results and possible interpretations as well as follow-up analyses and proposed observations.

  16. Integrating occupational health protection and health promotion: theory and program application.

    PubMed

    Blix, A

    1999-04-01

    1. The worksite offers an excellent setting to focus on both health protection and health promotion. Collaboration between health professionals concerned with health protection and health promotion would achieve common goals of risk reduction related to job risks and life risks. 2. Workers who experience "double jeopardy" because they are exposed to job risks and life risks would benefit most. 3. Benefits of integration include lower health risks, joint responsibility to promote health and safety shared between management and workers, and cost effectiveness. 4. The social ecological model is useful in developing an integrated program as it is multidimensional, interdisciplinary, and includes the dynamic interplay between the environment and personal factors impacting the health outcome.

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

    PubMed

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

    2015-01-01

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

  18. Integrating Human Health into Environmental Impact Assessment: An Unrealized Opportunity for Environmental Health and Justice

    PubMed Central

    Bhatia, Rajiv; Wernham, Aaron

    2008-01-01

    Objectives The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. Data sources We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. Data synthesis We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. Conclusions The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice. PMID:18709140

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

    PubMed Central

    Pronk, Nicolaas P.

    2014-01-01

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

  20. [The contribution of health professionals in the integration of health and environmental protection].

    PubMed

    Faggioli, Antonio

    2015-01-01

    This article first illustrates the EU and national regulatory frameworks related to policies and integrated actions for health and environmental protection, with particular reference to evaluation of the impact of the environment on health, then provides definitions of "evaluation of health impact" and of "environmental epidemiology" and provides synthetic proposals on procedures and operational levels (national, regional and local). Finally, the responsibilities of regional and local government bodies in supporting ARPA, Departments of Prevention of local health departments and physicians. PMID:26722828

  1. 78 FR 732 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

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

  2. 77 FR 15761 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

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

  3. 76 FR 77235 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

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

  4. 78 FR 53147 - Advisory Board on Radiation and Worker Health: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

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

  5. 76 FR 11483 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-29

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

  7. 78 FR 62635 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

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

  8. 75 FR 28626 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

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

  9. 75 FR 58408 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

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

  10. 77 FR 40890 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

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

  11. 75 FR 78998 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

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

  12. 76 FR 38183 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

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

  13. 77 FR 61756 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

    Ali, Ather; Katz, David L

    2015-11-01

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

  17. Participative mental health consumer research for improving physical health care: An integrative review.

    PubMed

    Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Stanton, Robert

    2016-10-01

    People with mental illness have a significantly lower life expectancy and higher rates of chronic physical illnesses than the general population. Health care system reform to improve access and quality is greatly needed to address this inequity. The inclusion of consumers of mental health services as co-investigators in research is likely to enhance service reform. In light of this, the current paper reviews mental health consumer focussed research conducted to date, addressing the neglect of physical health in mental health care and initiatives with the aim of improving physical health care. The international literature on physical healthcare in the context of mental health services was searched for articles, including mental health consumers in research roles, via Medline, CINAHL and Google Scholar, in October 2015. Four studies where mental health consumers participated as researchers were identified. Three studies involved qualitative research on barriers and facilitators to physical health care access, and a fourth study on developing technologies for more effective communication between GPs and patients. This review found that participatory mental health consumer research in physical health care reform has only become visible in the academic literature in 2015. Heightened consideration of mental health consumer participation in research is required by health care providers and researchers. Mental health nurses can provide leadership in increasing mental health consumer research on integrated care directed towards reducing the health gap between people with and without mental illness.

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

    PubMed

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

    2016-06-01

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

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

    USGS Publications Warehouse

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

    1998-01-01

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

  20. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

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

  1. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

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

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

    PubMed

    Holick, Michael F

    2016-03-01

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

  3. Fractional integration and radiative transfer in a multifractal atmosphere

    SciTech Connect

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

    1996-04-01

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

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

    PubMed

    Zolnierek, C D

    2008-09-01

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

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

    PubMed

    Riaz, Musarrat; Basit, Abdul

    2016-09-01

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

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

    PubMed

    Riaz, Musarrat; Basit, Abdul

    2016-09-01

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

  7. Integrating Health and Vocational Psychology: HIV and Employment

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  8. Integrated Care in College Health: A Case Study

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  9. The card integrated into the Slovene Health Care Information System.

    PubMed

    Suselj, M

    2000-01-01

    At the time of the congress, the health insurance card system national scale introduction in Slovenia is completed. This paper presents the main features of the implementation process and of the resulting system. In its first phase configuration, the system addresses administrative tasks in the health care and health insurance sectors. Yet, technological and organisational infrastructure introduced, as well as experiences gained, provide sound grounds for the system enhancement with new functions, the development of which has been carried out in parallel with the basic system implementation. Furthermore, the system is designed to be open to the integration into the overall health care information system and to be a component of the continuous process of bringing the health care to the citizens.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

    Testa, Marcia A.; Spackman, Thomas J.

    1985-01-01

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

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

    SciTech Connect

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

    2009-11-24

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

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

    PubMed

    Cadoná, Eliane; Scarparo, Helena

    2015-09-01

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

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

    PubMed Central

    2015-01-01

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

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

    PubMed Central

    Goddard, Maria; Weatherly, Helen; Chalkley, Martin

    2015-01-01

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

  17. 75 FR 38099 - Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

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

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

    PubMed

    Munir, Samina K; Kay, Stephen

    2003-01-01

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

  19. Integral radiation dose to normal structures with conformal external beam radiation

    SciTech Connect

    Aoyama, Hidefumi . E-mail: hao@radi.med.hokudai.ac.jp; Westerly, David Clark; Mackie, Thomas Rockwell; Olivera, Gustavo H.; Bentzen, Soren M.; Patel, Rakesh R.; Jaradat, Hazim; Tome, Wolfgang A.; Ritter, Mark A.; Mehta, Minesh P.

    2006-03-01

    Background: This study was designed to evaluate the integral dose (ID) received by normal tissue from intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Twenty-five radiation treatment plans including IMRT using a conventional linac with both 6 MV (6MV-IMRT) and 20 MV (20MV-IMRT), as well as three-dimensional conformal radiotherapy (3DCRT) using 6 MV (6MV-3DCRT) and 20 MV (20MV-3DCRT) and IMRT using tomotherapy (6MV) (Tomo-IMRT), were created for 5 patients with localized prostate cancer. The ID (mean dose x tissue volume) received by normal tissue (NTID) was calculated from dose-volume histograms. Results: The 6MV-IMRT resulted in 5.0% lower NTID than 6MV-3DCRT; 20 MV beam plans resulted in 7.7%-11.2% lower NTID than 6MV-3DCRT. Tomo-IMRT NTID was comparable to 6MV-IMRT. Compared with 6MV-3DCRT, 6MV-IMRT reduced IDs to the rectal wall and penile bulb by 6.1% and 2.7%, respectively. Tomo-IMRT further reduced these IDs by 11.9% and 16.5%, respectively. The 20 MV did not reduce IDs to those structures. Conclusions: The difference in NTID between 3DCRT and IMRT is small. The 20 MV plans somewhat reduced NTID compared with 6 MV plans. The advantage of tomotherapy over conventional IMRT and 3DCRT for localized prostate cancer was demonstrated in regard to dose sparing of rectal wall and penile bulb while slightly decreasing NTID as compared with 6MV-3DCRT.

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

    PubMed

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

    2015-12-01

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

  1. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

    Daniels, James

    2014-01-01

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

  2. Integrating health promotion with quality improvement in a Swedish hospital.

    PubMed

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals.

  3. Integrating health promotion with quality improvement in a Swedish hospital.

    PubMed

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals. PMID:25983332

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

    PubMed Central

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

    2008-01-01

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

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

    PubMed

    Sicurello, F; Nicolosi, A

    1997-01-01

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

  6. [General integral medicine: the strategic direction for complex health interventions].

    PubMed

    Hou, Zheng-kun; Liu, Feng-bin; Yang, Yun-ying; Chen, Xin-lin; Li, Li-juan; Li, Pei-wu; Liu, Yuan-peng

    2014-06-01

    Nowadays, the simple combination of Western medicine (WM) and complementary and alternative medicine (CAM) cannot resolve all the health problems and various requirements. This article proposed the general integral medicine (GIM) theoretical model, which declares the disease causes analysis, clinical intervention and outcomes assessment should be recognized, managed and evaluated both from physiological, psychological, and spiritual status, and all the four dimensions: orthodox medicine (WM, Chinese medicine, etc.), individual inherent characteristics (emotion, attitude, psychology, etc.), cultural influences (doctors, caregivers, groups care, etc.), and natural environment and social systems (economic status, social security system, environmental pollution, etc). As for health outcomes assessment, a more comprehensive system including biological, doctors, patients, health intimate, social and environmental evaluations were required. The GIM model has individualized, dynamic, standardized, objective, systematic inherent characteristics, and opening and compatible external characteristics. It aims to provide the new theoretical guidance and strategic development direction for complex health interventions, and solve various medical related psychological and social problems.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2010-11-01

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

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

    PubMed

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

    2010-11-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2012-11-21

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

  12. Approaches to integrated monitoring for environmental health impact assessment

    PubMed Central

    2012-01-01

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

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

    PubMed

    Mims, Susan

    2006-01-01

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

  14. Integrated Worker Radiation Dose Assessment for the K Basins

    SciTech Connect

    NELSON, J.V.

    1999-10-27

    This report documents an assessment of the radiation dose workers at the K Basins are expected to receive in the process of removing spent nuclear fuel from the storage basins. The K Basins (K East and K West) are located in the Hanford 100K Area.

  15. Intrinsic angular momentum for radiating spacetimes which agrees with the Komar integral in the axisymmetric case

    NASA Astrophysics Data System (ADS)

    Gallo, Emanuel; Moreschi, Osvaldo M.

    2014-04-01

    Here, we present a new definition of intrinsic angular momentum at future null infinity, based on the charge-integral approach. This definition is suitable for the general case of radiating spacetimes without symmetries, which does not suffer from supertranslation ambiguities. In the case of axial symmetry, this new definition agrees with the Komar integral.

  16. When Frontline Practice Innovations Are Ahead of the Health Policy Community: The Example of Behavioral Health and Primary Care Integration.

    PubMed

    Miller, Benjamin F

    2015-01-01

    Innovation in health care delivery often far outpaces the speed at which health policy changes to accommodate this innovation. Integrating behavioral health and primary care is a promising approach to defragment health care and help health care achieve the triple aim of decreasing costs, improving outcomes, and enhancing patients' experiences. However, the problem remains that health policy does not frequently support the integration of care. This commentary describes some of the reasons policy falters as well as potential opportunities to begin to influence health policy to better support practices that take an integrated approach to health care.

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

    NASA Astrophysics Data System (ADS)

    Sprigg, W. A.

    2014-12-01

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

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

    SciTech Connect

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

    2012-09-01

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

  19. Radiation direction control by optical slot antenna integrated with plasmonic waveguide

    NASA Astrophysics Data System (ADS)

    Park, Yeonsang; Kim, Jineun; Roh, Young-Geun; Lee, Chang-Won

    2016-04-01

    We present an optical slot antenna integrated with a metal-dielectric-metal (MIM) plasmonic waveguide. By integrating optical slot antenna on top metal layer of MIM waveguide, we can couple the plasmon guide mode into the feed antenna directly. The resonantly excited slot antenna works as a magnetic dipole and then radiates in dipole-like far-field pattern. By adding an auxiliary groove structure along with the slot antenna, the radiation can be directed into the direction where the structure determined. The demonstrated optical slot antenna integrated with a plasmonic waveguide can be used as a "plasmonic via" in plasmonic nanocircuits.

  20. Health-related aspects of integrated pest management.

    PubMed Central

    Smith, R F; Calvert, D J

    1976-01-01

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

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

    PubMed Central

    Suchar, Vasile Alexandru; Robberecht, Ronald

    2015-01-01

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

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

    PubMed

    Suchar, Vasile Alexandru; Robberecht, Ronald

    2015-07-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

    Rose, R. I.

    2001-01-01

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

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

    PubMed

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

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

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

    PubMed

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

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

  7. Technology integration performance assessment using lean principles in health care.

    PubMed

    Rico, Florentino; Yalcin, Ali; Eikman, Edward A

    2015-01-01

    This study assesses the impact of an automated infusion system (AIS) integration at a positron emission tomography (PET) center based on "lean thinking" principles. The authors propose a systematic measurement system that evaluates improvement in terms of the "8 wastes." This adaptation to the health care context consisted of performance measurement before and after integration of AIS in terms of time, utilization of resources, amount of materials wasted/saved, system variability, distances traveled, and worker strain. The authors' observations indicate that AIS stands to be very effective in a busy PET department, such as the one in Moffitt Cancer Center, owing to its accuracy, pace, and reliability, especially after the necessary adjustments are made to reduce or eliminate the source of errors. This integration must be accompanied by a process reengineering exercise to realize the full potential of AIS in reducing waste and improving patient care and worker satisfaction. PMID:24878516

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

    PubMed Central

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

    2009-01-01

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

  9. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    PubMed

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  10. [European integration and health policies: repercussions of the internal European Market on access to health services].

    PubMed

    Guimarães, Luisa; Giovanella, Lígia

    2006-09-01

    This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

  11. Public health may not be ready for health system change - but neither is the system ready to integrate public health.

    PubMed

    Frank, John; Jepson, Ruth

    2013-01-01

    In response to the lead paper, the authors of this commentary propose that there are three fundamental sorts of reform for which Canada's healthcare system would need to provide evidence of progress before public health professionals should get fired up about lumping everything together inside the care system, to help it "transform." These three central changes - the adoption of an integrated data system, the provision of meaningful incentives for prevention, and important structural design changes - would be essential to enabling public health talent (and their skills) to be really useful and effective as staff within the care system. They argue that without clear evidence of this progress, such integration might well lead to the capture of the hearts, minds and energies of many well-intended public health professionals by purely clinical services management work, to the exclusion of proper upstream public health activities to uplift population health status and reduce inequalities more fundamentally. PMID:24524576

  12. The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.

    PubMed

    Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

    2008-12-01

    This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business."

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

    PubMed

    Silveira, Elaine Rosner

    2012-09-01

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

  14. A tunable integrated system to simulate colder stellar radiation

    NASA Astrophysics Data System (ADS)

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

    2015-09-01

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

  15. Electrical integrity of oxides in a radiation field

    SciTech Connect

    Zinkle, S.J.; Kinoshita, C.

    1996-04-01

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

  16. IVHM Framework for Intelligent Integration for Vehicle Health Management

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

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

    PubMed

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

    2012-06-01

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

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

    ERIC Educational Resources Information Center

    Duda, Terrie

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

  19. Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers

    PubMed Central

    2013-01-01

    Background Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). Results These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to

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

    PubMed

    Lebret, Erik

    2016-01-01

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

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

    PubMed

    Lebret, Erik

    2016-01-01

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

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

    PubMed Central

    Lebret, Erik

    2015-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Johnston, Allan H.; Rax, Bernard G.

    2006-01-01

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

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

    PubMed

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

    2002-01-01

    There are few human data on low-dose-rate-radiation exposure and the consequent acute and late effects. This fact makes it difficult to assess health risks due to radiation in the space environment, especially for long-term missions. Epidemiological data on civilian flight personnel cohorts can provide information on effects due to the low-dose and low-dose rate mixed high- and low-LET radiation environment in the earth's atmosphere. The physical characteristics of the radiation environment of the atmosphere make the results of the studies of commercial flight personnel relevant to the studies of activities in space. The cooperative international effort now in progress to investigate dose reconstructions will contribute to our understanding of radiation risks for space exploration. PMID:12539781

  5. Implementing and Integrating a Clinically Driven Electronic Medical Record for Radiation Oncology in a Large Medical Enterprise

    PubMed Central

    Kirkpatrick, John P.; Light, Kim L.; Walker, Robyn M.; Georgas, Debra L.; Antoine, Phillip A.; Clough, Robert W.; Cozart, Heidi B.; Yin, Fang-Fang; Yoo, Sua; Willett, Christopher G.

    2013-01-01

    , compared to paper charts, time required by clinicians to access/enter patient information has substantially increased. While productivity is improving with experience, substantial growth will require better integration of the system components, decreased access times, and improved user interfaces. $127K was spent on new hardware and software; elimination of paper yields projected savings of $21K/year. One year after conversion to an EMR, more than 90% of department staff favored the EMR over the previous paper charts. Conclusion: Successful implementation of a Radiation Oncology EMR required not only the effort and commitment of all functions of the department, but support from senior health system management, corporate IT, and vendors. Realization of the full benefits of an EMR will require experience, faster/better integrated software, and continual improvement in underlying clinical processes. PMID:23616946

  6. Integrative medicine selects best practice from public health and biomedicine.

    PubMed

    Ryan, Terence J

    2013-03-01

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

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

    PubMed Central

    Ryan, Terence J

    2013-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2011-09-01

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

  10. 76 FR 47590 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

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

  11. 77 FR 52335 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

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

  12. 76 FR 5814 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

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

  13. 75 FR 66769 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

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

  14. Integrated controls and health monitoring for chemical transfer propulsion

    NASA Technical Reports Server (NTRS)

    Millis, Marc G.; Binder, Michael P.

    1990-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

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

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

    PubMed

    Frantz, E

    2006-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Patience, Luke

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. Integrating mitochondriomics in children’s environmental health

    PubMed Central

    Brunst, Kelly J.; Baccarelli, Andrea A.; Wright, Rosalind J.

    2016-01-01

    The amount of scientific research linking environmental exposures and childhood health outcomes continues to grow; yet few studies have teased out the mechanisms involved in environmentally-induced diseases. Cells can respond to environmental stressors in many ways: inducing oxidative stress/inflammation, changes in energy production and epigenetic alterations. Mitochondria, tiny organelles that each retains their own DNA, are exquisitely sensitive to environmental insults and are thought to be central players in these pathways. While it is intuitive that mitochondria play an important role in disease processes, given that every cell of our body is dependent on energy metabolism, it is less clear how environmental exposures impact mitochondrial mechanisms that may lead to enhanced risk of disease. Many of the effects of the environment are initiated in utero and integrating mitochondriomics into children’s environmental health studies is a critical priority. This review will highlight (i) the importance of exploring environmental mitochondriomics in children’s environmental health, (ii) why environmental mitochondriomics is well suited to biomarker development in this context, and (iii) how molecular and epigenetic changes in mitochondria and mitochondrial DNA (mtDNA) may reflect exposures linked to childhood health outcomes. PMID:26046650

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

    ERIC Educational Resources Information Center

    Bull, Sheana; Ezeanochie, Nnamdi

    2016-01-01

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

  2. The integration of behavioral health interventions in children's health care: services, science, and suggestions.

    PubMed

    Kolko, David J; Perrin, Ellen

    2014-01-01

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

  3. Integrative Health and Healing as the New Health Care Paradigm for the Military

    PubMed Central

    2015-01-01

    Abstract Background: The field of integrative health and healing (IH2) is emerging out of the dark recesses of “voodoo” stereotypes and into the light as a new and much needed health care paradigm. It is a philosophy of health and healing that seeks to place patients as the preeminent players in health management, disease prevention, and injury recovery. There is an emphasis of patient responsibility, which includes a holistic approach that merges allopathic with complementary medicine. Objective: The aim of this article is to explore the historical origins of integrative medicine and investigate the future role of the IH2 paradigm. Methods: This article reviews current available data and information regarding complementary and alternative medicine utilized in civilian and military populations as the basis for a new paradigm for a system of care—a system that empowers patients. Conclusions: The current U.S. health care system is reactive and disease-based, with a focus on reductionism. This system is not serving us well. IH2 is a new model of cost-effective patient-centered health care. PMID:26543516

  4. Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria

    PubMed Central

    Ibrahim, MTO; Saidu, SA; Ma’aji, SM; Danfulani, M; Yunusa, EU; Ikhuenbor, DB; Ige, TA

    2016-01-01

    Introduction Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. Aim To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. Materials and Methods A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). Results The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. Conclusion This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2015-08-01

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

  7. 76 FR 59133 - Subcommittee on Dose Reconstruction Reviews (SDRR), Advisory Board on Radiation and Worker Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Dose Reconstruction Reviews (SDRR), Advisory Board on Radiation and Worker Health (ABRWH or the Advisory Board), National Institute for Occupational Safety and Health...

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

    SciTech Connect

    1986-11-01

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

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

    SciTech Connect

    Not Available

    1990-05-01

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

  10. Integrated model for mental health care. Are health care providers satisfied with it?

    PubMed Central

    Farrar, S.; Kates, N.; Crustolo, A. M.; Nikolaou, L.

    2001-01-01

    OBJECTIVE: To determine whether health care providers are satisfied with an integrated program of mental health care. DESIGN: Surveys using a mailed questionnaire. Surveys were developed for each of the three disciplines; each survey had 30 questions. SETTING: Thirty-six primary care practices in Hamilton, Ont, participating in the Hamilton-Wentworth Health Service Organization's Mental Health Program. PARTICIPANTS: Family physicians, psychiatrists, and mental health counselors providing mental health care in primary care settings. MAIN OUTCOME MEASURE: Satisfaction as shown on 5-point Likert scales. RESULTS: High levels of satisfaction with the model were recorded. Family physicians increased their skills, felt more comfortable with handling mental health problems, and were satisfied with the benefit to their patients. Psychiatrists and counselors were gratified that they were accepted by other members of the primary care team. Areas for improvement included finding space in primary care settings and better scheduling to allow for optimal communication. CONCLUSION: Family physicians, counselors, and psychiatrists expressed great satisfaction with a shared mental health care program based in primary care. PMID:11785279

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

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

    PubMed

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

    2012-03-01

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

  13. On the Variability of the Solar Integral Radiation Constituents

    NASA Technical Reports Server (NTRS)

    Nikolsky, G. A.

    1990-01-01

    The results of spectral analysis of series of observations of the equatorial and polar diameters, as well as of series of satellite observations of the S sub O variations during 1975 to 1987 presented in papers by Laclare (1987), Delache (1988) and Delache et al. (1988) confirm with confidence the presence of an 11-year modulation in the Sun's radiation and diameter, and consequently, in the effective temperature of the photosphere. The same conclusion has been drawn with regard to the 1000th and 320th daily periodicities. In combination with the results of other research, several obvious conclusions can be drawn from the data presented. The 76-year variation in the period from 1967 to 1987 is not revealed in the data of observations; the data of the middle series will doubtless be made more precise after the facsimile from the initial information is obtained. The basic and comparable contributions to the radius variability yield the 11- and 22-year variations. The presence can easily be seen of harmonics with periods of 2 and 4 years; the 4-year period is revealed up to 1979 only, and the 2-year one, after 1980 only. This is possibly due to the combined contribution of the 11- and 22-year variations (to be more precise, 10.8 and 21.2 years) forming a certain mean 16-year periodicity. In this case, the 4- and 2-year variations can be regarded as the 4th and 8th harmonics of such a mean variation. Measurements of the horizontal diameter made at Greenwich Observatory have not lost their significance for the analysis of phenomena on the Sun, since they contain data having precision characteristics conforming to the level of the latest ground-based diameter measurements.

  14. New York State Health Foundation: integrating mental health and substance abuse care.

    PubMed

    Isaacs, Stephen; Jellinek, Paul; Martinez Garcel, Jacqueline; Hunt, Kelly A; Bunch, Will

    2013-10-01

    Roughly half of all people with severe mental disorders also have substance abuse problems. Yet their care is fragmented: They are treated by either the mental health system or the substance abuse system. In New York State only 10 percent of them receive evidence-based treatment for both conditions. Beginning in 2007 the New York State Health Foundation and two state agencies--the Office of Mental Health and the Office of Alcoholism and Substance Abuse Services--began collaborating on ways to integrate the treatment of people with co-occurring disorders. The state agencies removed financial and regulatory barriers to integrated treatment. The foundation provided funding to establish the Center for Excellence in Integrated Care. The center's goal: provide hands-on assistance in implementing best practices to at least half of the state's 1,200 mental health and substance abuse treatment clinics. An evaluation found that the percentage of clinics using best practices doubled after the regulatory and financial changes and the center's intervention. This illustrates the potential that foundations, governments, and nonprofits, working collaboratively, have to improve the care of a neglected and difficult-to-serve population.

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

    PubMed

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

    2013-08-01

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

  16. Sustainable Watersheds: Integrating Ecosystem Services and Public Health

    PubMed Central

    Jordan, Stephen J; Benson, William H

    2015-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Figueroa, Fernando

    2009-01-01

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

  18. Scientific integrity: critical issues in environmental health research

    PubMed Central

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

    2008-01-01

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

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

    PubMed

    Jordan, Stephen J; Benson, William H

    2015-01-01

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

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

    PubMed

    Jordan, Stephen J; Benson, William H

    2015-01-01

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

  1. [Current epidemiological evidence regarding the health effects of low-dose ionizing radiation. Implications for radiation protection, public health and forensic medicine].

    PubMed

    Manzoli, Lamberto; Romano, Ferdinando; Schioppa, Francesco; D'Ovidio, Cristian; Lodi, Vittorio; Pirone, Giovanni Maria

    2004-01-01

    The health effects of low-dose ionizing radiation have been widely studied, but remain uncertain. Up-to-date knowledge about epidemiologic evidence for potential human health effects of low dose ionizing radiation is important for revising national radiation protection legislation. This review, conducted by a multidisciplinary research team of the Italian Institute of Social Medicine, evaluates epidemiologic studies published since July 2003. After careful selection, a total of 302 studies were reviewed. Greater emphasis was given to papers that analyzed data using standardized incidence and mortality ratios and to studies regarding occupational exposures in all workers, healthcare workers and aircrew members. Nevertheless, studies regarding A-bomb survivors of Hiroshima/Nagasaki, Chernobyl cleanup workers, patients exposed for medical reasons, and workers in nuclear plants were also included. Given the limitations of epidemiological studies and excluding the cosmic rays context, which requires further research, the authors conclude that harmful effects from exposures to ionizing radiation at doses lower than 100 mSv cannot be ruled out. Nevertheless, if any harmful health effects do exist, they are certainly very small. The implications for radiation protection, public health and forensic medicine are discussed. PMID:15213763

  2. An Integrated Health Monitoring System for Fission Surface Power

    NASA Astrophysics Data System (ADS)

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

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

  3. Feasibility and Preliminary Outcomes From a Pilot Study of an Integrated Health-Mental Health Promotion Program in School Mental Health Services

    PubMed Central

    George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.

    2014-01-01

    The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program. PMID:24297005

  4. 77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

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

  5. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

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

  6. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

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

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

    SciTech Connect

    Morgan, William F.; Sowa, Marianne B.

    2015-01-01

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

  8. System integration and radiation pattern measurements of a phased array antenna employing an integrated photonic beamformer for radio astronomy applications.

    PubMed

    Burla, Maurizio; Roeloffzen, Chris G H; Zhuang, Leimeng; Marpaung, David; Khan, Muhammad Rezaul; Maat, Peter; Dijkstra, Klaas; Leinse, Arne; Hoekman, Marcel; Heideman, René

    2012-03-01

    In this paper we describe the system integration and the experimental demonstration of a photonically beamformed four-element receiving array antenna for radio astronomy applications. To our knowledge, the work described here is the first demonstration of the squint-free, continuously tunable beamsteering capability offered by an integrated photonic beamformer based on optical ring resonator true-time-delay units, with measured radiation patterns. The integrated beamformer is realized in a low loss, complementary metal-oxide-semiconductor (CMOS) compatible optical waveguide technology. The measurements show a wideband, continuous beamsteering operation over a steering angle of 23.5 degrees and an instantaneous bandwidth of 500 MHz limited only by the measurement setup.

  9. Ground Operations Autonomous Control and Integrated Health Management

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

  10. INTEGRAL/SPI Limits on Electron-Positron Annihilation Radiation from the Galactic Plane

    NASA Technical Reports Server (NTRS)

    Teegarden, B. J.; Watanabe, K.; Jean, P.; Knoedlseder, J.; Lonjou, V.; Roques, J. P.; Skinner, G. K.; vonBallmoos, P.; Weidenspointner, G.; Bazzano, A.

    2005-01-01

    The center of our Galaxy is a known strong source of electron-positron 511- keV annihilation radiation. Thus far, however, there have been no reliable detections of annihilation radiation outside of the central radian of our Galaxy. One of the primary objectives of the INTEGRAL (INTErnational Gamma-RAy Astrophysics Laboratory) mission, launched in Oct. 2002, is the detailed study of this radiation. The Spectrometer on INTEGRAL (SPI) is a high resolution coded-aperture gamma-ray telescope with an unprecedented combination of sensitivity, angular resolution and energy resolution. We report results from the first 10 months of observation. During this period a significant fraction of the observing time was spent in or near the Galactic Plane. No positive annihilation flux was detected outside of the central region (|l| greater than 40 degrees) of our Galaxy. In this paper we describe the observations and data analysis methods and give limits on the 511-keV flux.

  11. Modular, thermal bus-to-radiator integral heat exchanger design for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe; Ewert, Michael

    1990-01-01

    The baseline concept is introduced for the 'integral heat exchanger' (IHX) which is the interface of the two-phase thermal bus with the heat-rejecting radiator panels. A direct bus-to-radiator heat-pipe integral connection replaces the present interface hardware to reduce the weight and complexity of the heat-exchange mechanism. The IHX is presented in detail and compared to the baseline system assuming certain values for heat rejection, mass per unit width, condenser capacity, contact conductance, and assembly mass. The spreadsheet comparison can be used to examine a variety of parameters such as radiator length and configuration. The IHX is shown to permit the reduction of panel size and system mass in response to better conductance and packaging efficiency. The IHX is found to be a suitable heat-rejection system for the Space Station Freedom because it uses present technology and eliminates the interface mechanisms.

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2015-10-01

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

  14. Evolution of an integrated public health surveillance system.

    PubMed

    Chapman, Derek A; Ford, Nancy; Tlusty, Susan; Bodurtha, Joann N

    2011-01-01

    There is a growing recognition in maternal and child health of the importance of social, behavioral, biological, and genetic factors across the entire life course. Unfortunately, most state maternal and child health surveillance systems are not designed to readily address longitudinal research questions or track and follow children across multiple programs over time. The Virginia Department of Health (VDH) recently integrated its birth defects registry, newborn hearing screening tracking and management system, and electronic birth certificate (EBC) into a robust, Web-based surveillance system called the Virginia Vital Events and Screening Tracking System (VVESTS). Completely redesigning the existing birth defects and newborn hearing screening system (the Virginia Infant Screening and Infant Tracking System--VISITS I) with minimal disruption of ongoing reporting presented a number of challenges. Because VVESTS had different requirements such as required fields and data validations, extensive data preparation was required to ensure that existing VISITS I data would be included in the new system (VISITS II). Efforts included record deduplication, conversion of free text fields into discrete variables, dealing with missing/invalid data, and linkage with birth certificate data. VISITS II serves multiple program needs; improves data quality and security; automates linkages within families, across programs, and over time; and improves the ability of VDH to provide children with birth defects and their families necessary follow-up services and enhanced care coordination.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

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

    2013-12-01

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

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

    SciTech Connect

    Fabrikant, J.I.

    1980-03-01

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

  20. BEIR-III report and the health effects of low-level radiation

    SciTech Connect

    Fabrikant, J.I.

    1980-01-01

    The present BEIR-III Committee has not highlighted any controversy over the health effects of low-level radiation. In its evaluation of the experimental data and epidemiological surveys, the Committee has carefully reviewed and assessed the value of all the available scientific evidence for estimating numerical risk coefficients for the health hazards to human populations exposed to low levels of ionizing radiation. Responsible public awareness of the possible health effects of ionizing radiations from medical and industrial radiation exposure, centers on three important matters of societal concern: (1) to place into perspective the extent of harm to the health of man and his descendants to be expected in the present and in the future from those societal activities involving ionizing radiation; (2) to develop quantitative indices of harm based on dose-effect relationships; such indices could then be used with prudent caution to introduce concepts of the regulation of population doses on the basis of somatic and genetic risks; and (3) to identify the magnitude and extent of radiation activities which could cause harm, to assess their relative significance, and to provide a framework for recommendations on how to reduce unnecessary radiation exposure to human populations. The main difference of the BEIR Committee Report is not so much from new data or new interpretations of existing data, but rather from a philosophical approach and appraisal of existing and future radiation protection resulting from an atmosphere of constantly changing societal conditions and public attitudes. (PCS)

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-11-30

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

  3. The NOAA Integrated Surface Irradiance Study (ISIS) - A new surface radiation monitoring program

    SciTech Connect

    Hicks, B.B.; DeLuisi, J.J.

    1996-12-01

    This paper describes a new radiation monitoring program, the Integrated Surface Irradiance Study (ISIS), that builds upon and takes over from earlier NOAA networks monitoring components of solar radiation [both the visible component (SOLRAD) and the shortwave component that causes sunburn, UV-B] across the continental United States. ISIS is implemented in two levels. Level 1 addresses incoming radiation only, and level 2 addresses the surface radiation balance. Level 2 also constitutes the SURFRAD (Surface Radiation) program of the NOAA Office of Global Programs, specifically intended to provide radiation data to support large-scale hydrologic studies that will be conducted under the Global Energy and Water Cycle Experiment. Eventually, it is planned for level 2 sites to monitor all components of the surface energy balance. Both levels of ISIS will eventually measure both visible and UV radiation components. At present, there are nine sites that are considered to be at ISIS level 1 standard and an additional four level 2 SURFRAD sites. A 10th level 1 site will be in operation soon. Plans call for an increase in the number of sites of both kinds, up to about 15 ISIS sites, of which 6 will be at the SURFRAD level. 20 refs., 2 figs., 1 tab.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2014-04-01

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

  7. Intelligent Integrated Health Management for a System of Systems

    NASA Technical Reports Server (NTRS)

    Smith, Harvey; Schmalzel, John; Figueroa, Fernando

    2008-01-01

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

  8. Smart Sensors' Role in Integrated System Health Management

    NASA Technical Reports Server (NTRS)

    Perotti, Jose M.; Mata, Carlos

    2005-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. [Sterilization with ozone in health care: an integrative literature review].

    PubMed

    Sousa, Cristina Silva; Torres, Lilian Machado; Azevedo, Marcela Padilha Facetto; de Camargo, Tamara Carolina; Graziano, Kazuko Uchikawa; Lacerda, Rúbia Aparecida; Turrini, Ruth Natalia Teresa

    2011-10-01

    The objective of this integrative literature review was to find evidence to support using ozone as a sterilizing agent for health products. The search was performed on the following bases: MEDLINE, SCOPUS, COCHRANE, COMPENDEX, INSPEC and ENGINEERING RESEARCH DATABASE; using ozone and sterilization as descriptors. Five articles were found between 1990 and 2008, which tested ozone as a sterilizer. All studies used the same type of investigation (experimental laboratory study) and achieved sterilization with ozone, but with different scopes and products, besides using different methodological procedures. Considering the ever-growing technology for new products, with the vast range of forms and materials, the findings point at ozone sterilization as a promising method, but still in an initial phase of investigation. Further experimental studies are needed to provide broader evidence regarding the possibilities and limitations of ozone sterilization.

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

    PubMed Central

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Journal of American College Health, 2010

    2010-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Baroth, Edmund C.; Pallix, Joan

    2006-01-01

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

  15. CADe System Integrated within the Electronic Health Record

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2015-01-01

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

  17. CADe system integrated within the electronic health record.

    PubMed

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

    2013-01-01

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

  18. A Technical Assistance Framework to Facilitate the Delivery of Integrated Behavioral Health Services in Federally Qualified Health Centers (FQHCs).

    PubMed

    Chaple, Michael; Sacks, Stanley; Randell, Joan; Kang, Barbara

    2016-01-01

    An implementation approach, featuring direct, onsite technical assistance is described, and findings from a pilot study assessing the capability of Federally Qualified Health Centers to provide integrated behavioral health services are presented. Investigators used the Behavioral Health Integration in Medical Care (BHIMC) index to measure integration at baseline and follow-up at four FQHCs in New Jersey. Results indicate that the average baseline capability score of 1.95 increased to 2.44 at follow-up, almost one-half point on the five-point BHIMC index. This pilot project demonstrates that co-occurring capability can be assessed, and system-wide technical assistance can be delivered to assist FQHCs in integrating behavioral health services. Future research should test technical assistance as an implementation strategy to promote the integration of medical care and behavioral health treatment on a wider scale.

  19. Analogue of electromagnetically induced transparency in integrated plasmonics with radiative and subradiant resonators.

    PubMed

    Wang, Ting; Zhang, Yusheng; Hong, Zhi; Han, Zhanghua

    2014-09-01

    We propose the use of radiative and subradiant resonators coupled to a metal-insulator-metal waveguide to represent the three-level energy diagram in conventional atomic systems and demonstrate a new realization of on-chip plasmonic analogue of electromagnetically-induced transparency (EIT) in integrated plasmonics. The radiative resonator is achieved with the help of aperture-coupling while evanescent coupling is relied for the subradiant resonator. Numerical simulation results demonstrate well-pronounced intermediate transmission peak through the bus waveguide and also show that the EIT effect can be easily controlled by the relative position of the two Fabry-Perot resonators.

  20. SEM analysis of ionizing radiation effects in linear integrated circuits. [Scanning Electron Microscope

    NASA Technical Reports Server (NTRS)

    Stanley, A. G.; Gauthier, M. K.

    1977-01-01

    A successful diagnostic technique was developed using a scanning electron microscope (SEM) as a precision tool to determine ionization effects in integrated circuits. Previous SEM methods radiated the entire semiconductor chip or major areas. The large area exposure methods do not reveal the exact components which are sensitive to radiation. To locate these sensitive components a new method was developed, which consisted in successively irradiating selected components on the device chip with equal doses of electrons /10 to the 6th rad (Si)/, while the whole device was subjected to representative bias conditions. A suitable device parameter was measured in situ after each successive irradiation with the beam off.

  1. Efficient application of the spectrally integrated Voigt function to radiative transfer spectroscopy

    NASA Astrophysics Data System (ADS)

    Abrarov, Sanjar

    We present a new application of the spectrally integrated Voigt function (SIVF) to the radiative transfer spectroscopy that enables computation of the spectral radiance and radiance at reduced spectral resolution. Applying a technique based on the Fourier expansion of the exponential multiplier we obtain the series approximations providing high-accuracy and rapid SIVF computation. In contrast to traditional line-by-line (LBL) radiative transfer models, the proposed SIVF algorithm prevents underestimation in the absorption coefficients and, therefore, preserves the radiant energy. LBL sample computations utilizing SIVF algorithm show the advantages of the proposed methodology in terms of the accuracy and computational speed.

  2. Application of the spectrally integrated Voigt function to line-by-line radiative transfer modelling

    NASA Astrophysics Data System (ADS)

    Quine, B. M.; Abrarov, S. M.

    2013-09-01

    We show that a new approach based on the spectrally integrated Voigt function (SIVF) enables the computation of line-by-line (LBL) radiative transfer at reduced spectral resolution without loss of accuracy. The algorithm provides rapid and accurate computation of area under the Voigt function in a way that preserves spectral radiance and, consequently, radiant intensity. The error analysis we provide shows the high-accuracy of the proposed SIVF approximations. A comparison of the performance of the method with that of the traditional LBL approach is presented. Motivations for the use and advantage of the SIVF as a replacement for conventional line function computations in radiative transfer are discussed.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    SciTech Connect

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

    2012-05-01

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

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  9. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities

    PubMed Central

    Mercuri, Mathew; Rehani, Madan M.; Einstein, Andrew J.

    2013-01-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency’s Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the U.S., currently lags behind x-ray based procedures with respect to reporting of radiation dosimetric information. This paper discusses qualitative differences between nuclear medicine and x-ray based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying monitoring and reporting strategies used in x-ray based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  10. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities.

    PubMed

    Mercuri, Mathew; Rehani, Madan M; Einstein, Andrew J

    2012-10-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency's Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray-based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the US, currently lags behind x-ray-based procedures with respect to reporting of radiation dosimetric information. This article discusses qualitative differences between nuclear medicine and x-ray-based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying, monitoring, and reporting strategies used in x-ray-based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists, and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  11. The economic costs of radiation-induced health effects: Estimation and simulation

    SciTech Connect

    Nieves, L.A.; Tawil, J.J.

    1988-08-01

    This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.

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

    PubMed Central

    Kendall, Elizabeth

    2015-01-01

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

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

    PubMed Central

    Mishra, Arima

    2014-01-01

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

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

    PubMed

    Mishra, Arima

    2014-01-01

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

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

    PubMed

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

    2016-06-01

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

  16. New results on radiation effects on human health

    NASA Astrophysics Data System (ADS)

    Spurny, Frantisek; Dachev, Tsvetan

    2009-03-01

    Humans are exposed to ionizing radiation all the time, and it is known that it can induce a variety of harmful biological effects. Consequently, it is necessary to quantitatively assess the level of exposure to this radiation as the basis for estimating risks due to ionization radiation. During the Work Package 2400 of the COST-724/WG-2 action, a number of spacecraft and aircraft experiments have been performed with both active and passive detectors. A large data base has been created. In this contribution we would like to stress the results obtained and their importance in three particular directions: (i) Simultaneous investigation of galactic cosmic rays on aircraft and on the International Space Station (ISS); (ii) Onboard spacecraft neutron contribution as estimated on the basis of the comparison of results measured with MDU/Liulin equipment onboard ISS, foton capsule and a commercial aircraft flying at subsonic altitudes; (iii) Complex analysis of the results of long term measurements onboard a Czech Airlines aircraft. The results obtained are presented, analyzed, and discussed, and their complementary nature is underlined. The contribution represents a version of the Final Report of the Work Package 2400 of the COST-724/WG-2: Radiation Environment of the Earth.

  17. [Mobile phones radiate--risk to the health?].

    PubMed

    Jokela, Kari; Auvinen, Anssi; Hämäläinen, Heikki

    2011-01-01

    The mobile phones radiate electromagnetic energy which is partly absorbed into the tissues in the vicinity of the phone. The minor heating, in maximum up to 0.3 degrees C, may cause some alterations in the expression of genes and proteins similar to physiological response to other stimuli. Biophysical studies at the cellular and molecular level have not revealed any well established interaction mechanism, through which mobile phone radiation could induce toxic effects below the thermal effect level. Research results on various biological effects in vitro and in vivo are continuously published but there is no consistent evidence on well established harmful effects. The mobile phone radiation is not carcinogenic for experimental animals or genotoxic for cells. According to epidemiological studies and psychophysiological brain function studies the use of mobile phones does not seem to increase the risk of tumors in the head and brain or disturb the function of central nervous system. However, there is a need for more research on the long-term effects of mobile phone radiation particularly on children.

  18. The sociobiologic integrative model (SBIM): enhancing the integration of sociobehavioral, environmental, and biomolecular knowledge in urban health and disparities research.

    PubMed

    Gibbons, M Chris; Brock, Malcolm; Alberg, Anthony J; Glass, Thomas; LaVeist, Thomas A; Baylin, Stephen; Levine, David; Fox, C Earl

    2007-03-01

    Disentangling the myriad determinants of disease, within the context of urban health or health disparities, requires a transdisciplinary approach. Transdisciplinary approaches draw on concepts from multiple scientific disciplines to develop a novel, integrated perspective from which to conduct scientific investigation. Most historic and contemporary conceptual models of health were derived either from the sociobehavioral sciences or the biomolecular sciences. Those models deriving from the sociobehavioral sciences generally lack detail on involved biological mechanisms whereas those derived from the biomolecular sciences largely do not consider socioenvironmental determinants. As such, advances in transdisciplinary characterizations of health in complex systems like the urban environment or health disparities may be impeded. This paper suggests a sociobiologic organizing model that encourages a multilevel, integrative perspective in the study of urban health and health disparities.

  19. The Health Professional as Writer: Two Models for Integrating Writing into the Curricula of Baccalaureate Health Programs.

    ERIC Educational Resources Information Center

    Haneline, Douglas

    Current changes in health care professions requiring practitioners to have more and better communications skills are necessitating the integration of writing into the health curricula of higher education programs. At Ferris State University, a number of models (in Optometry, Dental Hygiene, Health Systems Management, Nursing, Pharmacy, Medical…

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

    EPA Science Inventory

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

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

    PubMed Central

    Sobczak, Alicja

    2002-01-01

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

  2. Responding to health care complexity: suggestions for integrated and interprofessional workplace learning.

    PubMed

    Kuipers, Pim; Ehrlich, Carolyn; Brownie, Sharon

    2014-05-01

    This report highlights complexity in health care and the relevance of integrated and interprofessional care and learning. It is proposed that appropriate workforce training in response to complexity should be contextually relevant and workplace integrated, and should focus on building interprofessional capability for reflective practice and critical thinking. This training should be interprofessional and foster systems thinking. It is suggested that the World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a useful integrating framework. PMID:23914938

  3. 75 FR 11186 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

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

  4. 76 FR 16787 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

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

  5. 78 FR 21370 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

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

  6. 75 FR 35496 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

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

  7. 78 FR 732 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

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

  8. 75 FR 81277 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

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

  9. 77 FR 62240 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

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

  10. 78 FR 44954 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

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

  11. 77 FR 43090 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

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

  12. Impact of late radiation effects on cancer survivor children: an integrative review

    PubMed Central

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-01-01

    ABSTRACT We aimed to identify the late effects of radiation exposure in pediatric cancer survivors. An integrated literature review was performed in the databases MEDLINE and LILACS and SciELO. Included were articles in Portuguese and English, published over the past 10 years, using the following keywords: “neoplasias/neoplasms” AND “radioterapia/radiotherapy” AND “radiação/radiation”. After analysis, 14 articles - published in nine well-known journals - met the inclusion criteria. The publications were divided into two categories: “Late endocrine effects” and “Late non-endocrine effects”. Considering the increased survival rates in children who had cancer, the impact of late effects of exposure to radiation during radiological examinations for diagnosis and treatment was analyzed. Childhood cancer survivors were exposed to several late effects and should be early and regularly followed up, even when exposed to low radiation doses. PMID:26313432

  13. A management system integrating radiation protection and safety supporting safety culture in the hospital.

    PubMed

    Almén, A; Lundh, C

    2015-04-01

    Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system. The main experience from developing a management system is that it is possible to create a vast number of common policies and routines for the whole hospital, resulting in a cost-efficient system. One of the key benefits is the involvement of management at all levels, including the hospital director. Furthermore, a transparent system will involve staff throughout the organisation as well. A management system supports a common view on what should be done, who should do it and how the activities are reviewed. An integrated management system for radiation protection and safety includes key elements supporting a safety culture. PMID:25429027

  14. A management system integrating radiation protection and safety supporting safety culture in the hospital.

    PubMed

    Almén, A; Lundh, C

    2015-04-01

    Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system. The main experience from developing a management system is that it is possible to create a vast number of common policies and routines for the whole hospital, resulting in a cost-efficient system. One of the key benefits is the involvement of management at all levels, including the hospital director. Furthermore, a transparent system will involve staff throughout the organisation as well. A management system supports a common view on what should be done, who should do it and how the activities are reviewed. An integrated management system for radiation protection and safety includes key elements supporting a safety culture.

  15. [Research progress on using index of biological integrity to assess aquatic ecosystem health].

    PubMed

    Liao, Jing-Qiu; Huang, Yi

    2013-01-01

    Index of biological integrity (IBI) is one of the most important and popular tools in assessing aquatic ecosystem health. This paper reviewed the selection of indicator species for IBI, its construction process, and its applications in assessing aquatic ecosystem health, summarized the commonly used candidate biological parameter indices of fish-index of biological integrity (F-IBI), benthos-index of biological integrity (B-IBI), and periphyton-index of biological integrity (P-IBI), and pointed out the feasibility and necessity of using microbe-index of biological integrity (M-IBI) to assess the health of aquatic ecosystem.

  16. Thermal management in MoS{sub 2} based integrated device using near-field radiation

    SciTech Connect

    Peng, Jiebin; Zhang, Gang; Li, Baowen

    2015-09-28

    Recently, wafer-scale growth of monolayer MoS{sub 2} films with spatial homogeneity is realized on SiO{sub 2} substrate. Together with the latest reported high mobility, MoS{sub 2} based integrated electronic devices are expected to be fabricated in the near future. Owing to the low lattice thermal conductivity in monolayer MoS{sub 2}, and the increased transistor density accompanied with the increased power density, heat dissipation will become a crucial issue for these integrated devices. In this letter, using the formalism of fluctuation electrodynamics, we explored the near-field radiative heat transfer from a monolayer MoS{sub 2} to graphene. We demonstrate that in resonance, the maximum heat transfer via near-field radiation between MoS{sub 2} and graphene can be ten times higher than the in-plane lattice thermal conduction for MoS{sub 2} sheet. Therefore, an efficient thermal management strategy for MoS{sub 2} integrated device is proposed: Graphene sheet is brought into close proximity, 10–20 nm from MoS{sub 2} device; heat energy transfer from MoS{sub 2} to graphene via near-field radiation; this amount of heat energy then be conducted to contact due to ultra-high lattice thermal conductivity of graphene. Our work sheds light for developing cooling strategy for nano devices constructing with low thermal conductivity materials.

  17. Integrated Cloud-Aerosol-Radiation Product using CERES, MODIS, CALIPSO and CloudSat Data

    NASA Technical Reports Server (NTRS)

    Sun-Mack, Sunny; Minnis, Patrick; Chen, Yan; Gibson, Sharon; Yi, Yuhong; Trepte, Qing; Wielicki, Bruce; Kato, Seiji; Winker, Dave

    2007-01-01

    This paper documents the development of the first integrated data set of global vertical profiles of clouds, aerosols, and radiation using the combined NASA A-Train data from the Aqua Clouds and Earth's Radiant Energy System (CERES) and Moderate Resolution Imaging Spectroradiometer (MODIS), Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO), and CloudSat. As part of this effort, cloud data from the CALIPSO lidar and the CloudSat radar are merged with the integrated column cloud properties from the CERES-MODIS analyses. The active and passive datasets are compared to determine commonalities and differences in order to facilitate the development of a 3- dimensional cloud and aerosol dataset that will then be integrated into the CERES broadband radiance footprint. Preliminary results from the comparisons for April 2007 reveal that the CERES-MODIS global cloud amounts are, on average, 0.14 less and 0.15 greater than those from CALIPSO and CloudSat, respectively. These new data will provide unprecedented ability to test and improve global cloud and aerosol models, to investigate aerosol direct and indirect radiative forcing, and to validate the accuracy of global aerosol, cloud, and radiation data sets especially in polar regions and for multi-layered cloud conditions.

  18. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant.

    PubMed

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-05-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered.

  19. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant

    PubMed Central

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-01-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. PMID:25413928

  20. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant.

    PubMed

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-05-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. PMID:25413928

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

    PubMed

    Sharma, A; Ross, J

    1990-01-01

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

  2. Combined exposure to simulated microgravity and acute or chronic radiation reduces neuronal network integrity and cell survival

    NASA Astrophysics Data System (ADS)

    Benotmane, Rafi

    During orbital or interplanetary space flights, astronauts are exposed to cosmic radiations and microgravity. This study aimed at assessing the effect of these combined conditions on neuronal network density, cell morphology and survival, using well-connected mouse cortical neuron cultures. To this end, neurons were exposed to acute low and high doses of low LET (X-rays) radiation or to chronic low dose-rate of high LET neutron irradiation (Californium-252), under the simulated microgravity generated by the Random Positioning Machine (RPM, Dutch space). High content image analysis of cortical neurons positive for the neuronal marker βIII-tubulin unveiled a reduced neuronal network integrity and connectivity, and an altered cell morphology after exposure to acute/chronic radiation or to simulated microgravity. Additionally, in both conditions, a defect in DNA-repair efficiency was revealed by an increased number of γH2AX-positive foci, as well as an increased number of Annexin V-positive apoptotic neurons. Of interest, when combining both simulated space conditions, we noted a synergistic effect on neuronal network density, neuronal morphology, cell survival and DNA repair. Furthermore, these observations are in agreement with preliminary gene expression data, revealing modulations in cytoskeletal and apoptosis-related genes after exposure to simulated microgravity. In conclusion, the observed in vitro changes in neuronal network integrity and cell survival induced by space simulated conditions provide us with mechanistic understanding to evaluate health risks and the development of countermeasures to prevent neurological disorders in astronauts over long-term space travels. Acknowledgements: This work is supported partly by the EU-FP7 projects CEREBRAD (n° 295552)

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

    PubMed Central

    Lawn, Sharon

    2015-01-01

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

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

    PubMed Central

    Murphy, Julia; Bindman, Andrew B.

    2015-01-01

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

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2015-11-01

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

  7. Behavioural health interventions in the Johns Hopkins Community Health Partnership: integrated care as a component of health systems transformation.

    PubMed

    Everett, Anita S; Reese, Jennifer; Coughlin, Janelle; Finan, Patrick; Smith, Michael; Fingerhood, Michael; Berkowitz, Scott; Young, J Hunter; Johnston, Diedre; Dunbar, Linda; Zollinger, Raymond; Ju, Jin; Reuland, Melissa; Strain, Eric C; Lyketsos, Constantine

    2014-12-01

    Health systems in the USA have received a mandate to improve quality while reining in costs. Several opportunities have been created to stimulate this transformation. This paper describes the design, early implementation and lessons learned for the behavioural components of the John Hopkins Community Health Partnership (J-CHiP) programme. J-CHiP is designed to improve health outcomes and reduce the total healthcare costs of a group of high healthcare use patients who are insured by the government-funded health insurance programmes, Medicaid and Medicare. These patients have a disproportionately high prevalence of depression, other psychiatric conditions, and unhealthy behaviours that could be addressed with behavioural interventions. The J-CHiP behavioural intervention is based on integrated care models, which include embedding mental health professionals into primary sites. A four-session behaviour-based protocol was developed to motivate self-efficacy through illness management skills. In addition to staff embedded in primary care, the programme design includes expedited access to specialist psychiatric services as well as a community outreach component that addresses stigma. The progress and challenges involved with developing this programme over a relatively short period of time are discussed.

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

    PubMed Central

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

    2004-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  10. Radon in the Workplace: the Occupational Safety and Health Administration (OSHA) Ionizing Radiation Standard.

    PubMed

    Lewis, Robert K

    2016-10-01

    On 29 December 1970, the Occupational Safety and Health Act of 1970 established the Occupational Safety and Health Administration (OSHA). This article on OSHA, Title 29, Part 1910.1096 Ionizing Radiation standard was written to increase awareness of the employer, the workforce, state and federal governments, and those in the radon industry who perform radon testing and radon mitigation of the existence of these regulations, particularly the radon relevant aspect of the regulations. This review paper was also written to try to explain what can sometimes be complicated regulations. As the author works within the Radon Division of the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection, the exclusive focus of the article is on radon. The 1910.1096 standard obviously covers many other aspects of radiation and radiation safety in the work place. PMID:27575350

  11. Radon in the Workplace: the Occupational Safety and Health Administration (OSHA) Ionizing Radiation Standard.

    PubMed

    Lewis, Robert K

    2016-10-01

    On 29 December 1970, the Occupational Safety and Health Act of 1970 established the Occupational Safety and Health Administration (OSHA). This article on OSHA, Title 29, Part 1910.1096 Ionizing Radiation standard was written to increase awareness of the employer, the workforce, state and federal governments, and those in the radon industry who perform radon testing and radon mitigation of the existence of these regulations, particularly the radon relevant aspect of the regulations. This review paper was also written to try to explain what can sometimes be complicated regulations. As the author works within the Radon Division of the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection, the exclusive focus of the article is on radon. The 1910.1096 standard obviously covers many other aspects of radiation and radiation safety in the work place.

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

    PubMed

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

    2015-04-01

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

  13. Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

    PubMed Central

    Lionis, Christos; Symvoulakis, Emmanouil K; Markaki, Adelais; Vardavas, Constantine; Papadakaki, Maria; Daniilidou, Natasa; Souliotis, Kyriakos; Kyriopoulos, Ioannis

    2009-01-01

    Background Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose This paper explores the extent to which integrated primary health care (PHC) is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development. PMID:19777112

  14. Alternative interpretations of statistics on health effects of low-level radiation

    SciTech Connect

    Hamilton, L.D.

    1983-11-01

    Four examples of the interpretation of statistics of data on low-level radiation are reviewed: (a) genetic effects of the atomic bombs at Hiroshima and Nagasaki, (b) cancer at Rocky Flats, (c) childhood leukemia and fallout in Utah, and (d) cancer among workers at the Portsmouth Naval Shipyard. Aggregation of data, adjustment for age, and other problems related to the determination of health effects of low-level radiation are discussed. Troublesome issues related to post hoc analysis are considered.

  15. Left Atrial Appendage Closure Guided by Integrated Echocardiography and Fluoroscopy Imaging Reduces Radiation Exposure

    PubMed Central

    Balzer, Jan; Eickholt, Christian; Petersen, Margot; Kehmeier, Eva; Veulemans, Verena; Kelm, Malte; Willems, Stephan; Meyer, Christian

    2015-01-01

    Aims To investigate whether percutaneous left atrial appendage (LAA) closure guided by automated real-time integration of 2D-/3D-transesophageal echocardiography (TEE) and fluoroscopy imaging results in decreased radiation exposure. Methods and Results In this open-label single-center study LAA closure (AmplatzerTM Cardiac Plug) was performed in 34 consecutive patients (8 women; 73.1±8.5 years) with (n = 17, EN+) or without (n = 17, EN-) integrated echocardiography/fluoroscopy imaging guidance (EchoNavigator® [EN]; Philips Healthcare). There were no significant differences in baseline characteristics between both groups. Successful LAA closure was documented in all patients. Radiation dose was reduced in the EN+ group about 52% (EN+: 48.5±30.7 vs. EN-: 93.9±64.4 Gy/cm2; p = 0.01). Corresponding to the radiation dose fluoroscopy time was reduced (EN+: 16.7±7 vs. EN-: 24.0±11.4 min; p = 0.035). These advantages were not at the cost of increased procedure time (89.6±28.8 vs. 90.1±30.2 min; p = 0.96) or periprocedural complications. Contrast media amount was comparable between both groups (172.3±92.7 vs. 197.5±127.8 ml; p = 0.53). During short-term follow-up of at least 3 months (mean: 8.1±5.9 months) no device-related events occurred. Conclusions Automated real-time integration of echocardiography and fluoroscopy can be incorporated into procedural work-flow of percutaneous left atrial appendage closure without prolonging procedure time. This approach results in a relevant reduction of radiation exposure. Trial Registration ClinicalTrials.gov NCT01262508 PMID:26465747

  16. Spectral model of depth-integrated water column photosynthesis and its inhibition by ultraviolet radiation

    NASA Astrophysics Data System (ADS)

    Cullen, John J.; Davis, Richard F.; Huot, Yannick

    2012-03-01

    Depth-integrated models of primary production (DIMs) are used to estimate water column photosynthesis as a function of chlorophyll concentration, irradiance at the surface, the penetration of photosynthetically available radiation (PAR), and parameters of the relationship between photosynthesis and PAR. These models are inherently unable to account for variability in the ratio of photosynthetically utilizable radiation (PUR) to PAR with depth and water type, and they cannot account for the inhibition of photosynthesis by ultraviolet radiation, UVR. These important spectral effects — all sensitive to climate change — are readily described with numerical models that require many computations and are unsuitable for some important applications, including the estimation of aquatic productivity from remote sensing. We present a simple DIM that accounts for the spectral effects of irradiance on photosynthesis, including inhibition by UVR. Water column photosynthesis, normalized to surface chlorophyll and scaled to the maximum rate per unit chlorophyll, is described as a function of four dimensionless derived variables:E*PUR, PUR at the surface scaled to the saturation irradiance for photosynthesis; T*PUR, water transparency, normalized to a depth scale and weighted spectrally for photosynthetic absorption; E*PIR, surface irradiance weighted spectrally for inhibition of photosynthesis; and T*PIR, scaled transparency weighted for photosynthesis-inhibiting radiation. Simple functions of these variables closely approximate (within 6%) the results of a full-spectral numerical model of instantaneous and daily integrated water column photosynthesis with and without UVR for a broad range of water types, solar angles, stratospheric ozone concentrations and biological properties of phytoplankton. The spectral DIM is suitable for examining patterns in global ocean productivity and can be used to assess the biological effects of variations in solar radiation (e.g., ozone

  17. Level of radiation dose in university hospital non-insured private health screening programs in Korea

    PubMed Central

    2016-01-01

    Objectives The aim of this study is to evaluate radiation exposure resulting from the comprehensive health examinations of selected university hospital programs and to present basic data for research and management strategies on the health effects of medical radiation exposure. Methods Radiation-based diagnostic studies of the comprehensive health examination programs of ten university hospitals in Seoul, Korea, as introduced in their websites, were analyzed. The medical radiation studies of the programs were reviewed by radiologists. Only the effective doses of the basic studies were included in the analysis. The optional studies of the programs were excluded. Results Among the 190 comprehensive health examination programs, 132 programs (69.5%) included computed tomography studies, with an average of 1.4 scans. The average effective dose of radiation by program was 3.62 mSv for an intensive program for specific diseases; 11.12 mSv for an intensive program for cancer; 18.14 mSv for a premium program; and 24.08 mSv for an overnight program. A higher cost of a programs was linked to a higher effective dose (r=0.812). The effective doses of the examination programs for the same purposes differed by as much as 2.1 times by hospital. Inclusion of positron emission tomography–computed tomography was the most critical factor in determining the level of effective dose. Conclusions It was found that radiation exposure dose from comprehensive health exam programs targeted for an asymptomatic, healthy public reached between 3.6 and 24 times the annual dose limit for the general public. Relevant management policies at the national level should be provided to minimize medical radiation exposure. PMID:27032387

  18. Choosing populations to study the health effects of low-dose ionizing radiation.

    PubMed Central

    Dreyer, N A; Loughlin, J E; Friedlander, E R; Clapp, R W; Fahey, F H

    1981-01-01

    In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public. PMID:7294269

  19. Nuclear Energy and Health: And the Benefits of Low-Dose Radiation Hormesis

    PubMed Central

    Cuttler, Jerry M.; Pollycove, Myron

    2009-01-01

    Energy needs worldwide are expected to increase for the foreseeable future, but fuel supplies are limited. Nuclear reactors could supply much of the energy demand in a safe, sustainable manner were it not for fear of potential releases of radioactivity. Such releases would likely deliver a low dose or dose rate of radiation, within the range of naturally occurring radiation, to which life is already accustomed. The key areas of concern are discussed. Studies of actual health effects, especially thyroid cancers, following exposures are assessed. Radiation hormesis is explained, pointing out that beneficial effects are expected following a low dose or dose rate because protective responses against stresses are stimulated. The notions that no amount of radiation is small enough to be harmless and that a nuclear accident could kill hundreds of thousands are challenged in light of experience: more than a century with radiation and six decades with reactors. If nuclear energy is to play a significant role in meeting future needs, regulatory authorities must examine the scientific evidence and communicate the real health effects of nuclear radiation. Negative images and implications of health risks derived by unscientific extrapolations of harmful effects of high doses must be dispelled. PMID:19343116

  20. Nuclear energy and health: and the benefits of low-dose radiation hormesis.

    PubMed

    Cuttler, Jerry M; Pollycove, Myron

    2009-01-01

    Energy needs worldwide are expected to increase for the foreseeable future, but fuel supplies are limited. Nuclear reactors could supply much of the energy demand in a safe, sustainable manner were it not for fear of potential releases of radioactivity. Such releases would likely deliver a low dose or dose rate of radiation, within the range of naturally occurring radiation, to which life is already accustomed. The key areas of concern are discussed. Studies of actual health effects, especially thyroid cancers, following exposures are assessed. Radiation hormesis is explained, pointing out that beneficial effects are expected following a low dose or dose rate because protective responses against stresses are stimulated. The notions that no amount of radiation is small enough to be harmless and that a nuclear accident could kill hundreds of thousands are challenged in light of experience: more than a century with radiation and six decades with reactors. If nuclear energy is to play a significant role in meeting future needs, regulatory authorities must examine the scientific evidence and communicate the real health effects of nuclear radiation. Negative images and implications of health risks derived by unscientific extrapolations of harmful effects of high doses must be dispelled.

  1. Murder by radiation poisoning: implications for public health.

    PubMed

    Miller, Charles W; Whitcomb, Robert C; Ansari, Armin; McCurley, Carol; Nemhauser, Jeffrey B; Jones, Robert

    2012-06-01

    On November 23, 2006, former Russian military intelligence officer Alexander Litvinenko died in a London hospital. Authorities determined he was deliberately poisoned with the radionuclide Polonium-210 (210Po). Police subsequently discovered that those involved in this crime had--apparently inadvertently--spread 210Po over many locations in London. The United Kingdom Health Protection Agency (HPA) contacted many persons who might have been exposed to 210Po and provided voluntary urine testing. Some of those identified as potentially exposed were U.S. citizens, whom the HPA requested that the Centers for Disease Control and Prevention (CDC) assist in contacting. CDC also provided health care professionals and state and local public health officials with guidance as to how they might respond should a Litvinenko-like incident occur in the U.S. This guidance has resulted in the identification of a number of lessons that can be useful to public health and medical authorities in planning for radiological incidents. Eight such lessons are discussed in this article.

  2. Radiation exposure assessment for portsmouth naval shipyard health studies.

    PubMed

    Daniels, R D; Taulbee, T D; Chen, P

    2004-01-01

    Occupational radiation exposures of 13,475 civilian nuclear shipyard workers were investigated as part of a retrospective mortality study. Estimates of annual, cumulative and collective doses were tabulated for future dose-response analysis. Record sets were assembled and amended through range checks, examination of distributions and inspection. Methods were developed to adjust for administrative overestimates and dose from previous employment. Uncertainties from doses below the recording threshold were estimated. Low-dose protracted radiation exposures from submarine overhaul and repair predominated. Cumulative doses are best approximated by a hybrid log-normal distribution with arithmetic mean and median values of 20.59 and 3.24 mSv, respectively. The distribution is highly skewed with more than half the workers having cumulative doses <10 mSv and >95% having doses <100 mSv. The maximum cumulative dose is estimated at 649.39 mSv from 15 person-years of exposure. The collective dose was 277.42 person-Sv with 96.8% attributed to employment at Portsmouth Naval Shipyard. PMID:15266069

  3. Health effects in women exposed to low levels of ionizing radiation

    SciTech Connect

    Fabrikant, J.I.

    1982-06-01

    There are three delayed health effects of radiation which appear at the present time to have importance to women in radiation protection. These are: (1) the probability of cancer-induction at low doses and low-dose rates; (2) the consideration of those cancers in women, notably the breast and the thyroid, attributable to radiation exposure; and (3) the probability of induction of developmental abnormalities in the newborn following low-dose exposure in utero. The bases for the concern over these effects are discussed. (ACR)

  4. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa.

    PubMed

    Mahomed, Ozayr Haroon; Asmall, Shaidah; Freeman, Melvyn

    2014-11-01

    The integrated chronic disease management model provides a systematic framework for creating a fundamental change in the orientation of the health system. This model adopts a diagonal approach to health system strengthening by establishing a service-linked base to training, supervision, and the opportunity to try out, assess, and implement integrated interventions.

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

    SciTech Connect

    MITCHELL, R.L.

    2000-01-10

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

  6. Mobile phone health risk policy in Germany: the role of the federal government and the Federal Office for Radiation Protection.

    PubMed

    Schweikardt, Christoph; Gross, Dominik

    2012-01-01

    In order to establish a regulatory framework for a given technology important to society, the government must make decisions in the face of existing unknowingness. In the last decade, health risks originating from electromagnetic fields of mobile telecommunication transmitting stations and devices have become a regulation policy issue in Germany. This article investigates the role of the government and the Federal Office for Radiation Protection in regard to policy-making by analysing publications and Federal Parliament reports, hearings and debates. The government and Federal Parliament perceived the research situation in 2001 as insufficient in the absence of hard evidence for health impairment. Against this background, the government struck a compromise with mobile telecommunication network operators, who did not want to integrate stricter limit values for transmission stations as precautionary measures. The network operators' voluntary self-commitment included financing half the budget of the German Mobile Telecommunication Research Programme (2002-2008) under the lead management of the Federal Office for Radiation Protection, which concluded that it was not required to change the position taken in 2001. The results of this programme provided the basis to continue the agreement of that year. With regard to health issues and all the other interests involved, this agreement was an acceptable and remarkably stable compromise.

  7. Folate degradation due to ultraviolet radiation: possible implications for human health and nutrition.

    PubMed

    Borradale, David C; Kimlin, Michael G

    2012-07-01

    Folate is essential for human health in the prevention of megaloblastic anemia and neural tube birth defects and plays important roles in cardiovascular disease and cancer. Therefore, research into environmental factors that may impact folate status, such as solar ultraviolet (UV) radiation, is of great health significance. In vitro studies have shown that UV radiation can degrade folate and folic acid in human blood and this has been confirmed in several human studies. Despite these findings, there is a dearth of epidemiological research into investigating the relationship between folate status and the links to solar UV exposure. PMID:22747844

  8. Comparisons of Integrated Radiation Transport Models with Microdosimetry Data in Spaceflight

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.; Nikjoo, H.; Kim, M. Y.; Hu, X.; Dicello, J. F.; Pisacane, V. L.

    2006-01-01

    Astronauts are exposed to galactic cosmic rays (GCR), trapped protons, and possible solar particle events (SPE) during spaceflight. For such complicated mixtures of radiation types and kinetic energies, tissue equivalent proportional counters (TEPC's) represent a simple time-dependent approach for radiation monitoring. Of interest in radiation protection is the average quality factor of a radiation field defined as a function of linear energy transfer, LET, Q(sub ave)(LET). However TEPC's measure the average quality factors as a function of lineal energy (y), Q(sub ave)(y) defined as the average energy deposition in a volume divided by the average chord length of the volume. Lineal energy, y deviates from LET due to energy straggling, delta-ray escape or entry, and nuclear fragments produced in the detector. Using integrated space radiation models that includes the transport code HZETRN/BRYNTRN, the quantum nuclear interaction model, QMSFRG, and results from Monte-Carlo track simulations of TEPC's response to ions, we consider comparisons of model calculations to TEPC results from NASA missions in low Earth orbit and make predictions for lunar and Mars missions. Good agreement between the model and measured spectra from past NASA missions is found. A finding of this work is that TEPC's values for trapped or solar protons of Q(sub ave)(y) range from 1.9-2.5, overestimating Q(sub ave)(LET), which ranges from 1.4-1.6 with both quantities increasing with shielding depth due to nuclear secondaries Comparisons for the complete GCR spectra show that Q(sub ave)(LET) for GCR is approximately 3.5-4.5, while TEPC's measure 2.9-3.4 for Q(sub ave)(y) with the GCR values decreasing with depth as heavy ions are absorbed in shielding material. Our results support the use of TEPC's for space radiation environmental monitoring when computational analysis is used for proper data interpretation.

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

    PubMed Central

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

    2010-01-01

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

  10. Using a patient-centered approach for health and social care integration.

    PubMed

    Poulymenopoulou, Mikaela; Papakonstantinou, Despoina; Malamateniou, Flora; Vassilacopoulos, George

    2012-01-01

    The drive in using health and social care resources more effectively has resulted in undertaking various efforts towards better coordination in order to improve patient-centered and personalized care for the individuals. This requires horizontal integration in terms of processes among health and social care organizations existing information systems (ISs) and personal health records (PHRs) in order to enable integrated patient information sharing among all the health and social care staff and individuals involved. Service-oriented and business process management (BPM) technologies are considered most appropriate for achieving such integration especially when is required to change existing processes and to integrate diverse information systems. On these grounds, a patient-centered approach is proposed for redesigning health and social care processes and for integrating diverse ISs and PHRs with the objective to meet holistic care goals.

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

    PubMed

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

    2013-07-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2016-03-01

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

  14. Modelling and measurement of the absolute level of power radiated by antenna integrated THz UTC photodiodes.

    PubMed

    Natrella, Michele; Liu, Chin-Pang; Graham, Chris; van Dijk, Frederic; Liu, Huiyun; Renaud, Cyril C; Seeds, Alwyn J

    2016-05-30

    We determine the output impedance of uni-travelling carrier (UTC) photodiodes at frequencies up to 400 GHz by performing, for the first time, 3D full-wave modelling of detailed UTC photodiode structures. In addition, we demonstrate the importance of the UTC impedance evaluation, by using it in the prediction of the absolute power radiated by an antenna integrated UTC, over a broad frequency range and confirming the predictions by experimental measurements up to 185 GHz. This is done by means of 3D full-wave modelling and is only possible since the source (UTC) to antenna impedance match is properly taken into account. We also show that, when the UTC-to-antenna coupling efficiency is modelled using the classical junction-capacitance/series-resistance concept, calculated and measured levels of absolute radiated power are in substantial disagreement, and the maximum radiated power is overestimated by a factor of almost 7 dB. The ability to calculate the absolute emitted power correctly enables the radiated power to be maximised through optimisation of the UTC-to-antenna impedance match.

  15. Modelling and measurement of the absolute level of power radiated by antenna integrated THz UTC photodiodes.

    PubMed

    Natrella, Michele; Liu, Chin-Pang; Graham, Chris; van Dijk, Frederic; Liu, Huiyun; Renaud, Cyril C; Seeds, Alwyn J

    2016-05-30

    We determine the output impedance of uni-travelling carrier (UTC) photodiodes at frequencies up to 400 GHz by performing, for the first time, 3D full-wave modelling of detailed UTC photodiode structures. In addition, we demonstrate the importance of the UTC impedance evaluation, by using it in the prediction of the absolute power radiated by an antenna integrated UTC, over a broad frequency range and confirming the predictions by experimental measurements up to 185 GHz. This is done by means of 3D full-wave modelling and is only possible since the source (UTC) to antenna impedance match is properly taken into account. We also show that, when the UTC-to-antenna coupling efficiency is modelled using the classical junction-capacitance/series-resistance concept, calculated and measured levels of absolute radiated power are in substantial disagreement, and the maximum radiated power is overestimated by a factor of almost 7 dB. The ability to calculate the absolute emitted power correctly enables the radiated power to be maximised through optimisation of the UTC-to-antenna impedance match. PMID:27410104

  16. Radial Transport, Local Acceleration, and Loss in the Radiation Belts: Integration of Theories and Observations (Invited)

    NASA Astrophysics Data System (ADS)

    Chan, A. A.; Elkington, S. R.; Albert, J.; Zheng, L.

    2013-12-01

    Although much is known about the dynamics of the radiation belts there are still many unanswered questions on the basic physical processes responsible for the storm-time variations of relativistic electrons. Two physical processes that are thought to be especially important are (i) drift-resonant wave-particle interactions with ULF perturbations, which may lead to radial diffusion, and (ii) cyclotron-resonant wave-particle interactions with VLF/ELF waves, which may lead to local energy and pitch-angle diffusion. While there is theoretical and observational support that both of these processes play important roles in radiation belt dynamics, their relative contributions are still not well understood quantitatively. Also, recent work suggests that magnetopause shadowing may play a larger role than previously expected, and the physical connections between changes in the radiation belts and different solar interplanetary drivers are not well understood. In this presentation I will briefly review published work on radial transport, local acceleration, and loss, and I will also present recent results (particularly for high-speed-stream storms) that emphasize the value of integrating theories and observations of the radiation belts, including comments on theories and observations of related electromagnetic fields and plasma populations in the Earth's inner magnetosphere.

  17. Examining the utility of behavioral health integration in well-child visits: implications for rural settings.

    PubMed

    Burt, Jennifer D; Garbacz, S Andrew; Kupzyk, Kevin A; Frerichs, Lynae; Gathje, Rebecca

    2014-03-01

    The purpose of this study was to assess the effect of integrating behavioral health services into well-child visits in underserved, remote, and/or fringe areas. Specifically, the following were examined: the structure of the well-child visit for standard care in comparison to when a behavioral health provider was integrated into the visit and the effect of integrating a behavioral health provider on behavioral health topics covered and parent satisfaction. Participants were 94 caregivers of children attending well-child visits. Group differences were examined for participants in well-child visits with a behavioral health provider and participants in a standard well-child visit. Findings suggest a statistically significant increase in caregiver-rated perception for the number of topics covered with the integration of a behavioral health provider in the well-child visits. No significant effects of caregiver-rated helpfulness or satisfaction were observed. Implications for the findings and future research directions are discussed.

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

    PubMed Central

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, implementation strategies, effects of the service integration, and lessons learned. Funded by the Health Resources and Services Administration (HRSA) as a Special Program of National Significance (SPNS), Whole Life efforts have been sustained beyond the demonstration funding period as a result of the changes brought about in organizational structures, service delivery, and the providers' conceptualization of health for HIV-infected women. PMID:15147649

  19. A Population Health Model for Integrated Assessment Models

    SciTech Connect

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

    2008-05-01

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

  20. Connecting Body and Mind: A Resource Guide to Integrated Health Care in Texas and the United States

    ERIC Educational Resources Information Center

    Lopez, Molly; Coleman-Beattie, Brenda; Jahnke, Lauren; Sanchez, Katherine

    2008-01-01

    There is a call across the country and in Texas to improve health care systems through integrated care. Integrated health care is the systematic coordination of physical and behavioral health services. The idea is that physical and behavioral health problems often occur at the same time and that integrating services will provide the best results…

  1. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit.

    PubMed

    Chancellor, Jeffery C; Scott, Graham B I; Sutton, Jeffrey P

    2014-09-11

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other "omics" areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts.

  2. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit.

    PubMed

    Chancellor, Jeffery C; Scott, Graham B I; Sutton, Jeffrey P

    2014-01-01

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other "omics" areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts. PMID:25370382

  3. Space Radiation: The Number One Risk to Astronaut Health beyond Low Earth Orbit

    PubMed Central

    Chancellor, Jeffery C.; Scott, Graham B. I.; Sutton, Jeffrey P.

    2014-01-01

    Projecting a vision for space radiobiological research necessitates understanding the nature of the space radiation environment and how radiation risks influence mission planning, timelines and operational decisions. Exposure to space radiation increases the risks of astronauts developing cancer, experiencing central nervous system (CNS) decrements, exhibiting degenerative tissue effects or developing acute radiation syndrome. One or more of these deleterious health effects could develop during future multi-year space exploration missions beyond low Earth orbit (LEO). Shielding is an effective countermeasure against solar particle events (SPEs), but is ineffective in protecting crew members from the biological impacts of fast moving, highly-charged galactic cosmic radiation (GCR) nuclei. Astronauts traveling on a protracted voyage to Mars may be exposed to SPE radiation events, overlaid on a more predictable flux of GCR. Therefore, ground-based research studies employing model organisms seeking to accurately mimic the biological effects of the space radiation environment must concatenate exposures to both proton and heavy ion sources. New techniques in genomics, proteomics, metabolomics and other “omics” areas should also be intelligently employed and correlated with phenotypic observations. This approach will more precisely elucidate the effects of space radiation on human physiology and aid in developing personalized radiological countermeasures for astronauts. PMID:25370382

  4. INTEGRAL/SPI Observations of Electron-Positron Annihilation Radiation from our Galaxy

    NASA Technical Reports Server (NTRS)

    Teegarden, B. J.; Watanabe, K.; Knoedlseder, J.; Jean, P.; Lonjou, V.; Weidenspointer, G.; Skinner, G.; Vedrenne, G.; Roques, J.-P.; Schanne, S.; Schoenfelder, V.

    2005-01-01

    The spectrometer on INTEGRAL (SPI) is a coded-aperture gamma-ray telescope with moderate angular resolution (3 deg) and superior energy resolution (2 keV at 511 kev). One of it's principal science goals is the detailed study of 511 keV electron-positron annihilation from our Galaxy. The origin of this radiation remains a mystery, however current morphological studies suggest an older stellar population. There has also been recent speculation on the possibility of the existence of light (< 100 MeV) dark matter particles whose annihilation or decay could produce the observed 511 keV emission. In this paper we summarize the current results from SPI, compare them with previous results and discuss their implication on possible models for the production of the annihilation radiation.

  5. Hardware Specific Integration Strategy for Impedance-Based Structural Health Monitoring of Aerospace Systems

    NASA Technical Reports Server (NTRS)

    Owen, Robert B.; Gyekenyesi, Andrew L.; Inman, Daniel J.; Ha, Dong S.

    2011-01-01

    The Integrated Vehicle Health Management (IVHM) Project, sponsored by NASA's Aeronautics Research Mission Directorate, is conducting research to advance the state of highly integrated and complex flight-critical health management technologies and systems. An effective IVHM system requires Structural Health Monitoring (SHM). The impedance method is one such SHM technique for detection and monitoring complex structures for damage. This position paper on the impedance method presents the current state of the art, future directions, applications and possible flight test demonstrations.

  6. Mindfulness and integrative self-knowledge: relationships with health-related variables.

    PubMed

    Ghasemipour, Yadollah; Robinson, Julie Ann; Ghorbani, Nima

    2013-01-01

    This study examined how mindfulness and integrative self-knowledge were related to health-related issues. Men in general population (n = 103) and coronary heart disease samples (n = 101) completed the Mindful Attention Awareness Scale, the Integrative Self-knowledge Scale, the Type 2 subscale of the Interpersonal Reactions Inventory, the Perceived Stress Scale, and the Anxiety and Depression Scales. In both samples, there was a moderate positive correlation between mindfulness and integrative self-knowledge and they were negatively correlated with all health-related variables. However, only integrative self-knowledge explained independent variance in health-related variables. Specifically, in both samples, the relationship between mindfulness and health-related variables was mediated by integrative self-knowledge. Mindfulness and integrative self-knowledge are related domains of self-awareness that are associated with a range of health-related variables. These relationships are robust across samples drawn from general population and patients with coronary heart disease. The finding that integrative self-knowledge explained additional variance in the health-related variables after the contribution of mindfulness had been accounted for suggests that reflective self-awareness in integrative self-knowledge may make a unique contribution to the explanation of individual differences in health variables.

  7. The Health Care Strengthening Act: The next level of integrated care in Germany.

    PubMed

    Milstein, Ricarda; Blankart, Carl Rudolf

    2016-05-01

    The lack of integration of health-care sectors and specialist groups is widely accepted as a necessity to effectively address the most urgent challenges in modern health care systems. Germany follows a more decentralized approach that allows for many degrees of freedom. With its latest bill, the German government has introduced several measures to explicitly foster the integration of health-care services. This article presents the historic development of integrated care services and offers insights into the construction of integrated care programs in the German health-care system. The measures of integrated care within the Health Care Strengthening Act are presented and discussed in detail from the perspective of the provider, the payer, and the political arena. In addition, the effects of the new act are assessed using scenario technique based on an analysis of the effects of previously implemented health policy reforms. Germany now has a flourishing integrated care scene with many integrated care programs being able to contain costs and improve quality. Although it will be still a long journey for Germany to reach the coordination of care standards set by leading countries such as the United Kingdom, New Zealand or Switzerland, international health policy makers may deliberately and selectively adopt elements of the German approach such as the extensive freedom of contract, the strong patient-focus by allowing for very need-driven and regional solutions, or the substantial start-up funding allowing for more unproven and progressive endeavors to further improve their own health systems.

  8. The Health Care Strengthening Act: The next level of integrated care in Germany.

    PubMed

    Milstein, Ricarda; Blankart, Carl Rudolf

    2016-05-01

    The lack of integration of health-care sectors and specialist groups is widely accepted as a necessity to effectively address the most urgent challenges in modern health care systems. Germany follows a more decentralized approach that allows for many degrees of freedom. With its latest bill, the German government has introduced several measures to explicitly foster the integration of health-care services. This article presents the historic development of integrated care services and offers insights into the construction of integrated care programs in the German health-care system. The measures of integrated care within the Health Care Strengthening Act are presented and discussed in detail from the perspective of the provider, the payer, and the political arena. In addition, the effects of the new act are assessed using scenario technique based on an analysis of the effects of previously implemented health policy reforms. Germany now has a flourishing integrated care scene with many integrated care programs being able to contain costs and improve quality. Although it will be still a long journey for Germany to reach the coordination of care standards set by leading countries such as the United Kingdom, New Zealand or Switzerland, international health policy makers may deliberately and selectively adopt elements of the German approach such as the extensive freedom of contract, the strong patient-focus by allowing for very need-driven and regional solutions, or the substantial start-up funding allowing for more unproven and progressive endeavors to further improve their own health systems. PMID:27103332

  9. One-stop shopping: efforts to integrate physical and behavioral health care in five California community health centers.

    PubMed

    Pourat, Nadereh; Hadler, Max W; Dixon, Brittany; Brindis, Claire

    2015-01-01

    More than 70 percent of behavioral health conditions are first diagnosed in the primary care setting. Yet physical and behavioral health care are typically provided separately, compelling many vulnerable patients to navigate the complexities of two separate systems of care. This policy brief examines five community health centers (CHCs) in California that have taken preliminary steps toward creating "one-stop shopping" for both physical and behavioral health care. The steps taken to increase integration by the CHCs include employing behavioral health providers, using a single electronic health record that includes both physical and behavioral health data, transforming the physical space, and developing mechanisms for effective transition of patients between providers. The findings emphasize the importance of changes to Medi-Cal reimbursement policies to promote same-day visits, as well as the importance of cultural changes to integrate behavioral health. They also highlight the need for comprehensive tools to assess and promote integration and to identify solutions for the most challenging activities required to achieve full integration.

  10. HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

    PubMed

    Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

    2011-11-01

    Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems.

  11. Integrating Healthy Communities concepts into health professions training.

    PubMed Central

    Kinder, G; Cashman, S B; Seifer, S D; Inouye, A; Hagopian, A

    2000-01-01

    To meet the demands of the evolving health care system, health professionals need skills that will allow them to anticipate and respond to the broader social determinants of health. To ensure that these skills are learned during their professional education and training, health professions institutions must look beyond the medical model of caring for communities. Models in Seattle and Roanoke demonstrate the curricular changes necessary to ensure that students in the health professions are adequately prepared to contribute to building Healthy Communities in the 21st century. In addition to these models, a number of resources are available to help promote the needed institutional changes. PMID:10968767

  12. The challenge of integrating ecosystem health throughout a veterinary curriculum.

    PubMed

    Stephen, Craig

    2009-01-01

    This paper focuses on the question, "How can concepts of ecosystem health be made widely applicable to the diverse interests of veterinary students?" To date, most effort has focused on promoting the training of veterinarians to take an active role in the field of ecosystem health. Less attention has been placed on how ecosystem health can be made useful and valuable to the full spectrum of students, from those intending to pursue careers in ecosystem health to those seeking employment in private clinical practice. The lack of standard curricula and expectations for ecosystem health courses makes it impossible to assess how educational experiences can be combined to deliver and assess the best course. In this paper, teaching goals and teaching techniques are suggested for institutions that are seeking to weave ecosystem health throughout their curricula. Rather than dogmatically defining ecosystem health, this paper outlines potential goals and attitudes for undergraduate veterinary education that can be extracted from the conceptual foundations of ecosystem health, health promotion, and population health. The participatory nature of ecosystem health argues in favor of teaching methods that are experiential, exploitative of stories, and inclusive of a diverse group of teachers and role models.

  13. An examination of the integration of certified peer specialists into community mental health centers.

    PubMed

    Grant, Emily A; Reinhart, Chrystal; Wituk, Scott; Meissen, Greg

    2012-08-01

    The formal role of Certified Peer Specialist (CPS) is a recent addition to the mental health field. CPSs are people in recovery employed within the mental health system, mostly by community mental health centers, to provide support through sharing life experiences with those working toward recovery from mental illness. This brief report examines participant's experiences being a CPS, responsibilities and activities as a CPS, and integration into community mental health centers. Findings suggest that CPSs demonstrate high levels of communal orientation, job satisfaction, workplace integration and organizational support and are well received in mental health centers. PMID:22806435

  14. Strategies for integrating mental health into schools via a multitiered system of support.

    PubMed

    Stephan, Sharon Hoover; Sugai, George; Lever, Nancy; Connors, Elizabeth

    2015-04-01

    To fully realize the potential of mental health supports in academic settings, it is essential to consider how to effectively integrate the mental health and education systems and their respective resources, staffing, and structures. Historically, school mental health services have not effectively spanned a full continuum of care from mental health promotion to treatment, and several implementation and service challenges have evolved. After an overview of these challenges, best practices and strategies for school and community partners are reviewed to systematically integrate mental health interventions within a school's multitiered system of student support. PMID:25773320

  15. Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

    PubMed Central

    Andrulis, Dennis P.; Brach, Cindy

    2016-01-01

    Objective To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection. Methods Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed. Results Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups’ needs. A vision for integrated care is presented. Conclusion Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. PMID:17931131

  16. Academic Integrity and Plagiarism: A Review of the Influences and Risk Situations for Health Students

    ERIC Educational Resources Information Center

    Jiang, Hai; Emmerton, Lynne; McKauge, Leigh

    2013-01-01

    Health professions are increasingly focusing on the development of integrity and professionalism in students of Health disciplines. While it is expected that Health students will develop, and commit to, the highest standards of conduct as undergraduates, and henceforth through their careers, the pressures of assessment and external commitments may…

  17. Integrated Health and Physical Education Program to Reduce Media Use and Increase Physical Activity in Youth

    ERIC Educational Resources Information Center

    Clocksin, Brian D.; Wattson, Doris L.; Williams, Daniel P.; Randsell, Lynda

    2009-01-01

    The purpose of this project was to compare an integrated health and physical education curriculum, focused on reducing media use and on increasing physical activity in middle school adolescents, to traditional and nonintegrated health and physical education curricula. Two middle schools' health and physical education classes were assigned to an…

  18. Some current advances in biophysical applications of ionizing radiation for health preservation

    NASA Astrophysics Data System (ADS)

    Watt, D. E.

    1987-03-01

    Radiation Physics is a subject of major importance in application to health preservation through investigative, diagnostic, analytical and therapeutic procedures for clinical purposes. Its benefits are enormous and well-established. However there are also hazards and so it is important for health preservation purposes to establish quantitatively the degree of risk undergone by persons exposed to radiation in the natural environment, in their occupations and in medical treatment. In this paper a brief indication is given of the extensive utilisation of the unique properties of radiation in biomedical application. This is followed by fuller discussion on new developments in our understanding of radiation damage mechanisms in radiotherapy and radiological protection. An example is given in biomedical research into the role of trace elements in gallstone formation using neutron activation anaysis, proton induced X-ray emission and X-ray fluorescence analysis as complementary techniques for maximising sensitivity in multielemental analysis by induced radiation. Procedures are described for measuring radiation effect, at bone/ tissue and lung/air interfaces, due to the uptake of radioactive material from the natural environment. Finally a topical subject in nuclear medicine viz. the possible advantages and hazards of Auger electron cascades resulting from inner shell vacancies in electron capture nuclides, is examined in the light of new evidence.

  19. The phase-integral method for radiative transfer problems with highly-peaked phase functions

    NASA Technical Reports Server (NTRS)

    Fricke, C. L.

    1978-01-01

    Complete solutions to the radiative transfer equation, including both azimuth and depth dependence, are provided by the discrete-ordinate method of Chandrasekhar, but these solutions are often limited because of large computer requirements. This paper presents a 'phase-integral' method which greatly reduces the number of discrete ordinates needed in the solution for highly peaked phase functions. A composite quadrature method is shown to be effective in further reducing the number of discrete ordinates required for highly anisotropic phase functions. Examples are given to indicate convergence requirements and expected accuracy in the complete solution for Henyey-Greenstein and cloud-type phase functions.

  20. Telehealth and Occupational Therapy: Integral to the Triple Aim of Health Care Reform.

    PubMed

    Cason, Jana

    2015-01-01

    Programs and concepts included in the Patient Protection and Affordable Care Act of 2010 are expected to transform health care in the United States from a volume-based health system to a value-based health system with increased emphasis on prevention and health promotion. The Triple Aim, a framework set forth by the Institute for Healthcare Improvement, focuses on improving the health care experience, the health of populations, and the affordability of care. This article describes telehealth as an integral component in achieving the Triple Aim of health care and discusses implications for occupational therapy practitioners. PMID:26122676

  1. The integration of health promotion and social marketing.

    PubMed

    Griffiths, Jenny; Blair-Stevens, Clive; Parish, Richard

    2009-11-01

    The urgency and scale of contemporary health challenges are enormous. The review It's Our Health! published in 2006 found that social marketing had considerable potential to increase the effectiveness of health improvement work, with the intention that it should build on core health promotion principles and not replace them. Health promotion has, however, lost its focus and identity in recent years in some parts of the country, partly due to repeated organizational change, and it has suffered from a lack of proactive workforce development. Over the last year, the National Social Marketing Centre (NSMC) and the Shaping the Future of Health Promotion Collaboration (StFofHP), hosted by the Royal Society for Public Health (RSPH), have explored the relationship between social marketing and health promotion and led a debate with stakeholders. A Delphi consultation with an expert panel drawn from specialists and strategic leaders in several settings, and the academic community, is currently under way and will report in the autumn. Findings so far emphasize the wide variation in understanding and interpretation of the two skill sets, much confusion about definitions and what added value both health promotion and social marketing bring to health improvement. Some of the distinctive contributions of both are described in this paper.

  2. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in the “Notices” section of the Federal Register. (b) Factors to be considered in evaluating scientific studies... the veteran population of interest. (5) The views of the appropriate panel of the Scientific...

  3. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in the “Notices” section of the Federal Register. (b) Factors to be considered in evaluating scientific studies... the veteran population of interest. (5) The views of the appropriate panel of the Scientific...

  4. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in the “Notices” section of the Federal Register. (b) Factors to be considered in evaluating scientific studies... the veteran population of interest. (5) The views of the appropriate panel of the Scientific...

  5. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in the “Notices” section of the Federal Register. (b) Factors to be considered in evaluating scientific studies... the veteran population of interest. (5) The views of the appropriate panel of the Scientific...

  6. Operating a Microwave Radiation Detection Monitor. Module 10. Vocational Education Training in Environmental Health Sciences.

    ERIC Educational Resources Information Center

    Consumer Dynamics Inc., Rockville, MD.

    This module, one of 25 on vocational education training for careers in environmental health occupations, contains self-instructional materials on operating a microwave radiation detection monitor. Following guidelines for students and instructors and an introduction that explains what the student will learn are three lessons: (1) testing the…

  7. Comments on the psychosocial aspects of the International Conference on Radiation and Health.

    PubMed Central

    Cwikel, J

    1997-01-01

    Summary comments on the psychosocial aspects of the International Conference on Radiation and Health highlighted the issues that were salient in the conference. There was a broad consensus that long-term psychosocial effects may turn out to be the most significant source of morbidity. In addressing health concerns there is a need to consider psychological responses, as they may be the source of the high rate of morbidity and use of health services. The public's response to radiation is one of anxiety, fear, and concerns about lack of control over modern technology. Aside from stress there may be alternative mechanisms that explain the high rates of morbidity, such as direct biological effects of radiation on the cardiovascular system. The issue of social stigma is not addressed in most studies of affected populations but may be a potent social force. There is a need for concerned scientists to reach a better consensus about the health effects of radiation and to communicate effectively with the lay public. We need more cross-cultural research on psychosocial aspects and how to more effectively help affected populations. There are auspicious beginnings in this direction. PMID:9467091

  8. Using Ionizing Radiation Detectors. Module 11. Vocational Education Training in Environmental Health Sciences.

    ERIC Educational Resources Information Center

    Consumer Dynamics Inc., Rockville, MD.

    This module, one of 25 on vocational education training for careers in environmental health occupations, contains self-instructional materials on using ionizing radiation detectors. Following guidelines for students and instructors and an introduction that explains what the student will learn are three lessons: (1) naming and telling the function…

  9. Radiation, Ergonomics, Ion Depletion, and VDTs: Healthful Use of Visual Display Terminals.

    ERIC Educational Resources Information Center

    Miller, R. Bruce

    1983-01-01

    Discusses health hazards associated with use of visual display terminals (VDTs) and provides guidelines for safe use of VDTs in the following areas: radiation, design of work stations, design of VDTs, illumination, glare, work/rest periods, visual testings, ion depletion. An 11-item annotated bibliography of recommended readings and bibliographies…

  10. Systems Modeling to Implement Integrated System Health Management Capability

    NASA Technical Reports Server (NTRS)

    Figueroa, Jorge F.; Walker, Mark; Morris, Jonathan; Smith, Harvey; Schmalzel, John

    2007-01-01

    ISHM capability includes: detection of anomalies, diagnosis of causes of anomalies, prediction of future anomalies, and user interfaces that enable integrated awareness (past, present, and future) by users. This is achieved by focused management of data, information and knowledge (DIaK) that will likely be distributed across networks. Management of DIaK implies storage, sharing (timely availability), maintaining, evolving, and processing. Processing of DIaK encapsulates strategies, methodologies, algorithms, etc. focused on achieving high ISHM Functional Capability Level (FCL). High FCL means a high degree of success in detecting anomalies, diagnosing causes, predicting future anomalies, and enabling health integrated awareness by the user. A model that enables ISHM capability, and hence, DIaK management, is denominated the ISHM Model of the System (IMS). We describe aspects of the IMS that focus on processing of DIaK. Strategies, methodologies, and algorithms require proper context. We describe an approach to define and use contexts, implementation in an object-oriented software environment (G2), and validation using actual test data from a methane thruster test program at NASA SSC. Context is linked to existence of relationships among elements of a system. For example, the context to use a strategy to detect leak is to identify closed subsystems (e.g. bounded by closed valves and by tanks) that include pressure sensors, and check if the pressure is changing. We call these subsystems Pressurizable Subsystems. If pressure changes are detected, then all members of the closed subsystem become suspect of leakage. In this case, the context is defined by identifying a subsystem that is suitable for applying a strategy. Contexts are defined in many ways. Often, a context is defined by relationships of function (e.g. liquid flow, maintaining pressure, etc.), form (e.g. part of the same component, connected to other components, etc.), or space (e.g. physically close

  11. 75 FR 57281 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... whether there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is...

  12. 76 FR 61364 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... whether there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is...

  13. 76 FR 71567 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such...

  14. 78 FR 11650 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable...

  15. 78 FR 38347 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that such...

  16. 78 FR 58543 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-24

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable...

  17. 75 FR 43180 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... whether there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is...

  18. 75 FR 22607 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... there is a class of employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable...

  19. 76 FR 26301 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health... employees at any Department of Energy (DOE) facility who were exposed to radiation but for whom it is not feasible to estimate their radiation dose, and on whether there is reasonable likelihood that...

  20. Combining Radiation Epidemiology With Molecular Biology-Changing From Health Risk Estimates to Therapeutic Intervention.

    PubMed

    Abend, Michael; Port, Matthias

    2016-08-01

    The authors herein summarize six presentations dedicated to the key session "molecular radiation epidemiology" of the ConRad meeting 2015. These presentations were chosen in order to highlight the promise when combining conventional radiation epidemiology with molecular biology. Conventional radiation epidemiology uses dose estimates for risk predictions on health. However, combined with molecular biology, dose-dependent bioindicators of effect hold the promise to improve clinical diagnostics and to provide target molecules for potential therapeutic intervention. One out of the six presentations exemplified the use of radiation-induced molecular changes as biomarkers of exposure by measuring stabile chromosomal translocations. The remaining five presentations focused on molecular changes used as bioindicators of the effect. These bioindicators of the effect could be used for diagnostic purposes on colon cancers (genomic instability), thyroid cancer (CLIP2), or head and neck squamous cell cancers. Therapeutic implications of gene expression changes were examined in Chernobyl thyroid cancer victims and Mayak workers. PMID:27356062