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Sample records for health integrating radiative

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. Integrated structural health monitoring

    NASA Astrophysics Data System (ADS)

    Farrar, Charles R.; Sohn, Hoon; Fugate, Michael L.; Czarnecki, Jerry J.

    2001-07-01

    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 author's 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.

  9. 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.

  10. 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.

  11. [Health in Andean regional integration].

    PubMed

    Agudelo, Carlos A

    2007-01-01

    Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of experiences in health has shown that integration depends on the countries' respective strengths and to a major extent on national political processes.

  12. 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.

  13. The NASA Space Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Schimmerling, W.; Sulzman, F. M.

    1994-01-01

    The NASA Space Radiation Health Program is a part of the Life Sciences Division in the Office of Space Science and Applications (OSSA). The goal of the Space Radiation Health Program is development of scientific bases for assuring adequate radiation protection in space. A proposed research program will determine long-term health risks from exposure to cosmic rays and other radiation. Ground-based animal models will be used to predict risk of exposures at varying levels from various sources and the safe levels for manned space flight.

  14. 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.

  15. 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

  16. Allied health: integral to transforming health.

    PubMed

    Lizarondo, Lucylynn; Turnbull, Catherine; Kroon, Tracey; Grimmer, Karen; Bell, Alison; Kumar, Saravana; McEvoy, Maureen; Milanese, Steve; Russell, Mary; Sheppard, Lorraine; Walters, Julie; Wiles, Louise

    2016-04-01

    Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the 'maximum value for spend' of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to

  17. [Integrated health care at Nuremberg].

    PubMed

    Männl, V

    2006-01-01

    This paper reports in detail on a project of Integrated Health Care in cardiology at Nuremberg, Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data.

  18. 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.

  19. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.

    2014-01-01

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

  20. 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…

  1. 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.

  2. Integration of video and radiation analysis data

    SciTech Connect

    Menlove, H.O.; Howell, J.A.; Rodriguez, C.A.; Eccleston, G.W.; Beddingfield, D.; Smith, J.E.; Baumgart, C.W.

    1995-12-31

    For the past several years, the integration of containment and surveillance (C/S) with nondestructive assay (NDA) sensors for monitoring the movement of nuclear material has focused on the hardware and communications protocols in the transmission network. Little progress has been made in methods to utilize the combined C/S and NDA data for safeguards and to reduce the inspector time spent in nuclear facilities. One of the fundamental problems in the integration of the combined data is that the two methods operate in different dimensions. The C/S video data is spatial in nature; whereas, the NDA sensors provide radiation levels versus time data. The authors have introduced a new method to integrate spatial (digital video) with time (radiation monitoring) information. This technology is 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. This technique has the potential of significantly reducing the frequency of inspection visits to key facilities without a loss of safeguards effectiveness.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. [Radiation from mobile phone and the health].

    PubMed

    Wang, Yan; Cao, Zhao-jin

    2006-07-01

    With the development of the mobile communication industry, there are considerable public concerns about the relationship between mobile phone radiations and human health. With regard to electromagnetic field emitted by mobile phone maybe influence tumor,learning and memory, subjective symptoms and blood-brain barrier, a large number of studies have been performed abroad. This paper reviews the research development abroad on these problems, and analysizes the mechanism, through which the mobile phone effects on human health.

  11. 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)

  12. 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…

  13. On the integral law of thermal radiation

    NASA Astrophysics Data System (ADS)

    Gusev, Y. V.

    2014-10-01

    The integral law of thermal radiation by finite-size emitters is studied. Two geometrical characteristics of a radiating body or a cavity, its volume and its boundary area, define two terms in its radiance. The term defined by the volume corresponds to the Stefan-Boltzmann law. The term defined by the boundary area is proportional to the third power of temperature and inversely proportional to emitter's effective size, which is defined as the ratio of its volume to its boundary area. This generalized law is valid for arbitrary temperature and effective size. It is shown that the cubic temperature contribution is observed in experiments. This term explains the intrinsic uncertainty of the NPL experiment on radiometric determination of the Stefan-Boltzmann constant. It is also quantitatively confirmed by data from the NIST calibration of cryogenic blackbodies. Its relevance to the size of source effect in optical radiometry is proposed and supported by the experiments on thermal emission from nano-heaters.

  14. 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

  15. Health systems analysis: radiation therapy services

    SciTech Connect

    Not Available

    1981-10-01

    A plan for the distribution of radiation therapy services within Health Services Area I (HSA I) is presented in this report. Four problems concerning health status or health system aspects of megavoltage radiation therapy services within HSA I are identified: (1) the health status of the populations residing in the area of Lexington, Winchester, Louisa and Fluvanna with respect to cancer; (2) the failure of Rockingham Memorial Hospital to meet minimum volume standards and the projection of a failure to meet this minimum volume standard by 1986; (3) the absence of the specialities of hematology or medical oncology on the medical staff of the hospital at Rockingham; and (4) a lack of registered nurses/licensed practical nurses and a docimetrist at Winchester Memorial Hospital, which could impact on the quality of care. An additional area of concern is the increase in charges on the linear accelerator at the University of Virginia. Preliminary findings do not indicate that radiation therapy services within HSA I are inappropriate. Recommendations for addressing problem areas are proposed.

  16. 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.

  17. Integrating child health information systems in public health agencies.

    PubMed

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y

    2009-01-01

    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  18. [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.

  19. 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.

  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. Integrated health care systems: the key characteristics.

    PubMed

    Coddington, D C; Moore, K D; Fischer, E A

    1993-01-01

    Cooperation among the traditionally adversarial factions of physicians and hospitals has arisen in the early 1990s to develop the integrated health care system. Authors Dean C. Coddington, Keith D. Moore and Elizabeth A. Fischer explain how these two groups have been joined in the integration by an unlikely participant: health plans.

  3. 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.

  4. 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

  5. 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.

  6. Integrating sustainability and health care.

    PubMed

    Podein, Rian J; Hernke, Michael T

    2010-03-01

    Unsustainable development around the world has contributed to ecological degradation and human suffering while compromising the ability of ecosystems and social institutions to support human life. The United States health care system and its institutions are significant contributors to unsustainable development, but leaders of change are emerging from the health care arena. Health professionals, including primary care providers, are poised to serve as models for sustainability and to facilitate the necessary transformation toward more sustainable practices. Health professionals must, within a practical framework, embrace an objective definition of sustainability and then act to achieve it.

  7. Radiation-Hardened Wafer Scale Integration

    DTIC Science & Technology

    1989-10-25

    tim technology. A system built with conventional ICs and packaging would be very much larger. The required radiation dose rate and single - event upset ...assuming a 10:1 scaling at the analog to digital converters . (See footnote in Section 2.5.1.) This scale factor is used, for example, in ground-based...transistors which resulted in 5 different circuits . Static CMOS circuitry was used for radiation resistance. All 5 circuits were designed and built

  8. Evaluation performance of digital integrated circuits while exposed to radiation

    NASA Astrophysics Data System (ADS)

    Barbashov, V. M.; Trushkin, N. S.

    2016-10-01

    The methods of functional-logical simulation of digital integrated circuits (ICs) exposed to radiation are observed. It is shown that in a number of cases functional and electrical deterioration of ICs performances have both deterministic and non-deterministic nature. Methods for simulating IC failure exposed to radiation based on the model of fuzzy digital machine and Brauer probabilistic reliability machine are proposed.

  9. NCSE Conference 2017: Integrating Environment & Health

    EPA Pesticide Factsheets

    This conference will bring together scientist and professionals to discuss the complex relationships between people, the planet, and all living beings. The focus will specifically be integrating environment and health.

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    PubMed

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-04-08

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  15. Radiation health: mechanisms of radiation-induced cataracts in astronauts.

    PubMed

    Frey, Mary Anne

    2009-06-01

    Dr. Blakely and colleagues have conducted a series of experiments to explain the molecular basis by which space radiation causes cataracts, particularly with regard to elucidating how space radiation alters gene expression profiles in the process of lens cell differentiation. To do this, they "developed an in vitro model of differentiating human lens epithelial cells...that mimicked the normal growth environment in the tissue" (2). They have shown that radiation, especially high-LET (linear energy transfer) iron ion radiation, affects gene and protein expression of many cells involved in lens cell differentiation and cell cycle regulation. They have also developed a schematic model to explain the action of ionizing radiation on specific molecules leading to perturbations in cell cycle regulation and ultimately affecting lens cell differentiation. These results can provide a basis for developing countermeasures to protect astronauts in long-duration spaceflight and for improving risk assessments of space-radiation-caused cataracts. This research can also benefit individuals on Earth who are exposed to clinical and occupational radiation.

  16. 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.

  17. 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.

  18. 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.

  19. Radiation effects in power converters: Design of a radiation hardened integrated switching DC/DC converter

    NASA Astrophysics Data System (ADS)

    Adell, Philippe

    When electronic devices are used in space and military systems, they may be exposed to various types of radiation, including photons, electrons, protons, neutrons, and heavy ions. The effects of radiation on the semiconductor devices within the systems range from gradual degradation to catastrophic failure. In order to design and produce reliable systems for space or military applications, it is necessary to understand the device-level effects of radiation and develop appropriate strategies for reducing system susceptibility. This research focuses on understanding radiation effects in power converters for space and military applications. We show that power converters are very sensitive to radiation (total-dose, single event effects and displacement damage) and that their radiation response is dependent on input bias conditions and load conditions. We compared the radiation hardness of various power converter topologies using experiments and simulations. Evaluation of these designs under different modes of operation is demonstrated to be critical for determining radiation hardness. We emphasize the correlation between radiation effects and the role of the dynamic response of these topologies. For instance, total dose exposure has been found to degrade loop gain and affect regulation in some converters. We propose several radiation-hardening solutions to improve the radiation response of these designs. For instance, we demonstrate the design of a digitally controlled boost converter suitable for space applications based on an SRAM FPGA. A design hardening solution has been developed and successfully applied through VHDL simulations and experiments to assure the continuous operation of the converter in the presence of SEES (more precisely SEFIs). This research led to the design of a digitally controlled radiation hardened integrated switching buck converter. The proposed design is suitable for micro-satellite applications and is based on a high-voltage/CMOS process

  20. The Monte Carlo calculation of integral radiation dose in xeromammography.

    PubMed

    Dance, D R

    1980-01-01

    A Monte Carlo computer program has been developed for the computation of integral radiation dose to the breast in xeromammography. The results are given in terms of the integral dose per unit area of the breast per unit incident exposure. The calculations have been made for monoenergetic incident photons and the results integrated over a variety of X-ray spectra from both tungsten and molybdenum targets. This range incorporates qualities used in conventional and xeromammography. The program includes the selenium plate used in xeroradiography; the energy absorbed in this detector has also been investigated. The latter calculations have been used to predict relative values of exposure and of integral dose to the breast for xeromammograms taken at various radiation qualities. The results have been applied to recent work on the reduction of patient exposure in xeromammography by the addition of aluminium filters to the X-ray beam.

  1. Integrating Advanced Molecular Technologies into Public Health.

    PubMed

    Gwinn, Marta; MacCannell, Duncan R; Khabbaz, Rima F

    2017-03-01

    Advances in laboratory and information technologies are transforming public health microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. public health laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for public health.

  2. Integrated health systems: promise and performance.

    PubMed

    Conrad, D A; Shortell, S M

    1996-01-01

    Today's ¿virtually¿ and vertically integrated health systems increasingly are much better positioned than the multihospital systems of the 1980s to respond to the healthcare challenges of the twenty-first century. The authors argue that the control of the health services ¿value chain¿ will devolve naturally to those market players who have the comparative advantage in coordinating the flows of information, human, and physical resources along the continuum of services required to improve and maintain the health of populations. Available evidence does not render a clear verdict on whether superior performance is generated by the virtual integration of strategic alliances and affiliations or the vertical integration represented by unified single ownership of all system components. While inertia, acute care-based ¿mental models,¿ weak incentives, and insufficiently developed information systems represent important barriers to the creation and sustainability of integrated systems, the authors argue that system evolution is occurring and offers promise of enhanced efficiency and patient benefit. However, the full potential of these systems will only be realized as they accept explicit accountability for meeting the health needs of their local communities. The transition from ¿covered lives¿ to accountability for the community population is crucial.

  3. Integrating oral health throughout cancer care.

    PubMed

    Hartnett, Erin

    2015-10-01

    Oral health is often not a priority during cancer treatment; however, patients with cancer are at increased risk for oral complications during and after treatment. This article focuses on the importance of oral health care before, during, and after cancer treatment using the head, eyes, ears, nose, oral cavity, and throat, or HEENOT, approach. AT A GLANCE: Oral health is linked to overall health, and healthcare providers must be cognizant of the oral-systemic connection with patients undergoing cancer treatment, which may cause acute and chronic oral health problems. 
Oral assessment, prevention, early recognition, and treatment of oral problems must be incorporated into cancer care, particularly with the aid of an interprofessional team to meet patients' oral care needs. 
The head, eyes, ears, nose, oral cavity, and throat, or HEENOT, approach integrates oral care into patients' history taking, physical examination, and plan of cancer care.
.

  4. 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.

  5. Investigation of Integrated Vehicle Health Management Approaches

    NASA Technical Reports Server (NTRS)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  6. 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.

  7. 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

  8. [Radiated drugs, the way of health].

    PubMed

    Raynal, Cécile

    2011-04-01

    During the inter-war years, the word "radiated" did not only suggest radioactivity, but it was also used to indicate exposure to others radiations, such as ultraviolets. The actinotherapy, a new therapy in vogue, was applied to many pathologies and tried on many substances. "Radiated drugs" result of those experimentations. Their therapeutical characteristics were found during searches on rickets. Our study relates the story of fight against rickets in France, from the use of cod liver oil to the synthesis of Vitamine D.

  9. Outcome mapping for health system integration.

    PubMed

    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.

  10. 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

  11. Radiation and annealing effects on integrated bipolar Operational Amplifier

    NASA Astrophysics Data System (ADS)

    Assaf, J.

    2017-02-01

    Integrated bipolar Operational Amplifier (op-amp) type μA 741 was irradiated with neutrons and gamma rays. The radiation on gain factors, slew rate, and power supply current have been evaluated. The experimental results show a decrease of these parameter values after exposing to the radiation. The advantage of the increase of the voltage power supplies and the thermal annealing treatment on the damaged parameters was also explored. The relationship among different frequency response parameters is also studied leading to an analytical formula for the above degraded parameters.

  12. 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.

  13. 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.

  14. [History of health management for radiation accident and disaster].

    PubMed

    Miyazaki, Makoto; Yamashita, Shunichi

    2012-03-01

    According to the chronological evidences of radiation accident and disaster in the world, we can easily learn the valuable lessons on radiation health effects and also a necessity of well preparatory and organized system and network of emergency radiation medicine. Especially countermeasures on emergency radiation medicine have been categorized simply into two groups: acute and chronic effects, and high-dose and low-dose consequences. Based on the identification of potential impacts on radiation health and environmental effects, referring the past accidents and disasters, comprehensive risk analysis including risk estimation, risk management and risk communication is really required for maintaining healthy lives and safeguards in the unavoidable nuclear age of the 21st century.

  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.

  17. NUCLEAR NEW BUILD-INTEGRATING CULTURAL DIFFERENCES IN RADIATION PROTECTION.

    PubMed

    Haemmerli, Valentin; Bryant, Peter A; Cole, Peter

    2016-11-24

    Across the world, we are seeing a resurgence in Nuclear New Build. In the UK alone, plans are under way for the construction of 10 new reactors, using 4 different reactor designs all of which are to be provided by foreign vendors, and operated by 3 newly formed licensees within the UK. As these new licensees embark on the task of establishing themselves and progressing the design and build of these reactors, there are challenges faced in integrating the Radiation Protection Requirements and Culture from the various Foreign Investors and Vendors into the UK 'Context'. The following paper identifies the origin of the Radiation Protection Requirements within the UK and foreign investor/vendor countries, in an attempt to integrate them into the UK licensing and approval process. Thus, allowing due credit to be taken for the regulatory regime of the foreign countries where these reactors originate.

  18. 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.

  19. Integrating mental health into general health care: lessons from HIV.

    PubMed

    Joska, J A; Sorsdahl, K R

    2012-11-01

    Mental disorders are highly prevalent across all health settings. Where they are co-morbid with other chronic physical disorders, a complex bidirectional relationship exists between them. While mental disorders may result in an increase in adverse healthrelated outcomes, they are amenable to cost-effective treatments. In resource-limited settings, many barriers to the detection and treatment of mental disorders exist. One approach to the effective targeting of the available resources is to utilize a "risk-flag" approach, wherein individuals at-risk of treatment failure are identified and routed into more intensive mental health screening and intervention. This paper discusses how lessons from HIV services may inform how to improve mental health care and integration in HIV settings, as well as in other chronic diseases.

  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. 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

  2. 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.

  3. Integrating Behavioral Health into Primary Care

    PubMed Central

    Bauer, Amy M.; Collins, Laura; Dugdale, David C.

    2016-01-01

    Abstract 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

  4. Integration of the feline radiation hybrid and linkage maps.

    PubMed

    Sun, S; Murphy, W J; Menotti-Raymond, M; O'Brien, S J

    2001-06-01

    The recent development of genome mapping resources for the domestic cat provides a unique opportunity to study comparative medicine in this companion animal which can inform and benefit both veterinary and human biomedical concerns. We describe here the integration and order comparison of the feline radiation hybrid (RH) map with the feline interspecies backcross (ISB) genetic linkage map, constructed by a backcross of F1 hybrids between domestic cat (Felis catus) and the Asian leopard cat (Prionailurus bengalensis). Of 253 microsatellite loci mapped in the ISB, 176 equivalently spaced markers were ordered among a framework of 424 Type I coding markers in the RH map. The integration of the RH and ISB maps resolves the orientation of multiple linkage groups and singleton loci from the ISB genetic map. This integrated map provides the foundation for gene mapping assessments in the domestic cat and in related species of the Felidae family.

  5. 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.

  6. 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

  7. 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.

  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. 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...

  10. 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...

  11. 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.

  12. DREAM: An integrated space radiation nowcast system for natural and nuclear radiation belts

    NASA Astrophysics Data System (ADS)

    Reeves, G.

    2011-09-01

    The natural space environment continues to surprise us. We recently witnessed the quietest solar minimum in the past 100 years, casting huge uncertainties on our expectations for approach to Solar Maximum. The overall space environment is made up of many related but independent parts. The Dynamic Radiation Environment Assimilation Model (DREAM) focuses on the spacecraft charging environment. DREAM-RB (Radiation Belt) covers the internal charging (penetrating radiation) environment and DREAM-RC (Ring Current) covers the external, surface charging environment. A third component of DREAM is an electron source model (ESM) that calculates the trapped electron environment produced by high altitude nuclear explosions (HANE). All three major components of DREAM have undergone accelerated development over the past 18 months and now comprise an integrated code system for realtime “nowcasting”, for retrospective analysis of events, and for assessing threats from nuclear scenarios. DREAMESM has many similarities to the legacy SNRTACS code system but was developed to give us a modern code architecture with well-understood physics that could be integrated into the full DREAM system. The core of that system is the radiation belt model that uses data assimilation from geosynchronous, GPS, and other radiation measuring platforms to provide a highly accurate nowcast of the penetrating electron environment. DREAM includes codes that implement spacecraft tracking using the space catalog to calculate the specific internal charging and dose rate conditions at a specific satellite of interest. Targeted applications include alerts/warnings, anomaly resolution for more reliable operations, and attack/anomaly assessment for space situational awareness. The DREAM system is written to be fully compliant with Service Oriented Architecture standards and even has an iDREAM Space Weather app for the publicly-available space weather services.

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

    PubMed

    von Neubeck, Claere; Geniza, Matthew J; Kauer, Paula M; Robinson, R Joe; 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Health monitoring techniques using integrated sensors

    NASA Astrophysics Data System (ADS)

    Pfleiderer, Klaus; Stoessel, Rainer; Busse, Gerhard

    2003-08-01

    Advanced high performance materials and components such as CFRP, GFRP and Smart Structures require improved testing techniques. The first part of our contribution deals with nonlinear vibrometry as a defect selective non-destructive testing method. This method uses higher harmonics (which are generated only at defects) to locate the defect by scanning across the surface of the sample with a laser interferometer. For input coupling of the elastic wave both an external (like ultrasound welding converters) or internal (integrated piezo actuators) excitation source can be used. The external detection tools are a microphone or a scanning laser vibrometer. With this technique, we characterized Smart Structures made of aerospace materials and composites with embedded piezoelectric actuators. The next part is about health monitoring techniques and diagnostics where integrated elements are used for excitation and detection. Thus, we monitored the transfer function over a large frequency spectrum and especially its changes caused e.g. by defects. Changes in the properties of structures by fatigue, impacts, and thermoplasticity have been successfully observed. Also the changes in reinforced plastics under tensile stress have been monitored. The results were correlated with destructive measurements. For health monitoring we also present the impedance analysis of embedded piezo ceramic sensors. A defect causes changes in the modal response of the hole structure and that effect can be detected using the phase angle of the electric impedance of the piezo element. Additionally some types of defects cause a non-linear behavior of the structure which was verified by extracting higher harmonics as a reaction to sinusoidal single frequency excitation.

  19. 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...

  20. 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.

  1. Moving toward integrated health: an opportunity for social work.

    PubMed

    Stanhope, Victoria; Videka, Lynn; Thorning, Helle; McKay, Mary

    2015-01-01

    With the passage of the Patient Protection and Affordable Care Act (PPACA) and ongoing health care reform efforts, this is a critical time for the social work profession. The approaches and values embedded in health care reform are congruent with social work. One strategy is to improve care for people with co-morbid and chronic illnesses by integrating primary care and behavioral health services. This paper defines integrated health and how the PPACA promotes integrated health care through system redesign and payment reform. We consider how social workers can prepare for health care reform and discuss the implications of these changes for the future of the profession.

  2. Is health systems integration being advanced through Local Health District planning?

    PubMed

    Saunders, Carla; Carter, David J

    2016-04-21

    Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned.Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans.Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care.Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW.What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems.What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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...

  8. 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.

  9. 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.

  10. Integration of a radiation biomarker into modeling of thyroid carcinogenesis and post-Chernobyl risk assessment

    PubMed Central

    Kaiser, Jan Christian; Meckbach, Reinhard; Eidemüller, Markus; Selmansberger, Martin; Unger, Kristian; Shpak, Viktor; Blettner, Maria; Zitzelsberger, Horst; Jacob, Peter

    2016-01-01

    Strong evidence for the statistical association between radiation exposure and disease has been produced for thyroid cancer by epidemiological studies after the Chernobyl accident. However, limitations of the epidemiological approach in order to explore health risks especially at low doses of radiation appear obvious. Statistical fluctuations due to small case numbers dominate the uncertainty of risk estimates. Molecular radiation markers have been searched extensively to separate radiation-induced cancer cases from sporadic cases. The overexpression of the CLIP2 gene is the most promising of these markers. It was found in the majority of papillary thyroid cancers (PTCs) from young patients included in the Chernobyl tissue bank. Motivated by the CLIP2 findings we propose a mechanistic model which describes PTC development as a sequence of rate-limiting events in two distinct paths of CLIP2-associated and multistage carcinogenesis. It integrates molecular measurements of the dichotomous CLIP2 marker from 141 patients into the epidemiological risk analysis for about 13 000 subjects from the Ukrainian-American cohort which were exposed below age 19 years and were put under enhanced medical surveillance since 1998. For the first time, a radiation risk has been estimated solely from marker measurements. Cross checking with epidemiological estimates and model validation suggests that CLIP2 is a marker of high precision. CLIP2 leaves an imprint in the epidemiological incidence data which is typical for a driver gene. With the mechanistic model, we explore the impact of radiation on the molecular landscape of PTC. The model constitutes a unique interface between molecular biology and radiation epidemiology. PMID:27729373

  11. National Institutes of Health funding in radiation oncology: a snapshot.

    PubMed

    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.

  12. 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.

  13. 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.

  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. Ten Key Principles for Successful Health Systems Integration

    PubMed Central

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

    2010-01-01

    Integrated health systems are considered part of the solution to the challenge of sustaining Canada’s healthcare system. This systematic literature review was undertaken to guide decision-makers and others to plan for and implement integrated health systems. This review identified 10 universal principles of successfully integrated healthcare systems which may be used by decision-makers to assist with integration efforts. These principles define key areas for restructuring and allow organizational flexibility and adaptation to local context. The literature does not contain a one-size-fits-all model or process for successful integration, nor is there a firm empirical foundation for specific integration strategies and processes. PMID:20057244

  16. Acute and long term health effects of radiation

    SciTech Connect

    Voelz, G.L.

    1986-11-19

    This paper covers selected aspects of the acute and long term health effects excluding acute radiation syndrome and carcinogenesis, resulting from exposure to ionizing radiation. The changes addressed in this paper are those witnessed within an organ or whole body rather than at the molecular or even cellular level. They include acute and late health effects. Some of these effects are threshold effects, meaning that the dose must exceed a certain threshold before one sees these effects. Less than the threshold dose results in no observable organ or whole body effect. The severity of the effects correlate directly with the amount of cell damage or cell death that has occurred. 15 refs., 4 figs., 8 tabs.

  17. Thyroid cancer radioiodine therapy: health service performance and radiation safety.

    PubMed

    Vogiatzi, S; Liossis, A; Lamprinakou, M

    2015-07-01

    Greek Atomic Energy Commission collected data related to radioiodine I-131 therapy (RAIT) delivery to differentiated thyroid carcinoma patients, for the period 2003-13, corresponding to 100 % of hospitals at national level. Radiation safety and health service performance outcome indicators were assessed. The numbers of hospitals and nuclear medicine (NM) therapy wards, as well as RAIT annual frequencies, have increased. Geographical inhomogeneous distribution of existing infrastructure is recorded. In some cases, the observed inefficient use of NM therapy wards seems to be due to lack of human resources (e.g. nurses). Regular assessment of appropriate key indicators could serve as a useful tool for radiation safety monitoring and health service performance improvement.

  18. Enhanced Composites Integrity Through Structural Health Monitoring

    NASA Astrophysics Data System (ADS)

    Giurgiutiu, Victor; Soutis, Constantinos

    2012-10-01

    This paper discusses the topic of how the integrity of safety-critical structural composites can be enhanced by the use of structural health monitoring (SHM) techniques. The paper starts with a presentation of how the certification of flight-critical composite structures can be achieved within the framework of civil aviation safety authority requirements. Typical composites damage mechanisms, which make this process substantially different from that for metallic materials are discussed. The opportunities presented by the use of SHM techniques in future civil aircraft developments are explained. The paper then focuses on active SHM with piezoelectric wafer active sensors (PWAS). After reviewing the PWAS-based SHM options, the paper follows with a discussion of the specifics of guided wave propagation in composites and PWAS-tuning effects. The paper presents a number of experimental results for damage detection in simple flat unidirectional and quasi-isotropic composite specimens. Calibrated through holes of increasing diameter and impact damage of various energies and velocities are considered. The paper ends with conclusions and suggestions for further work.

  19. 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.

  20. ASA conference on radiation and health, Coolfont VI: Final report

    SciTech Connect

    Not Available

    1988-05-01

    The 1986 ASA Conference on Radiation and Health (Coolfont VI) continued the procedure established in 1981 of holding forenoon and evening sessions, leaving afternoons free for discussion and relaxation. One exception was made this year in that Michael and Marie Stoline were invited to discuss the Chernobyl Disaster on Monday afternoon. The program consisted of the following topics: a general overview of radiation and health problems; cytogenetics and radiation (human and animal studies and statistical analysis of dose-response curves); uranium and health effects, including continuing emphasis on radon, which has attracted considerable national interest lately; epidemiologic studies of workers at nuclear power plants and an uranium processing plant; the latest assessment of atomic bomb dosimetry. These Coolfont Conferences provide an excellent environment for an interchange of ideas and information in an assemblage of scientists from a variety of disciplines. Unfortunately there is one important factor which limits this interchange: language. In order to overcome the difficulty of statisticians understanding nuclear scientists and nuclear scientists understanding statisticians, I suggested one of two procedures: each group prepare a set of commonly used terms with definitions which would be understood by the other group(s); have an introductory session in which each group attempts to explain its language to the other group(s). This problem of communication is even more serious when scientists attempt to explain their research efforts to the general public. The Coolfont Conferences on Radiation and Health should be ideal forums for development of a language which could be understood by the general public as well as different scientific groups. This document contains the abstracts of 12 presented papers.

  1. The organizing vision of integrated health information systems.

    PubMed

    Ellingsen, Gunnar; Monteiro, Eric

    2008-09-01

    The notion of 'integration' in the context of health information systems is ill-defined yet in widespread use. We identify a variety of meanings ranging from the purely technical integration of information systems to the integration of services. This ambiguity (or interpretive flexibility), we argue, is inherent rather than accidental: it is a necessary prerequisite for mobilizing political and ideological support among stakeholders for integrated health information systems. Building on this, our aim is to trace out the career dynamics of the vision of 'integration/ integrated'. The career dynamics is the transformation of both the imaginary and the material (technological) realizations of the unfolding implementation of the vision of integrated care. Empirically we draw on a large, ongoing project at the University Hospital of North Norway (UNN) to establish an integrated health information system.

  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. Holistic health care for native women: an integrated model.

    PubMed

    Napoli, Maria

    2002-10-01

    Providing health care services to Native women has become a challenge owing to the severity of illness--in particular, diabetes, alcoholism, and arthritis--in this group today. If comprehensive health care is to be offered, coordination of services between health and mental health practitioners is needed. Gathering together to support each other has been a traditional custom for Native women. An integrated health care model is discussed that offers Native women an opportunity to deal with the challenge of mental health and health issues through traditional activities, enhancing their physical and spiritual health and receiving education while creating an atmosphere of empowerment and mutual support.

  4. 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.

  5. Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

    PubMed

    de Leeuw, Evelyne

    2017-03-20

    Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

  6. 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.

  7. 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...

  8. 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.

  9. 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…

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. The University of Michigan Student Health Physics Society's Radiation and Health Physics World Wide Web Site.

    PubMed

    Dreyer, Jonathan G; West, W Geoffrey; Wagner, Eric; Kearfott, Kimberlee J

    2005-05-01

    The University of Michigan Student Health Physics Society's (UMSHPS) Radiation and Health Physics World Wide Web Site is an informative database of radiation and health physics related topics. With over 1,000 visitors each day, the UMSHPS web site provides professionals and the general public with a valuable resource for information and research. Users of this site can either search for information by topic or submit questions directly to the qualified members the national Health Physics Society. During the past year, progress has been made in replacing the site's older, less versatile framework with new search engines and refined submittal forms, as well as a "Frequently Asked Questions" section. Within the database, references will include brief summaries of the site's available information and target audience. Although these changes have been beneficial for the site, the UMSHPS continuously seeks professional opinions and ideas to further the services that this online resource can provide to the profession and to the general public.

  15. 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.

  16. The Atmospheric Radiation Monitoring (ARM) Education Program: An Integrated Approach

    NASA Astrophysics Data System (ADS)

    Barnes, F.; Marsh, L. K.; Springer, M.; Talus, C. E.; Haruta, A.; Kloesel, K.; Zak, B. D.; Clements, W. E.

    2001-12-01

    The Atmospheric Radiation Measurement (ARM) Education and Outreach program supports ARM Operations at all three CART sites (North Slope of Alaska, Tropical West Pacific, and Southern Great Plains) in ways that are relevant to the needs of the communities and regions that host the ARM program sites. The goal of the education and outreach program is to develop basic science awareness, critical thinking skills, and improve environmental science capacity building for communities, teachers and students in ARM host communities and regions. This year, the primary goal is to extend the existing program to cover all three sites and to coordinate activities among the sites. In order to achieve this goal, we: o Bring awareness of the ARM program to host communities through public education relevant to the culture of the region; o Aid capacity building and community involvement in developing and implementing ARM education at each site; o Promote a broader knowledge of regional and international climate concerns for teachers and students through integration of ARM education across sites; o Assist access to ARM data for educational programs as technical resources permit, and to provide real time research experiences for students; and o Increase the knowledge base for teachers and students in basic science and critical thinking skills using curriculum-based enrichment activities in climate, climate change, and climate change effects relevant to each region.

  17. Integrated experimental and computational approach to understand the effects of heavy ion radiation on skin homeostasis.

    PubMed

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

    2013-10-01

    The effects of low dose high linear energy transfer (LET) radiation on human health are of concern for space, occupational, 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(-1)), 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.

  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. 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…

  20. Psychoneuroimmunology and health psychology: an integrative model.

    PubMed

    Lutgendorf, Susan K; Costanzo, Erin S

    2003-08-01

    The biopsychosocial model describes interactions between psychosocial and biological factors in the etiology and progression of disease. How an individual interprets and responds to the environment determines responses to stress, influences health behaviors, contributes to the neuroendocrine and immune response, and may ultimately affect health outcomes. Health psychology interventions are designed to modulate the stress response and improve health behaviors by teaching individuals more adaptive methods of interpreting life challenges and more effective coping responses. These interactions are discussed in the context of aging.

  1. 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.

  2. 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.

  3. 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.

  4. [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.

  5. Buildings' integral role in good health.

    PubMed

    Hall, Chris

    2014-05-01

    As reported in last month's HEJ, the new Sustainable Development Strategy for the Health, Public Health and Social Care System for 2014-20 rightly emphasises the importance of the built environment to health and well-being. Chris Hall, the BRE's health sector lead, says this message 'stretches far beyond hospitals and healthcare buildings into the communities and homes that people live in'. Here he highlights some of the key elements relating to the current carbon efficiency of healthcare buildings, considers the impact of 'good' housing on health and preventing illness, and looks forward to a series of joint IHEEM and BRE 'Building Sustainable Development' mini-conference events planned in the run-up to October's Healthcare Estates 2014 event in response to the new Strategy, designed to share ideas and good practice on sustainable estates issues. The first takes place in London later this month (see panel below).

  6. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing.

    ERIC Educational Resources Information Center

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.

    1999-01-01

    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. Community matters - why outbreak responses need to integrate health promotion.

    PubMed

    Kickbusch, Ilona; Reddy, K Srikanth

    2016-03-01

    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

  13. 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…

  14. 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

  15. Developing integrated multistate environmental public health surveillance.

    PubMed

    Wartenberg, Daniel; Thompson, W Douglas; Fitzgerald, Edward F; Gross, Hillary J; Condon, Suzanne K; Kim, Nancy; Goun, Barbara D; Opiekun, Richard E

    2008-01-01

    Environmental exposures cause substantial morbidity and mortality in the United States. A major goal of Centers for Disease Control and Prevention Environmental Public Health Tracking program is the development of a national network of health and environmental data with analytic tools for rapid evaluation of specific national or regional environmental health concerns. A six-state collaborative project in the northeast United States was established to assess the feasibility of such a system, assessing the possible association between ambient air quality and adverse birth outcomes. For this regional surveillance project, issues were discussed surrounding the design of a mutually acceptable protocol, obtaining human subjects' protection approvals, obtaining and organizing both the exposure and outcome data, analyzing the data both locally and regionally, and planning subsequent interventions to address identified public health concerns.

  16. 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...

  17. 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)

  18. Integrated primary health care: Finnish solutions and experiences

    PubMed Central

    Kokko, Simo

    2009-01-01

    Background Finland has since 1972 had a primary health care system based on health centres run and funded by the local public authorities called ‘municipalities’. On the world map of primary health care systems, the Finnish solution claims to be the most health centre oriented and also the widest, both in terms of the numbers of staff and also of different professions employed. Offering integrated care through multi-professional health centres has been overshadowed by exceptional difficulties in guaranteeing a reasonable access to the population at times when they need primary medical or dental services. Solutions to the problems of access have been found, but they do not seem durable. Description of policy practice During the past 10 years, the health centres have become a ground of active development structural change, for which no end is in sight. Broader issues of municipal and public administration structures are being solved through rearranging primary health services. In these rearrangements, integration with specialist services and with social services together with mergers of health centres and municipalities are occurring at an accelerated pace. This leads into fundamental questions of the benefits of integration, especially if extensive integration leads into the threat of the loss of identity for primary health care. Discussion This article ends with some lessons to be learned from the situation in Finland for other countries. PMID:19590612

  19. Effects of the Integrated Behavioral Health Project's Efforts to Promote Integrated Care Under Funding from the California Mental Health Services Authority

    PubMed Central

    Cerully, Jennifer L.; Collins, Rebecca L.; Wong, Eunice C.; Seelam, Rachana; Roth, Elizabeth; Yu, Jennifer

    2016-01-01

    Abstract Describes the methods and results of a RAND evaluation of the Integrated Behavioral Health Project's efforts to promote the integration of mental and physical health care among various health care stakeholders in California. PMID:28083420

  20. 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.

  1. 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

  2. ASA conference on radiation and health: Coolfont 7: Final report

    SciTech Connect

    Not Available

    1987-01-01

    These proceedings provide a summary of papers presented at the seventh annual ASA Conference on Radiation and Health, held at the Coolfont Conference Center in Berkeley Springs, West Virginia. More than forty scientists, including statisticians, epidemiologists, biologists, and physicists, participated in the conference. The 1987 conference focused on lung cancer risks, especially lung cancer risks due to radon. The BEIR IV report, which addresses health risks of radon and other internally deposited alpha-emitters, was summarized early in the conference. Results of analyses of data on miners in Colorado and in New Mexico were presented, as well as analyses of combined data from several studies, which were used as the basis of estimates in the BEIR IV report. Statistical issues related to appropriate analysis of chronic exposure and of smoking data received considerable attention and discussion. Papers describing models for lung cancer risks based on exposure to cigarette smoke, radiation, and other substances provided insights into general understanding of lung cancer mechanisms. Carcinogenic models were also the subject of a presentation on radiation-induced skin cancer in humans and animals. In addition, relevant data on animal experiments involving radon exposure were summarized. Understanding risks requires relating them to dose, and thus the presentation on dosimetry, both for miner populations and for residents of US homes, made an important contribution to the conference. Presentations on current efforts at the state and national level to assess radon levels in US homes were also of considerable interest to the participants. Individual papers were processed separately for the data base.

  3. The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons.

    PubMed

    Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

    2007-03-01

    The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.

  4. 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.…

  5. 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…

  6. 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,…

  7. Integrated Learning and Health: A Call for Increasing Coordination Efforts

    ERIC Educational Resources Information Center

    Chafouleas, Sandra M.; Polifroni, E. Carol

    2016-01-01

    This commentary reinforces a call to recognize the need for substantive collaboration, communication, and cooperation across education and health sectors. Themes throughout the body of articles contained in the special issue are discussed as strengthening knowledge about the benefits to integration of education and health domains in prevention and…

  8. 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.

  9. 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…

  10. The Children's Mental Health Integrated Fund: A Preliminary Report.

    ERIC Educational Resources Information Center

    Cox, Gary; Brandt, Vickie

    This report is a comprehensive description of Minnesota's children's mental health system. It is designed to provide background and guidance to the Children's Integrated Fund Task Force, to assist local coordinating councils, and to serve policymakers outside of mental health who are increasingly asked to consider problems from an interagency…

  11. 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…

  12. Entrepreneurship management in health services: an integrative model.

    PubMed

    Guo, Kristina L

    2006-01-01

    This research develops an integrated systems model of entrepreneurship management as a method for achieving health care organizational survival and growth. Specifically, it analyzes current health care environment challenges, identifies roles of managers and discusses organizational theories that are relevant to the health care environment, outlines the role of entrepreneurship in health care, and describes the entrepreneurial manager in the entrepreneurial management process to produce desirable organizational outcomes. The study concludes that as current health care environment continues to show intense competition, entrepreneurial managers are responsible for creating innovations, managing change, investing in resources, and recognizing opportunities in the environment to increase organizational viability.

  13. Community assessment in a vertically integrated health care system.

    PubMed Central

    Plescia, M; Koontz, S; Laurent, S

    2001-01-01

    OBJECTIVES: In this report, the authors present a representative case of the implementation of community assessment and the subsequent application of findings by a large, vertically integrated health care system. METHODS: Geographic information systems technology was used to access and analyze secondary data for a geographically defined community. Primary data included a community survey and asset maps. RESULTS: In this case presentation, information has been collected on demographics, prevalent health problems, access to health care, citizens' perceptions, and community assets. The assessment has been used to plan services for a new health center and to engage community members in health promotion interventions. CONCLUSIONS: Geographically focused assessments help target specific community needs and promote community participation. This project provides a practical application for integrating aspects of medicine and public health. PMID:11344895

  14. Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

    PubMed

    Coll-Black, Sarah; Bhushan, Anjana; Fritsch, Kathleen

    2007-12-01

    Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

  15. Physician Satisfaction With Integrated Behavioral Health in Pediatric Primary Care.

    PubMed

    Hine, Jeffrey F; Grennan, Allison Q; Menousek, Kathryn M; Robertson, Gail; Valleley, Rachel J; Evans, Joseph H

    2017-04-01

    As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services. Such models of care may increase access to care and reduce other service barriers encountered by individuals and their families with behavioral health concerns (ie, those who otherwise would seek services through referrals to traditional tertiary care facilities).

  16. 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.

  17. Integrated Approaches to Occupational Health and Safety: A Systematic Review.

    PubMed

    Cooklin, A; Joss, N; Husser, E; Oldenburg, B

    2016-01-05

    Objective . The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Data Source . Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Study Inclusion and Exclusion Criteria . Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data Extraction . Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Data Synthesis . Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. Results . A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Conclusion . Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

  18. 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.

  19. Integrating animal health and foodborne disease surveillance.

    PubMed

    Berman, E M; Shimshony, A

    2013-08-01

    The control of foodborne diseases from an animal source has become an important part of public health policy. Since the agents that cause these diseases originate in animals, Veterinary Services, as well as Public Health Services, must be involved in their control. Control programmes should be established either through cooperation between the two Services or by the consolidation of all those involved into a single food control agency. Surveillance is an important part of these control programmes. The following questions must be addressed when planning an effective surveillance programme. What is the relative incidence, morbidity, mortality and economic cost of the foodborne disease in humans? Is the animal population the exclusive or a significant source of the human foodborne infection? What kind of surveillance is needed to identify the disease-causing agent in the animal population? Are we interested in identifying all cases of a disease in order to eradicate it or is our aim to reduce its incidence in the animal population? Do we have the ability to control the disease in the animal population? What disease detection tests are available? What are the sensitivity, specificity and cost of these diagnostic tests? Finally, does the country, region or agency involved have the legal, financial and educational resources to carry out this surveillance and follow it up with appropriate action? After these questions have been resolved,the veterinary and public health sectors must jointly decide if surveillance and control are feasible. If so, they can then begin to develop an appropriate programme.

  20. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... health effects of radiation exposure. (a) From time to time, the Secretary shall publish evaluations of... studies affecting epidemiological assessments including case series, correlational studies and...

  1. A Model for Implementing Integrative Practice in Health Care Agencies

    PubMed Central

    Patterson, Chris; Arthur, Heather M.

    2008-01-01

    Over the last few years, there has been increased awareness and use of complementary/alternative therapies (CAM) in many countries without the health care infrastructure to support it. The National Centre for Complementary and Alternative Medicine referred to the combining of mainstream medical therapies and CAM as integrative medicine. The creation of integrative health care teams will definitely result in redefining roles, but more importantly in a change in how services are delivered. The purpose of this paper is to describe a model of the necessary health care agency resources to support an integrative practice model. A logic model is used to depict the findings of a review of current evidence. Logic models are designed to show relationships between the goals of a program or initiative, the resources to achieve desired outputs and the activities that lead to outcomes. The four major resource categories necessary for implementing integrative care are within the domains of a) professional and research development, b) health human resource planning, c) regulation and legislation and d) practice and management in clinical areas. It was concluded that the system outcomes from activities within these resource categories should lead to freedom of choice in health care; a culturally sensitive health care system and a broader spectrum of services for achieving public health goals. PMID:21614155

  2. Analysis of the ORNL radiation-streaming integral experiments

    SciTech Connect

    Santoro, R.T.; Alsmiller, R.G. Jr.; Barnes, J.M.; Chapman, G.T.; Tang, J.S.

    1981-01-01

    The determination of radiation streaming through the various penetrations that will be present in the blanket and shield of a D-T burning fusion reactor is one of the more complicated problems facing nuclear design engineer. Penetrations of varying size and shape will be required for neutral particle injection, rf heating, vacuum pumping, and plasma diagnostics. The radiation streaming through these openings will degrade the reactor performance by the adverse effects of nuclear heating, induced activation, and radiation damage in vital components. The effects of radiation streaming must be estimated during the design of the reactor. Measurements have been made to determine the streaming of approx. 14-MeV neutrons through a simple iron duct imbedded in a concrete shield.

  3. Systematic review of youth mental health service integration research.

    PubMed

    Kinchin, Irina; Tsey, Komla; Heyeres, Marion; Cadet-James, Yvonne

    2016-06-16

    Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998-2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12-25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.

  4. 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.

  5. Integrated health of the girl child.

    PubMed

    Ghosh, S

    1995-01-01

    This article discusses factors that affect the well-being and health of female children in India: sex ratio, literacy, food intake, morbidity, mortality, early marriage, maternal mortality, nutrition, prenatal care and delivery, family planning responsibilities, and access to health services. India has recognized within its Constitution and other government documents and programs equality for women, but practices lag behind principles. A National Action Plan was formulated for the period 1991-2000 for the girl child. Women themselves must change their attitudes about themselves and their female children. Several pilot programs have demonstrated the potential to empower girls to be outspoken, vocal, and enthusiastic. Girls in India are disadvantaged even before their birth. Patriarchal norms reinforce the view of girls as a bad investment. Women are blamed for not bearing a son, despite the evidence that males carry the deciding gender-specific chromosome. Tamil Nadu districts are known for their female infanticide. The declining sex ratio is attributed to the higher death rate among females younger than 35 years. Females until recently had a lower life expectancy than males. Sex ratios vary between states. The only state with a positive female sex ratio is Kerala. Males outnumber females by almost 10% in most of the northern and eastern states. Illiteracy among women is high in about 100 districts. Female school enrollment is 50% less than male enrollment. Females suffer from higher rates of malnutrition, morbidity, and death. Girls' adolescent growth spurt is delayed until 18 years. Maternal mortality accounts for the largest proportion of deaths among women of reproductive age. The most common reason for abortion is "too many children." Lower socioeconomic status is associated with lower nutrition. Women do not have control over their fertility. Women are limited in their access to reproductive health care.

  6. 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... for the Advisory Group on Prevention, Health Promotion, and Integrative and Public ] Health (the... Prevention, Health Promotion and Public Health (the ``Council''). The Advisory Group shall provide...

  7. 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.

  8. Integrating reproductive health services in a reforming health sector: the case of Tanzania.

    PubMed

    Oliff, Monique; Mayaud, Philippe; Brugha, Ruairí; Semakafu, Ave Maria

    2003-05-01

    Universal access to comprehensive reproductive health services, integrated into a well-functioning health system, remains an unfulfilled objective in many countries. In 2000-2001, in Tanzania, in-depth interviews were conducted with central level stakeholders and focus group discussions held with health management staff in three regional and nine district health offices, to assess progress in the integration of reproductive health services. Respondents at all levels reported stalled integration and lack of synchronisation in the planning and management of key services. This was attributed to fear of loss of power and resources among national level managers, uncertainty as to continuation of donor support and lack of linkages with the Health Sector Reform Secretariat. Among reproductive health programmes, sexually transmitted infection (STI) control alone retained its vertical planning, management and implementation structures. District-level respondents expressed frustration in their efforts to coordinate STI service delivery with other, more integrated programmes. They reported contradictory directives and poor communication channels with higher levels of the Ministry of Health; lack of technical skills at district level to undertake supervision of integrated services; low morale due to low salaries; and lack of district autonomy in decision-making. Integration requires a coherent policy environment. The uncoordinated and conflicting agendas of donors, on whom Tanzania is too heavily reliant, is a major obstacle.

  9. 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

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

    PubMed

    Broach, Debra

    2015-04-01

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

  11. [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.

  12. 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…

  13. Synergy for health equity: integrating health promotion and social determinants of health approaches in and beyond the Americas.

    PubMed

    Jackson, Suzanne F; Birn, Anne-Emanuelle; Fawcett, Stephen B; Poland, Blake; Schultz, Jerry A

    2013-12-01

    Health promotion and social determinants of health approaches, when integrated, can better contribute to understanding and addressing health inequities. Yet, they have typically been pursued as two solitudes. This paper presents the key elements, principles, actions, and potential synergies of these complementary frameworks for addressing health equity. The value-added of integrating these two approaches is illustrated by three examples drawn from the authors' experiences in the Americas: at the community level, through a community-based coalition for reducing chronic disease disparities among minorities in an urban center in the United States; at the national level, through healthy-settings interventions in Canada; and at the Regional level, through health cooperation based on social justice values in Latin America. Challenges to integrating health promotion and social determinants of health approaches in the Americas are also discussed.

  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. 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. Integrating mental health parity for homebound older adults under the medicare home health care benefit.

    PubMed

    Davitt, Joan K; Gellis, Zvi D

    2011-04-01

    Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.

  17. 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

  18. 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.

  19. Integrating mental health into cardiovascular disease research in India.

    PubMed

    Narayanan, Gitanjali; Prabhakaran, Dorairaj

    2012-01-01

    Mental health refers to a diverse field where individuals can cope with daily stress, realize their potential and maintain a state of well-being. In recent years, there has been increasing recognition of the influence of mental health on general health, and in particular on cardiovascular diseases and their risk factors. Epidemiological research has focused on several psychosocial components including social determinants, comorbid psychiatric disorders, psychological stress, coping styles, social support, burden on the family, well-being, life satisfaction, personality and cognitive factors in connection with cardiovascular diseases. There is epidemiological research in India that integrates mental health with common cardiovascular diseases such as coronary health disease and stroke. Data from mental health research is sufficiently compelling to highlight the role of chronic stress, socioeconomic status and psychiatric disorders such as depression, substance use, social networks and support in relation to vulnerability to cardiovascular diseases. There are psychosocial consequences of cardiovascular diseases including deficits in the domains of life skills, coping skills and neurocognition, in addition to caregiver burden. The implications of bio-psychosocial models of assessments and interventions that target complex individual and contextual variables simultaneously on cardiovascular treatment outcomes have highlighted the importance of studying mental health in Indian settings. Integration of mental health into mainstream research is the need of the hour. A multidimensional approach to accomplish this is required including at the level of research conceptualization, discussions with key stakeholders, at the policy level, at the institutional level, and at the clinical and community level.

  20. Tackling community integration in mental health home visit integration in Finland.

    PubMed

    Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

    2016-09-01

    Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge.

  1. Fast evaluation of Sommerfeld integrals for EM scattering and radiation by three-dimensional buried objects

    SciTech Connect

    Cui, T.J.; Chew, W.C.

    1999-03-01

    This paper presents a fast method for electromagnetic scattering and radiation problems pertinent to three-dimensional (3-D) buried objects. In this approach, a new symmetrical form of the Green`s function is derived, which can reduce the number of Sommerfeld integrals involved in the buried objects problem. The integration along steepest descent paths and leading-order approximations are introduced to evaluate these Sommerfeld integrals, which can greatly accelerate the computation. Based on the fast evaluation of Sommerfeld integrals, the radiation of an arbitrarily oriented electric dipole buried in a half space is first analyzed and computed. Then, the scattering by buried dielectric objects and conducting objects is considered using the method of moments (MOM). Numerical results show that the fast method can save tremendous CPU time in radiation and scattering problems involving buried objects.

  2. Integration of peer specialists working in mental health service settings.

    PubMed

    Kuhn, Wendy; Bellinger, Jillian; Stevens-Manser, Stacey; Kaufman, Laura

    2015-05-01

    Peer specialists are people in recovery employed to share their experiences to promote the recovery of others affected by mental illness. Examining workplace integration indicators that predict the job satisfaction of peer specialists employed in a variety of behavioral health settings is critical to ensure the retention and effectiveness of this viable workforce. A survey of Texas Certified Peer Specialists (n = 86) examined workplace integration indicators. Results suggest that supervisor's understanding of the peer specialist job role has a significant impact on job satisfaction. Better workforce integration may be achieved through targeted efforts to educate supervisors about peer specialist job roles.

  3. 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

  4. 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...

  5. 78 FR 14798 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... 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... ] Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  6. 78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... 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...

  7. 77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-15

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory Group... Prevention, Health Promotion and Public Health Council (the ``Council''). The Advisory Group shall...

  8. 76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory Group... provide recommendations and advice to the National Prevention, Health Promotion and Public Health...

  9. 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... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory... Prevention, Health Promotion and Public Health Council (the ``Council''). The Advisory Group shall...

  10. 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

    ... HUMAN SERVICES Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and... 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....

  11. 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.

  12. 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…

  13. 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

    2016-01-28

    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.

  14. 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

  15. 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.

  16. We must integrate services for people with mental health issues.

    PubMed

    2017-02-10

    It is clear from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report published last month that hospitals are failing to integrate physical and mental healthcare. As a result, patients with mental health issues are receiving poor care and nurses are too often failing to refer such patients to the appropriate specialist support.

  17. 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…

  18. How to enhance integrated care towards the personal health paradigm?

    PubMed

    Blobel, Bernd G M E; Pharow, Peter; Norgall, Thomas

    2007-01-01

    For improving quality and efficiency of health delivery under the well-known burdens, the health service paradigm has to change from organization-centered over process-controlled to personal health. The growing complexity of highly distributed and fully integrated healthcare settings can only be managed through an advanced architectural approach, which has to include all dimensions of personal health. Here, ICT, medicine, biomedical engineering, bioinformatics and genomics, legal and administrative aspects, terminology and ontology have to be mentioned. The Generic Component Model allows for different domains' concept representation and aggregation. Framework, requirements, methodology and process design possibilities for such a future-proof and meanwhile practically demonstrated approach are discussed in detail. The deployment of the Generic Component Model and the concept representation to biomedical engineering aspects of eHealth are touched upon as essential issues.

  19. 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.

  20. INTEGRATED SACHS-WOLFE EFFECT FOR GRAVITATIONAL RADIATION

    SciTech Connect

    Laguna, Pablo; Larson, Shane L.; Spergel, David; Yunes, Nicolas

    2010-05-20

    Gravitational waves (GWs) are messengers carrying valuable information about their sources. For sources at cosmological distances, the waves will also contain the imprint left by the intervening matter. The situation is in close analogy with cosmic microwave photons, for which the large-scale structures the photons traverse contribute to the observed temperature anisotropies, in a process known as the integrated Sachs-Wolfe effect. We derive the GW counterpart of this effect for waves propagating on a Friedman-Robertson-Walker background with scalar perturbations. We find that the phase, frequency, and amplitude of the GWs experience Sachs-Wolfe-type integrated effects, in addition to the magnification effects on the amplitude from gravitational lensing. We show that for supermassive black hole binaries, the integrated effects could account for measurable changes on the frequency, chirp mass, and luminosity distance of the binary, thus unveiling the presence of inhomogeneities, and potentially dark energy, in the universe.

  1. 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.

  2. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    PubMed

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2016-12-15

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  3. 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

  4. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    PubMed Central

    Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael

    2014-01-01

    Background A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Conclusion Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients. PMID:24648834

  5. Integrated networks and health care provider cooperatives: new models for rural health care delivery and financing.

    PubMed

    Casey, M M

    1997-01-01

    Minnesota's 1994 health care reform legislation authorized the establishment of community integrated service networks (CISNs) and health care provider cooperatives, which were envisioned as new health care delivery models that could be successfully implemented in rural areas of the state. Four CISNs are licensed, and three organizations are incorporated as health care provider cooperatives. Many of the policy issues Minnesota has faced regarding the development of CISNs and health care provider cooperatives in rural areas are similar to those raised by current Medicare reform proposals.

  6. 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

  7. Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions.

    PubMed

    Dawkins-Moultin, Lenna; McDonald, Andrea; McKyer, Lisako

    2016-01-01

    While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.

  8. 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.

  9. 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

  10. Numerical simulation and experimental research of the integrated high-power LED radiator

    NASA Astrophysics Data System (ADS)

    Xiang, J. H.; Zhang, C. L.; Gan, Z. J.; Zhou, C.; Chen, C. G.; Chen, S.

    2017-01-01

    The thermal management has become an urgent problem to be solved with the increasing power and the improving integration of the LED (light emitting diode) chip. In order to eliminate the contact resistance of the radiator, this paper presented an integrated high-power LED radiator based on phase-change heat transfer, which realized the seamless connection between the vapor chamber and the cooling fins. The radiator was optimized by combining the numerical simulation and the experimental research. The effects of the chamber diameter and the parameters of fin on the heat dissipation performance were analyzed. The numerical simulation results were compared with the measured values by experiment. The results showed that the fin thickness, the fin number, the fin height and the chamber diameter were the factors which affected the performance of radiator from primary to secondary.

  11. Effects of Integrated Health Management Intervention on Overweight and Obesity

    PubMed Central

    Yang, Yiting; Ma, Chung Wah; Yang, Yide; Wang, Xiaoling; Lin, Xiaoliang; Fu, Lianguo; Wang, Shuo; Yang, Zhongping; Wang, Zhenghe; Meng, Xiangkun; Ma, Dongmei; Ma, Rui

    2017-01-01

    Overweight or obese adults aged 20~55 years and living in Beijing more than one year were randomly divided into different management groups. A one-year integrated health management intervention was applied in the health management groups. The physical indicators and metabolic indicators changed after one-year intervention on the overweight and obese adults. The annual reduction of the physical indicators was significant in all groups (p < 0.05) except the weight loss in the placebo + general management group. The health management and the dietary supplement have statistically significant (p < 0.001, p < 0.001) effects on the annual reduction of these indicators and interactive effect between them was found on some of these indicators such as bodyweight, body mass index (BMI), body fat ratio (BFR), and hipline (p < 0.05). The dietary supplement + health management group had the best annual reduction effects for the indicators among the groups. Integrated health management interventions including both dietary supplements intervention and health management could improve metabolic indicators in overweight and obese adults together with the physical indicators, suggesting the intermediated role of metabolic indictors in controlling obesity. PMID:28115972

  12. 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...

  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. 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...

  15. 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...

  16. 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

  17. 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.

  18. An integral equation formulation for predicting radiation patterns of a space shuttle annular slot antenna

    NASA Technical Reports Server (NTRS)

    Jones, J. E.; Richmond, J. H.

    1974-01-01

    An integral equation formulation is applied to predict pitch- and roll-plane radiation patterns of a thin VHF/UHF (very high frequency/ultra high frequency) annular slot communications antenna operating at several locations in the nose region of the space shuttle orbiter. Digital computer programs used to compute radiation patterns are given and the use of the programs is illustrated. Experimental verification of computed patterns is given from measurements made on 1/35-scale models of the orbiter.

  19. Basic Mechanisms of Radiation Effects on Electronic Materials, Devices, and Integrated Circuits

    DTIC Science & Technology

    1982-08-01

    such changes on de’ ice properties. To gain detailed insight regarding the effects that occur when an integrated circuit is placed in a radiation...the interaction produces energetic free elec- trons. The energy range in which photoelectr~ ic collisions dominate depends on the atomic number Z of...neutron energy dependent, as discussed in Sec- ticn 3.0, this makes it difficult to compare directly results obtained by workers using different radiation

  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. Integrating worksite health protection and health promotion: A conceptual model for intervention and research.

    PubMed

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

    2016-10-01

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

  2. Radiation Effects in 3D Integrated SOl SRAM Circuits

    DTIC Science & Technology

    2011-08-23

    Comparing Neutrons and Protons Data Monoenergetic neutrons and protons are used to characterize single event effects in electronics circuits, and are...for proton irradiation with energies between 4.8 and 500 MeV. Results are compared with 14-MeV neutron irradiation. Single event upset cross-section...fabricating circuits for space applications. singIe event effects, SOl, fully depleted, 3D integration, neutron , protons, upset cross-section U U U U SAR

  3. 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.

  4. 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.

  5. Radiation-hardened CMOS integrated circuit development for space nuclear power applications

    NASA Astrophysics Data System (ADS)

    Gover, J. E.; Gregory, B. L.

    Examination of the types of systems required for space nuclear power applications suggests a need for microelectronics technology that can function during and after exposure to radiation levels exceeding 1 x 10 to the 16th neutrons/sq cm and gamma ray doses in excess of 1 x 10 to the 7th rad(Si). Radiation-hardened Complimentary Metal Oxide Silicon and Silicon Nitride Oxide Silicon (SNOS) ICs presently in development at Sandia National Laboratories' Center for Radiation-Hardened Microelectronics satisfy these radiation requirements. Future integrated circuit development will further advance the radiation hardness capabilities while extending the IC technology to 32-bit enhanced microprocessors and 1-Mbyte SNOS EEPROM memories.

  6. 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

  7. Changes in Quality of Health Care Delivery after Vertical Integration

    PubMed Central

    Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

    2015-01-01

    Objectives To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Data Sources/Study Setting Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. Study Design We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data Collection/Extraction Methods Data were assembled by the health plan’s informatics team. Principal Findings Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care–sensitive admissions increased when the acquisition caused disruption in admitting patterns. Conclusions Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. PMID:25529312

  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. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

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

    2013-01-01

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

  10. [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.

  11. From social integration to health: Durkheim in the new millennium.

    PubMed

    Berkman, L F; Glass, T; Brissette, I; Seeman, T E

    2000-09-01

    It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.

  12. 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.

  13. 78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-21

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory Group... established to assist in carrying out the mission of the National Prevention, Health Promotion, and...

  14. 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

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice... be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health....healthcare.gov/prevention/nphpphc/advisorygrp/index.html . DATES: The meeting will be held on June 25,...

  15. 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...

  16. Integrating information for community-based health care.

    PubMed

    Garets, D E

    1996-08-01

    Healthcare providers are increasingly faced with the need to develop comprehensive, clinically-oriented, community-focused information systems in order to remain financially viable and meet the information demands of healthcare consumers. Some providers interface and integrate their disparate information systems on their own. Others form integrated delivery systems that take advantage of economies of scale from an enterprise approach to information technology management. Still others form health information networks that allow them to pool information technology resources while pursuing independent business goals.

  17. 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.

  18. 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.

  19. Non-targeted effects induced by ionizing radiation: mechanisms and potential impact on radiation induced health effects.

    PubMed

    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 (>1 Gy), at low doses (<100 mGy) 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.

  20. 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.

  1. 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

  2. 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.

  3. Rock Burst Monitoring by Integrated Microseismic and Electromagnetic Radiation Methods

    NASA Astrophysics Data System (ADS)

    Li, Xuelong; Wang, Enyuan; Li, Zhonghui; Liu, Zhentang; Song, Dazhao; Qiu, Liming

    2016-11-01

    For this study, microseismic (MS) and electromagnetic radiation (EMR) monitoring systems were installed in a coal mine to monitor rock bursts. The MS system monitors coal or rock mass ruptures in the whole mine, whereas the EMR equipment monitors the coal or rock stress in a small area. By analysing the MS energy, number of MS events, and EMR intensity with respect to rock bursts, it has been shown that the energy and number of MS events present a "quiet period" 1-3 days before the rock burst. The data also show that the EMR intensity reaches a peak before the rock burst and this EMR intensity peak generally corresponds to the MS "quiet period". There is a positive correlation between stress and EMR intensity. Buckling failure of coal or rock depends on the rheological properties and occurs after the peak stress in the high-stress concentration areas in deep mines. The MS "quiet period" before the rock burst is caused by the heterogeneity of the coal and rock structures, the transfer of high stress into internal areas, locked patches, and self-organized criticality near the stress peak. This study increases our understanding of coal and rock instability in deep mines. Combining MS and EMR to monitor rock burst could improve prediction accuracy.

  4. Integration services to enable regional shared electronic health records.

    PubMed

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  5. Integration of Oral Health into Primary Health Care System: Views of Primary Health Care Workers in Lagos State, Nigeria

    PubMed Central

    Ogunbodede, Eyitope; Adeniyi, Abiola

    2014-01-01

    The limited access to oral health care in developing countries can be greatly improved by integrating oral health into the Primary Health Care (PHC) system. This study was designed to assess the views of PHC workers on integrating oral health care into the PHC system. A self-administered questionnaire survey was conducted in two selected local government areas of Lagos State. The instrument contained three sections assessing sociodemographic features, knowledge of common oral diseases and views on integration of oral health into PHC respectively. The mean knowledge score was 7.75 (SD=±1.81), while 60.4% of the respondents had average knowledge scores. Educational status (P=0.018) and designation (P=0.033) were significantly related to the mean knowledge scores. There was no significant difference in the oral health knowledge of the various cadres (P=0.393). Majority (85.4%) of the respondents were willing to include oral health education in their job schedule and 82% believed they needed more training on oral health. The knowledge of the respondents on the causes of the common oral diseases was deficient. Oral health education should be included in the future curriculum of these personnel. PMID:28299117

  6. Utilization of the integral equation method for determining the characteristic radiation features of antennas

    NASA Astrophysics Data System (ADS)

    Zink, M.

    The integral equation method in the form of the electric field integral equation for wire grid models provides the current distribution on the surface of structures under study. Characteristic parameters such as the input impedance and the radiation diagram are obtained in this fashion. These parameters are determined for a dipole in free space, a monopole over a circular ground plane, and a torus antenna. Good results are obtained for the far field and the variables related to it.

  7. Computerized mental health assessment in integrative health clinics: a cross-sectional study using structured interview.

    PubMed

    Leung, Sau Fong; French, Peter; Chui, Caroline; Arthur, David

    2007-12-01

    Computerized mental health assessment is gaining popularity. It enables the standardization of assessment of clinical problems, increases the capacity to collect sensitive or confidential information, facilitates personal assessment at one's own pace, and offers rapid screening of mental health status. The use of computer technology to conduct mental health assessment was an initiative proposed for two nurse-led integrative health clinics affiliated to a University in Hong Kong. It was intended to provide an efficient screening for depression, anxiety, alcohol abuse, and problem gambling common in the primary health-care settings to facilitate early intervention. This study was conducted to assess the effectiveness of using a computerized health assessment kiosk to perform mental health assessment. The assessment items were derived from an abbreviated World Health Organization Mental Disorders Checklist and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Criteria for Pathological Gambling. The study involved an opportunity sample of 31 subjects who volunteered to complete the computerized mental health assessment during their waiting time in the clinics. The results showed that most subjects had positive feelings about using a computer to perform a mental health assessment and had increased understanding of their mental health. Suggestions made to improve computerized mental health assessments included touch screen, voice instructions, and enlarged print font size.

  8. 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

  9. Analysing radiative and non-radiative recombination in InAs QDs on Si for integrated laser applications

    NASA Astrophysics Data System (ADS)

    Orchard, Jonathan R.; Woodhead, Chris; Shutts, Samuel; Wu, Jiang; Sobiesierski, Angela; Young, Rob J.; Beanland, Richard; Liu, Huiyun; Smowton, Peter M.; Mowbray, David J.

    2016-03-01

    Three InAs quantum dot (QD) samples with dislocation filter layers (DFLs) are grown on Si substrates with and without in-situ annealing. Comparison is made to a similar structure grown on a GaAs substrate. The three Si grown samples have different dislocation densities in their active region as revealed by structural studies. By determining the integrated emission as a function of laser power it is possible to determine the power dependence of the radiative efficiency and compare this across the four samples. The radiative efficiency increases with decreasing dislocation density; this also results in a decrease in the temperature quenching of the PL. A laser structures grown on Si and implementing the same optimum DFL and annealing procedure exhibits a greater than 3 fold reduction in threshold current as well as a two fold increase in slope efficiency in comparison to a device in which no annealing is applied.

  10. A stochastic collocation approach for efficient integrated gear health prognosis

    NASA Astrophysics Data System (ADS)

    Zhao, Fuqiong; Tian, Zhigang; Zeng, Yong

    2013-08-01

    Uncertainty quantification in damage growth is critical in equipment health prognosis and condition based maintenance. Integrated health prognostics has recently drawn growing attention due to its capability to produce more accurate predictions through integrating physical models and real-time condition monitoring data. In the existing literature, simulation is commonly used to account for the uncertainty in prognostics, which is inefficient. In this paper, instead of using simulation, a stochastic collocation approach is developed for efficient integrated gear health prognosis. Based on generalized polynomial chaos expansion, the approach is utilized to evaluate the uncertainty in gear remaining useful life prediction as well as the likelihood function in Bayesian inference. The collected condition monitoring data are incorporated into prognostics via Bayesian inference to update the distributions of uncertainties at given inspection times. Accordingly, the distribution of the remaining useful life is updated. Compared to conventional simulation methods, the stochastic collocation approach is much more efficient, and is capable of dealing with high dimensional probability space. An example is used to demonstrate the effectiveness and efficiency of the proposed approach.

  11. [Update - health risks induced by ionizing radiation from diagnostic imaging].

    PubMed

    Knüsli, Claudio; Walter, Martin

    2013-12-01

    Ionizing radiation is the most thoroughly investigated exogenous noxa. Since the early 20th century it is well known that using ionizing radiation in diagnostic procedures causes cancer - physicians themselves frequently being struck by this disease in those early days of radiology. Radiation protection therefore plays an important role. Below doses of 100 Millisievert (mSv) however much research has to be accomplished yet because not only malignant tumors, but cardiovascular diseases, malformations and genetic sequelae attributable to low dose radiation have been described. Unborns, children and adolescents are highly vulnerable. Dose response correlations are subject to continuing discussions because data stem mostly from calculations studying Japanese atomic bomb survivors. Radiation exposure is not exactly known, and it is unknown, if observations of radiation induced diseases in this ethnicity can be generalized. Nowadays the main source of low dose ionizing radiation from medical diagnostics is due to computertomography (CT). Large recent clinical studies from the UK and Australia investigating cancer incidence after exposition to CT in childhood and adolescence confirm that low doses in the range of 5 mSv already significantly increase the risk of malignant diseases during follow up. Imaging techniques as ultrasound and magnetic resonance tomography therefore should be preferred whenever appropriate.

  12. 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.

  13. 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.

  14. 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

  15. 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)

  16. 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)

  17. Integration of a Mobile-Integrated Therapy with Electronic Health Records: Lessons Learned

    PubMed Central

    Peeples, Malinda M.; Iyer, Anand K.; Cohen, Joshua L.

    2013-01-01

    Background: Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient–provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. Methods: In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Results: Findings from the diverse stakeholder group of a MIT–EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Conclusions: Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. PMID:23759392

  18. Developing Multipurpose Reproductive Health Technologies: An Integrated Strategy

    PubMed Central

    Harrison, P. F.; Hemmerling, A.; Romano, J.; Whaley, K. J.; Young Holt, B.

    2013-01-01

    Women worldwide confront two frequently concurrent reproductive health challenges: the need for contraception and for protection from sexually transmitted infections, importantly HIV/AIDS. While conception and infection share the same anatomical site and mode of transmission, there are no reproductive health technologies to date that simultaneously address that reality. Relevant available technologies are either contraceptive or anti-infective, are limited in number, and require different modes of administration and management. These “single-indication” technologies do not therefore fully respond to what is a substantial reproductive health need intimately linked to pivotal events in many women's lives. This paper reviews an integrated attempt to develop multipurpose prevention technologies—“MPTs”—products explicitly designed to simultaneously address the need for both contraception and protection from sexually transmitted infections. It describes an innovative and iterative MPT product development strategy with the following components: identifying different needs for such technologies and global variations in reproductive health priorities, defining “Target Product Profiles” as the framework for a research and development “roadmap,” collating an integrated MPT pipeline and characterizing significant pipeline gaps, exploring anticipated regulatory requirements, prioritizing candidates for problem-solving and resource investments, and implementing an ancillary advocacy agenda to support this breadth of effort. PMID:23533733

  19. Integration of health and environment through health impact assessment: cases from three continents.

    PubMed

    Negev, Maya; Levine, Hagai; Davidovitch, Nadav; Bhatia, Rajiv; Mindell, Jennifer

    2012-04-01

    Despite the strong linkage between environment and health, institutions responsible for these fields operate in largely fragmented ways with limited interaction. As illustrated in the recent engagement between health and urban planning institutions, inter-institutional cooperation could support more effective and politically acceptable solutions for both local and global problems. Analysis of three case-studies, from three different continents, shows that HIA might serve to promote synergies among health and environmental disciplines in different local contexts, and could lead to institutional and procedural changes that promote health. Case examples provided supportive evidence for these effects, despite differences in approaches to HIA and governance levels. Obstacles to the use of HIA for inter-institutional integration also differed between countries. Lessons learned could support cooperation in other common interests of health and environment disciplines such as research, training and preparedness, and mitigation of public health emergencies related to the environment.

  20. Health information technology: integration of clinical workflow into meaningful use of electronic health records.

    PubMed

    Bowens, Felicia M; Frye, Patricia A; Jones, Warren A

    2010-10-01

    This article examines the role that clinical workflow plays in successful implementation and meaningful use of electronic health record (EHR) technology in ambulatory care. The benefits and barriers of implementing EHRs in ambulatory care settings are discussed. The researchers conclude that widespread adoption and meaningful use of EHR technology rely on the successful integration of health information technology (HIT) into clinical workflow. Without successful integration of HIT into clinical workflow, clinicians in today's ambulatory care settings will continue to resist adoption and implementation of EHR technology.

  1. Computerization of Mental Health Integration complexity scores at Intermountain Healthcare.

    PubMed

    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).

  2. [Juvenile obesity with a focus on health promotion: integrative review].

    PubMed

    Luna, Izaildo Tavares; Moreira, Rosa Aparecida Nogueira; da Silva, Kelanne Lima; Caetano, Joselany Afio; Pinheiro, Patrícia Neyva da Costa; Rebouças, Cristiana Brasil de Almeida

    2011-06-01

    This integrative review summarizes nursing researches that contribute to study juvenile obesity with a focus on health promotion. 20 articles were identified in a bibliographical survey that followed the criteria: date, language, and the descriptors: nursing, adolescent, obesity and health promotion. The Pediatric Nursing Journal published seven of these papers (35%). Indexed papers were published in the last ten years in Portuguese and English. Results showed the construction of scientific knowledge in nursing that developed health promotion strategies in cases of juvenile obesity, thus contributing to the development of the profession. Showing the cumulative risk that juvenile obesity presents of turning subjects into obese adults is a precious resource to plan nursing actions for this population, and for these actions to achieve effective results.

  3. 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.

  4. [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.

  5. 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.

  6. 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."

  7. Adaptive radiations, ecological specialization, and the evolutionary integration of complex morphological structures.

    PubMed

    Monteiro, Leandro R; Nogueira, Marcelo R

    2010-03-01

    The evolutionary integration of complex morphological structures is a macroevolutionary pattern in which morphogenetic components evolve in a coordinated fashion, which can result from the interplay among processes of developmental, genetic integration, and different types of selection. We tested hypotheses of ecological versus developmental factors underlying patterns of within-species and evolutionary integration in the mandible of phyllostomid bats, during the most impressive ecological and morphological radiation among mammals. Shape variation of mandibular morphogenetic components was associated with diet, and the transition of integration patterns from developmental to within-species to evolutionary was examined. Within-species (as a proxy to genetic) integration in different lineages resembled developmental integration regardless of diet specialization, however, evolutionary integration patterns reflected selection in different mandibular components. For dietary specializations requiring extensive functional changes in mastication patterns or biting, such as frugivores and sanguivores, the evolutionary integration pattern was not associated with expected within-species or developmental integration. On the other hand, specializations with lower mastication demands or without major functional reorganization (such as nectarivores and carnivores), presented evolutionary integration patterns similar to the expected developmental pattern. These results show that evolutionary integration patterns are largely a result of independent selection on specific components regardless of developmental modules.

  8. Impact of late radiation effects on cancer survivor children: an integrative review.

    PubMed

    Coura, Cibeli Fernandes; Modesto, Patrícia Cláudia

    2016-01-01

    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.

  9. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    PubMed Central

    Polanco, Nuria Toro; Zabalegui, Iñaki Berraondo; Irazusta, Itziar Pérez; Solinís, Roberto Nuño; Del Río Cámara, Mario

    2015-01-01

    Introduction This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework. Results The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes. PMID:26150764

  10. Case study of the integration of a local health department and a community health center.

    PubMed

    Lambrew, J M; Ricketts, T C; Morrissey, J P

    1993-01-01

    As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration.

  11. 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.

  12. 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

  13. Integral dose and radiation-induced secondary malignancies: comparison between stereotactic body radiation therapy and three-dimensional conformal radiotherapy.

    PubMed

    D'Arienzo, Marco; Masciullo, Stefano G; de Sanctis, Vitaliana; Osti, Mattia F; Chiacchiararelli, Laura; Enrici, Riccardo M

    2012-11-19

    The aim of the present paper is to compare the integral dose received by non-tumor tissue (NTID) in stereotactic body radiation therapy (SBRT) with modified LINAC with that received by three-dimensional conformal radiotherapy (3D-CRT), estimating possible correlations between NTID and radiation-induced secondary malignancy risk. Eight patients with intrathoracic lesions were treated with SBRT, 23 Gy × 1 fraction. All patients were then replanned for 3D-CRT, maintaining the same target coverage and applying a dose scheme of 2 Gy × 32 fractions. The dose equivalence between the different treatment modalities was achieved assuming α/β = 10 Gy for tumor tissue and imposing the same biological effective dose (BED) on the target (BED = 76 Gy(10)). Total NTIDs for both techniques was calculated considering α/β = 3 Gy for healthy tissue. Excess absolute cancer risk (EAR) was calculated for various organs using a mechanistic model that includes fractionation effects. A paired two-tailed Student t-test was performed to determine statistically significant differences between the data (p ≤ 0.05). Our study indicates that despite the fact that for all patients integral dose is higher for SBRT treatments than 3D-CRT (p = 0.002), secondary cancer risk associated to SBRT patients is significantly smaller than that calculated for 3D-CRT (p = 0.001). This suggests that integral dose is not a good estimator for quantifying cancer induction. Indeed, for the model and parameters used, hypofractionated radiotherapy has the potential for secondary cancer reduction. The development of reliable secondary cancer risk models seems to be a key issue in fractionated radiotherapy. Further assessments of integral doses received with 3D-CRT and other special techniques are also strongly encouraged.

  14. 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.

  15. Practical Approaches for Achieving Integrated Behavioral Health Care in Primary Care Settings

    PubMed Central

    Ratzliff, Anna; Phillips, Kathryn E.; Sugarman, Jonathan R.; Unützer, Jürgen; Wagner, Edward H.

    2016-01-01

    Behavioral health problems are common, yet most patients do not receive effective treatment in primary care settings. Despite availability of effective models for integrating behavioral health care in primary care settings, uptake has been slow. The Behavioral Health Integration Implementation Guide provides practical guidance for adapting and implementing effective integrated behavioral health care into patient-centered medical homes. The authors gathered input from stakeholders involved in behavioral health integration efforts: safety net providers, subject matter experts in primary care and behavioral health, a behavioral health patient and peer specialist, and state and national policy makers. Stakeholder input informed development of the Behavioral Health Integration Implementation Guide and the GROW Pathway Planning Worksheet. The Behavioral Health Integration Implementation Guide is model neutral and allows organizations to take meaningful steps toward providing integrated care that achieves access and accountability. PMID:26698163

  16. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

    PubMed Central

    2013-01-01

    Background Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted

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

    PubMed

    Lebret, Erik

    2015-12-23

    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.

  18. 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

  19. Integrated Working for Enhanced Health Care in English Nursing Homes

    PubMed Central

    McNall, Anne; Thompson, Juliana; Hodgson, Philip; Shaw, Lynne; Cowie, Daniel

    2016-01-01

    Abstract Background The increasingly complex nature of care home residents’ health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England. Study Aims To explore the views and experiences of practitioners, social care officers, and carers involved in the enhanced health care in care home programme, in order to develop understanding of the service delivery model and associated workforce needs for the provision of health care to older residents. Methods A qualitative constructivist methodology was adopted. The study had two stages. Stage 1 explored the experiences of the programme enhanced healthcare workforce through group, dyad, and individual interviews with 45 participants. Stage 2 involved two workshops with 28 participants to develop Stage 1 findings (data were collected during February–March 2016). Thematic and content analysis were applied. Findings The enhanced healthcare programme provides a whole system approach to the delivery of proactive and responsive care for nursing home residents. The service model enables information exchange across organizational and professional boundaries that support effective decision making and problem solving. Clinical Relevance Understanding of the processes and outcomes of a model of integrated health care between public and independent sector care home services for older people. PMID:28094909

  20. Retaining physicians in Lithuania: integrating research and health policy.

    PubMed

    Starkiene, Liudvika; Macijauskiene, Jurate; Riklikiene, Olga; Stricka, Marius; Padaiga, Zilvinas

    2013-04-01

    Many of the strategic planning studies worldwide have made recommendations to the policy makers on the steps to be taken in eliminating the perceived shortages of physician workforce or in improving their distribution and retention. Policy makers have also considered various policy interventions to ensure adequate numbers of physicians. This study reviewed the research evidence and health policy decisions taken from 2000 to 2010 in Lithuania and evaluated the chronological links over time between scientific recommendations and policy decisions. From the analysis it would seem that Lithuania's success in retaining physicians between 2000 and 2010 was influenced by the timely implementation of particular research recommendations, such as increased salaries and increased enrolment to physician training programmes. In addition were the health policy interventions such as health sector reform, change in the legal status of medical residents and establishment of professional re-entry programmes. Based on this evidence it is recommended that policy makers in Lithuania as well as in other countries should consider comprehensive and systematic health policy approaches that combine and address various aspects of physician training, retention, geographic mal-distribution and emigration. Implementation of such an inclusive policy however is impossible without the integration of research into strategic decision making in workforce planning and effective health policy interventions.

  1. Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

    PubMed

    Hadi, Tamer A; Fleshler, Keren

    2016-10-01

    Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

  2. Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.

    PubMed

    Fernandez, Ana; Gillespie, James A; Smith-Merry, Jennifer; Feng, Xiaoqi; Astell-Burt, Thomas; Maas, Cailin; Salvador-Carulla, Luis

    2016-03-24

    Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence.Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD.Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing.Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care.What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system.What does this paper add? This paper provides a critical analysis of

  3. [The hospital perspective: disease management and integrated health care].

    PubMed

    Schrappe, Matthias

    2003-06-01

    Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

  4. Integrated approach for managing health risks at work--the role of occupational health nurses.

    PubMed

    Marinescu, Luiza G

    2007-02-01

    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

  5. 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

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory.../prevention/nphpphc/advisorygrp/index.html DATES: The meeting will be held on November 21, 2011, 3 p.m. to 5...

  6. Does temperature nudging overwhelm aerosol radiative effects in regional integrated climate models?

    NASA Astrophysics Data System (ADS)

    He, Jian; Glotfelty, Timothy; Yahya, Khairunnisa; Alapaty, Kiran; Yu, Shaocai

    2017-04-01

    Nudging (data assimilation) is used in many regional integrated meteorology-air quality models to reduce biases in simulated climatology. However, in such modeling systems, temperature changes due to nudging could compete with temperature changes induced by radiatively active and hygroscopic short-lived tracers leading to two interesting dilemmas: when nudging is continuously applied, what are the relative sizes of these two radiative forces at regional and local scales? How do these two forces present in the free atmosphere differ from those present at the surface? This work studies these two issues by converting temperature changes due to nudging into pseudo radiative effects (PRE) at the surface (PRE_sfc), in troposphere (PRE_atm), and at the top of atmosphere (PRE_toa), and comparing PRE with the reported aerosol radiative effects (ARE). Results show that the domain-averaged PRE_sfc is smaller than ARE_sfc estimated in previous studies and this work, but could be significantly larger than ARE_sfc at local scales. PRE_atm is also much smaller than ARE_atm. These results indicate that appropriate nudging methodology could be applied to the integrated models to study aerosol radiative effects at continental/regional scales, but it should be treated with caution for local scale applications.

  7. Mobile phone radiation health risk controversy: the reliability and sufficiency of science behind the safety standards

    PubMed Central

    2010-01-01

    There is ongoing discussion whether the mobile phone radiation causes any health effects. The International Commission on Non-Ionizing Radiation Protection, the International Committee on Electromagnetic Safety and the World Health Organization are assuring that there is no proven health risk and that the present safety limits protect all mobile phone users. However, based on the available scientific evidence, the situation is not as clear. The majority of the evidence comes from in vitro laboratory studies and is of very limited use for determining health risk. Animal toxicology studies are inadequate because it is not possible to "overdose" microwave radiation, as it is done with chemical agents, due to simultaneous induction of heating side-effects. There is a lack of human volunteer studies that would, in unbiased way, demonstrate whether human body responds at all to mobile phone radiation. Finally, the epidemiological evidence is insufficient due to, among others, selection and misclassification bias and the low sensitivity of this approach in detection of health risk within the population. This indicates that the presently available scientific evidence is insufficient to prove reliability of the current safety standards. Therefore, we recommend to use precaution when dealing with mobile phones and, whenever possible and feasible, to limit body exposure to this radiation. Continuation of the research on mobile phone radiation effects is needed in order to improve the basis and the reliability of the safety standards. PMID:20205835

  8. Health effects of low level radiation: carcinogenesis, teratogenesis, and mutagenesis

    SciTech Connect

    Ritenour, E.R.

    1986-04-01

    The carcinogenic effects of radiation have been demonstrated at high dose levels. At low dose levels, such as those encountered in medical diagnosis, the magnitude of the effect is more difficult to quantify. Three reasons for this difficulty are (1) the effects in human populations are small compared with the natural incidence of cancer in the populations; (2) it is difficult to transfer results obtained in animal studies to the human experience; and (3) the effects of latency period and plateau increase the complexity of population studies. In spite of these difficulties, epidemiologic studies of human populations exposed to low levels of radiation still play a valuable role in the determination of radiation carcinogenecity. They serve to provide upper estimates of risk and to rule out the appearance of new effects that may be masked by the effects of high doses. While there is evidence for mutagenic effects of radiation in experimental animals, no conclusive human data exist at the present. It is not possible to rule out the presence of genetic effects of radiation in humans, however, because many problems exist with regard to the epidemiologic detection of small effects when the natural incidence is relatively large. In animals, subtle effects (eg, a decrease in the probability of survival from egg to adult) may occur with greater frequency than more dramatic disorders in irradiated populations. However, these types of genetic abnormalities are difficult to quantitate. Current risk estimates are based primarily upon data pertaining to dominant mutations in rodents. Some specific locus studies also permit identification of recessive mutation rates. The embryo and fetus are considered to be at greater risk for adverse effects of radiation than is the adult.

  9. The Readiness for Integrated Care Questionnaire (RICQ): An Instrument to Assess Readiness to Integrate Behavioral Health and Primary Care.

    PubMed

    Scott, Victoria C; Kenworthy, Tara; Godly-Reynolds, Erin; Bastien, Gilberte; Scaccia, Jonathan; McMickens, Courtney; Rachel, Sharon; Cooper, Sayon; Wrenn, Glenda; Wandersman, Abraham

    2017-04-10

    Integration of behavioral health and primary care services is a promising approach for reducing health disparities. The growing national emphasis on care coordination has mobilized efforts to integrate behavioral health and primary care services across the United States. These efforts align with broader health care system goals of improving health care quality, health equity, utilization efficiency, and patient outcomes. Drawing from our work on a multiyear integrated care initiative (Integrated Care Leadership Program; ICLP) and an implementation science heuristic for organizational readiness (Readiness = Motivation x General Capacity and Innovation-Specific Capacity; R = MC2), this article describes the development and implementation of a tool to assess organizational readiness for integrated care, referred to as the Readiness for Integrated Care Questionnaire (RICQ). The tool was piloted with 11 health care practices that serve vulnerable, underprivileged populations. Initial results from the RICQ revealed that participating practices were generally high in motivation, innovation-specific capacities, and general capacities at the start of ICLP. Additionally, analyses indicated that practices particularly needed support with increasing staff capacities (general knowledge and skills), improving access to and use of resources, and simplifying the steps in integrating care so the effort appears less daunting and difficult to health care team members. We discuss insights from the initial use of RICQ and practical implications of the new tool for driving integrated care efforts that can contribute to health equity. (PsycINFO Database Record

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

    PubMed

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

    2014-09-08

    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.

  11. Design, Fabrication, Calibration, Testing and Satellite Integration of a Space-Radiation Dosimeter.

    DTIC Science & Technology

    1981-12-01

    IU2I 0 AFGL-TR-81-0354 DESIGN, FABRICATION, CALIBRATION, TESTING AND SATELLITE INTEGRATION OF A SPACE-RADIATION DOSIMETER ~ Bach Sellers Ralph...1978 - Dec. 1981 Radiation Dosimeter 6. PERFoRMu *PG. RgPORT NUges, AUT"OR(a) 4. CONTRACT an calT uMei[ews) Bach Sellers Frederick A. Hanser Ralph...SIOPPLEMENTARy NOTES 9. KEY WORDS (Confnlow ..n tevrs* lie If ft.ea4.# w IioaflFp by bleek ainb,) Dosimeter Particle Fluxes Electron Dose Nuclear Stars

  12. Shuttle active thermal control system development testing. Volume 5: Integrated radiator/expendable cooling system tests

    NASA Technical Reports Server (NTRS)

    Scheps, P. B.

    1974-01-01

    Tests were conducted to gather data on a space shuttle active control system (ATCS) incorporating both radiators and an expendable cooling device to provide vehicle heat removal. Two systems were tested and design information was provided for both nominal and limit conditions. The tests verified the concept that an integrated radiator/expendable cooling system can adequately maintain desired water quantities while responding to variations in heat loads and environments. In addition, the need for duct heating was demonstrated, while exhaust nozzle heating was also shown to be unnecessary.

  13. 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.

  14. 78 FR 53147 - Advisory Board on Radiation and Worker Health: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Advisory Board on Radiation and Worker Health: Notice of Charter Renewal This gives notice under the Federal Advisory Committee Act (Pub. L....

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  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. 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...

  8. [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.

  9. 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.

  10. [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.

  11. 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

  12. Airborne Transducer Integrity under Operational Environment for Structural Health Monitoring.

    PubMed

    Salmanpour, Mohammad Saleh; Sharif Khodaei, Zahra; Aliabadi, Mohammad Hossein

    2016-12-12

    This paper investigates the robustness of permanently mounted transducers used in airborne structural health monitoring systems, when exposed to the operational environment. Typical airliners operate in a range of conditions, hence, structural health monitoring (SHM) transducer robustness and integrity must be demonstrated for these environments. A set of extreme temperature, altitude and vibration environment test profiles are developed using the existing Radio Technical Commission for Aeronautics (RTCA)/DO-160 test methods. Commercially available transducers and manufactured versions bonded to carbon fibre reinforced polymer (CFRP) composite materials are tested. It was found that the DuraAct transducer is robust to environmental conditions tested, while the other transducer types degrade under the same conditions.

  13. Integrating modelling and smart sensors for environmental and human health.

    PubMed

    Reis, Stefan; Seto, Edmund; Northcross, Amanda; Quinn, Nigel W T; Convertino, Matteo; Jones, Rod L; Maier, Holger R; Schlink, Uwe; Steinle, Susanne; Vieno, Massimo; Wimberly, Michael C

    2015-12-01

    Sensors are becoming ubiquitous in everyday life, generating data at an unprecedented rate and scale. However, models that assess impacts of human activities on environmental and human health, have typically been developed in contexts where data scarcity is the norm. Models are essential tools to understand processes, identify relationships, associations and causality, formalize stakeholder mental models, and to quantify the effects of prevention and interventions. They can help to explain data, as well as inform the deployment and location of sensors by identifying hotspots and areas of interest where data collection may achieve the best results. We identify a paradigm shift in how the integration of models and sensors can contribute to harnessing 'Big Data' and, more importantly, make the vital step from 'Big Data' to 'Big Information'. In this paper, we illustrate current developments and identify key research needs using human and environmental health challenges as an example.

  14. 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.

  15. Airborne Transducer Integrity under Operational Environment for Structural Health Monitoring

    PubMed Central

    Salmanpour, Mohammad Saleh; Sharif Khodaei, Zahra; Aliabadi, Mohammad Hossein

    2016-01-01

    This paper investigates the robustness of permanently mounted transducers used in airborne structural health monitoring systems, when exposed to the operational environment. Typical airliners operate in a range of conditions, hence, structural health monitoring (SHM) transducer robustness and integrity must be demonstrated for these environments. A set of extreme temperature, altitude and vibration environment test profiles are developed using the existing Radio Technical Commission for Aeronautics (RTCA)/DO-160 test methods. Commercially available transducers and manufactured versions bonded to carbon fibre reinforced polymer (CFRP) composite materials are tested. It was found that the DuraAct transducer is robust to environmental conditions tested, while the other transducer types degrade under the same conditions. PMID:27973450

  16. Integrating modelling and smart sensors for environmental and human health

    PubMed Central

    Reis, Stefan; Seto, Edmund; Northcross, Amanda; Quinn, Nigel W.T.; Convertino, Matteo; Jones, Rod L.; Maier, Holger R.; Schlink, Uwe; Steinle, Susanne; Vieno, Massimo; Wimberly, Michael C.

    2015-01-01

    Sensors are becoming ubiquitous in everyday life, generating data at an unprecedented rate and scale. However, models that assess impacts of human activities on environmental and human health, have typically been developed in contexts where data scarcity is the norm. Models are essential tools to understand processes, identify relationships, associations and causality, formalize stakeholder mental models, and to quantify the effects of prevention and interventions. They can help to explain data, as well as inform the deployment and location of sensors by identifying hotspots and areas of interest where data collection may achieve the best results. We identify a paradigm shift in how the integration of models and sensors can contribute to harnessing ‘Big Data’ and, more importantly, make the vital step from ‘Big Data’ to ‘Big Information’. In this paper, we illustrate current developments and identify key research needs using human and environmental health challenges as an example. PMID:26644778

  17. 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

  18. 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…

  19. 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.

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

    PubMed

    Petri, Richard P

    2015-10-01

    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.

  1. The Integration of Behavioral Health Interventions in Children’s Health Care: Services, Science, and Suggestions

    PubMed Central

    Kolko, David J.; Perrin, Ellen C.

    2014-01-01

    Objective 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 paper examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. Method This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices (EBP), 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. Results 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 addressing methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Discussion 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. PMID:24588366

  2. 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

  3. Emotional labour in mental health nursing: An integrative systematic review.

    PubMed

    Edward, Karen-Leigh; Hercelinskyj, Gylo; Giandinoto, Jo-Ann

    2017-04-04

    Emotional labour is the effort consumed by suppressing one's own emotions to care for others effectively while also caring for oneself. Mental health nurses are required to engage in effective therapeutic interactions in emotionally-intense situations. The aim of the present integrative systematic review was to investigate the emotional labour of mental health work and how this manifested, the impacts, and the ways to mitigate these impacts. In June 2016, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, a systematic search of the bibliographic databases was undertaken to identify relevant literature. Screening, data extraction, and synthesis were performed by three reviewers. The inclusion criteria included any original research that investigated the emotional work of mental health nurses. We identified a total of 20 papers to be included in this review. Thematic synthesis of the findings revealed three emergent themes: emotional labour and caring, emotional exhaustion, and self-protection (expressed as emotional intelligence). Emotional labour, emotional exhaustion, and emotional intelligence were considered to be intrinsically linked, where they were both the influencing factor for burnout and a contributor to attrition. The results highlighted that emotional labour could inspire the development and personal growth of emotional intelligence in mental health nurses. In light of these findings, recommendations for clinical practice were considered; they included supportive work environments, involving nurses in shared decision-making, and the provision of ongoing professional development opportunities that facilitate the development of emotional intelligence and resilience.

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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

  9. Project INTEGRATE - a common methodological approach to understand integrated health care in Europe

    PubMed Central

    Cash-Gibson, Lucinda; Rosenmoller, Magdalene

    2014-01-01

    Background The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing) and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness). Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach) to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field. Methodology To compare the different integrated care experiences, a mixed-methods approach has been adopted with the

  10. Integrating mental health into primary care within the Veterans Health Administration.

    PubMed

    Post, Edward P; Metzger, Maureen; Dumas, Patricia; Lehmann, Laurent

    2010-06-01

    The Veterans Health Administration (VHA) has been undertaking a major transformational program of integrating collaborative mental health resources into primary care settings. Key components of the program include colocated collaborative care provided by mental health professionals; care management; and blended programs that combine elements of these two components, whose functions are highly complementary to each other. The program has grown since 2007 from an initiative implementing pilot programs at participating facilities, to a routine expectation of primary care within all VHA medical centers and large community-based outpatient clinics. The national program office supports this VHA initiative in multiple ways, including technical assistance to sites, program and policy development, dissemination of informational tools to facilitate continuous quality improvement, education and training, and partnerships with other existing and emerging VHA programs such as postdeployment health clinics and the patient-centered medical home.

  11. Towards a performance measurement system for health equity in a local health integration network.

    PubMed

    Nakaima, April; Sridharan, Sanjeev; Gardner, Bob

    2013-02-01

    While there is a growing literature on building performance measurement systems for health equities, this literature for the most part has not dealt with the challenges of coordinating the various parts of the system, the heterogeneous nature of such systems, or how evaluations and measurement can themselves improve performance. This paper describes the initial steps taken to build a performance measurement system to coordinate health equity across 18 hospitals led by the Toronto Central Local Health Integration Network, which is a regional health authority serving a population of more than 2.5 million residents (near in population to Chicago and Rome) and the most socially diverse urban network in Ontario, Canada. This paper also describes some principles that can help inform a performance measurement system. The innovative aspect of this paper is that these principles were developed through feedback by the hospitals.

  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. Integrating acupuncture: are there positive health outcomes for women

    PubMed Central

    Robinson, Nicola

    2017-01-01

    The key health issues for women tend to be primarily associated with the female reproductive system. There are also other gender priorities and consequences associated with ageing, which require effective interventions. Acupuncture is used worldwide and its evidence base is increasing on both mechanisms of action and its effectiveness in clinical care. Although acupuncture may be a valuable addition to healthcare for some conditions, it is rarely fully integrated into mainstream Western medicine clinical practice. Inadequate design and poor reporting of clinical trials have been barriers. Additionally systematic reviews and meta-analyses have tended to be equivocal and have reported that there is insufficient evidence for its recommendation. Future research should focus on ensuring good trial design including cost effectiveness and qualitative data and using a more pragmatic stance which reflects acupuncture in clinical practice. Undoubtedly, effective interventions are always needed to ensure the best health outcomes and address preventable deaths, morbidities, and disabilities among women but integration will be compromised unless underpinned by good evidence. PMID:28271658

  14. 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.

  15. Integrated health care for patients with motor neurone disease.

    PubMed

    Brewah, Helen

    This article presents the findings from a study trip to Kaiser Permanente (KP), a private healthcare provider in the USA. The aim of the trip was to understand how healthcare integration is managed in KP and how this might help patients in the UK with motor neurone disease (MND). This article makes reference to the American and British healthcare systems, identifying the simple differences between health economies, and their impact on health care, with specific reference to MND. The trip was undertaken as part of the author's ongoing work on how patients with MND rate services delivered by the multidisciplinary team (MDT) in the UK. The author's community matron role involves caring for patients with long-term conditions (LTCs) including long-term neurological conditions (LTNCs). In executing this role and in service delivery to patients with LTNCs, specifically MND, the author noticed a lack of robust integration, highlighting the need to consider and address the various contributory factors. This article presents a literature review and analyses the role of the MDT including specialist neurological professionals in executing duties and in delivering healthcare services to patients diagnosed with MND. The implications for practice are also presented along with areas for practice development.

  16. 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.

  17. 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

  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. Numerical evaluation of the Rayleigh integral for planar radiators using the FFT

    NASA Technical Reports Server (NTRS)

    Williams, E. G.; Maynard, J. D.

    1982-01-01

    Rayleigh's integral formula is evaluated numerically for planar radiators of any shape, with any specified velocity in the source plane using the fast Fourier transfrom algorithm. The major advantage of this technique is its speed of computation - over 400 times faster than a straightforward two-dimensional numerical integration. The technique is developed for computation of the radiated pressure in the nearfield of the source and can be easily extended to provide, with little computation time, the vector intensity in the nearfield. Computations with the FFT of the nearfield pressure of baffled rectangular plates with clamped and free boundaries are compared with the 'exact' solution to illuminate any errors. The bias errors, introduced by the FFT, are investigated and a technique is developed to significantly reduce them.

  20. Feasibility and preliminary outcomes from a pilot study of an integrated health-mental health promotion program in school mental health services.

    PubMed

    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.

  1. 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

  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. Integrating Biological Covariates into Gene Expression-Based Predictors of Radiation Sensitivity

    PubMed Central

    Kamath, Vidya P.; Torres-Roca, Javier F.

    2017-01-01

    The use of gene expression-based classifiers has resulted in a number of promising potential signatures of patient diagnosis, prognosis, and response to therapy. However, these approaches have also created difficulties in trying to use gene expression alone to predict a complex trait. A practical approach to this problem is to integrate existing biological knowledge with gene expression to build a composite predictor. We studied the problem of predicting radiation sensitivity within human cancer cell lines from gene expression. First, we present evidence for the need to integrate known biological conditions (tissue of origin, RAS, and p53 mutational status) into a gene expression prediction problem involving radiation sensitivity. Next, we demonstrate using linear regression, a technique for incorporating this knowledge. The resulting correlations between gene expression and radiation sensitivity improved through the use of this technique (best-fit adjusted R2 increased from 0.3 to 0.84). Overfitting of data was examined through the use of simulation. The results reinforce the concept that radiation sensitivity is not driven solely by gene expression, but rather by a combination of distinct parameters. We show that accounting for biological heterogeneity significantly improves the ability of the model to identify genes that are associated with radiosensitivity.

  4. Integrating complementary therapies into health care education: a cautious approach.

    PubMed

    Richardson, J

    2001-11-01

    The movement of complementary therapy training and education into higher education in the United Kingdom (UK) and the interest in alternative therapeutic approaches within the health professions presents an ideal opportunity for multidisciplinary teaching and shared learning. The diversity and similarities of complementary therapies and areas of convergence with conventional healthcare practice can be explored. The recent publication of the House of Lords Select Committee on Science and Technology report on complementary and alternative medicine (HL Paper 123) provides a broader context for discussion and makes specific recommendations about regulation, education and research in the UK. This paper considers the appropriateness of integrating complementary therapies into education for conventional healthcare practitioners, what we should integrate, and when might be the most appropriate time in the education of healthcare practitioners to introduce different therapeutic modalities and their respective philosophical languages. Rather than present a range of solutions, the paper raises some fundamental issues that are central to the integration of complementary therapeutic approaches. If these issues are neglected as we hurry to incorporate different 'techniques' into our conventional practice, we may simply be left with additional tools that we are ill equipped to use.

  5. 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

  6. 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.

  7. Thermal management in MoS2 based integrated device using near-field radiation

    NASA Astrophysics Data System (ADS)

    Peng, Jiebin; Zhang, Gang; Li, Baowen

    2015-09-01

    Recently, wafer-scale growth of monolayer MoS2 films with spatial homogeneity is realized on SiO2 substrate. Together with the latest reported high mobility, MoS2 based integrated electronic devices are expected to be fabricated in the near future. Owing to the low lattice thermal conductivity in monolayer MoS2, 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 MoS2 to graphene. We demonstrate that in resonance, the maximum heat transfer via near-field radiation between MoS2 and graphene can be ten times higher than the in-plane lattice thermal conduction for MoS2 sheet. Therefore, an efficient thermal management strategy for MoS2 integrated device is proposed: Graphene sheet is brought into close proximity, 10-20 nm from MoS2 device; heat energy transfer from MoS2 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.

  8. Radiation induced currents in MRI RF coils: application to linac/MRI integration

    PubMed Central

    Burke, B; Fallone, B G; Rathee, S

    2010-01-01

    The integration of medical linear accelerators (linac) with magnetic resonance imaging (MRI) systems is advancing the current state of image-guided radiotherapy. The MRI in these integrated units will provide real-time, accurate tumor locations for radiotherapy treatment, thus decreasing geometric margins around tumors and reducing normal tissue damage. In the real-time operation of these integrated systems, the radiofrequency (RF) coils of MRI will be irradiated with radiation pulses from the linac. The effect of pulsed radiation on MRI radio frequency (RF) coils is not known and must be studied. The instantaneous radiation induced current (RIC) in two different MRI RF coils were measured and presented. The frequency spectra of the induced currents were calculated. Some basic characterization of the RIC was also done: isolation of the RF coil component responsible for RIC, dependence of RIC on dose rate, and effect of wax buildup placed on coil on RIC. Both the time and frequency characteristics of the RIC were seen to vary with the MRI RF coil used. The copper windings of the RF coils were isolated as the main source of RIC. A linear dependence on dose rate was seen. The RIC was decreased with wax buildup, suggesting an electronic disequilibrium as the cause of RIC. This study shows a measurable RIC present in MRI RF coils. This unwanted current could be possibly detrimental to the signal to noise ratio in MRI and produce image artifacts. PMID:20071754

  9. 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.

  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.

  11. 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)

  12. Integrating cultural humility into health care professional education and training.

    PubMed

    Chang, E-shien; Simon, Melissa; Dong, XinQi

    2012-05-01

    As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article proposes to move forward by integrating the concept of cultural humility into current trainings, in which we believe, is vital in complementing the current model, and better prepare future professionals to address health challenges with culturally appropriate care. Based on the works of Chinese philosophers, cultural values and the contemporary Chinese immigrants' experience, we hereby present the QIAN (Humbleness) curriculum: the importance of self-Questioning and critique, bi-directional cultural Immersion, mutually Active-listening, and the flexibility of Negotiation. The principles of the QIAN curriculum reside not only between the patient and the healthcare professional dyad, but also elicit the necessary support of family, health care system as well as the community at large. The QIAN curriculum could improve practice and enhance the exploration, comprehension and appreciation of the cultural orientations between healthcare professionals and patients which ultimately could improve patient satisfaction, patient-healthcare professional relationship, medical adherence and the reduction of health disparities. QIAN model is highly adaptable to other cultural and ethnic groups in multicultural societies around the globe. Incorporating its framework into the current medical education may enhance cross-cultural clinical encounters.

  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. Integrating federal health care resources at the local level.

    PubMed

    Simmons, J

    1989-01-01

    Hospitals throughout the country are increasingly sharing health services, jointly purchasing supplies, and merging. The Veterans Administration (VA)-Department of Defense (DoD) Health Resources Sharing Law of 1982 (PL 97-174) has encouraged much closer relationships between hospitals of these agencies than had existed previously. All VA hospitals within 50 miles of a military treatment facility now have multiservice agreements. Before passage of the law, only a handful of facilities were involved in limited sharing. Closer relationships have led to expanded care for federal beneficiaries at considerable cost savings. In Albuquerque, New Mexico, for example, the VA Medical Center houses the VA and Air Force hospital operations, obviating the need for a separate freestanding hospital. The lack of VA authority to receive reimbursement from the Civilian Health and Medical Program for the Uniformed Services and a lack of a reimbursement incentive for military hospitals to share are identified as factors preventing greater coordination. Even greater local integration of services is likely to occur in the future.

  15. 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.

  16. 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.

  17. 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

  18. A different approach to evaluating health effects from radiation exposure

    SciTech Connect

    Bond, V.P.; Sondhaus, C.A.; Feinendegen, L.E.

    1988-01-01

    Absorbed dose D is shown to be a composite variable, the product of the fraction of cells hit (I/sub H/) and the mean /open quotes/dose/close quotes/ (hit size) /ovr z/ to those cells. D is suitable for use with high level (HLE) to radiation and its resulting acute organ effects because, since I/sub H/ = 1.0, D approximates closely enough the mean energy density in the cell as well as in the organ. However, with low-level exposure (LLE) to radiation and its consequent probability of cancer induction from a single cell, stochastic delivery of energy to cells results in a wide distribution of hit sizes z, and the expected mean value, /ovr z/, is constant with exposure. Thus, with LLE, only I/sub H/ varies with D so that the apparent proportionality between /open quotes/dose/close quotes/ and the fraction of cells transformed is misleading. This proportionality therefore does not mean that any (cell) dose, no matter how small, can be lethal. Rather, it means that, in the exposure of a population of individual organisms consisting of the constituent relevant cells, there is a small probabililty of particle-cell interactions which transfer energy. The probability of a cell transforming and initiating a cancer can only be greater than zero if the hit size (/open quotes/dose of energy/close quotes/) to the cell is large enough. Otherwise stated, if the /open quotes/dose/close quotes/ is defined at the proper level of biological organization, namely, the cell and not the organ, only a large dose z to that cell is effective. The above precepts are utilized to develop a drastically different approach to evaluation oif risk from LLE, that holds promise of obviating any requirement for the components of the present system: absorbed organ dose, LET, a standard radiation, REB(Q), dose equivalent and rem. 12 refs., 11 figs.

  19. 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

  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. 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

  2. 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)

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. Reducing barriers to mental health care for student-athletes: An integrated care model.

    PubMed

    Sudano, Laura E; Collins, Greg; Miles, Christopher M

    2017-03-01

    Research suggests that National Collegiate Athletic Association (NCAA) Division I student-athletes have higher levels of stress and other behavioral health issues, including substance use, than nonathletes. For several reasons, student-athletes may be less likely to admit to behavioral health issues and seek mental health care. Integrated care is a model of care that integrates behavioral health into a medical practice. This article explores the newly released NCAA Best Mental Health Practice guidelines and the application of integrated care to a Division I athletic training room setting using the three-worldview framework for successful integration, incorporating clinical outcomes, operational reliability, and financial stability. (PsycINFO Database Record

  9. 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

    ... HUMAN SERVICES Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and... Services announces the recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and... Prevention; 1600 Clifton Road, NE., MS D-28; Atlanta, GA 30329; Telephone: (404) 639-7514; and/ or...

  10. Mental health policy and development in Egypt - integrating mental health into health sector reforms 2001-9

    PubMed Central

    2010-01-01

    Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen) 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines) to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme initiated a reform programme

  11. 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.

  12. 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

  13. Reduction of Fallout Radiation Hazards in Health Installations

    PubMed Central

    Waters, W. R.

    1962-01-01

    The purpose of this paper is to provide guidance for Canadian hospital medical directors in planning the provision of protection for their patients and staff against gamma radiation hazard from nuclear war. The implications of the distribution of fallout in Canada are that the probability of exposures in excess of 600 r in the period “96 hours after fallout” is high in Southern Ontario and Quebec but low in the western provinces and in the North. All hospitals should have a shielding capacity; for many, this will entail structural alterations. The aim would be to provide a protective factor of 100 or better, together with necessary standards of habitability. The engineering significance of the recommendations is discussed. PMID:13999154

  14. 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

  15. 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.

  16. The World Health Organization Network for Radiation Emergency Medical Preparedness and Assistance (REMPAN).

    PubMed Central

    Souchkevitch, G

    1997-01-01

    The World Health Organization (WHO) has established a system of collaborating centers known as the Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) to promote radiation emergency medical preparedness, assistance, and advice to countries in cases of overexposure of populations from any source of radiation. This network consists of 13 specialized institutions located in 10 countries. Within the REMPAN there are three separate but linked activities. The first is aimed at strengthening radiation emergency medical preparedness and assistance to treat and monitor acutely exposed individuals. The second activity is directed toward improving public health advice to mitigate long-term effects of exposure to low and protracted doses that might accrue in populations living in the affected territories. This involves giving advice on protecting public health, e.g., iodine prophylaxis, psychosocial risks associated with countermeasures, and public information strategies. In addition, the REMPAN develops activities aimed at improving long-term follow-up studies and preparedness for epidemiologic investigations in territories contaminated by radionuclides from a nuclear accident. The WHO's response in a radiation emergency depends on the type of accident and its time phase. This includes a wide range of actions from studying the situation to providing medical and public health assistance through the network of collaborating centers and relevant institutions within the REMPAN. The process of creating a reliable international system for radiation emergency medical preparedness and assistance has not yet been completed. Deficiencies in this system are outlined in this paper to attract the attention of specialists in the field of radiation protection and potential donors of the WHO program. PMID:9467087

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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

  5. Integrating health profile with survival for quality of life assessment.

    PubMed

    Hwang, Jing-Shiang; Wang, Jung-Der

    2004-02-01

    In cohort studies or clinical trials, measurements of quality of life (QoL) were averaged across available individuals for each group at given points in time to produce single measures for comparisons. However, estimates of these single measures may be severely biased if substantial mortality occurs over time. The objective of this study is to develop a method that integrates QoL measurement and survival for long-term evaluation of health services. We defined a mean QoL score function over time for an index population as the average QoL score of all individuals both alive and dead at each time point in the population. While a living subject's QoL can be assessed by asking one's subjective preference, the score of a decedent can be assigned a fixed value depending on the specific facet on health profile. The mean QoL score function over time is reduced to a single measure of expected cumulative QoL score, which is the area under the curve of mean QoL score function over a given time interval and can be estimated by taking a random sample from a cross-sectional survey. For the QoL score function to be extrapolated to life-long, it requires the assumption that the disease causes premature death or a long-term moderate impairment of QoL. We provided methods and computer programs for estimating mean QoL score functions and the reduced single measures for use in comparisons. A cohort of 779 breast cancer patients from Chiangmai, Thailand were followed for 12 years to demonstrate the proposed methods. The data included the 12-year complete survival records and QoL scores on 233 patients collected from a cross-sectional survey using WHOQOL questionnaire and standard gamble method. The expected cumulative QoL scores using utility and psychometric scales were compared among patients in four groups of clinical stages in this cohort for time from onset up to 12 years and life-long. We conclude that such an integration of QoL measurement with survival can be useful for the

  6. 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

  7. '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.

  8. ‘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

  9. 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.

  10. [Radiation-related health effects of major nuclear events].

    PubMed

    Orgiazzi, Jacques

    2015-01-01

    Three major nuclear events, the Hirosima and Nagasaki bombings and the Chernobyl and Fukushima catastrophes, have been selected to Illustrate the health consequences, observed or anticipated, of irradation of populations. Differences in doses and modalities of irradiation, with the combination of clinical epidemiology and dose estimates, recently revisited, allow for more accurate dose-effect relationship models of the risks. However, extrapolation to the low-doses (< 0.1 Gy) or very low-doses of these models obtained with doses ≥ 0.2 Gy remains hazardous.

  11. 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…

  12. Calculating the reflected radiation error between turbine blades and vanes based on double contour integral method

    NASA Astrophysics Data System (ADS)

    Feng, Chi; Li, Dong; Gao, Shan; Daniel, Ketui

    2016-11-01

    This paper presents a CFD (Computation Fluid Dynamic) simulation and experimental results for the reflected radiation error from turbine vanes when measuring turbine blade's temperature using a pyrometer. In the paper, an accurate reflection model based on discrete irregular surfaces is established. Double contour integral method is used to calculate view factor between the irregular surfaces. Calculated reflected radiation error was found to change with relative position between blades and vanes as temperature distribution of vanes and blades was simulated using CFD. Simulation results indicated that when the vanes suction surface temperature ranged from 860 K to 1060 K and the blades pressure surface average temperature is 805 K, pyrometer measurement error can reach up to 6.35%. Experimental results show that the maximum pyrometer absolute error of three different targets on the blade decreases from 6.52%, 4.15% and 1.35% to 0.89%, 0.82% and 0.69% respectively after error correction.

  13. 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.

  14. Level of Integration of Community Health Workers in Missouri Health Systems.

    PubMed

    Rhodes, Darson; Visker, Joseph; Cox, Carol; Banez, J Christian; Wang, Anna

    2016-11-16

    The purpose of this study was to describe the level of integration of community health workers (CHWs) into Missouri public healthcare systems using a cross-sectional survey research design. Representatives of all Missouri Local Public Health Agencies, Rural Health Clinics, and Federally Qualified Health Centers were pre-contacted by telephone to provide the electronic mail of the most knowledgeable person in the facility/location to complete a brief electronic survey on their use of CHWs. 103 representatives of the 273 (37.7% response rate) contacted from the health systems completed the Profile of Community Health Workers in Missouri Health Systems to assess role, professional development, and information needs of CHWs used in the key informants' agencies. An Abridged Survey was created for participants who responded to the survey but indicated that CHWs were not currently working for their organization. Descriptive statistics and measures of central tendency were computed. Only 16% (16/103) of participants noted that CHWs were employed in their organizations; and most CHWs connected people with services, served low-income and rural populations, and addressed heart disease issues. Participants who did not currently employ CHWs indicated they did not anticipate needing them in the near future. Of those utilizing CHWs, most perceived CHWs have a vital role in healthcare (M = 4.27/5.0, SD = 0.64) but securing sustainable funding for CHWs was challenging (M = 4.18/5.0, SD = 0.87). Utilization of CHWs in Missouri healthcare systems is limited. If their role in Missouri healthcare systems is to expand, a campaign to educate on their role and value is needed.

  15. Survival, DNA Integrity, and Ultrastructural Damage in Antarctic Cryptoendolithic Eukaryotic Microorganisms Exposed to Ionizing Radiation.

    PubMed

    Pacelli, Claudia; Selbmann, Laura; Zucconi, Laura; Raguse, Marina; Moeller, Ralf; Shuryak, Igor; Onofri, Silvano

    2017-02-01

    Life dispersal between planets, planetary protection, and the search for biosignatures are main topics in astrobiology. Under the umbrella of the STARLIFE project, three Antarctic endolithic microorganisms, the melanized fungus Cryomyces antarcticus CCFEE 515, a hyaline strain of Umbilicaria sp. (CCFEE 6113, lichenized fungus), and a Stichococcus sp. strain (C45A, green alga), were exposed to high doses of space-relevant gamma radiation ((60)Co), up to 117.07 kGy. After irradiation survival, DNA integrity and ultrastructural damage were tested. The first was assessed by clonogenic test; viability and dose responses were reasonably described by the linear-quadratic formalism. DNA integrity was evaluated by PCR, and ultrastructural damage was observed by transmission electron microscopy. The most resistant among the tested organisms was C. antarcticus both in terms of colony formation and DNA preservation. Besides, results clearly demonstrate that DNA was well detectable in all the tested organisms even when microorganisms were dead. This high resistance provides support for the use of DNA as a possible biosignature during the next exploration campaigns. Implication in planetary protection and contamination during long-term space travel are put forward. Key Words: Biosignatures-Ionizing radiation-DNA integrity-Eukaryotic microorganisms-Fingerprinting-Mars exploration. Astrobiology 17, 126-135.

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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

    ... Prevention Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for... 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...

  2. 77 FR 69486 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. The Sociobiologic Integrative Model (SBIM): Enhancing the Integration of Sociobehavioral, Environmental, and Biomolecular Knowledge in Urban Health and Disparities Research

    PubMed Central

    Brock, Malcolm; Alberg, Anthony J.; Glass, Thomas; LaVeist, Thomas A.; Baylin, Stephen; Levine, David; Fox, C. Earl

    2007-01-01

    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. PMID:17216571

  9. 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…

  10. 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…

  11. 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…

  12. Commentary: ethical issues of current health-protection policies on low-dose ionizing radiation.

    PubMed

    Socol, Yehoshua; Dobrzyński, Ludwik; Doss, Mohan; Feinendegen, Ludwig E; Janiak, Marek K; Miller, Mark L; Sanders, Charles L; Scott, Bobby R; Ulsh, Brant; Vaiserman, Alexander

    2014-05-01

    The linear no-threshold (LNT) model of ionizing-radiation-induced cancer is based on the assumption that every radiation dose increment constitutes increased cancer risk for humans. The risk is hypothesized to increase linearly as the total dose increases. While this model is the basis for radiation safety regulations, its scientific validity has been questioned and debated for many decades. The recent memorandum of the International Commission on Radiological Protection admits that the LNT-model predictions at low doses are "speculative, unproven, undetectable and 'phantom'." Moreover, numerous experimental, ecological, and epidemiological studies show that low doses of sparsely-ionizing or sparsely-ionizing plus highly-ionizing radiation may be beneficial to human health (hormesis/adaptive response). The present LNT-model-based regulations impose excessive costs on the society. For example, the median-cost medical program is 5000 times more cost-efficient in saving lives than controlling radiation emissions. There are also lives lost: e.g., following Fukushima accident, more than 1000 disaster-related yet non-radiogenic premature deaths were officially registered among the population evacuated due to radiation concerns. Additional negative impacts of LNT-model-inspired radiophobia include: refusal of some patients to undergo potentially life-saving medical imaging; discouragement of the study of low-dose radiation therapies; motivation for radiological terrorism and promotion of nuclear proliferation.

  13. Integrating an academic radiation safety program into an environmental management system.

    PubMed

    Zurosky, Daniel M

    2003-08-01

    The Environmental Health and Safety (EH&S) Program at the University of South Carolina recently developed an environmental management system (EMS) based on the ISO 14001 International Standard. Since our radiation safety program must already meet strict state licensing requirements, the process of conforming to this standard was relatively easy to accomplish. The EH&S program achieved certification to the ISO 14001 standard in August of 2002. The benefits of the EMS include: better interaction between radiation safety and other EH&S program entities, holds all employees accountable by closely tracking program activities, presents a clear picture of program accomplishments to the university administration, allows for better use of limited resources and provides for continuous program improvement.

  14. Impact of the 1980 BEIR-III report on low-level radiation risk assessment, radiation protection guides, and public health policy

    SciTech Connect

    Fabrikant, J.I.

    1981-06-01

    The author deals with the scientific basis for establishing appropriate radiation protection guides, and this effect on evaluation of societal activities concerned with the health effects in human populations exposed to low-level radiation. Methodology is discussed for estimating risks of radio-induced cancer and genetically related ill-health in man, the sources of data, the dose-response models used, and the precision ascribed to the process. (PSB)

  15. J-integral fracture toughness and tearing modulus measurement of radiation cross-linked UHMWPE.

    PubMed

    Gomoll, A; Wanich, T; Bellare, A

    2002-11-01

    Radiation and chemical cross-linking of medical grade ultrahigh molecular weight polyethylene (UHMWPE) has recently been utilized in an effort to improve wear performance of total joint replacement components. However, reductions in mechanical properties with cross-linking are cause for concern regarding the use of cross-linked UHMWPE for high-stress applications such as in total knee replacement prostheses. In this study, the fracture behavior of radiation cross-linked UHMWPE was compared to that of uncross-linked UHMWPE. The Rice and Sorensen model that utilizes mechanical parameters obtained from uniaxial tensile and compact tension tests was used to calculate the steady state J-integral fracture toughness, Jss, for radiation cross-linked UHMWPE. Jss decreased monotonically with increase in radiation dose. UHMWPE exhibited tough, ductile tearing behavior with stable crack growth when it was cross-linked using a gamma radiation dose of 0-50 kGy. However, in cross-linked UHMWPE irradiated to a dose of 100 and 200 kGy, unstable fracture occurred spontaneously upon attaining the initial crack driving force, J1c. This indicates that a high degree of cross-linking is less desirable for high-stress applications in orthopaedic implants. However, a substantial increase in J1c, even at a low degree of cross-linking, suggests that a low degree of cross-linking may be beneficial for resistance to delamination and catastrophic failure, both of which require an initiation step for the fracture to propagate in the material. This mechanical test should, however, be considered along with fatigue tests and joint simulator testing before determination of an appropriate amount of cross-linking for total joint replacement prostheses that experience high stresses.

  16. Radiation release and health effects lessons from the Three Mile Island incident: assessment of objective risks for emergency preparedness planning

    SciTech Connect

    Berger, C.D.; Mynatt, F.R.

    1980-01-01

    The accepted theories of radiation health effects are briefly discussed so that the Three Mile Island health effects estimations can be better understood. The author recommends that emergency response planners weigh the objective risks rather than the perceived risks of low-level radiation against those associated with evacuation of large population zones before a final plan is put into effect. (ACR)

  17. Integral method for the calculation of Hawking radiation in dispersive media. I. Symmetric asymptotics.

    PubMed

    Robertson, Scott; Leonhardt, Ulf

    2014-11-01

    Hawking radiation has become experimentally testable thanks to the many analog systems which mimic the effects of the event horizon on wave propagation. These systems are typically dominated by dispersion and give rise to a numerically soluble and stable ordinary differential equation only if the rest-frame dispersion relation Ω^{2}(k) is a polynomial of relatively low degree. Here we present a new method for the calculation of wave scattering in a one-dimensional medium of arbitrary dispersion. It views the wave equation as an integral equation in Fourier space, which can be solved using standard and efficient numerical techniques.

  18. Integral method for the calculation of Hawking radiation in dispersive media. II. Asymmetric asymptotics.

    PubMed

    Robertson, Scott

    2014-11-01

    Analog gravity experiments make feasible the realization of black hole space-times in a laboratory setting and the observational verification of Hawking radiation. Since such analog systems are typically dominated by dispersion, efficient techniques for calculating the predicted Hawking spectrum in the presence of strong dispersion are required. In the preceding paper, an integral method in Fourier space is proposed for stationary 1+1-dimensional backgrounds which are asymptotically symmetric. Here, this method is generalized to backgrounds which are different in the asymptotic regions to the left and right of the scattering region.

  19. Inconsistencies and open questions regarding low-dose health effects of ionizing radiation.

    PubMed Central

    Nussbaum, R H; Köhnlein, W

    1994-01-01

    The effects on human health of exposures to ionizing radiation at low doses have long been the subject of dispute. In this paper we focus on open questions regarding the health effects of low-dose exposures that require further investigations. Seemingly contradictory findings of radiation health effects have been reported for the same exposed populations, or inconsistent estimates of radiation risks were found when different populations and exposure conditions were compared. Such discrepancies may be indicative of differences in sensitivities among the applied methods of epidemiological analysis or indicative of significant discrepancies in health consequences after comparable total exposures of different populations under varying conditions. We focus first on inconsistencies and contradictions in presentations of the state of knowledge by different authoritative experts. We then review studies that found positive associations between exposure and risks in dose ranges where traditional notions (generalized primarily from high-dose studies of A-bomb survivors or exposed animals) would have predicted negligible effects. One persistent notion in many reviews of low-dose effects is the hypothesis of reduced biological effectiveness of fractionated low-dose exposures, compared to that of the same acute dose. This assumption is not supported by data on human populations. From studies of populations that live in contaminated areas, more and more evidence is accumulating on unusual rates of various diseases other than radiation-induced malignancies, health effects that are suspected to be associated with relatively low levels of internal exposures originating from radioactive fallout. Such effects include congenital defects, neonatal mortality, stillbirths, and possibly genetically transmitted disease. A range of open questions challenges scientists to test imaginative hypotheses about induction of disease by radiation with novel research strategies. Images Figure 1. PMID

  20. Integrating service user participation in mental health care: what will it take?

    PubMed

    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.

  1. Radiation health consequences for astronauts: mechanisms, monitoring and prevention

    NASA Astrophysics Data System (ADS)

    Neyfakh, E.

    During space flights crews are exposed chronically to uneven irradiation of enhanced bioefficiency following with significant elevation for chromosomal aberrations as minimum. To protect in space rationally monitoring and preventing of health radiogenic individual primary consequences for astronauts are of high importance. Majority of Chernobyl-touched population has some common etiologic radiogenic mechanisms and radioloads with astronauts ones during long-term missions and former is able to be used well as the close ground-level model. Primary radiogenic deviations. Two radiogenic pathologies as lipoperoxic ( LP ) stress with coupled deficits for essential bioantioxidants ( BAO ) were typical for chronic low-dose Chernobyl-touched contingents. When BAO expenditure had led to their subnormal levels, radiogenic free radical chain -b ranched LP processes occurred in vivo hyperbolically. Catabolites and their free radicals of the abnormal LP cascade are known to be toxic, mutagenic / carcinogenic and teratogenic factors as such, as they are for retinol and tocopherol deficiencies. Both coupled pathogenic factors interrelated synergistically. Simultaneous dysbalances for LP and / or BAO systems were evaluated as the cause and markers for metabolic disregulations. Human LP stress was proved to be the most radiosensible known marker to mo nitor least invasively of blood microsamples in a ground lab via the developed PC Program. But for capsule conditions the best approach is assumed to be LP monitoring via skin ultraweak green-blue chemiluminescence ( CL ) caused by recombination of peroxyl radicals. CL from surfaces of organs was embedded first ( E. Neyfakh, 1964 - 71 ) to reflect their internal LP velocities in vivo and it is the non-invasive on-line simple method of the highest sensitivity, supplying with data transmissible to the ground directly. Related deviations. a) Radiogenic hypermutagenesis: LP catabolites and their free radicals are responsible for direct DNA

  2. The International Atomic Energy Agency's activities in radiation medicine and cancer: promoting global health through diplomacy.

    PubMed

    Deatsch-Kratochvil, Amanda N; Pascual, Thomas Neil; Kesner, Adam; Rosenblatt, Eduardo; Chhem, Rethy K

    2013-02-01

    Global health has been an issue of seemingly low political importance in comparison with issues that have direct bearing on countries' national security. Recently, health has experienced a "political revolution" or a rise in political importance. Today, we face substantial global health challenges, from the spread of infectious disease, gaps in basic maternal and child health care, to the globalization of cancer. A recent estimate states that the "overall lifetime risk of developing cancer (both sexes) is expected to rise from more than one in three to one in two by 2015." These issues pose significant threats to international health security. To successfully combat these grave challenges, the international community must embrace and engage in global health diplomacy, defined by scholars Thomas Novotny and Vicanne Adams as a political activity aimed at improving global health, while at the same time maintaining and strengthening international relations. The IAEA (International Atomic Energy Agency) is an international organization with a unique mandate to "accelerate and enlarge the contribution of atomic energy to peace, health, and prosperity throughout the world." This article discusses global health diplomacy, reviews the IAEA's program activities in human health by focusing on radiation medicine and cancer, and the peaceful applications of atomic energy within the context of global health diplomacy.

  3. Development of a synchrotron radiation beam monitor for the Integrable Optics Test Accelerator

    SciTech Connect

    Scarpelli, Andrea

    2016-01-01

    Nonlinear integrable optics applied to beam dynamics may mitigate multi-particle instabilities, but proof of principle experiments have never been carried out. The Integrable Optics Test Accelerator (IOTA) is an electron and proton storage ring currently being built at Fermilab, which addresses tests of nonlinear lattice elements in a real machine in addition to experiments on optical stochastic cooling and on the single-electron wave function. These experiments require an outstanding control over the lattice parameters, achievable with fast and precise beam monitoring systems. This work describes the steps for designing and building a beam monitor for IOTA based on synchrotron radiation, able to measure intensity, position and transverse cross-section beam.

  4. The integrated project: a promising promotional strategy for primary health care.

    PubMed

    Daniel, C; Mora, B

    1985-10-01

    The integrated project using parasite control and nutrition as entry points for family planning practice has shown considerable success in promoting health consciousness among health workers and project beneficiaries. This progress is evident in the Family Planning, Parasite Control and Nutrition (FAPPCAN) areas. The project has also mobilized technical and financial support from the local government as well as from private and civic organizations. The need for integration is underscored by the following considerations: parasite control has proved to be effective for preventive health care; the integrated project uses indigenous community health workers to accomplish its objectives; the primary health care (PHC) movement depends primarily on voluntary community participation and the integrated project has shown that it can elicit this participation. The major health problems in the Philippines are: a prevalence of communicable and other infectious diseases; poor evironmental sanitation; malnutrition; and a rapid population growth rate. The integrated program utilizes the existing village health workers in identifying problems related to family planning, parasite control and nutrition and integrates these activities into the health delivery system; educates family members on how to detect health and health-related problems; works out linkages with government agencies and the local primary health care committee in defining the scope of health-related problems; mobilizes community members to initiate their own projects; gets the commitment of village officials and committe members. The integrated project operates within the PHC. A health van with a built-in video playback system provides educational and logistical support to the village worker. The primary detection and treatment of health problems are part of the village health workers' responsibilities. Research determines the project's capability to reactivate the village primary health care committees and sustain

  5. 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

  6. Integrated physical and mental health care at a nurse-managed clinic: report from the trenches.

    PubMed

    Nardi, Deena

    2011-07-01

    The Health and Wellness Center (HWC), located in Joliet, Illinois, is a nurse-managed universally accessible primary health care center funded by a grant from the Health Resources and Services Administration. The goals of the HWC are to improve access to quality primary health care services for all patients, including those who are uninsured and underserved, and to develop and implement a model of nurse-managed primary health care that integrates both physical and mental health assessment and treatment. After 5 years of developing and using this model, it is clear that integration requires strategic supports from the financial, political, and professional sectors to be considered a cost-effective model of health care delivery. Recommendations for policy and practice change are offered based on the author's experiences of providing integrated health care at the HWC and the health care industry's responses to uninsured or underinsured patients' needs.

  7. 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.

  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. Environmental health disparities: a framework integrating psychosocial and environmental concepts.

    PubMed

    Gee, Gilbert C; Payne-Sturges, Devon C

    2004-12-01

    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.

  10. Development and characterization of the integrated fiber-optic radiation sensor for the simultaneous detection of neutrons and gamma rays.

    PubMed

    Jang, Kyoung Won; Lee, Bong Soo; Moon, Joo Hyun

    2011-04-01

    Sometimes, detection of thermal neutrons in the presence of gamma rays is required. This study developed and characterized an integrated fiber-optic radiation sensor for the simultaneous detection of thermal neutrons and gamma rays in a mixed radiation field. The performance of the integrated sensor was verified by measuring the distributions of thermal neutrons and gamma rays released from a nuclear fuel rod at the Kyoto University Critical Assembly. The experimental results show that the integrated sensor produced similar distribution patterns to those of thermal neutrons and gamma rays released from a fuel rod.

  11. Perspectives in radiation and health: reflections on the International Conference in Beer Sheva.

    PubMed Central

    Baverstock, K F

    1997-01-01

    Insofar as international conferences reflect the state of development of the subject under discussion, they provide an opportunity to question, at a rather fundamental level, the direction of and progress in the subject. With regard to the effects of radiation on health, many of the problems faced today, including uncertainties in the relationship between risk and dose and the origins of the psychosocial phenomena associated with many aspects of environmental radiation exposure, arise from a lack of adequate frameworks within which to understand the radiopathological impact of radiation exposure and the psychological and social implications of such exposures. It is concluded that in seeking an understanding of the relationship of health effects to exposure, through the underlying radiobiological processes, the perturbation of the dynamic interactions within the components of the organism should receive more emphasis. The public perception of risk from environmental radiation exposures appears to encompass factors in addition to the accrued health detriment. It is argued that the radiological protection of the public might be seen more beneficially in the context of other environmental risks. PMID:9467093

  12. Evaluation of HFIR (High Flux Isotope Reactor) pressure-vessel integrity considering radiation embrittlement

    SciTech Connect

    Cheverton, R.D.; Merkle, J.G.; Nanstad, R.K.

    1988-04-01

    The High Flux Isotope Reactor (HFIR) pressure vessel has been in service for 20 years, and during this time, radiation damage was monitored with a vessel-material surveillance program. In mid-November 1986, data from this program indicated that the radiation-induced reduction in fracture toughness was greater than expected. As a result, a reevaluation of vessel integrity was undertaken. Updated methods of fracture-mechanics analysis were applied, and an accelerated irradiations program was conducted using the Oak Ridge Research Reactor. Results of these efforts indicate that (1) the vessel life can be extended 10 years if the reactor power level is reduced 15% and if the vessel is subjected to a hydrostatic proof test each year; (2) during the 10-year life extension, significant radiation damage will be limited to a rather small area around the beam tubes; and (3) the greater-than-expected damage rate is the result of the very low neutron flux in the HFIR vessel relative to that in samples of material irradiated in materials-testing reactors (a factor of approx.10/sup 4/ less), that is, a rate effect.

  13. Clinical Trials Integrating Immunotherapy and Radiation for Non-Small-Cell Lung Cancer.

    PubMed

    Daly, Megan E; Monjazeb, Arta M; Kelly, Karen

    2015-12-01

    Methods of harnessing the immune system to treat cancer have been investigated for decades, but yielded little clinical progress. However, in recent years, novel drugs that allow immune recognition and destruction of tumor cells are emerging as potent cancer therapies. Building upon previous immunotherapy strategies that included therapeutic vaccines, recombinant cytokines, and other immunostimulatory agents, newer immunotherapy agents targeting immune checkpoints including programmed cell death 1, programmed cell death ligand-1, and cytotoxic T-lymphocyte-associated protein 4, among others, have garnered substantial enthusiasm after demonstrating clinical activity in a broad spectrum of tumor types. Trials evaluating immune checkpoint inhibitors in metastatic non-small-cell lung cancer (NSCLC) demonstrate robust and durable responses in a subset of patients. However, with overall response rates less than 20%, combinatorial strategies that extend the benefit of these agents to more patients are desirable. The integration of radiotherapy with immunotherapy is a conceptually promising strategy, as radiotherapy has potent immunomodulatory effects and may contribute not only to local control but may also augment systemic antitumor immune response. Preclinical data and case reports suggest the potential for robust clinical responses in metastatic NSCLC patients using this strategy, but prospective clinical trials evaluating the integration of radiation and immunotherapy are limited. The use of immunotherapy in nonmetastatic settings is also intriguing but understudied. We review the potential clinical settings of interest for the partnering of immunotherapy and radiation in NSCLC, including early stage, locally advanced, and metastatic disease, and review completed, accruing, and developing clinical trials.

  14. An Integrated X-Ray/Optical Tomography System for Pre-clinical Radiation Research

    PubMed Central

    Eslami, S.; Yang, Y.; Wong, J.; Patterson, M. S.; Iordachita, I.

    2013-01-01

    The current Small Animal Radiation Research Platform (SARRP) is poor for localizing small soft tissue targets for irradiation or tumor models growing in a soft tissue environment. Therefore, an imaging method complementary to x-ray CT is required to localize the soft tissue target’s Center of Mass (CoM) to within 1 mm. In this paper, we report the development of an integrated x-ray/bioluminescence imaging/tomography (BLI/BLT) system to provide a pre-clinical, high resolution irradiation system. This system can be used to study radiation effects in small animals under the conebeam computed tomography (CBCT) imaging guidance by adding the bioluminescence imaging (BLI) system as a standalone system which can also be docked onto the SARRP. The proposed system integrates two robotic rotating stages and an x-ray source rated at maximum 130 kVp and having a small variable focal spot. A high performance and low noise CCD camera mounted in a light-tight housing along with an optical filter assembly is used for multi-wavelength BL tomography. A three-mirror arrangement is implemented to eliminate the need of rotating the CCD camera for acquiring multiple views. The mirror system is attached to a motorized stage to capture images in angles between 0–90° (for the standalone system). Camera and CBCT calibration are accomplished. PMID:25745539

  15. A Fast and Scalable Radiation Hybrid Map Construction and Integration Strategy

    PubMed Central

    Agarwala, Richa; Applegate, David L.; Maglott, Donna; Schuler, Gregory D.; Schäffer, Alejandro A.

    2000-01-01

    This paper describes a fast and scalable strategy for constructing a radiation hybrid (RH) map from data on different RH panels. The maps on each panel are then integrated to produce a single RH map for the genome. Recurring problems in using maps from several sources are that the maps use different markers, the maps do not place the overlapping markers in same order, and the objective functions for map quality are incomparable. We use methods from combinatorial optimization to develop a strategy that addresses these issues. We show that by the standard objective functions of obligate chromosome breaks and maximum likelihood, software for the traveling salesman problem produces RH maps with better quality much more quickly than using software specifically tailored for RH mapping. We use known algorithms for the longest common subsequence problem as part of our map integration strategy. We demonstrate our methods by reconstructing and integrating maps for markers typed on the Genebridge 4 (GB4) and the Stanford G3 panels publicly available from the RH database. We compare map quality of our integrated map with published maps for GB4 panel and G3 panel by considering whether markers occur in the same order on a map and in DNA sequence contigs submitted to GenBank. We find that all of the maps are inconsistent with the sequence data for at least 50% of the contigs, but our integrated maps are more consistent. The map integration strategy not only scales to multiple RH maps but also to any maps that have comparable criteria for measuring map quality. Our software improves on current technology for doing RH mapping in areas of computation time and algorithms for considering a large number of markers for mapping. The essential impediments to producing dense high-quality RH maps are data quality and panel size, not computation. PMID:10720576

  16. 78 FR 70040 - Draft Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

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

  17. 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.

  18. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China

    PubMed Central

    Wang, Xin; Birch, Stephen; Ma, Huifen; Zhu, Weiming

    2016-01-01

    Introduction: Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Method: Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Results: Health system integration in Huangzhong is higher than in Hualong, so is system effectiveness. The patient referral network in Hualong has more “leapfrog” referrals. The information sharing networks in both counties are larger than the other types of networks. The average distance in the joint training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Conclusion: Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration. PMID:28316541

  19. Sustainability in Primary Care and Mental Health Integration Projects in Veterans Health Administration

    PubMed Central

    Ford, James H.; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn

    2015-01-01

    Objective To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Data Sources Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. Study Design One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Principal Findings Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Conclusions Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change. PMID:23011071

  20. Effect of electromagnetic radiations from mobile phone base stations on general health and salivary function

    PubMed Central

    Singh, Kushpal; Nagaraj, Anup; Yousuf, Asif; Ganta, Shravani; Pareek, Sonia; Vishnani, Preeti

    2016-01-01

    Objective: Cell phones use electromagnetic, nonionizing radiations in the microwave range, which some believe may be harmful to human health. The present study aimed to determine the effect of electromagnetic radiations (EMRs) on unstimulated/stimulated salivary flow rate and other health-related problems between the general populations residing in proximity to and far away from mobile phone base stations. Materials and Methods: A total of four mobile base stations were randomly selected from four zones of Jaipur, Rajasthan, India. Twenty individuals who were residing in proximity to the selected mobile phone towers were taken as the case group and the other 20 individuals (control group) who were living nearly 1 km away in the periphery were selected for salivary analysis. Questions related to sleep disturbances were measured using Pittsburgh Sleep Quality Index (PSQI) and other health problems were included in the questionnaire. Chi-square test was used for statistical analysis. Results: It was unveiled that a majority of the subjects who were residing near the mobile base station complained of sleep disturbances, headache, dizziness, irritability, concentration difficulties, and hypertension. A majority of the study subjects had significantly lesser stimulated salivary secretion (P < 0.01) as compared to the control subjects. Conclusions: The effects of prolonged exposure to EMRs from mobile phone base stations on the health and well-being of the general population cannot be ruled out. Further studies are warranted to evaluate the effect of electromagnetic fields (EMFs) on general health and more specifically on oral health. PMID:27011934

  1. Fielding a current idea: exploring the public health impact of electromagnetic radiation.

    PubMed

    Genuis, Stephen J

    2008-02-01

    Several publications in the scientific literature have raised concern about the individual and public health impact of adverse non-ionizing radiation (a-NIR) from electromagnetic field (EMF) exposure emanating from certain power, electrical and wireless devices commonly found in the home, workplace, school and community. Despite the many challenges in establishing irrefutable scientific proof of harm and the various gaps in elucidating the precise mechanisms of harm, epidemiological analyses continue to suggest considerable potential for injury and affliction as a result of a-NIR exposure. As environmental health has not been emphasized in medical education, some clinicians are not fully aware of possible EMF-related health problems and, as a result, manifestations of a-NIR may remain misdiagnosed and ineffectually managed. It is important for physicians and public health officials to be aware of the fundamental science and clinical implications of EMF exposure. A review of the scientific literature relating to the link between electromagnetic radiation and human health, several public health recommendations, and four case histories are presented for consideration.

  2. Effects of the Effect of Ultra High Frequency Mobile Phone Radiation on Human Health

    PubMed Central

    Moradi, Mosa; Naghdi, Nasrollah; Hemmati, Hamidreza; Asadi-Samani, Majid; Bahmani, Mahmoud

    2016-01-01

    Introduction Public and occupational exposure to electromagnetic fields due to the growing trend of electronic devices may cause adverse effects on human health. This paper describes the risk of mutation and sexual trauma and infertility in masculine sexual cell by mobile phone radiations. Methods In this study, we measured the emitted dose from a radiofrequency device, such as switching high voltage at different frequencies using a scintillation detector. The switching high voltage power supply (HVPS) was built for the Single Photon Emission Computed Tomography (SPECT) system. For radiation dosimetry, we used an ALNOR scintillator that can measure gamma radiation. The simulation was performed by MATLAB software, and data from the International Commission on Non-Ionizing Radiation Protection (ICNIRP) were used to verify the simulation. Results We investigated the risks that result from the waves, according to a report by International Commission on Non Ionizing Radiation Protection (ICNIRP), to every organ of the body is defined by the beam and electromagnetic radiation from this electronic device on people. The results showed that the maximum personal dose over a 15-min period working at the mentioned HVPS did not exceed 0.31 μSV/h (with an aluminum shield). So, according to other sources of radiation, continuous working time of the system should not be more than 10 hours. Finally, a characteristic curve for secure working with modules at different frequencies was reported. The RF input signal to the body for maximum penetration depth (δ) and electromagnetic energy absorption rate (SAR) of biological tissue were obtained for each tissue. Conclusion The results of this study and International Commission of Non Ionization Radiation Protection (ICNIRP) reports showed the people who spend more than 50 minutes a day using a cell phone could have early dementia or other thermal damage due to the burning of glucose in the brain. PMID:27382458

  3. 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

  4. 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.

  5. Barriers and Enablers to Integrating Mental Health into Primary Care: A Policy Analysis.

    PubMed

    Durbin, Anna; Durbin, Janet; Hensel, Jennifer M; Deber, Raisa

    2016-01-01

    Integrating care for physical health and behavioural health (mental health and addictions) has been a longstanding challenge, although research supports the clinical and cost effectiveness of integrated care for many clients. In one such model, primary care (PC) physicians work with specialist physicians and non-physician providers (NPPs) to provide mental health and addictions care in PC settings. This Ontario, Canada-focused policy analysis draws on research evidence to examine potential barriers and enablers to this model of integrated care, focusing on mental health. Funding challenges pertain to incentivizing PC physicians to select patients with mental illness, include NPPs on the treatment team, and collaborate with specialist providers. Legal/regulatory challenges pertain to NPP scopes of practice for prescribing and counselling. Integrated care also requires revising the role of the physician and distribution of functions among the team. Policy support to integrate addictions treatment in PC may face similar challenges but requires further exploration.

  6. 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.

  7. Gamma radiation shielding and health physics characteristics of diaspore-flyash concretes.

    PubMed

    Singh, Kanwaldeep; Singh, Sukhpal; Singh, S P; Mudahar, Gurmel S; Dhaliwal, A S

    2015-06-01

    Different gamma radiation interaction parameters has been measured experimentally for the prepared diaspore-flyash concretes at 59.54, 662, 1173 and 1332 keV using narrow-beam transmission geometry and results are found to be in good agreement with theoretical values computed with a computer programme, WinXCom. The radiation exposure rate and absorbed dose rate for the gamma radiation with and without shielding of diaspore-flyash concretes have been determined using linear attenuation results. The results show that on average, there is reduction of 95%, 53% and 40% in dose rate for gamma sources (241)Am, (137)Cs and (60)Co, respectively with diaspore-flyash concretes as shielding material. Other health physics parameters namely equivalent dose, effective dose, gamma flux and energy fluence rate have also been determined.

  8. 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

  9. 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…

  10. Program Collaboration and Service Integration Activities Among HIV Programs in 59 U.S. Health Departments

    PubMed Central

    Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A.; Nesheim, Steven R.

    2014-01-01

    Objectives We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Methods Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. Results HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. Conclusions HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs. PMID:24385647

  11. Medical provider attitudes about behavioral health consultants in integrated primary care: a preliminary study.

    PubMed

    Torrence, Nicole D; Mueller, Anne E; Ilem, Allison A; Renn, Brenna N; DeSantis, Brian; Segal, Daniel L

    2014-12-01

    Integrated behavioral health increases service utilization and treatment success, particularly with high-risk populations. This study assessed medical personnel's attitudes and perceptions of behavioral health clinicians (BHCs) in primary care using a brief self-report measure. A 6-item survey was given to medical providers (n = 45) from a health care system that includes integrated behavioral health services. Survey items assessed providers' attitudes and perceptions about BHCs. Attitudes about behavioral health were largely favorable. For all items, 73.3% to 100% of participants endorsed strongly agree or agree. Chi-square analyses revealed that those who interacted more frequently with BHCs were more comfortable discussing behavioral health issues with their patients, χ²(6, n = 45) = 13.43, p < .05, and that physicians believe that BHCs help patients effectively address their behavioral health problems, χ²(2, n = 45) = 6.36, p < .05. Age, gender, and health center in which the providers worked were not significantly related to any survey items. Medical providers surveyed believe that BHCs are valuable members of integrated health care, improving their abilities to provide care and to address their patients' physical and behavioral health problems. Although these preliminary results are promising, the setting surveyed has well-integrated behavioral health care services and thus might not be representative of other settings without such integration. Future studies should address medical providers' opinions of BHCs in a variety of settings with larger samples.

  12. Enhancing Interprofessional Education: Integrating Public Health and Social Work Perspectives

    PubMed Central

    Browne, Teri; Blake, Elizabeth W.; Bailey, Jennifer

    2015-01-01

    National stakeholders in health system improvement and patient safety including accreditation bodies have requested health professional educational programs to include multiple interprofessional experiences through didactic and experiential opportunities. Clinical and population health faculty at the University of South Carolina redesigned and expanded an introductory interprofessional course to include more than 500 students from public health, social work, medicine, pharmacy, and nursing. Students participated in 3 live class meetings and completed required online coursework to explore concepts related to social determinants of health and health disparities, health system improvement, patient safety, cultural competency, and ethics to address interprofessional education core competencies. Course modifications and expanded student enrollment improved understanding of key health concepts and appreciation of interprofessional collaboration. PMID:25706002

  13. 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.

  14. The Origin and Early Radiation of Archosauriforms: Integrating the Skeletal and Footprint Record

    PubMed Central

    Bernardi, Massimo; Klein, Hendrik; Petti, Fabio Massimo; Ezcurra, Martín D.

    2015-01-01

    We present a holistic approach to the study of early archosauriform evolution by integrating body and track records. The ichnological record supports a Late Permian–Early Triassic radiation of archosauriforms not well documented by skeletal material, and new footprints from the Upper Permian of the southern Alps (Italy) provide evidence for a diversity not yet sampled by body fossils. The integrative study of body fossil and footprint data supports the hypothesis that archosauriforms had already undergone substantial taxonomic diversification by the Late Permian and that by the Early Triassic archosauromorphs attained a broad geographical distribution over most parts of Pangea. Analysis of body size, as deduced from track size, suggests that archosauriform average body size did not change significantly from the Late Permian to the Early Triassic. A survey of facies yielding both skeletal and track record indicate an ecological preference for inland fluvial (lacustrine) environments for early archosauromorphs. Finally, although more data is needed, Late Permian chirotheriid imprints suggest a shift from sprawling to erect posture in archosauriforms before the end-Permian mass extinction event. We highlight the importance of approaching palaeobiological questions by using all available sources of data, specifically through integrating the body and track fossil record. PMID:26083612

  15. The Origin and Early Radiation of Archosauriforms: Integrating the Skeletal and Footprint Record.

    PubMed

    Bernardi, Massimo; Klein, Hendrik; Petti, Fabio Massimo; Ezcurra, Martín D

    2015-01-01

    We present a holistic approach to the study of early archosauriform evolution by integrating body and track records. The ichnological record supports a Late Permian-Early Triassic radiation of archosauriforms not well documented by skeletal material, and new footprints from the Upper Permian of the southern Alps (Italy) provide evidence for a diversity not yet sampled by body fossils. The integrative study of body fossil and footprint data supports the hypothesis that archosauriforms had already undergone substantial taxonomic diversification by the Late Permian and that by the Early Triassic archosauromorphs attained a broad geographical distribution over most parts of Pangea. Analysis of body size, as deduced from track size, suggests that archosauriform average body size did not change significantly from the Late Permian to the Early Triassic. A survey of facies yielding both skeletal and track record indicate an ecological preference for inland fluvial (lacustrine) environments for early archosauromorphs. Finally, although more data is needed, Late Permian chirotheriid imprints suggest a shift from sprawling to erect posture in archosauriforms before the end-Permian mass extinction event. We highlight the importance of approaching palaeobiological questions by using all available sources of data, specifically through integrating the body and track fossil record.

  16. Incidence of dementia among atomic-bomb survivors--Radiation Effects Research Foundation Adult Health Study.

    PubMed

    Yamada, Michiko; Kasagi, Fumiyoshi; Mimori, Yasuyo; Miyachi, Takafumi; Ohshita, Tomohiko; Sasaki, Hideo

    2009-06-15

    Radiotherapy has been reported to cause neuropsychological dysfunction. Here we examined whether exposure to atomic bomb radiation affected the incidence of dementia among 2286 atomic bomb survivors and controls - all members of the Adult Health Study cohort. Study subjects were non-demented and aged >or=60 years at baseline examination and had been exposed in 1945 at >or=13 years of age to a relatively low dose (health examinations with a two-phase procedure. DSM IV criteria were used for diagnosing dementia, NINCDS-ADRDA for Alzheimer disease, and NINDS-AIREN for vascular disease. To estimate the effect of radiation on the dementia incidence rate, we applied Poisson regression analysis. Incidence per 1000 person-years was 16.3 in the <5 mGy group, 17.0 in the 5-499 mGy group, and 15.2 in the >or=500 mGy group. Alzheimer disease was the predominant type of dementia in each dose category. After adjustment for potential risk factors, radiation exposure did not affect the incidence rate of either all dementia or any of its subtypes. No case of dementia had a history of therapeutic cranial irradiation. Although we found no relationship between radiation exposure and the development of dementia among atomic bomb survivors exposed at >or=13 years old in this longitudinal study, effects on increased risk of early death among atomic bomb survivors will be considered.

  17. 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.

  18. 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.

  19. Analysis of social inequalities in health through an integrated measure of perceived and experienced health in Spanish and Portuguese adolescents.

    PubMed

    Ramos, Pilar; Moreno, Carmen; Rivera, Francisco; de Matos, Margarida Gaspar; Morgan, Antony

    2012-01-01

    This article compares the self reported health of a sample of 9854 Spanish and Portuguese adolescents aged 11-15 years using an integrated measure of health, which takes account of positive and negative factors that affect overall feelings of health and wellbeing. This improved measure supports the emergence of health agendas that aim to make wellbeing improvements in populations through a combination of both the promotion of positive protective factors and the need to deal with those risk factors that inhibit individuals, communities and populations to attain good health.

  20. Ethnic Variation in Oral Health and Social Integration among Older Rural Adults

    PubMed Central

    Arcury, Thomas A.; Chen, Haiying; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Bell, Ronny A.; Quandt, Sara A.

    2011-01-01

    This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, white) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size. Minority elders have poorer oral health than do white older adults. Most rural elders have substantial social engagement and social networks. Better oral health (greater number of teeth) is directly associated with social engagement, while the relationship of oral health to social network size is complex. The association of oral health with social engagement does not differ by ethnicity. Poorer oral health is associated with less social integration among African American, American Indian and white elders. More research on the ways oral health affects the lives of older adults is warranted. PMID:23788829

  1. Ethnic variation in oral health and social integration among older rural adults.

    PubMed

    Arcury, Thomas A; Chen, Haiying; Savoca, Margaret R; Anderson, Andrea M; Leng, Xiaoyan; Bell, Ronny A; Quandt, Sara A

    2013-04-01

    This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, White) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size. Minority elders have poorer oral health than do White older adults. Most rural elders have substantial social engagement and social networks. Better oral health (greater number of teeth) is directly associated with social engagement, whereas the relationship of oral health to social network size is complex. The association of oral health with social engagement does not differ by ethnicity. Poorer oral health is associated with less social integration among African American, American Indian, and White elders. More research on the ways oral health affects the lives of older adults is warranted.

  2. Physical and biological studies with protons and HZE particles in a NASA supported research center in radiation health

    NASA Technical Reports Server (NTRS)

    Chatterjee, A.; Borak, T. H.

    2001-01-01

    NASA has established and supports a specialized center for research and training (NSCORT) to specifically address the potential deleterious effects of HZE particles on human health. The NSCORT in radiation health is a joint effort between Lawrence Berkeley National Laboratory (LBNL) and Colorado State University (CSU). The overall scope of research encompasses a broad range of subjects from microdosimetric studies to cellular and tissue responses to initial damage produced by highly energetic protons and heavy charged particles of the type found in galactic cosmic rays (GCR) spectrum. The objectives of the microdosimetry studies are to determine the response of Tissue Equivalent Proportional Counter (TEPC) to cosmic rays using ground based accelerators. This includes evaluation of energy loss due to the escape of high-energy delta rays and increased energy deposition due to the enhanced delta ray production in the wall of the detector. In this report major results are presented for 56Fe at 1000, 740, 600 and 400 MeV/nucleon. An assessment of DNA repair and early development of related chromosomal changes is extremely important to our overall understanding of enhanced biological effectiveness of high LET particle radiation. Results are presented with respect to the fidelity of the rejoining of double strand breaks and the implications of misrejoining. The relationship between molecular and cytogenetic measurements is presented by studying damage processing in highly heterochromatic supernumerary (correction of sypernumerary) X chromosomes and the active X-chromosome. One of the important consequences of cell's inability to handle DNA damage can be evaluated through mutation studies. Part of our goal is the assessment of potential radioprotectors to reduce the mutation yield following HZE exposures, and some promising results are presented on one compound. A second goal is the integration of DNA repair and mutation studies. Results are presented on a direct

  3. Physical and biological studies with protons and HZE particles in a NASA supported research center in radiation health.

    PubMed

    Chatterjee, A; Borak, T H

    2001-01-01

    NASA has established and supports a specialized center for research and training (NSCORT) to specifically address the potential deleterious effects of HZE particles on human health. The NSCORT in radiation health is a joint effort between Lawrence Berkeley National Laboratory (LBNL) and Colorado State University (CSU). The overall scope of research encompasses a broad range of subjects from microdosimetric studies to cellular and tissue responses to initial damage produced by highly energetic protons and heavy charged particles of the type found in galactic cosmic rays (GCR) spectrum. The objectives of the microdosimetry studies are to determine the response of Tissue Equivalent Proportional Counter (TEPC) to cosmic rays using ground based accelerators. This includes evaluation of energy loss due to the escape of high-energy delta rays and increased energy deposition due to the enhanced delta ray production in the wall of the detector. In this report major results are presented for 56Fe at 1000, 740, 600 and 400 MeV/nucleon. An assessment of DNA repair and early development of related chromosomal changes is extremely important to our overall understanding of enhanced biological effectiveness of high LET particle radiation. Results are presented with respect to the fidelity of the rejoining of double strand breaks and the implications of misrejoining. The relationship between molecular and cytogenetic measurements is presented by studying damage processing in highly heterochromatic supernumerary (correction of sypernumerary) X chromosomes and the active X-chromosome. One of the important consequences of cell's inability to handle DNA damage can be evaluated through mutation studies. Part of our goal is the assessment of potential radioprotectors to reduce the mutation yield following HZE exposures, and some promising results are presented on one compound. A second goal is the integration of DNA repair and mutation studies. Results are presented on a direct

  4. Integrated Radiation Transport and Nuclear Fuel Performance for Assembly-Level Simulations

    SciTech Connect

    Clarno, Kevin T; Hamilton, Steven P; Philip, Bobby; Berrill, Mark A; Sampath, Rahul S; Allu, Srikanth; Pugmire, Dave; Dilts, Gary; Banfield, James E

    2012-02-01

    The Advanced Multi-Physics (AMP) Nuclear Fuel Performance code (AMPFuel) is focused on predicting the temperature and strain within a nuclear fuel assembly to evaluate the performance and safety of existing and advanced nuclear fuel bundles within existing and advanced nuclear reactors. AMPFuel was extended to include an integrated nuclear fuel assembly capability for (one-way) coupled radiation transport and nuclear fuel assembly thermo-mechanics. This capability is the initial step toward incorporating an improved predictive nuclear fuel assembly modeling capability to accurately account for source-terms and boundary conditions of traditional (single-pin) nuclear fuel performance simulation, such as the neutron flux distribution, coolant conditions, and assembly mechanical stresses. A novel scheme is introduced for transferring the power distribution from the Scale/Denovo (Denovo) radiation transport code (structured, Cartesian mesh with smeared materials within each cell) to AMPFuel (unstructured, hexagonal mesh with a single material within each cell), allowing the use of a relatively coarse spatial mesh (10 million elements) for the radiation transport and a fine spatial mesh (3.3 billion elements) for thermo-mechanics with very little loss of accuracy. In addition, a new nuclear fuel-specific preconditioner was developed to account for the high aspect ratio of each fuel pin (12 feet axially, but 1 4 inches in diameter) with many individual fuel regions (pellets). With this novel capability, AMPFuel was used to model an entire 17 17 pressurized water reactor fuel assembly with many of the features resolved in three dimensions (for thermo-mechanics and/or neutronics), including the fuel, gap, and cladding of each of the 264 fuel pins; the 25 guide tubes; the top and bottom structural regions; and the upper and lower (neutron) reflector regions. The final, full assembly calculation was executed on Jaguar using 40,000 cores in under 10 hours to model over 162

  5. Integrated Radiation Transport and Nuclear Fuel Performance for Assembly-Level Simulations

    SciTech Connect

    Hamilton, Steven P; Clarno, Kevin T; Philip, Bobby; Berrill, Mark A; Sampath, Rahul S; Allu, Srikanth

    2012-01-01

    The Advanced Multi-Physics (AMP) Nuclear Fuel Performance code (AMPFuel) is focused on predicting the temperature and strain within a nuclear fuel assembly to evaluate the performance and safety of existing and advanced nuclear fuel bundles within existing and advanced nuclear reactors. AMPFuel was extended to include an integrated nuclear fuel assembly capability for (one-way) coupled radiation transport and nuclear fuel assembly thermo-mechanics. This capability is the initial step toward incorporating an improved predictive nuclear fuel assembly modeling capability to accurately account for source-terms, such as neutron flux distribution, coolant conditions and assembly mechanical stresses, of traditional (single-pin) nuclear fuel performance simulation. A novel scheme is introduced for transferring the power distribution from the Scale/Denovo (Denovo) radiation transport code (structured, Cartesian mesh with smeared materials within each cell) to AMPFuel (unstructured, hexagonal mesh with a single material within each cell), allowing the use of a relatively coarse spatial mesh (10 million elements) for the radiation transport and a fine spatial mesh (3.3 billion elements) for thermo-mechanics with very little loss of accuracy. With this novel capability, AMPFuel was used to model an entire 1717 pressurized water reactor fuel assembly with many of the features resolved in three dimensions (for thermo-mechanics and/or neutronics). A full assembly calculation was executed on Jaguar using 40,000 cores in under 10 hours to model over 160 billion degrees of freedom for 10 loading steps. The single radiation transport calculation required about 50% of the time required to solve the thermo-mechanics with a single loading step, which demonstrates that it is feasible to incorporate, in a single code, a high-fidelity radiation transport capability with a high-fidelity nuclear fuel thermo-mechanics capability and anticipate acceptable computational requirements. The

  6. 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.

  7. 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

  8. 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…

  9. Severity of Mental Health Impairment and Trajectories of Improvement in an Integrated Primary Care Clinic

    ERIC Educational Resources Information Center

    Bryan, Craig J.; Corso, Meghan L.; Corso, Kent A.; Morrow, Chad E.; Kanzler, Kathryn E.; Ray-Sannerud, Bobbie

    2012-01-01

    Objective: To model typical trajectories for improvement among patients treated in an integrated primary care behavioral health service, multilevel models were used to explore the relationship between baseline mental health impairment level and eventual mental health functioning across follow-up appointments. Method: Data from 495 primary care…

  10. 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…

  11. Implications for human and environmental health of low doses of ionising radiation.

    PubMed

    Mothersill, Carmel; Seymour, Colin

    2014-07-01

    The last 20 years have seen a major paradigm shift in radiation biology. Several discoveries challenge the DNA centric view which holds that DNA damage is the critical effect of radiation irrespective of dose. This theory leads to the assumption that dose and effect are simply linked - the more energy deposition, the more DNA damage and the greater the biological effect. This is embodied in radiation protection (RP) regulations as the linear-non-threshold (LNT) model. However the science underlying the LNT model is being challenged particularly in relation to the environment because it is now clear that at low doses of concern in RP, cells, tissues and organisms respond to radiation by inducing responses which are not readily predictable by dose. These include adaptive responses, bystander effects, genomic instability and low dose hypersensitivity, and are commonly described as stress responses, while recognizing that "stress" can be good as well as bad. The phenomena contribute to observed radiation responses and appear to be influenced by genetic, epigenetic and environmental factors, meaning that dose and response are not simply related. The question is whether our discovery of these phenomena means that we need to re-evaluate RP approaches. The so-called "non-targeted" mechanisms mean that low dose radiobiology is very complex and supra linear or sub-linear (even hormetic) responses are possible but their occurrence is unpredictable for any given system level. Issues which may need consideration are synergistic or antagonistic effects of other pollutants. RP, at present, only looks at radiation dose but the new (NTE) radiobiology means that chemical or physical agents, which interfere with tissue responses to low doses of radiation, could critically modulate the predicted risk. Similarly, the "health" of the organism could determine the effect of a given low dose by enabling or disabling a critical response. These issues will be discussed.

  12. Arctic stratospheric ozone depletion and increased UVB radiation: potential impacts to human health.

    PubMed

    De Fabo, Edward C

    2005-12-01

    Contrary to popular belief, stratospheric ozone depletion, and the resultant increase in solar UV-B (280-320 nm), are unlikely to fully recover soon. Notwithstanding the success of the Montreal Protocol in reducing the amount of ozone destroying chemicals into the stratosphere, the life-times of these compounds are such that even with full compliance with the Protocol by all countries, it will be decades before stratospheric ozone could return to pre-1980 levels. This raises the question, therefore, of what will happen to biological processes essential to the maintenance of life on earth which are sensitive to damage by increased UV-B radiation, particularly those involved with human health? The polar regions, because of the vagaries of climate and weather, are the bellwether for stratospheric ozone depletion and will, therefore, be the first to experience impacts due to increases in solar UV-B radiation. The impacts of these are incompletely understood and cannot be predicted with certainty. While some UV-B impacts on human health are recognized, much is unknown, unclear and uncertain. Thus, this paper attempts, as a first approximation, to point out potential impacts to the health and welfare of human inhabitants of the Arctic due to increased solar UV-B radiation associated with stratospheric ozone depletion. As will be seen, much more data is critically needed before adequate risk assessment can occur.

  13. 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.

  14. 77 FR 19017 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-29

    ...] [FR Doc No: 2012-7554] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory...

  15. The Development of Countermeasures for Space Radiation Induced Adverse Health Effects

    NASA Astrophysics Data System (ADS)

    Kennedy, Ann

    The Development of Countermeasures for Space Radiation Induced Adverse Health Effects Ann R. Kennedy Department of Radiation Oncology, University of Pennsylvania School of Medicine, 195 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA, United States 19104-6072 The development of countermeasures for radiation induced adverse health effects is a lengthy process, particularly when the countermeasure/drug has not yet been evaluated in human trials. One example of a drug developed from the bench to the clinic is the soybean-derived Bowman-Birk inhibitor (BBI), which has been developed as a countermeasure for radiation induced cancer. It was originally identified as a compound/drug that could prevent the radiation induced carcinogenic process in an in vitro assay system in 1975. The first observation that BBI could inhibit carcinogenesis in animals was in 1985. BBI received Investigational New Drug (IND) Status with the U.S. Food and Drug Administration (FDA) in 1992 (after several years of negotiation with the FDA about the potential IND status of the drug), and human trials began at that time. Phase I, II and III human trials utilizing BBI have been performed under several INDs with the FDA, and an ongoing Phase III trial will be ending in the very near future. Thus, the drug has been in development for 35 years at this point, and it is still not a prescription drug on the market which is available for human use. A somewhat less time-consuming process is to evaluate compounds that are on the GRAS (Generally Recognized as Safe) list. These compounds would include some over-the-counter medications, such as antioxidant vitamins utilized in human trials at the levels for which Recommended Dietary Allowances (RDAs) have been established. To determine whether GRAS substances are able to have beneficial effects on radiation induced adverse health effects, it is still likely to be a lengthy process involving many years to potentially decades of human trial work. The

  16. J-integral fracture toughness, Tearing modulus and tensile properties of Vitamin E stabilized radiation crosslinked UHMWPE.

    PubMed

    Bellare, Anuj; Dorfman, Robert; Samuel, Ashwanth; Thornhill, Thomas S

    2016-08-01

    Radiation crosslinking of ultra-high molecular weight polyethylene (UHMWPE) increases its wear resistance in total joint replacement prostheses. Unfortunately, it is accompanied by a dose-dependent decrease in several mechanical properties. In this study, the tensile properties and fracture behavior of radiation crosslinked, Vitamin E stabilized UHMWPE was studied as a function of radiation dose. The Rice and Sorensen model, applicable to elastic-plastic materials, was utilized to obtain the initial crack driving force, J1c, steady state J-integral fracture toughness, Jss and the Tearing modulus. Tensile tests showed the dependence of tensile properties on radiation dose. Jss of non-crosslinked UHMWPE was higher than for crosslinked UHMWPE׳s but there was no dose dependent change in Jss whereas there was almost no change in J1c over the entire dose range. Finally, a monotonic decrease in Tearing modulus was observed with radiation dose.

  17. Integrating a clinical service line for maternal-child health.

    PubMed

    Stichler, J F; Branciforte, L

    1998-01-01

    Clinical integration is a developmental process that calls on the combined resources, expertise, and knowledge of individuals who may be working together for the first time. The process is dependent on the acknowledgment of the value of integration and a shared vision for the service line. By using a strategic thinking and planning process, the service line can be reshaped to function as an integrated system of programs and services that is sensitive to needs at a local level. While the task of integration is not an easy one, the outcomes of the process lead to a synergy that cannot be realized in any other manner.

  18. Accelerating execution of the integrated TIGER series Monte Carlo radiation transport codes

    SciTech Connect

    Smith, L.M.; Hochstedler, R.D.

    1997-02-01

    Execution of the integrated TIGER series (ITS) of coupled electron/photon Monte Carlo radiation transport codes has been accelerated by modifying the FORTRAN source code for more efficient computation. Each member code of ITS was benchmarked and profiled with a specific test case that directed the acceleration effort toward the most computationally intensive subroutines. Techniques for accelerating these subroutines included replacing linear search algorithms with binary versions, replacing the pseudo-random number generator, reducing program memory allocation, and proofing the input files for geometrical redundancies. All techniques produced identical or statistically similar results to the original code. Final benchmark timing of the accelerated code resulted in speed-up factors of 2.00 for TIGER (the one-dimensional slab geometry code), 1.74 for CYLTRAN (the two-dimensional cylindrical geometry code), and 1.90 for ACCEPT (the arbitrary three-dimensional geometry code).

  19. NASA/GEWEX Surface Radiation Budget: First Results From The Release 4 GEWEX Integrated Data Products

    NASA Astrophysics Data System (ADS)

    Stackhouse, Paul; Cox, Stephen; Gupta, Shashi; Mikovitz, J. Colleen; zhang, taiping

    2016-04-01

    The NASA/GEWEX Surface Radiation Budget (SRB) project produces shortwave and longwave surface and top of atmosphere radiative fluxes for the 1983-near present time period. Spatial resolution is 1 degree. The current release 3 (available at gewex-srb.larc.nasa.gov) uses the International Satellite Cloud Climatology Project (ISCCP) DX product for pixel level radiance and cloud information. This product is subsampled to 30 km. ISCCP is currently recalibrating and recomputing their entire data series, to be released as the H product, at 10km resolution. The ninefold increase in pixel number should help improve the RMS of the existing products and allow for future higher resolution SRB gridded product (e.g. 0.5 degree). In addition to the input data improvements, several important algorithm improvements have been made. Most notable has been the adaptation of Angular Distribution Models (ADMs) from CERES to improve the initial calculation of shortwave TOA fluxes, from which the surface flux calculations follow. Other key input improvements include a detailed aerosol history using the Max Planck Institut Aerosol Climatology (MAC), temperature and moisture profiles from HIRS, and new topography, surface type, and snow/ice. Here we present results for the improved GEWEX Shortwave and Longwave algorithm (GSW and GLW) with new ISCCP data, the various other improved input data sets and the incorporation of many additional internal SRB model improvements. As of the time of abstract submission, results from 2007 have been produced with ISCCP H availability the limiting factor. More SRB data will be produced as ISCCP reprocessing continues. The SRB data produced will be released as part of the Release 4.0 Integrated Product, recognizing the interdependence of the radiative fluxes with other GEWEX products providing estimates of the Earth's global water and energy cycle (I.e., ISCCP, SeaFlux, LandFlux, NVAP, etc.).

  20. 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.