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Memon, Neelusha. "Disability in Health Impact Assessment." Thesis, University of Canterbury. School of Social and Political Sciences, 2012. http://hdl.handle.net/10092/7015.
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People with disabilities are a ‘disadvantaged’ group, not only due to their impairment, but also due to the formal and informal institutional inertia that they contend with in Western Societies. This disadvantage has been recognised and acknowledged in the social model of disability. This model understands that disability is a social construction placed on people with impairments.
The Health Impact Assessment (HIA) is a tool which identifies inequities in policy, and is potentially a useful tool to aid the response of policy makers to the needs of people with disabilities. Arguably, the New Zealand HIA guidelines reflect the underlying principles of the social model of disability.
Using a mixed methods research strategy, this thesis sets out to understand in a global context using a top-down quantitative analysis, to what extent the New Zealand HIA guidelines which acknowledge the social model of disability are translated into practice. It then subsequently investigates from a bottom-up qualitative perspective, what factors influence this relationship. It is argued in this thesis that there are barriers to translating the rhetoric about people with disabilities found in the HIA guidelines into practice. Three sets of inter-related barriers identified include attitudinal barriers to people with disabilities, generic HIA barriers, and barriers related to the feminist interpretation of the construction of disability.
In this thesis, the research findings conclude that it is difficult to operationalise the disability awareness present in the HIA guidelines due to barriers which are related to the ‘othering’ of people with disabilities. This is discussed in relation to feminist analyses of the construction of people with disabilities, and it needs to be addressed by wider societal reforms. The thesis makes the recommendation that a national awareness-raising campaign about people with disabilities be undertaken in New Zealand in an attempt to rectify this situation.
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Mesa-Frias, M. "Modelling uncertainty in environmental health impact assessment." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2391599/.
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Quantifying uncertainty in environmental health impact assessment models is important, particularly if the models are to be used for decision support. This thesis develops a new non-probabilistic framework to quantify uncertainty in environmental health impact assessment models. The framework takes into account two different perspectives of uncertainty: conceptual and analytical in terms of where uncertainty occurs in the model. The first perspective is concerned with uncertainty in the framing assumptions of health impact assessment, whereas the second perspective is concerned with uncertainty in the parameters of a model. The construction of the framework was achieved by focusing on five specific objectives: (i) to describe the complexity of how uncertainty arises in environmental health impact assessment and classify the uncertainty to be amenable for quantitative modelling;(ii) to critically appraise the strengths and limitations of current methods used to handle the uncertainty in environmental health impact assessment; (iii) to develop a novel quantitative framework for quantifying uncertainty from the conceptual and analytical perspectives; (iv) to formulate two detailed case-study examples on health impact assessment of indoor housing interventions; (v) to apply the framework to the two case-studies. After critiquing the uncertainty quantification methods that are currently applied in environmental health impact assessment, the thesis develops the framework for quantifying uncertainty, starting with the conceptual uncertainty (uncertainty associated with the framing assumptions or formulation of the model), then quantifying the analytical uncertainty (uncertainty associated with the input parameters and outputs of the model). The first case-study was concerned with the health impact assessment of improving housing insulation. Using fuzzy cognitive maps, the thesis identifies key indoor factors and their pathways highly sensitive to the framing assumptions of the health impact assessment. The second case-study was concerned with estimating the uncertainty in the health burdens in England, associated with three ventilation exposure scenarios using fuzzy sets and interval analysis. The thesis presents a wider uncertainty framework as a first step forward in quantifying conceptual and analytical uncertainty in environmental health impact assessment when dealing with limited information.
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Benkhalti, Jandu Maria. "Health Impact Assessment and the Inclusion of Migrants." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32226.
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There is an increasing number of international migrants worldwide and in Canada. The majority of migrants arrive with a health status higher than the average of their host country. This advantage is often lost within ten years of migration due to various reasons, most notably through the social determinants of health. These determinants are the conditions in which individuals live and work and the most relevant to migrant health include racialization, education, employment, housing, social capital, and gender.
Health impact assessment (HIA) is a process with the capacity to address changes in health due to the social determinants of health by assessing the intended and unintended impacts on health that a policy, program, or project might have and recommend ways to promote positive and mitigate negative impacts. For this reason, HIA has the potential to address the observed decrease in health experienced by migrants. Various frameworks have been developed to guide the undertaking of HIA including frameworks explicitly aiming at addressing health inequities by considering particular socially disadvantaged population groups. One such example is the Health Equity Impact Assessment (HEIA) tool developed by the Ontario Ministry of Health and Long-Term Care. Although there have been a few studies addressing the inclusion of inequities in HIA in general, there has been no previous assessment of the inclusion of migrants in HIA.
This doctoral thesis sought to assess the degree and way in which migrants are included in HIAs globally and across various types of HIAs and contexts. It also sought to assess the degree to which migrants were considered in local initiatives through an examination of the implementation of the Ontario HEIA tool in public health units.
A scoping review of the international literature including 117 HIAs and two HIA evaluations found that only 14% of hand-searched HIAs mentioned migrants, 5% analysed migrants and only 2% included them in their recommendations. Although migrant groups were sometimes included in the process, this was seldom the case for citizens. The main reported barriers to considering migrants were a lack of available data and the significant additional resources needed. In order to undertake an evaluation throughout the province, it was first necessary to assess the way in which the Ontario HEIA had been implemented and used by public health units across the province. The scan found that nearly half of public health units had used the HEIA tool either in its original form or modified to the needs of the unit. The use of the tool was found to be influenced by the following factors: the available inputs or resources, the nature of the HIA tool, the actors and stakeholders involved, the decision-making processes within the unit or team involved, the context of the social, economic, and political environments, the nature of the project, program, or policy being assessed, and lastly, the various outputs of completing the HEIA process. Lastly, a Process and Impact evaluation assessed the way in which PHUs with a high proportion of migrants considered these migrants in their HEIAs. This study found that although migrants had been included in HEIAs, this tended to be done when the impact on migrants was anticipated. Additionally, there remains an incoherent terminology accompanied by a confounding of the concepts of migration, racialization, and ethnicity, which are reflected in the type of recommendations developed. These recommendations often focused on translation of documents into various languages and the acquiring of greater information through community partnerships. The process and capacity to include migrants in HEIAs were influenced by the availability of resources and evidence, the prioritisation of recommendations relating to migrants, and the overall impressions the staff had on the HEIA process. Nonetheless, the HEIA process was beneficial in that it strengthened relationships with migrant community organisations.
This thesis work also resulted in the development of a HIA-specific theoretical framework based on the literature and empirical findings of this work. This framework is conducive to adopting a tactical approach to HIA by considering the various contextual factors influencing the completion of an HIA and implementation of its recommendations.
In conclusion, although migrants are understood to be an important group often facing circumstances of disadvantage, they are only sometimes considered in HIAs. Several procedural and contextual barriers are encountered which influence their consideration. Significant guidance is still required to facilitate their adequate consideration and ensure the development of optimal recommendations. HIA frameworks should explicitly mention migrants as a potentially disadvantaged group and guidance documents could be developed to address the current gaps in understanding migrant issues.
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Bekker, Marleen Petra Maria. "The politics of healthy policies redesigning health impact assessment to integrate health in public policy /." Delft : Rotterdam : Eburon ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10491.
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Jones, Jennifer. "Stakeholder perceptions of the Wishbone Hill Health Impact Assessment." Thesis, University of Alaska Anchorage, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1543904.
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Stakeholder engagement in a health impact assessment (HIA) is a way to involve communities in the decision-making process of a proposed project or policy. Research conducted on the proposed Wishbone Hill Coal Mine (WHM) in Alaska sought to identify if participants felt the stakeholder engagement process used in a recent HIA was able to respond to cultural differences and inequitable distribution of health impacts. Using a qualitative methodology, 12 interviews were conducted with individuals who participated in the WHM HIA. Results indicate that existing issues of trust between the general public, Alaska Native peoples, and the government impact how the findings of an HIA are received by stakeholders. Recommendations were developed from the research findings and are intended to support continued public trust in the use of HIA in the State of Alaska. Recommendations include ensuring HIA practitioner competencies when working with communities, and implementing transparent stakeholder engagement processes.
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Mueller, Natalie 1988. "Health impact assessment of urban and transport planning policies." Doctoral thesis, Universitat Pompeu Fabra, 2017. http://hdl.handle.net/10803/664239.
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Urbanization processes are ongoing. Some aspects of urban life such as a sedentary lifestyle, the risk of traffic incidents, high levels of air pollution, noise and heat, and a lack of green spaces can have detrimental effects on our health and well-being. Despite consensus that these exposures related to urban and transport planning affect our health, there is little quantification of these health risk factors in the urban context. Quantitative health impact assessment (HIA) can provide numeric indices of health risk factors and can inform the health benefit-risk tradeoff of public policies. The present thesis sheds light on the utility of quantitative HIA in urban and transport planning policies. Almost 3,000 premature deaths, over 50,000 disability-adjusted life-years (DALYs) and over 20 million € in direct health care spending were estimated to be attributable to current urban and transport planning practices in Barcelona, Spain annually. The present thesis suggests that overwhelming motor transport fleets in cities need to be reduced through (1) the promotion of active transport (i.e. walking and cycling for transport in combination with public transport), facilitated by for instance the expansion of cycling networks and (2) the reinforcement of green spaces. Active transport together with green spaces, were assessed to provide considerable net health benefits through increases in physical activity levels and mitigation of motor transport-associated emissions of air pollution, noise and heat. The present thesis concludes that HIA is a useful tool for quantification of anticipated health impacts of public policies and more extensive application of HIA is encouraged.Algunas de las características de la vida urbana como el estilo de vida sedentario, el riesgo de sufrir accidentes de tráfico, los altos niveles de contaminación atmosférica, el ruido, el calor y la falta de espacios verdes pueden tener efectos perjudiciales en nuestra salud y bienestar. Aunque se sabe que estas exposiciones afectan nuestra salud, existe poca cuantificación de estos factores de riesgo en el contexto urbano. Las evaluaciones del impacto sobre la salud cuantitativas (HIA por sus siglas en inglés) proporcionan datos sobre los factores de riesgo en la salud e información del equilibrio entre beneficio y riesgo de las políticas públicas. Se estima que cada año casi 3,000 muertes prematuras, más de 50,000 años de vida ajustados por discapacidad (DALYs por sus siglas en inglés) y más de 20 millones de € de gastos directos en el sistema de salud que son atribuibles a las actuales políticas urbanas y de transporte en Barcelona, España. Esta tesis sugiere que el tráfico rodado en las ciudades necesita ser reducido mediante (1) la promoción del transporte activo (caminar, ir en bicicleta, transporte público), facilitada p.ej. por la expansión de la red de carril de bicicleta, y (2) con el aumento de los espacios verdes. Se estimó que el transporte activo y los espacios verdes proporcionan considerables beneficios netos para la salud a través del aumento de la actividad física y de la mitigación de las emisiones de contaminantes atmosféricos, ruido y calor asociadas al transporte motorizado. La presente tesis concluye que la HIA es una herramienta útil para la cuantificación anticipada de los impactos en la salud de las políticas públicas y se recomienda una aplicación extensiva de esta metodología
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Bacelar-Nicolau, Leonor. "Health Impact Assessment : Quantifying and Modeling to Better Decide." Thesis, Paris, CNAM, 2017. http://www.theses.fr/2017CNAM1151/document.
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L’Évaluation d’Impact sur la Santé (EIS) est un instrument de support à la décision, pour juger une politique quant aux effets potentiels sur la santé et leur distribution (équité). C’est encore souvent une approche qualitative.L’objectif principal est de montrer l’utilité de méthodologies statistiques quantitatives multivariées pour enrichir la pratique d’EIS, améliorant la compréhension des résultats par des professionnels non-statisticiens.Les futures réformes des systèmes de santé déplacent le centre d’évaluation des services de santé des fournisseurs aux citoyens (besoins, préférences, équité d’accès aux gains de santé), exploitant big data associant information de soins aux données sociales, économiques et de déterminants de santé. Des méthodologies statistiques et d’évaluation innovantes sont nécessaires à cette transformation.Les méthodes de data mining et data science, souvent complexes, peuvent gérer des résultats graphiques compréhensibles pour amplifier l’usage d’EIS, qui deviendrait ainsi un outil précieux d’évaluation de politiques publiques pour amener les citoyens au centre de la prise de décisionHealth Impact Assessment (HIA) is a decision-making support tool to judge a policy as to its potential effects and its distribution on a population’s health (equity). It’s still very often a qualitative approach.The main aim here is to show the usefulness of applying quantified multivariate statistical methodologies to enrich HIA practice, while making the decision-making process easier, by issuing understandable outputs even for non-statisticians.The future of healthcare reforms shifts the center of evaluation of health systems from providers to people’s individual needs and preferences, reducing health inequities in access and health outcomes, using big data linking information from providers to social and economic health determinants. Innovative statistical and assessment methodologies are needed to make this transformation.Data mining and data science methods, however complex, may lead to graphical outputs simple to understand by decision makers. HIA is thus a valuable tool to assure public policies are indeed evaluated while considering health determinants and equity and bringing citizens to the center of the decision-making process
A Avaliação de Impacte na Saúde (AIS) é um instrumento de suporte à decisão para julgar política quanto aos seus efeitos potenciais e à sua distribuição na saúde de uma população (equidade). É geralmente ainda uma abordagem qualitativa.O principal objetivo é mostrar a utilidade das metodologias estatísticas quantitativas e multivariadas para enriquecer a prática de AIS, melhorando a compreensão dos resultados por profissionais não-estatísticos.As futuras reformas dos sistemas de saúde deslocam o centro da avaliação dos serviços de saúde dos prestadores para as necessidades e preferências dos cidadãos, reduzindo iniquidades no acesso à saúde e ganhos em saúde, usando big data que associam informação de prestadores a dados sociais e económicos de determinantes de saúde. São necessárias metodologias estatísticas e de avaliação inovadoras para esta transformação.Métodos de data mining e data science, mesmo complexos, podem gerar resultados gráficos compreensíveis para os decisores. A AIS é assim uma ferramenta valiosa para avaliar políticas públicas considerando determinantes de saúde, equidade e trazendo os cidadãos para o centro da tomada de decisão
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Balby, Cecilia Negrão. "Avaliação de impactos à saúde:desenvolvimento internacional e perspectivas no Brasil." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/6/6134/tde-26092012-145539/.
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Introdução: A Avaliação de Impactos à Saúde (AIS) é adotada em vários países como estratégia para abordar os potenciais impactos à saúde relacionados a políticas, planos, programas ou projetos, mas não é ainda utilizada no Brasil. Objetivo: Identificar as condições brasileiras que podem corroborar com vantagens e limitações da AIS já descritas na literatura internacional, considerando sua aplicação futura no Brasil, especialmente no caso de projetos. Métodos: Revisão da literatura científica e de outros documentos internacionais sobre AIS, identificados através de bases de dados (Pub Med e Science Direct), e de portais especializados, para entender o contexto e compilar vantagens e limitações da AIS. Revisão da literatura científica nacional e de outros documentos sobre avaliação de impactos e saúde, identificados através das bases de dados LILACS, SCIELO e outros portais brasileiros que tratam desses temas. Pesquisa qualitativa complementar com profissionais e pesquisadores brasileiros. Resultados e discussão: A AIS ainda está se desenvolvendo no mundo, por isso há vantagens e limitações igualmente importantes associadas aos seus indutores; ao objeto da avaliação (políticas, planos, programas ou projetos); à fase em que é conduzida (prospectiva ou retrospectiva); aos patrocinadores e avaliadores; ao tipo de AIS adotada; à sua institucionalização; à integração a outras formas de avaliação de impactos (AIA ou AAE); à abordagem em saúde, ao escopo e aos métodos adotados; à participação das partes afetadas e a sua influência no processo de tomada de decisão. No Brasil, os estudos que abordam os impactos à saúde são frequentemente retrospectivos e a abordagem de saúde na AIA apresenta lacunas. Os poucos estudos prospectivos ainda não utilizam as ferramentas e passos da AIS. O Ministério da Saúde vem articulando o processo de introdução da AIS no país. Conclusões e Recomendações: Há oportunidades para introduzir a AIS de projetos no país. Entretanto, é urgente o engajamento dos profissionais brasileiros da área de saúde e de avaliação de impactos com as redes de profissionais nacionais e internacionais, visando aprimorar a discussão e prepará-los para enfrentar questionamentos à AIS eventualmente levantados por aqueles que veem no processo de avaliação de impactos obstáculos para a eficiência e rapidez da tomada de decisão sobre projetos. É também preciso organizar padrões mínimos para que não sejam reproduzidos no Brasil problemas já vivenciados e solucionados em outras localidadesIntroduction: Health Impact Assessment (HIA) is adopted as a strategy to address the potential health impacts associated with policies, plans, programs or projects in various countries, but not yet in Brazil. Objective: To identify the Brazilian conditions that can contribute to HIA advantages and constraints already described in the literature, considering its future adoption in Brazil, particularly in the case of projects. Method: Review of scientific literature and other documents on HIA, identified in Pub Med and Science Direct, as well as in HIA websites, in order to understand the context and compile HIA advantages and constraints already described in the literature. Review of Brazilian scientific literature and other Brazilian documents on impact assessment and health, identified through LILACS and SCIELO databases as well as other Brazilian web sites that address the subject. Additional qualitative research with Brazilian stakeholders. Results and discussion: HIA is still developing worldwide. Due to that, there are equally important advantages and limitations associated to its drivers, its object (policies, plans, programs or projects), when it is conducted (prospective or retrospective), HIA sponsors and assessors, HIA types, if HIA is institutionalized, if it is integrated with other forms of impact assessment (AIA, SEA), its approach to health, its scope and methods, the participation of affected parties and its influence to decision making. In Brazil, health impact assessments are frequently retrospective and do not adopt HIA tools and its steps. The Brazilian Ministry of Health is working to introduce HIA in the country. Conclusions and recommendations: There are opportunities to introduce HIA of projects in the country. However, it is urgent to engage Brazilian health and impact assessment professionals with national and international networks, in order to deepen and improve the discussion and to prepare them to face future questioning to HIA eventually raised by those that view the impact assessment process as an obstacle to efficiency in the context of project decision making. It is also necessary to develop minimum standards so that some issues already faced and solved elsewhere are not repeated in Brazil
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Veerman, Jacob Lennert. "Quantitative health impact assessment: an exploration of methods and validity." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10490.
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Buroni, Andrew R. "Spatial susceptibility : a scoping and screening tool for health impact assessment." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/9b541fa3-ff82-450f-b54f-4d03e0b257b5.
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It is recognised that formal methods for evaluating the effects of development, for example Environmental Impact Assessment (EIA), whether at policy or project level, have often neglected the potential effects of development upon human health. It is now understood that Health Impact Assessment (HIA) is a necessary component of planning and decision-making.
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Robertson, Dianne A. "Social Impact Assessment: Engaging in Participatory Evaluation - Implications and Practice." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/416058.
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This social marketing evaluation project explores how a research and industry partnership can develop an approach to evaluation to understand the social impact of health promotion intervention. This thesis proposes the need for a participatory approach to Social Impact Assessment (SIA). Specifically, this research project sought to understand: first, how social impact is considered and measured with health promotion interventions in four comparable Commonwealth contexts (Australia, Canada, New Zealand, and the United Kingdom); and second, how an Australian NGO may (or may not be) delivering social impact within health promotion and how an SIA assessment may add insight into social impact measurement within health promotion. This research implemented the SIA methodology of Social Return on Investment (SROI) to evaluate the social impact of an NGO Health Promotion program aiming to help children make safe and healthy life choices (Lane & Devin, 2018; McHugh, Domegan, & Duane, 2018).
While a Theory of Change (ToC) or program logic is essential for effective measurement of the outcomes or effects of interventions (Breuer, Lee, De Silva, & Lund, 2016; Hamdani et al., 2021; Meiksin et al., 2021), as a standalone process it is insufficient to understand the intricacies of social change. To understand intervention mechanisms of behaviour change—where and how social change (has or has not occurred)—there is a need to implement a measurement process that captures the broader social and economic determinants of health. These wider determinants extend beyond the current linear outcome focus of ToC, which shows a sequential approach to behaviour change along a social impact chain or program logic (Mayne, 2015; McHugh et al., 2018). This thesis proposes a participatory approach to SIA enabling a reflexive approach to evaluation that allows a deeper understanding of the complexities of how children make healthy life choices. Furthermore, a participatory approach enables program outcomes and evaluation to accurately attribute long-term behaviour change to interventions (Arkesteijn, Van Mierlo, & Leeuwis, 2015). Achieving reflexivity in SIA requires a relational approach to stakeholder engagement, which is often non-linear and iterative, throughout the program or intervention (Esponda et al., 2021; Lane & Devin, 2018; Missonier, 2014).
Accordingly, this research highlighted the need to close the gap between theoretical and practitioner knowledge and application. Consequently, two processes should be embedded into intervention design, implementation, and measurement for social impact to be effectively measured in behaviour change interventions. The first is theory use, since theories may extend program outcomes by focusing on constructs known to cause specific behaviours (Abraham et al., 2015; Hardeman et al., 2005; Michie et al., 2011). The second process is deepening essential stakeholder involvement throughout interventions (Dabravolskaj et al., 2020; Hurley, Dietrich, & Rundle-Thiele, 2019) to understand the value of improved health behaviours and outcomes for school community stakeholders such as students, schools, and parental school communities.
Subsequently, the fundamental motivation of this thesis was: To examine social impact within primary school health promotion interventions from design to evaluation and understand the role of Social Impact Assessment in contributing to more effective behaviour change interventions within health promotion.
A systematic review was conducted, which sought to examine the role of social impact assessment within primary school health promotion interventions. This review considered four comparable Commonwealth countries, Australia, Canada, New Zealand, and the United Kingdom, and aimed to answer the following research question: To what extent has the social impact been considered and evaluated in health promotion interventions in primary school contexts in Australia, Canada, New Zealand, and the United Kingdom?
The review found 77 studies representing 55 health promotion interventions delivered in primary school settings. Only eight (15%) measured or attempted to measure the social impact of these interventions, while another eight (15%) alluded to social impact. The prevailing theories reported were social-based theories (theories which examine the social influences on people, environments, and behaviours) (n = 17, 59%), and almost a third of interventions were not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system was applied to identify stakeholder engagement (n = 30, 53%). The review highlighted the lack of social impact measurement within health promotion and indicated that social impact is poorly understood in the reviewed academic literature.
Study 2 was a Social Return on Investment (SROI) Baseline, which measured the social impact of two NGO Health Promotion modules. This study examined the strengths and limitations of applying social impact measurement within a primary school health promotion intervention. The second research question asked how the application of an SIA, specifically an SROI, contributes insights into the strengths and limitations of social impact measurement within a specific primary school health promotion context. This question explored the theoretical and practical insights social impact assessment (SIA) contributes to estimating social impact within a particular context—specifically, two health promotion modules delivered by [redacted] ([redacted]). The purpose was to apply SIA to understand what community benefits (if any) can be derived from health promotion program delivery, and assess what outcomes and social impact could reasonably be expected from a 90-minute health education module. Although study 2’s findings indicated the strengths of applying an SIA to health promotion, specifically, Social Return on Investments (SROI), there is still a long way to go in both theory and application. The SROI conducted on the two modules demonstrated a positive social impact for the two 90-minute modules. However, this effect dropped off over time.
Overall, this research contributes to bridging the divide between academic and practitioner-informed behaviour change interventions. Notwithstanding its predominant health promotion focus, the theoretical parallels and convergences with social marketing are considered, suggesting implications for more robust theory-informed health promotion interventions. This thesis proposes an iterative participatory process involving key stakeholders as salient to the provision of evidence beyond intervention outputs and outcomes. To measure the social impact of an intervention beyond nominal indicators requires a shift in what is measured within behaviour change interventions—individual determinants—to the broader social and economic determinants of health. From a practitioner perspective, key stakeholders must be involved in longer-duration interventions from design through implementation and evaluation. This thesis advocates for a better understanding of social impact relevant to applied settings to more clearly evidence the value of behaviour change interventions demonstrating beyond doubt how ‘wicked problems’ are reduced.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Dept of Marketing
Griffith Business School
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Ramirez, Javier Cortes. "Incorporating epidemiological studies into Integrated Environmental Health Impact Assessment of coal mining." Thesis, University of Queensland, 2019.
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Åström, Christofer, Hans Orru, Joacim Rocklöv, Gustav Strandberg, Kristie L. Ebi, and Bertil Forsberg. "Heat-related respiratory hospital admissions in Europe in a changing climate : a health impact assessment." Umeå universitet, Yrkes- och miljömedicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-64372.
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Objectives Respiratory diseases are ranked second in Europe in terms of mortality, prevalence and costs. Studies have shown that extreme heat has a large impact on mortality and morbidity, with a large relative increase for respiratory diseases. Expected increases in mean temperature and the number of extreme heat events over the coming decades due to climate change raise questions about the possible health impacts. We assess the number of heat-related respiratory hospital admissions in a future with a different climate. Design A Europe-wide health impact assessment. Setting An assessment for each of the EU27 countries. Methods Heat-related hospital admissions under a changing climate are projected using multicity epidemiological exposure–response relationships applied to gridded population data and country-specific baseline respiratory hospital admission rates. Times-series of temperatures are simulated with a regional climate model based on four global climate models, under two greenhouse gas emission scenarios. Results Between a reference period (1981–2010) and a future period (2021–2050), the total number of respiratory hospital admissions attributed to heat is projected to be larger in southern Europe, with three times more heat attributed respiratory hospital admissions in the future period. The smallest change was estimated in Eastern Europe with about a twofold increase. For all of Europe, the number of heat-related respiratory hospital admissions is projected to be 26 000 annually in the future period compared with 11 000 in the reference period. Conclusions The results suggest that the projected effects of climate change on temperature and the number of extreme heat events could substantially influence respiratory morbidity across Europe.
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Hjortswang, Henrik. "A strategy for health assessment : the case of ulcerative colitis /." Linköping Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med767s.pdf.
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Robertson, Laura Anne. "Quantification of orphanhood, assessment of its impacts on child health and design of an impact mitigation trial." Thesis, Imperial College London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.528284.
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Stjernman, Henrik. "Crohn’s Disease in Sickness and in Health : Studies of Health Assessment Strategies and Impact on Health-Related Quality of Life." Doctoral thesis, Linköpings universitet, Gastroenterologi och hepatologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-66249.
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Background and aims. Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) with potentially deleterious effects on well-being and daily-life functioning. A complete picture of health status in CD therefore comprises both disease activity (DA) and health-related quality of life (HRQL). Several measures of DA and HRQL in CD have been developed. Some have gained prominence as standard endpoints in clinical trials, but none has been validated in Swedish CD patients and their use in clinical practice has been limited. A conceptual health status model of five dimensions (Biological variables, Symptoms, Function, Worries, and Well-being) has been proposed for IBD health assessment, enabling the construction of the Short Health Scale (SHS), a four-item questionnaire intended to facilitate assessment and interpretation of HRQL in IBD. The aims of this thesis were: (1) to evaluate the Swedish versions of the Inflammatory Bowel Disease Questionnaire (IBDQ) and the Rating Form of IBD Patient Concerns (RFIPC); (2) to evaluate the Short Health Scale; (3) to study the relationship between DA and HRQL variables by identifying determinants of DA outcome and by validating the SHS health status model; (4) to describe the spectrum of disease-related worries and repercussions on general HRQL in a context of social variables, sickness, and disability. Methods. The thesis is based on clinical variables and HRQL data measured in a population-based cohort of 505 CD patients, consecutively included in conjunction with their regular outpatient visits at three hospitals (Jönköping, Örebro, Linköping). The HRQL questionnaires were evaluated regarding construct validity, reliability, and responsiveness. Multivariate analyses were used to investigate the relationship between Crohn’s Disease Activity Index (CDAI) and physician-assessed DA. The SHS health status model was validated with structural equation modelling (SEM). Disease-related worries and concerns, general HRQL, social variables, sickness, and work disability were compared with data from background population or patients with ulcerative colitis (UC). Results. The IBDQ had good validity, reliability, and responsiveness, but the original dimensional structure was not supported. The RFIPC was valid, and reliable, but less sensitive to change in disease activity. The SHS had the highest completion rate and proved adequate psychometric properties. The CDAI correlated weakly with the physician’s appraisal of disease activity, being more influenced by subjective health perception than objective disease activity. SEM showed that the SHS model had a good fit to measured data, explaining >98% of the covariance of the variables. Worries and general HRQL impairment were greater in CD than in UC, especially for women. Disease complications and impaired life achievements elicited most worries. CD patients had lower educational level. Female patients were more often living single. The rates of long-term sickness and disability were doubled compared with background population, with worse outcome for women. Conclusions. The IBDQ, the RFIPC, and the SHS all demonstrated adequate psychometric properties. The SHS was easier to administer and provided a more comprehensive picture of subjective health status. The weak correlation between CDAI and physician-assessed DA was explained by a strong influence of subjective variables on CDAI, stressing the importance of assessing DA and HRQL separately. The SHS health status model was further supported by SEM. CD has tangible effects on subjective health perception, worries and work capacity, especially for women.
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Fantke, Peter [Verfasser], and Rainer [Akademischer Betreuer] Friedrich. "Health impact assessment of pesticide use in Europe / Peter Fantke. Betreuer: Rainer Friedrich." Stuttgart : Universitätsbibliothek der Universität Stuttgart, 2012. http://d-nb.info/1023870460/34.
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Grellier, James. "Environmental health impact assessment of exposure to disinfection by-products in drinking water." Thesis, Imperial College London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542936.
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Rutten, Martine. "The economic impact of health care provision : a CGE assessment for the UK." Thesis, University of Nottingham, 2004. http://eprints.nottingham.ac.uk/10318/.
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This thesis seeks to determine the macro-economic impacts of changes in health care provision, whilst recognising the simultaneous effects of consequent changes in health on effective labour supplies and the resource claims made by the health care sector. The resource allocation issues have been explored in theory, by developing an extension of the standard Rybczynski theorem from a low-dimension Heckscher-Ohlin framework, and empirically, by developing a Computable General Equilibrium model, calibrated to a purpose-built dataset for the UK. The theory predicts that, if the government is solely concerned with improving per capita income, a morally questionable policy of targeting health care provision towards skilled workers performs best. Furthermore, the impact of an expanding health sector on the outputs of non-health sectors is shown to depend on the sign and magnitude of a scale effect of increased effective labour supplies and a factor-bias effect of changes in the ratio of skilled to unskilled labour, although the latter effect dominates if effective labour supplies are relatively inelastic with respect to health care provision. The theoretical predictions are not generally validated by the applied model due to added real-life complexities. The main findings are that a rise in NHS expenditures, the employment of foreign health care-specific skilled workers, and costless factor-neutral and skill-biased technical change in the UK health sector have a positive impact upon overall welfare via direct improvements in population well-being and indirect benefits from increased worker incomes. The study indicates that if an expansion of the health sector is financed from a reduction in state benefits, the non-working households and pensioners may require some compensation since they rely relatively heavily on these as a source of income. The presence of health care-specific factors and rising pharmaceutical prices impact negatively upon the health sector and overall welfare, suggesting the importance of tackling rising input costs and structural rigidities. This may be achieved by the immigration policy, although since effects on domestic workers if their wages are not sustained, and on countries of origin faced by a 'brain-drain', are negative, in the long-term increasing the number of medical school places may be more desirable. Another suitable policy response is to purchase a more effective pharmaceutical product. Fairly small productivity gains in health care were shown to generate overall welfare gains. Finally, factor-neutral and skill-biased technical improvements yield significant welfare gains and cost-savings in the health sector. Such technical improvements may come in the form of improved medical procedures, which have been developed abroad yet are freely available or have been funded by charitable institutions, but also may reflect domestic policy which aims at reducing administrative overheads so that more resources can be devoted to front-line staff. The sensitivity of the results to the elasticity of the waiting lists with respect to health care indicates the importance of ensuring that additional resources are effectively employed, attainable by the technical and administrative improvements in health care.
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Cuyno, Leah Marquez. "An Economic Evaluation of the Health and Environmental Benefits of the Integrated Pest Management Program (IPM CRSP) in the Philippines." Diss., Virginia Tech, 1999. http://hdl.handle.net/10919/27941.
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Concern about externalities associated with pesticide use in developing countries has motivated the development of integrated pest management (IPM) programs in these areas. In the Philippines, the IPM Collaborative Research Support Program (IPM CRSP) was established to specifically address the widespread misuse of pesticides in the rice-vegetable systems of Nueva Ecija, one of the major rice and onion producing regions in the country. IPM CRSP initiatives include research on the optimal use of pesticides, complementary weed control strategies, and alternative cultural and biological controls. If successful, the program should generate benefits that can be measured in economic terms. These benefits include improvements in water quality, food safety, pesticide applicator safety, and long run sustainability of pest management systems.
This study was designed to measure the health and environmental benefits of the IPM CRSP in the Philippines. A survey questionnaire was administered to 176 onion farmers in five villages in Nueva Ecija to identify farm and farmer characteristics, pesticide usage, pest management practices, perceptions about pesticide hazards, awareness of IPM strategies, and willingness to adopt specific technologies being developed under the IPM CRSP. In addition, a contingent valuation survey was used to elicit farmers' willingness-to-pay to avoid risks posed by pesticides to different environmental categories.
A comprehensive economic measure of the benefits of IPM CRSP was derived by 1) assessing the hazards associated with pesticide usage, 2) providing an ex ante measure of program impacts on pesticide usage, 3) predicting IPM adoption rates, and 4) estimating society's willingness-to-pay to avoid the health and environmental risks from pesticides under Philippine conditions. A measure of the amount of risks avoided as a result of IPM CRSP adoption was combined with farmers' willingness to pay bids for risk avoidance to derive a monetary value of the program benefits. The estimated economic benefits of the IPM CRSP to farmer residents in 5 villages in Nueva Ecija amount to 230,912.00 pesos for one onion season.Ph. D.
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Paez, Omar. "Financial Assessment of Health and Safety Programs in the Workplace." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1383909213.
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Iroz-Elardo, Nicole. "Participation, Information, Values, and Community Interests Within Health Impact Assessments." PDXScholar, 2014. https://pdxscholar.library.pdx.edu/open_access_etds/1846.
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Health impact assessment (HIA) has emerged in the U.S. as one promising process to increase social and environmental justice through addressing health equity issues within planning. HIA practice is guided by values such as democracy and equity and grounded in broad social determinants of health. The most readily applied definition of democracy is problematic because it implies an element of direct, participatory engagement with the public. This is at odds with HIA practice that largely relies on stakeholder engagement strategies.
This dissertation critically examines the engagement strategies of three transportation planning HIA cases to more fully understand how the HIA process may or may not promote democratic values and protect community health interests. It employs a multi-case study design that uses qualitative content analysis to trace community health interests through the HIA process, HIA document, and target plan. It finds that while the field is overstating the participatory nature of HIA, commitments to health equity and broad determinants of health protect community health interests with and without robust engagement of community stakeholders.
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Ferreira, Pêgo Cíntia Sofia. "Assessment of fluid intake as a determinant of lifestyle and its impact on health." Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/399565.
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A causa de la manca d’informació sobre la ingesta de líquids i begudes a la població general, es va avaluar el seu consum diari, el percentatge d’individus cobrint les recomanacions d’ingesta d'aigua segons la Agència Europea de Seguretat Alimentària (AESA), així com de sucres senzills segons la Organització Mundial de la Salut (OMS) en adults Espanyols i de 12 països d’arreu del món. Aproximadament el 50% dels individus no cobria les recomanacions de l’AESA, i el 44,5% superava les recomanacions de la OMS, només a través de líquids. També es va avaluar els hàbits de consum de fluids dels adults espanyols en funció del seu nivell d'adherència a la dieta mediterrània (DM) i a l’activitat física. S'ha descrit que els individus que presenten altes puntuacions d’adherència a la DM i a l’exercici físic, tenen un patró de consum de begudes més saludable.
També hem avaluat prospectivament l'associació entre el consum de begudes endolcides amb sucre, begudes endolcides artificialment i sucs de fruita embotellats i naturals i la incidència de síndrome metabòlica (SM) en una població mediterrània (n=1868 participants) amb alt risc cardiovascular, en el marc d'estudi PREDIMED. El consum ocasional de begudes ensucrades i begudes endolcides artificialment (1-5 racions/setmana) no es va associar amb la incidència de SM en persones de mitjana edat i d'edat avançada amb alt risc de malaltia cardiovascular. El consum de més de 5 porcions/setmana de tots els tipus de begudes analitzades es va associar amb un major risc de SM i alguns dels seus components.
Finalment, per tal d'analitzar l'associació entre la ingesta de líquids i begudes en el futur, hem dissenyat i validat un qüestionari específic per l’avaluació de líquids a la població Espanyola. Aquesta validació es va dur a terme en el context de l'estudi PREDIMED-PLUS.Debido a la escasez de datos sobre la ingesta de líquidos en población general, se evaluó el consumo de los diferentes tipos de bebidas, el porcentaje de individuos que cumplían con las recomendaciones de ingesta de agua de la Agencia Europea de Seguridad Alimentaria (AESA) y de azúcares simples según la Organización Mundial de la Salud (OMS), en adultos Españoles y de otros 12 países. Aproximadamente el 50% de la población no cumplía con las recomendaciones de la AESA, y el 44,5% superaba las recomendaciones de la OMS, únicamente a través de fluidos. Se evaluó los hábitos de consumo de líquidos en función de su nivel de adherencia a la dieta Mediterránea (DM) y de actividad física. Los individuos que presentan puntuaciones más altas de adherencia a la DM y ejercicio físico presentan un patrón de consumo de líquidos más saludable. También hemos evaluado prospectivamente la asociación entre el consumo de bebidas azucaradas, bebidas endulzadas artificialmente y zumos de fruta embotellados y naturales y la incidencia de síndrome metabólico (SM) en una población mediterránea (n=1868 participantes) con alto riesgo cardiovascular, en el marco de estudio PREDIMED. El consumo ocasional de bebidas azucaradas y bebidas endulzadas artificialmente (1-5 raciones/semana) no se asoció con la incidencia de SM en personas de mediana edad y de edad avanzada con alto riesgo de enfermedad cardiovascular. El consumo de >5 porciones/semana de todos los tipos de bebidas analizadas se asoció con un mayor riesgo de SM y algunos de sus componentes. Por último, con el fin de analizar la asociación entre la ingesta de líquidos y bebidas en el futuro, hemos diseñado y validado un cuestionario-español fluido específico. Esta validación se llevó a cabo en el contexto del estudio PREDIMED-PLUS.
The scarcity and the inconsistency of the evidence available about beverages intake, led us to examine the consumption of different types of beverages and total daily fluid intake in Spanish adults and other 12 countries using data from the Liq.In7 study. We found that approximately 50% of the population did not complied with European Food Safety Agency adequate intake and 44.5% exceeded the World Health Organization energy intake provided by free sugar recommendations, solely by fluids. Furthermore, differences in total fluid intake between countries, gender and ages were found. The beverage pattern of Spanish adults was assessed categorized by the Mediterranean Diet (MedDiet) adherence and physical activity. For the first time, we show that individuals with high scores for MedDiet adherence and physical exercise presented a healthy beverage profile. We have also prospectively assessed the associations between the consumption of sugar sweetened beverages (SSBs), artificially sweetened beverages and bottled and natural fruit juices and incidence of metabolic syndrome (MetS) in a Mediterranean population (n=1868 participants) at high cardiovascular risk, within the framework of PREDIMED study. The occasional consumption of SSBs and artificially sweetened beverages (1-5 servings/week) was not associated with the incidence of MetS in middle-aged and elderly individuals at high risk of CVD. The consumption of >5 servings/week of all of the types of beverages analyzed was associated with an increased risk of MetS and some of its components. Finally, in order to analyze the associations between fluid and beverage intake in the future, we designed and validated a Spanish fluid-specific questionnaire. This validation was conducted in the context of the PREDIMED-PLUS study, a multicenter randomized trial aiming at assess the beneficial effect of weight loss using a MedDiet and physical exercise promotion on the primary prevention of cardiovascular disease.
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Randeris, Stine. "Ambient air pollution and low birth weight : A health impact assessment in the Philippines." Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-384773.
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Introduction: The attention on environmental impact on human health is rising. But, the association between particulate matter 2.5 and birth weight is still not acknowledged in the global burden of diseases, and the association has not yet been studied in the Philippines. The aim was to explore how increasing/decreasing concentrations of particulate matter 2.5 in pregnant women’s residence area was associated with the risk of having a child with low birth weight in the Philippines. Method: 1462 women pregnant in 2016 from the Demographic and Health Survey done in the Philippines in 2017 were analyzed by exposure to particulate matter 2.5 in their residence area. Particulate matter 2.5 was derived from the DIMAQ model, which estimated the annual mean exposure based on a mix of methods. A logistic regression adjusted for demographic variables and variables important for fetal growth, and the birth season was done. Results: The results of the logistic regression when adjusted for all variables showed that the non-statistically significant odds of low birth weight in the children from to the particulate matter 2.5 categories: 7-10 μg/m3, 11-14 μg/m3, and 15-18 μg/m3 were respectively 21% lower (CI: 0.42-1.50), 33% lower (CI: 0.39-1.21) and 34% lower (CI: 0.39-1.14) compared to the highest exposure category of 19-22 μg/m3. Discussion: The study had several limitations in regard to the study design, especially in dealing with seasonal changes in low birth weight. Yet, the study did not disagree with the results from similar studies done in other countries or globally.
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Ingles, Amy. "Incorporating health considerations into collaborative transportation decision making." Thesis, Georgia Institute of Technology, 2013. http://hdl.handle.net/1853/50412.
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Performance measurement and management have been evolving at state Departments of Transportation (DOTs) in recent years, and a variety of performance data is being utilized in different ways to guide decision-making processes. However, health considerations beyond air quality and safety are not yet being incorporated into performance management programs at state DOTs. Concurrently, Health Impact Assessments (HIAs) and other public health tools have seen increasing use among Metropolitan Planning Organizations (MPOs) and their stakeholders through collaboration with public health professionals. With the 2012 reauthorization of the surface transportation bill - Moving Ahead for Progress in the 21st Century (MAP-21) - state DOTs and MPOs have the opportunity to consider health proactively in transportation decision making to address the environmental sustainability requirements of MAP-21. This study investigates the possibility for integration between transportation performance measurement and management and the HIA approach, identifying and explaining the linkages between the two previously isolated processes. The study draws from best practices in performance measurement/management at state DOTs and various examples of health-related activities among MPOs and other planning to inform a suggested approach for incorporating health considerations and metrics in transportation decision making. The suggested approach recognizes common goals of health and transportation agencies, which are well-aligned with national objectives, and emphasizes the role of multidisciplinary interagency collaboration and partnership. This approach is intended to be a resource for state DOTs and MPOs that are interested in extending their performance measurement/management activities to formally include health considerations, as it can ease many of the implementation issues currently faced when considering broader health impacts of transportation.
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Behjat, Marta. "Assessment of the health impact from air pollution in Ravenna (Italy) using the EVA model." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amslaurea.unibo.it/12233/.
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The aim of this work is to assess the health impact from air pollution in Ravenna, a small Italian city located in the Pianura Padana. In this area the environmental pressure, because of air pollution, is worsened by unfavourable meteorological conditions. In fact Ravenna, in addition to being a large industrial area and one of the most important commercial harbours of Italy, has a temperate-continental climate characterised by a high relative humidity, because of the presence of fog, frequent thermal inversions during the winter and frequent conditions of wind lull. Because of these peculiar meteorological conditions and high pollutant emissions, e.g. from intense industrial activities, often alarming levels of air pollution occur, giving public health concern. These conditions stimulated the present study of the effects of air pollution on health in the area of Ravenna using the EVA model. This system was developed in the Atmospheric Modelling (ATMO) section of the Environmental Science Department of the Aarhus University (DK) to assess health-related economic externalities of air pollution, considering the main emission sectors and quantifying their relative importance in term of impacts on human health.
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Halliday, Nnennaya. "Assessment of Major Air Pollutants, Impact on Air Quality and Health Impacts on Residents: Case Study of Cardiovascular Diseases." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1626357360619301.
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Scanlon, Molly Marion, and Molly Marion Scanlon. "Occupational Stress Risk Assessment: Assessing the Impact of Health Promotion Lifestyle and Perceived Nature Contact on Nursing Health and Wellness." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/623165.
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The purpose of the study was to perform a quantitative occupational stress risk assessment (OSRA) to evaluate the impact of health promotion (HP) lifestyle and perceived nature contact on the consequences of perceived stress from exposure to nursing stress risk factors. Perceived stress is defined as the employee’s personal interpretation of his or her work circumstance and any discrepancy between workplace demands (stressors) and individual capacities (resources). Registered nurses (RNs) in patient care settings are prone to high levels of perceived stress, which can cause errors in clinical care giving. High perceived stress is a consequence of risk factors from a nurse’s daily work routine including: workload, death and dying, inadequate preparation for role, staff support, uncertainty concerning treatment, communication with physicians, and communication with other nurses. Mitigating perceived stress improves nursing job performance, job satisfaction, and overall employee health, while reducing mental fatigue, absenteeism, and burnout. Methods performed included: Aim 1) a systematic literature and meta-analysis to establish benchmarks for perceived stress in nursing professionals for comparison of United States (US) and International healthcare settings; Aim 2) a cross-sectional study using a 125-item survey instrument administered online to an RN study population to evaluate relationships between perceived stress, HP lifestyle, and perceived nature contact; and Aim 3) a quantitative OSRA to rank nursing stress risk factors and examine differences by gender, ethnicity, and race. Results were: Aim 1) Perceived Stress Scale 14-item (PSS14) value for International nursing studies was 25.41 (95% CI 21.1 to 29.7), while US PSS14 nursing studies yielded a value of 23.8 (95% CI 19.8 to 27.7). Aim 2) the present study found Southern California RNs (n=161) had the same perceived stress (m = 22.8, 7.06 SD, p=0.082) as other US nursing professionals. RN perceived stress scores were negatively correlated (p<0.001) to HP lifestyle. HP lifestyle was positively correlated (p<0.001) to perceived nature contact. Aim 3) the OSRA model using HP lifestyle for coping exhibited the highest strength (92%) and reliability (90%); this model established RNs' risk factor rankings (RFRs) from high to low as: 1) communication with physicians, 2) workload, 3) uncertainty concerning treatment, 4) death and dying, 5) inadequate preparation for role, 6) communication with other nurses, and 7) staff support. High nursing RFRs were the same by gender. Differences were found with Hispanic RNs who ranked communication with other nurses as RFR 3 compared to non-Hispanic RNs at RFR 7. Also, non-white RNs ranked inadequate preparation for role as RFR 2 compared to white RNs at RFR 5. Although present study results focused on a single health provider RN population using self-reported survey instruments, the OSRA process can be applied to any occupational setting. This study supports introducing a quantitative OSRA process initiated in Europe to US worksites to identify and rank occupational stress risk factors for strategic prioritization and alignment with interventional resources. With continuous replication of OSRA within and between work-sectors, this process could elucidate US industry health and safety best practices. The present study focused on nurses as a first-test-case high-stress occupation. More OSRA nursing studies are recommended across a wider US geographic area to create normative values of comparison including stratum for gender, ethnicity, and race. Intervention, intervention effectiveness, and organizational change studies are needed to mitigate high nursing stress risk factors emanating from healthcare organizational challenges and to emphasize implications for improved patient care outcomes.
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Orru, Hans. "Exposure to particulate matter and the related health impacts in major Estonian cities." Doctoral thesis, Umeå : Occupational and Environmental Medicine, Umeå University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-29769.
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Little, Marie Emma. "Health Impact Assessment of Climate Change in Rural Western Australia: The Blackwood Stirling Area 2030." Thesis, Curtin University, 2017. http://hdl.handle.net/20.500.11937/57624.
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This research uses Health Impact Assessment methodology to identifying future health impacts of climate change by 2030 to a rural area in Western Australia called the Blackwood Stirling region. This mixed method qualitative research identifies potential health impacts, vulnerability and residual harm from climatic factors. Barriers to effective adaptation for government, industry and communities are examined. Cost effective anticipatory adaptation provides multiple benefits to address risks associated with likely climate change.
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Jones, Teresa Helen. "From health research to clinical practice : understanding pathways that use journal articles and informing impact assessment." Thesis, Brunel University, 2017. http://bura.brunel.ac.uk/handle/2438/15606.
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For biomedical research to improve clinical practice, and for funding levels to be sustained, it is increasingly important to understand the pathways from research to clinical practice and to assess the societal impact of research. Approaches to research evaluation through traditional study of journals, journal articles and standard citation analysis, have played comparatively small roles in these developments. In this thesis I critically review how I applied existing methods, and developed a new approach, to study two pathways from research to clinical practice. For Pathway 1, questionnaire surveys of clinicians' views on journals read to inform their clinical practice, and comparisons with impact factors, revealed that a few journals were read widely and considered important by clinicians. Relationships between journal importance and impact factor were complex. For Pathway 2, I applied a novel methodology to identify important citations to four key research papers in an attempt to trace important citations through numerous citing generations. My findings included: few cited papers were important to the citing papers; the number of citation occasions within the citing paper correlated strongly with a cited paper's importance; self-citations were also important; and it was feasible to trace through a series of generations of citations. Evidence of societal impact of the four key research papers examined in my studies included important papers in subsequent generations cited in clinical guidelines, many of which were international. In assessing the impact of my own studies, I found Pathway 1 papers had societal impact on research evaluation methodology; journal editorial policy; and medical library provision policy and practice. Societal impacts of the new methodology, Pathway 2, included informing further methodological development and research evaluation. My portfolio, together with my critical review, adds understanding and provides additional data to current assessment methods of wider impacts of research, and bases for further studies.
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Li, Ying, Daven Henze, Darby Jack, and Patrick L. Kinney. "The Influence of Air Quality Model Resolution on Health Impact Assessment for Fine Particulate Matter and Its Components." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/10.
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Health impact assessments for fine particulate matter (PM2.5) often rely on simulated concentrations generated from air quality models. However, at the global level, these models often run at coarse resolutions, resulting in underestimates of peak concentrations in populated areas. This study aims to quantitatively examine the influence of model resolution on the estimates of mortality attributable to PM2.5 and its species in the USA. We use GEOS-Chem, a global 3-D model of atmospheric composition, to simulate the 2008 annual average concentrations of PM2.5 and its six species over North America. The model was run at a fine resolution of 0.5 × 0.66° and a coarse resolution of 2 × 2.5°, and mortality was calculated using output at the two resolutions. Using the fine-modeled concentrations, we estimate that 142,000 PM2.5-related deaths occurred in the USA in 2008, and the coarse resolution produces a national mortality estimate that is 8 % lower than the fine-model estimate. Our spatial analysis of mortality shows that coarse resolutions tend to substantially underestimate mortality in large urban centers. We also re-grid the fine-modeled concentrations to several coarser resolutions and repeat mortality calculation at these resolutions. We found that model resolution tends to have the greatest influence on mortality estimates associated with primary species and the least impact on dust-related mortality. Our findings provide evidence of possible biases in quantitative PM2.5 health impact assessments in applications of global atmospheric models at coarse spatial resolutions.
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Abritis, Alison J. "An Assessment of Retractions as a Measure of Scientific Misconduct and Impact on Public Health Risks." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5630.
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Research misconduct has been generally considered a limited issue, occurring in a small percentage of research studies. Studies of the number of article retractions use retraction percentages to perpetuate the idea that research misconduct is not a common event, and use information in the retraction notice to quantify types of research misconduct and types or research error. However, retractions appear to be the wrong variable with which to assess misconduct rates and characteristics. Using final misconduct findings in hard science research from the Office of Research Integrity (ORI) for investigations closed from 1993 through 2013, the number of publications and subsequent retractions or corrections per final ORI finding was analyzed. Out of 167 subjects who received ORI sanctions, 84 (50.3%) had no publications associated with their misconduct. Of the remaining 83 subjects, only 72 had at least one retraction associated with their misconduct, i.e., only 43.1% of the all study subjects sanctioned for misconduct had at least one retraction from misconduct. Of the 231 retractions and corrections arising from the sanctioned misconduct, only 94 notices (40.6%) gave research misconduct as a cause for the retraction or correction. Thus, the study demonstrates that research misconduct occurs at a greater rate than retractions for misconduct are published, and retraction and correction notices cannot be relied upon to convey the presence of fraudulent data within the publication.
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Varghese, Arun 1972. "Point-of-use water treatment systems in rural Haiti : human health and water quality impact assessment." Thesis, Massachusetts Institute of Technology, 2002. http://hdl.handle.net/1721.1/84828.
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Louw, E. J. M. "Climate change in the Western Cape : a disaster risk assessment of the impact on human health." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1158.
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Thesis (DPhil (Geography and Environmental Studies))—University of Stellenbosch, 2007.Background The Disaster Management Act (Act 57 of 2002) instructs a paradigm shift from preparedness, response and recovery towards risk reduction. In order to plan for and mitigate risks, all spheres of government must firstly assess their hazards, vulnerabilities, capacity to cope and therefore risks. Studies in this regard, in South Africa, have however only focussed on current risks. Climate Change has now been accepted by leading international studies as a reality. Climate change can impact upon many aspects of life on earth. Studies to quantify the impact of climate change on water resources, biodiversity, agriculture and sustainable development are steadily increasing, but human health seem to have been neglected. Only general predictions, mostly regarding vector-borne disease and injury related to natural disasters are found in literature. Studies in South Africa have only focussed on malaria distribution. Most studies, internationally and the few in South Africa, were based on determining empirical relationships between weather parameters and disease incidence, therefore assessing only the hazard, and not the disaster risk. Methodology This study examines the impact of climate change on human health in the Western Cape, within the context of disaster management. A qualitative approach is followed and includes: · A literature overview examining predicted changes in climate on a global and regional scale, · A discussion on the known relationships and possible impacts climate change might have on human health, · A disaster risk assessment based on the status quo for a case study area, the Cape Winelands District Municipality, · An investigation into the future risks in terms of health, taking into account vulnerabilities and secondary impacts of climate change, resulting in the prioritisation of future risks. · Suggestions towards mitigation within the South African context. Results The secondary impacts of climate change were found to have the larger qualitative impact. The impact of climate change on agriculture, supporting 38% of the population can potentially destroy the livelihoods of the workforce, resulting in poverty-related disease. Other impacts identified were injuries and disease relating to temperature, floods, fire and water quality. Conclusion Risk is a function of hazard, vulnerability and capacity to cope. The impact of an external factor on a ‘spatial system’ should be a function of the impacts on all these factors. Disasters are not increasing because of the increase in the frequency of hazards, but because of the increasing vulnerability to hazards. This study illustrated that the major impacts of the external factor could actually be on the vulnerabilities and the indirect impacts, and not on the hazard itself. Climate change poses a threat to many aspects of the causative links that should be addressed by disaster management, and its impacts should be researched further to determine links and vulnerabilities. This research also illustrates that slow onset disasters hold the potential to destroy just as much as extreme events such as Katrina, Rita or a tsunami. It also reiterates that secondary impacts may not be as obvious, but are certainly not of secondary importance.
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Erler, Antje. "Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile." Springer International Publishing AG, 2018. https://ul.qucosa.de/id/qucosa%3A35213.
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Abstract Purpose Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. Methods In this prospective clinical study, a sample of 126 adult patients (age 17–83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at followup to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients’ ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments.
Response shift was calculated as the difference between the initial and retrospective baseline assessments. Results Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. Conclusion Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.:Inhaltsverzeichnis
1. Einführung in die Thematik…………………………………………………2
2. Formatierte Publikation……………………………………………………..11
3. Zusammenfassung…………………………………………………………. 19
4. Literaturverzeichnis……………………………………………………….... 24
5. Anlagen
5.1. Darstellung des eigenen Beitrags……………………………………. 27
5.2. Selbstständigkeitserklärung…………………………………………... 28
5.3. Lebenslauf……………………………………………………………… 29
5.4. Publikationen…………………………………………………………… 30
5.5. Danksagung……………………………………………………………. 31
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Ferguson, Kaethe Post. "Impact of Technology on Rural Appalachian Health Care Providers: Assessment of Technological Infrastructure, Behaviors, and Attitudes." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etd/1071.
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The Internet offers potential for reducing professional isolation of Appalachian health care providers by enhancing access to medical information and facilitating contact with colleagues. However, there is a gap in the knowledge of current computer and Internet access in Appalachia, and in the technology-related behaviors and attitudes of health care professionals there. This study examined Internet-related access and behaviors of Appalachian family physicians and advanced practice nurses.
A survey was mailed to 429 graduates of East Tennessee State University's family medicine residency and advanced practice nursing programs currently in practice in southern and central Appalachia. Demographic information was collected from ETSU graduate records. The Dillman survey method included a pre-notice letter, two survey mailings, and post card and telephone follow-ups. Two hundred sixty-four providers (61.5%) returned surveys. Data were analyzed using SPSS.
Respondents were similar to the total population in gender, provider discipline, age, and percentage in rural practice. Workplace computer access was common; 59.6% had sole access and 40.2% shared access. Internet access was: 82.7% broadband, 13.5% dial-up, and 2.4% no access. Although rural providers were more likely than urban to have slower dial-up access, they regularly used the Internet. Over 75% of providers accessed the Internet at home for work; 34% reported dial-up and 66% broadband home connection. Although 50% used the Internet for continuing education in 2004, most preferred in-person workshops or print-based modes of continuing education; 58.9% e-mailed daily and 80% accessed medical information via the Internet regularly. Other Internet uses included accessing online journals and patient information, receiving professional association updates, filing insurance, and writing prescriptions. The Internet is ubiquitous in Appalachia; health care providers access it for a variety of professional activities daily. Telemedicine was not a popular technological innovation. Of those 20.8% reporting telemedicine availability in the practice, few used it. When presented with a list of possible benefits of telemedicine, 41.1% selected "none of the above".
Although many technological innovations are used regularly by Appalachian health care providers, barriers to the use of new technologies lie more in attitudes than in technology access.
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Huelskamp, Amelia Catherine. "A National Assessment of the Impact of the Institutes for Higher Education Academy on School Health Faculty." University of Toledo / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1452199276.
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Lock, Karen. "Public health, nutrition and agriculture : how can burden of disease analyses and health impact assessment inform food and agriculture policy in Europe?" Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://researchonline.lshtm.ac.uk/682355/.
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This thesis aims to understand how public health evidence can be used better to inform the development of food and agriculture policy. It sets out to achieve this by developing and applying two methods that have been advocated for use in evidence-based policy making: health impact assessment (IDA) of agriculture and food policy and calculation of the burden of disease attributable to nutritional risk factors. Neither of the methods had previously been used in this policy context. They were selected as they illustrate two extreme models of evidence-based public health. The first consists of research based, investigator-led analysis producing generalisable, quantitative estimates. The second involves a more contextual, participatory, inter-sectoral approach to collecting. analysing and applying a broader range of data. The methods have been developed and applied using the fruit and vegetable sector as a case study, with specific reference to policies in the Republic of Slovenia, a country that was, during the course of this work, acceding to the European Union and presented a unique political opportunity. This thesis explores how these different evidence-based public health approaches are likely to inform policy, in the light of what we already know about influences on policy making. This thesis finds the total worldwide mortality currently attributable to inadequate consumption of fruit and vegetables is. estimated to be up to 2.635 million deaths per year. Increasing individual fruit and vegetable consumption to up to 600 g per day (the baseline of choice) could reduce the total worldwide burden of disease by 1.8%, and the burden of disease in Slovenia by 2%. The greatest impact would be on reduction of ischaemic heart disease and ischaemic stroke. However, such descriptive epidemiology is an insufficient basis for policy formulation as the results say nothing about how interventions are likely to reduce a problem The results of the health impact assessment show that evidence demonstrating priorities for public health action will be different from the type of evidence required for planning, policy implementation or evaluation.
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Chanda, Emmanuel. "Optimizing impact assessment of entomological intervention for malaria control in an operational setting in Zambia." Thesis, University of Liverpool, 2011. http://livrepository.liverpool.ac.uk/3413/.
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The study aimed at optimally assessing the impact of indoor residual spraying (IRS) and insecticide treated nets (ITNs) on vector species abundance, their infectivity and resistance status, and Plasmodium falciparum prevalence, malaria deaths and case fatality rates in the human population. Malaria prevalence surveys were conducted and routine surveillance data was retrospectively analyzed. The average P. falciparum prevalence in children between the ages of 1 and 14 years was below 10% across the study period. The intervention effect was more pronounced in IRS areas than in ITNs localities but with an incremental protective effect of their combined use. Age-specific comparison showed better intervention effect on children below 5 years than older children 5 to 14 years old. While the average number of deaths and case fatality rates in children under the age of five plunged precipitately, the reductions were more significant in IRS districts than in ITNs districts. Results indicate the need for supplementing parasite prevalence survey data with routine surveillance data in low transmission intensity areas and demonstrate the significance of evidence-based age-specific deployment of interventions. To monitor vector species abundance and infectivity, mosquitoes were collected daily using exit window traps. The three major vectors; An. gambiae s.s, An. arabiensis and An. funestus s.s, and three potential vectors of malaria, An. nili, An. rivulorum and An. funestus-like species were identified. Overall, the biggest impact of IRS and ITNs was on An. gambiae s.s, and An. funestus abundance. No An. gambiae s.s was collected in IRS localities, thus validating the fact that An. gambiae s.s and An. funestus are characteristically more amenable to control by IRS and ITNs than An. arabiensis. The transmission potential for all malaria vectors, as expressed by the calculated transmission index, was zero as none of the trapped mosquitoes tested positive for P. falciparum sporozoites. The identification of An. nili, An. rivulorum and An. funestus-like necessitate further research to determine their role in malaria transmission in the country. The low numbers of mosquitoes collected also indicate a compromise in the efficiency of exit window traps in low transmission settings, suggesting the need for their replacement with a more robust collection tool like the CDC light trap. While the persistence of An. arabiensis suggests the presence of resistance segregating in this population or, that this outdoor species is not in contact with IRS or ITNs, it could as well imply that it’s the one species perpetuating malaria transmission in these meso-to hypo- endemic areas. To determine the impact of interventions on insecticide resistance status of malaria vectors, susceptibility assays using the WHO standard protocol were conducted in 17 localities. High levels of resistance were detected in both An, gambiae s.l and An, funestus s.l to pyrethroids and DDT but with 100% susceptibility to malathion and bendiocarb. The level of resistance was significantly higher in IRS areas than in ITN areas. These findings indicate that resistance has been selected for following extensive vector control. Resistance to both DDT and deltamethrin in IRS localities and ITN areas with intense cotton growing was detected suggesting selection due to either historical use of DDT, gene flow or cross-resistance. All An. gambiae s.s were molecular s-forms and only the west (leu-phe) kdr was detected. Complete susceptibility to the organophosphates and carbamates provides a possibility to switch to these alternative insecticide classes for IRS. The detected increases in the malaria prevalence in localities with high insecticide resistance levels indicate vector control failure. These findings point to the need for information on underlying biochemical and molecular resistance mechanisms to make possible the design of an effective resistance management strategy, and for the assessment of the impact of resistance on interventions. The results indicate that the impact of malaria control can be optimally assessed by using a combination of epidemiological (routine surveillance and prevalence data) and entomological indicators, in the context of a malaria decision support system, to enhance policy formulation for objective implementation of malaria control interventions and rational use of available resources.
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Chilaka, Marcus Akalazu. "An evaluation of the utility of local knowledge to the evidence base of health impact assessment (HIA)." Thesis, Keele University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.489026.
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Health Impact Assessment (HIA) has been defined as: "A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population" (IMPACT, 2004a). HIA aims to influence public policy in such a way that would enhance the identified positive health impacts and also to mitigate negative impacts. Although community participation has become widely incorporated into the HIA process, there is paucity of research and information regarding the actual value of engaging with local community members in terms of their contributions to the evidence base of HIA (Parry and Wright, 2003). Therefore, in order to evaluate the utility of local knowledge as a source of evidence in HIA, several methods were employed in this study, namely Structured Literature Review (SLR) of twenty completed HIA reports and the completion of questionnaires by 52 HIA practitioners. Other facets of the methodology were semi-structured interview with 11 HIA practitioners, and a fieldwork that entailed the conduct of two health impact assessments. The major findings from this research indicate that 69.2% of the questionnaire respondents had engaged with local residents as part of their evidence base for HIA predictions. 98.4% of these respondents rated their perceived usefulness of local knowledge to be either useful or very useful. Additionally 61.9% of those who had engaged with local residents encountered some differences between local knowledge and expert opinion. All of these put local knowledge in the position of the second most widely used out of 10 different sources of evidence investigated through this study. The implications of these and several other discoveries are examined in various sections of this thesis
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Warfield, Tina Marie. "Implementation of an Evidence-Based Diabetic Foot Care Protocol and Impact on Health Outcomes." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7770.
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Diabetes is a condition that can lead to foot ulcers that often progress to amputation of a limb. Providing patients with education about foot care is crucial because it can help to prevent or minimize the incidence of foot ulcer development and amputation of a limb. Foot care education as a strategy not only empowers patients with proper foot care knowledge and skill to support and motivate self-care but can also enhance the partnership between the provider and patient. The purpose of this quality improvement project was the implementation of a sustainable evidence-based foot care program for adult patients with diabetes as a routine organizational protocol for quality improvement in diabetic care in a primary care clinic. The question for this project was: How does the implementation of an evidence-based diabetic foot care protocol impact the health outcomes of diabetic patients in a primary care clinic? Orem’s self-care deficit nursing theory and the logic model for evidence-based practice were used to guide this DNP project. The research method for the quality improvement project was a review of the literature. The participants were staff and adults with diabetes at the primary care clinic. The results of the chart review showed that 80% of the charts included documented foot assessments and patient education, which was an improvement when compared to 40% pre-implementation of the foot care program. The program has improved the foot health knowledge and skills of clinicians and people with diabetes and has also helped to reduce the burden of healthcare costs related to the lower incidence of hospitalization for the treatment of wounds and amputation associated with complications of diabetes.
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REDLE, ERIN E. "THE PEDIATRIC FEEDING AND SWALLOWING DISORDERS FAMILY IMPACT SCALE: SCALE DEVELOPMENT AND INITIAL PSYCHOMETRIC PROPERTIES." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1186584174.
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Wattenmaker, Amanda B. "Analysis of the Impact of a Social Norms Campaign on the Alcohol Use of Undergraduate Students at a Public, Urban University." VCU Scholars Compass, 2005. http://hdl.handle.net/10156/1827.
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Smith, Jenny. "Impact of the word "counseling" on likelihood to schedule an appointment for genetic counseling." Cincinnati, Ohio : University of Cincinnati, 2005. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1123171118.
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Thesis. (M.S.)--University of Cincinnati, 2005.Title from electronic thesis title page (viewed Feb. 25, 2006). Includes abstract. Keywords: genetic counseling, genetic risk assessment, referral terminology, attitude, barriers. Includes bibliographical references.
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Smith, David A. "An integrated approach to evaluating the environmental impact following a radiological dispersal event." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1148312072.
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Singh, Leticia. "An oral health-related quality of life assessment of cleft patients at the Wentworth Foundation Clinic (Kwazulu-Natal)." University of the Western Cape, 2020. http://hdl.handle.net/11394/8131.
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Magister Chirurgiae Dentium (MChD)An analysis of the oral health related quality of life (OHRQoL) of patients with orofacial clefts at the Wentworth Foundation in Durban, KZN is presented. Objectives: To assess whether the OHRQoL of orofacial cleft patients varies amongst different age groups, genders or cleft types as well as demographic factors. Method: 46 participants, aged 8- 18, completed a self-administered Child Oral Health Impact Profile (COHIP) questionnaire. Results: The most prevalent cleft type was the Unilateral Cleft Left, 45.7%. The COHIP mean score was 84.195 (SD 18.244) ranging from 35 to 110. The age related subscales which were statistically significant included Functional well-being (p value: 0.0456), School Environment (p value: 0.0145) and Treatment Expectancy. The subscale School Environment was statistically significant for: Transport (p value: 0.0267) and Place of accommodation (p value 0.028). The Oral Health subscale and the Educational level were statistically significant (p value 0.043). Conclusion: Statistically significant age-related differences and demographic factors were noted. The OHRQoL of cleft patients was low largely due to socioeconomic factors and difficulty accessing multidisciplinary care. Therefore, our findings highlight the importance of establishing a Cleft lip and palate multidisciplinary facility for these patients in the Wentworth foundation and subsidised transport to the Wentworth Foundation is recommended.
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Carlander, Anneli. "Assessment of microbial health hazards associated with wastewater application to willow coppice, coniferous forest and wetland systems /." Uppsala : Department of Crop Production Ecology, Swedish University of Agricultural Sciences, 2006. http://epsilon.slu.se/200629.pdf.
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Sankoh, Alhaji Ibrahim. "An assessment of pesticide use, contamination and impact on the environment and the health of people in Sierra Leone." Thesis, Lancaster University, 2016. http://eprints.lancs.ac.uk/82526/.
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One of the biggest challenges faced by Sierra Leonean farmers is pest control. Birds, insects, rodents, crustaceans and other organisms can drastically reduce yields. In order to prevent these organisms from destroying their crops, farmers use pesticides. However there are reports that these chemicals are being misused and are having negative impact on the environment and the health of the farmers. This research aimed to investigate pesticide use in rice fields and its potential effects on the environment and the health of rice farmers. The research also studied the fate of chlorpyrifos (the most widely used pesticide) in Sierra Leone soils when applied using local methods used by farmers in Sierra Leone. Five hundred farmers and one hundred health workers across the country were interviewed. Fifty focused group discussion were done. Field observations were also done. Two experimental plots (one on a boliland and one on a riverine ecosystem) on which rice cultivated were setup. Three concentrations of each of chlorpyrifos diethyl, chlorpyrifos dimethyl and a 1:1 mixture of chlorpyrifos diethyl and chlorpyrifos dimethyl were applied. Soils and rice samples from the plots were analysed for residual chlorpyrifos. Soils, rice and biota samples were from rice fields were also analysed for residual chlorpyrifos. It was found that the prevalence of pesticide use on rice farms is high and the chemicals are misused. Farmers are exposed to pesticides. Cases of pesticide related symptoms investigated in this research were found to be more prevalent among farmers that use pesticides than those not using pesticides. Chlorpyrifos is not persistent in Sierra Leone soils when recommended doses are applied. Levels of chlorpyrifos in rice samples are far below the UK and WHO recommended maximum limits when recommended doses are applied during cultivation. Soils from farms are highly contaminated. Rice and biota samples from the farms are contaminated and their consumption can expose humans to levels that could cause chronic effects.
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Zaman, Tanzida. "Assessment of Female Genital Cutting in the Arab World with a Focus on Egypt: Health Impact and Preventative Programming." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/322097.
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