The focus of this research project was to evaluate individual stakeholder perceptions of the implementation of Structured Decision Making (SDM) as a tool in risk assessment of elder abuse/neglect case referrals in Riverside County Adult Protective Services (APS). The researchers interviewed ten social workers from Riverside County APS, from line workers up to Deputy Director. Constructivist theory was used to develop a joint construct which indicated that the primary benefit of SDM was consistency. Consistency resulted in safety and proctection of the client, social worker and the agency.

Bushfires are an integral part of the Australian environment, and consequently Australian fire fighters are regularly confronted with the challenge of bushfire fighting activities. Bushfires can be extensive and long-lasting, and as a result fire fighters can be exposed to bushfire smoke for long periods without respite. Anecdotal evidence suggests that bushfire smoke exposure can lead to respiratory symptoms such as coughing, wheezing, and shortness of breath. In an optimal environment, fire fighters are equipped with respirators and protective filters to prevent the inhalation of the air toxics in bushfire smoke. Yet, reports from the fire ground indicate that the protective filters are not effective in preventing the inhalation of bushfire smoke. As a result, fire fighters have increasingly expressed concern about the ineffective equipment and the resultant respiratory symptoms during and after bushfire fighting. This research aims to establish a scientific data base to support the anecdotal evidence. The objectives of the research were: (1) to identify and quantify the air toxics in Western Australian bushfire smoke; (2) to profile the acute respiratory health effects associated with bushfire smoke exposure; (3) to assess the effectiveness of three different types of filters under controlled conditions in a smoke chamber, and in the field during fuel reduction burn-off; (4) to formulate recommendations for reducing fire fighters' exposure to bushfire smoke; and (5) to inform policy decision makers about the most effective form of respiratory protective equipment for bushfire fighting. Exposure trials were conducted in an experimental setting utilising bushfire smoke conditions in a smoke chamber and during prescribed burn-offs. Repeated measurements of respiratory symptoms, pulmonary function and oximetry were undertaken before and after bushfire smoke exposure. In addition, personal air sampling inside the respirators was undertaken to quantify and compare the levels of filtered air toxics. The analysis of the collected data demonstrated that, of those compared, the particulate/organic vapour formaldehyde filter was most effective in protecting fire fighters' respiratory health during the smoke exposure period of maximally 120 minutes. Further research would be useful to determine the v effectiveness of the filters under more realistic conditions during bushfire fighting activities. The findings of this research have resulted in a policy review in Western Australia. In 2006, the Fire and Emergency Services Authority of Western Australia (FESA) reviewed its Bush Fire Smoke Exposure Standard Operational Procedures 51, and now issues the recommended particulate/organic vapour/formaldehyde filters to the 1,000 FESA career fire fighters. The use of protective equipment for bushfire fighters is inadequately regulated worldwide and the recommendation implemented by FESA can be seen as proactive and in advance of national and international best practice. In conclusion, this project was instrumental in the translation of public health research into best practice that protects occupational health, without the need for the lengthy process of legislative reform. Fire fighter organisations in other countries with high frequencies of bushfires could learn from this example, and move to review their policies and introduce adequate personal protection for fire fighters.

Human activities over the years, especially the unconventional exploitation of oil sands deposits, downstream on the Athabasca River (AR), might have affected the water quality and ecological integrity of the river basin, thereby presenting a threat to the environment and human health. There have been concerns that the oil sands process-affected waters stored in tailing ponds may be percolating to surface waters as well as underground waters, contaminating neighboring watersheds with a cocktail of chemicals including Polycyclic aromatic hydrocarbons (PAHs). PAHs are present both naturally and from human activities as pollutants in the environment. Forest fires, geologic activities, and oil seeps are examples of natural sources of PAHs in the environment. The major sources of PAHs in the Athabasca region are leaching of oil sands deposits and contamination from oil sands production. On occasions, forest fires contribute PAHs in the area. There has been no comparative data on the exposure of PAHs to fish along the AR and Slave River. I used an integrative monitoring of selected fishes as an indicator to achieve four objectives: i) describe the spatial and seasonal distribution of measurable concentrations of products of biotransformation of polycyclic aromatic hydrocarbons (PBPAH) in bile of fish; ii) determine the levels of parent PAHs in the muscle of fish, and extrapolate the data to estimate potential risk to human consumers, and to identify which species and geographic regions, if any, pose the greatest risk to humans; iii) use patterns of contamination to provide a scientific basis for elucidating the source of contamination; and iv) perform fish health investigation by collecting morphometric health measures and perform a systematic assessment of the occurrence of lesions in the fishes. I sampled whitefish (Coregonus clupeaformis), jackfish/northern pike (Esox luscius), walleye (Sander vitreus), goldeye (Hiodon alosoides) and burbot (Lota lota) from Fort McMurray, Fort McKay, and Fort Chipewyan in Alberta, and from Fort Smith and Fort Resolution on the Slave River in the Northwest Territories. The rationale for selecting fishes included: their abundance along the basin (some have short ranges, e.g., northern pike); their dietary/nutritional and cultural significance to communities in the area; their feeding strategy, such as benthic, supra-benthic, or pelagic, trophic status, and patterns of migration and habits of spawning. I addressed the first objective in Chapter 2, where the total PBPAHs were determined. Concentrations of products of biotransformation of 2 and 3-ringed, 4-ringed, and 5-ringed PAHs were measured using synchronous fluorescence spectroscopy. Spatial and seasonal differences were observed with greater concentrations of PBPAHs in samples of bile of fish collected from Fort McKay as well as greater concentrations of PBPAHs in bile of fish collected during summer compared to those collected in other seasons. Overall, PBPAHs were greater in fishes of lower trophic levels and fishes more closely associated with sediments. In particular, goldeye (Hiodon alosoides), consistently contained greater concentrations of all the PBPAHs studied. In Chapter 3, I achieved the second objective by measuring levels of parent PAHs in muscle of selected fishes and extrapolated the results to determine potential human health risks due to fish consumption. Dorsal muscle of fishes from upstream reaches of the AR close to oil sands extraction and upgrading activities, contained greater concentrations of individual PAHs than concentrations in muscle of fishes from further downstream in the Slave River. Risks posed by PAHs to humans were assessed using a B[a]P equivalents approach. According to the risk assessment results, the average lifetime risk of additional cancers for humans who consumed fish was less than 10-6. In Chapter 4, alkylated PAHs were also measured in fish muscle to achieve the third objective. The general presence of naphthalenes and phenanthrenes and the evaluation of molecular ratios (i.e., LMW/HMW alkyl-PAHs) allowed me to conclude that the major source of pollution is petrogenic, probably due to increases in oil sand activities around Fort McMurray and Fort McKay. I achieved the fourth objective in Chapter 5 by studying the health status and potential effects of industrial development on individuals of economically and culturally significant fishes. A resurgence in condition factor of all species after a low in 2011 was observed. Annual variation was also observed in condition factor and the incidence of anomalies or lesions. Morphometric data demonstrated relatively consistent health among fishes in both the Athabasca and Slave rivers. Analysis of condition factor and somatic indices did not demonstrate consistent differences along the river system. Overall, the health of fish as determined by the metrics employed in this study, does not appear to be adversely affected by the current level of development in the Alberta oil sands region. The data presented in this dissertation make invaluable contribution to the much needed monitoring program in the Athabasca and Slave Rivers. Overall, my findings provide baseline data on fish health, concentrations of parent and alkylated PAHs, and products of biotransformation of PAH in five species of large-bodied fishes consumed by humans in communities in the Lower Athabasca and Slave River basin. These results will be useful for establishing the status and trends and spatial distribution of PAHs during monitoring of the lower Athabasca basin and most importantly, as a valuable reference point before any potential permitted discharges of wastewaters from processing of oil sands to the AR.

Thesis (Masters Diploma in Technology (Public Health)) -- Cape Technikon, Cape Town, 1992 / In order to evaluate a health education programme for food handlers at a meat plant, a bakery/confectionery and a catering premises, changes in hygiene were assessed by the bacteriological analysis of swabs for hygiene indicator organisms from food contact surfaces. In this evaluation three phases were established on the basis of bacteriological assessment prior to, during and after the education programme. The first phase involved the establishment of a base line for hygiene indicator organisms prior to the education programme by taking 5 sets of bacteriological swabs over a two month period at each of the three premises, each swab set consisting of 14 swabs of food contact surfaces making a total of 210 swabs. During this time the food hygiene educational needs of the employees were assessed and on this basis a set of three video taped presentations were produced relating respectively to personal hygiene, environmental hygiene and food handling practices. The second phase consisted of the implementation of a health education programme involving consecutive tutorial sessions at one month intervals during which the video taped programme was presented. At this stage a further 5 sets of bacteriological swabs was taken at each of the premises. The third phase involved the assessment of hygiene shortly after completion of the education programme by taking a final 5 sets of bacteriological swabs of food contact surfaces at each of the premises over a further two month period. Statistically significant reductions in a number of the indicator organisms were observed during the course of the study.

Currently, there are an estimated 2.8 million breast cancer survivors in the United States. Due to modern screening practices and raised awareness, the majority of these cases will be diagnosed in the early stages of disease where highly effective treatment options are available, leading a large proportion of these patients to fail from causes other than breast cancer. The primary cause of death in the United States today is cardiovascular disease, which can be delayed or prevented with interventions such as lifestyle modifications or medications. In order to identify individuals who may be at high risk for a cardiovascular event or cardiovascular mortality, a number of prognostic models have been developed. The majority of these models were developed on populations free of comorbid conditions, utilizing statistical methods that did not account for the competing risks of death from other causes, therefore it is unclear whether they will be generalizable to a cancer population remaining at an increased risk of death from cancer and other causes. Consequently, the purpose of this work is multi-fold. We will first summarize the major statistical methods available for analyzing competing risk data and include a simulation study comparing them. This will be used to inform the interpretation of the real data analysis, which will be conducted on a large, contemporary cohort of breast cancer survivors. For these women, we will categorize the major causes of death, hypothesizing that it will include cardiovascular failure. Next, we will evaluate the existing cardiovascular disease risk models in our population of cancer survivors, and then propose a new model to simultaneously predict a survivor's risk of death due to her breast cancer or due to cardiovascular disease, while accounting for additional competing causes of death. Lastly, model predicted outcomes will be calculated for the cohort, and evaluation methods will be applied to determine the clinical utility of such a model.

Obesity is a major public health problem and is a risk factor for hypertension, diabetes, heart disease and cancer. In addition, the prevalence of obesity appears to be increasing worldwide, making it important to determine the nature and extent of obesity in populations at risk. The aim of this study was to determine the predictors of body mass index (BMI) in Taiwanese adults 19 through 44 years old. Independent variables from the Nutrition and Health Survey in Taiwan (NAHSIT) included biological factors (age and sex), dietary factors (energy intake and fat intake), environmental factors (educational level, residence area, and nutrition knowledge), and lifestyle factors (leisure time physical activity, smoking habits, and alcohol consumption). Results indicated that nearly 40% of the 1,182 adult survey participants were obese or overweight, by Taiwanese standards. Regression analysis found that significant predictors of BMI were residence area, educational level, and age. Taiwanese adults more likely to have higher BMIs were from the mountainous area, had less education. An increase in ten years of age was related to an average increase in BMI of 1.13 kg/m�� (p<0.0001), controlling for other variables. These three factors accounted for 21% of the variance in all adults (15% of the variance in men, and 28% of the variance in women). In addition, smoking was a predictor of higher BMI in males, and alcohol intake was a predictor for higher BMI in females. Energy intake, fat intake, leisure time physical activity, and nutrition knowledge were not significant predictors for either males or females. The findings from this study will help public health professionals identify target areas and program needs to reduce obesity in Taiwan, particularly in the mountainous areas where the prevalence of obesity/overweight was seventy percent. / Graduation date: 2004

The assessment of volatile organic compounds (VOCs) has become an area of particular interest in the field of atmospheric pollution due to their adverse health and environmental effects. This study is aimed to identify, quantify and characterize VOC in different urban areas and industrial areas in Bursa. The spatial distribution, seasonal variation as well as health risks assessment of VOC were discussed. Air samples were collected by means of sorbent passive sampling at over 50 sampling points in Bursa and analyzed by GC-thermal desorption. A total of seven weekly measurement periods were completed across the city center from 2005 to 2007. The source of VOC was apportioned with the commonly used receptor model, namely Factor Analysis. Motor vehicles and industrial solvent usage are the most abundant VOC sources to contribute to urban atmosphere in Bursa, 63% and 20%, respectively. The health risks of VOC were also evaluated. The questionnaire was filled out by selected people living in Bursa to obtain time-activity pattern for health risk assessment. Lifetime cancer risks were estimated with the measured VOC data. All the statistical parameters used to represent cancer risks for the selected compounds exceeded the stated level. Benzene had the highest adverse health effect among these compounds according to USEPA (2009) calculation with the mean cancer risk 3x10-4. In addition to intensive field sampling campaigns conducted in Bursa, the VOC measurement were completed for a period of six months to evaluate uptake rate of VOC in Ankara. Uptake rate equations depending on relative humidity and wind speed were developed for 25 VOCs.

The purpose of this study was to explore, from readily available data, the best predictors of medical claims costs at Ball State University (BSU). Multiple regression equations were developed to predict BSU's medical claims costs from selected demographic and health-related measures among 1,799 BSU employees. The predictors were chosen from data previously collected during the three-year study period: July 1, 1995 to June 30, 1998. Regression equations were developed for the entire BSU population and the high-cost population. The linear composite of number of emergency room visits, number of chronic health problems, gender and age predicted 17.86% of the variation in transformed medical claims costs for the entire BSU population. The linear composite of age, number of emergency room visits and gender predicted 9.95% of the variation in transformed medical claims costs for high-cost BSU employees. Logistic regression, performed on the entire BSU population, did not differentiate low and highcost employees well: only 15.0% of high-cost employees were classified correctly. / Fisher Institute for Wellness

Thesis (M.S.) -- Mississippi State University. Department of Geosciences. / Title from title screen. Includes bibliographical references.

Thesis (M.S.)--University of Montana, 2007. / Title from title screen. Description based on contents viewed June 18, 2007. Includes bibliographical references (p. 59-61).