Thesis (Ph.D.)--George Mason University, 2008. / Vita: p. 246. Thesis director: Jack A. Goldstone. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Public Policy. Title from PDF t.p. (viewed Jan. 11, 2009). Includes bibliographical references (p. 226-245). Also issued in print.

Thesis (M. P. H.)--University of Hong Kong, 2005. / Also available in print.

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 67-74).

Thesis (M.P.H.)--University of Hong Kong, 2005.

Early detection of a new outbreak or new information about a public health issue could prevent morbidity and mortality and reduce healthcare expenditures for the economy. Syndromic surveillance is a subset of public health surveillance practice that uses pre-diagnostic data to monitor public health threats. The syndromic surveillance approach posits that patients first interface with the healthcare system in non-traditional ways (e.g., buying over-the-counter medications, calling healthcare hotlines) before seeking traditional healthcare avenues such as emergency rooms and outpatient clinics. Thus detection of public health issues may be more timely using syndromic surveillance data sources compared to diagnosis-based surveillance systems. One source of information not yet fully integrated in syndromic surveillance is calls to poison centers. United States poison centers offer free, confidential medical advice through a national help line to assist in poison exposures. Call data are transmitted and stored in an electronic database within minutes to the National Poison Data System (NPDS), which can be used for near-real-time surveillance for disease conditions or exposures. The studies presented in the dissertation explore new ways for poison center records to be used for early identification of public health threats and for evaluating policy and program impact by identifying changing trends in poison center records. The approach and findings from these three studies expand upon current knowledge of how poison center records can be used for syndromic surveillance and provide evidence that justifies expansion of poison center surveillance into avenues not yet explored by local, state, and federal public health.

Resumo: O estudo descreve a municipalização das ações de vigilância sanitária, em Marília, São Paulo, e identifica determinantes políticos, técnicos e administrativos que conformaram o processo, segundo a percepção dos sujeitos envolvidos. Trata-se de uma pesquisa qualitativa, sendo a entrevista escolhida como técnica para coleta dos dados. A entrevista foi orientada por um roteiro composto por questões específicas, previamente formuladas. Foram entrevistados doze sujeitos oriundos do serviço de vigilância sanitária do município de Marília, da divisão de vigilância sanitária da DIR-XIV-Marília e da direção do sistema de saúde local e regional. Para a análise dos dados, foi adotada a técnica de análise de conteúdo que possibilitou a construção de cinco categorias empíricas: a) movimento de mudança; b) qualificação dos recursos humanos; c) perda de espaço e poder na municipalização; d) conflito nas relações de trabalho; e) organização gradativa do serviço de vigilância sanitária municipal. A análise permitiu compreender que as determinações legais não foram suficientes para garantir a municipalização, de fato, da vigilância sanitária, e ainda, que o processo foi gradativo e pontuado de conflitos e indefinições. O processo de municipalização das ações de vigilância sanitária se deu sem que estivessem claramente definidas atribuições, fluxos, responsabilidades, coordenação, regulamentação. Como conseqüências surgiram entre os servidores da área, reações negativas de perda, desinteresse pelo trabalho, rejeição, inferioridade, insegurança e revolta. As conseqüências das mudanças, ocasionadas pela municipalização, foram evidenciadas nas falas dos sujeitos como: conflitos nas relações de trabalho, insegurança, resistência, falta de qualificação para o trabalho, perda do poder, divisão... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The study describes the municipalization of the actions of the health surveillance in Marília, SP, and identifies political determinants, technicians and administrators who have set up the process, according to the perception of the health professionals involved. It is a qualitative research, being the interview chosen as a technique for the collection of data. The interview was guided by a set made up of specific questions previously formulated. Twelve health professionals from the health surveillance of the municipality of Marília, the division of health surveillance of the DIR-XIV-Marília and the management of the local and regional health care system were interviewed. For data analyses, the technique of content analyses used brought about a construction of five empirical categories: a) movement of change; b) qualification of the human resources; c) loss of influence and power of the municipalization; d) work related conflicts; e) gradual organization of the municipal services of the health surveillance. The analyses permitted a comprehension that the legal determinations were not enough to guarantee the municipalization, in fact, of the health surveillance, and yet, the process was gradual and full of conflicts and uncertainties. The process of municipalization of the health surveillance happened without clear definite attributions, flows, responsibilities, coordination, regulations. As a consequence, among the workers of the area, there was a negative reaction of loss, lack of work-related interest, rejection, inferiority, lack of work-related security and revolt. The consequences of the changes caused by municipalization were evidenced in the words of the health professionals involved, such as: work-related conflicts, lack of security, resistance, lack of qualification for the job, loss of power, sharing workplace, gradual rise of... (Complete abstract click electronica access below) / Orientador: Antonio Luiz Caldas Junior / Coorientador: Roseli Ferreira da Silva / Mestre

Chlorpyrifos, an organophosphate pesticide moderately toxic to humans via inhalation and dermal absorption (LD50 oral, rat = 226 mg kg-1, LD50 skin, rabbits = 1265 mg kg-1), is widely used to eradicate termites in Australia. A series of 28 surveys totaling 32 separate assessments, or 10% of all professional users in Perth, Western Australia, comprised biological monitoring, exposure assessment techniques, a health symptoms and work practices questionnaire. Chlorpyrifos metabolite 3,5,6-trichloro-2-pyridinol and alkyl phosphates were extracted from urine, and serum cholinesterase (SChE) and erythrocyte acetylcholinesterase from blood. Chlorpyrifos was extracted from 24 patches removed from a supplied cotton overall, cotton gloves worn under protective gloves, 7 absorbent patches placed on the skin and an organic vapour collection tube. Surface wipes were collected in the workers vehicle and on the workers forehead. Chlorpyrifos was applied in either 0.5% (n=2) or 1% (n=26) concentration of active ingredient in water solution. Surveys took place at pre-construction sites (n=5) where pesticide was sprayed onto a prepared site, existing buildings with concrete foundations (n=17) where pesticide was injected under pressure around the perimeter of the building and existing buildings with suspended floors requiring the worker to spray under floor (n=6). Combined left and right glove deposition was 9 mg hour- 1 (SD = 18 mg.hour-1). Mean deposition on overalls was 14 mg.hour-1 (SD = 12 mg.hour-1), on skin patches was 0.2 ƒÝg.cm-1.hour-1, on vehicle gear-stick was 3 ƒÝg (SD = 8 ƒÝg) and, on steering wheels¡¦ was 3 ƒÝg (SD = 3 ƒÝg). The mean protection 4 factor of overalls, a ratio of outer layer and inner levels, was 75 (SD = 411). Mean air concentration of chlorpyrifos during an application was 30 ƒÝg m-3, and 17 ƒÝg m-3 8 hour TWA (SD = 40 ƒÝg m-3 8 hour TWA), and in one group of 17 workers correlated (p<0.05) with ambient air temperature (15 to 38 oC). Urinary metabolites and SChE activity were effective indicators of exposure. The health symptoms questionnaire did not highlight significant health effects. A discrepancy between operators¡¦ perception of risk and their actual exposure requires addressing, for example the measured high deposition rate to hands was ineffectively controlled, as 48% or workers wore inappropriate or no gloves and only 26% washed their hands after completing their tasks. All workers indicated in the questionnaire they would wash their hands after completing their tasks. The questionnaire also highlighted a high incidence of poor work practices, 58% spilt the concentrate at least once a week, 74% had recently spilt/splashed diluted chlorpyrifos in their eyes and 90% on their boots, and 52% believed they would benefit from more education concerning chlorpyrifos. Observations concluded that workers unnecessarily increased their exposure by poor work practice. Recommendations include modification to pesticide worker education, licencing and health surveillance systems; an improvement in the understanding of the benefits of a health and safety management systems for employers, and pesticide suppliers taking a stewardship role in the usage of their products.

Thesis (M.S. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, December 2006. / Thesis Advisor(s): Peter R. Lavoy, Anne L. Clunan. "December 2006." Includes bibliographical references (p. 113-121).

Thesis (M.S.)--University of North Texas, Dec., 2007. / Title from title page display. Includes bibliographical references.

Thesis (M.A. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, March 2007. / Thesis Advisor(s): Robert Bach "March 2007." Includes bibliographical references (p. 67-68).