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Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide

Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide
Author: Agency for Health Care Research and Quality (U.S.)
Publisher: Government Printing Office
Total Pages: 204
Release: 2013-02-21
Genre: Medical
ISBN: 1587634236

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This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)


Personal Exposures

Personal Exposures
Author: Elliott Erwitt
Publisher: National Geographic Books
Total Pages: 0
Release: 2012-06-19
Genre: Photography
ISBN: 0393026167

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Elliott Erwitt’s eye for humor catches at the same time the subtle hint of tragedy. Seeing what few others see, and capturing it for all of us, is the essence of Personal Exposures. For this volume Elliott painstakingly culled the work of a lifetime, rediscovering prints he had not seen in years and creating a unified whole that reflects a consistent, mature vision of photography and humanity. Here are men, women, and children in off-guard moments; old people; little girls hamming it up; and even various dogs, who have their own preoccupations. The pictures reflect a lifetime of humorous, ironic observation and sensitivity to the human condition.


Clinical Environmental Health and Toxic Exposures

Clinical Environmental Health and Toxic Exposures
Author: John Burke Sullivan
Publisher: Lippincott Williams & Wilkins
Total Pages: 1348
Release: 2001
Genre: Medical
ISBN: 9780683080278

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Now in its revised and updated Second Edition, this volume is the most comprehensive and authoritative text in the rapidly evolving field of environmental toxicology. The book provides the objective information that health professionals need to prevent environmental health problems, plan for emergencies, and evaluate toxic exposures in patients.Coverage includes safety, regulatory, and legal issues; clinical toxicology of specific organ systems; emergency medical response to hazardous materials releases; and hazards of specific industries and locations. Nearly half of the book examines all known toxins and environmental health hazards. A Brandon-Hill recommended title.


Exposure Science in the 21st Century

Exposure Science in the 21st Century
Author: National Research Council
Publisher: National Academies Press
Total Pages: 210
Release: 2012-10-28
Genre: Nature
ISBN: 0309264685

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From the use of personal products to our consumption of food, water, and air, people are exposed to a wide array of agents each day-many with the potential to affect health. Exposure Science in the 21st Century: A Vision and A Strategy investigates the contact of humans or other organisms with those agents (that is, chemical, physical, and biologic stressors) and their fate in living systems. The concept of exposure science has been instrumental in helping us understand how stressors affect human and ecosystem health, and in efforts to prevent or reduce contact with harmful stressors. In this way exposure science has played an integral role in many areas of environmental health, and can help meet growing needs in environmental regulation, urban and ecosystem planning, and disaster management. Exposure Science in the 21st Century: A Vision and A Strategy explains that there are increasing demands for exposure science information, for example to meet needs for data on the thousands of chemicals introduced into the market each year, and to better understand the health effects of prolonged low-level exposure to stressors. Recent advances in tools and technologies-including sensor systems, analytic methods, molecular technologies, computational tools, and bioinformatics-have provided the potential for more accurate and comprehensive exposure science data than ever before. This report also provides a roadmap to take advantage of the technologic innovations and strategic collaborations to move exposure science into the future.


Exposure Assessment in Environmental Epidemiology

Exposure Assessment in Environmental Epidemiology
Author: Mark J. Nieuwenhuijsen
Publisher: Oxford University Press, USA
Total Pages: 417
Release: 2015
Genre: Medical
ISBN: 0199378789

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Preceded by Exposure assessment in occupational and environmental epidemiology / edited by Mark J. Nieuwenhuijsen. 1st ed. 2003.


Air Pollution, the Automobile, and Public Health

Air Pollution, the Automobile, and Public Health
Author: Sponsored by The Health Effects Institute
Publisher: National Academies Press
Total Pages: 703
Release: 1988-01-01
Genre: Science
ISBN: 0309037263

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"The combination of scientific and institutional integrity represented by this book is unusual. It should be a model for future endeavors to help quantify environmental risk as a basis for good decisionmaking." â€"William D. Ruckelshaus, from the foreword. This volume, prepared under the auspices of the Health Effects Institute, an independent research organization created and funded jointly by the Environmental Protection Agency and the automobile industry, brings together experts on atmospheric exposure and on the biological effects of toxic substances to examine what is knownâ€"and not knownâ€"about the human health risks of automotive emissions.


Exposure Analysis

Exposure Analysis
Author: Wayne R. Ott
Publisher: CRC Press
Total Pages: 554
Release: 2006-10-26
Genre: Medical
ISBN: 1420012630

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Written by experts, Exposure Analysis is the first complete resource in the emerging scientific discipline of exposure analysis. A comprehensive source on the environmental pollutants that affect human health, the book discusses human exposure through pathways including air, food, water, dermal absorption, and, for children, non-food ingesti


Strategies to Protect the Health of Deployed U.S. Forces

Strategies to Protect the Health of Deployed U.S. Forces
Author: National Research Council
Publisher: National Academies Press
Total Pages: 273
Release: 2000-04-21
Genre: Medical
ISBN: 0309068754

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Since Operation Desert Shield/Desert Storm, Gulf War veterans have expressed concerns about health effects that could be associated with their deployment and service during the war. Although similar concerns were raised after other military operations, the Gulf War deployment focused national attention on the potential, but uncertain, relationship between the presence of chemical and biological (CB) agents and other harmful agents in theater and health symptoms reported by military personnel. Strategies to Protect the Health of Deployed U.S. Forces which is one of the four two-year studies, examines the detection and tracking of exposures of deployed personnel to multiple harmful agents.


Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure

Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure
Author: National Research Council
Publisher: National Academies Press
Total Pages: 199
Release: 2013-04-20
Genre: Medical
ISBN: 0309267366

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Lead is a ubiquitous metal in the environment, and its adverse effects on human health are well documented. Lead interacts at multiple cellular sites and can alter protein function in part through binding to amino acid sulfhydryl and carboxyl groups on a wide variety of structural and functional proteins. In addition, lead mimics calcium and other divalent cations, and it induces the increased production of cytotoxic reactive oxygen species. Adverse effects associated with lead exposure can be observed in multiple body systems, including the nervous, cardiovascular, renal, hematologic, immunologic, and reproductive systems. Lead exposure is also known to induce adverse developmental effects in utero and in the developing neonate. Lead poses an occupational health hazard, and the Occupational Safety and Health Administration (OSHA) developed a lead standard for general industry that regulates many workplace exposures to this metal. The standard was promulgated in 1978 and encompasses several approaches for reducing exposure to lead, including the establishment of a permissible exposure limit (PEL) of 50 μg/m3 in air (an 8-hour time-weighted average [TWA]), exposure guidelines for instituting medical surveillance, guidelines for removal from and return to work, and other risk-management strategies. An action level of 30 μg/m3 (an 8-hour TWA) for lead was established to trigger medical surveillance in employees exposed above that level for more than 30 days per year. Another provision is that any employee who has a blood lead level (BLL) of 60 μg/dL or higher or three consecutive BLLs averaging 50 μg/dL or higher must be removed from work involving lead exposure. An employee may resume work associated with lead exposure only after two BLLs are lower than 40 μg/dL. Thus, maintaining BLLs lower than 40 μg/dL was judged by OSHA to protect workers from adverse health effects. The OSHA standard also includes a recommendation that BLLs of workers who are planning a pregnancy be under 30μg/dL. In light of knowledge about the hazards posed by occupational lead exposure, the Department of Defense (DOD) asked the National Research Council to evaluate potential health risks from recurrent lead exposure of firing-range personnel. Specifically, DOD asked the National Research Council to determine whether current exposure standards for lead on DOD firing ranges protect its workers adequately.The committee also considered measures of cumulative lead dose. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure will help to inform decisions about setting new air exposure limits for lead on firing ranges, about whether to implement limits for surface contamination, and about how to design lead-surveillance programs for range personnel appropriately.