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Trichloroethylene is a chlorinated solvent widely used as a degreasing agent in industrial and manufacturing settings. It is also used as a chemical intermediate in making other chemicals and is a component of products such as typewriter correction fluid, paint removers, adhesives, and spot removers. In 2001, EPA issued a draft health risk assessment and proposed exposure standards for trichloroethylene. PA's Scientific Advisory Board (SAB) reviewed the draft and it was issued for public comment. A number of scientific issues were raised during the course of these reviews. Assessing the Human Health Risks of Trichloroethylene identifies and assesses the key scientific issues relevant to analyzing the human health risks of trichloroethylene, considering pertinent toxicologic, epidemiologic, population susceptibility, and other available information, including relevant published scientific literature, EPA's 2001 draft health risk assessment of trichloroethylene, scientific and technical comments received by EPA from public and private sources, and additional relevant information to be provided by the sponsoring agencies. This report highlights issues critical to the development of an objective, realistic, and scientifically balanced trichloroethylene health risk assessment. Guidance for hazard characterization of trichloroethylene is presented in Chapters 2 through 10. Chapter 2 provides guidance for evaluating large sets of epidemiologic data. In Chapter 3, the committee applies this guidance as an example in its evaluation of the epidemiologic data on trichloroethylene and kidney cancer, and this example should help guide evaluations of other cancer risks. Chapter 3 also assesses new information on the kidney toxicity of trichloroethylene and its metabolites and potential modes of action. Chapters 4, 5, 6, 7, and 8 evaluate the key issues regarding liver toxicity and cancer, reproductive and developmental toxicity, neurotoxicity, respiratory tract toxicity and cancer, and immunotoxicity, respectively. However, the committee's review focused on mode-of-action information to understand how trichloroethylene might affect certain processes differently in different species. Chapter 9 discusses susceptibility to trichloroethylene and its metabolites, and Chapter 10 describes important factors in considering trichloroethylene in mixtures. Physiologically based pharmacokinetic models are evaluated in Chapter 11, and guidance is provided on future directions for model development. Finally, Chapter 12 considers issues related to dose-response assessment and quantitative assessment of risk.
This One-Of-A-Kind Text Is A Comprehensive Examination Of Special Populations In The U.S. Healthcare System. Critical Topics Related To The Health Of The Public Including Vulnerable Populations, Continuum Of Care, Paying For Healthcare, Access To Care, And Quality Of Care Are Thoroughly Explored In 10 Detailed Chapters. The Text Explores The Following Topics: •Identifying The Vulnerable •Comparing Vulnerable Groups •Why Are Some More Vulnerable Than Others? •Seeking An Effective Care Continuum •Paying For Health Care •Accessing Health Care •Evaluating The Cost Of Care •Monitoring The Quality Of Care •Studying Vulnerable Populations •Where Do We Go From Here?
Counseling Special Populations in Schools provides school-based mental health professionals with practical, specific strategies for counseling special populations of students who are at risk for academic, social, emotional, and behavioral problems in school. These special populations include students who are homeless, living in foster care, involved with the juvenile justice system, LGBTQ, pregnant or parenting, gifted, in military families, at-risk for school failure and dropout, and impacted by incarcerated parents. Each chapter focuses on one group of students, highlighting critical background information and providing evidence-informed counseling approaches and strategies to promote resilience and support student development. Chapters provide specific information about how to use basic counseling skills, as well as more advanced counseling techniques such as Solution-Focused Brief Therapy, Cognitive Behavioral Therapy, and Motivational Interviewing, to address the needs and challenges of these special populations of students. This advanced-level counseling book is an excellent resource for mental health professionals and graduate students who want to be able to provide effective counseling services for all students.
In this congressionally mandated study, an expert committee of the Institute of Medicine takes a close look at where treatment for people with alcohol problems seems to be headed, and provides its best advice on how to get there. Careful consideration is given to how the creative growth of treatment can best be encouraged while keeping costs within reasonable limits. Particular attention is devoted to the importance of developing therapeutic approaches that are sensitive to the special needs of the many diverse groups represented among those who have developed problems related to their use of "man's oldest friend and oldest enemy." This book is the most comprehensive examination of alcohol treatment to date.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. This updated 2nd Edition of Williamson’s highly applied Exercise for Special Populations provides just enough background for practicing and future personal trainers, exercise physiologists, and other health and fitness professionals to develop and implement exercise programs for special populations. For each condition, the book provides a general description, anatomy and physiology variances, precautions, recommendations for exercise testing and prescription, instructions and images of various exercises, and nutritional considerations. Reflecting the latest best practices in the field, the 2nd Edition features new chapters and pedagogy and a powerful suite of online resources.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Pain is both a symptom and a disease. It manifests in multiple forms and its treatment is complex. Physical, social, economic, and emotional consequences of pain can impair an individual's overall health, well-being, productivity, and relationships in myriad ways. The impact of pain at a population level is vast and, while estimates differ, the Centers for Disease Control and Prevention reported that 50 million U.S. adults are living in pain. In terms of pain's global impact, estimates suggest the problem affects approximately 1 in 5 adults across the world, with nearly 1 in 10 adults newly diagnosed with chronic pain each year. In recent years, the issues surrounding the complexity of pain management have contributed to increased demand for alternative strategies for treating pain. One such strategy is to expand use of topical pain medicationsâ€"medications applied to intact skin. This nonoral route of administration for pain medication has the potential benefit, in theory, of local activity and fewer systemic side effects. Compounding is an age-old pharmaceutical practice of combining, mixing, or adjusting ingredients to create a tailored medication to meet the needs of a patient. The aim of compounding, historically, has been to provide patients with access to therapeutic alternatives that are safe and effective, especially for people with clinical needs that cannot otherwise be met by commercially available FDA-approved drugs. Compounded Topical Pain Creams explores issues regarding the safety and effectiveness of the ingredients in these pain creams. This report analyzes the available scientific data relating to the ingredients used in compounded topical pain creams and offers recommendations regarding the treatment of patients.
The National Strength and Conditioning Association (NSCA) has long been at the forefront of aiding aspiring and established exercise professionals in working with clients from special populations, such as children, aging adults, and clients with temporary or permanent physical or cognitive conditions and disorders. Clients with special conditions often require modifications to general exercise recommendations, specific exercise facility design, and particular training equipment. They may also require exercise programming supervised by exercise professionals with specialized training. NSCA's Essentials of Training Special Populations will help exercise professionals design customized programs for clients with unique considerations. It is an ideal preparatory resource for those seeking to become an NSCA Certified Special Population Specialist (CSPS) as well as professionals who work in collaboration with health care professionals to assess, educate, and train special population clients of all ages regarding their health and fitness needs. Editor Patrick L. Jacobs, who has extensive experience as both a practitioner and scholar, and a team of qualified contributors provide evidence-based information and recommendations on particular training protocols for a breadth of conditions, including musculoskeletal conditions, cardiovascular conditions, immunologic disorders, and cancer. The book discusses the benefits of exercise for clients with special conditions and the exercise-related challenges they often face, as well as the importance of safe and effective health and fitness assessments for these clients. With an emphasis on published research, NSCA's Essentials of Training Special Populations reviews the pathology and pathophysiology of numerous conditions and disorders, including the known effects of exercise on those conditions and disorders. Each chapter includes tables that provide exercise recommendations for specific conditions, complete with training modifications, precautions, and contraindications. Also included are case studies with practical examples of the application of these population-specific recommendations, as well as a summary of the commonly prescribed medications and their potential effects on exercise responses and adaptations. NSCA's Essentials of Training Special Populations includes a number of learning aids designed to assist the reader. Chapter objectives appear at the beginning of each chapter, study questions are at the end of each chapter, key points in easy-to-find boxes summarize important concepts for the reader, and key terms are identified and defined throughout the text. Recommended readings are also provided for readers wishing to learn more about a topic in general or specifically in preparation for the CSPS exam. For instructors using NSCA's Essentials of Training Special Populations in a higher education course or for a training symposium, ancillary materials are available to make class preparation easy. The materials are designed to complement the content and assist in its instruction. The ancillaries consist of an instructor's guide, test package, and presentation package plus image bank.