Sample records for acceptable risk criteria

  1. Development of quantitative risk acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Griesmeyer, J. M.; Okrent, D.

    Some of the major considerations for effective management of risk are discussed, with particular emphasis on risks due to nuclear power plant operations. Although there are impacts associated with the rest of the fuel cycle, they are not addressed here. Several previously published proposals for quantitative risk criteria are reviewed. They range from a simple acceptance criterion on individual risk of death to a quantitative risk management framework. The final section discussed some of the problems in the establishment of a framework for the quantitative management of risk.

  2. Safety analysis, risk assessment, and risk acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jamali, K.; Stack, D.W.; Sullivan, L.H.

    1997-08-01

    This paper discusses a number of topics that relate safety analysis as documented in the Department of Energy (DOE) safety analysis reports (SARs), probabilistic risk assessments (PRA) as characterized primarily in the context of the techniques that have assumed some level of formality in commercial nuclear power plant applications, and risk acceptance criteria as an outgrowth of PRA applications. DOE SARs of interest are those that are prepared for DOE facilities under DOE Order 5480.23 and the implementing guidance in DOE STD-3009-94. It must be noted that the primary area of application for DOE STD-3009 is existing DOE facilities andmore » that certain modifications of the STD-3009 approach are necessary in SARs for new facilities. Moreover, it is the hazard analysis (HA) and accident analysis (AA) portions of these SARs that are relevant to the present discussions. Although PRAs can be qualitative in nature, PRA as used in this paper refers more generally to all quantitative risk assessments and their underlying methods. HA as used in this paper refers more generally to all qualitative risk assessments and their underlying methods that have been in use in hazardous facilities other than nuclear power plants. This discussion includes both quantitative and qualitative risk assessment methods. PRA has been used, improved, developed, and refined since the Reactor Safety Study (WASH-1400) was published in 1975 by the Nuclear Regulatory Commission (NRC). Much debate has ensued since WASH-1400 on exactly what the role of PRA should be in plant design, reactor licensing, `ensuring` plant and process safety, and a large number of other decisions that must be made for potentially hazardous activities. Of particular interest in this area is whether the risks quantified using PRA should be compared with numerical risk acceptance criteria (RACs) to determine whether a facility is `safe.` Use of RACs requires quantitative estimates of consequence frequency and magnitude.« less

  3. Periodic benefit-risk assessment using Bayesian stochastic multi-criteria acceptability analysis

    PubMed Central

    Li, Kan; Yuan, Shuai Sammy; Wang, William; Wan, Shuyan Sabrina; Ceesay, Paulette; Heyse, Joseph F.; Mt-Isa, Shahrul; Luo, Sheng

    2018-01-01

    Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle. In this paper, we propose a general statistical framework for periodic benefit-risk assessment, in which Bayesian meta-analysis and stochastic multi-criteria acceptability analysis (SMAA) will be combined to synthesize the accumulating evidence. The proposed approach allows us to compare the acceptability of different drugs dynamically and effectively and accounts for the uncertainty of clinical measurements and imprecise or incomplete preference information of decision makers. We apply our approaches to two real examples in a post-hoc way for illustration purpose. The proposed method may easily be modified for other pre and post market settings, and thus be an important complement to the current structured benefit-risk assessment (sBRA) framework to improve the transparent and consistency of the decision-making process. PMID:29505866

  4. Periodic benefit-risk assessment using Bayesian stochastic multi-criteria acceptability analysis.

    PubMed

    Li, Kan; Yuan, Shuai Sammy; Wang, William; Wan, Shuyan Sabrina; Ceesay, Paulette; Heyse, Joseph F; Mt-Isa, Shahrul; Luo, Sheng

    2018-04-01

    Benefit-risk (BR) assessment is essential to ensure the best decisions are made for a medical product in the clinical development process, regulatory marketing authorization, post-market surveillance, and coverage and reimbursement decisions. One challenge of BR assessment in practice is that the benefit and risk profile may keep evolving while new evidence is accumulating. Regulators and the International Conference on Harmonization (ICH) recommend performing periodic benefit-risk evaluation report (PBRER) through the product's lifecycle. In this paper, we propose a general statistical framework for periodic benefit-risk assessment, in which Bayesian meta-analysis and stochastic multi-criteria acceptability analysis (SMAA) will be combined to synthesize the accumulating evidence. The proposed approach allows us to compare the acceptability of different drugs dynamically and effectively and accounts for the uncertainty of clinical measurements and imprecise or incomplete preference information of decision makers. We apply our approaches to two real examples in a post-hoc way for illustration purpose. The proposed method may easily be modified for other pre and post market settings, and thus be an important complement to the current structured benefit-risk assessment (sBRA) framework to improve the transparent and consistency of the decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION, NEVADA SITE OFFICE

    This document establishes the U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal. Mixed waste generated within the State of Nevada by NNSA/NSO activities is accepted for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Site for storage or disposal.

  6. Hanford Site Solid Waste Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1993-11-17

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities.

  7. Nevada Test Site Waste Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  8. Acceptance criteria for urban dispersion model evaluation

    NASA Astrophysics Data System (ADS)

    Hanna, Steven; Chang, Joseph

    2012-05-01

    The authors suggested acceptance criteria for rural dispersion models' performance measures in this journal in 2004. The current paper suggests modified values of acceptance criteria for urban applications and tests them with tracer data from four urban field experiments. For the arc-maximum concentrations, the fractional bias should have a magnitude <0.67 (i.e., the relative mean bias is less than a factor of 2); the normalized mean-square error should be <6 (i.e., the random scatter is less than about 2.4 times the mean); and the fraction of predictions that are within a factor of two of the observations (FAC2) should be >0.3. For all data paired in space, for which a threshold concentration must always be defined, the normalized absolute difference should be <0.50, when the threshold is three times the instrument's limit of quantification (LOQ). An overall criterion is then applied that the total set of acceptance criteria should be satisfied in at least half of the field experiments. These acceptance criteria are applied to evaluations of the US Department of Defense's Joint Effects Model (JEM) with tracer data from US urban field experiments in Salt Lake City (U2000), Oklahoma City (JU2003), and Manhattan (MSG05 and MID05). JEM includes the SCIPUFF dispersion model with the urban canopy option and the urban dispersion model (UDM) option. In each set of evaluations, three or four likely options are tested for meteorological inputs (e.g., a local building top wind speed, the closest National Weather Service airport observations, or outputs from numerical weather prediction models). It is found that, due to large natural variability in the urban data, there is not a large difference between the performance measures for the two model options and the three or four meteorological input options. The more detailed UDM and the state-of-the-art numerical weather models do provide a slight improvement over the other options. The proposed urban dispersion model acceptance

  9. Nevada Test Site Waste Acceptance Criteria (NTSWAC)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NNSA /NSO Waste Management Project

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive (LLW) and LLW Mixed Waste (MW) for disposal.

  10. Acceptance Criteria Framework for Autonomous Biological Detectors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dzenitis, J M

    2006-12-12

    The purpose of this study was to examine a set of user acceptance criteria for autonomous biological detection systems for application in high-traffic, public facilities. The test case for the acceptance criteria was the Autonomous Pathogen Detection System (APDS) operating in high-traffic facilities in New York City (NYC). However, the acceptance criteria were designed to be generally applicable to other biological detection systems in other locations. For such detection systems, ''users'' will include local authorities (e.g., facility operators, public health officials, and law enforcement personnel) and national authorities [including personnel from the Department of Homeland Security (DHS), the BioWatch Program,more » the Centers for Disease Control and Prevention (CDC), and the Federal Bureau of Investigation (FBI)]. The panel members brought expertise from a broad range of backgrounds to complete this picture. The goals of this document are: (1) To serve as informal guidance for users in considering the benefits and costs of these systems. (2) To serve as informal guidance for developers in understanding the needs of users. In follow-up work, this framework will be used to systematically document the APDS for appropriateness and readiness for use in NYC.« less

  11. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA, JUNE 2006

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION NEVADA SITE OFFICE

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  12. 77 FR 51880 - Requirements for Maintenance of Inspections, Tests, Analyses, and Acceptance Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Maintenance of Inspections, Tests, Analyses, and Acceptance Criteria AGENCY: Nuclear Regulatory Commission... construction activities through inspections, tests, analyses, and acceptance criteria (ITAAC) under a combined... inspections, tests, or analyses were performed as required, or that acceptance criteria are met, and to notify...

  13. Acceptability of Health Care-Related Risks: A Literature Review.

    PubMed

    Quintard, Bruno; Roberts, Tamara; Nitaro, Léa; Quenon, Jean-Luc; Michel, Philippe

    2016-03-01

    Risk management aims at reducing risks associated with hospital care to an acceptable level, both in their frequency and their impact on health. The social acceptability of risk on the part of the general population and of the health-care professionals, faced with regular information about adverse events, is undoubtedly evolving rapidly.In contrast to risk acceptability, the concept of risk perception is of limited interest to risk managers because it does not inform on the behaviors and actions resulting from these perceptions. The aim of this work was to define the concept of social acceptability of risk through an in-depth examination of a wide-ranging and multidisciplinary literature. A 1990-2010 English and French literature review was carried out in medical, epidemiological, and human and social sciences online databases, gray literature, and books. Of the 5931 references retrieved, 203 met the inclusion criteria. We identified contributions from 5 major research fields: economic, sociocognitive, psychometric, sociological/anthropological, and interactionist. When assessing risks, individuals use a variety of psychological and social processes that include their perception not only of a given risk but also of their own personal and social resources. This global perception has a direct impact on the responses and actual behavior of individuals and groups, enabling them to cope with the risk and/or manage it. Social acceptability includes perceptions related to risks and the stated intentions of individual behavior. This concept may therefore be relevant for defining local and national patient safety priorities.

  14. Common Risk Criteria for National Test Ranges

    DTIC Science & Technology

    2010-12-01

    AFSPCMAN 91 - 710 . See footnote on previous page. Common Risk Criteria Standards For National Test Ranges, RCC Standard 321-10, December 2010 2-10...choice of 1/ 3 is consistent with the recommendation in Air Force Space Command (AFSPC) Manual 91 - 710VI, 1 July 2004, which uses 30×10 -6 as the...acceptability criterion for casualty expectation. In the range between 10 and 30×10 -6 (equivalent to one third of the risk criterion), AFSPCMAN 91 -710V1

  15. 46 CFR 28.275 - Acceptance criteria for instructors and course curricula.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Acceptance criteria for instructors and course curricula... the Aleutian Trade § 28.275 Acceptance criteria for instructors and course curricula. (a) A Fishing Vessel Safety Instructor shall submit a detailed course curriculum that relates directly to the...

  16. 46 CFR 28.275 - Acceptance criteria for instructors and course curricula.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Acceptance criteria for instructors and course curricula... the Aleutian Trade § 28.275 Acceptance criteria for instructors and course curricula. (a) A Fishing Vessel Safety Instructor shall submit a detailed course curriculum that relates directly to the...

  17. Steam generator tube integrity flaw acceptance criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cochet, B.

    1997-02-01

    The author discusses the establishment of a flaw acceptance criteria with respect to flaws in steam generator tubing. The problem is complicated because different countries take different approaches to the problem. The objectives in general are grouped in three broad areas: to avoid the unscheduled shutdown of the reactor during normal operation; to avoid tube bursts; to avoid excessive leak rates in the event of an accidental overpressure event. For each degradation mechanism in the tubes it is necessary to know answers to an array of questions, including: how well does NDT testing perform against this problem; how rapidly doesmore » such degradation develop; how well is this degradation mechanism understood. Based on the above information it is then possible to come up with a policy to look at flaw acceptance. Part of this criteria is a schedule for the frequency of in-service inspection and also a policy for when to plug flawed tubes. The author goes into a broad discussion of each of these points in his paper.« less

  18. Approaches to acceptable risk

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Whipple, C

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, inmore » a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.« less

  19. 78 FR 38411 - Vogtle Electric Generating Plant, Unit 4; Inspections, Tests, Analyses, and Acceptance Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... Plant, Unit 4; Inspections, Tests, Analyses, and Acceptance Criteria AGENCY: Nuclear Regulatory Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  20. Reinforced concrete pipe cracks : acceptance criteria [revised July 29, 2011].

    DOT National Transportation Integrated Search

    2011-07-01

    Inspection of recently placed reinforced concrete pipes often reveals cracks. Florida DOT was in : need of in-place crack acceptance criteria. This project was intended to determine the influential parameters : responsible for crack healing in in-pla...

  1. A new approach to criteria for health risk assessment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au; Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia; Katscherian, Dianne

    2012-01-15

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component alsomore » identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.« less

  2. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective...

  3. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  4. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

  5. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

  6. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  7. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

  8. Preliminary operational requirements and acceptability criteria for the cooperative breath analyzer

    DOT National Transportation Integrated Search

    1971-09-01

    This report presents a series of criteria and requirements relevant to establishing user acceptability for the cooperative alcohol analyzer being developed by the Transportation Systems Center. The information presented herein was obtained with the c...

  9. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  10. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  11. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and material...

  12. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  13. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  14. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  15. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  16. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Weld toughness test acceptance criteria. 54.05-17 Section 54.05-17 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING... impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in weld...

  17. Risk assessment in ginecology and obstetrics in Sicily: an approach based on Wolff's Criteria.

    PubMed

    Matranga, D; Marsala, M G L; Vadalà, M; Morici, M; Restivo, V; Ferrara, C; Vitale, F; Firenze, A

    2013-01-01

    To apply Wolff's Criteria to hospital discharge records (HDR) in order to detect adverse events worthy of further study. Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed, by random selection of 10 controls at maximum for each case. Matching was performed on the variables age and speciality of admission (gynecology or obstetrics). Out of a total of 7011 HDR examined, 114 cases were identified with Wolff's Criteria. Multivariate analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance and length of stay: there was a decreased risk of Wolff's event in patients having urgent admission compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR = 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI = [12.56-42.7]) compared to less or equal than 3 days Wolff's Criteria can be applied for the analysis of clinical risk in hospitals with different structural characteristics, on condition that the HDR database is complete and good quality.

  18. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems required...

  19. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems required...

  20. Corrosion control acceptance criteria for sacrificial anode type, cathodic protection systems (user guide)

    NASA Astrophysics Data System (ADS)

    Hock, Vincent F.; Noble, Michael; McLeod, Malcolm E.

    1994-07-01

    The Army currently operates and maintains more than 20,000 underground storage tanks and over 3000 miles of underground gas pipelines, all of which require some form of corrosion control. Cathodic protection is one method of corrosion control used to prevent corrosion-induced leaks when a steel structure is exposed to an aggressive soil. The corrosion control acceptance criteria for sacrificial anode type CP systems provides guidelines for the DEH/DPW cathodic protection installation inspectors whose responsibilities are to ensure that the materials and equipment specified are delivered to the job site and subsequently installed in accordance with the engineering drawings and specifications. The sacrificial anode CP acceptance criteria includes all components for the sacrificial anode system such as insulated conductors, anodes, anode backfills, and auxiliary equipment. The sacrificial anode CP acceptance criteria is composed of a checklist that lists each component and that contains a space for the inspector to either check 'yes' or 'no' to indicate whether the component complies with the job specifications. In some cases, the inspector must measure and record physical dimensions or electrical output and compare the measurements to standards shown in attached tables.

  1. Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey.

    PubMed

    Mataix-Cols, D; Fernández de la Cruz, L; Nakao, T; Pertusa, A

    2011-12-01

    The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested. Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual. Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80-90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did. The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

  2. Criteria required for an acceptable point-of-care test for UTI detection: Obtaining consensus using the Delphi technique.

    PubMed

    Weir, Nichola-Jane M; Pattison, Sally H; Kearney, Paddy; Stafford, Bob; Gormley, Gerard J; Crockard, Martin A; Gilpin, Deirdre F; Tunney, Michael M; Hughes, Carmel M

    2018-01-01

    Urinary Tract Infections (UTIs) are common bacterial infections, second only to respiratory tract infections and particularly prevalent within primary care. Conventional detection of UTIs is culture, however, return of results can take between 24 and 72 hours. The introduction of a point of care (POC) test would allow for more timely identification of UTIs, facilitating improved, targeted treatment. This study aimed to obtain consensus on the criteria required for a POC UTI test, to meet patient need within primary care. Criteria for consideration were compiled by the research team. These criteria were validated through a two-round Delphi process, utilising an expert panel of healthcare professionals from across Europe and United States of America. Using web-based questionnaires, panellists recorded their level of agreement with each criterion based on a 5-point Likert Scale, with space for comments. Using median response, interquartile range and comments provided, criteria were accepted/rejected/revised depending on pre-agreed cut-off scores. The first round questionnaire presented thirty-three criteria to the panel, of which 22 were accepted. Consensus was not achieved for the remaining 11 criteria. Following response review, one criterion was removed, while after revision, the remaining 10 criteria entered the second round. Of these, four were subsequently accepted, resulting in 26 criteria considered appropriate for a POC test to detect urinary infections. This study generated an approved set of criteria for a POC test to detect urinary infections. Criteria acceptance and comments provided by the healthcare professionals also supports the development of a multiplex point of care UTI test.

  3. How to pass a sensor acceptance test: using the gap between acceptance criteria and operational performance

    NASA Astrophysics Data System (ADS)

    Bijl, Piet

    2016-10-01

    When acquiring a new imaging system and operational task performance is a critical factor for success, it is necessary to specify minimum acceptance requirements that need to be met using a sensor performance model and/or performance tests. Currently, there exist a variety of models and test from different origin (defense, security, road safety, optometry) and they all do different predictions. This study reviews a number of frequently used methods and shows the effects that small changes in procedure or threshold criteria can have on the outcome of a test. For example, a system may meet the acceptance requirements but not satisfy the needs for the operational task, or the choice of test may determine the rank order of candidate sensors. The goal of the paper is to make people aware of the pitfalls associated with the acquisition process, by i) illustrating potential tricks to have a system accepted that is actually not suited for the operational task, and ii) providing tips to avoid this unwanted situation.

  4. Sample acceptance time criteria, electronic issue and alloimmunisation in thalassaemia.

    PubMed

    Trompeter, S; Baxter, L; McBrearty, M; Zatkya, E; Porter, J

    2015-12-01

    To determine the safety of a 1-week acceptance criteria of sample receipt in laboratory to transfusion commencement in transfusion dependent thalassaemia with respect to alloimmunisation. To determine the safety of electronic issue of blood components in such a setting. Retrospective audit of alloimmunisation (1999-2012) and blood exposure in registered thalassaemia patients at a central London thalassaemia centre where the acceptance criteria for the group and save sample from arrival in the laboratory to the time of issue of blood for transfusion for someone who has been transfused in the last 28 days was 1 week, and there was electronic issue protocol for patients who have always had a negative antibody screen (other than temporary positivity in pregnant women receiving prophylactic anti-D or anti Le-a, Anti Le-b and Anti P1 that are no longer detectable). There were 133 patients with thalassemia variants regularly attending UCLH for review. A total of 105 patients had transfusion dependent thalassaemia (TDT) (7 E-beta thalassaemia, 98 beta thalassaemia major). Ten of the 84 patients who received their transfusions at UCLH were alloimmunised. Seven of them had been alloimmunised prior to arrival at UCLH. Only two patients developed antibodies at UCLH during this period. The prevalence of alloantibody formation of 2% in UCLH transfused patients, with presumptive incidence of 0.01 alloantibodies per 100 units or 0·001 immunisations per person per year compares favourably with other reported series and suggests that 1 week interval with appropriate electronic issue is acceptable practice. © 2015 British Blood Transfusion Society.

  5. Criteria required for an acceptable point-of-care test for UTI detection: Obtaining consensus using the Delphi technique

    PubMed Central

    Kearney, Paddy; Stafford, Bob; Gormley, Gerard J.; Crockard, Martin A.; Gilpin, Deirdre F.

    2018-01-01

    Background Urinary Tract Infections (UTIs) are common bacterial infections, second only to respiratory tract infections and particularly prevalent within primary care. Conventional detection of UTIs is culture, however, return of results can take between 24 and 72 hours. The introduction of a point of care (POC) test would allow for more timely identification of UTIs, facilitating improved, targeted treatment. This study aimed to obtain consensus on the criteria required for a POC UTI test, to meet patient need within primary care. Methods Criteria for consideration were compiled by the research team. These criteria were validated through a two-round Delphi process, utilising an expert panel of healthcare professionals from across Europe and United States of America. Using web-based questionnaires, panellists recorded their level of agreement with each criterion based on a 5-point Likert Scale, with space for comments. Using median response, interquartile range and comments provided, criteria were accepted/rejected/revised depending on pre-agreed cut-off scores. Results The first round questionnaire presented thirty-three criteria to the panel, of which 22 were accepted. Consensus was not achieved for the remaining 11 criteria. Following response review, one criterion was removed, while after revision, the remaining 10 criteria entered the second round. Of these, four were subsequently accepted, resulting in 26 criteria considered appropriate for a POC test to detect urinary infections. Conclusion This study generated an approved set of criteria for a POC test to detect urinary infections. Criteria acceptance and comments provided by the healthcare professionals also supports the development of a multiplex point of care UTI test. PMID:29879161

  6. Definition of acceptance criteria for the ITER divertor plasma-facing components through systematic experimental analysis

    NASA Astrophysics Data System (ADS)

    Escourbiac, F.; Richou, M.; Guigon, R.; Constans, S.; Durocher, A.; Merola, M.; Schlosser, J.; Riccardi, B.; Grosman, A.

    2009-12-01

    Experience has shown that a critical part of the high-heat flux (HHF) plasma-facing component (PFC) is the armour to heat sink bond. An experimental study was performed in order to define acceptance criteria with regards to thermal hydraulics and fatigue performance of the International Thermonuclear Experimental Reactor (ITER) divertor PFCs. This study, which includes the manufacturing of samples with calibrated artificial defects relevant to the divertor design, is reported in this paper. In particular, it was concluded that defects detectable with non-destructive examination (NDE) techniques appeared to be acceptable during HHF experiments relevant to heat fluxes expected in the ITER divertor. On the basis of these results, a set of acceptance criteria was proposed and applied to the European vertical target medium-size qualification prototype: 98% of the inspected carbon fibre composite (CFC) monoblocks and 100% of tungsten (W) monoblock and flat tiles elements (i.e. 80% of the full units) were declared acceptable.

  7. 46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Non-standard components; acceptance criteria and procedures. 164.019-7 Section 164.019-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED...) Outer Envelope Fabric (exterior fabrics on wearable PFDs); (ii) Cover Fabric (for throwable PFDs); (iii...

  8. 46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Non-standard components; acceptance criteria and procedures. 164.019-7 Section 164.019-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED...) Outer Envelope Fabric (exterior fabrics on wearable PFDs); (ii) Cover Fabric (for throwable PFDs); (iii...

  9. Shoulder dystocia--malpractice or acceptable risk?

    PubMed

    Skolbekken, J A

    2000-09-01

    In 1988 a new patient insurance system was introduced in Norway. It was initially described as an 'objectified' system, similar to one based on the no-fault principle. Early doubts were raised about the system's status, as it contains rules stating that compensation will not be given if the medical intervention is adequate and the involved risk is acceptable. This study was undertaken to examine the practice of these rules. An archival study was performed on the 41 shoulder dystocia cases that had been closed in the decade from 1988-1997. These cases were selected as shoulder dystocia was found to be the obstetrical event most often leading to a decision on acceptable risk. The most common injury in these cases was Erb's palsy, but fatalities and brain injuries were also observed. Compensation was given in nine cases, whereas it was denied due to an acceptable medical risk in the remaining cases. Indications of inconsistency among the reached decisions were found, and judged to be a result of differences of opinion between expert witnesses on the adequacy of the obstetrical practice. Doubts are raised as to whether similar decisions are reached in similar cases. Shoulder dystocia may be an acceptable risk in the sense that it is hard to predict and prevent. Whether the consequences of such a risk should be compensated, remains a political and economical issue. Present thinking leads to decisions that create a divide between the lucky unlucky and the plainly unlucky.

  10. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  11. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  12. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  13. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  14. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a) A...

  15. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  16. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  17. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  18. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  19. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's cost...

  20. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

  1. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

  2. Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios

    PubMed Central

    Hongoh, Valerie; Campagna, Céline; Panic, Mirna; Samuel, Onil; Gosselin, Pierre; Waaub, Jean-Philippe; Ravel, André; Samoura, Karim; Michel, Pascal

    2016-01-01

    The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual

  3. Risk Acceptance Personality Paradigm: How We View What We Don't Know We Don't Know

    NASA Technical Reports Server (NTRS)

    Massie, Michael J.; Morris, A. Terry

    2011-01-01

    The purpose of integrated hazard analyses, probabilistic risk assessments, failure modes and effects analyses, fault trees and many other similar tools is to give managers of a program some idea of the risks associated with their program. All risk tools establish a set of undesired events and then try to evaluate the risk to the program by assessing the severity of the undesired event and the likelihood of that event occurring. Some tools provide qualitative results, some provide quantitative results and some do both. However, in the end the program manager and his/her team must decide which risks are acceptable and which are not. Even with a wide array of analysis tools available, risk acceptance is often a controversial and difficult decision making process. And yet, today's space exploration programs are moving toward more risk based design approaches. Thus, risk identification and good risk assessment is becoming even more vital to the engineering development process. This paper explores how known and unknown information influences risk-based decisions by looking at how the various parts of our personalities are affected by what they know and what they don't know. This paper then offers some criteria for consideration when making risk-based decisions.

  4. Acceptance Probability (P a) Analysis for Process Validation Lifecycle Stages.

    PubMed

    Alsmeyer, Daniel; Pazhayattil, Ajay; Chen, Shu; Munaretto, Francesco; Hye, Maksuda; Sanghvi, Pradeep

    2016-04-01

    This paper introduces an innovative statistical approach towards understanding how variation impacts the acceptance criteria of quality attributes. Because of more complex stage-wise acceptance criteria, traditional process capability measures are inadequate for general application in the pharmaceutical industry. The probability of acceptance concept provides a clear measure, derived from specific acceptance criteria for each quality attribute. In line with the 2011 FDA Guidance, this approach systematically evaluates data and scientifically establishes evidence that a process is capable of consistently delivering quality product. The probability of acceptance provides a direct and readily understandable indication of product risk. As with traditional capability indices, the acceptance probability approach assumes that underlying data distributions are normal. The computational solutions for dosage uniformity and dissolution acceptance criteria are readily applicable. For dosage uniformity, the expected AV range may be determined using the s lo and s hi values along with the worst case estimates of the mean. This approach permits a risk-based assessment of future batch performance of the critical quality attributes. The concept is also readily applicable to sterile/non sterile liquid dose products. Quality attributes such as deliverable volume and assay per spray have stage-wise acceptance that can be converted into an acceptance probability. Accepted statistical guidelines indicate processes with C pk > 1.33 as performing well within statistical control and those with C pk < 1.0 as "incapable" (1). A C pk > 1.33 is associated with a centered process that will statistically produce less than 63 defective units per million. This is equivalent to an acceptance probability of >99.99%.

  5. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  6. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  7. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  8. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results pursuant to...

  9. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

  10. Classifying Nanomaterial Risks Using Multi-Criteria Decision Analysis

    NASA Astrophysics Data System (ADS)

    Linkov, I.; Steevens, J.; Chappell, M.; Tervonen, T.; Figueira, J. R.; Merad, M.

    There is rapidly growing interest by regulatory agencies and stakeholders in the potential toxicity and other risks associated with nanomaterials throughout the different stages of the product life cycle (e.g., development, production, use and disposal). Risk assessment methods and tools developed and applied to chemical and biological material may not be readily adaptable for nanomaterials because of the current uncertainty in identifying the relevant physico-chemical and biological properties that adequately describe the materials. Such uncertainty is further driven by the substantial variations in the properties of the original material because of the variable manufacturing processes employed in nanomaterial production. To guide scientists and engineers in nanomaterial research and application as well as promote the safe use/handling of these materials, we propose a decision support system for classifying nanomaterials into different risk categories. The classification system is based on a set of performance metrics that measure both the toxicity and physico-chemical characteristics of the original materials, as well as the expected environmental impacts through the product life cycle. The stochastic multicriteria acceptability analysis (SMAA-TRI), a formal decision analysis method, was used as the foundation for this task. This method allowed us to cluster various nanomaterials in different risk categories based on our current knowledge of nanomaterial's physico-chemical characteristics, variation in produced material, and best professional judgement. SMAA-TRI uses Monte Carlo simulations to explore all feasible values for weights, criteria measurements, and other model parameters to assess the robustness of nanomaterial grouping for risk management purposes.1,2

  11. 78 FR 65007 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00026; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  12. 78 FR 53484 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 4

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00026; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria (ITAAC) completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  13. 78 FR 53483 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 052-00025; NRC-2008-0252] Inspections, Tests, Analyses... Commission. ACTION: Determination of inspections, tests, analyses, and acceptance criteria (ITAAC) completion. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) staff has determined that the inspections, tests...

  14. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... What controls and acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining...

  15. Parents' "Hard" Knowledge of Admission Criteria and Acceptance in Philadelphia's High School Choice Process

    ERIC Educational Resources Information Center

    Haxton, Clarisse L.; Neild, Ruth Curran

    2012-01-01

    We examine parents' knowledge of discrete, verifiable facts--what we call "hard knowledge"--in a high school application process. Using parent survey data (n = 658) from the School District of Philadelphia, this study examines whether parents knew the admission criteria and acceptance rate at the high school they most wanted their child…

  16. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  17. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  18. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  19. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION... acceptance criteria must I have for my finished PET drug products? (a) Specifications. You must establish specifications for each PET drug product, including criteria for determining identity, strength, quality, purity...

  20. Expanded criteria donor kidneys for younger recipients: acceptable outcomes.

    PubMed

    Goplani, K R; Kute, V B; Vanikar, A V; Shah, P R; Gumber, M R; Patel, H V; Modi, P R; Trivedi, H L

    2010-12-01

    European senior programme (ESP) is well known for acceptable outcomes using expanded criteria donor (ECD) kidneys from donors older than 65 years for recipients older than 65 years. The incidence of end-stage renal disease (ESRD) is 229/million in India with a mean age of 45 years. We performed a retrospective analysis of transplantation of ECD versus standard criteria donor (SCD) kidneys into younger recipients. Forty-three ECD transplantations among 158 deceased donor organ transplantation (DDOT) were performed between January 2006 and December 2009. Among 43 transplantation from 30 donors, 14 were dual kidney transplantations (DKT) performed based upon biopsy evaluation. All recipients received thymoglobulin (rATG) induction followed by immunosuppression with a steroid, mycophenolate mofetil (MMF), and a calcineurin inhibitor. Statistical analysis used chi-square test and unpaired Student t test. Kaplan-Meier curves were used for survival analysis. For ECD the mean donor age was 64 ± 11 years. Cerebrovascular accidents (CVA) were the cause of death among 60% of donors, 73.13% of whom were hypertensive and 23.13% diabetic. Mean DKT donor age was 75 ± 9.17 years versus 60 ± 8.0 years for single kidney transplantation (SKT). Mean recipient age of DKT versus SKT was 44 ± 12.4 years versus 43 ± 14 years. Mean serum creatinine (SCr; mg/dL) of SKT patients was 1.64 ± 0.75 versus 1.68 ± 0.46 in DKT. Mean follow-up was 455 ± 352 days. Mean SCr of 43 ECD recipients of mean age, 43.4 ± 14.2 years was 1.61 ± 0.61 mg/dL. Among 43 recipients, 23.25% were diabetic, 41.86% displayed delayed graft function (DGF), and 23.25% experienced biopsy-proven acute rejection (BPAR). Patient survival rate was 72.09% and graft survival rate was 67.44%. For SCD transplantations (n = 115), the mean donor age was 36 ± 14 years and recipient mean age was 32.8 ± 14.07 years. Mean SCr was 1.32 ± 0.46 mg/dL with 26.95% recipients displaying DGF, whereas 20.86% had BPAR. In the SCD

  1. 7 CFR 3052.525 - Criteria for Federal program risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ORGANIZATIONS Auditors § 3052.525 Criteria for Federal program risk. (a) General. The auditor's determination... to the Federal program. The auditor shall use auditor judgment and consider criteria, such as... part of the risk analysis, the auditor may wish to discuss a particular Federal program with auditee...

  2. La composition academique: les limites de l'acceptabilite (Composition for Academic Purposes: Criteria for Acceptability).

    ERIC Educational Resources Information Center

    Grenall, G. M.

    1981-01-01

    Examines the pedagogical approaches and problems attendant to the development of English writing programs for foreign students. Discusses the skills necessary to handle course work, such as essay tests, term papers and reports, theses and dissertations, and focuses particularly on diagnostic problems and acceptability criteria. Societe Nouvelle…

  3. II. Species sensitivity distributions based on biomarkers and whole organism responses for integrated impact and risk assessment criteria.

    PubMed

    Sanni, Steinar; Lyng, Emily; Pampanin, Daniela M; Smit, Mathijs G D

    2017-06-01

    The aim of this paper is to bridge gaps between biomarker and whole organism responses related to oil based offshore discharges. These biomarker bridges will facilitate acceptance criteria for biomarker data linked to environmental risk assessment and translate biomarker results to higher order effects. Biomarker based species sensitivity distributions (SSD biomarkers ) have been constructed for relevant groups of biomarkers based on laboratory data from oil exposures. SSD curves express the fraction of species responding to different types of biomarkers. They have been connected to SSDs for whole organism responses (WORs) constructed in order to relate the SSD biomarkers to animal fitness parameters that are commonly used in environmental risk assessment. The resulting SSD curves show that biomarkers and WORs can be linked through their potentially affected fraction of species (PAF) distributions, enhancing the capability to monitor field parameters with better correlation to impact and risk assessment criteria and providing improved chemical/biological integration. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Managing Competing Influences: Risk Acceptance in Operation Rolling Thunder

    DTIC Science & Technology

    2017-03-12

    Managing Competing Influences: Risk Acceptance in Operation Rolling Thunder A Monograph by Major Benjamin C. Williams US Air Force School of...REPORT TYPE Master’s Thesis 3. DATES COVERED (From - To) JUN 2016 – MAY 2017 4. TITLE AND SUBTITLE Managing Competing Influences: Risk Acceptance in...ANSI Std. Z39.18 ii Monograph Approval Page Name of Candidate: Major Benjamin C. Williams, USAF Monograph Title: Managing Competing Influences

  5. Preliminary Mark-18A (Mk-18A) Target Material Recovery Program Product Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robinson, Sharon M.; Patton, Bradley D.

    2016-09-01

    The Mk-18A Target Material Recovery Program (MTMRP) was established in 2015 to preserve the unique materials, e.g. 244Pu, in 65 previously irradiated Mk-18A targets for future use. This program utilizes existing capabilities at SRS and Savannah River National Laboratory (SRNL) to process targets, recover materials from them, and to package the recovered materials for shipping to ORNL. It also utilizes existing capabilities at ORNL to receive and store the recovered materials, and to provide any additional processing of the recovered materials or residuals required to prepare them for future beneficial use. The MTMRP is presently preparing for the processing ofmore » these valuable targets which is expected to begin in ~2019. As part of the preparations for operations, this report documents the preliminary acceptance criteria for the plutonium and heavy curium materials to be recovered from the Mk-18A targets at SRNL for transport and storage at ORNL. These acceptance criteria were developed based on preliminary concepts developed for processing, transporting, and storing the recovered Mk-18A materials. They will need to be refined as these concepts are developed in more detail.« less

  6. Comparative research on NIMBY risk acceptability between Chinese and Japanese college students.

    PubMed

    Wu, Yunqing; Zhai, Guofang; Li, Shasha; Ren, Chongqiang; Tsuchida, Shoji

    2014-10-01

    Along with the progressive acceleration of urbanization, the need to identify potentially troublesome "Not In My Back Yard" (NIMBY) facilities in the city is inevitable. To resolve NIMBY conflict, it is important to know people's NIMBY risk acceptability for these facilities. A questionnaire survey was used among Chinese and Japanese college students to identify NIMBY risk acceptability. LISREL was used to construct a structural equation model to analyze the difference in NIMBY risk acceptability between the Chinese and Japanese college students. Factors that may affect NIMBY risk acceptability were analyzed: "perceiving utility," "perceiving risk," "trust in government," "reasonable compensation," and "procedural justice." The findings show that Japanese students' concerns were greater than Chinese students' concerns. Perceiving utility and perceiving risk were the most important factors that affect people's NIMBY risk acceptability, followed by procedural justice, trust in government, and reasonable compensation. There is a difference between the different cultural backgrounds in confronting the risk: Chinese students focus more on the reputation and value of real estate, while Japanese students pay more attention to environmental pollution and damage to health. Furthermore, cultural influences play a role in students' risk perception. To improve the risk acceptability for NIMBY facilities and provide a basis for resolving NIMBY conflicts, it is necessary to ensure the benefits of the NIMBY facility while reducing environmental pollution. The findings of this study may be of interest for policy makers and practitioners to devise future NIMBY strategies.

  7. Can acceptable risk be defined in wildland firefighting?

    Treesearch

    David Clancy

    2011-01-01

    Risk is an ever-present challenge for fire agencies, fire managers, and firefighters, who must ensure that risks are managed at a level that is as low as reasonably practicable. This challenge provides a significant dilemma as there is no one prescriptive method for—or consensus on—defining "acceptable risk" in the field of firefighting....

  8. Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?

    PubMed

    Rehm, Jürgen; Lachenmeier, Dirk W; Room, Robin

    2014-10-21

    Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking. The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol's exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation. A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.

  9. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Selective Enforcement Auditing § 89.510...

  10. Objective criteria for acceptability and constancy tests of digital subtraction angiography.

    PubMed

    de las Heras, Hugo; Torres, Ricardo; Fernández-Soto, José Miguel; Vañó, Eliseo

    2016-01-01

    Demonstrate an objective procedure to quantify image quality in digital subtraction angiography (DSA) and suggest thresholds for acceptability and constancy tests. Series of images were obtained in a DSA system simulating a small (paediatric) and a large patient using the dynamic phantom described in the IEC and DIN standards for acceptance tests of DSA equipment. Image quality was quantified using measurements of contrast-to-noise ratio (CNR). Overall scores combining the CNR of 10-100 mg/ml Iodine at a vascular diameter of 1-4 mm in a homogeneous background were defined. Phantom entrance surface air kerma (Ka,e) was measured with an ionisation chamber. The visibility of a low-contrast vessel in DSA images has been identified with a CNR value of 0.50 ± 0.03. Despite using 14 times more Ka,e (8.85 vs 0.63 mGy/image), the protocol for large patients showed a decrease in the overall score CNRsum of 67% (4.21 ± 0.06 vs 2.10 ± 0.05). The uncertainty in the results of the objective method was below 5%. Objective evaluation of DSA images using CNR is feasible with dedicated phantom measurements. An objective methodology has been suggested for acceptance tests compliant with the IEC/DIN standards. The defined overall scores can serve to fix a reproducible baseline for constancy tests, as well as to study the device stability within one acquisition series and compare different imaging protocols. This work provides aspects that have not been included in the recent European guidelines on Criteria for Acceptability of Medical Radiological Equipment. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. Two criteria for evaluating risk prediction models

    PubMed Central

    Pfeiffer, R.M.; Gail, M.H.

    2010-01-01

    SUMMARY We propose and study two criteria to assess the usefulness of models that predict risk of disease incidence for screening and prevention, or the usefulness of prognostic models for management following disease diagnosis. The first criterion, the proportion of cases followed PCF(q), is the proportion of individuals who will develop disease who are included in the proportion q of individuals in the population at highest risk. The second criterion is the proportion needed to follow-up, PNF(p), namely the proportion of the general population at highest risk that one needs to follow in order that a proportion p of those destined to become cases will be followed. PCF(q) assesses the effectiveness of a program that follows 100q% of the population at highest risk. PNF(p) assess the feasibility of covering 100p% of cases by indicating how much of the population at highest risk must be followed. We show the relationship of those two criteria to the Lorenz curve and its inverse, and present distribution theory for estimates of PCF and PNF. We develop new methods, based on influence functions, for inference for a single risk model, and also for comparing the PCFs and PNFs of two risk models, both of which were evaluated in the same validation data. PMID:21155746

  12. A Guide to the Application of Probability Risk Assessment Methodology and Hazard Risk Frequency Criteria as a Hazard Control for the Use of the Mobile Servicing System on the International Space Station

    NASA Astrophysics Data System (ADS)

    D'silva, Oneil; Kerrison, Roger

    2013-09-01

    A key feature for the increased utilization of space robotics is to automate Extra-Vehicular manned space activities and thus significantly reduce the potential for catastrophic hazards while simultaneously minimizing the overall costs associated with manned space. The principal scope of the paper is to evaluate the use of industry standard accepted Probability risk/safety assessment (PRA/PSA) methodologies and Hazard Risk frequency Criteria as a hazard control. This paper illustrates the applicability of combining the selected Probability risk assessment methodology and hazard risk frequency criteria, in order to apply the necessary safety controls that allow for the increased use of the Mobile Servicing system (MSS) robotic system on the International Space Station. This document will consider factors such as component failure rate reliability, software reliability, and periods of operation and dormancy, fault tree analyses and their effects on the probability risk assessments. The paper concludes with suggestions for the incorporation of existing industry Risk/Safety plans to create an applicable safety process for future activities/programs

  13. Psoriasis patients' willingness to accept side-effect risks for improved treatment efficacy.

    PubMed

    Kauf, Teresa L; Yang, Jui-Chen; Kimball, Alexa B; Sundaram, Murali; Bao, Yanjun; Okun, Martin; Mulani, Parvez; Hauber, A Brett; Johnson, F Reed

    2015-01-01

    Previous studies suggest that efficacy is more important than side-effect risks to psoriasis patients. However, those studies did not consider potentially fatal risks of biologic treatments. To quantify the risks patients are willing to accept for improvements in psoriasis symptoms. Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma. For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma. Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ. Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.

  14. Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods.

    PubMed

    Shanks, Orin C; Kelty, Catherine A; Oshiro, Robin; Haugland, Richard A; Madi, Tania; Brooks, Lauren; Field, Katharine G; Sivaganesan, Mano

    2016-05-01

    There is growing interest in the application of human-associated fecal source identification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data quality across laboratories. Data quality is typically determined through a series of specifications that ensure good experimental practice and the absence of bias in the results due to DNA isolation and amplification interferences. However, there is currently a lack of consensus on how best to evaluate and interpret human fecal source identification qPCR experiments. This is, in part, due to the lack of standardized protocols and information on interlaboratory variability under conditions for data acceptance. The aim of this study is to provide users and reviewers with a complete series of conditions for data acceptance derived from a multiple laboratory data set using standardized procedures. To establish these benchmarks, data from HF183/BacR287 and HumM2 human-associated qPCR methods were generated across 14 laboratories. Each laboratory followed a standardized protocol utilizing the same lot of reference DNA materials, DNA isolation kits, amplification reagents, and test samples to generate comparable data. After removal of outliers, a nested analysis of variance (ANOVA) was used to establish proficiency metrics that include lab-to-lab, replicate testing within a lab, and random error for amplification inhibition and sample processing controls. Other data acceptance measurements included extraneous DNA contamination assessments (no-template and extraction blank controls) and calibration model performance (correlation coefficient, amplification efficiency, and lower limit of quantification). To demonstrate the implementation of the proposed standardized protocols and data acceptance criteria, comparable data from two additional laboratories were reviewed. The data acceptance criteria

  15. Generic Assessment Criteria for human health risk assessment of potentially contaminated land in China.

    PubMed

    Cheng, Yuanyuan; Nathanail, Paul C

    2009-12-20

    Generic Assessment Criteria (GAC) are derived using widely applicable assumptions about the characteristics and behaviour of contaminant sources, pathways and receptors. GAC provide nationally consistent guidance, thereby saving money and time. Currently, there are no human health based Generic Assessment Criteria (GAC) for contaminated sites in China. Protection of human health is therefore difficult to ensure and demonstrate; and the lack of GAC makes it difficult to tell if there is potential significant risk to human health unless site-specific criteria are derived. This paper derived Chinese GAC (GAC) for five inorganic and eight organic substances for three regions in China for three land uses: urban residential without plant uptake, Chinese cultivated land, and commercial/industrial using the SNIFFER model. The SNIFFER model has been further implemented with a dermal absorption algorithm and the model default input values have been changed to reflect the Chinese exposure scenarios. It is envisaged that the modified SNIFFER model could be used to derive GAC for more contaminants, more Regions, and more land uses. Further research to enhance the reliability and acceptability of the GAC is needed in regional/national surveys in diet and working patterns.

  16. Proposed GTA welding specification and acceptance criteria for the MC4163

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kwiatkowski, J.J.

    1991-04-12

    This specification documents the gas tungsten arc (GTA) welding process and production weld acceptance criteria requirements for the MC4163. This document is written specifically to apply to the welds on the MC4163 and is not to be used as a general gas tungsten arc welding specification. All sections of this specification must be complied with unless specifically exempted in writing. There are a total of five welds with three different joint designs required to fabricate the MC4163. In the order of fabrication they are (1) initiator closure disc, (2) nozzle to case girth welds, two and, (3) nozzle closure discmore » welds, two. This specification will only address the nozzle to case girth welds and the nozzle closure disc welds.« less

  17. Risk Perception and the Public Acceptance of Drones.

    PubMed

    Clothier, Reece A; Greer, Dominique A; Greer, Duncan G; Mehta, Amisha M

    2015-06-01

    Unmanned aircraft, or drones, are a rapidly emerging sector of the aviation industry. There has been limited substantive research, however, into the public perception and acceptance of drones. This article presents the results from two surveys of the Australian public designed to investigate (1) whether the public perceive drones to be riskier than existing manned aviation, (2) whether the terminology used to describe the technology influences public perception, and (3) what the broader concerns are that may influence public acceptance of the technology. We find that the Australian public currently hold a relatively neutral attitude toward drones. Respondents did not consider the technology to be overly unsafe, risky, beneficial, or threatening. Drones are largely viewed as being of comparable risk to that of existing manned aviation. Furthermore, terminology had a minimal effect on the perception of the risks or acceptability of the technology. The neutral response is likely due to a lack of knowledge about the technology, which was also identified as the most prevalent public concern as opposed to the risks associated with its use. Privacy, military use, and misuse (e.g., terrorism) were also significant public concerns. The results suggest that society is yet to form an opinion of drones. As public knowledge increases, the current position is likely to change. Industry communication and media coverage will likely influence the ultimate position adopted by the public, which can be difficult to change once established. © 2014 Society for Risk Analysis.

  18. Acceptable Risk Analysis for Abrupt Environmental Pollution Accidents in Zhangjiakou City, China.

    PubMed

    Du, Xi; Zhang, Zhijiao; Dong, Lei; Liu, Jing; Borthwick, Alistair G L; Liu, Renzhi

    2017-04-20

    Abrupt environmental pollution accidents cause considerable damage worldwide to the ecological environment, human health, and property. The concept of acceptable risk aims to answer whether or not a given environmental pollution risk exceeds a societally determined criterion. This paper presents a case study on acceptable environmental pollution risk conducted through a questionnaire survey carried out between August and October 2014 in five representative districts and two counties of Zhangjiakou City, Hebei Province, China. Here, environmental risk primarily arises from accidental water pollution, accidental air pollution, and tailings dam failure. Based on 870 valid questionnaires, demographic and regional differences in public attitudes towards abrupt environmental pollution risks were analyzed, and risk acceptance impact factors determined. The results showed females, people between 21-40 years of age, people with higher levels of education, public servants, and people with higher income had lower risk tolerance. People with lower perceived risk, low-level risk knowledge, high-level familiarity and satisfaction with environmental management, and without experience of environmental accidents had higher risk tolerance. Multiple logistic regression analysis indicated that public satisfaction with environmental management was the most significant factor in risk acceptance, followed by perceived risk of abrupt air pollution, occupation, perceived risk of tailings dam failure, and sex. These findings should be helpful to local decision-makers concerned with environmental risk management (e.g., selecting target groups for effective risk communication) in the context of abrupt environmental accidents.

  19. Acceptable Risk Analysis for Abrupt Environmental Pollution Accidents in Zhangjiakou City, China

    PubMed Central

    Du, Xi; Zhang, Zhijiao; Dong, Lei; Liu, Jing; Borthwick, Alistair G. L.; Liu, Renzhi

    2017-01-01

    Abrupt environmental pollution accidents cause considerable damage worldwide to the ecological environment, human health, and property. The concept of acceptable risk aims to answer whether or not a given environmental pollution risk exceeds a societally determined criterion. This paper presents a case study on acceptable environmental pollution risk conducted through a questionnaire survey carried out between August and October 2014 in five representative districts and two counties of Zhangjiakou City, Hebei Province, China. Here, environmental risk primarily arises from accidental water pollution, accidental air pollution, and tailings dam failure. Based on 870 valid questionnaires, demographic and regional differences in public attitudes towards abrupt environmental pollution risks were analyzed, and risk acceptance impact factors determined. The results showed females, people between 21–40 years of age, people with higher levels of education, public servants, and people with higher income had lower risk tolerance. People with lower perceived risk, low-level risk knowledge, high-level familiarity and satisfaction with environmental management, and without experience of environmental accidents had higher risk tolerance. Multiple logistic regression analysis indicated that public satisfaction with environmental management was the most significant factor in risk acceptance, followed by perceived risk of abrupt air pollution, occupation, perceived risk of tailings dam failure, and sex. These findings should be helpful to local decision-makers concerned with environmental risk management (e.g., selecting target groups for effective risk communication) in the context of abrupt environmental accidents. PMID:28425956

  20. Donor understanding and attitudes about current and potential deferral criteria for high-risk sexual behavior.

    PubMed

    Goldman, Mindy; Yi, Qi-Long; Ye, Xibiao; Tessier, Lorna; O'Brien, Sheila F

    2011-08-01

    Few donor criteria are as contentious as the deferral of men who have had sex with men (MSM). We performed an anonymous donor survey to determine attitudes toward current screening and the feasibility and acceptability of adoption of alternate donor criteria for MSM. Donors who had successfully donated to Canadian Blood Services were randomly mailed an anonymous questionnaire several weeks after donation; there were 40,000 donors sampled, evenly split between first-time and repeat donors. The response rate was 45.5%. The vast majority of donors found the current screening questions and clinic environment acceptable. Attention to clinic educational materials was poor. A total of 53% felt that the MSM criteria should be changed; many were supportive of criteria based on specific behaviors rather than a period of abstinence. Gender-neutral questions such as number of sexual partners would result in deferral of large numbers of donors. Many donors would support a change in MSM deferral policy. Implementation of strategies based on donor attention to additional material would be challenging. Universal use of simple gender-neutral questions would result in very high donor loss and are therefore not an acceptable option. The acceptability and feasibility of various screening approaches should be explored further with both donors and advocacy groups. © 2011 American Association of Blood Banks.

  1. 29 CFR 99.525 - Criteria for Federal program risk.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Auditors § 99.525 Criteria for Federal program risk. (a) General. The auditor's determination should be... Federal program. The auditor shall use auditor judgment and consider criteria, such as described in... analysis, the auditor may wish to discuss a particular Federal program with auditee management and the...

  2. SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, D; Kang, S; Kim, T

    2015-06-15

    Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, andmore » it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded

  3. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable flight risk. 415.35 Section 415.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... collective members of the public exposed to debris hazards from any one launch. To obtain safety approval, an...

  4. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable flight risk. 415.35 Section 415.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... collective members of the public exposed to debris hazards from any one launch. To obtain safety approval, an...

  5. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable flight risk. 415.35 Section 415.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... collective members of the public exposed to debris hazards from any one launch. To obtain safety approval, an...

  6. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Acceptable flight risk. 415.35 Section 415.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... collective members of the public exposed to debris hazards from any one launch. To obtain safety approval, an...

  7. 14 CFR 415.35 - Acceptable flight risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Acceptable flight risk. 415.35 Section 415.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... collective members of the public exposed to debris hazards from any one launch. To obtain safety approval, an...

  8. Warning Signals: Basic Criteria for Tracking At-Risk Infants and Toddlers.

    ERIC Educational Resources Information Center

    Blackman, James

    Developed by a multidisciplinary group (convened by Project Zero to Three) of 17 experts in the identification and evaluation of high risk infants and young children, this manual presents basic criteria for tracking at risk infants and toddlers. The first section answers such questions about the criteria as the following: What is a tracking system…

  9. Detecting extinction risk from climate change by IUCN Red List criteria.

    PubMed

    Keith, David A; Mahony, Michael; Hines, Harry; Elith, Jane; Regan, Tracey J; Baumgartner, John B; Hunter, David; Heard, Geoffrey W; Mitchell, Nicola J; Parris, Kirsten M; Penman, Trent; Scheele, Ben; Simpson, Christopher C; Tingley, Reid; Tracy, Christopher R; West, Matt; Akçakaya, H Resit

    2014-06-01

    Anthropogenic climate change is a key threat to global biodiversity. To inform strategic actions aimed at conserving biodiversity as climate changes, conservation planners need early warning of the risks faced by different species. The IUCN Red List criteria for threatened species are widely acknowledged as useful risk assessment tools for informing conservation under constraints imposed by limited data. However, doubts have been expressed about the ability of the criteria to detect risks imposed by potentially slow-acting threats such as climate change, particularly because criteria addressing rates of population decline are assessed over time scales as short as 10 years. We used spatially explicit stochastic population models and dynamic species distribution models projected to future climates to determine how long before extinction a species would become eligible for listing as threatened based on the IUCN Red List criteria. We focused on a short-lived frog species (Assa darlingtoni) chosen specifically to represent potential weaknesses in the criteria to allow detailed consideration of the analytical issues and to develop an approach for wider application. The criteria were more sensitive to climate change than previously anticipated; lead times between initial listing in a threatened category and predicted extinction varied from 40 to 80 years, depending on data availability. We attributed this sensitivity primarily to the ensemble properties of the criteria that assess contrasting symptoms of extinction risk. Nevertheless, we recommend the robustness of the criteria warrants further investigation across species with contrasting life histories and patterns of decline. The adequacy of these lead times for early warning depends on practicalities of environmental policy and management, bureaucratic or political inertia, and the anticipated species response times to management actions. © 2014 Society for Conservation Biology.

  10. Trust in risk regulation: cause or consequence of the acceptability of GM food?

    PubMed

    Poortinga, Wouter; Pidgeon, Nick F

    2005-02-01

    Although there is ample empirical evidence that trust in risk regulation is strongly related to the perception and acceptability of risk, it is less clear what the direction of this relationship is. This article explores the nature of the relationship, using three separate data sets on perceptions of genetically modified (GM) food among the British public. The article has two discrete but closely interrelated objectives. First, it compares two models of trust. More specifically, it investigates whether trust is the cause (causal chain account) or the consequence (associationist view) of the acceptability of GM food. Second, this study explores whether the affect heuristic can be applied to a wider number of risk-relevant concepts than just perceived risk and benefit. The results suggest that, rather than a determinant, trust is an expression or indicator of the acceptability of GM food. In addition, and as predicted, "affect" accounts for a large portion of the variance between perceived risk, perceived benefit, trust in risk regulation, and acceptability. Overall, the results support the associationist view that specific risk judgments are driven by more general evaluative judgments The implications of these results for risk communication and policy are discussed.

  11. Establishing endangered species recovery criteria using predictive simulation modeling

    USGS Publications Warehouse

    McGowan, Conor P.; Catlin, Daniel H.; Shaffer, Terry L.; Gratto-Trevor, Cheri L.; Aron, Carol

    2014-01-01

    Listing a species under the Endangered Species Act (ESA) and developing a recovery plan requires U.S. Fish and Wildlife Service to establish specific and measurable criteria for delisting. Generally, species are listed because they face (or are perceived to face) elevated risk of extinction due to issues such as habitat loss, invasive species, or other factors. Recovery plans identify recovery criteria that reduce extinction risk to an acceptable level. It logically follows that the recovery criteria, the defined conditions for removing a species from ESA protections, need to be closely related to extinction risk. Extinction probability is a population parameter estimated with a model that uses current demographic information to project the population into the future over a number of replicates, calculating the proportion of replicated populations that go extinct. We simulated extinction probabilities of piping plovers in the Great Plains and estimated the relationship between extinction probability and various demographic parameters. We tested the fit of regression models linking initial abundance, productivity, or population growth rate to extinction risk, and then, using the regression parameter estimates, determined the conditions required to reduce extinction probability to some pre-defined acceptable threshold. Binomial regression models with mean population growth rate and the natural log of initial abundance were the best predictors of extinction probability 50 years into the future. For example, based on our regression models, an initial abundance of approximately 2400 females with an expected mean population growth rate of 1.0 will limit extinction risk for piping plovers in the Great Plains to less than 0.048. Our method provides a straightforward way of developing specific and measurable recovery criteria linked directly to the core issue of extinction risk. Published by Elsevier Ltd.

  12. Classification criteria and probability risk maps: limitations and perspectives.

    PubMed

    Saisana, Michaela; Dubois, Gregoire; Chaloulakou, Archontoula; Spyrellis, Nikolas

    2004-03-01

    Delineation of polluted zones with respect to regulatory standards, accounting at the same time for the uncertainty of the estimated concentrations, relies on classification criteria that can lead to significantly different pollution risk maps, which, in turn, can depend on the regulatory standard itself. This paper reviews four popular classification criteria related to the violation of a probability threshold or a physical threshold, using annual (1996-2000) nitrogen dioxide concentrations from 40 air monitoring stations in Milan. The relative advantages and practical limitations of each criterion are discussed, and it is shown that some of the criteria are more appropriate for the problem at hand and that the choice of the criterion can be supported by the statistical distribution of the data and/or the regulatory standard. Finally, the polluted area is estimated over the different years and concentration thresholds using the appropriate risk maps as an additional source of uncertainty.

  13. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  14. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  15. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  16. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  17. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false What criteria do I use in deciding whether to accept a recipient's cost sharing? 37.530 Section 37.530 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre...

  18. 38 CFR 41.525 - Criteria for Federal program risk.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.525 Criteria for Federal program risk. (a) General. The auditor's determination should be based on an overall evaluation of the risk of noncompliance occurring, which could be material to the Federal program. The auditor shall...

  19. Industry Application Emergency Core Cooling System Cladding Acceptance Criteria Early Demonstration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Szilard, Ronaldo H.; Youngblood, Robert W.; Zhang, Hongbin

    2015-09-01

    The U. S. NRC is currently proposing rulemaking designated as “10 CFR 50.46c” to revise the loss-of-coolant-accident (LOCA)/emergency core cooling system (ECCS) acceptance criteria to include the effects of higher burnup on cladding performance as well as to address other technical issues. The NRC is also currently resolving the public comments with the final rule expected to be issued in April 2016. The impact of the final 50.46c rule on the industry may involve updating of fuel vendor LOCA evaluation models, NRC review and approval, and licensee submittal of new LOCA evaluations or re-analyses and associated technical specification revisions formore » NRC review and approval. The rule implementation process, both industry and NRC activities, is expected to take 4-6 years following the rule effective date. As motivated by the new rule, the need to use advanced cladding designs may be a result. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently, there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin. The proposed rule would apply to a light water reactor and to all cladding types.« less

  20. Perception and acceptance of risk from radiation exposure in space flight

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Slovic, P

    There are a number of factors that influence how a person views a particular risk. These include whether the risk is judged to be voluntary and/or controllable, whether the effects are immediate or delayed, and the magnitude of the benefits that are to be gained as a result of being exposed to the risk. An important aspect of the last factor is whether those who suffer the risks are also those who stand to reap the benefits. The manner in which risk is viewed is also significantly influenced by the manner in which it is framed and presented. In short,more » risk does not exist in the world independent of our minds and cultures, waiting to be measured. Assessments of risk are based on models whose structure is subjective and associated evaluations are laden with assumptions whose inputs are dependent on judgments. In fact, subjectivity permeates every aspect of risk assessment. The assessment of radiation risks in space is no exception. The structuring of the problem includes judgments related to the probability, magnitude, and effects of the various types of radiation likely to be encountered and assumptions related to the quantitative relationship between dose and a range of specific effects, all of which have associated uncertainties. For these reasons, there is no magic formula that will lead us to a precise level of acceptable risk from exposure to radiation in space. Acceptable risk levels must evolve through a process of negotiation that integrates a large number of social, technical, and economic factors. In the end, a risk that is deemed to be acceptable will be the outgrowth of the weighing of risks and benefits and the selection of the option that appears to be best.« less

  1. Risk Management in EVA

    NASA Technical Reports Server (NTRS)

    Hall, Jonathan; Lutomski, M.

    2006-01-01

    This viewgraph presentation reviews the use of risk management in Extravehicular Activities (EVA). The contents include: 1) EVA Office at NASA - JSC; 2) EVA Project Risk Management: Why and When; 3) EVA Office Risk Management: How; 4) Criteria for Closing a Risk; 5) Criteria for Accepting a Risk; 6) ISS IRMA Reference Card Data Entry Requirement s; 7) XA/ EVA Office Risk Activity Summary; 8) EVA Significant Change Summary; 9) Integrated Risk Management Application (XA) Matrix, March 31, 2004; 10) ISS Watch Item: 50XX Summary Report; and 11) EVA Project RM Usefulness

  2. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  3. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  4. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  5. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  6. 14 CFR 435.35 - Acceptable reentry risk for reentry of a reentry vehicle.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Acceptable reentry risk for reentry of a reentry vehicle. 435.35 Section 435.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... reentry vehicle, does not exceed acceptable risk for the conduct of an RLV mission as defined in...

  7. Risk perception and public acceptance toward a highly protested Waste-to-Energy facility.

    PubMed

    Ren, Xiangyu; Che, Yue; Yang, Kai; Tao, Yun

    2016-02-01

    The application of Waste-to-Energy treatment in Municipal Solid Waste faces strong protest by local communities, especially in cities with high population densities. This study introduces insight into the public awareness, acceptance and risk perception toward Waste-to-Energy through a structured questionnaire survey around a Waste-to-Energy facility in Shanghai, China. The Dichotomous-Choice contingent valuation method was applied to study the willingness to accept of residents as an indicator of risk perception and tolerance. The factors influencing risk perception and the protest response choice were analyzed. The geographical distributions of the acceptance of Waste-to-Energy facility and protest response were explored using geographical information systems. The findings of the research indicated an encouraging vision of promoting Waste-to-Energy, considering its benefits of renewable energy and the conservation of land. A high percentage of protest willingness to accept (50.94%) was highlighted with the effect of income, opinion about Waste-to-Energy, gender and perceived impact. The fuzzy classification among people with different opinions on compensation (valid 0, positive or protest willingness to accept) revealed the existing yet rejected demand of compensation among protesters. Geographical distribution in the public attitude can also be observed. Finally significant statistical relation between knowledge and risk perception indicates the need of risk communication, as well as involving public into whole management process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Which is the optimal risk stratification system for surgically treated localized primary GIST? Comparison of three contemporary prognostic criteria in 171 tumors and a proposal for a modified Armed Forces Institute of Pathology risk criteria.

    PubMed

    Goh, Brian K P; Chow, Pierce K H; Yap, Wai-Ming; Kesavan, Sittampalam M; Song, In-Chin; Paul, Pradeep G; Ooi, Boon-Swee; Chung, Yaw-Fui A; Wong, Wai-Keong

    2008-08-01

    This study aims to validate and compare the performance of the National Institute of Health (NIH) criteria, Huang modified NIH criteria, and Armed Forces Institute of Pathology (AFIP) risk criteria for gastrointestinal stromal tumors (GISTs) in a large series of localized primary GISTs surgically treated at a single institution to determine the ideal risk stratification system for GIST. The clinicopathological features of 171 consecutive patients who underwent surgical resection for GISTs were retrospectively reviewed. Statistical analyses were performed to compare the prognostic value of the three risk criteria by analyzing the discriminatory ability linear trend, homogeneity, monotonicity of gradients, and Akaike information criteria. The median actuarial recurrence-free survival (RFS) for all 171 patients was 70%. On multivariate analyses, size >10 cm, mitotic count >5/50 high-power field, tumor necrosis, and serosal involvement were independent prognostic factors of RFS. All three risk criteria demonstrated a statistically significant difference in the recurrence rate, median actuarial RFS, actuarial 5-year RFS, and tumor-specific death across the different stages. Comparison of the various risk-stratification systems demonstrated that our proposed modified AFIP criteria had the best independent predictive value of RFS when compared with the other systems. The NIH, modified NIH, and AFIP criteria are useful in the prognostication of GIST, and the AFIP risk criteria provided the best prognostication among the three systems for primary localized GIST. However, remarkable prognostic heterogeneity exists in the AFIP high-risk category, and with our proposed modification, this system provides the most accurate prognostic information.

  9. Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery

    PubMed Central

    Wee, Christina C.; Hamel, Mary Beth; Apovian, Caroline M.; Blackburn, George L.; Bolcic-Jankovic, Dragana; Colten, Mary Ellen; Hess, Donald T.; Huskey, Karen W.; Marcantonio, Edward R.; Schneider, Benjamin E.; Jones, Daniel B.

    2015-01-01

    Importance Weight loss surgery (WLS) has been shown to produce long-term weight loss but is not risk free or universally effective. The weight loss expectations and willingness to undergo perioperative risk among patients seeking WLS remain unknown. Objectives To examine the expectations and motivations of WLS patients and the mortality risks they are willing to undertake and to explore the demographic characteristics, clinical factors, and patient perceptions associated with high weight loss expectations and willingness to assume high surgical risk. Design We interviewed patients seeking WLS and conducted multivariable analyses to examine the characteristics associated with high weight loss expectations and the acceptance of mortality risks of 10% or higher. Setting Two WLS centers in Boston. Participants Six hundred fifty-four patients. Main Outcome Measures Disappointment with a sustained weight loss of 20% and willingness to accept a mortality risk of 10% or higher with WLS. Results On average, patients expected to lose as much as 38% of their weight after WLS and expressed disappointment if they did not lose at least 26%. Most patients (84.8%) accepted some risk of dying to undergo WLS, but only 57.5% were willing to undergo a hypothetical treatment that produced a 20% weight loss. The mean acceptable mortality risk to undergo WLS was 6.7%, but the median risk was only 0.1%; 19.5% of all patients were willing to accept a risk of at least 10%. Women were more likely than men to be disappointed with a 20% weight loss but were less likely to accept high mortality risk. After initial adjustment, white patients appeared more likely than African American patients to have high weight loss expectations and to be willing to accept high risk. Patients with lower quality-of-life scores and those who perceived needing to lose more than 10% and 20% of weight to achieve “any” health benefits were more likely to have unrealistic weight loss expectations. Low quality

  10. Non Destructive Test Dye Penetrant and Ultrasonic on Welding SMAW Butt Joint with Acceptance Criteria ASME Standard

    NASA Astrophysics Data System (ADS)

    Endramawan, T.; Sifa, A.

    2018-02-01

    The purpose of this research is to know the type of discontinuity of SMAW welding result and to determine acceptance criteria based on American Society of Mechanical Engineer (ASME) standard. Material used is mild steel 98,71% Fe and 0,212% C with hardness 230 VHN with specimen diameter 20 cm and thickness 1.2 cm which is welded use SMAW butt joint with electrode for rooting LB 52U diameter 2.6 mm, current 70 Ampere and voltage 380 volt, filler used LB 5218 electrode diameter 3.2 mm with current 80 Ampere and 380 volt. The method used to analyze the welded with non destructive test dye penetrant (PT) method to see indication on the surface of the object and Ultrasonic (UT) to see indication on the sub and inner the surface of the object, the result is discontinuity recorded and analyzed and then the discontinuity is determine acceptance criteria based on the American Society of Mechanical Engineer (ASME) standards. The result show the discontinuity of porosity on the surface of the welded and inclusion on sub material used ultrasonic test, all indication on dye penetrant or ultrasonic test if there were rejected of result of welded that there must be gouging on part which rejected and then re-welding.

  11. Extensions of criteria for evaluating risk prediction models for public health applications.

    PubMed

    Pfeiffer, Ruth M

    2013-04-01

    We recently proposed two novel criteria to assess the usefulness of risk prediction models for public health applications. The proportion of cases followed, PCF(p), is the proportion of individuals who will develop disease who are included in the proportion p of individuals in the population at highest risk. The proportion needed to follow-up, PNF(q), is the proportion of the general population at highest risk that one needs to follow in order that a proportion q of those destined to become cases will be followed (Pfeiffer, R.M. and Gail, M.H., 2011. Two criteria for evaluating risk prediction models. Biometrics 67, 1057-1065). Here, we extend these criteria in two ways. First, we introduce two new criteria by integrating PCF and PNF over a range of values of q or p to obtain iPCF, the integrated PCF, and iPNF, the integrated PNF. A key assumption in the previous work was that the risk model is well calibrated. This assumption also underlies novel estimates of iPCF and iPNF based on observed risks in a population alone. The second extension is to propose and study estimates of PCF, PNF, iPCF, and iPNF that are consistent even if the risk models are not well calibrated. These new estimates are obtained from case-control data when the outcome prevalence in the population is known, and from cohort data, with baseline covariates and observed health outcomes. We study the efficiency of the various estimates and propose and compare tests for comparing two risk models, both of which were evaluated in the same validation data.

  12. Bridging the Gap between Social Acceptance and Ethical Acceptability.

    PubMed

    Taebi, Behnam

    2017-10-01

    New technology brings great benefits, but it can also create new and significant risks. When evaluating those risks in policymaking, there is a tendency to focus on social acceptance. By solely focusing on social acceptance, we could, however, overlook important ethical aspects of technological risk, particularly when we evaluate technologies with transnational and intergenerational risks. I argue that good governance of risky technology requires analyzing both social acceptance and ethical acceptability. Conceptually, these two notions are mostly complementary. Social acceptance studies are not capable of sufficiently capturing all the morally relevant features of risky technologies; ethical analyses do not typically include stakeholders' opinions, and they therefore lack the relevant empirical input for a thorough ethical evaluation. Only when carried out in conjunction are these two types of analysis relevant to national and international governance of risky technology. I discuss the Rawlsian wide reflective equilibrium as a method for marrying social acceptance and ethical acceptability. Although the rationale of my argument is broadly applicable, I will examine the case of multinational nuclear waste repositories in particular. This example will show how ethical issues may be overlooked if we focus only on social acceptance, and will provide a test case for demonstrating how the wide reflective equilibrium can help to bridge the proverbial acceptance-acceptability gap. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  13. Risk-accepting personality and personal protective equipment use within the Agricultural Health Study.

    PubMed

    DellaValle, Curt T; Hoppin, Jane A; Hines, Cynthia J; Andreotti, Gabriella; Alavanja, Michael C R

    2012-01-01

    Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. The authors examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4160 [21%]; commercial applicators: n=199 [14%]; spouses: n=829 [23%]) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.65-0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34-1.77) but not among spouses (OR = 1.09, 95% CI: 0.90-1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 feet of the home (OR = 1.21, 95% CI: 1.01-1.44), compared to further than ¼ mile. These findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits.

  14. Defining "Acceptable Risk" for Earthquakes Worldwide

    NASA Astrophysics Data System (ADS)

    Tucker, B.

    2001-05-01

    The greatest and most rapidly growing earthquake risk for mortality is in developing countries. Further, earthquake risk management actions of the last 50 years have reduced the average lethality of earthquakes in earthquake-threatened industrialized countries. (This is separate from the trend of the increasing fiscal cost of earthquakes there.) Despite these clear trends, every new earthquake in developing countries is described in the media as a "wake up" call, announcing the risk these countries face. GeoHazards International (GHI) works at both the community and the policy levels to try to reduce earthquake risk. GHI reduces death and injury by helping vulnerable communities recognize their risk and the methods to manage it, by raising awareness of its risk, building local institutions to manage that risk, and strengthening schools to protect and train the community's future generations. At the policy level, GHI, in collaboration with research partners, is examining whether "acceptance" of these large risks by people in these countries and by international aid and development organizations explains the lack of activity in reducing these risks. The goal of this pilot project - The Global Earthquake Safety Initiative (GESI) - is to develop and evaluate a means of measuring the risk and the effectiveness of risk mitigation actions in the world's largest, most vulnerable cities: in short, to develop an earthquake risk index. One application of this index is to compare the risk and the risk mitigation effort of "comparable" cities. By this means, Lima, for example, can compare the risk of its citizens dying due to earthquakes with the risk of citizens in Santiago and Guayaquil. The authorities of Delhi and Islamabad can compare the relative risk from earthquakes of their school children. This index can be used to measure the effectiveness of alternate mitigation projects, to set goals for mitigation projects, and to plot progress meeting those goals. The preliminary

  15. When Failure Means Success: Accepting Risk in Aerospace Development

    NASA Technical Reports Server (NTRS)

    Dumbacher, Daniel L.; Singer, Christopher E.

    2009-01-01

    Over the last three decades, NASA has been diligent in qualifying systems for human space flight. As the Agency transitions from operating the Space Shuttle, its employees must learn to accept higher risk levels to generate the data needed to certify its next human space flight system. The Marshall Center s Engineering workforce is developing the Ares I crew launch vehicle and designing the Ares V cargo launch vehicle for safety, reliability, and cost-effective operations. This presentation will provide a risk retrospective, using first-hand examples from the Delta Clipper-Experimental Advanced (DC-XA) and the X-33 single-stage-to-orbit flight demonstrators, while looking ahead to the upcoming Ares I-X uncrewed test flight. The DC-XA was successfully flown twice in 26 hours, setting a new turnaround-time record. Later, one of its 3 landing gears did not deploy, it tipped over, and was destroyed. During structural testing, the X-33 s advanced composite tanks were unable to withstand the forces to which it was subjected and the project was later cancelled. These are examples of successful failures, as the data generated are captured in databases used by vehicle designers today. More recently, the Ares I-X flight readiness review process was streamlined in keeping with the mission's objectives, since human lives are not at stake, which reflects the beginning of a cultural change. Failures are acceptable during testing, as they provide the lessons that actually lead to mission success. These and other examples will stimulate the discussion of when to accept risk in aerospace projects.

  16. Risk-Accepting Personality and Personal Protective Equipment Use within the Agricultural Health Study

    PubMed Central

    DellaValle, Curt T.; Hoppin, Jane A.; Hines, Cynthia J.; Andreotti, Gabriella; Alavanja, Michael C.R.

    2012-01-01

    Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. We examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4,160 (21%); commercial applicators: n=199 (14%); spouses: n=829 (23%)) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio (OR) = 0.72; 95% Confidence Interval (CI): 0.65 – 0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34 – 1.77) but not among spouses (OR = 1.09, 95% CI: 0.90 – 1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 ft of the home (OR=1.21; 95% CI: 1.01 – 1.44), compared to further than ¼ mile. Our findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits. PMID:22732067

  17. Study on Influencing Factor Analysis and Application of Consumer Mobile Commerce Acceptance

    NASA Astrophysics Data System (ADS)

    Li, Gaoguang; Lv, Tingjie

    Mobile commerce (MC) refers to e-commerce activities carried out using a mobile device such as a phone or PDA. With new technology, MC will be rapidly growing in the near future. At the present time, what factors making consumer accept MC and what MC applications are acceptable by consumers are two of hot issues both for MC providers and f or MC researchers. This study presents a proposed MC acceptance model that integrates perceived playfulness, perceived risk and cost into the TAM to study which factors affect consumer MC acceptance. The proposed model includes five variables, namely perceived risk, cost, perceived usefulness, perceived playfulness, perceived ease of use, perceived playfulness. Then, using analytic hierarchy process (AHP) to calculate weight of criteria involved in proposed model. Finally, the study utilizes fuzzy comprehensive evaluation method to evaluate MC applications accepted possibility, and then a MC application is empirically tested using data collected from a survey of MC consumers.

  18. A cross-cultural study of perceived benefit versus risk as mediators in the trust-acceptance relationship.

    PubMed

    Bronfman, Nicolás C; Vázquez, Esperanza López

    2011-12-01

    Several recent studies have identified the significant role social trust in regulatory organizations plays in the public acceptance of various technologies and activities. In a cross-cultural investigation, the current work explores empirically the relationship between social trust in management authorities and the degree of public acceptability of hazards for individuals residing in either developed or emerging Latin American economies using confirmatory rather than exploratory techniques. Undergraduates in Mexico, Brazil, and Chile and the United States and Spain assessed trust in regulatory authorities, public acceptance, personal knowledge, and the risks and benefits for 23 activities and technological hazards. Four findings were encountered. (i) In Latin American nations trust in regulatory entities was strongly and significantly (directly as well as indirectly) linked with the public's acceptance of any activity or technology. In developed countries trust and acceptability are essentially linked indirectly (through perceived risk and perceived benefit). (ii) Lack of knowledge strengthened the magnitude and statistical significance of the trust-acceptability relationship in both developed and developing countries. (iii) For high levels of claimed knowledge, the impact on the trust-acceptability relationship varied depending upon the origin of the sample. (iv) Confirmatory analysis revealed the relative importance of perceived benefit over perceived risk in meditating the trust-acceptability causal chain. © 2011 Society for Risk Analysis.

  19. A simple way to unify multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) using a Dirichlet distribution in benefit-risk assessment.

    PubMed

    Saint-Hilary, Gaelle; Cadour, Stephanie; Robert, Veronique; Gasparini, Mauro

    2017-05-01

    Quantitative methodologies have been proposed to support decision making in drug development and monitoring. In particular, multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) are useful tools to assess the benefit-risk ratio of medicines according to the performances of the treatments on several criteria, accounting for the preferences of the decision makers regarding the relative importance of these criteria. However, even in its probabilistic form, MCDA requires the exact elicitations of the weights of the criteria by the decision makers, which may be difficult to achieve in practice. SMAA allows for more flexibility and can be used with unknown or partially known preferences, but it is less popular due to its increased complexity and the high degree of uncertainty in its results. In this paper, we propose a simple model as a generalization of MCDA and SMAA, by applying a Dirichlet distribution to the weights of the criteria and by making its parameters vary. This unique model permits to fit both MCDA and SMAA, and allows for a more extended exploration of the benefit-risk assessment of treatments. The precision of its results depends on the precision parameter of the Dirichlet distribution, which could be naturally interpreted as the strength of confidence of the decision makers in their elicitation of preferences. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Reinforced concrete pipe cracks : acceptance criteria [summary].

    DOT National Transportation Integrated Search

    2011-01-01

    Reinforced concrete pipe (RCP) is widely used by the Florida Department of Transportation (FDOT) in installations expected to serve for periods of decades before replacement, and extremely slow deterioration of RCP can be accepted. However, cracks in...

  1. Quality of laboratory studies assessing effects of Bt-proteins on non-target organisms: minimal criteria for acceptability.

    PubMed

    De Schrijver, Adinda; Devos, Yann; De Clercq, Patrick; Gathmann, Achim; Romeis, Jörg

    2016-08-01

    The potential risks that genetically modified plants may pose to non-target organisms and the ecosystem services they contribute to are assessed as part of pre-market risk assessments. This paper reviews the early tier studies testing the hypothesis whether exposure to plant-produced Cry34/35Ab1 proteins as a result of cultivation of maize 59122 is harmful to valued non-target organisms, in particular Arthropoda and Annelida. The available studies were assessed for their scientific quality by considering a set of criteria determining their relevance and reliability. As a case-study, this exercise revealed that when not all quality criteria are met, weighing the robustness of the study and its relevance for risk assessment is not obvious. Applying a worst-case expected environmental concentration of bioactive toxins equivalent to that present in the transgenic crop, confirming exposure of the test species to the test substance, and the use of a negative control were identified as minimum criteria to be met to guarantee sufficiently reliable data. This exercise stresses the importance of conducting studies meeting certain quality standards as this minimises the probability of erroneous or inconclusive results and increases confidence in the results and adds certainty to the conclusions drawn.

  2. Extended Criteria Donors in Liver Transplantation.

    PubMed

    Vodkin, Irine; Kuo, Alexander

    2017-05-01

    Mortality rates on the liver transplant waiting list are increasing. The shortage of organs has resulted in higher utilization of extended criteria donors (ECDs), with centers pushing the limits of what is acceptable for transplantation. Donor quality is more appropriately represented as a continuum of risk, and careful selection and matching of ECD grafts with recipients may lead to excellent outcomes. Although there is no precise definition for what constitutes an ECD liver, this review focuses on frequently cited characteristics, including donor age, steatosis, donation after cardiac death, and donors with increased risk of disease transmission. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The Mutable Nature of Risk and Acceptability: A Hybrid Risk Governance Framework.

    PubMed

    Wong, Catherine Mei Ling

    2015-11-01

    This article focuses on the fluid nature of risk problems and the challenges it presents to establishing acceptability in risk governance. It introduces an actor-network theory (ANT) perspective as a way to deal with the mutable nature of risk controversies and the configuration of stakeholders. To translate this into a practicable framework, the article proposes a hybrid risk governance framework that combines ANT with integrative risk governance, deliberative democracy, and responsive regulation. This addresses a number of the limitations in existing risk governance models, including: (1) the lack of more substantive public participation throughout the lifecycle of a project; (2) hijacking of deliberative forums by particular groups; and (3) the treatment of risk problems and their associated stakeholders as immutable entities. The framework constitutes a five-stage process of co-selection, co-design, co-planning, and co-regulation to facilitate the co-production of collective interests and knowledge, build capacities, and strengthen accountability in the process. The aims of this article are twofold: conceptually, it introduces a framework of risk governance that accounts for the mutable nature of risk problems and configuration of stakeholders. In practice, this article offers risk managers and practitioners of risk governance a set of procedures with which to operationalize this conceptual approach to risk and stakeholder engagement. © 2015 Society for Risk Analysis.

  4. 7 CFR 42.133 - Portion of production acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS On-Line Sampling and Inspection Procedures... determined by comparing the calculated CuSum value with the acceptance limit (“L”) for the specified AQL. (b) A portion of production is acceptable if the CuSum value, calculated from the subgroup representing...

  5. Acceptability of risk from radiation: Application to human space flight

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    This one of NASA`s sponsored activities of the NCRP. In 1983, NASA asked NCRP to examine radiation risks in space and to make recommendations about career radiation limits for astronauts (with cancer considered as the principal risk). In conjunction with that effort, NCRP was asked to convene this symposium; objective is to examine the technical, strategic, and philosophical issues pertaining to acceptable risk and radiation in space. Nine papers are included together with panel discussions and a summary. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  6. Sustainable and safe design of footwear integrating ecological footprint and risk criteria.

    PubMed

    Herva, Marta; Álvarez, Antonio; Roca, Enrique

    2011-09-15

    The ecodesign of a product implies that different potential environmental impacts of diverse nature must be taken into account considering its whole life cycle, apart from the general design criteria (i.e. technical, functional, ergonomic, aesthetic or economic). In this sense, a sustainability assessment methodology, ecological footprint (EF), and environmental risk assessment (ERA), were combined for the first time to derive complementary criteria for the ecodesign of footwear. Four models of children's shoes were analyzed and compared. The synthetic shoes obtained a smaller EF (6.5 gm(2)) when compared to the leather shoes (11.1 gm(2)). However, high concentrations of hazardous substances were detected in the former, even making the Hazard Quotient (HQ) and the Cancer Risk (CR) exceed the recommended safety limits for one of the synthetic models analyzed. Risk criteria were prioritized in this case and, consequently, the design proposal was discarded. For the other cases, the perspective provided by the indicators of different nature was balanced to accomplish a fairest evaluation. The selection of fibers produced under sustainable criteria and the reduction of the materials consumption was recommended, since the area requirements would be minimized and the absence of hazardous compounds would ensure safety conditions during the use stage. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Multi-Criteria Decision Making for a Spatial Decision Support System on the Analysis of Changing Risk

    NASA Astrophysics Data System (ADS)

    Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

    2014-05-01

    Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in

  8. Safety margins in zircaloy oxidation and embrittlement criteria for emergency core cooling system acceptance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williford, R.E.

    1986-09-01

    Current emergency core cooling system acceptance criteria for light water reactors specify that, under loss-of-coolant accident (LOCA) conditions, the Baker-Just (BJ) correlation must be used to calculate Zircaloy-steam oxidation, calculated peak cladding temperatures (PCT) must not exceed 1204/sup 0/C, and calculated oxidation must not exceed 17% equivalent cladding reacted (ECR). An appropriately defined minimum margin of safety was estimated for each of these criteria. The currently required BJ oxidation correlation provides margins only over the 1100 to 1500/sup 0/C temperature range at the 95% confidence level. The PCT margins for thermal shock and handling failures are adequate at oxidation temperaturesmore » above 1204/sup 0/C for up to 210 and 160 s, respectively, at the 95% confidence level. The ECR thermal shock and handling margins at the 50 and 95% confidence levels, respectively, range between 2 and 7% ECR for the BJ correlation, but vanish at temperatures above 1100 to 1160/sup 0/C for the best-estimate Cathcart-Pawel correlation. However, use of the Cathcart Pawel correlation for ''design basis'' LOCA calculations can be justified at the 85 to 88% confidence level if cooling rate effects can be neglected.« less

  9. Multi Criteria Evaluation Module for RiskChanges Spatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Olyazadeh, Roya; Jaboyedoff, Michel; van Westen, Cees; Bakker, Wim

    2015-04-01

    Multi-Criteria Evaluation (MCE) module is one of the five modules of RiskChanges spatial decision support system. RiskChanges web-based platform aims to analyze changes in hydro-meteorological risk and provides tools for selecting the best risk reduction alternative. It is developed under CHANGES framework (changes-itn.eu) and INCREO project (increo-fp7.eu). MCE tool helps decision makers and spatial planners to evaluate, sort and rank the decision alternatives. The users can choose among different indicators that are defined within the system using Risk and Cost Benefit analysis results besides they can add their own indicators. Subsequently the system standardizes and prioritizes them. Finally, the best decision alternative is selected by using the weighted sum model (WSM). The Application of this work is to facilitate the effect of MCE for analyzing changing risk over the time under different scenarios and future years by adopting a group decision making into practice and comparing the results by numeric and graphical view within the system. We believe that this study helps decision-makers to achieve the best solution by expressing their preferences for strategies under future scenarios. Keywords: Multi-Criteria Evaluation, Spatial Decision Support System, Weighted Sum Model, Natural Hazard Risk Management

  10. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

    PubMed

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

  11. Communicating Conservation Status: How Different Statistical Assessment Criteria Affect Perceptions of Extinction Risk.

    PubMed

    Song, Hwanseok; Schuldt, Jonathon P

    2017-09-01

    Although alternative forms of statistical and verbal information are routinely used to convey species' extinction risk to policymakers and the public, little is known about their effects on audience information processing and risk perceptions. To address this gap in literature, we report on an experiment that was designed to explore how perceptions of extinction risk differ as a function of five different assessment benchmarks (Criteria A-E) used by scientists to classify species within IUCN Red List risk levels (e.g., Critically Endangered, Vulnerable), as well as the role of key individual differences in these effects (e.g., rational and experiential thinking styles, environmental concern). Despite their normative equivalence within the IUCN classification system, results revealed divergent effects of specific assessment criteria: on average, describing extinction risk in terms of proportional population decline over time (Criterion A) and number of remaining individuals (Criterion D) evoked the highest level of perceived risk, whereas the single-event probability of a species becoming extinct (Criterion E) engendered the least perceived risk. Furthermore, participants scoring high in rationality (analytic thinking) were less prone to exhibit these biases compared to those low in rationality. Our findings suggest that despite their equivalence in the eyes of scientific experts, IUCN criteria are indeed capable of engendering different levels of risk perception among lay audiences, effects that carry direct and important implications for those tasked with communicating about conservation status to diverse publics. © 2016 Society for Risk Analysis.

  12. The importance of multiple performance criteria for understanding trust in risk managers.

    PubMed

    Johnson, Branden B; White, Mathew P

    2010-07-01

    Effective risk management requires balancing several, sometimes competing, goals, such as protecting public health and ensuring cost control. Research examining public trust of risk managers has largely focused on trust that is unspecified or for a single goal. Yet it can be reasonable to have a high level of trust in one aspect of a target's performance but not another. Two studies involving redevelopment of contaminated land (Study 1) and drinking water standards (Study 2) present preliminary evidence on the value of distinguishing between performance criteria for understanding of trust. Study 1 assessed perceptions of several trust targets (councilors, developers, scientists, residents) on their competence (capacity to achieve goals) and willingness to take action under uncertainty for four criteria. Study 2 assessed competence, willingness, and trust for five criteria regarding a single government agency. In both studies overall trust in each target was significantly better explained by considering perceptions of their performance on multiple criteria than on the single criterion of public health. In Study 1, the influence of criteria also varied plausibly across trust targets (e.g., willingness to act under uncertainty increased trust in developers on cost control and councilors on local economic improvement, but decreased it for both targets on environmental protection). Study 2 showed that explained variance in trust increased with both dimension- and trust-based measures of criteria. Further conceptual and methodological development of the notion of multiple trust criteria could benefit our understanding of stated trust judgments.

  13. 29 CFR 99.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Auditors § 99.530 Criteria for a low-risk auditee. An auditee which meets all of the following conditions... agreed to in advance by the cognizant or oversight agency for audit. (b) The auditor's opinions on the...

  14. 7 CFR 3052.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ORGANIZATIONS Auditors § 3052.530 Criteria for a low-risk auditee. An auditee which meets all of the following... agreed to in advance by the cognizant or oversight agency for audit. (b) The auditor's opinions on the...

  15. 29 CFR 99.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Auditors § 99.530 Criteria for a low-risk auditee. An auditee which meets all of the following conditions... agreed to in advance by the cognizant or oversight agency for audit. (b) The auditor's opinions on the...

  16. 7 CFR 3052.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ORGANIZATIONS Auditors § 3052.530 Criteria for a low-risk auditee. An auditee which meets all of the following... agreed to in advance by the cognizant or oversight agency for audit. (b) The auditor's opinions on the...

  17. Assessment of safety margins in zircaloy oxidation and embrittlement criteria for ECCS acceptance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williford, R.E.

    1986-04-01

    Current Emergency Core Cooling System (ECCS) Acceptance Criteria for light-water reactors include certain requirements pertaining to calculations of core performance during a Loss of Coolant Accident (LOCA). The Baker-Just correlation must be used to calculate Zircaloy-steam oxidation, calculated peak cladding temperatures (PCT) must not exceed 1204/sup 0/C, and calculated oxidation must not exceed 17% equivalent cladding reacted (17% ECR). The minimum margin of safety was estimated for each of these criteria, based on research performed in the last decade. Margins were defined as the amounts of conservatism over and above the expected extreme values computed from the data base atmore » specified confidence levels. The currently required Baker-Just oxidation correlation provides margins only over the 1100/sup 0/C to 1500/sup 0/C temperature range at the 95% confidence level. The PCT margins for thermal shock and handling failures are adequate at oxidation temperatures above 1204/sup 0/C for 210 and 160 seconds, respectively, at the 95% confidence level. ECR thermal shock and handling margins at the 50% and 95% confidence levels, respectively, range between 2% and 7% ECR for the Baker-Just correlation, but vanish at temperatures between 1100/sup 0/C and 1160/sup 0/C for the best-estimate Cathcart-Pawel correlation. Use of the Cathcart-Pawel correlation for LOCA calculations can be justified at the 85% to 88% confidence level if cooling rate effects can be neglected. 75 refs., 21 figs.« less

  18. A qualitative study on acceptable levels of risk for pregnant women in clinical research.

    PubMed

    van der Zande, Indira S E; van der Graaf, Rieke; Oudijk, Martijn A; van Delden, Johannes J M

    2017-05-15

    There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members (RECs) and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals' individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient

  19. Low acceptance of HSV-2 testing among high-risk women.

    PubMed

    Roth, A M; Dodge, B M; Van Der Pol, B; Reece, M; Zimet, G D

    2011-06-01

    We evaluated the acceptability of a community-based herpes simplex virus type 2 (HSV-2) screening programme for at-risk women and assessed factors related to uptake of point of care HSV-2 testing. One hundred recently arrested women (median age 34 years) were recruited from a community court handling lower-level misdemeanour cases in Indianapolis, Indiana. Individuals completed a survey assessing factors related to HSV-2 screening intentions and were offered point of care HSV-2 testing. Rates of HSV-2 infection in this population are high; 61.1% of women tested were positive. The majority (81%) accepted a prescription for suppressive therapy. Women in this sample indicated that HSV-2 screening is an important component of health care but were unwilling to pay the US$10 it cost to be tested. To encourage this and other high-risk populations to be screened for HSV-2, public health resources will be needed to help individuals overcome cost-related barriers to care.

  20. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is...

  1. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is...

  2. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is...

  3. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is...

  4. 14 CFR 431.35 - Acceptable reusable launch vehicle mission risk.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Acceptable reusable launch vehicle mission risk. 431.35 Section 431.35 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION... launch flight through orbital insertion of an RLV or vehicle stage or flight to outer space, whichever is...

  5. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

    PubMed Central

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance

  6. Social acceptability of phytoremediation: The role of risk and values.

    PubMed

    Weir, Ellen; Doty, Sharon

    2016-10-02

    A former gas production site that was converted to a public park was chosen as the research location for the present study. Some of the contaminants at the site have been remediated; however, much of the soil is still contaminated with polycyclic aromatic hydrocarbons (PAHs). PAHs are toxic pollutants that have been shown to have numerous negative health effects. The primary form of remediation at the site has been capping, which is usually considered a temporary remediation strategy since it does not remove contaminants from the site but simply covers them, and this requires repeated re-capping efforts. Endophyte-assisted phytoremediation using willow shrubs is an alternative remediation strategy that could improve soil quality and permanently reduce contaminant levels in the soil. The goal of the present study was to explore the social acceptability of utilizing phytoremediation strategies. Surveys were used to explore public perceptions of the park and of using phytoremediation to clean up existing contamination. Results indicated a high level of social acceptability of phytoremediation at the park. Additionally, ecocentrism was shown to be a significant predictor of phytoremediation acceptability. Risk and anthropocentrism were not significant predictors of acceptability. Results suggest that messages intended to encourage the use and acceptability of phytoremediation should focus on the environmental benefits of phytoremediation.

  7. End-To-End Risk Assesment: From Genes and Protein to Acceptable Radiation Risks for Mars Exploration

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.; Schimmerling, Walter

    2000-01-01

    The human exploration of Mars will impose unavoidable health risks from galactic cosmic rays (GCR) and possibly solar particle events (SPE). It is the goal of NASA's Space Radiation Health Program to develop the capability to predict health risks with significant accuracy to ensure that risks are well below acceptable levels and to allow for mitigation approaches to be effective at reasonable costs. End-to-End risk assessment is the approach being followed to understand proton and heavy ion damage at the molecular, cellular, and tissue levels in order to predict the probability of the major health risk including cancer, neurological disorders, hereditary effects, cataracts, and acute radiation sickness and to develop countermeasures for mitigating risks.

  8. Multi-criteria decision analysis and environmental risk assessment for nanomaterials

    NASA Astrophysics Data System (ADS)

    Linkov, Igor; Satterstrom, F. Kyle; Steevens, Jeffery; Ferguson, Elizabeth; Pleus, Richard C.

    2007-08-01

    Nanotechnology is a broad and complex discipline that holds great promise for innovations that can benefit mankind. Yet, one must not overlook the wide array of factors involved in managing nanomaterial development, ranging from the technical specifications of the material to possible adverse effects in humans. Other opportunities to evaluate benefits and risks are inherent in environmental health and safety (EHS) issues related to nanotechnology. However, there is currently no structured approach for making justifiable and transparent decisions with explicit trade-offs between the many factors that need to be taken into account. While many possible decision-making approaches exist, we believe that multi-criteria decision analysis (MCDA) is a powerful and scientifically sound decision analytical framework for nanomaterial risk assessment and management. This paper combines state-of-the-art research in MCDA methods applicable to nanotechnology with a hypothetical case study for nanomaterial management. The example shows how MCDA application can balance societal benefits against unintended side effects and risks, and how it can also bring together multiple lines of evidence to estimate the likely toxicity and risk of nanomaterials given limited information on physical and chemical properties. The essential contribution of MCDA is to link this performance information with decision criteria and weightings elicited from scientists and managers, allowing visualization and quantification of the trade-offs involved in the decision-making process.

  9. Instruments for Assessing Risk of Bias and Other Methodological Criteria of Published Animal Studies: A Systematic Review

    PubMed Central

    Krauth, David; Woodruff, Tracey J.

    2013-01-01

    Background: Results from animal toxicology studies are critical to evaluating the potential harm from exposure to environmental chemicals or the safety of drugs prior to human testing. However, there is significant debate about how to evaluate the methodology and potential biases of the animal studies. There is no agreed-upon approach, and a systematic evaluation of current best practices is lacking. Objective: We performed a systematic review to identify and evaluate instruments for assessing the risk of bias and/or other methodological criteria of animal studies. Method: We searched Medline (January 1966–November 2011) to identify all relevant articles. We extracted data on risk of bias criteria (e.g., randomization, blinding, allocation concealment) and other study design features included in each assessment instrument. Discussion: Thirty distinct instruments were identified, with the total number of assessed risk of bias, methodological, and/or reporting criteria ranging from 2 to 25. The most common criteria assessed were randomization (25/30, 83%), investigator blinding (23/30, 77%), and sample size calculation (18/30, 60%). In general, authors failed to empirically justify why these or other criteria were included. Nearly all (28/30, 93%) of the instruments have not been rigorously tested for validity or reliability. Conclusion: Our review highlights a number of risk of bias assessment criteria that have been empirically tested for animal research, including randomization, concealment of allocation, blinding, and accounting for all animals. In addition, there is a need for empirically testing additional methodological criteria and assessing the validity and reliability of a standard risk of bias assessment instrument. Citation: Krauth D, Woodruff TJ, Bero L. 2013. Instruments for assessing risk of bias and other methodological criteria of published animal studies: a systematic review. Environ Health Perspect 121:985–992 (2013); http://dx.doi.org/10

  10. [From the licensure of vaccines to the recommendation of the Standing Committee on Vaccination in Germany : criteria for the assessment of benefits and risks].

    PubMed

    Pfleiderer, Michael; Wichmann, Ole

    2015-03-01

    Vaccines are among the most effective preventive measures in modern medicine and have led to a dramatic decline and-for a few diseases-even to the elimination of severely infectious diseases. There are some particularities of the risk-benefit assessment of vaccines compared with that of therapeutic drugs. These include the fact that vaccines are applied to healthy individuals with the aim of preventing an infectious disease, while therapeutic drugs are administered to sick people to cure them of an already acquired disease. The acceptable level of risk associated with the application of a vaccine is therefore much lower. In addition, high vaccination coverage can lead to population-level effects (e.g., the indirect protection of unvaccinated individuals) that can confer additional benefits to the population overall. When a marketing authorization application (MAA) for a novel vaccine is evaluated, conclusions are made regarding its quality, safety, and efficacy, and a benefit-risk assessment is carried out accordingly. In contrast, when deciding on the introduction of a new vaccine into a national immunization program or on a recommendation for a specific risk-group, the focus is shifted to considerations of how a licensed vaccine can be best used in a population (e.g., which immunization strategy is most effective in preventing deaths or hospitalizations, or in reducing treatment costs for the health care system). Stringent assessment criteria have been developed that require a robust safety analysis before a new vaccine is administered to humans for the first time in pre-licensure studies. Similarly, criteria are applied for calculating the benefit-risk ratio at the time of the licensure of a new vaccine in addition to during the entire post-licensure period. However, when deciding if and how a licensed vaccine can best be integrated into an existing immunization program, additional criteria are applied that are different, yet complementary to those applied for

  11. IMPROVED RISK CHARACTERIZATION METHODS FOR DEVELOPING AQUATIC LIFE CRITERIA FOR NON-BIOACCUMULATIVE TOXICANTS

    EPA Science Inventory

    This project will use existing and developing information to evaluate and demonstrate procedures for more fully characterizing risks of non-bioaccumulative toxicants to aquatic organisms, and for incorporating these risks into aquatic life criteria. These efforts will address a v...

  12. Criteria for risk acceptance: a health physicist's view. [Cost benefits of nuclear power

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hull, A P

    1977-01-01

    A controversy over the safety of nuclear energy has grown in the U.S. since about 1970 and has now spread to near worldwide proportions. This controversy has been fueled by a variety of issues. Initially in the U.S. the most prominent issue concerned the degree of hazard of low-level radiation, in particular that associated with the nuclear fuel cycle. Since then, attention has shifted successively to the reliability of emergency core cooling systems, the longevity of nuclear wastes, the possible misuse of radioactivity by terrorists and the potential for diversion of nuclear-power-produced plutonium to weapons fabrication. Underlying each of thesemore » issues has been the implication that the employment of nuclear power will entail an unacceptable risk to the public. A reasonable perspective in this regard is a yearly risk of 1 x 10/sup -6/ compared to the level of natural hazards such as earthquakes, floods, hurricanes, and tornados. Following a satisfactory demonstration of the safety of nuclear energy, hopefully the nuclear argument could be terminated. Society could then move on to the real issues affecting energy, population and quality of life.« less

  13. A FRAMEWORK TO DEVELOP FLAW ACCEPTANCE CRITERIA FOR STRUCTURAL INTEGRITY ASSESSMENT OF MULTIPURPOSE CANISTERS FOR EXTENDED STORAGE OF USED NUCLEAR FUEL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, P.; Sindelar, R.; Duncan, A.

    2014-04-07

    A multipurpose canister (MPC) made of austenitic stainless steel is loaded with used nuclear fuel assemblies and is part of the transfer cask system to move the fuel from the spent fuel pool to prepare for storage, and is part of the storage cask system for on-site dry storage. This weld-sealed canister is also expected to be part of the transportation package following storage. The canister may be subject to service-induced degradation especially if exposed to aggressive environments during possible very long-term storage period if the permanent repository is yet to be identified and readied. Stress corrosion cracking may bemore » initiated on the canister surface in the welds or in the heat affected zone because the construction of MPC does not require heat treatment for stress relief. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defects be detected by periodic Inservice Inspection. The external loading cases include thermal accident scenarios and cask drop conditions with the contribution from the welding residual stresses. The determination of acceptable flaw size is based on the procedure to evaluate flaw stability provided by American Petroleum Institute (API) 579 Fitness-for-Service (Second Edition). The material mechanical and fracture properties for base and weld metals and the stress analysis results are obtained from the open literature such as NUREG-1864. Subcritical crack growth from stress corrosion cracking (SCC), and its impact on inspection intervals and acceptance criteria, is not addressed.« less

  14. Acceptability of HIV self-testing: a systematic literature review.

    PubMed

    Krause, Janne; Subklew-Sehume, Friederike; Kenyon, Chris; Colebunders, Robert

    2013-08-08

    The uptake of HIV testing and counselling services remains low in risk groups around the world. Fear of stigmatisation, discrimination and breach of confidentiality results in low service usage among risk groups. HIV self-testing (HST) is a confidential HIV testing option that enables people to find out their status in the privacy of their homes. We evaluated the acceptability of HST and the benefits and challenges linked to the introduction of HST. A literature review was conducted on the acceptability of HST in projects in which HST was offered to study participants. Besides acceptability rates of HST, accuracy rates of self-testing, referral rates of HIV-positive individuals into medical care, disclosure rates and rates of first-time testers were assessed. In addition, the utilisation rate of a telephone hotline for counselling issues and clients` attitudes towards HST were extracted. Eleven studies met the inclusion criteria (HST had been offered effectively to study participants and had been administered by participants themselves) and demonstrated universally high acceptability of HST among study populations. Studies included populations from resource poor settings (Kenya and Malawi) and from high-income countries (USA, Spain and Singapore). The majority of study participants were able to perform HST accurately with no or little support from trained staff. Participants appreciated the confidentiality and privacy but felt that the provision of adequate counselling services was inadequate. The review demonstrates that HST is an acceptable testing alternative for risk groups and can be performed accurately by the majority of self-testers. Clients especially value the privacy and confidentiality of HST. Linkage to counselling as well as to treatment and care services remain major challenges.

  15. Understanding and acknowledging the ice throw hazard - consequences for regulatory frameworks, risk perception and risk communication

    NASA Astrophysics Data System (ADS)

    Bredesen, R. E.; Drapalik, M.; Butt, B.

    2017-11-01

    This study attempts to provide the necessary framework required to make sufficiently informed decisions regarding the safety implications of ice throw. The framework elaborates on how to cope with uncertainties, and how to describe results in a meaningful and useful manner to decision makers. Moreover, it points out the moral, judicial and economical obligations of wind turbine owners such that they are able to minimize risk of ice throws as much as possible. Building on the strength of knowledge as well as accounting for uncertainty are also essential in enabling clear communication with stakeholders on the most important/critical/vital issues. With increasing empirical evidence, one can assign a higher confidence level on the expert opinions on safety. Findings regarding key uncertainties of ice risk assessments are presented here to support the ongoing IEA Wind Task 19's work on creating the international guidelines on ice risk assessment due in 2018 (Krenn et al. 2017)[1-6]. In addition the study also incorporates the findings of a Norwegian information project, which focuses on the ice throw hazard for the public (Bredesen, Flage, Butt, Winterwind 2018)[7-9]. This includes measures to reduce damage and hazard from wind turbines for the general public. Recent theory of risk assessment questions the use of risk criteria for achieving optimum risk reduction and favours the use of the ALARA (as low as reasonably achievable) principle. Given the several practical problems associated with the ALARA approach (e.g. judicial realization), a joint approach, which uses a minimum set of criteria as well as the obligation to meet ALARA is suggested (associated with acceptable cost). The actual decision about acceptance criteria or obligations is a societal one, thus suggestions can be made at best. Risk acceptance, risk perception and risk communication are inextricably linked and should thus never be considered separately. Risk communication can shape risk perception

  16. Public Risk Criteria and Rationale for Commercial Launch and Reentry

    NASA Astrophysics Data System (ADS)

    Wilde, P. D.

    2012-01-01

    This paper summarizes the rationale for risk criteria intended to protect the public during commercial spaceflight, including launch, reentry, and suborbital missions. The recommended approach includes: (1) safety goals to guide periodic updates of the quantitative collective risk limits if warranted based on the quantity of launch and reentry missions; the demonstrated safety record and benefits provided; technological capabilities and maturity of the industry; and contemporary attitudes about the risks from commercial space transportation; (2) separate limits on the risks from each type of mission with explicit definitions of the extent of launch and reentry missions; and (3) quantitative risk limits consistent with the safety goals. For current conditions, the author's recommends (a) maximum of 1E-6 probability of casualty per-mission (b) a maximum of 100E-6 expected casualties per-mission, and (c) equal per-mission risk limits for orbital and suborbital launches, as well as controlled and uncontrolled reentries.

  17. Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico

    PubMed Central

    Galárraga, Omar; Sosa-Rubí, Sandra G.; Infante, César; Gertler, Paul J.; Bertozzi, Stefano M.

    2014-01-01

    The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9% for the monthly model, and 80.4% for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and it was 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$288 per person per year, but it was lower for MSW: USD$156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM & MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average willingness-to-accept estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model for targeted HIV/STI prevention. PMID:23377757

  18. Identification of vascular patients at very high risk for recurrent cardiovascular events: validation of the current ACC/AHA very high risk criteria.

    PubMed

    van den Berg, M Johanneke; Bhatt, Deepak L; Kappelle, L Jaap; de Borst, Gert J; Cramer, Maarten J; van der Graaf, Yolanda; Steg, Ph Gabriel; Visseren, Frank L J

    2017-11-14

    To validate and assess performance of the current ACC/AHA very high risk criteria in patients with clinically manifest arterial disease. Data were used from the SMART study (n = 7216) and REACH Registry (n = 48 322), two prospective cohorts of patients with manifest atherosclerotic arterial disease. Prevalence and incidence rates of recurrent major adverse cardiovascular events (MACE) were calculated, according to the ACC/AHA VHR criteria (cardiovascular disease combined with diabetes, smoking, dyslipidaemia, and/or recent recurrent coronary events). Performance of the ACC/AHA criteria was compared with single very high risk factors in terms of C-statistics and Net Reclassification Index. All patients were at VHR according to the ESC guidelines (incidence of recurrent MACE in SMART was 2.4/100PY, with 95% CI 2.3-2.5/100PY and in REACH 5.1/100PY with 95% CI 5.0-5.3/100PY). In SMART 57% of the patients were at VHR according to the ACC/AHA criteria (incidence of recurrent MACE 2.7/100PY, 95% CI 2.5-2.9/100PY) and in REACH this was 64% (5.9/100PY, 95% CI 5.7-6.1/100PY). The C-statistic for the ACC/AHA VHR criteria was 0.53 in REACH and 0.54 in SMART. Very high risk factors with comparable or slightly better performance were eGFR < 45, polyvascular disease and age >70 years. Around two third of the patients meeting the ACC/AHA VHR criteria had a predicted 10-year risk of recurrent MACE <30%. The ACC/AHA VHR criteria have limited discriminative power. Identifying patients with clinically manifest arterial disease at VHR for recurrent vascular events using eGFR <45, polyvascular disease, or age >70 years performs as well as the ACC/AHA VHR criteria. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  19. Monitoring Reading Behavior: Criteria for Performance.

    ERIC Educational Resources Information Center

    Powell, William R.

    Effective use of the informal reading inventory (IRI) depends upon the criteria used in determining the functional reading levels and more specifically the word recognition criteria employed in describing acceptable limits of oral reading behavior. The author of this paper looks at the diverse sets of criteria commonly used, the problems…

  20. Risk Assessment for Criteria Pollutants and Air Toxics in two Sites of Mexico City During 2003 Field Campaign

    NASA Astrophysics Data System (ADS)

    García, A. R.; Grutter, M. M.; Volkamer, R. M.

    2007-05-01

    An environmental risk assessment for criteria pollutants and air toxics in Mexico City is presented. The data used in the study were collected by FTIR and DOAS systems during the Mexico City Metropolitan Area field campaign on April 2003 (MCMA2003). The systems were deployed in two different sites: One in downtown (Merced) and the other in the south east (CENICA). Concentrations of criteria pollutants and air toxics were obtained every 5 min and were used to obtain hourly average concentrations and the month average for April. The concentration values were used to estimate the risks of acute and chronic exposure to ambient concentrations using risk measures like hazard index, life cancer probability, life lost expectancy and maximum individual cancer risk. Results revealed that both sites have similar risk values. For acute exposure, criteria pollutants have larger risks than air toxics, but air toxics have larger risks for chronic exposure. Ambient concentrations of benzene showed the largest carcinogenic risk of the measured air toxics.

  1. Social trust, risk perceptions and public acceptance of recycled water: testing a social-psychological model.

    PubMed

    Ross, Victoria L; Fielding, Kelly S; Louis, Winnifred R

    2014-05-01

    Faced with a severe drought, the residents of the regional city of Toowoomba, in South East Queensland, Australia were asked to consider a potable wastewater reuse scheme to supplement drinking water supplies. As public risk perceptions and trust have been shown to be key factors in acceptance of potable reuse projects, this research developed and tested a social-psychological model of trust, risk perceptions and acceptance. Participants (N = 380) were surveyed a few weeks before a referendum was held in which residents voted against the controversial scheme. Analysis using structural equation modelling showed that the more community members perceived that the water authority used fair procedures (e.g., consulting with the community and providing accurate information), the greater their sense of shared identity with the water authority. Shared social identity in turn influenced trust via increased source credibility, that is, perceptions that the water authority is competent and has the community's interest at heart. The findings also support past research showing that higher levels of trust in the water authority were associated with lower perceptions of risk, which in turn were associated with higher levels of acceptance, and vice versa. The findings have a practical application for improving public acceptance of potable recycled water schemes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Facts and values: on the acceptability of risks in children's sport using the example of rugby - a narrative review.

    PubMed

    Quarrie, Kenneth Lincoln; Brooks, John H M; Burger, Nicholas; Hume, Patria A; Jackson, Steve

    2017-08-01

    A clash of values has been identified between those who assert that:1. all childhood injuries, regardless of origin, are inherently undesirable and should be prevented and;2. those who believe that some measure of injury to children is an acceptable compromise for the physical benefits associated with physical activity and the development of abilities to appraise and deal with risks.A debate regarding whether the tackles and collisions permitted in schools' rugby represent acceptable risks, and what steps should be taken if they do not, exemplifies the issue.Questions regarding the magnitude of injury risks in sport are issues of fact and can be quantified via the results of injury surveillance studies. Risks are neither high nor low in isolation; they are relatively high or low with reference to other activities or across groups participating in an activity. Issues of the acceptability of a given degree of risk are value dependent. Research regarding perceptions of risk reveals wide variations in the degree of risk people view as acceptable. Factors impacting on risk perception include whether the risks are well known and understood, whether they are 'dread' risks and the degree to which people undertake the risks voluntarily and feel they have control over them.Based on the evidence currently available, the risks to children playing rugby do not appear to be inordinately high compared with those in a range of other childhood sports and activities, but better comparative information is urgently needed. Further evidence, however, should not necessarily be expected to result in the resolution of acceptable risk debates-pre-existing values shape our perspectives on whether new evidence is relevant, valid and reliable. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Four ECG left ventricular hypertrophy criteria and the risk of cardiovascular events and mortality in patients with vascular disease.

    PubMed

    van Kleef, Monique E A M; Visseren, Frank L J; Vernooij, Joris W P; Nathoe, Hendrik M; Cramer, Maarten-Jan M; Bemelmans, Remy H H; van der Graaf, Yolanda; Spiering, Wilko

    2018-06-06

    The relation between different electrocardiographic left ventricular hypertrophy (ECG-LVH) criteria and cardiovascular risk in patients with clinical manifest arterial disease is unclear. Therefore, we determined the association between four ECG-LVH criteria: Sokolow-Lyon, Cornell product, Cornell/strain index and Framingham criterion; and risk of cardiovascular events and mortality in this population. Risk of cardiovascular events was estimated in 6913 adult patients with clinical manifest arterial disease originating from the Secondary Manifestations of ARTerial disease (SMART) cohort. Cox proportional regression analysis was used to estimate the risk of the four ECG-LVH criteria and the primary composite outcome: myocardial infarction (MI), stroke or cardiovascular death; and secondary outcomes: MI, stroke and all-cause mortality; adjusted for confounders. The highest prevalence of ECG-LVH was observed for Cornell product (10%) and Cornell/strain index (9%). All four ECG-LVH criteria were associated with an increased risk of the primary composite endpoint: Sokolow-Lyon (hazard ratio 1.37, 95% CI 1.13-1.66), Cornell product (hazard ratio 1.54, 95% CI 1.30-1.82), Cornell/strain index (hazard ratio 1.70, 95% CI 1.44-2.00) and Framingham criterion (hazard ratio 1.78, 95% CI 1.21-2.62). Cornell product, Cornell/strain index and Framingham criterion ECG-LVH were additionally associated with an elevated risk of secondary outcomes. Cardiovascular risk increased whenever two, or three or more ECG-LVH criteria were present concurrently. All four ECG-LVH criteria are associated with an increased risk of cardiovascular events. As Cornell/strain index is both highly prevalent and carries a high cardiovascular risk, this is likely the most relevant ECG-LVH criterion for clinical practice.

  4. Risk-based containment and air monitoring criteria for work with dispersible radioactive materials.

    PubMed

    Veluri, Venkateswara Rao; Justus, Alan L

    2013-04-01

    This paper presents readily understood, technically defensible, risk-based containment and air monitoring criteria, which are developed from fundamental physical principles. The key for the development of each criterion was the use of a calculational de minimis level, in this case chosen to be 100 mrem (or 40 DAC-h). Examples are provided that demonstrate the effective use of each criterion. Comparison to other often used criteria is provided.

  5. Downstaging therapy followed by liver transplantation for hepatocellular carcinoma beyond Milan criteria.

    PubMed

    Kim, Young; Stahl, Christopher C; Makramalla, Abouelmagd; Olowokure, Olugbenga O; Ristagno, Ross L; Dhar, Vikrom K; Schoech, Michael R; Chadalavada, Seetharam; Latif, Tahir; Kharofa, Jordan; Bari, Khurram; Shah, Shimul A

    2017-12-01

    Orthotopic liver transplantation is a curative treatment for hepatocellular carcinoma within Milan criteria, but these criteria preclude many patients from transplant candidacy. Recent studies have demonstrated that downstaging therapy can reduce tumor burden to meet conventional criteria. The present study reports a single-center experience with tumor downstaging and its effects on post-orthotopic liver transplantation outcomes. All patients with hepatocellular carcinoma who were evaluated by our multidisciplinary liver services team from 2012 to 2016 were identified (N = 214). Orthotopic liver transplantation candidates presenting outside of Milan criteria at initial radiographic diagnosis and/or an initial alpha-fetoprotein >400 ng/mL were categorized as at high risk for tumor recurrence and post-transplant mortality. Of the 214 patients newly diagnosed with hepatocellular carcinoma, 73 (34.1%) eventually underwent orthotopic liver transplantation. The majority of patients who did not undergo orthotopic liver transplantation were deceased or lost to follow-up (47.5%), with 14 of 141 (9.9%) currently listed for transplantation. Among transplanted patients, 21 of 73 (28.8%) were considered high-risk candidates. All 21 patients were downstaged to within Milan criteria with an alpha-fetoprotein <400 ng/mL before orthotopic liver transplantation, through locoregional therapies. Recurrence of hepatocellular carcinoma was higher but acceptable between downstaged high-risk and traditional candidates (9.5% vs 1.9%; P > .05) at a median follow-up period of 17 months. Downstaged high-risk candidates had a similar overall survival compared with those transplanted within Milan criteria (log-rank P > .05). In highly selected cases, patients with hepatocellular carcinoma outside of traditional criteria for orthotopic liver transplantation may undergo downstaging therapy in a multidisciplinary fashion with excellent post-transplant outcomes. These data support an

  6. Prototype Training Materials for Acceptance Criteria of Maintenance ASAP Events Occurring Within Social Context

    NASA Technical Reports Server (NTRS)

    Taylor, J. C.

    2004-01-01

    The aviation maintenance community is at a crossroads with respect to implementing the Aviation Safety Action Program (ASAP). While there is considerable interest, several key issues have emerged that cast doubt on how to assure a successful implementation, including buy-in from all levels of the company and training for key participants. There are two objectives for the present report. The first is to provide an examination of limits (or more properly, examples) of the degree of acceptability of more problematic events for risk-based decisions within the current ASAP guidelines. The second objective is to apply these limits of community standards to a set of further refined ASAP training scenarios.

  7. 77 FR 37803 - Customer Clearing Documentation, Timing of Acceptance for Clearing, and Clearing Member Risk...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... COMMODITY FUTURES TRADING COMMISSION 17 CFR Part 38 RIN 3038-0092, -0094 Customer Clearing Documentation, Timing of Acceptance for Clearing, and Clearing Member Risk Management; Core Principles and Other... for Clearing, and Clearing Member Risk Management, and Core Principles and Other Requirements for...

  8. The Effect of Marriage and HIV Risks on Condom Use Acceptability in Rural Malawi

    PubMed Central

    Anglewicz, Philip; Clark, Shelley

    2013-01-01

    A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent’s HIV status, HIV perceptions, and risk behaviors, and (3) spouse’s HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. PMID:24161086

  9. A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy.

    PubMed

    Margari, Niki; Pouliakis, Abraham; Anoinos, Dionysios; Terzakis, Emmanouil; Koureas, Nikolaos; Chrelias, Charalampos; Marios Makris, George; Pappas, Assimakis; Bilirakis, Evripidis; Goudeli, Christina; Damaskou, Vasileia; Papantoniou, Nicolaos; Panayiotides, Ioannis; Karakitsos, Petros

    2016-11-01

    There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy. The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated. The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively. We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888-901. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Criteria for assessing the ecological risk of nonylphenol for aquatic life in Chinese surface fresh water.

    PubMed

    Zhang, Liangmao; Wei, Caidi; Zhang, Hui; Song, Mingwei

    2017-10-01

    The typical environmental endocrine disruptor nonylphenol is becoming an increasingly common pollutant in both fresh and salt water; it compromises the growth and development of many aquatic organisms. As yet, water quality criteria with respect to nonylphenol pollution have not been established in China. Here, the predicted "no effect concentration" of nonylphenol was derived from an analysis of species sensitivity distribution covering a range of species mainly native to China, as a means of quantifying the ecological risk of nonylphenol in surface fresh water. The resulting model, based on the log-logistic distribution, proved to be robust; the minimum sample sizes required for generating a stable estimate of HC 5 were 12 for acute toxicity and 13 for chronic toxicity. The criteria maximum concentration and criteria continuous concentration were, respectively 18.49 μg L -1 and 1.85 μg L -1 . Among the 24 sites surveyed, two were associated with a high ecological risk (risk quotient >1) and 12 with a moderate ecological risk (risk quotient >0.1). The potentially affected fraction ranged from 0.008% to 24.600%. The analysis provides a theoretical basis for both short- and long-term risk assessments with respect to nonylphenol, and also a means to quantify the risk to aquatic ecosystems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Perceived Risk in College Selection: Differences in Evaluative Criteria Used by Students and Parents

    ERIC Educational Resources Information Center

    Warwick, Jacquelyn; Mansfield, Phylis M.

    2003-01-01

    Students and parents base college selection on how well the college will overcome the perceived financial, social, psychological, physical, and functional risks associated with the college experience. Nineteen criteria associated with these risks were evaluated for significant differences between students and parents as well as for their level of…

  12. The risk of cancer in recipients of living-donor, standard and expanded criteria deceased donor kidney transplants: a registry analysis.

    PubMed

    Ma, Maggie K M; Lim, Wai H; Turner, Robin M; Chapman, Jeremy R; Craig, Jonathan C; Wong, Germaine

    2014-12-27

    Kidneys from expanded criteria deceased donors may elicit a strong inflammatory response, predisposing recipients to an increased risk of cancer after transplantation. We aimed to determine the association between donor types and cancer risk after kidney transplantation. Using the Australian and New Zealand Dialysis and Transplant Registry, we assessed the association between different donor types (living donor, standard, and expanded criteria deceased donors) and the risk of cancer after kidney transplantation using adjusted Cox proportional hazard and competing risk models. Over a median follow-up period of 4.4 years in 7,040 patients (34,684 patient-years), 468 patients (6.6%) developed cancer. The overall risks for cancer were 1,080, 1,444, and 2,018 per 100,000 patient-years for recipients of living donor, standard, and expanded criteria deceased donor kidneys, respectively. Compared to recipients of living-donor kidneys, recipients of expanded criteria deceased donor kidneys were at an increased risk of cancer (adjusted hazard ratio [HR], 1.52; 95% confidence interval [95% CI], 1.15-2.02; P = 0.004), particularly for genitourinary cancer (adjusted HR, 1.79; 95% CI, 1.03-3.10; P = 0.038) and post-transplant lymphoproliferative disease (adjusted HR, 2.72; 95% CI, 1.38-5.37; P = 0.004). Recipients of expanded criteria deceased donor kidneys are at substantially increased risk of cancer, especially cancers with a viral etiology. Allocation of expanded criteria deceased donor kidneys to potential recipients should balance the harms, such as the excess risk of cancer against the survival gains and quality-of-life benefits associated with transplantation.

  13. Risk-based maintenance of ethylene oxide production facilities.

    PubMed

    Khan, Faisal I; Haddara, Mahmoud R

    2004-05-20

    This paper discusses a methodology for the design of an optimum inspection and maintenance program. The methodology, called risk-based maintenance (RBM) is based on integrating a reliability approach and a risk assessment strategy to obtain an optimum maintenance schedule. First, the likely equipment failure scenarios are formulated. Out of many likely failure scenarios, the ones, which are most probable, are subjected to a detailed study. Detailed consequence analysis is done for the selected scenarios. Subsequently, these failure scenarios are subjected to a fault tree analysis to determine their probabilities. Finally, risk is computed by combining the results of the consequence and the probability analyses. The calculated risk is compared against known acceptable criteria. The frequencies of the maintenance tasks are obtained by minimizing the estimated risk. A case study involving an ethylene oxide production facility is presented. Out of the five most hazardous units considered, the pipeline used for the transportation of the ethylene is found to have the highest risk. Using available failure data and a lognormal reliability distribution function human health risk factors are calculated. Both societal risk factors and individual risk factors exceeded the acceptable risk criteria. To determine an optimal maintenance interval, a reverse fault tree analysis was used. The maintenance interval was determined such that the original high risk is brought down to an acceptable level. A sensitivity analysis is also undertaken to study the impact of changing the distribution of the reliability model as well as the error in the distribution parameters on the maintenance interval.

  14. Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico.

    PubMed

    Galárraga, Omar; Sosa-Rubí, Sandra G; Infante, César; Gertler, Paul J; Bertozzi, Stefano M

    2014-01-01

    The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9 % for the monthly model, and 80.4 % for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$ 288 per person per year, but it was lower for MSW: USD$ 156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM and MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average WTA estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model to targeted HIV/STI prevention.

  15. Societal acceptance of controversial facilities: The role of two public participation strategies---negotiation and risk communication

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wolfe, A.K.

    Public participation in decision making about the siting of controversial facilities is viewed in contradictory ways by different groups of people. Some see public participation as an impediment, while others think it is an important mechanism in gaining societal acceptance for eventual siting. This paper discusses two strategies for obtaining societal acceptance--- negotiation and risk communication---in light of the extent to which they (1) involve members of the public; (2) focus on risk-related issues; and (3) contribute to decisions to site controversial facilities. The paper presents an integrated conceptual model for public participation in siting decisions that incorporates risk asmore » well as social, political, and historical contexts. 20 refs., 1 fig.« less

  16. The effect of marriage and HIV risks on condom use acceptability in rural Malawi.

    PubMed

    Anglewicz, Philip; Clark, Shelley

    2013-11-01

    A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... must be subjected to the Drop Weight Impact Sensitivity Test (Test Method 3(a)(i)), the Friction... substance has a friction sensitiveness equal to or greater than that of dry pentaerythrite tetranitrate (PETN) when tested in the Friction Sensitivity Test; (4) The substance fails to pass the test criteria...

  18. Optimal Utilization of Donor Grafts With Extended Criteria

    PubMed Central

    Cameron, Andrew M.; Ghobrial, R Mark; Yersiz, Hasan; Farmer, Douglas G.; Lipshutz, Gerald S.; Gordon, Sherilyn A.; Zimmerman, Michael; Hong, Johnny; Collins, Thomas E.; Gornbein, Jeffery; Amersi, Farin; Weaver, Michael; Cao, Carlos; Chen, Tony; Hiatt, Jonathan R.; Busuttil, Ronald W.

    2006-01-01

    Objective: Severely limited organ resources mandate maximum utilization of donor allografts for orthotopic liver transplantation (OLT). This work aimed to identify factors that impact survival outcomes for extended criteria donors (ECD) and developed an ECD scoring system to facilitate graft-recipient matching and optimize utilization of ECDs. Methods: Retrospective analysis of over 1000 primary adult OLTs at UCLA. Extended criteria (EC) considered included donor age (>55 years), donor hospital stay (>5 days), cold ischemia time (>10 hours), and warm ischemia time (>40 minutes). One point was assigned for each extended criterion. Cox proportional hazard regression model was used for multivariate analysis. Results: Of 1153 allografts considered in the study, 568 organs exhibited no extended criteria (0 score), while 429, 135 and 21 donor allografts exhibited an EC score of 1, 2 and 3, respectively. Overall 1-year patient survival rates were 88%, 82%, 77% and 48% for recipients with EC scores of 0, 1, 2 and 3 respectively (P < 0.001). Adjusting for recipient age and urgency at the time of transplantation, multivariate analysis identified an ascending mortality risk ratio of 1.4 and 1.8 compared to a score of 0 for an EC score of 1, and 2 (P < 0.01) respectively. In contrast, an EC score of 3 was associated with a mortality risk ratio of 4.5 (P < 0.001). Further, advanced recipient age linearly increased the death hazard ratio, while an urgent recipient status increased the risk ratio of death by 50%. Conclusions: Extended criteria donors can be scored using readily available parameters. Optimizing perioperative variables and matching ECD allografts to appropriately selected recipients are crucial to maintain acceptable outcomes and represent a preferable alternative to both high waiting list mortality and to a potentially futile transplant that utilizes an ECD for a critically ill recipient. PMID:16772778

  19. Viability criteria for steelhead of the south-central and southern California coast

    USGS Publications Warehouse

    Boughton, David A.; Adams, Peter B.; Anderson, Eric; Fusaro, Craig; Keller, Edward A.; Kelley, Elsie; Lentsch, Leo; Nielsen, Jennifer L.; Perry, Katie; Regan, Helen; Smith, Jerry; Swift, Camm C.; Thompson, Lisa; Watson, Fred

    2007-01-01

    Recovery planning for threatened and endangered steelhead requires measurable, objective criteria for determining an acceptably low risk of extinction. Here we propose viability criteria for two levels of biological organization: individual populations, and groups of populations within the SouthCentral/Southern California Coast Steelhead Recovery Planning Domain. For populations, we adapt criteria commonly used by the IUCN (The World Conservation Union) for identifying at-risk species. For groups of populations we implement a diversity-based “representation and redundancy rule,” in which diversity includes both life-history diversity and biogeographic groupings of populations. The resulting criteria have the potential for straightforward assessment of the risks posed by evolutionary, demographic, environmental, and catastrophic factors; and are designed to use data that are readily collected. However, our prescriptive approach led to one criterion whose threshold could not yet be specified due to inadequate data, and others in which the simplicity of the criteria may render them inefficient for populations with stable run sizes or stable life-history polymorphisms. Both of these problems could likely be solved by directed programs of research and monitoring aimed at developing more efficient (but equally risk-averse) “performance-based criteria.” Of particular utility would be data on the natural fluctuations of populations, research into the stabilizing influence of life-history polymorphisms, and research on the implications of drought, wildfires, and fluvial sediment regimes. Research on estuarine habitat could also yield useful information on the generality and reliability of its role as nursery habitat. Currently, risk assessment at the population level is not possible due to data deficiency, highlighting the need to implement a comprehensive effort to monitor run sizes, anadromous fractions, spawner densities and perhaps marine survival. Assessment at

  20. Criteria for use of composite end points for competing risks-a systematic survey of the literature with recommendations.

    PubMed

    Manja, Veena; AlBashir, Siwar; Guyatt, Gordon

    2017-02-01

    Composite end points are frequently used in reports of clinical trials. One rationale for the use of composite end points is to account for competing risks. In the presence of competing risks, the event rate of a specific event depends on the rates of other competing events. One proposed solution is to include all important competing events in one composite end point. Clinical trialists require guidance regarding when this approach is appropriate. To identify publications describing criteria for use of composite end points for competing risk and to offer guidance regarding when a composite end point is appropriate on the basis of competing risks. We searched MEDLINE, CINAHL, EMBASE, The Cochrane's Central & Systematic Review databases including the Health Technology Assessment database, and the Cochrane's Methodology register from inception to April 2015, and candidate textbooks, to identify all articles providing guidance on this issue. Eligible publications explicitly addressed the issue of a composite outcome to address competing risks. Two reviewers independently screened the titles and abstracts for full-text review; independently reviewed full-text publications; and abstracted specific criteria authors offered for use of composite end points to address competing risks. Of 63,645 titles and abstracts, 166 proved potentially relevant of which 43 publications were included in the final review. Most publications note competing risks as a reason for using composite end points without further elaboration. None of the articles or textbook chapters provide specific criteria for use of composite end points for competing risk. Some advocate using composite end points to avoid bias due to competing risks and others suggest that composite end points seldom or never be used for this purpose. We recommend using composite end points for competing risks only if the competing risk is plausible and if it occurs with sufficiently high frequency to influence the interpretation

  1. Pre-risk HIV-prevention paradigm shift: the feasibility and acceptability of the parents matter! Program in HIV risk communities.

    PubMed

    Miller, Kim S; Maxwell, Karl D; Fasula, Amy M; Parker, J Terry; Zackery, Shannon; Wyckoff, Sarah C

    2010-01-01

    Many youth begin human immunodeficiency virus (HIV) sexual risk behaviors in preadolescence, yet risk-reduction programs are typically implemented in middle or late adolescence, missing an important window for prevention. Parent-based programming may play an important role in reaching youth early with prevention messages. One such program is the Parents Matter! Program (PMP), a five-session theory- and evidence-based intervention for parents of children aged 9 to 12 years. A randomized controlled trial showed PMP to be efficacious in promoting effective parent-child communication about sexuality and sexual risk reduction. We assessed the feasibility and acceptability of PMP when implemented under typical programmatic circumstances in communities at high risk for HIV infection. We selected 15 sites (including health departments, local education agencies, community-based organizations, and faith-based organizations) throughout the U.S. and Puerto Rico to participate in delivering PMP. Sites were provided training, program materials, and ongoing technical assistance. We collected multilevel data to assess the feasibility of program implementation and delivery, program relevance, and satisfaction with PMP activities and materials. PMP was successfully implemented and evaluated in 13 of 15 sites; 76% of parents attended at least four of five sessions. Organization-, facilitator-, and parent-level data indicated the feasibility and acceptability of PMP, and overall high satisfaction with PMP activities and materials. The results of this project demonstrate that HIV pre-risk prevention programs for parents can be implemented and embraced by a variety of community organizations in HIV at-risk communities. The time to embrace parents as partners in public health HIV-prevention efforts has come.

  2. Participation in Counseling Programs: High-Risk Participants Are Reluctant to Accept HIV-Prevention Counseling

    PubMed Central

    Earl, Allison; Albarracín, Dolores; Durantini, Marta R.; Gunnoe, Joann B.; Leeper, Josh; Levitt, Justin H.

    2013-01-01

    HIV-prevention intervention effectiveness depends on understanding whether clients with highest need for HIV-prevention counseling accept it. With this objective, a field study with a high-risk community sample from the southeastern United States (N = 350) investigated whether initial knowledge about HIV, motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use correlate with subsequent acceptance of an HIV-prevention counseling session. Ironically, participants with high (vs. low) motivation to use condoms, high (vs. low) condom-use-relevant behavioral skills, and high (vs. low) prior condom use were more likely to accept the HIV-prevention counseling. Moreover, the influence of motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use on acceptance of the counseling was mediated by expectations that the counseling session would be useful. Methods to reduce barriers to recruitment of clients for counseling programs are discussed. PMID:19634960

  3. Acceptability of hypothetical dengue vaccines among travelers.

    PubMed

    Benoit, Christine M; MacLeod, William B; Hamer, Davidson H; Sanchez-Vegas, Carolina; Chen, Lin H; Wilson, Mary E; Karchmer, Adolf W; Yanni, Emad; Hochberg, Natasha S; Ooi, Winnie W; Kogelman, Laura; Barnett, Elizabeth D

    2013-01-01

    Dengue viruses have spread widely in recent decades and cause tens of millions of infections mostly in tropical and subtropical areas. Vaccine candidates are being studied aggressively and may be ready for licensure soon. We surveyed patients with past or upcoming travel to dengue-endemic countries to assess rates and determinants of acceptance for four hypothetical dengue vaccines with variable efficacy and adverse event (AE) profiles. Acceptance ratios were calculated for vaccines with varied efficacy and AE risk. Acceptance of the four hypothetical vaccines ranged from 54% for the vaccine with lower efficacy and serious AE risk to 95% for the vaccine with higher efficacy and minor AE risk. Given equal efficacy, vaccines with lower AE risk were better accepted than those with higher AE risk; given equivalent AE risk, vaccines with higher efficacy were better accepted than those with lower efficacy. History of Japanese encephalitis vaccination was associated with lower vaccine acceptance for one of the hypothetical vaccines. US-born travelers were more likely than non-US born travelers to accept a vaccine with 75% efficacy and a risk of minor AEs (p = 0.003). Compared with North American-born travelers, Asian- and African-born travelers were less likely to accept both vaccines with 75% efficacy. Most travelers would accept a safe and efficacious dengue vaccine if one were available. Travelers valued fewer potential AEs over increased vaccine efficacy. © 2013 International Society of Travel Medicine.

  4. Minimum training criteria for police traffic accident reconstruction.

    DOT National Transportation Integrated Search

    1987-03-01

    This report summarizes the development of a set of minimum training criteria for police accident reconstructionists. Prior to this effort, no nationally accepted standards or criteria were recognized for evaluating the qualifications of police engage...

  5. Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields.

    PubMed

    Freudenstein, Frederik; Wiedemann, Peter M; Brown, Tim W C

    2015-01-01

    The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one's own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed.

  6. Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields

    PubMed Central

    Wiedemann, Peter M.; Brown, Tim W. C.

    2015-01-01

    The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one's own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed. PMID:26229540

  7. Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Driver, C.J.

    1994-05-01

    Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approachesmore » proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.« less

  8. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  9. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  10. 16 CFR 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  11. Developing acceptance limits for measured bearing wear of the Space Shuttle Main Engine high pressure oxidizer turbopump

    NASA Technical Reports Server (NTRS)

    Genge, Gary G.

    1991-01-01

    The probabilistic design approach currently receiving attention for structural failure modes has been adapted for obtaining measured bearing wear limits in the Space Shuttle Main Engine high-pressure oxidizer turbopump. With the development of the shaft microtravel measurements to determine bearing health, an acceptance limit was neeed that protects against all known faiure modes yet is not overly conservative. This acceptance criteria limit has been successfully determined using probabilistic descriptions of preflight hardware geometry, empirical bearing wear data, mission requirements, and measurement tool precision as an input for a Monte Carlo simulation. The result of the simulation is a frequency distribution of failures as a function of preflight acceptance limits. When the distribution is converted into a reliability curve, a conscious risk management decision is made concerning the acceptance limit.

  12. Using the androgen excess-PCOS society criteria to diagnose polycystic ovary syndrome and the risk of metabolic syndrome in adolescents.

    PubMed

    Roe, Andrea Hsu; Prochaska, Erica; Smith, Matthew; Sammel, Mary; Dokras, Anuja

    2013-05-01

    To use the Androgen Excess-PCOS Society (AE-PCOS) criteria in adolescents to diagnose polycystic ovary syndrome (PCOS) and identify the prevalence of metabolic risk factors. Retrospective chart review of adolescents (>2 years postmenarche) presenting at a specialty clinic from 2008 through 2010 with complete evaluation for PCOS and metabolic risk were reviewed. Metabolic risk in adolescents with PCOS was compared with those with ≤ 1 AE-PCOS criteria. Of the 205 adolescents evaluated, 66% were found to have PCOS based on the AE-PCOS criteria. The most common presenting symptom was menstrual irregularity, followed by acne, hirsutism, and weight gain. Adolescents with PCOS had a significantly higher prevalence of obesity, hypertension, and low level of high-density lipoprotein cholesterol. Subjects with PCOS had ≥ 1 metabolic risk factor compared with the subjects without PCOS (63.6% vs 33.3%, P = .002). More adolescents with PCOS had ≥ 2 abnormal metabolic risk factors excluding body mass index compared with those without PCOS (P < .02). The prevalence of metabolic syndrome (≥ 3 risk factors) was 10.8% in adolescents with PCOS compared with 1.7% in those without PCOS (P < .04). Adolescents diagnosed with PCOS based on the AE-PCOS criteria are at a significantly increased risk of ≥ 1 metabolic abnormality. Our data underscore the need to accurately diagnose PCOS in the adolescent population instead of delaying the diagnosis to adulthood. Further, using similar criteria for the diagnosis of PCOS in adolescents (>2 years postmenarche) and adults will be more convenient for the clinician. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Using multi-criteria risk ranking methodology to select case studies for a generic risk assessment framework for exotic disease incursion and spread through Europe.

    PubMed

    Horigan, V; De Nardi, M; Simons, R R L; Bertolini, S; Crescio, M I; Estrada-Peña, A; Léger, A; Maurella, C; Ru, G; Schuppers, M; Stärk, K D C; Adkin, A

    2018-05-01

    We present a novel approach of using the multi-criteria pathogen prioritisation methodology as a basis for selecting the most appropriate case studies for a generic risk assessment framework. The approach uses selective criteria to rank exotic animal health pathogens according to the likelihood of introduction and the impact of an outbreak if it occurred in the European Union (EU). Pathogens were evaluated based on their impact on production at the EU level and international trade. A subsequent analysis included criteria of relevance to quantitative risk assessment case study selection, such as the availability of data for parameterisation, the need for further research and the desire for the case studies to cover different routes of transmission. The framework demonstrated is flexible with the ability to adjust both the criteria and their weightings to the user's requirements. A web based tool has been developed using the RStudio shiny apps software, to facilitate this. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  14. EU landfill waste acceptance criteria and EU Hazardous Waste Directive compliance testing of incinerated sewage sludge ash.

    PubMed

    Donatello, S; Tyrer, M; Cheeseman, C R

    2010-01-01

    A hazardous waste assessment has been completed on ash samples obtained from seven sewage sludge incinerators operating in the UK, using the methods recommended in the EU Hazardous Waste Directive. Using these methods, the assumed speciation of zinc (Zn) ultimately determines if the samples are hazardous due to ecotoxicity hazard. Leaching test results showed that two of the seven sewage sludge ash samples would require disposal in a hazardous waste landfill because they exceed EU landfill waste acceptance criteria for stabilised non-reactive hazardous waste cells for soluble selenium (Se). Because Zn cannot be proven to exist predominantly as a phosphate or oxide in the ashes, it is recommended they be considered as non-hazardous waste. However leaching test results demonstrate that these ashes cannot be considered as inert waste, and this has significant implications for the management, disposal and re-use of sewage sludge ash.

  15. Crew Transportation Technical Standards and Design Evaluation Criteria

    NASA Technical Reports Server (NTRS)

    Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

    2015-01-01

    Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

  16. Prevalence of Premorbid Metabolic Syndrome in Spanish Adult Workers Using IDF and ATPIII Diagnostic Criteria: Relationship with Cardiovascular Risk Factors

    PubMed Central

    Tauler, Pedro; Bennasar-Veny, Miquel; Morales-Asencio, Jose M.; Lopez-Gonzalez, Angel A.; Vicente-Herrero, Teofila; De Pedro-Gomez, Joan; Royo, Vanessa; Pericas-Beltran, Jordi; Aguilo, Antoni

    2014-01-01

    Background Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. Research Methodology/Findings A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20–65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. Conclusions PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and

  17. Prevalence of premorbid metabolic syndrome in Spanish adult workers using IDF and ATPIII diagnostic criteria: relationship with cardiovascular risk factors.

    PubMed

    Tauler, Pedro; Bennasar-Veny, Miquel; Morales-Asencio, Jose M; Lopez-Gonzalez, Angel A; Vicente-Herrero, Teofila; De Pedro-Gomez, Joan; Royo, Vanessa; Pericas-Beltran, Jordi; Aguilo, Antoni

    2014-01-01

    Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20-65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and type 2 diabetes.

  18. [Effects of message and personal involvement on risk perception and acceptance].

    PubMed

    Masuchi, A; Takigawa, T

    1999-10-01

    The present study analyzed people's risk perception regarding driving a car with studded or non-studded winter tires. Subjects were 252 residents of Sapporo, where a recent municipal ordinance prohibited studded tires, allowing only non-studded ones. Questionnaire data were examined concerning (1) the relationship between risk perception and its acceptance, (2) the effect of an inserted message, which was either positive or negative about the use of non-studded tires, and (3) the role of personal involvement, assessed with Personal Involvement Inventory (Zaichkowsky, 1985), regarding winter driving. Results were as follows: (1) The use of non-studded tires was favorably judged because of social benefit, but subjects hesitated to choose them because of a higher perceived possibility of an accident. (2) The inserted message had significant effects on benefit evaluation and perceived accident possibility. The effects were weaker for drivers who had experienced driving a car with studded tires. And (3) personal involvement had a weak correlation with risk judgements of the present study.

  19. Space Radiation Cancer Risks

    NASA Technical Reports Server (NTRS)

    Cucinotta, Francis A.

    2007-01-01

    Space radiation presents major challenges to astronauts on the International Space Station and for future missions to the Earth s moon or Mars. Methods used to project risks on Earth need to be modified because of the large uncertainties in projecting cancer risks from space radiation, and thus impact safety factors. We describe NASA s unique approach to radiation safety that applies uncertainty based criteria within the occupational health program for astronauts: The two terrestrial criteria of a point estimate of maximum acceptable level of risk and application of the principle of As Low As Reasonably Achievable (ALARA) are supplemented by a third requirement that protects against risk projection uncertainties using the upper 95% confidence level (CL) in the radiation cancer projection model. NASA s acceptable level of risk for ISS and their new lunar program have been set at the point-estimate of a 3-percent risk of exposure induced death (REID). Tissue-averaged organ dose-equivalents are combined with age at exposure and gender-dependent risk coefficients to project the cumulative occupational radiation risks incurred by astronauts. The 95% CL criteria in practice is a stronger criterion than ALARA, but not an absolute cut-off as is applied to a point projection of a 3% REID. We describe the most recent astronaut dose limits, and present a historical review of astronaut organ doses estimates from the Mercury through the current ISS program, and future projections for lunar and Mars missions. NASA s 95% CL criteria is linked to a vibrant ground based radiobiology program investigating the radiobiology of high-energy protons and heavy ions. The near-term goal of research is new knowledge leading to the reduction of uncertainties in projection models. Risk projections involve a product of many biological and physical factors, each of which has a differential range of uncertainty due to lack of data and knowledge. The current model for projecting space radiation

  20. Investigation of risk factors of psychological acceptance and burnout syndrome among nurses in China.

    PubMed

    Yao, Yongcheng; Yao, Wu; Wang, Wei; Li, Hong; Lan, Yajia

    2013-10-01

    The objectives of this study were to determine reliability of Chinese version of Acceptance and Action Questionnaire-II (AAQ-II), the relationship between psychological acceptance (PA), and burnout syndrome and their risk factors among nurses in China. The reliability of AAQ-II in Chinese was evaluated first by testing on 111 doctors and 108 nurses in China. On the number of 845 nurses selected from nine city hospitals by using stratified cluster sampling method, the Maslach Burnout Inventory-General Survey was administered to establish the presence of burnout, and the AAQ-II was used to measure their PA. Results showed that the AAQ-II in Chinese had a good test-retest reliability. PA was statistically significantly negatively correlated to the three dimensionalities of burnout among nurses in China. Male and female nurses had a significant difference in PA. Risk factors for burnout were age (25-44 years), marital status (married), gender (male), hospital department (emergency) and position (primary title) as well as PA. The findings provide insights into the risk factors of burnout in Chinese nurses and may have clinical implications in preventing burnout in Chinese nurses. © 2013 Wiley Publishing Asia Pty Ltd.

  1. Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species.

    PubMed

    Davidson, Alisha D; Hewitt, Chad L; Kashian, Donna R

    2015-01-01

    Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources.

  2. The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: An integrative review.

    PubMed

    Stephen, Catherine; McInnes, Susan; Halcomb, Elizabeth

    2018-02-01

    To explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice/family practice). Growing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions. Integrative review guided by the work of Whittemore and Knafl (). Database search of CINAHL, Medline and Web of Science was conducted to identify relevant literature published between 2000-2015. Papers were assessed for methodological quality and data abstracted before thematic analysis was undertaken. Eleven papers met the inclusion criteria. Analysis uncovered four themes: (1) facilitators of interventions; (2) barriers to interventions; (3) consumer satisfaction; and (4) primary care nurse role. Literature supports the feasibility and acceptability of nurse-led interventions in primary care for lifestyle risk factor modification. The ongoing sustainability of these interventions rests largely on organizational factors such as funding, educational pathways and professional support of the primary care nursing role. Further robust research around primary care nurse interventions is required to strengthen the evidence base. © 2017 John Wiley & Sons Ltd.

  3. Impact of Risk-Benefit Perception and Trust on Medical Technology Acceptance in Relation to Drug and Device Lag: A Tripartite Cross-Sectional Survey.

    PubMed

    Todaka, Koji; Kishimoto, Junji; Ikeda, Masayuki; Ikeda, Koji; Yamamoto, Haruko

    2017-01-01

    New drug and medical device introduction in Japan usually lags behind that in the West. Many reports indicate that in Japan, the associated risks are considered greater than the benefits recognized in other countries. This study aimed to compare the relationship between risk-benefit perception and acceptance of medical technologies in 3 leading markets. A tripartite cross-sectional survey of the general public was used. In total, 3345 adults in the United Kingdom, the United States, and Japan participated, and sexes and age groups were equally represented. Questions about the perception of risk, benefit, and acceptance of medical and other scientific technologies, and trust of medical product providers or regulatory authorities were included. Five-step Likert coding for risk/benefit/acceptance of 4 medical items (x-rays, antibiotics, vaccines, and cardiac pacemakers) and 6 general items (such as automobiles and airplanes) were collected. Relationships between benefit perception and acceptance were linear for 4 medical technologies. The relationship had a similar slope but was shifted downward in Japan compared with the UK and US ( P < .01), suggesting a lower acceptance in Japan for all benefit perceptions. The trend was the same between risk perception and acceptance, except for slopes that were negative. Correspondence analysis showed a strong correlation among acceptance of medical technologies, benefits of medical technologies, trust in doctors, and trust in the Department of Health. The UK and US attributes were clustered with positive responses such as "useful," "acceptable," and "trustworthy," whereas Japan was clustered with intermediate to negative responses such as "neither" and "untrustworthy." Acceptance of medical technologies was low in Japan because of significant differences in trust for doctors and authorities compared with that in the UK and US. This is a possible basis for delays of 24 to 60 months for medical product approval in Japan.

  4. 16 CFR § 1616.4 - Sampling and acceptance procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... specimen to one of the three samples. Test each set of three samples and accept or reject each seam design... all the test criteria of § 1616.3(b), accept the seam design. If one or more of the three additional.... Test the sets of three samples and accept or reject the type of trim and design on the same basis as...

  5. Application of risk-based multiple criteria decision analysis for selection of the best agricultural scenario for effective watershed management.

    PubMed

    Javidi Sabbaghian, Reza; Zarghami, Mahdi; Nejadhashemi, A Pouyan; Sharifi, Mohammad Bagher; Herman, Matthew R; Daneshvar, Fariborz

    2016-03-01

    Effective watershed management requires the evaluation of agricultural best management practice (BMP) scenarios which carefully consider the relevant environmental, economic, and social criteria involved. In the Multiple Criteria Decision-Making (MCDM) process, scenarios are first evaluated and then ranked to determine the most desirable outcome for the particular watershed. The main challenge of this process is the accurate identification of the best solution for the watershed in question, despite the various risk attitudes presented by the associated decision-makers (DMs). This paper introduces a novel approach for implementation of the MCDM process based on a comparative neutral risk/risk-based decision analysis, which results in the selection of the most desirable scenario for use in the entire watershed. At the sub-basin level, each scenario includes multiple BMPs with scores that have been calculated using the criteria derived from two cases of neutral risk and risk-based decision-making. The simple additive weighting (SAW) operator is applied for use in neutral risk decision-making, while the ordered weighted averaging (OWA) and induced OWA (IOWA) operators are effective for risk-based decision-making. At the watershed level, the BMP scores of the sub-basins are aggregated to calculate each scenarios' combined goodness measurements; the most desirable scenario for the entire watershed is then selected based on the combined goodness measurements. Our final results illustrate the type of operator and risk attitudes needed to satisfy the relevant criteria within the number of sub-basins, and how they ultimately affect the final ranking of the given scenarios. The methodology proposed here has been successfully applied to the Honeyoey Creek-Pine Creek watershed in Michigan, USA to evaluate various BMP scenarios and determine the best solution for both the stakeholders and the overall stream health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Feasibility and acceptability of cell phone diaries to measure HIV risk behavior among female sex workers.

    PubMed

    Roth, Alexis M; Hensel, Devon J; Fortenberry, J Dennis; Garfein, Richard S; Gunn, Jayleen K L; Wiehe, Sarah E

    2014-12-01

    Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group.

  7. Evaluating Partnerships to Enhance Disaster Risk Management using Multi-Criteria Analysis: An Application at the Pan-European Level

    NASA Astrophysics Data System (ADS)

    Hochrainer-Stigler, Stefan; Lorant, Anna

    2018-01-01

    Disaster risk is increasingly recognized as a major development challenge. Recent calls emphasize the need to proactively engage in disaster risk reduction, as well as to establish new partnerships between private and public sector entities in order to decrease current and future risks. Very often such potential partnerships have to meet different objectives reflecting on the priorities of stakeholders involved. Consequently, potential partnerships need to be assessed on multiple criteria to determine weakest links and greatest threats in collaboration. This paper takes a supranational multi-sector partnership perspective, and considers possible ways to enhance disaster risk management in the European Union by better coordination between the European Union Solidarity Fund, risk reduction efforts, and insurance mechanisms. Based on flood risk estimates we employ a risk-layer approach to determine set of options for new partnerships and test them in a high-level workshop via a novel cardinal ranking based multi-criteria approach. Whilst transformative changes receive good overall scores, we also find that the incorporation of risk into budget planning is an essential condition for successful partnerships.

  8. Risk appreciation for living kidney donors: another new subspecialty?

    PubMed

    Steiner, Robert W

    2004-05-01

    Quantitative estimates of the risk of end stage renal disease (ESRD) for living donors would seem essential to defensible donor selection practices, as the 'safe/unsafe' model for donor selection is not viable. All kidney donors take risk, and four fundamental, qualitative criteria should instead be used to decide when donor rejection is justified. These criteria are lack of donor education about transplantation, donor irrationality, lack of free and voluntary donation, and/or that donor acceptance would unavoidably threaten the public trust or the integrity of the center's selection procedures. Such a data-based selection policy, with explicit documentation of unbiased and comprehensive donor education, will help neutralize the center's self interest in a more defensible way than by rejecting 'complicated' kidney donors out of hand, and in a more practical way than by the creation of center-independent donor counselors or waiting for donor registries to come to fruition. Living kidney donors with isolated medical abnormalities comprise a sizable subset of at risk donors for whom center acceptance practices vary markedly. This population provides a paradigm opportunity for quantitative risk estimation and counseling.

  9. Regulatory acceptance and use of 3R models for pharmaceuticals and chemicals: expert opinions on the state of affairs and the way forward.

    PubMed

    Schiffelers, Marie-Jeanne W A; Blaauboer, Bas J; Bakker, Wieger E; Beken, Sonja; Hendriksen, Coenraad F M; Koëter, Herman B W M; Krul, Cyrille

    2014-06-01

    Pharmaceuticals and chemicals are subjected to regulatory safety testing accounting for approximately 25% of laboratory animal use in Europe. This testing meets various objections and has led to the development of a range of 3R models to Replace, Reduce or Refine the animal models. However, these models must overcome many barriers before being accepted for regulatory risk management purposes. This paper describes the barriers and drivers and options to optimize this acceptance process as identified by two expert panels, one on pharmaceuticals and one on chemicals. To untangle the complex acceptance process, the multilevel perspective on technology transitions is applied. This perspective defines influences at the micro-, meso- and macro level which need alignment to induce regulatory acceptance of a 3R model. This paper displays that there are many similar mechanisms within both sectors that prevent 3R models from becoming accepted for regulatory risk assessment and management. Shared barriers include the uncertainty about the value of the new 3R models (micro level), the lack of harmonization of regulatory requirements and acceptance criteria (meso level) and the high levels of risk aversion (macro level). In optimizing the process commitment, communication, cooperation and coordination are identified as critical drivers. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Shifting from glucose diagnostic criteria to the new HbA(1c) criteria would have a profound impact on prevalence of diabetes among a high-risk Spanish population.

    PubMed

    Costa, B; Barrio, F; Cabré, J-J; Piñol, J-L; Cos, F-X; Solé, C; Bolibar, B; Castell, C; Lindström, J; Barengo, N; Tuomilehto, J

    2011-10-01

    To investigate changes in the prevalence of diabetes and pre-diabetes by shifting from 2-h plasma glucose and/or fasting plasma glucose diagnostic criteria to the proposed new HbA(1c) -based criteria when applied to a Mediterranean population detected to have a high risk of Type 2 diabetes. Individuals without diabetes aged 45-75 years (n = 2287) were screened using the Finnish Diabetes Risk Score questionnaire, a 2-h oral glucose tolerance test plus HbA(1c) test. Prevalence and degree of diagnostic overlap between three sets of criteria (2-h plasma glucose, fasting plasma glucose and HbA(1c) ) and three diagnostic categories (normal, pre-diabetes and diabetes) were calculated. Defining diabetes by a single HbA(1c) measurement resulted in a dramatic decrease in prevalence (1.3%), particularly in comparison with diabetes defined by 2-h plasma glucose (8.6%), but was also significant with regard to fasting plasma glucose (2.8%). A total of 201 screened subjects (8.8%) were classified as having diabetes and 1023 (44.7%) as having pre-diabetes based on at least one of these criteria; among these, the presence of all three criteria simultaneously classified only 21 and 110 individuals respectively, about ten percent of each group. The single overlap index between subjects diagnosed as having diabetes by 2-h plasma glucose/fasting plasma glucose vs. HbA(1c) was 13.9/28%. Similarly, the single overlap index regarding pre-diabetes was 19.2/27.1%. A shift from the glucose-based diagnosis to the HbA(1c) -based diagnosis for diabetes will reduce diabetes prevalence with a low overall or single degree of overlap between diagnostic categories in this high-risk Spanish population. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  11. Gis-Based Multi-Criteria Decision Analysis for Forest Fire Risk Mapping

    NASA Astrophysics Data System (ADS)

    Akay, A. E.; Erdoğan, A.

    2017-11-01

    The forested areas along the coastal zone of the Mediterranean region in Turkey are classified as first-degree fire sensitive areas. Forest fires are major environmental disaster that affects the sustainability of forest ecosystems. Besides, forest fires result in important economic losses and even threaten human lives. Thus, it is critical to determine the forested areas with fire risks and thereby minimize the damages on forest resources by taking necessary precaution measures in these areas. The risk of forest fire can be assessed based on various factors such as forest vegetation structures (tree species, crown closure, tree stage), topographic features (slope and aspect), and climatic parameters (temperature, wind). In this study, GIS-based Multi-Criteria Decision Analysis (MCDA) method was used to generate forest fire risk map. The study was implemented in the forested areas within Yayla Forest Enterprise Chiefs at Dursunbey Forest Enterprise Directorate which is classified as first degree fire sensitive area. In the solution process, "extAhp 2.0" plug-in running Analytic Hierarchy Process (AHP) method in ArcGIS 10.4.1 was used to categorize study area under five fire risk classes: extreme risk, high risk, moderate risk, and low risk. The results indicated that 23.81 % of the area was of extreme risk, while 25.81 % was of high risk. The result indicated that the most effective criterion was tree species, followed by tree stages. The aspect had the least effective criterion on forest fire risk. It was revealed that GIS techniques integrated with MCDA methods are effective tools to quickly estimate forest fire risk at low cost. The integration of these factors into GIS can be very useful to determine forested areas with high fire risk and also to plan forestry management after fire.

  12. 2017 Draft Aquatic Life Criteria for Aluminum in Freshwater

    EPA Pesticide Factsheets

    EPA has released draft updated aluminum aquatic life ambient water quality criteria for freshwater under Section 304(a)(1) of the Clean Water Act. EPA will accept public comments on the draft criteria for 60 days upon publication in the Federal Register.

  13. Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review.

    PubMed

    Glenn, Catherine R; Kleiman, Evan M; Cha, Christine B; Deming, Charlene A; Franklin, Joseph C; Nock, Matthew K

    2018-01-01

    The field is in need of novel and transdiagnostic risk factors for suicide. The National Institute of Mental Health's Research Domain Criteria (RDoC) provides a framework that may help advance research on suicidal behavior. We conducted a meta-analytic review of existing prospective risk and protective factors for suicidal thoughts and behaviors (ideation, attempts, and deaths) that fall within one of the five RDoC domains or relate to a prominent suicide theory. Predictors were selected from a database of 4,082 prospective risk and protective factors for suicide outcomes. A total of 460 predictors met inclusion criteria for this meta-analytic review and most examined risk (vs. protective) factors for suicidal thoughts and behaviors. The overall effect of risk factors was statistically significant, but relatively small, in predicting suicide ideation (weighted mean odds ratio: wOR = 1.72; 95% CI: 1.59-1.87), suicide attempt (wOR = 1.66 [1.57-1.76), and suicide death (wOR = 1.41 [1.24-1.60]). Across all suicide outcomes, most risk factors related to the Negative Valence Systems domain, although effect sizes were of similar magnitude across RDoC domains. This study demonstrated that the RDoC framework provides a novel and promising approach to suicide research; however, relatively few studies of suicidal behavior fit within this framework. Future studies must go beyond the "usual suspects" of suicide risk factors (e.g., mental disorders, sociodemographics) to understand the processes that combine to lead to this deadly outcome. © 2017 Wiley Periodicals, Inc.

  14. The challenge of defining risk-based metrics to improve food safety: inputs from the BASELINE project.

    PubMed

    Manfreda, Gerardo; De Cesare, Alessandra

    2014-08-01

    In 2002, the Regulation (EC) 178 of the European Parliament and of the Council states that, in order to achieve the general objective of a high level of protection of human health and life, food law shall be based on risk analysis. However, the Commission Regulation No 2073/2005 on microbiological criteria for foodstuffs requires that food business operators ensure that foodstuffs comply with the relevant microbiological criteria. Such criteria define the acceptability of a product, a batch of foodstuffs or a process, based on the absence, presence or number of micro-organisms, and/or on the quantity of their toxins/metabolites, per unit(s) of mass, volume, area or batch. The same Regulation describes a food safety criterion as a mean to define the acceptability of a product or a batch of foodstuff applicable to products placed on the market; moreover, it states a process hygiene criterion as a mean indicating the acceptable functioning of the production process. Both food safety criteria and process hygiene criteria are not based on risk analysis. On the contrary, the metrics formulated by the Codex Alimentarius Commission in 2004, named Food Safety Objective (FSO) and Performance Objective (PO), are risk-based and fit the indications of Regulation 178/2002. The main aims of this review are to illustrate the key differences between microbiological criteria and the risk-based metrics defined by the Codex Alimentarius Commission and to explore the opportunity and also the possibility to implement future European Regulations including PO and FSO as supporting parameters to microbiological criteria. This review clarifies also the implications of defining an appropriate level of human protection, how to establish FSO and PO and how to implement them in practice linked to each other through quantitative risk assessment models. The contents of this review should clarify the context for application of the results collected during the EU funded project named BASELINE (www

  15. Acceptability of a novel vaginal microbicide during a safety trial among low-risk women.

    PubMed

    Bentley, M E; Morrow, K M; Fullem, A; Chesney, M A; Horton, S D; Rosenberg, Z; Mayer, K H

    2000-01-01

    The increasing recognition that women who are unable or unwilling to discuss or use condoms with their sexual partners need female-controlled methods for preventing sexually transmitted diseases (STDs), including HIV, has led to considerable focus on the development of vaginal microbicides. While many such products are being tested for safety and effectiveness, clinical trials generally overlook another key factor in a product's impact on infection rates-its acceptability to users. A Phase I clinical trial of a microbicidal gel included an assessment of the product's acceptability among 27 low-risk participants. Information on acceptability was gathered from structured interviews, participants' daily diaries and unstructured exit interviews. Participants reported only minor side effects of product use, such as itching, burning and difficulty urinating; two women developed candida infections while participating in the study. None of the side effects could be conclusively linked to use of the gel. Some women noted product discharge and messiness as drawbacks of the method, but this experience varied according to how often the women applied the gel. For example, one-third of those who used it once daily said that at least some of the time, it was too "wet or drippy," compared with two-thirds of women who inserted the gel twice a day. However, participants considered these "nuisance factors" that could be outweighed by the potential protective characteristics of the product. The majority reported that they would use the product if it were available and proven efficacious, and if they perceived that they were at risk of STD infection. Additional testing of this product is urgently needed. Furthermore, as other products approach Phase I testing, acceptability assessments should be a key component of clinical trials.

  16. Cognitive Processes Underlying Women's Risk Judgments: Associations with Sexual Victimization History and Rape Myth Acceptance

    ERIC Educational Resources Information Center

    Yeater, Elizabeth A.; Treat, Teresa A.; Viken, Richard J.; McFall, Richard M.

    2010-01-01

    Objective: This study evaluated the effects of sexual victimization history, rape myth acceptance, implicit attention, and recent learning on the cognitive processes underlying undergraduate women's explicit risk judgments. Method: Participants were 194 undergraduate women between 18 and 24 years of age. The sample was ethnically diverse and…

  17. 21 CFR 820.80 - Receiving, in-process, and finished device acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Receiving, in-process, and finished device acceptance. 820.80 Section 820.80 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... acceptance to ensure that each production run, lot, or batch of finished devices meets acceptance criteria...

  18. 21 CFR 820.80 - Receiving, in-process, and finished device acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Receiving, in-process, and finished device acceptance. 820.80 Section 820.80 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... acceptance to ensure that each production run, lot, or batch of finished devices meets acceptance criteria...

  19. Older Adults' Perceptions of and Preferences for a Fall Risk Assessment System: Exploring Stages of Acceptance Model.

    PubMed

    Galambos, Colleen; Rantz, Marilyn; Back, Jessie; Jun, Jung Sim; Skubic, Marjorie; Miller, Steven J

    2017-07-01

    Aging in place is a preferred and cost-effective living option for older adults. Research indicates that technology can assist with this goal. Information on consumer preferences will help in technology development to assist older adults to age in place. The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study examined the perceptions, attitudes, and preferences of 13 older adults and five family members about their experience living with the fall risk assessment system during five points in time. Themes emerged in relation to preferences and expectations about the technology and how it fits into daily routines. We were able to capture changes that occurred over time for older adult participants. Results indicated that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation. Identified themes, stages of acceptance, and design and development considerations are discussed.

  20. Identification of foot and mouth disease risk areas using a multi-criteria analysis approach

    PubMed Central

    Silva, Gustavo Sousa e; Weber, Eliseu José; Hasenack, Heinrich; Groff, Fernando Henrique Sautter; Todeschini, Bernardo; Borba, Mauro Riegert; Medeiros, Antonio Augusto Rosa; Leotti, Vanessa Bielefeldt; Canal, Cláudio Wageck; Corbellini, Luis Gustavo

    2017-01-01

    Foot and mouth disease (FMD) is a highly infectious disease that affects cloven-hoofed livestock and wildlife. FMD has been a problem for decades, which has led to various measures to control, eradicate and prevent FMD by National Veterinary Services worldwide. Currently, the identification of areas that are at risk of FMD virus incursion and spread is a priority for FMD target surveillance after FMD is eradicated from a given country or region. In our study, a knowledge-driven spatial model was built to identify risk areas for FMD occurrence and to evaluate FMD surveillance performance in Rio Grande do Sul state, Brazil. For this purpose, multi-criteria decision analysis was used as a tool to seek multiple and conflicting criteria to determine a preferred course of action. Thirteen South American experts analyzed 18 variables associated with FMD introduction and dissemination pathways in Rio Grande do Sul. As a result, FMD higher risk areas were identified at international borders and in the central region of the state. The final model was expressed as a raster surface. The predictive ability of the model assessed by comparing, for each cell of the raster surface, the computed model risk scores with a binary variable representing the presence or absence of an FMD outbreak in that cell during the period 1985 to 2015. Current FMD surveillance performance was assessed, and recommendations were made to improve surveillance activities in critical areas. PMID:28552973

  1. Toward a Framework for Benefit-Risk Assessment in Diagnostic Imaging: Identifying Scenario-specific Criteria.

    PubMed

    Agapova, Maria; Bresnahan, Brian W; Linnau, Ken F; Garrison, Louis P; Higashi, Mitchell; Kessler, Larry; Devine, Beth

    2017-05-01

    Diagnostic imaging has many effects and there is no common definition of value in diagnostic radiology. As benefit-risk trade-offs are rarely made explicit, it is not clear which framework is used in clinical guideline development. We describe initial steps toward the creation of a benefit-risk framework for diagnostic radiology. We performed a literature search and an online survey of physicians to identify and collect benefit-risk criteria (BRC) relevant to diagnostic imaging tests. We operationalized a process for selection of BRC with the use of four clinical use case scenarios that vary by diagnostic alternatives and clinical indication. Respondent BRC selections were compared across clinical scenarios and between radiologists and nonradiologists. Thirty-six BRC were identified and organized into three domains: (1) those that account for differences attributable only to the test or device (n = 17); (2) those that account for clinical management and provider experiences (n = 12); and (3) those that capture patient experience (n = 7). Forty-eight survey participants selected 22 criteria from the initial list in the survey (9-11 per case). Engaging ordering physicians increased the number of criteria selected in each of the four clinical scenarios presented. We developed a process for standardizing selection of BRC in guideline development. These results suggest that a process relying on elements of comparative effectiveness and the use of standardized BRC may ensure consistent examination of differences among alternatives by way of making explicit implicit trade-offs that otherwise enter the decision-making space and detract from consistency and transparency. These findings also highlight the need for multidisciplinary teams that include input from ordering physicians. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  2. The effectiveness of training acceptance / commitment and training emotion regulation on high-risk behaviors of students with dyscalculia.

    PubMed

    Narimani, Mohammad; Abbasi, Moslem; Abolghasemi, Abbas; Ahadi, Batoul

    2013-09-01

    Now a days the utilization of Acceptance / Commitment and Emotion Regulation Strategy as a comprehensive treatment plan has been discussed in both the prevention and the control of destructive and risky behaviors. Treatment based on Acceptance/Commitment and Emotion Regulation was effective in both the improvement and the control of high-risk behaviors of students with dyscalculia. The purpose of this study was to investigate the effectiveness of Acceptance and Commitment, and Emotional Regulation training in high-risk behaviors of students with dyscalculia. This research was experimental, with pre-test, post-test and a control group. The statistical universe of this study included all sixth-grade male students in Ardabil city in the academic year of 2012-2013 (A.H.). The subjects of this study involved 800 sixth-grade elementary students in Ardabil province, selected using a multi-stage cluster sampling. From among them, 60 students with dyscalculia were selected using random sampling method after the initial diagnosis by structured clinical interview and the Keymath Mathematic test. Twenty pupil were selected for either the experimental or the control group. To collect data, the questionnaires of "Keymath Mathematic test" and High-risk Behavior" were used. The results of Multivariate Analysis of Variance (MANOVA) showed that "Acceptance / Commitment and Emotion Regulation" treatment trainings were effective in reducing high-risk behaviors, in a manner that they led to a reduction in negative emotions, self-destructive and impulsive behaviors of students with math disorder (dyscalculia). It can be concluded that teaching these skills to the students has been influential in enhancing awareness level and change or positive attitude creation in the subjects. Therefore, it is essential to design and implement interventions based on "prevention caused by the peer group, in collaboration with the parents either at the school or at home among the family members".

  3. [Early diagnosis of HIV in Primary Care in Spain. Results of a pilot study based on targeted screening based on indicator conditions, behavioral criteria and region of origin].

    PubMed

    Agustí, Cristina; Martín-Rabadán, María; Zarco, José; Aguado, Cristina; Carrillo, Ricard; Codinachs, Roger; Carmona, Jose Manuel; Casabona, Jordi

    2018-03-01

    To estimate the prevalence of HIV infection in patients diagnosed with an indicator condition (IC) for HIV and/or risk behavior for their acquisition and/or coming from high prevalence countries. To determine the acceptability and feasibility of offering HIV testing based on IC and behavioral and origin criteria in Primary Care (PC). Cross-sectional study in a convenience sample. Six PC centers in Spain. The inclusion criteria were: patients between 16 and 65years old who presented at least one of the proposed ICs and/or at least one of the proposed behavioral and/or origin criteria. A total of 388 patients participated. HIV serology was offered to all patients who met the inclusion criteria. Description of IC frequency, behavioral and origin criteria. Prevalence of HIV infection. Level of acceptability and feasibility of the HIV screening based on IC and behavioral and origin criteria. A total of 174 patients had an IC (44.84%). The most common behavioral criterion was: having unprotected sex at some time in life with people who did not know their HIV status (298; 76.8%). Four HIV+ patients (1.03%) were diagnosed. All had an IC and were men who had sex with men. The level of acceptability in PC was high. Offering HIV testing to patients with IC and behavioral criteria is feasible and effective in PC. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. A systematic review of patient acceptance of consumer health information technology.

    PubMed

    Or, Calvin K L; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.

  5. Water quality criteria derivation and ecological risk assessment for triphenyltin in China.

    PubMed

    Wen, Jingjing; Cui, Xiaoying; Gibson, Mark; Li, Zhengyan

    2018-06-12

    Triphenyltin (TPT) is one of the most toxic chemicals artificially discharged into aquatic environment with human activities. Due to its intensive use in antifouling paints and adverse effects on non-target species, TPT has aroused wide concern in both saltwater and freshwater environment. Nevertheless, the water quality criteria (WQC) are not available in China, which impedes the risk assessment for this emerging pollutant. This study aims to establish the WQC of TPT for both freshwater and saltwater ecosystems. With the derived WQC, a four-level tiered ecological risk assessment (ERA) approach was employed to assess the ecological risks of this emerging pollutant in Chinese waters. Through the species sensitivity distribution (SSD) methodology, the freshwater criterion maximum concentration (CMC) and criterion continuous concentration (CCC) were derived as 396 ng Sn L -1 and 5.60 ng Sn L -1 , respectively, whereas the saltwater CMC and CCC were 66.5 ng Sn L -1 and 4.11 ng Sn L -1 , respectively. The ecological risk assessment for TPT demonstrated that the acute risk was negligible whereas the chronic risk was significant with HQ (Hazard Quotient) values of up to 5.669 and 57.1% of coastal waters in China facing clear risk. TPT contamination in coastal environment, therefore, warrants further concern. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Discrete choice experiment produced estimates of acceptable risks of therapeutic options in cancer patients with febrile neutropenia.

    PubMed

    Sung, Lillian; Alibhai, Shabbir M; Ethier, Marie-Chantal; Teuffel, Oliver; Cheng, Sylvia; Fisman, David; Regier, Dean A

    2012-06-01

    To use a discrete choice experiment (DCE) to describe patient/proxy tolerance for the number of clinic visits, and chances of readmission, intensive care unit admission, and mortality to accept oral outpatient management of low-risk febrile neutropenia. Adults and children aged 12-18 years with cancer and parents of pediatric cancer patients were asked to choose between outpatient oral and inpatient intravenous management of low-risk febrile neutropenia. Using a DCE, we varied the attribute levels with the outpatient option and kept them constant for the inpatient option. Seventy-eight adults, 153 parents, and 43 children provided responses. All four attributes significantly affected choices. The mean tolerance (95% confidence interval) for the number of clinic visits per week was 3.6 (2.2-4.8), 2.1 (1.1-3.2), and 4.3 (2.5-6.0) to accept outpatient management among adults, parents, and children, respectively. With thrice weekly clinic visits and 7.5% chance of readmission, probabilities of accepting the outpatient strategy were 50% (44-54%) for adults, 43% (39-48%) for parents, and 53% (46-59%) for children. Using a DCE, we determined that a 7.5% chance of readmission and clinic visits more frequently than thrice weekly are unlikely to be acceptable. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Spatially explicit multi-criteria decision analysis for managing vector-borne diseases

    PubMed Central

    2011-01-01

    The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular

  8. Acceptability of text messages for safety netting patients with low-risk cancer symptoms: a qualitative study.

    PubMed

    Hirst, Yasemin; Lim, Anita Wey Wey

    2018-05-01

    Safety netting is an important diagnostic strategy for patients presenting to primary care with potential (low-risk) cancer symptoms. Typically, this involves asking patients to return if symptoms persist. However, this relies on patients re-appraising their symptoms and making follow-up appointments, which could contribute to delays in diagnosis. Text messaging is increasingly used in primary care to communicate with patients, and could be used to improve safety netting. To explore the acceptability and feasibility of using text messages to safety net patients presenting with low-risk cancer symptoms in GP primary care (txt-netting). Qualitative focus group and interview study with London-based GPs. Participants were identified using convenience sampling methods. Five focus groups and two interviews were conducted with 22 GPs between August and December 2016. Sessions were audiorecorded, transcribed verbatim, and analysed using thematic analysis. GPs were amenable to the concept of using text messages in cancer safety netting, identifying it as an additional tool that could help manage patients and promote symptom awareness. There was wide variation in GP preferences for text message content, and a number of important potential barriers to txt-netting were identified. Concerns were raised about the difficulties of conveying complex safety netting advice within the constraints of a text message, and about confidentiality, widening inequalities, and workload implications. Text messages were perceived to be an acceptable potential strategy for safety netting patients with low-risk cancer symptoms. Further work is needed to ensure it is cost-effective, user friendly, confidential, and acceptable to patients. © British Journal of General Practice 2018.

  9. A Note on the Validity and Reliability of Multi-Criteria Decision Analysis for the Benefit-Risk Assessment of Medicines.

    PubMed

    Garcia-Hernandez, Alberto

    2015-11-01

    The comparative evaluation of benefits and risks is one of the most important tasks during the development, market authorization and post-approval pharmacovigilance of medicinal products. Multi-criteria decision analysis (MCDA) has been recommended to support decision making in the benefit-risk assessment (BRA) of medicines. This paper identifies challenges associated with bias or variability that practitioners may encounter in this field and presents solutions to overcome them. The inclusion of overlapping or preference-complementary criteria, which are frequent violations to the assumptions of this model, should be avoided. For each criterion, a value function translates the original outcomes into preference-related scores. Applying non-linear value functions to criteria defined as the risk of suffering a certain event during the study introduces specific risk behaviours in this prescriptive, rather than descriptive, model and is therefore a questionable practice. MCDA uses weights to compare the importance of the model criteria with each other; during their elicitation a frequent situation where (generally favourable) mild effects are directly traded off against low probabilities of suffering (generally unfavourable) severe effects during the study is known to lead to biased and variable weights and ought to be prevented. The way the outcomes are framed during the elicitation process, positively versus negatively for instance, may also lead to differences in the preference weights, warranting an appropriate justification during each implementation. Finally, extending the weighted-sum MCDA model into a fully inferential tool through a probabilistic sensitivity analysis is desirable. However, this task is troublesome and should not ignore that clinical trial endpoints generally are positively correlated.

  10. Decision-making when data and inferences are not conclusive: risk-benefit and acceptable regret approach.

    PubMed

    Hozo, Iztok; Schell, Michael J; Djulbegovic, Benjamin

    2008-07-01

    The absolute truth in research is unobtainable, as no evidence or research hypothesis is ever 100% conclusive. Therefore, all data and inferences can in principle be considered as "inconclusive." Scientific inference and decision-making need to take into account errors, which are unavoidable in the research enterprise. The errors can occur at the level of conclusions that aim to discern the truthfulness of research hypothesis based on the accuracy of research evidence and hypothesis, and decisions, the goal of which is to enable optimal decision-making under present and specific circumstances. To optimize the chance of both correct conclusions and correct decisions, the synthesis of all major statistical approaches to clinical research is needed. The integration of these approaches (frequentist, Bayesian, and decision-analytic) can be accomplished through formal risk:benefit (R:B) analysis. This chapter illustrates the rational choice of a research hypothesis using R:B analysis based on decision-theoretic expected utility theory framework and the concept of "acceptable regret" to calculate the threshold probability of the "truth" above which the benefit of accepting a research hypothesis outweighs its risks.

  11. Examining the Acceptability of mHealth Technology in HIV Prevention Among High-Risk Drug Users in Treatment.

    PubMed

    Shrestha, Roman; Huedo-Medina, Tania B; Altice, Frederick L; Krishnan, Archana; Copenhaver, Michael

    2017-11-01

    Despite promising trends of the efficacy of mobile health (mHealth) based strategies to a broad range of health conditions, very few if any studies have been done in terms of the examining the use of mHealth in HIV prevention efforts among people who use drugs in treatment. Thus, the goal of this study was to gain insight into the real-world acceptance of mHealth approaches among high-risk people who use drugs in treatment. A convenience sample of 400 HIV-negative drug users, who reported drug- and/or sex-related risk behaviors, were recruited from a methadone clinic in New Haven, Connecticut. Participants completed standardized assessments of drug- and sex-related risk behaviors, neurocognitive impairment (NCI), and measures of communication technology access and utilization, and mHealth acceptance. We found a high prevalence of current ownership and use of mobile technologies, such as cell phone (91.5%) including smartphone (63.5%). Participants used mobile technologies to communicate mostly through phone calls (M = 4.25, SD = 1.24), followed by text messages (M = 4.21, SD = 1.29). Participants expressed interest in using mHealth for medication reminders (72.3%), receive information about HIV (65.8%), and to assess drug-related (72.3%) and sex-related behaviors (64.8%). Furthermore, participants who were neurocognitively impaired were more likely to use cell phone without internet and show considerable interest in using mHealth as compared to those without NCI. The findings from this study provide empirical evidence that mHealth-based programs, specifically cell phone text messaging-based health programs, may be acceptable to this high-risk population.

  12. Negotiable Acceptability: Reflections on the Interactions between Language Professionals in Europe and NNS Scientists Wishing to Publish in English

    ERIC Educational Resources Information Center

    Burrough-Boenisch, Joy

    2006-01-01

    Prior to submitting a paper to a science journal, many European scientists employ language professionals to check that the English is acceptable. What influences these language professionals' criteria of acceptability? How do they interact with the authors for whom they work? And how do journals' criteria of acceptability affect their work? In…

  13. Treatment thresholds for osteoporosis and reimbursability criteria: perspectives associated with fracture risk-assessment tools.

    PubMed

    Adami, Silvano; Bertoldo, Francesco; Gatti, Davide; Minisola, Giovanni; Rossini, Maurizio; Sinigaglia, Luigi; Varenna, Massimo

    2013-09-01

    The definition of osteoporosis was based for several years on bone mineral density values, which were used by most guidelines for defining treatment thresholds. The availability of tools for the estimation of fracture risk, such as FRAX™ or its adapted Italian version, DeFRA, is providing a way to grade osteoporosis severity. By applying these new tools, the criteria identified in Italy for treatment reimbursability (e.g., "Nota 79") are confirmed as extremely conservative. The new fracture risk-assessment tools provide continuous risk values that can be used by health authorities (or "payers") for identifying treatment thresholds. FRAX estimates the risk for "major osteoporotic fractures," which are not counted in registered fracture trials. Here, we elaborate an algorithm to convert vertebral and nonvertebral fractures to the "major fractures" of FRAX, and this allows a cost-effectiveness assessment for each drug.

  14. Section 4. Further expanding the criteria for HCC in living donor liver transplantation: the Tokyo University experience.

    PubMed

    Tamura, Sumihito; Sugawara, Yasuhiko; Kokudo, Norihiro

    2014-04-27

    In Asia, evidence-based guidelines for the management of hepatocellular carcinoma (HCC) have evolved, including the option of liver transplantation. Because of the continuing serious organ shortage, however, living donor liver transplantation (LDLT) remains the mainstream in Japan. Unlike deceased donor transplantation, living donor transplantation is not always limited by the restrictions imposed by the nationwide organ allocation system. The decision for transplantation may depend on institutional or case-by-case considerations, balancing the will of the donor, the operative risk, and the overall survival benefit. Cumulative data from the Japanese national multicenter registry analysis as well as individual center experiences suggest further expanding the criteria for LDLT for HCC from the Milan criteria is feasible with acceptable outcomes.

  15. Risk factors in various subtypes of ischemic stroke according to TOAST criteria.

    PubMed

    Aquil, Nadia; Begum, Imtiaz; Ahmed, Arshia; Vohra, Ejaz Ahmed; Soomro, Bashir Ahmed

    2011-05-01

    To identify the frequency of risk factors in various subtypes of acute ischemic stroke according to TOAST criteria. Cross-sectional, observational study. Ziauddin Hospital, Karachi, from January to December 2007. Patients with acute ischemic stroke were enrolled. Studied variables included demographic profile, history of risk factors, physical and neurological examination, and investigations relevant with the objectives of the study. Findings were described as frequency percentages. Proportions of risk factors against subtypes was compared using chi-square test with significance at p < 0.05. Out of the 100 patients with acute ischemic stroke, mean age at presentation was 63.5 years. Risk factor distribution was hypertension in 85%, Diabetes mellitus in 49%, ischemic heart disease in 30%, dyslipedemia in 22%, smoking in 9%, atrial fibrillation in 5%, and previous history of stroke in 29%. The various subtypes of acute ischemic stroke were lacunar infarct in 43%, large artery atherosclerosis in 31%, cardioembolic type in 8%, stroke of other determined etiology in 1% and stroke of undetermined etiology in 18%. Hypertension and Diabetes were the most important risk factors in both large and small artery atherosclerosis. In patients with cardio-embolic stroke significant association was found with ischemic heart disease (p=0.01). Importance and relevance of risk factors evaluated for subtypes rather than ischemic stroke as a whole should be reflected in preventive efforts against the burden of ischemic stroke.

  16. Construction and evaluation of thoracic injury risk curves for a finite element human body model in frontal car crashes.

    PubMed

    Mendoza-Vazquez, Manuel; Davidsson, Johan; Brolin, Karin

    2015-12-01

    There is a need to improve the protection to the thorax of occupants in frontal car crashes. Finite element human body models are a more detailed representation of humans than anthropomorphic test devices (ATDs). On the other hand, there is no clear consensus on the injury criteria and the thresholds to use with finite element human body models to predict rib fractures. The objective of this study was to establish a set of injury risk curves to predict rib fractures using a modified Total HUman Model for Safety (THUMS). Injury criteria at the global, structural and material levels were computed with a modified THUMS in matched Post Mortem Human Subjects (PMHSs) tests. Finally, the quality of each injury risk curve was determined. For the included PMHS tests and the modified THUMS, DcTHOR and shear stress were the criteria at the global and material levels that reached an acceptable quality. The injury risk curves at the structural level did not reach an acceptable quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Estimating urban flood risk - uncertainty in design criteria

    NASA Astrophysics Data System (ADS)

    Newby, M.; Franks, S. W.; White, C. J.

    2015-06-01

    The design of urban stormwater infrastructure is generally performed assuming that climate is static. For engineering practitioners, stormwater infrastructure is designed using a peak flow method, such as the Rational Method as outlined in the Australian Rainfall and Runoff (AR&R) guidelines and estimates of design rainfall intensities. Changes to Australian rainfall intensity design criteria have been made through updated releases of the AR&R77, AR&R87 and the recent 2013 AR&R Intensity Frequency Distributions (IFDs). The primary focus of this study is to compare the three IFD sets from 51 locations Australia wide. Since the release of the AR&R77 IFDs, the duration and number of locations for rainfall data has increased and techniques for data analysis have changed. Updated terminology coinciding with the 2013 IFD release has also resulted in a practical change to the design rainfall. For example, infrastructure that is designed for a 1 : 5 year ARI correlates with an 18.13% AEP, however for practical purposes, hydraulic guidelines have been updated with the more intuitive 20% AEP. The evaluation of design rainfall variation across Australia has indicated that the changes are dependent upon location, recurrence interval and rainfall duration. The changes to design rainfall IFDs are due to the application of differing data analysis techniques, the length and number of data sets and the change in terminology from ARI to AEP. Such changes mean that developed infrastructure has been designed to a range of different design criteria indicating the likely inadequacy of earlier developments to the current estimates of flood risk. In many cases, the under-design of infrastructure is greater than the expected impact of increased rainfall intensity under climate change scenarios.

  18. Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

    PubMed

    Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel

    2012-01-01

    Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.

  19. A research for Class II defect Bored Pile’s Accept Criteria: A case of Penang Second Marine bridge

    NASA Astrophysics Data System (ADS)

    Huang, Kang

    2018-03-01

    The aim of this preliminary research is to study the accept criteria of class II bored pile with subtle defect. According to a detailed comparison of the existed different standards, Chinese ones are more applicable especially for the large diameter bored piles. Through the concrete coring at pile No P25-03 of this case and the comparison to the actual calculation, the Class II pile’s defects were very minor. Comparison was also made for the effects on pile structural capacities before and after repair of the defects. the feasible repair proposal may bring forward to more defects to the piles. The Class II piles don’t need any further repairation when piles have typical of similar character and sonic logging test result with P25-03‘s one. For other Class II piles with some differences in characters, verification is needed through further concrete coring on the pile. The recommendation of this research could be adopted for the similar huge marine structures which installed large diameter bored piles.

  20. Eliciting and Combining Decision Criteria Using a Limited Palette of Utility Functions and Uncertainty Distributions: Illustrated by Application to Pest Risk Analysis.

    PubMed

    Holt, Johnson; Leach, Adrian W; Schrader, Gritta; Petter, Françoise; MacLeod, Alan; van der Gaag, Dirk Jan; Baker, Richard H A; Mumford, John D

    2014-01-01

    Utility functions in the form of tables or matrices have often been used to combine discretely rated decision-making criteria. Matrix elements are usually specified individually, so no one rule or principle can be easily stated for the utility function as a whole. A series of five matrices are presented that aggregate criteria two at a time using simple rules that express a varying degree of constraint of the lower rating over the higher. A further nine possible matrices were obtained by using a different rule either side of the main axis of the matrix to describe situations where the criteria have a differential influence on the outcome. Uncertainties in the criteria are represented by three alternative frequency distributions from which the assessors select the most appropriate. The output of the utility function is a distribution of rating frequencies that is dependent on the distributions of the input criteria. In pest risk analysis (PRA), seven of these utility functions were required to mimic the logic by which assessors for the European and Mediterranean Plant Protection Organization arrive at an overall rating of pest risk. The framework enables the development of PRAs that are consistent and easy to understand, criticize, compare, and change. When tested in workshops, PRA practitioners thought that the approach accorded with both the logic and the level of resolution that they used in the risk assessments. © 2013 Society for Risk Analysis.

  1. Design criteria for maglev structures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandberg, H.R.; Williams, J.R.

    1997-05-01

    Maglev systems represent an entirely new concept in transportation. They will not operate on nor share the right-of-way with any other system. It is important, therefore, that the guideways be designed and constructed so as to be economical, constructable, durable, adaptable, reliable, and readily maintained. Comparisons should be made with the current transportation systems, especially highways and railroads. Since most of the guideway will be elevated, the comparison should be with the bridges. The object of the comparisons should be to avoid the shortcomings of the other systems while building on their strengths. This paper develops in some detail designmore » and construction criteria that will ensure a good, long-lived performance of the maglev guideway. The importance of beauty should have a low priority in comparison to the other design criteria. Clean, simple details meeting other criteria will ensure an acceptable appearance. These criteria were used in evaluating the four maglev concepts developed for the National Maglev Initiative.« less

  2. Smartphone Delivery of Mobile HIV Risk Reduction Education.

    PubMed

    Phillips, Karran A; Epstein, David H; Mezghanni, Mustapha; Vahabzadeh, Massoud; Reamer, David; Agage, Daniel; Preston, Kenzie L

    2013-01-01

    We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability "as is" in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P < 0.05). Additionally, all of our video modules met our a priori criteria for feasibility: ≤20% of data were missing due to participant noncompliance and ≤20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings.

  3. Communicating ecological importance in a risk-based world: linking numeric nutrient criteria to waterbody expectations

    NASA Astrophysics Data System (ADS)

    Kaufman, G.; Crawford, T. N.

    2016-12-01

    To protect the integrity of US waters, the Clean Water Act calls for the development of water quality standards. One key component of standards is limits for pollutants, known as water quality criteria. A cornerstone of deriving water quality criteria is determining how nutrients and other chemicals affect the goals for a waterbody set by a state or tribe, known as designated uses. By establishing a quantifiable and predictable relationship between nutrients and nutrient sensitive organisms and processes, known as assessment endpoints, researchers can help policy makers to address the consequences of pollution in a risk-based, understandable way tied to the goals for a waterbody. Furthermore, public buy-in and effectiveness of criteria can be enhanced by using endpoints to show the connection between nutrient pollution and the uses of waters that are important to the public. This talk will communicate the work done by the US Environmental Protection Agency in cooperation with state, federal, and academic partners to explore the connections between biological and ecological responses and nutrient pollution to derive numeric nutrient criteria in estuarine and coastal waters. The presentation will examine the variety of endpoints that have been used in the work of various research efforts and assessment frameworks. Examples will also be given of numeric nutrient criteria development using assessment endpoints and some of the key decisions that were made during endpoint selection and criteria development will be discussed. Aspects of those decisions that will be presented include development of selection factors for endpoints, data considerations when selecting endpoints, and spatial and temporal representation of endpoints for criteria development. Promising endpoints and future research needs will also be highlighted.

  4. Communicating ecological importance in a risk-based world: linking numeric nutrient criteria to waterbody expectations

    NASA Astrophysics Data System (ADS)

    Kaufman, G.; Crawford, T. N.

    2016-02-01

    To protect the integrity of US waters, the Clean Water Act calls for the development of water quality standards. One key component of standards is limits for pollutants, known as water quality criteria. A cornerstone of deriving water quality criteria is determining how nutrients and other chemicals affect the goals for a waterbody set by a state or tribe, known as designated uses. By establishing a quantifiable and predictable relationship between nutrients and nutrient sensitive organisms and processes, known as assessment endpoints, researchers can help policy makers to address the consequences of pollution in a risk-based, understandable way tied to the goals for a waterbody. Furthermore, public buy-in and effectiveness of criteria can be enhanced by using endpoints to show the connection between nutrient pollution and the uses of waters that are important to the public. This talk will communicate the work done by the US Environmental Protection Agency in cooperation with state, federal, and academic partners to explore the connections between biological and ecological responses and nutrient pollution to derive numeric nutrient criteria in estuarine and coastal waters. The presentation will examine the variety of endpoints that have been used in the work of various research efforts and assessment frameworks. Examples will also be given of numeric nutrient criteria development using assessment endpoints and some of the key decisions that were made during endpoint selection and criteria development will be discussed. Aspects of those decisions that will be presented include development of selection factors for endpoints, data considerations when selecting endpoints, and spatial and temporal representation of endpoints for criteria development. Promising endpoints and future research needs will also be highlighted.

  5. Development of flaw acceptance criteria for aging management of spent nuclear fuel multiple-purpose canisters

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, P.; Sindelar, R.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defectsmore » be detected by periodic In-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.« less

  6. Development of flaw acceptance criteria for aging management of spent nuclear fuel multi-purpose canisters

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lam, Poh -Sang; Sindelar, Robert L.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defectsmore » be detected by periodic in-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.« less

  7. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    PubMed Central

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K.

    2016-01-01

    Introduction The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65–101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9–100]) with a negative predictive value of 100 (98.7–100). Conclusion Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls. PMID:27330655

  8. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

    PubMed

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

    2016-05-01

    The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  9. Examining the Application of the DC-IA-A Diagnostic Criteria for Internet Addiction Disorder in At-Risk College Students.

    PubMed

    Hsu, Wen-Yu; Chang, Shan-Mei; Chiu, Nan-Ying; Lin, Sunny S J; Tseng, Yin-Hsing

    2015-01-01

    Internet addiction disorder is a relatively new condition, and the criteria for its diagnosis have been developed only over the last several years. The criteria for Internet addiction remain controversial. We strive to further elucidate the clinical validity of the diagnostic criteria for Internet addiction. To test items of the diagnostic criteria for Internet addiction among adolescents, we conducted a clinical interview study of college students based on longitudinal data on their risky use of the Internet. Forty-one high-risk cases were selected from a 3-year 5-time point longitudinal survey of 716 college freshmen. We examined disputes relevant to symptoms and impairment in the DC-IA-A (Diagnostic Criteria for Internet Addiction among Taiwanese Adolescents). Of the 41 cases, 21 were diagnosed with Internet addiction via a psychiatric interview. In the Internet addiction disorder group, 23.8% of cases had a diagnosis of depression, whereas only 15.0% of the cases in the non-Internet addiction group had a diagnosis of depression. Two major criteria (A8 and A3) had low incidences in these high-risk college students and thus did not help provide a differential diagnosis between the groups. We suggest that A8, 'excessive effort spent on activities necessary to obtain access to the Internet', should be omitted, and that A3, 'tolerance: a marked increase in the duration of Internet use needed to achieve satisfaction', should be modified. A1 and A9 should be discussed regarding their role in the diagnosis of Internet addiction disorder. Additional well-designed studies examining the diagnostic criteria and the relationship between factors are needed. © 2015 S. Karger AG, Basel.

  10. Who should donate blood? Policy decisions on donor deferral criteria should protect recipients and be fair to donors.

    PubMed

    Brailsford, S R; Kelly, D; Kohli, H; Slowther, A; Watkins, N A

    2015-08-01

    An important element in the development of voluntary blood donation schemes throughout the world has been the attention given to minimising the risk to recipients of donated blood, primarily the risk of transfusion transmitted infections. In response to the appearance of human immunodeficiency virus (HIV) in the 1980s a range of national policies emerged that excluded populations at high risk of contracting HIV from donating blood, with a particular focus on men who have sex with men (MSM), the primary reason being the protection of recipients of donated blood. Recently some countries, including the UK, have revised their policies, informed by advances in screening tests, epidemiological evidence of transmission rates and an increasing concern about unfair discrimination of specific groups in society. Policy makers face a difficult task of balancing safety of recipients; an adequate blood supply for those who require transfusion; and societal/legal obligations to treat everyone fairly. Given that no transfusion is risk free, the question is what degree of risk is acceptable in order to meet the needs of recipients and society. Decisions about acceptance of risk are complex and policy makers who set acceptable risk levels must provide ethically justifiable reasons for their decisions. We suggest it is possible to provide a set of reasons that stakeholders could agree are relevant based on careful evaluation of the evidence of all relevant risks and explicit acknowledgement of other morally relevant values. We describe using such a process in the Safety of Blood Tissue and Organs (SaBTO) review of donor deferral criteria related to sexual behaviour. © 2015 British Blood Transfusion Society.

  11. Who accepts a rapid HIV antibody test? The role of race/ethnicity and HIV risk behavior among community adolescents.

    PubMed

    Swenson, Rebecca R; Hadley, Wendy S; Houck, Christopher D; Dance, S Kwame; Brown, Larry K

    2011-05-01

    Centers for Disease Control and Prevention guidelines recommend routine human immunodeficiency virus (HIV) screening in health care settings for all individuals aged 13-64 years; however, overall testing rates among adolescents still continue to remain low. This study examined factors related to the acceptance of HIV testing among an at-risk sample of ethnically/racially diverse community adolescents. Adolescents aged 15-21 (N = 81) years were recruited from community-based youth organizations to complete HIV risk assessment surveys. After the completion of the survey, participants were offered a free OraQuick rapid HIV antibody test. More than half (53.1%) of the participants accepted the test, with the black population being more likely to accept testing as compared to Latinos (75% vs. 39%). After controlling for race/ethnicity, significant predictors of test acceptance included history of sexual intercourse (OR = 5.43), having only one sexual partner in the past 3 months (OR = 4.88), not always using a condom with a serious partner (OR = 3.94), and not using a condom during last sexual encounter (OR = 4.75). Given that many adolescents are willing to know their HIV status, policies that support free or low-cost routine testing may lead to higher rates of case identification among youth. However, approaches must be developed to increase test acceptance among Latino adolescents and teenagers with multiple sexual partners. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. 76 FR 82201 - General Site Suitability Criteria for Nuclear Power Stations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ..., and 52 [NRC-2011-0297] General Site Suitability Criteria for Nuclear Power Stations AGENCY: Nuclear... Suitability Criteria for Nuclear Power Stations.'' This guide describes a method that the NRC staff considers acceptable to implement the site suitability requirements for nuclear power stations. DATES: Submit comments...

  13. Reliability, resilience and vulnerability criteria for the evaluation of time-dependent health risks: A hypothetical case study of wellhead protection

    NASA Astrophysics Data System (ADS)

    Rodak, C. M.; Silliman, S. E.; Bolster, D.

    2012-12-01

    A hypothetical case study of groundwater contaminant protection was carried out using time-dependent health risk calculations. The case study focuses on a hypothetical zoning project for parcels of land around a well field in northern Indiana, where the control of cancer risk relative to a mandated cancer risk threshold is of concern in the management strategy. Within our analysis, we include both uncertainty in the subsurface transport and variability in population behavior in the calculation of time-dependent health risks. From these results we introduce risk maps, a visual representation of the probability of an unacceptable health risk as a function of population behavior and the time at which exposure to the contaminant begins. We also evaluate the time-dependent risks with three criteria from water resource literature: reliability, resilience, and vulnerability (RRV). With respect to health risk from a groundwater well, the three criteria determine: the probability that a well produces safe water (reliability), the probability that a contaminated well returns to an uncontaminated state within a specified time interval (resilience), and the overall severity in terms of health impact of the contamination at a well head (vulnerability). The results demonstrate that the distributions of RRV values for each parcel of land are linked to the time-dependent concentration profile of the contaminant at the well, and the toxicological characteristics of the contaminant. The proposed time-dependent risk calculation expands on current techniques to include a continuous exposure start time, capable of reproducing the maximum risk while providing information on the severity and duration of health risks. Overall this study suggests that, especially in light of the inherent complexity of health-groundwater systems, RRV are viable criteria for relatively simple and effective evaluation of time-dependent health risk. It is argued that the RRV approach, as applied to

  14. [New approach for managing microbial risks in food].

    PubMed

    Augustin, Jean-Christophe

    2015-01-01

    The aim of the food legislation is to ensure the protection of human health. Traditionally, the food legislation requires food business operators to apply good hygiene practices and specific procedures to control foodborne pathogens. These regulations allowed reaching a high level of health protection. The improvement of the system will require risk-based approaches. Firstly, risk assessment should allow the identification of high-risk situations where resources should be allocated for a better targeting of risk management. Then, management measures should be adapted to the health objective. In this approach, the appropriate level of protection is converted intofood safety and performance objectives on the food chain, i.e., maximum microbial contamination to fulfil the acceptable risk level. When objectives are defined, the food business operators and competent authorities can identify control options to comply with the objectives and establish microbiological criteria to verify compliance with these objectives. This approach, described for approximately 10 years, operative thanks to the development of quantitative risk assessment techniques, is still difficult to use in practical terms since it requires a commitment of competent authorities to define the acceptable risk and needs also the implementation of sometimes complex risk models.

  15. Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning.

    PubMed

    Coffey, Michael; Cohen, Rachel; Faulkner, Alison; Hannigan, Ben; Simpson, Alan; Barlow, Sally

    2017-06-01

    Communication and information sharing are considered crucial to recovery-focused mental health services. Effective mental health care planning and coordination includes assessment and management of risk and safety. Using data from our cross-national mixed-method study of care planning and coordination, we examined what patients, family members and workers say about risk assessment and management and explored the contents of care plans. Thematic analysis of qualitative research interviews (n = 117) with patients, family members and workers, across four English and two Welsh National Health Service sites. Care plans were reviewed (n = 33) using a structured template. Participants have contrasting priorities in relation to risk. Patients see benefit in discussions about risk, but cast the process as a worker priority that may lead to loss of liberty. Relationships with workers are key to family members and patients; however, worker claims of involving people in the care planning process do not extend to risk assessment and management procedures for fear of causing upset. Workers locate risk as coming from the person rather than social or environmental factors, are risk averse and appear to prioritize the procedural aspects of assessment. Despite limitations, risk assessment is treated as legitimate work by professionals. Risk assessment practice operates as a type of fiction in which poor predictive ability and fear of consequences are accepted in the interests of normative certainty by all parties. As a consequence, risk adverse options are encouraged by workers and patients steered away from opportunities for ordinary risks thereby hindering the mobilization of their strengths and abilities. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  16. Remarks on the Acceptance of Proofs: The Case of Some Recently Tackled Major Theorems.

    ERIC Educational Resources Information Center

    Neubrand, Michael

    1989-01-01

    Lists five criteria in the acceptance of mathematical theorems, such as understanding, significance, compatibility, reputation, and convincing argument. Concludes that social and language factors are involved in the process of the acceptance. (YP)

  17. A pilot RCT of an intervention to reduce HIV sexual risk and increase self-acceptance among MSM in Chennai, India.

    PubMed

    Safren, Steven A; Thomas, Beena E; Mayer, Kenneth H; Biello, Katie B; Mani, Jamuna; Rajagandhi, Vijaylakshmi; Periyasamy, Murugesan; Swaminathan, Soumya; Mimiaga, Matthew J

    2014-10-01

    This is a 2-arm pilot randomized controlled trial (N = 96) of a behavioral intervention (4 group and 4 individual sessions) integrating risk reduction counseling with counseling to foster self-acceptance in MSM in India compared to enhanced standard of care (ESOC). Both conditions involved HIV and STI testing and counseling at baseline and 6-months, and assessments of condomless sex at baseline, 3-, and 6-months. A significant condition by time interaction suggested a difference in the rate of change in number of anal sex acts without condoms in the intervention versus ESOC (p < 0.0001). Post hoc contrasts suggested that the overall difference was due to intervention-response at 3-months. The incidence of bacterial STIs was 17.5 % in the intervention condition and a 28.6 % in ESOC. Addressing self-acceptance and related psychosocial concerns in the context sexual risk reduction counseling for MSM in India was feasible and acceptable. Testing the intervention for efficacy is justified.

  18. [Organization of socially acceptable working hours in nursing].

    PubMed

    Büssing, A; Glaser, J

    1994-05-01

    Three dimensions in the structure of the working hour system of nurses, rendering them socially acceptable, are becoming important: duration of the working day, the time of day which is being worked and the distribution of working hours. The latter two are of particular importance because flexible shift is becoming the dominant pattern in nursing. Six indicators are discussed as criteria for social acceptability: security of employment which includes access to the labour-market, level of income, health, opportunity for social relationships, social participation, and autonomy. Responses of 297 nurses in one General Hospital taking part in a study, were analysed to examine empirically the concept of 'socially acceptable structure of the working hours'. Ideal and factual patterns are considered first. Secondly aspects of autonomy are considered and the way this depends on time, thirdly the criteria used to define 'social acceptability' are examined for validity. Results show firstly the cross contrast between the hospital's expectation and the nurses' wishes with regard to working hours. Furthermore, inspite of the demand for flexibility, staff have very little choice and there is little sign of joint decision making. Thirdly results show that health, interpersonal and social aspects are of special importance and that, correspondingly, in the view of nurses, financial and practical problems are of lesser importance in their every day life.

  19. Developing a Game Interface to Assess Risk Perception with Respect to Two Key Dimensions of Risk (Frequency and Severity) in Contexts Where Risks Are Elevated from Their Accepted, "Typical" Values.

    PubMed

    Goodman, William M; Ma, Zhenfeng; Andrade, Angie

    2015-06-01

    This four-stage study culminated in a game interface designed to calibrate people's perceptions of net risk (combining frequency and severity), in contexts where risks are elevated from their accepted, "typical" values, as when avalanche threats elevate the risks of "skiing" above levels skiers normally accept. Risk prompts are displayed dynamically, in naturalistic language, and not, for example, as static displays of dollar amounts or probabilities. Individual differences are measured. In Stage 1 (pilot), focus groups (n=9) piloted procedures, visual prompts, and examples of contexts where risks elevated from the "usual," for use in upcoming stages. In Stage 2 (exploratory), participants (primarily students; n=119; mean age, 20.1 years; 64 percent male) were assigned to risk contexts, answered demographic and risk-history questions, and then matched risk-description prompts to perceived "appropriate" levels along an ordinal risk scale. Descriptive measures and graphs showed response distributions; chi-squared analyses compared responses for different demographics. In Stage 3 (manipulating "cards"), participants (n=80; mean age, 37 years; 60 percent male) matched naturalistic risk prompts with ordinal risk positions. Regressions compared cards' placements with their "expected" (per exploratory Stage 2) placements. In Stage 4, the interface was coded in the Unity(®) (implemented at Business and IT Capstone, University of Ontario Institute of Technology, Oshawa, ON, Canada) development environment. In Stage 1, ambiguities in draft wordings/displays for Stage 2 were identified and corrected. Three risk contexts emerged: traffic/hidden intersection; skiing/avalanche; and swimming/drowning. In Stage 2, for traffic and skiing contexts, responses relating ordinal risk categories to realistic examples were observed to cluster around values potentially usable as markers. No associations appeared with demographic variables. In Stage 3, actual and "expected" ordinal-risk

  20. Selection criteria of residents for residency programs in Kuwait

    PubMed Central

    2013-01-01

    Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

  1. Design Criteria for Low Risk Re-Entry Vehicles

    NASA Astrophysics Data System (ADS)

    Monti, R.; Pezzella, G.

    2005-02-01

    The paper shows how a sharp vehicle with low wing loading, is able to follow re-entry trajectories with low thermal risks by using Ultra High Temperature Ceramics (UHTC) to thermally protect the vehicle front edges. These reusable materials can withstand the global radiative equilibrium temperatures that are experienced during reentry characterized by a longer and a more gradual conversion of the kinetic and potential energy of the vehicle into thermal energy. A number of aerothermodynamic problems are addressed to assess the feasibility of the vehicle design and of the thermal protection of the payload. In particular, the boundary layer thermal protection concept is illustrated to show how a UHTC massive tip edges (fuselage and wings) are able to protect also the remaining vehicle structure made of conventional material, promoting a revolutionary approach to the Thermal Protection System (TPS) configuration for hypersonic vehicle flying at small angle of attack. CFD results and engineering formulations are adopted for the computation of the aerodynamic coefficients and heat fluxes. The analysis identifies the design criteria for a conventional looking vehicle for a crew return from LEO (e.g. from the International Space Station).

  2. 78 FR 64030 - Monitoring Criteria and Methods To Calculate Occupational Radiation Doses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... NUCLEAR REGULATORY COMMISSION [NRC-2013-0234] Monitoring Criteria and Methods To Calculate... regulatory guide (DG), DG-8031, ``Monitoring Criteria and Methods to Calculate Occupational Radiation Doses.'' This guide describes methods that the NRC staff considers acceptable for licensees to use to determine...

  3. Tornado wind-loading requirements based on risk assessment techniques

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Deobald, T.L.; Coles, G.A.; Smith, G.L.

    Regulations require that nuclear power plants be protected from tornado winds. If struck by a tornado, a plant must be capable of safely shutting down and removing decay heat. Probabilistic techniques are used to show that risk to the public from the US Department of Energy (DOE) SP-100 reactor is acceptable without tornado hardening parts of the secondary system. Relaxed requirements for design wind loadings will result in significant cost savings. To demonstrate an acceptable level of risk, this document examines tornado-initiated accidents. The two tornado-initiated accidents examined in detail are loss of cooling resulting in core damage and lossmore » of secondary system boundary integrity leading to sodium release. Loss of core cooling is analyzed using fault/event tree models. Loss of secondary system boundary integrity is analyzed by comparing the consequences to acceptance criteria for the release of radioactive material or alkali metal aerosol. 4 refs., 4 figs.« less

  4. Review of weapon noise measurement and damage risk criteria: considerations for auditory protection and performance.

    PubMed

    Nakashima, Ann; Farinaccio, Rocco

    2015-04-01

    Noise-induced hearing loss resulting from weapon noise exposure has been studied for decades. A summary of recent work in weapon noise signal analysis, current knowledge of hearing damage risk criteria, and auditory performance in impulse noise is presented. Most of the currently used damage risk criteria are based on data that cannot be replicated or verified. There is a need to address the effects of combined noise exposures, from similar or different weapons and continuous background noise, in future noise exposure regulations. Advancements in hearing protection technology have expanded the options available to soldiers. Individual selection of hearing protection devices that are best suited to the type of exposure, the auditory task requirements, and hearing status of the user could help to facilitate their use. However, hearing protection devices affect auditory performance, which in turn affects situational awareness in the field. This includes communication capability and the localization and identification of threats. Laboratory training using high-fidelity weapon noise recordings has the potential to improve the auditory performance of soldiers in the field, providing a low-cost tool to enhance readiness for combat. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  5. USGS to accept private funds

    NASA Astrophysics Data System (ADS)

    The U.S. Geological Survey (USGS), the federal government's largest earth science research agency, is now authorized to accept contributions from private sources and to collaborate with such sources in projects that support the agency's scientific research and its development of technology and data systems.Before the USGS can accept outside contributions, however, the proposed project must be deemed to be in the public interest and must be deemed compatible with the basic USGS mission. Among the responsibilities of the USGS, are assessing the nation's land, water, energy, and mineral resources and developing methods to define and mitigate hazards associated with earthquakes, volcanic eruptions, and landslides. Details on criteria and procedures for making contributions and entering into collaborative projects are outlined in the June 2 Federal Register.

  6. [Clinical policy for management and risk stratification of community-acquired pneumonia in patients hospitalized on the basis of conventional admission criteria].

    PubMed

    Putinati, Stefano; Ballerin, Licia; Piattella, Marco; Ritrovato, Lucia; Zabini, Franco; Potena, Alfredo

    2003-05-01

    To identify discrepancies between Pneumonia Severity Index (PSI) risk class and the conventional criteria for deciding the site of care we performed a prospective observational study on 229 patients hospitalized for community-acquired pneumonia. PSI classes and corresponding mortality rates were as following: class I, 41 patients (0%); class II, 20 (0%); class III, 58 (1.7%); class IV, 86 (8.1%); class V, 24 (33.3%). Overall, 119 patients (52%) who were hospitalized according to conventional criteria were assigned to low-risk classes (I-III). Among these low risk patients, 58 (49%) had complications as respiratory failure, pleural effusion, hypotension or shock; among remaining patients, no reasons for admission were found. This latter group deserves prospective evaluation in randomized studies comparing in-hospital versus outpatient management.

  7. Does the evidence for an inverse relationship between serum vitamin D status and breast cancer risk satisfy the Hill criteria?

    PubMed

    Mohr, Sharif B; Gorham, Edward D; Alcaraz, John E; Kane, Christopher I; Macera, Caroline A; Parsons, J Kellogg; Wingard, Deborah L; Garland, Cedric F

    2012-04-01

    A wide range of epidemiologic and laboratory studies combined provide compelling evidence of a protective role of vitamin D on risk of breast cancer. This review evaluates the scientific evidence for such a role in the context of the A.B. Hill criteria for causality, in order to assess the presence of a causal, inverse relationship, between vitamin D status and breast cancer risk. After evaluation of this evidence in the context of Hill's criteria, it was found that the criteria for a causal relationship were largely satisfied. Studies in human populations and the laboratory have consistently demonstrated that vitamin D plays an important role in the prevention of breast cancer. Vitamin D supplementation is an urgently needed, low cost, effective, and safe intervention strategy for breast cancer prevention that should be implemented without delay. In the meantime, randomized controlled trials of high doses of vitamin D(3) for prevention of breast cancer should be undertaken to provide the necessary evidence to guide national health policy.

  8. Religiousness and Rape Myth Acceptance: Risk and Protective Effects.

    PubMed

    Ensz, Samantha; Jankowski, Peter J

    2017-03-01

    This study addressed the lack of research simultaneously examining multiple dimensions of religiousness when predicting rape myth acceptance, and extended prior findings of a mediating role for right-wing authoritarianism (i.e., uncritical submission to authority and aggressive attitude toward those who do not conform to social norms) in the association between religiousness and prejudice. The sample consisted of 99 undergraduate and graduate students ( M age = 31.87 years, 66.7% female, 80.82% White, and 93% Christian affiliated) from a religiously affiliated university in the Midwest United States. As hypothesized, dimensions of religiousness exhibited differential associations with rape myth acceptance. Religious motivation characterized by openness and exploration (i.e., quest religiousness) was a significant negative predictor of rape myth acceptance, directly, and indirectly through right-wing authoritarianism. In contrast, rigid adherence to religious beliefs, assumed to be "right" and absolutely true (i.e., religious fundamentalism), and extrinsically motivated religiousness each exhibited a positive association with rape myth acceptance through right-wing authoritarianism. In addition, internally motivated religiousness and religious fundamentalism each moderated the nonlinear effect for quest predicting rape myth acceptance. Findings suggest that uncritical religious and secular submission to external authorities or uncommitted and nonexploring religiousness may have increased the extent to which persons adhered to rape myths, whereas religious exploration was protective. Practical implications center on the need for socioculturally relevant prevention and intervention efforts with religious identifying college students.

  9. [Revision of McDonald's new diagnostic criteria for multiple sclerosis].

    PubMed

    Wiendl, H; Kieseier, B C; Gold, R; Hohlfeld, R; Bendszus, M; Hartung, H-P

    2006-10-01

    In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

  10. Proposal of a risk-factor-based analytical approach for integrating occupational health and safety into project risk evaluation.

    PubMed

    Badri, Adel; Nadeau, Sylvie; Gbodossou, André

    2012-09-01

    Excluding occupational health and safety (OHS) from project management is no longer acceptable. Numerous industrial accidents have exposed the ineffectiveness of conventional risk evaluation methods as well as negligence of risk factors having major impact on the health and safety of workers and nearby residents. Lack of reliable and complete evaluations from the beginning of a project generates bad decisions that could end up threatening the very existence of an organization. This article supports a systematic approach to the evaluation of OHS risks and proposes a new procedure based on the number of risk factors identified and their relative significance. A new concept called risk factor concentration along with weighting of risk factor categories as contributors to undesirable events are used in the analytical hierarchy process multi-criteria comparison model with Expert Choice(©) software. A case study is used to illustrate the various steps of the risk evaluation approach and the quick and simple integration of OHS at an early stage of a project. The approach allows continual reassessment of criteria over the course of the project or when new data are acquired. It was thus possible to differentiate the OHS risks from the risk of drop in quality in the case of the factory expansion project. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis

    PubMed Central

    Mokotedi, Lebogang; Gunter, Sulé; Robinson, Chanel; Norton, Gavin R.; Woodiwiss, Angela J.

    2017-01-01

    This study compared the estimated prevalence and potential determinants of left ventricular (LV) diastolic dysfunction upon applying different classification criteria in rheumatoid arthritis (RA). LV diastolic function was assessed echocardiographically by pulsed Doppler (E/A), tissue Doppler (E/e′, lateral and septal e′), and left atrial volume index in 176 RA patients. Relationships of traditional cardiovascular risk factors and RA characteristics with LV diastolic function and dysfunction according to previous and current criteria were determined in multivariate regression models. Waist-hip ratio was associated with E/A (standardised β (SE) = −0.28 ± 0.09, p = 0.0002) and lateral e′ (standardised β (SE) = 0.26 ± 0.09, p = 0.01); low diastolic blood pressure was related to E/e′ (standardised β (SE) = −0.16 ± 0.08, p = 0.04). Diastolic dysfunction prevalence differed upon applying previous (59%) compared to current (22%) criteria (p < 0.0001). One SD increase in waist-hip ratio was associated with diastolic dysfunction when applying current criteria (OR = 2.61 (95% CI = 1.51–4.52), p = 0.0006), whereas one SD increase in diastolic blood pressure was inversely related to diastolic dysfunction upon using previous criteria (OR = 0.57 (95% CI = 0.40–0.81), p = 0.002). In conclusion, application of current and previous diastolic dysfunction criteria markedly alters the prevalence and risk factors associated with diastolic dysfunction in RA. PMID:29348754

  12. [Quality criteria in medicine: which limits?].

    PubMed

    Minvielle, E

    2006-06-01

    This article aims to develop a critical appraisal of the criteria's development in medicine. The COMPAQH (Coordination for Measuring Performance and Assuring Quality in Hospitals) project (Ministry of Health/ High Authority of Health/ National Institute of Medical Research) helps to support this analysis. This project based on the test of 42 Quality indicators (QI) gives findings not only about the manner to build criteria, but also to interpret and diffuse results among physicians and hospital managers. Criteria must be elaborated in a pragmatic way. They must be in compliance with practice guidelines supported by scientific evidences. The associated risk is to create and develop a normative medicine. Collaboration with professional societies may be useful in preventing this risk.

  13. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria.

    PubMed

    Yildiz, Bulent Okan; Bozdag, Gurkan; Yapici, Zuhal; Esinler, Ibrahim; Yarali, Hakan

    2012-10-01

    What is the prevalence, phenotype and metabolic features of polycystic ovary syndrome (PCOS) in the same population according to three different diagnostic criteria? The prevalence of PCOS under National Institutes of Health (NIH), Rotterdam and Androgen Excess and PCOS (AE-PCOS) Society criteria was 6.1, 19.9 and 15.3%, respectively. PCOS carried a 2-fold increased risk of metabolic syndrome regardless of the diagnostic criteria used. The prevalence rates of PCOS differ depending on the diagnostic criteria used to define the syndrome. The current paper gives the prevalence rates of the component and composite phenotypes of PCOS in the same population and reports similar rates of metabolic syndrome in women with PCOS under contrasting diagnostic criteria. In this cross-sectional study, 392 women between the ages of 18 and 45 years were analyzed. When the prevalence of PCOS according to NIH was set to 8% with a precision of 2.2% and confidence interval of 95%, the sample size required for a prevalence survey was found to be 400 subjects. The study was carried out in the General Directorate of Mineral Research and Exploration, a government-based institute, in which the largest number of female staff (n = 527) are employed within a single institute in Ankara, Turkey. The study was performed between 7 December 2009 and 30 April 2010. All female subjects between the ages of 18 and 45 years were invited to participate. Women older than 45 or younger than 18 years, post-menopausal women, women with a history of hysterectomy or bilateral oopherectomy and pregnant women were excluded. Totally, 392 of the employees were recruited for the final analyses. The prevalence of PCOS under NIH, Rotterdam and AE-PCOS Society criteria were 6.1, 19.9 and 15.3%, respectively. While the prevalence of metabolic syndrome was 6.1% in the whole study group, within the patients diagnosed as PCOS according to NIH, Rotterdam and AE-PCOS Society criteria, it was 12.5, 10.3 and 10

  14. Quantum cryptography: Security criteria reexamined

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kaszlikowski, Dagomir; Liang, Y.C.; Englert, Berthold-Georg

    2004-09-01

    We find that the generally accepted security criteria are flawed for a whole class of protocols for quantum cryptography. This is so because a standard assumption of the security analysis, namely that the so-called square-root measurement is optimal for eavesdropping purposes, is not true in general. There are rather large parameter regimes in which the optimal measurement extracts substantially more information than the square-root measurement.

  15. R&D Plan for RISMC Industry Application #1: ECCS/LOCA Cladding Acceptance Criteria

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Szilard, Ronaldo Henriques; Zhang, Hongbin; Epiney, Aaron Simon

    The Nuclear Regulatory Commission (NRC) is finalizing a rulemaking change that would revise the requirements in 10 CFR 50.46. In the proposed new rulemaking, designated as 10 CFR 50.46c, the NRC proposes a fuel performance-based equivalent cladding reacted (ECR) criterion as a function of cladding hydrogen content before the accident (pre-transient) in order to include the effects of higher burnup on cladding performance as well as to address other technical issues. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licenseemore » costs as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. The Idaho National Laboratory (INL) has initiated a project, as part of the DOE Light Water Reactor Sustainability Program (LWRS), to develop analytical capabilities to support the industry in the transition to the new rule. This project is called the Industry Application 1 (IA1) within the Risk-Informed Safety Margin Characterization (RISMC) Pathway of LWRS. The general idea behind the initiative is the development of an Integrated Evaluation Model (IEM). The motivation is to develop a multiphysics framework to analyze how uncertainties are propagated across the stream of physical disciplines and data involved, as well as how risks are evaluated in a LOCA safety analysis as regulated under 10 CFR 50.46c. This IEM is called LOTUS which stands for LOCA Toolkit for US, and it represents the LWRS Program’s response to the proposed new rule making. The focus of this report is to complete an R&D plan to describe the demonstration of the LOCA/ECCS RISMC Industry Application # 1 using the advanced RISMC Toolkit and methodologies. This report includes the description and development plan for a RISMC LOCA tool that fully couples advanced MOOSE tools already in development in order to characterize and

  16. Wild Fire Risk Map in the Eastern Steppe of Mongolia Using Spatial Multi-Criteria Analysis

    NASA Astrophysics Data System (ADS)

    Nasanbat, Elbegjargal; Lkhamjav, Ochirkhuyag

    2016-06-01

    Grassland fire is a cause of major disturbance to ecosystems and economies throughout the world. This paper investigated to identify risk zone of wildfire distributions on the Eastern Steppe of Mongolia. The study selected variables for wildfire risk assessment using a combination of data collection, including Social Economic, Climate, Geographic Information Systems, Remotely sensed imagery, and statistical yearbook information. Moreover, an evaluation of the result is used field validation data and assessment. The data evaluation resulted divided by main three group factors Environmental, Social Economic factor, Climate factor and Fire information factor into eleven input variables, which were classified into five categories by risk levels important criteria and ranks. All of the explanatory variables were integrated into spatial a model and used to estimate the wildfire risk index. Within the index, five categories were created, based on spatial statistics, to adequately assess respective fire risk: very high risk, high risk, moderate risk, low and very low. Approximately more than half, 68 percent of the study area was predicted accuracy to good within the very high, high risk and moderate risk zones. The percentages of actual fires in each fire risk zone were as follows: very high risk, 42 percent; high risk, 26 percent; moderate risk, 13 percent; low risk, 8 percent; and very low risk, 11 percent. The main overall accuracy to correct prediction from the model was 62 percent. The model and results could be support in spatial decision making support system processes and in preventative wildfire management strategies. Also it could be help to improve ecological and biodiversity conservation management.

  17. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  18. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  19. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  20. 15 CFR Appendix A to Part 946 - National Weather Service Modernization Criteria

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... specifically in Addendum I, Appendix D of the ASOS Site Component Commissioning Evaluation Package (the ASOS Package). Criteria: a. ASOS Acceptance Test: The site component acceptance test, which includes objective..., has been successfully completed in accordance with item 1a, p. D-2 of Appendix D of the ASOS Package...

  1. Vehicles instability criteria for flood risk assessment of a street network

    NASA Astrophysics Data System (ADS)

    Arrighi, Chiara; Huybrechts, Nicolas; Ouahsine, Abdellatif; Chassé, Patrick; Oumeraci, Hocine; Castelli, Fabio

    2016-05-01

    The mutual interaction between floods and human activity is a process, which has been evolving over history and has shaped flood risk pathways. In developed countries, many events have illustrated that the majority of the fatalities during a flood occurs in a vehicle, which is considered as a safe shelter but it may turn into a trap for several combinations of water depth and velocity. Thus, driving a car in floodwaters is recognized as the most crucial aggravating factor for people safety. On the other hand, the entrainment of vehicles may locally cause obstructions to the flow and induce the collapse of infrastructures. Flood risk to vehicles can be defined as the combination of the probability of a vehicle of being swept away (i.e. the hazard) and the actual traffic/parking density, i.e. the vulnerability. Hazard for vehicles can be assessed through the spatial identification and mapping of the critical conditions for vehicles incipient motion. This analysis requires a flood map with information on water depth and velocity and consistent instability criteria accounting for flood and vehicles characteristics. Vulnerability is evaluated thanks to the road network and traffic data. Therefore, vehicles flood risk mapping can support people's education and management practices in order to reduce the casualties. In this work, a flood hazard classification for vehicles is introduced and an application to a real case study is presented and discussed.

  2. Acceptance and barriers to access of occupational e-mental health: cross-sectional findings from a health-risk population of employees.

    PubMed

    Hennemann, Severin; Witthöft, Michael; Bethge, Matthias; Spanier, Katja; Beutel, Manfred E; Zwerenz, Rüdiger

    2018-04-01

    Occupational e-mental-health (OEMH) may extend existing instruments for preservation or restoration of health and work ability. As a key precondition to efficient implementation, this study examined acceptance and person-centered barriers to potential uptake of OEMH for work-related distress in employees with an elevated risk of early retirement. Within the framework of the "Third German Sociomedical Panel of Employees", 1829 employees with prior sickness absence payments filled out a self-administered questionnaire. Participants had a mean age of 49.93 years (SD = 4.06). 6.2% indicated prior use of eHealth interventions. Potential predictors of acceptance of OEMH were examined based on the "Unified Theory of Acceptance and Use of Technology" (UTAUT) extended by work ability, mental health, eHealth literacy and demographic characteristics. 89.1% (n = 1579) showed low to moderate acceptance (M = 2.20, SD = 1.05, range 1-5). A path analysis revealed significant, positive direct effects of UTAUT predictors on acceptance (performance expectancy: 0.48, SE = 0.02, p < 0.001; effort expectancy: 0.20, SE = 0.02, p < 0.001; social influence: 0.28, SE = 0.02, p < 0.001).Online time and frequency of online health information search were further positive direct predictors of acceptance. Model fit was good [χ 2 (7) = 12.91, p = 0.07, RMSEA = 0.02, CFI = 1.00, TLI = 0.99, SRMR = 0.01]. Attitudes towards OEMH are rather disadvantageous in the studied risk group. Implementation of OEMH, therefore, requires a-priori education including promotion of awareness, favorable attitudes regarding efficacy and usability in a collaborative approach.

  3. Determining the Criteria and Their Weights for Medical Schools' Ranking: A National Consensus.

    PubMed

    Mojtahedzadeh, Rita; Mohammadi, Aeen; Kohan, Noushin; Gharib, Mitra; Zolfaghari, Mitra

    2016-06-01

    Delphi as a consensus development technique enables anonymous, systematic refinement of expert opinion with the aim of arriving at a combined or consensual position. In this study, we determined the criteria and their weights for Iranian Medical Schools' ranking through a Delphi process. An expert committee devised 13 proposed criteria with 32 indicators with their weights, which were arranged hierarchically in the form of a tree diagram. We used the Delphi technique to reach a consensus on these criteria and weights among the deans of 38 public Iranian medical schools. For this purpose, we devised and sent a questionnaire to schools and asked them to suggest or correct the criteria and their weights. We repeated this process in two rounds till all the schools reached an acceptable consensus on them. All schools reached a consensus on the set of 13 criteria and 30 indicators and their weights in three main contexts of education, research and facilities, and equipment which were used for Medical Schools' ranking. Using Delphi technique for devising the criteria and their weights in evaluation processes such as ranking makes their results more acceptable among universities.

  4. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk.

    PubMed

    Wu, Ping; Fang, Yunyun; Guan, Zhiqiang; Fan, Bin; Kong, Junhui; Yao, Zhongling; Liu, Xinhua; Fuller, Cordelia J; Susser, Ezra; Lu, Jin; Hoven, Christina W

    2009-05-01

    We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China. In 2006, randomly selected employees (n = 549) of a hospital in Beijing were surveyed concerning their exposure to the 2003 SARS outbreak, and the ways in which the outbreak had affected their mental health. About 10% of the respondents had experienced high levels of posttraumatic stress (PTS) symptoms since the SARS outbreak. Respondents who had been quarantined, or worked in high-risk locations such as SARS wards, or had friends or close relatives who contracted SARS, were 2 to 3 times more likely to have high PTS symptom levels, than those without these exposures. Respondents' perceptions of SARS-related risks were significantly positively associated with PTS symptom levels and partially mediated the effects of exposure. Altruistic acceptance of work-related risks was negatively related to PTS levels. The psychological impact of stressful events related to an infectious disease outbreak may be mediated by peoples' perceptions of those events; altruism may help to protect some health care workers against these negative impacts.

  5. Diffusion of Educational Knowledge Through Journals: Gatekeepers' Selection Criteria

    ERIC Educational Resources Information Center

    Silverman, Robert J.

    1978-01-01

    Report is made of a survey of 248 editors representing scholarly, professional, association, and research journals in regard to their editorial role, criteria for accepting or rejecting manuscripts, and selection of editorial boards and reviewers. (Author/MJB)

  6. 49 CFR 611.11 - Local financial commitment criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Local financial commitment criteria. 611.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAJOR CAPITAL INVESTMENT PROJECTS § 611.11 Local financial... proposed project is supported by an acceptable degree of local financial commitment, as required by section...

  7. 49 CFR 611.11 - Local financial commitment criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Local financial commitment criteria. 611.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MAJOR CAPITAL INVESTMENT PROJECTS § 611.11 Local financial... proposed project is supported by an acceptable degree of local financial commitment, as required by section...

  8. Launch Risk Acceptability: The Public Speaks

    NASA Technical Reports Server (NTRS)

    Haber, Jerold M.; Lamoreaux, Richard W.

    2008-01-01

    The perspective of those assuming risk has become increasingly important to launch agencies. The IAASS white paper "An ICAO for Space?" proposed four ultimate goals of any international regulatory framework. The first of these was to "Ensure that citizens of all nations are equally protected from "unreasonable levels" of risk from overflight by missiles, launch vehicles and returning spacecraft". A key component of this concept is the issue of what is an "unreasonable level" of risk from the perspective of those assuming the risk.

  9. How do risk preferences relate to malaria care-seeking behavior and the acceptability of a new health technology in Nigeria?

    PubMed

    Liu, Jenny; Modrek, Sepideh; Anyanti, Jennifer; Nwokolo, Ernest; De La Cruz, Anna; Schatzkin, Eric; Isiguzo, Chinwoke; Ujuju, Chinazo; Montagu, Dominic

    2014-09-05

    To reduce the burden of disease from malaria, innovative approaches are needed to engender behavior change. One unobservable, but fundamental trait-preferences for risk-may influence individuals' willingness to adopt new health technologies. We explore the association of risk preferences with malaria care-seeking behavior and the acceptability of malaria rapid diagnostic tests (RDTs) to inform RDT scale-up plans. In Oyo State, Nigeria, adult customers purchasing anti-malarial medications at selected drug shops took surveys and received an RDT as they exited. After an initial risk preference assessment via a simple lottery game choice, individuals were given their RDT result and treatment advice, and called four days later to assess treatment adherence. We used bivariable and multivariable regression analysis to assess the association of risk game choices with malaria care-seeking behaviors and RDT acceptability. Of 448 respondents, 63.2% chose the lottery game with zero variance in expected payout, 27.9% chose the game with low variance, and 8.9% chose the game with high variance. Compared to participants who chose lower variance games, individuals choosing higher variance games were older, less educated, more likely to be male, and were more likely to patronize lower quality drug shops, seek care immediately, and report complete disability due to their illness. In contrast, individuals choosing lower variance games were more likely to follow the correct treatment directions and were more likely to report an increase in their willingness to pay for an RDT compared to other risk groups, our two measures of RDT acceptability. Differences in estimated associations between risk game choices and selected care-seeking behaviors remained after controlling sociodemographic confounders. The uptake of health diagnostic information in terms of translating the RDT experience into willingness to pay for an RDT and treatment adherence to test results may vary according to risk

  10. Knowledge and Acceptability of Anal Cytology Screening Among Women.

    PubMed

    Blankenship, Stephanie A; Debnath, Priyanka; Szlachta-McGinn, Alec W; Maguire, Karla; Garcia, Jorge J; Aserlind, Alexandra; Lipshultz, Emma; Potter, JoNell E

    2016-01-01

    Medical providers have initiated anal cytology screening among women to detect anal neoplasia early. Lack of knowledge of the human papillomavirus (HPV) and anticipated screening discomfort may limit patient acceptance. This study investigates attitudes toward anal cytology screening among women. Women seen for gynecologic care at an urban university medical center were invited to complete an anonymous survey assessing their understanding of HPV and interest in anal cytology screening. Subjects reported the level of pain, discomfort, and embarrassment they expected from screening on a 100-mm visual analog scale. Four hundred four women with mean (SD) age 36 (13) years met criteria for participation. Three hundred thirty-five women reported their race: 52% were white and 36% were African American. Three hundred forty-eight women reported their ethnicities: 76% were Hispanic and 12% were Haitian. Twenty-two percent had never heard of HPV, 57% were not familiar with anal cytology screening, 67% acknowledged that screening was very helpful in detecting anal neoplasia early, and 28% were very interested in undergoing screening. Mean (SD) level of anticipated pain, discomfort, and embarrassment during screening was 62 (32), 68 (30), and 58 (34) mm, respectively. Level of familiarity with anal cytology screening (p < .001), belief in its utility in detecting anal neoplasia (p < .001), and level of anticipated pain (p = .004) were significant predictors of acceptability. Medical providers should improve counseling about anal cytology screening among at-risk women to familiarize them with the procedure, describe its role in detecting anal neoplasia, and address expectations surrounding pain to increase its acceptability.

  11. Major psychological factors affecting acceptance of gene-recombination technology.

    PubMed

    Tanaka, Yutaka

    2004-12-01

    The purpose of this study was to verify the validity of a causal model that was made to predict the acceptance of gene-recombination technology. A structural equation model was used as a causal model. First of all, based on preceding studies, the factors of perceived risk, perceived benefit, and trust were set up as important psychological factors determining acceptance of gene-recombination technology in the structural equation model. An additional factor, "sense of bioethics," which I consider to be important for acceptance of biotechnology, was added to the model. Based on previous studies, trust was set up to have an indirect influence on the acceptance of gene-recombination technology through perceived risk and perceived benefit in the model. Participants were 231 undergraduate students in Japan who answered a questionnaire with a 5-point bipolar scale. The results indicated that the proposed model fits the data well, and showed that acceptance of gene-recombination technology is explained largely by four factors, that is, perceived risk, perceived benefit, trust, and sense of bioethics, whether the technology is applied to plants, animals, or human beings. However, the relative importance of the four factors was found to vary depending on whether the gene-recombination technology was applied to plants, animals, or human beings. Specifically, the factor of sense of bioethics is the most important factor in acceptance of plant gene-recombination technology and animal gene-recombination technology, and the factors of trust and perceived risk are the most important factors in acceptance of human being gene-recombination technology.

  12. Risk in the pursuit of benefit

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Terra, S.

    1978-11-01

    A summer conference was held by the Electric Power Research Institute (EPRI) Advisory Council to discuss the impact of energy production on health and the environment. The government's role as a funding agent for energy research includes disseminating risk assessments to the public. This was faulted by some, particularly in the area of nuclear energy. Conferees disagreed over the quality and interpretation of data that government agencies release to the public, but agreed that public confusion over goals and acceptable risks makes it difficult for regulators. Legislation and court decisions, often responding to pressure-group influence, are constantly shifting the balancemore » between individual and societal goals even though there is often little correlation between statistical and perceived risks. A refocusing of the concept of hazards and the criteria for risks was recommended, and a set of new guidelines for technology risk assessment was suggested that ignores minor risks, bans large risks and actively studies all others.« less

  13. Two approaches to incorporate clinical data uncertainty into multiple criteria decision analysis for benefit-risk assessment of medicinal products.

    PubMed

    Wen, Shihua; Zhang, Lanju; Yang, Bo

    2014-07-01

    The Problem formulation, Objectives, Alternatives, Consequences, Trade-offs, Uncertainties, Risk attitude, and Linked decisions (PrOACT-URL) framework and multiple criteria decision analysis (MCDA) have been recommended by the European Medicines Agency for structured benefit-risk assessment of medicinal products undergoing regulatory review. The objective of this article was to provide solutions to incorporate the uncertainty from clinical data into the MCDA model when evaluating the overall benefit-risk profiles among different treatment options. Two statistical approaches, the δ-method approach and the Monte-Carlo approach, were proposed to construct the confidence interval of the overall benefit-risk score from the MCDA model as well as other probabilistic measures for comparing the benefit-risk profiles between treatment options. Both approaches can incorporate the correlation structure between clinical parameters (criteria) in the MCDA model and are straightforward to implement. The two proposed approaches were applied to a case study to evaluate the benefit-risk profile of an add-on therapy for rheumatoid arthritis (drug X) relative to placebo. It demonstrated a straightforward way to quantify the impact of the uncertainty from clinical data to the benefit-risk assessment and enabled statistical inference on evaluating the overall benefit-risk profiles among different treatment options. The δ-method approach provides a closed form to quantify the variability of the overall benefit-risk score in the MCDA model, whereas the Monte-Carlo approach is more computationally intensive but can yield its true sampling distribution for statistical inference. The obtained confidence intervals and other probabilistic measures from the two approaches enhance the benefit-risk decision making of medicinal products. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Judging Statistical Models of Individual Decision Making under Risk Using In- and Out-of-Sample Criteria

    PubMed Central

    Drichoutis, Andreas C.; Lusk, Jayson L.

    2014-01-01

    Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error) for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two) using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample. PMID:25029467

  15. Judging statistical models of individual decision making under risk using in- and out-of-sample criteria.

    PubMed

    Drichoutis, Andreas C; Lusk, Jayson L

    2014-01-01

    Despite the fact that conceptual models of individual decision making under risk are deterministic, attempts to econometrically estimate risk preferences require some assumption about the stochastic nature of choice. Unfortunately, the consequences of making different assumptions are, at present, unclear. In this paper, we compare three popular error specifications (Fechner, contextual utility, and Luce error) for three different preference functionals (expected utility, rank-dependent utility, and a mixture of those two) using in- and out-of-sample selection criteria. We find drastically different inferences about structural risk preferences across the competing functionals and error specifications. Expected utility theory is least affected by the selection of the error specification. A mixture model combining the two conceptual models assuming contextual utility provides the best fit of the data both in- and out-of-sample.

  16. Rethinking Normal: Benefits and Risks of Not Reporting Harmless Incidental Findings.

    PubMed

    Pandharipande, Pari V; Herts, Brian R; Gore, Richard M; Mayo-Smith, William W; Harvey, H Benjamin; Megibow, Alec J; Berland, Lincoln L

    2016-07-01

    The authors explore the benefits and risks of not reporting imaging findings that do not have clinical relevance, with the goal of developing recommendations to reduce their reporting. The authors review the example of incidentally detected, simple renal cysts (Bosniak category I), including medicolegal conditions required for such a shift in reporting practices to be acceptable. The authors propose four potential criteria for not reporting clinically unimportant findings and recommend that these criteria be debated in other contexts, so that they can be refined and implemented. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. ACR Appropriateness Criteria® growth disturbances - risk of intrauterine growth restriction.

    PubMed

    Zelop, Carolyn M; Javitt, Marcia C; Glanc, Phyllis; Dubinsky, Theodore; Harisinghani, Mukesh G; Harris, Robert D; Khati, Nadia J; Mitchell, Donald G; Pandharipande, Pari V; Pannu, Harpreet K; Podrasky, Ann E; Shipp, Thomas D; Siegel, Cary Lynn; Simpson, Lynn; Wall, Darci J; Wong-You-Cheong, Jade J

    2013-09-01

    Fetal growth disturbances include fetuses at risk for intrauterine growth restriction. These fetuses may have an estimated fetal weight at less than the 10% or demonstrate a plateau of fetal growth with an estimated fetal growth greater than the 10%. Uteroplacental insufficiency may play a major role in the etiology of intrauterine growth restriction. Fetuses at risk for intrauterine fetal growth restriction are susceptible to the potential hostility of the intrauterine environment leading to fetal hypoxia and fetal acidosis. Fetal well-being can be assessed using biophysical profile, Doppler velocimetry, fetal heart rate monitoring, and fetal movement counting.Fetal growth disturbances include fetuses at risk for intrauterine growth restriction. These fetuses may have an estimated fetal weight at less than the 10% or demonstrate a plateau of fetal growth with an estimated fetal growth greater than the 10%. Uteroplacental insufficiency may play a major role in the etiology of intrauterine growth restriction. Fetuses at risk for intrauterine fetal growth restriction are susceptible to the potential hostility of the intrauterine environment leading to fetal hypoxia and fetal acidosis. Fetal well-being can be assessed using biophysical profile, Doppler velocimetry, fetal heart rate monitoring, and fetal movement counting.The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  18. Screening criteria for increased susceptibility to heat stress during work or leisure in hot environments in healthy individuals aged 31-70 years.

    PubMed

    Flouris, Andreas D; McGinn, Ryan; Poirier, Martin P; Louie, Jeffrey C; Ioannou, Leonidas G; Tsoutsoubi, Lydia; Sigal, Ronald J; Boulay, Pierre; Hardcastle, Stephen G; Kenny, Glen P

    2018-01-01

    Population aging and global warming generate important public health risks, as older adults have increased susceptibility to heat stress (SHS). We defined and validated sex-specific screening criteria for SHS during work and leisure activities in hot environments in individuals aged 31-70 years using age, anthropometry, and cardiorespiratory fitness. A total of 123 males and 44 females [44 ± 14 years; 22.9 ± 7.4% body fat; 40.3 ± 8.6 peak oxygen uptake (mlO 2 /kg/min)] participated, separated into the Analysis (n = 111) and Validation (n = 56) groups. Within these groups, participants were categorized into YOUNG (19-30 years; n = 47) and OLDER (31-70 years; n = 120). All participants performed exercise in the heat inside a direct calorimeter. Screening criteria for OLDER participants were defined from the Analysis group and were cross-validated in the Validation group. Results showed that 30% of OLDER individuals in the Analysis group were screened as SHS positive. A total of 274 statistically valid (p < 0.05) criteria were identified suggesting that OLDER participants were at risk for SHS when demonstrating two or more of the following (males/females): age ≥ 53.0/55.8 years; body mass index ≥29.5/25.7 kg/m 2 ; body fat percentage ≥ 28.8/34.9; body surface area ≤2.0/1.7 m 2 ; peak oxygen uptake ≤48.3/41.4 mlO 2 /kg fat free mass/min. In the Validation group, McNemar χ 2 comparisons confirmed acceptable validity for the developed criteria. We conclude that the developed criteria can effectively screen individuals 31-70 years who are at risk for SHS during work and leisure activities in hot environments and can provide simple and effective means to mitigate the public health risks caused by heat exposure.

  19. [Acceptance and willingness-to-pay for colorectal colonoscopy screening among high-risk populations for colorectal cancer in urban China].

    PubMed

    Shi, Jufang; Huang, Huiyao; Guo, Lanwei; Ren, Jiansong; Ren, Ying; Lan, Li; Zhou, Qi; Mao, Ayan; Qi, Xiao; Liao, Xianzhen; Liu, Guoxiang; Bai, Yana; Cao, Rong; Liu, Yuqin; Wang, Yuanzheng; Gong, Jiyong; Li, Ni; Zhang, Kai; He, Jie; Dai, Min

    2015-05-01

    To survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China. From 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as "high risk for colorectal cancer" by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening. The current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25 = 49.0, P75 = 61.0 years) and an annual income per capita of 17 thousand (range: 10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0% (1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school: OR = 0.34, 95% CI: 0.22-0.52; high school OR = 0.41, 95% CI: 0.26-0.66; college or over OR = 0.35, 95% CI: 0.20-0.59). Of all the participants, 13.0% (210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR = 1.48, 95% CI: 1.06-2.07), not in marriage (OR = 2.15, 95% CI: 1.25-3.70) or with family member(s) to raise (OR = 1.60, 95% CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR = 0.61, 95% CI: 0.44-0.84) or enterprise sectors (OR = 0.60, 95% CI: 0.38-0.94), but 82.3% (1 141/1 386) of whom would only pay less than 100 CNY; 14.5% (236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR = 4.08, 95% CI: 2.75-6.33) or high GDP per capita (OR = 3.26, 95% CI: 2

  20. Relevance and reliability of experimental data in human health risk assessment of pesticides.

    PubMed

    Kaltenhäuser, Johanna; Kneuer, Carsten; Marx-Stoelting, Philip; Niemann, Lars; Schubert, Jens; Stein, Bernd; Solecki, Roland

    2017-08-01

    Evaluation of data relevance, reliability and contribution to uncertainty is crucial in regulatory health risk assessment if robust conclusions are to be drawn. Whether a specific study is used as key study, as additional information or not accepted depends in part on the criteria according to which its relevance and reliability are judged. In addition to GLP-compliant regulatory studies following OECD Test Guidelines, data from peer-reviewed scientific literature have to be evaluated in regulatory risk assessment of pesticide active substances. Publications should be taken into account if they are of acceptable relevance and reliability. Their contribution to the overall weight of evidence is influenced by factors including test organism, study design and statistical methods, as well as test item identification, documentation and reporting of results. Various reports make recommendations for improving the quality of risk assessments and different criteria catalogues have been published to support evaluation of data relevance and reliability. Their intention was to guide transparent decision making on the integration of the respective information into the regulatory process. This article describes an approach to assess the relevance and reliability of experimental data from guideline-compliant studies as well as from non-guideline studies published in the scientific literature in the specific context of uncertainty and risk assessment of pesticides. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. A Latent Class Analysis of Pathological-Gambling Criteria Among High School Students: Associations With Gambling, Risk and Health/Functioning Characteristics

    PubMed Central

    Kong, Grace; Tsai, Jack; Krishnan-Sarin, Suchitra; Cavallo, Dana A.; Hoff, Rani A.; Steinberg, Marvin A.; Rugle, Loreen; Potenza, Marc N.

    2015-01-01

    Objectives To identify subtypes of adolescent gamblers based on the 10 Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for pathological gambling and the 9 Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for gambling disorder and to examine associations between identified subtypes with gambling, other risk behaviors, and health/functioning characteristics. Methods Using cross-sectional survey data from 10 high schools in Connecticut (N = 3901), we conducted latent class analysis to classify adolescents who reported past-year gambling into gambling groups on the basis of items from the Massachusetts Gambling Screen. Adolescents also completed questions assessing demographic information, substance use (cigarette, marijuana, alcohol, and other drugs), gambling behaviors (relating to gambling formats, locations, motivations, and urges), and health/functioning characteristics (eg, extracurricular activities, mood, aggression, and body mass index). Results The optimal solution consisted of 4 classes that we termed low-risk gambling (86.4%), at-risk chasing gambling (7.6%), at-risk negative consequences gambling (3.7%), and problem gambling (PrG) (2.3%). At-risk and PrG classes were associated with greater negative functioning and more gambling behaviors. Different patterns of associations between at-risk and PrG classes were also identified. Conclusions Adolescent gambling classifies into 4 classes, which are differentially associated with demographic, gambling patterns, risk behaviors, and health/functioning characteristics. Early identification and interventions for adolescent gamblers should be sensitive to the heterogeneity of gambling subtypes. PMID:25275877

  2. The number of lung transplants can be safely doubled using extended criteria donors; a single-center review.

    PubMed

    Meers, Caroline; Van Raemdonck, Dirk; Verleden, Geert M; Coosemans, Willy; Decaluwe, Herbert; De Leyn, Paul; Nafteux, Philippe; Lerut, Toni

    2010-06-01

    Relaxing the standard lung donor criteria may significantly increase the reported 15% organ yield but post-transplant recipient outcome should be carefully monitored. Charts from all consecutive deceased organ donors within our hospital network were reviewed over a 2-year period. Reasons for lung refusals and number of lungs transplanted were analysed. Hospital outcome including early recipient survival was compared between standard- and extended criteria donors. Out of 283 referrals, 164 (58%) qualified as donor of any organ. The majority (65.9%) of these effective donors were declined for lung donation because of chest X-ray abnormalities (20%), age >70 years (13%), poor oxygenation (10%), or aspiration (9%). Out of 56 (34.1%) accepted lung donors, 50 transplants were performed at our center, 23 from standard criteria donors versus 27 from extended criteria donors. There were no significant differences in hospital outcome and in early survival between lung recipients from both donor groups. Lung acceptance rate (34.1%) in our donor network is 10-20% higher than reported figures. The number of lung transplants in our center doubled by accepting extended criteria donors. This policy did not negatively influence our results after lung transplantation.

  3. Neck injury criteria formulation and injury risk curves for the ejection environment: a pilot study.

    PubMed

    Parr, Jeffrey C; Miller, Michael E; Pellettiere, Joseph A; Erich, Roger A

    2013-12-01

    Helmet mounted displays provide increased pilot capability, but can also increase the risk of injury during ejection. The National Highway Transportation Safety Administration's (NHTSA's) neck injury criteria (Nij) metric is evaluated for understanding the impact of helmet mass on the risk of injury and modified risk curves are developed which are compatible with the needs of the aviation community. Existent human subject data collected under various accelerative and head loading conditions were applied to understand the sensitivity of the Nij construct to changes in acceleration and helmet mass, as well as its stability with respect to gender, body mass, neck circumference, and sitting height. A portion of this data was combined with data from an earlier postmortem human subject study to create pilot study modified risk curves. These curves were compared and contrasted with the NHTSA risk curves. A statistically significant difference in the peak mean Nij was observed when seat acceleration increased by 2 G, but not when helmet mass was varied from 1.6 kg to 2 kg at a constant seat acceleration of 8 G. Although NHTSA risk curves predict a 13% risk of AIS 2+ injury for the 8-G, 2-kg helmet condition mean Nij of 0.138, no AIS 2+ injuries were observed. Modified risk curves were produced which predict a 0.91% risk of AIS 2+ injury under these conditions. The Nij was shown to be sensitive to changes in acceleration and generally robust to anthropometric differences between individuals. Modified risk curves are proposed which improve risk prediction at lower Nij values.

  4. Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa.

    PubMed

    Morojele, Neo K; Kitleli, Naledi; Ngako, Kgalabi; Kekwaletswe, Connie T; Nkosi, Sebenzile; Fritz, Katherine; Parry, Charles D H

    2014-01-01

    Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and referrals to the patrons of the bars. A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the community at large) was an important contributor to the feasibility and acceptability of the intervention.

  5. Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa

    PubMed Central

    Morojele, Neo K.; Kitleli, Naledi; Ngako, Kgalabi; Kekwaletswe, Connie T.; Nkosi, Sebenzile; Fritz, Katherine; Parry, Charles D.H.

    2014-01-01

    Abstract Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counsellors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and referrals to the patrons of the bars. A responsible server sub-component that had also been planned was not delivered as it was not feasible to train the staff in the two participating bars. Over the eight-month period the counsellors were approached by and provided advice and counselling for alcohol and sexual risk-related problems to 111 bar patrons. The peer interventionists reported 1323 risk reduction interactions with their fellow bar patrons during the same period. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities in some instances. The buy-in that we received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the community at large) was an important contributor to the feasibility and acceptability of the intervention. PMID:24750106

  6. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation.

    PubMed

    Lafranca, Jeffrey A; Spoon, Emerentia Q W; van de Wetering, Jacqueline; IJzermans, Jan N M; Dor, Frank J M F

    2017-01-01

    The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

  7. Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

    PubMed Central

    Spoon, Emerentia Q. W.; van de Wetering, Jacqueline; IJzermans, Jan N. M.; Dor, Frank J. M. F.

    2017-01-01

    Background The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals. Methods An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide. Results 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Conclusions Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based. PMID:28732093

  8. Prevalence of sarcopenia and associated risk factors by two diagnostic criteria in community-dwelling older men: the São Paulo Ageing & Health Study (SPAH).

    PubMed

    Figueiredo, C P; Domiciano, D S; Lopes, J B; Caparbo, V F; Scazufca, M; Bonfá, E; Pereira, R M R

    2014-02-01

    Sarcopenia is an aging syndrome that can be characterized by many criteria adjusted or not by fat mass. This study suggested that the optimal criteria should be selected according to body mass index (BMI) in older men and identified age, BMI, race, smoking, physical activity, hip bone mineral density (BMD) as risk factors for this syndrome. This study aims to analyze the prevalence of sarcopenia and associated risk factors using appendicular skeletal mass (ASM)/height(2) and ASM adjusted for total fat mass criteria in older men from community. Three hundred ninety-nine men were included and answered a questionnaire about lifestyle and medical history. Individuals were classified by their BMI using the classification adjusted by age. Body composition and bone mineral density were measured by dual X-ray absorptiometry. Sarcopenia was classified according to both criteria. Logistic regression models were used to analyze risk factors associated with sarcopenia. The mean BMI was 26.46 kg/m(2): 12.5 % underweight, 43.6 % normal, and 43.9 % overweight/obese. Fifty-four (13.5 %) were considered sarcopenic by ASM/height(2) and 79 (19.8 %) by ASM adjusted for fat (p = 0.001). Fifty-one (12.8 %) individuals had discordant sarcopenia classification: 13 were classified only by ASM/height(2) and 38 only by ASM adjusted for fat. Of the 13 subjects classified as sarcopenic only by ASM/height(2), 84.6 % (11/13) were underweight and solely one (7.7 %) was considered overweight/obese. In contrast, of those 38 older men classified as sarcopenic only by ASM adjusted for fat, none were underweight and 53 % (20/38) were overweight/obese. Subjects classified as sarcopenic according to both criteria had the same risk factors in the final model analyses (age, BMI, race, smoking, physical activity, hip BMD; p < 0.05). This study suggested that the optimal criteria for sarcopenia should be selected according to BMI in community-dwelling older men.

  9. Dysplastic naevus: histological criteria and their inter-observer reproducibility.

    PubMed

    Hastrup, N; Clemmensen, O J; Spaun, E; Søndergaard, K

    1994-06-01

    Forty melanocytic lesions were examined in a pilot study, which was followed by a final series of 100 consecutive melanocytic lesions, in order to evaluate the inter-observer reproducibility of the histological criteria proposed for the dysplastic naevus. The specimens were examined in a blind fashion by four observers. Analysis by kappa statistics showed poor reproducibility of nuclear features, while reproducibility of architectural features was acceptable, improving in the final series. Consequently, we cannot apply the combined criteria of cytological and architectural features with any confidence in the diagnosis of dysplastic naevus, and, until further studies have documented that architectural criteria alone will suffice in the diagnosis of dysplastic naevus, we, as pathologists, shall avoid this term.

  10. Proposed minimal diagnostic criteria for myelodysplastic syndromes (MDS) and potential pre-MDS conditions

    PubMed Central

    Valent, Peter; Orazi, Attilio; Steensma, David P.; Ebert, Benjamin L.; Haase, Detlef; Malcovati, Luca; van de Loosdrecht, Arjan A.; Haferlach, Torsten; Westers, Theresia M.; Wells, Denise A.; Giagounidis, Aristoteles; Loken, Michael; Orfao, Alberto; Lübbert, Michael; Ganser, Arnold; Hofmann, Wolf-Karsten; Ogata, Kiyoyuki; Schanz, Julie; Béné, Marie C.; Hoermann, Gregor; Sperr, Wolfgang R.; Sotlar, Karl; Bettelheim, Peter; Stauder, Reinhard; Pfeilstöcker, Michael; Horny, Hans-Peter; Germing, Ulrich; Greenberg, Peter; Bennett, John M.

    2017-01-01

    Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid neoplasms characterized by peripheral cytopenia, dysplasia, and a variable clinical course with about 30% risk to transform to secondary acute myeloid leukemia (AML). In the past 15 years, diagnostic evaluations, prognostication, and treatment of MDS have improved substantially. However, with the discovery of molecular markers and advent of novel targeted therapies, new challenges have emerged in the complex field of MDS. For example, MDS-related molecular lesions may be detectable in healthy individuals and increase in prevalence with age. Other patients exhibit persistent cytopenia of unknown etiology without dysplasia. Although these conditions are potential pre-phases of MDS they may also transform into other bone marrow neoplasms. Recently identified molecular, cytogenetic, and flow-based parameters may add in the delineation and prognostication of these conditions. However, no generally accepted integrated classification and no related criteria are as yet available. In an attempt to address this challenge, an international consensus group discussed these issues in a working conference in July 2016. The outcomes of this conference are summarized in the present article which includes criteria and a proposal for the classification of pre-MDS conditions as well as updated minimal diagnostic criteria of MDS. Moreover, we propose diagnostic standards to delineate between ´normal´, pre-MDS, and MDS. These standards and criteria should facilitate diagnostic and prognostic evaluations in clinical studies as well as in clinical practice. PMID:29088721

  11. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study.

    PubMed

    Brooks, Ronald A; Landovitz, Raphael J; Kaplan, Rachel L; Lieber, Eli; Lee, Sung-Jae; Barkley, Thomas W

    2012-02-01

    The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.

  12. Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer.

    PubMed

    Takeda, Takashi; Tsuji, Kosuke; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Tominaga, Eiichiro; Aoki, Daisuke

    2018-05-01

    Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM₅ were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM₅, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  13. Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer

    PubMed Central

    2018-01-01

    Objective Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. Methods The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM5 were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. Results Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM5, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. Conclusion This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients. PMID:29400022

  14. Multi-criteria assessment of community-based fluoride-removal technologies for rural Ethiopia.

    PubMed

    Osterwalder, Lars; Johnson, C Annette; Yang, Hong; Johnston, Richard B

    2014-08-01

    Elevated concentrations of naturally-occurring fluoride in groundwater pose a serious health risk to millions of people living in the Ethiopian Rift Valley. In the absence of low-fluoride water resources of sufficient capacity, fluoride removal from drinking water is the accepted mitigation option. To date, five different community-level fluoride-removal technologies have been implemented in Ethiopia, although only a few units have been found in a functional state in the field. Which technology should be promoted and up-scaled is the subject of controversial debate amongst key stakeholders. This paper describes a multi-criteria decision analysis exercise, which was conducted with the participation of stakeholders in Ethiopia during a one-day workshop, to assess in an objective and transparent manner the available technology options. Criteria for technology comparison were selected and weighted, thus enabling the participants to assess the advantages and disadvantages of the different technologies and hear the views of other stakeholders. It was shown that there is no single most-preferable, technical solution for fluoride removal in Ethiopia. Selection of the most suitable solution depends on location-specific parameters and on the relative importance given to different criteria by the stakeholders involved. The data presented in this paper can be used as reference values for Ethiopia. © 2013. Published by Elsevier B.V. All rights reserved.

  15. Accounting for unprotected sex: stories of agency and acceptability.

    PubMed

    Rhodes, Tim; Cusick, Linda

    2002-07-01

    Based on the idea that risks are knowable, calculable and preventable, dominant social scientific and health promotion discourses foster an image of individual risk control and responsibility. The presentation of the self is a moral enterprise. Accounts of unprotected sex by HIV positive people who have the potential to transmit HIV to their sexual partners can be particularly morally charged. Drawing on 73 depth qualitative interviews with HIV positive people and their sexual partners, this paper explores how the interview accounts of unprotected sex can illuminate the way in which the self is presented within the context of situated norms of risk acceptability and moral responsibility. We identify two forms of account: stories of agency; and stories of acceptability. Stories of agency tend to deny agency and abdicate individual responsibility given the circumstances, and were also a key feature of accounts in which the sexual partners of HIV positive people were placed at risk of HIV transmission. Categories of appeal included the denial of agency as a consequence of: risk calculus and condom accidents; alcohol and drug effects; powerlessness and coercion; and forces of nature. By contrast, stories of acceptability tend to justify unprotected sex as acceptable. Categories of appeal included: HIV positive concordance; and commitment in relationships. Other forms of justification included: alter responsibility; and intentional HIV transmission. We conclude that accounts of risk management are risk managed. We call for greater attention by social scientists to the way in which accounts are constructed, and in particular, to 'anti-rational' forms of explanation within accounts.

  16. Detection methods and performance criteria for genetically modified organisms.

    PubMed

    Bertheau, Yves; Diolez, Annick; Kobilinsky, André; Magin, Kimberly

    2002-01-01

    Detection methods for genetically modified organisms (GMOs) are necessary for many applications, from seed purity assessment to compliance of food labeling in several countries. Numerous analytical methods are currently used or under development to support these needs. The currently used methods are bioassays and protein- and DNA-based detection protocols. To avoid discrepancy of results between such largely different methods and, for instance, the potential resulting legal actions, compatibility of the methods is urgently needed. Performance criteria of methods allow evaluation against a common standard. The more-common performance criteria for detection methods are precision, accuracy, sensitivity, and specificity, which together specifically address other terms used to describe the performance of a method, such as applicability, selectivity, calibration, trueness, precision, recovery, operating range, limit of quantitation, limit of detection, and ruggedness. Performance criteria should provide objective tools to accept or reject specific methods, to validate them, to ensure compatibility between validated methods, and be used on a routine basis to reject data outside an acceptable range of variability. When selecting a method of detection, it is also important to consider its applicability, its field of applications, and its limitations, by including factors such as its ability to detect the target analyte in a given matrix, the duration of the analyses, its cost effectiveness, and the necessary sample sizes for testing. Thus, the current GMO detection methods should be evaluated against a common set of performance criteria.

  17. Development of Second Generation Intact Stability Criteria

    DTIC Science & Technology

    2011-12-01

    the intact stability performance of ships, have motivated the development of the second generation intact stability criteria by the IMO Subcommittee on...primary modes of stability failures which are being addressed. The second generation intact stability criteria are planned to have a multitiered structure...and 2 vulnerability criteria that are used as a preliminary design process check of dynamic stability failure risk. This report describes the U.S

  18. A Subjective Assessment of Alternative Mission Architecture Operations Concepts for the Human Exploration of Mars at NASA Using a Three-Dimensional Multi-Criteria Decision Making Model

    NASA Technical Reports Server (NTRS)

    Tavana, Madjid

    2003-01-01

    The primary driver for developing missions to send humans to other planets is to generate significant scientific return. NASA plans human planetary explorations with an acceptable level of risk consistent with other manned operations. Space exploration risks can not be completely eliminated. Therefore, an acceptable level of cost, technical, safety, schedule, and political risks and benefits must be established for exploratory missions. This study uses a three-dimensional multi-criteria decision making model to identify the risks and benefits associated with three alternative mission architecture operations concepts for the human exploration of Mars identified by the Mission Operations Directorate at Johnson Space Center. The three alternatives considered in this study include split, combo lander, and dual scenarios. The model considers the seven phases of the mission including: 1) Earth Vicinity/Departure; 2) Mars Transfer; 3) Mars Arrival; 4) Planetary Surface; 5) Mars Vicinity/Departure; 6) Earth Transfer; and 7) Earth Arrival. Analytic Hierarchy Process (AHP) and subjective probability estimation are used to captures the experts belief concerning the risks and benefits of the three alternative scenarios through a series of sequential, rational, and analytical processes.

  19. On the public perception of the risks from nuclear weapons: Would oralloy be more acceptable than plutonium

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kunsman, D.M.

    We technologists generally only address risk magnitudes in our analyses, although other studies have found nineteen additional dimensions for the way the public perceives risk. These include controllability, voluntariness, catastrophic potential, and trust in the institution putting forth the risk. We and the geneml public use two different languages, and to understand what their concerns are, we need to realize that the culture surrounding nuclear weapons is completely alien to the general public. Ultimately, the acceptability of a risk is a values question, not a technical question. For most of the risk dimensions, the public would perceive no significant differencemore » between using oralloy and plutonium. This does not mean that the suggested design change should not be proposed, only that the case for, or against, it be made comprehensively using the best information available today. The world has changed: the ending of the cold war has decreased the benefit of nuclear weapons in the minds of the public and the specter of Chernobyl has increased the perceived risks of processes that use radioactive materials. Our analyses need to incorporate the lessons pertinent to this newer world.« less

  20. On the public perception of the risks from nuclear weapons: Would oralloy be more acceptable than plutonium?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kunsman, D.M.

    We technologists generally only address risk magnitudes in our analyses, although other studies have found nineteen additional dimensions for the way the public perceives risk. These include controllability, voluntariness, catastrophic potential, and trust in the institution putting forth the risk. We and the geneml public use two different languages, and to understand what their concerns are, we need to realize that the culture surrounding nuclear weapons is completely alien to the general public. Ultimately, the acceptability of a risk is a values question, not a technical question. For most of the risk dimensions, the public would perceive no significant differencemore » between using oralloy and plutonium. This does not mean that the suggested design change should not be proposed, only that the case for, or against, it be made comprehensively using the best information available today. The world has changed: the ending of the cold war has decreased the benefit of nuclear weapons in the minds of the public and the specter of Chernobyl has increased the perceived risks of processes that use radioactive materials. Our analyses need to incorporate the lessons pertinent to this newer world.« less

  1. Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11

    PubMed Central

    Prigerson, Holly G.; Horowitz, Mardi J.; Jacobs, Selby C.; Parkes, Colin M.; Aslan, Mihaela; Goodkin, Karl; Raphael, Beverley; Marwit, Samuel J.; Wortman, Camille; Neimeyer, Robert A.; Bonanno, George; Block, Susan D.; Kissane, David; Boelen, Paul; Maercker, Andreas; Litz, Brett T.; Johnson, Jeffrey G.; First, Michael B.; Maciejewski, Paul K.

    2009-01-01

    Background Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction. Methods and Findings A total of 291 bereaved respondents were interviewed three times, grouped as 0–6, 6–12, and 12–24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment. Conclusions The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for Editors

  2. Acceptability and Potential Efficacy of Single-Sex After-School Activity Programs for Overweight and At-Risk Children: The Wollongong SPORT RCT.

    PubMed

    Jones, Rachel A; Kelly, Jacque; Cliff, Dylan P; Batterham, Marijka; Okely, Anthony D

    2015-11-01

    Single sex after-school physical activity programs show potential to prevent unhealthy weight gain. The aim of this study was to assess the acceptability and potential efficacy of single-sex after-school physical activity programs for overweight and at-risk children from low-income communities. 7-month, 2-arm parallel-group, RCT, conducted at an elementary school in a disadvantaged area in Wollongong, Australia (March-November 2010). 20 boys and 17 girls were randomized to intervention (PA) or active comparison groups (HL). Primary outcomes included implementation, acceptability, percentage body fat and BMI z-score. The PA programs were acceptable with high implementation and enjoyment rates. At 7 months postintervention girls in the PA group displayed greater changes in percentage body fat (adjust diff. = -1.70, [95% CI -3.25, -0.14]; d = -0.83) and BMI z-score (-0.19 [-0.36, -0.03]; d= -1.00). At 7 months boys in the PA group showed greater changes in waist circumference (-3.87 cm [-7.80, 0.15]; d= -0.90) and waist circumference z-score (-0.33 [-0.64, -0.03]; d= -0.98). For both boys' and girls' PA groups, changes in adiposity were not maintained at 12-month follow-up. Single-sex after-school physical activity programs are acceptable and potentially efficacious in preventing unhealthy weight gain among overweight and at-risk children. However improvements are hard to sustain once programs finish operating.

  3. College Student Invulnerability Beliefs and HIV Vaccine Acceptability

    ERIC Educational Resources Information Center

    Ravert, Russell D.; Zimet, Gregory D.

    2009-01-01

    Objective: To examine behavioral history, beliefs, and vaccine characteristics as predictors of HIV vaccine acceptability. Methods: Two hundred forty-five US under graduates were surveyed regarding their sexual history, risk beliefs, and likelihood of accepting hypothetical HIV vaccines. Results: Multivariate regression analysis indicated that…

  4. Perceived risk as a barrier to appropriate diagnosis of irritable bowel syndrome.

    PubMed

    Ahn, Eunmi; Son, Ki Young; Shin, Dong Wook; Han, Min Kyu; Lee, Hyejin; An, Ah Reum; Kim, Eun Ho; Cho, BeLong

    2014-12-28

    To evaluate perceived risk, diagnostic testing, and acceptance of a diagnosis of irritable bowel syndrome (IBS) among the Korean laypersons. We designed a conceptual framework to evaluate the health-seeking behavior of subjects based on a knowledge, attitude, and practice model. We developed a vignette-based questionnaire about IBS based on a literature review and focused group interviews. The vignette described a 40-year-old woman who meets the Rome III criteria for IBS without red-flag signs. It was followed by questions about demographic characteristics, health behaviors, IBS symptoms, risk perception, perceived need for diagnostic tests, and acceptance of a positive diagnosis of IBS. We planned a nationwide survey targeting laypersons without IBS and between the ages of 20 and 69 years. Survey participants were selected by quota sampling stratified by gender, age, and nationwide location. A multivariate logistic model was constructed based on literature reviews, univariate analysis, and a stepwise selection method to investigate correlations between the perceived risk, need for diagnostic tests, and acceptance of a positive diagnosis. Of 2354 eligible households, 1000 subjects completed the survey and 983 subjects were analyzed, excluding those who met symptom criteria for IBS. After reading the IBS vignette, the majority of subjects (86.8%) responded that the patient was at increased risk of severe disease. The most frequent concern was colon cancer (59.8%), followed by surgical condition (51.5%). Most subjects responded the patient needs diagnostic tests (97.2%). Colonoscopy was the most commonly required test (79.5%). Less than half of the respondents requested a stool examination (45.0%), blood test (40.7%), abdominal ultrasound (36.0%), or computed tomography (20.2%). The subjects who felt increased risk were more likely to see a need for colonoscopy [adjusted odds ratio (aOR) = 2.10, 95%CI: 1.38-3.18]. When asked about the positive diagnosis, the most

  5. 14 CFR 170.23 - LORAN-C establishment criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ratio of the present value of the LORAN-C life-cycle benefits (PVB) to the present value of LORAN-C life-cycle costs (PVC): PVB/PVC ≥ 1.0 (c) The criteria do not cover all situations that may arise and are not... acceptable for instrument flight rules operations as a result of an airport airspace analysis conducted in...

  6. Science and Safety: 'Acceptable' Risk

    ERIC Educational Resources Information Center

    Science News, 1976

    1976-01-01

    Stresses ways to answer questions related to widespread publicity - are nuclear reactors safe, will dangerous research in genetic manipulation be banned? - with emphasis on true meaning of safety as related to risks. (EB)

  7. Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture.

    PubMed

    Kyritsis, Polyvios; Bahr, Roald; Landreau, Philippe; Miladi, Riadh; Witvrouw, Erik

    2016-08-01

    The decision as to whether or not an athlete is ready to return to sport (RTS) after ACL reconstruction is difficult as the commonly used RTS criteria have not been validated. To evaluate whether a set of objective discharge criteria, including muscle strength and functional tests, are associated with risk of ACL graft rupture after RTS. 158 male professional athletes who underwent an ACL reconstruction and returned to their previous professional level of sport were included. Before players returned to sport they underwent a battery of discharge tests (isokinetic strength testing at 60°, 180° and 300°/s, a running t test, single hop, triple hop and triple crossover hop tests). Athletes were monitored for ACL re-ruptures once they returned to sport (median follow-up 646 days, range 1-2060). Of the 158 athletes, 26 (16.5%) sustained an ACL graft rupture an average of 105 days after RTS. Two factors were associated with increased risk of ACL graft rupture: (1) not meeting all six of the discharge criteria before returning to team training (HR 4.1, 95% CI 1.9 to 9.2, p≤0.001); and (2) decreased hamstring to quadriceps ratio of the involved leg at 60°/s (HR 10.6 per 10% difference, 95% CI 10.2 to 11, p=0.005). Athletes who did not meet the discharge criteria before returning to professional sport had a four times greater risk of sustaining an ACL graft rupture compared with those who met all six RTS criteria. In addition, hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Emperical Tests of Acceptance Sampling Plans

    NASA Technical Reports Server (NTRS)

    White, K. Preston, Jr.; Johnson, Kenneth L.

    2012-01-01

    Acceptance sampling is a quality control procedure applied as an alternative to 100% inspection. A random sample of items is drawn from a lot to determine the fraction of items which have a required quality characteristic. Both the number of items to be inspected and the criterion for determining conformance of the lot to the requirement are given by an appropriate sampling plan with specified risks of Type I and Type II sampling errors. In this paper, we present the results of empirical tests of the accuracy of selected sampling plans reported in the literature. These plans are for measureable quality characteristics which are known have either binomial, exponential, normal, gamma, Weibull, inverse Gaussian, or Poisson distributions. In the main, results support the accepted wisdom that variables acceptance plans are superior to attributes (binomial) acceptance plans, in the sense that these provide comparable protection against risks at reduced sampling cost. For the Gaussian and Weibull plans, however, there are ranges of the shape parameters for which the required sample sizes are in fact larger than the corresponding attributes plans, dramatically so for instances of large skew. Tests further confirm that the published inverse-Gaussian (IG) plan is flawed, as reported by White and Johnson (2011).

  9. Prototypicality ratings of DSM-III criteria for personality disorders.

    PubMed

    Livesley, W J; Reiffer, L I; Sheldon, A E; West, M

    1987-07-01

    Although DSM-III personality disorder criteria have demonstrated acceptable reliability, the question of validity has not been adequately addressed. A first step in establishing the validity of diagnoses is to establish the validity of the criteria used to assess each diagnosis. The content validity of diagnostic criteria was investigated in relation to the larger set of potential criteria culled from the psychiatric literature. For each DSM-III axis II diagnosis, a panel of clinicians rated how prototypical each potential criterion was of the diagnosis in question. The results reveal problems with the organization and content of the criteria for most diagnoses. Many DSM-III criteria are composed of several statements linked by conjunctions or disjunctions. These component statements often received markedly different ratings, suggesting that criteria should be single statements. For most diagnoses, traits not included in DSM-III received higher ratings than did some DSM-III criteria. Suggestions are made to improve the distinctiveness and content validity of paranoid, schizoid, antisocial, borderline, avoidant, dependent, and compulsive personality disorders. The results for schizotypal personality disorder suggest that many clinicians are uncertain about this diagnosis. These findings provide a systematic way to modify definitions that contrasts with the more arbitrary ways in which diagnoses have previously been defined and redefined.

  10. Perceptions and attitude effects on nanotechnology acceptance: an exploratory framework

    NASA Astrophysics Data System (ADS)

    Ganesh Pillai, Rajani; Bezbaruah, Achintya N.

    2017-02-01

    Existing literature in people's attitude toward nanotechnology and acceptance of nanotechnology applications has generally investigated the impact of factors at the individual or context levels. While this vast body of research is very informative, a comprehensive understanding of how attitude toward nanotechnology are formed and factors influencing the acceptance of nanotechnology are elusive. This paper proposes an exploratory nanotechnology perception-attitude-acceptance framework (Nano-PAAF) to build a systematic understanding of the phenomenon. The framework proposes that perceptions of risks and benefits of nanotechnology are influenced by cognitive, affective, and sociocultural factors. The sociodemographic factors of consumers and contextual factors mitigate the influence of cognitive, affective, and sociocultural factors on the perception of risks and benefits. The perceived risks and benefits in turn influence people's attitude toward nanotechnology, which then influences acceptance of nanotechnology products. This framework will need further development over time to incorporate emerging knowledge and is expected to be useful for researchers, decision and policy makers, industry, and business entities.

  11. Predictors of HIV-related risk perception and PrEP acceptability among young adult female family planning patients.

    PubMed

    Garfinkel, Danielle B; Alexander, Kamila A; McDonald-Mosley, Reagan; Willie, Tiara C; Decker, Michele R

    2017-06-01

    HIV pre-exposure prophylaxis (PrEP) presents new opportunities for HIV prevention. While women comprise approximately 20% of new HIV infections in the US, significant questions remain about how to most effectively facilitate PrEP uptake for this population. Family planning clinics are a dominant source of health care for young women and support an estimated 4.5 million women annually. We explore characteristics associated with HIV risk perception and PrEP acceptability among young adult women seeking reproductive health services in a high-prevalence setting. A cross-sectional, clinic-based survey was conducted with women ages 18-35 (n = 146) seeking health care at two family planning clinics in the greater Baltimore, Maryland area, from January to April 2014. An estimated 22% of women reported being worried about HIV risk, and 60% reported they would consider taking a pill daily to prevent HIV. In adjusted models, HIV-related worry was associated with having no college education, being single or dating more than one person, practicing consistent condom use during vaginal sex, and having ever traded sex. PrEP acceptability was significantly associated with being Black (71% vs. 49%, AOR 2.23, CI: 1.89-2.64) and having ever traded sex (83% vs. 58%, AOR 4.94, CI: 2.00-12.22). For women with a history of intimate partner violence (IPV), PrEP acceptability was significantly lower (57% vs. 62%, AOR .71, CI: .59-.85) relative to their non-abused counterparts. Results suggest that family planning clinics may be a natural setting for PrEP discussion and roll-out. They should be considered in the context of integrating HIV prevention with reproductive health services. Women with a trauma history may need additional support for implementing HIV prevention in the form of PrEP.

  12. Acceptability of Family Violence: Underlying Ties Between Intimate Partner Violence and Child Abuse.

    PubMed

    Gracia, Enrique; Rodriguez, Christina M; Martín-Fernández, Manuel; Lila, Marisol

    2017-05-01

    Intimate partner violence (IPV) and child abuse (CA) are two forms of family violence with shared qualities and risk factors, and are forms of violence that tend to overlap. Acceptability of violence in partner relationships is a known risk factor in IPV just as acceptability of parent-child aggression is a risk factor in CA. We hypothesized that these acceptability attitudes may be linked and represent the expression of a general, underlying nonspecific acceptance of violence in close family relationships. The sample involved 164 male IPV offenders participating in a batterer intervention program. Implicit measures, which assess constructs covertly to minimize response distortions, were administered to assess acceptability of partner violence against women and acceptability of parent-child aggression. To determine whether acceptability attitudes regarding both forms of violence were related to a higher order construct tapping general acceptance of family violence, Bayesian confirmatory factor analyses were conducted. Findings supported a hierarchical (bifactor) model with a general factor expressing a nonspecific acceptance of family violence, and two specific factors reflecting acceptability of violence in intimate partner and parent-child relationships, respectively. This hierarchical model supporting a general acceptance of violence in close family relationships can inform future research aiming to better understand the connections between IPV and CA.

  13. Analysis of existing work-zone devices with MASH safety performance criteria.

    DOT National Transportation Integrated Search

    2009-02-01

    Crashworthy, work-zone, portable sign support systems accepted under NCHRP Report No. 350 were analyzed to : predict their safety peformance according to the TL-3 MASH evaluation criteria. An analysis was conducted to determine : which hardware param...

  14. Acceptability of GM foods among Pakistani consumers.

    PubMed

    Ali, Akhter; Rahut, Dil Bahadur; Imtiaz, Muhammad

    2016-04-02

    In Pakistan majority of the consumers do not have information about genetically modified (GM) foods. In developing countries particularly in Pakistan few studies have focused on consumers' acceptability about GM foods. Using comprehensive primary dataset collected from 320 consumers in 2013 from Pakistan, this study analyzes the determinants of consumers' acceptability of GM foods. The data was analyzed by employing the bivariate probit model and censored least absolute deviation (CLAD) models. The empirical results indicated that urban consumers are more aware of GM foods compared to rural consumers. The acceptance of GM foods was more among females' consumers as compared to male consumers. In addition, the older consumers were more willing to accept GM food compared to young consumers. The acceptability of GM foods was also higher among wealthier households. Low price is the key factor leading to the acceptability of GM foods. The acceptability of the GM foods also reduces the risks among Pakistani consumers.

  15. Acceptability of GM foods among Pakistani consumers

    PubMed Central

    Ali, Akhter; Rahut, Dil Bahadur; Imtiaz, Muhammad

    2016-01-01

    ABSTRACT In Pakistan majority of the consumers do not have information about genetically modified (GM) foods. In developing countries particularly in Pakistan few studies have focused on consumers' acceptability about GM foods. Using comprehensive primary dataset collected from 320 consumers in 2013 from Pakistan, this study analyzes the determinants of consumers' acceptability of GM foods. The data was analyzed by employing the bivariate probit model and censored least absolute deviation (CLAD) models. The empirical results indicated that urban consumers are more aware of GM foods compared to rural consumers. The acceptance of GM foods was more among females' consumers as compared to male consumers. In addition, the older consumers were more willing to accept GM food compared to young consumers. The acceptability of GM foods was also higher among wealthier households. Low price is the key factor leading to the acceptability of GM foods. The acceptability of the GM foods also reduces the risks among Pakistani consumers. PMID:27494790

  16. HIV vaccine acceptability among communities at risk: the impact of vaccine characteristics.

    PubMed

    Newman, Peter A; Duan, Naihua; Lee, Sung-Jae; Rudy, Ellen T; Seiden, Danielle S; Kakinami, Lisa; Cunningham, William E

    2006-03-15

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic; yet, the advent of HIV vaccines will not ensure their acceptability. We conducted a cross-sectional survey (n=143), incorporating conjoint analysis, to assess HIV vaccine acceptability among participants recruited using multi-site (n=9), venue-based sampling in Los Angeles. We used a fractional factorial experimental design to construct eight hypothetical HIV vaccines, each with seven dichotomous attributes. The acceptability of each vaccine was assessed individually and then averaged across participants. Next, the impact of each attribute on vaccine acceptability was estimated for each participant using ANOVA and then analyzed across participants. Acceptability of the eight hypothetical HIV vaccines ranged from 33.2 (S.D. 34.9) to 82.2 (S.D. 31.3) on a 0-100 scale; mean=60.0 (S.D. 21.9). Efficacy had the greatest impact on acceptability (22.7; CI: 18.5-27.1; p<0.0001), followed by cross-clade protection (12.5; CI: 8.7-16.3, p<0.0001), side effects (11.5; CI: 7.4-15.5; p<0.0001), and duration of protection (6.1; CI: 3.2-9.0; p<.0001). Route of administration, number of doses and cost were not significant. Low acceptability of "partial efficacy" vaccines may present obstacles to future HIV vaccine dissemination. Educational and social marketing interventions may be necessary to ensure broad HIV vaccine uptake.

  17. Multi-criteria decision-making for flood risk management: a survey of the current state of the art

    NASA Astrophysics Data System (ADS)

    Madruga de Brito, Mariana; Evers, Mariele

    2016-04-01

    This paper provides a review of multi-criteria decision-making (MCDM) applications to flood risk management, seeking to highlight trends and identify research gaps. A total of 128 peer-reviewed papers published from 1995 to June 2015 were systematically analysed. Results showed that the number of flood MCDM publications has exponentially grown during this period, with over 82 % of all papers published since 2009. A wide range of applications were identified, with most papers focusing on ranking alternatives for flood mitigation, followed by risk, hazard, and vulnerability assessment. The analytical hierarchy process (AHP) was the most popular method, followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), and Simple Additive Weighting (SAW). Although there is greater interest in MCDM, uncertainty analysis remains an issue and was seldom applied in flood-related studies. In addition, participation of multiple stakeholders has been generally fragmented, focusing on particular stages of the decision-making process, especially on the definition of criteria weights. Therefore, addressing the uncertainties around stakeholders' judgments and endorsing an active participation in all steps of the decision-making process should be explored in future applications. This could help to increase the quality of decisions and the implementation of chosen measures.

  18. Hypoglycaemia and hypocalcaemia as determinants of admission birth weight criteria for term stable low risk macrosomic neonates.

    PubMed

    Bandika, Victor L; Were, Fred N; Simiyu, Eseli D; Oyatsi, Donald P

    2014-09-01

    Large for gestational age (LGA) accounts for about 6.3% of admissions in kenyatta national hospital, newborn unit. As a policy all IGA's, defined by birth weight of 4000 g and above are admitted for 24 hours to monitor blood glucose levels. The rational for this policy is questionable and contributes to unnecessary burden on resources needed for new born care. To study birth weight related incidence of hypoglycemia and hypocalcaemia in stable low risk lgas in knh and use it to establish a new admission weight based criteria. prospective cohort study done in new born-unit, post natal and labour wards of knh. Term lga neonates (birth weight = 4000 g) were recruited as subjects and controlled against term appropriate weight (aga) neonates. the incidence of hypoglycemia and hypocalcaemia in lgas was 21% and 9% respectively. Hypoglycemia was rarely encountered after 12 hours of life in lgas. Hypoglycemia and hypocalcaemia showed a direct upward relationship with weight beyond 4250 g. No significant difference in incidence of hypoglycemia and hypocalcaemia between controls and 4000-4249 g category to justify their routine admission to newborn unit. the study identified 4275 g as new admission birth weight criteria for stable term low risk IGA's admission.

  19. Plasma Hazards and Acceptance for International Space Station Extravehicular Activities

    NASA Astrophysics Data System (ADS)

    Patton, Thomas

    2010-09-01

    Extravehicular activity(EVA) is accepted by NASA and other space faring agencies as a necessary risk in order to build and maintain a safe and efficient laboratory in space. EVAs are used for standard construction and as contingency operations to repair critical equipment for vehicle sustainability and safety of the entire crew in the habitable volume. There are many hazards that are assessed for even the most mundane EVA for astronauts, and the vast majority of these are adequately controlled per the rules of the International Space Station Program. The need for EVA repair and construction has driven acceptance of a possible catastrophic hazard to the EVA crewmember which cannot currently be controlled adequately. That hazard is electrical shock from the very environment in which they work. This paper describes the environment, causes and contributors to the shock of EVA crewmembers attributed to the ionospheric plasma environment in low Earth orbit. It will detail the hazard history, and acceptance process for the risk associated with these hazards that give assurance to a safe EVA. In addition to the hazard acceptance process this paper will explore other factors that go into the decision to accept a risk including criticality of task, hardware design and capability, and the probability of hazard occurrence. Also included will be the required interaction between organizations at NASA(EVA Office, Environments, Engineering, Mission Operations, Safety) in order to build and eventually gain adequate acceptance rationale for a hazard of this kind. During the course of the discussion, all current methods of mitigating the hazard will be identified. This paper will capture the history of the plasma hazard analysis and processes used by the International Space Station Program to formally assess and qualify the risk. The paper will discuss steps that have been taken to identify and perform required analysis of the floating potential shock hazard from the ISS environment

  20. Applying Criteria of Active Surveillance to Low-Risk Papillary Thyroid Cancer Over a Decade: How Many Surgeries and Complications Can Be Avoided?

    PubMed

    Griffin, Andrew; Brito, Juan P; Bahl, Manisha; Hoang, Jenny K

    2017-04-01

    The 2015 American Thyroid Association guidelines acknowledged that "an active surveillance management approach can be considered as an alternative to immediate surgery" in patients with low-risk papillary thyroid carcinoma (PTC). The aim of this study was to determine the proportion of PTC that would meet the criteria for active surveillance and the surgeries and complications that could have been avoided. A total of 681 patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012 were retrospectively reviewed. A decision-making framework for active surveillance was applied to patients with PTC in nodules measuring ≤1.5 cm on ultrasound. Patients were identified as suitable for active surveillance based on imaging and patient characteristics. These patients were reviewed for management and outcomes. PTC was diagnosed based on fine-needle aspiration histology of Bethesda V or VI in thyroid nodules in 243 patients. Of these, 77 patients had nodules measuring ≤1.5 cm on ultrasound, and 56/77 (23%) patients met the criteria for surveillance: 15/243 (6%) patients met the criteria with a ≤1 cm size threshold, and 41/243 (17%) met the criteria with a 1.1-1.5 cm threshold. Of the 56 patients who met the criteria for active surveillance, 52 underwent total thyroidectomy, and four had a lobectomy. Forty-five (80%) patients had elective central nodal dissection, and 14 had nodal metastases on pathology (all <4 mm). Three patients had permanent complications from surgery, including vocal cord paralysis, hypoparathyroidism, and a chipped tooth from intubation. No patients died or had recurrent disease. Future programs in the United States should consider increasing the size threshold for active surveillance of PTC to 1.5 cm, since this will allow up to one quarter of patients to be eligible instead of only 6% with a 1 cm size threshold. Without an active surveillance program, the majority of patients with low-risk cancers have thyroidectomy

  1. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations.

    PubMed

    Galea, J T; Kinsler, J J; Salazar, X; Lee, S-J; Giron, M; Sayles, J N; Cáceres, C; Cunningham, W E

    2011-05-01

    This study examined pre-exposure prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, P < 0.001), followed by efficacy (21.4, P < 0.001) and potential side-effects (14.7, P < 0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health-care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out.

  2. Structural design criteria applicable to a space shuttle

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The structural criteria are limited to general and mission-oriented criteria and are not configuration specific. Care was taken to ensure that the criteria will not restrict configuration development and will not establish the overall risk level. In some instances, margins of confidence are indicated, not only because experience shows them to be necessary but also because technology now permits quantitative values to be established.

  3. Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal.

    PubMed

    Dahl, V; Mellhammar, L; Bajunirwe, F; Björkman, P

    2008-07-01

    A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (<20 years: OR = 1.0; 20-24 years: OR = 1.81; 95%CI: 0.58-5.67; 25-29 years: OR = 2.15; 95%CI: 0.66-6.97; 30-34 years: OR = 3.88; 95%CI: 1.21-13.41), mistrust in reliability of the HIV test (OR = 20.60; 95%CI: 3.24-131.0) and not having been tested for HIV previously (OR = 2.15; 95%CI: 1.02-4.54) were associated with test refusal. Testing sites operating for longer durations had higher rates of acceptance. The most common reasons claimed for test refusal were: lack of access to antiretroviral therapy (ART) for HIV-infected women (88%; n=57), a need to discuss with partner before decision (82%; n=57) and fear of partner's reaction (54%; n=57). Comparison with previous periods showed that the acceptance rate increased with the duration of the program. Our study identified risk factors for HIV test refusal among pregnant women in Uganda and common reasons for not accepting testing. These findings may suggest modifications and improvements in the performance of HIV testing in this and similar populations.

  4. Evaluating the impacts of reducing the number of hot mix asphalt plant testing acceptance criteria on mix variability.

    DOT National Transportation Integrated Search

    2012-11-01

    The acceptance testing of Hot Mix Asphalt (HMA) conducted at the HMA production facility is an : important portion of the overall acceptance process used by the Connecticut Department of : Transportation (ConnDOT) for paving projects. In 2004, ConnDO...

  5. A proposed rationale and test methodology for establishment of acceptance criteria for vacuum integrity testing of pharmaceutical freeze dryers.

    PubMed

    Hardwick, Lisa M; Nail, Steven L; Jarman, James; Hasler, Kai; Hense, Thomas

    2013-10-01

    A scientific rationale is proposed for the establishment of acceptance criteria for leak rates in pharmaceutical freeze dryers. A method was developed to determine the quantity of air that could leak into any lyophilizer from the outside while still maintaining Class 100/Grade A microbial conditions. A lyophilizing product is assumed most vulnerable to microbial contamination during secondary drying, when mass transfer of water vapor from product to condenser is minimal. Using the void volume of the dryer, calculated from change in internal pressure when a known volume of air is introduced, and the potential maximum bioburden of the leaked air (based on measured values), calculations can determine the allowable leaked volume of air, the flow rate required to admit that volume in a given time frame, and the pressure rise that would result from the leak over a given testing period. For the dryers in this study, using worst-case air quality conditions, it was determined that a leak resulting in a pressure rise of 0.027 mbar over a 30 min period would allow the dryers to remain in secondary drying conditions for 62 h before the established action level of one colony forming unit for each cubic meter of air space would be reached. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Improving Estimates of Acceptable Growiing Stock in Young Upland Oak Forests in the Missouri Ozarks

    Treesearch

    Daniel C. Dey; Paul S. Johnson; H.E. Garrett

    1998-01-01

    Estimates of regeneration or growing stock in young oak forests may be too high unless criteria are established that define explicitly acceptable growing stock. In young hardwood stands, crown class can be used to identify acceptable growing stock because it is related to the future growth and survival of reproduction. A method is presented for assigning crown class...

  7. Approaches for derivation of environmental quality criteria for substances applied in risk assessment of discharges from offshore drilling operations.

    PubMed

    Altin, Dag; Frost, Tone Karin; Nilssen, Ingunn

    2008-04-01

    In order to achieve the offshore petroleum industries "zero harm" goal to the environment, the environmental impact factor for drilling discharges was developed as a tool to identify and quantify the environmental risks associated with disposal of drilling discharges to the marine environment. As an initial step in this work the main categories of substances associated with drilling discharges and assumed to contribute to toxic or nontoxic stress were identified and evaluated for inclusion in the risk assessment. The selection were based on the known toxicological properties of the substances, or the total amount discharged together with their potential for accumulation in the water column or sediments to levels that could be expected to cause toxic or nontoxic stress to the biota. Based on these criteria 3 categories of chemicals were identified for risk assessment the water column and sediments: Natural organic substances, metals, and drilling fluid chemicals. Several approaches for deriving the environmentally safe threshold concentrations as predicted no effect concentrations were evaluated in the process. For the water column consensus were reached for using the species sensitivity distribution approach for metals and the assessment factor approach for natural organic substances and added drilling chemicals. For the sediments the equilibrium partitioning approach was selected for all three categories of chemicals. The theoretically derived sediment quality criteria were compared to field-derived threshold effect values based on statistical approaches applied on sediment monitoring data from the Norwegian Continental Shelf. The basis for derivation of predicted no effect concentration values for drilling discharges should be consistent with the principles of environmental risk assessment as described in the Technical Guidance Document on Risk Assessment issued by the European Union.

  8. A systematic review of the Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence.

    PubMed

    DiFranza, Joseph; Ursprung, W W Sanouri; Lauzon, Béatrice; Bancej, Christina; Wellman, Robert J; Ziedonis, Douglas; Kim, Sun S; Gervais, André; Meltzer, Bruce; McKay, Colleen E; O'Loughlin, Jennifer; Okoli, Chizimuzo T C; Fortuna, Lisa R; Tremblay, Michèle

    2010-05-01

    The Diagnostic and Statistical Manual diagnostic criteria for nicotine dependence (DSM-ND) are based on the proposition that dependence is a syndrome that can be diagnosed only when a minimum of 3 of the 7 proscribed features are present. The DSM-ND criteria are an accepted research measure, but the validity of these criteria has not been subjected to a systematic evaluation. To systematically review evidence of validity and reliability for the DSM-ND criteria, a literature search was conducted of 16 national and international databases. Each article with original data was independently reviewed by two or more reviewers. In total, 380 potentially relevant articles were examined and 169 were reviewed in depth. The DSM-ND criteria have seen wide use in research settings, but sensitivity and specificity are well below the accepted standards for clinical applications. Predictive validity is generally poor. The 7 DSM-ND criteria are regarded as having face validity, but no data support a 3-symptom ND diagnostic threshold, or a 4-symptom withdrawal syndrome threshold. The DSM incorrectly states that daily smoking is a prerequisite for withdrawal symptoms. The DSM shows poor to modest concurrence with all other measures of nicotine dependence, smoking behaviors and biological measures of tobacco use. The data support the DSM-ND criteria as a valid measure of nicotine dependence severity for research applications. However, the data do not support the central premise of a 3-symptom diagnostic threshold, and no data establish that the DSM-ND criteria provide an accurate diagnosis of nicotine dependence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  9. Non-Scientific Criteria for Belief Sustain Counter-Scientific Beliefs.

    PubMed

    Metz, S Emlen; Weisberg, Deena S; Weisberg, Michael

    2018-02-01

    Why is evolutionary theory controversial among members of the American public? We propose a novel explanation: allegiance to different criteria for belief. In one interview study, two online surveys, and one nationally representative phone poll, we found that evolutionists and creationists take different justifications for belief as legitimate. Those who accept evolution emphasize empirical evidence and scientific consensus. Creationists emphasize not only the Bible and religious authority, but also knowledge of the heart. These criteria for belief remain predictive of views about evolution even when taking into account other related factors like religion, political affiliation, and education. Each view is supported by its own internally specified criteria for what constitutes a justified belief. Changing minds may thus require changing epistemic norms. Copyright © 2018 Cognitive Science Society, Inc.

  10. Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria.

    PubMed

    Fang, Cheng; Huang, Qin; Lu, Lin; Shi, Jiong; Sun, Qi; Xu, Gui Fang; Gold, Jason; Mashimo, Hiroshi; Zou, Xiao Ping

    2015-06-01

    The incidence of proximal gastric carcinoma (PGC) is rising worldwide for unknown reasons. Herein we compare the risk factors of early PGC with distal gastric carcinoma (DGC) in patients treated at a single tertiary hospital in China. Risk factors of 379 consecutive surgically resected early gastric carcinoma (EGC) diagnosed according to the 2010 World Health Organization criteria were studied by reviewing their medical records and esophagogastroduodenoscopy/biopsy findings and interviewing patients and family members for the patients' history of environmental toxin exposure (ETE), dietary habits, family (FCH) and personal cancer history (PCH) and survival. Differences between PGC (n = 115), DGC (n = 264) and age-matched and gender-matched controls (n = 225) were compared. Proportion of early PGC in all EGC patients was increased significantly (P < 0.05). The independent risk factors for both PGC and DGC identified by multivariate analysis were intake of preserved food and little fruit, and gastric mucosal intestinal metaplasia and atrophy (all P < 0.05). Advanced age (odds ratio [OR] 9.83, P < 0.01), PCH (OR 5.09, P < 0.05), a high body mass index (>24 kg/m(2) ) (OR 2.79, P < 0.01) and ETE (OR 2.31, P < 0.05) were independent risk factors for PGC, but not male gender, tobacco or alcohol abuse, hiatus hernia, gastroesophageal reflux disease or columnar-lined esophagus. In contrast, FCH (OR 2.34, P < 0.01) and Helicobacter pylori infection (OR 2.81, P < 0.001) were independent risk factors for DGC. Independent risk factors for PGC in Chinese patients differ from those of DGC or esophageal adenocarcinoma, supporting the classification of PGC as a separate gastric carcinoma entity in the Chinese populations. © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  11. Integrating the Ergonomics Techniques with Multi Criteria Decision Making as a New Approach for Risk Management: An Assessment of Repetitive Tasks -Entropy Case Study.

    PubMed

    Khandan, Mohammad; Nili, Majid; Koohpaei, Alireza; Mosaferchi, Saeedeh

    2016-01-01

    Nowadays, the health work decision makers need to analyze a huge amount of data and consider many conflicting evaluation criteria and sub-criteria. Therefore, an ergonomic evaluation in the work environment in order to the control occupational disorders is considered as the Multi Criteria Decision Making (MCDM) problem. In this study, the ergonomic risks factors, which may influence health, were evaluated in a manufacturing company in 2014. Then entropy method was applied to prioritize the different risk factors. This study was done with a descriptive-analytical approach and 13 tasks were included from total number of employees who were working in the seven halls of an ark opal manufacturing (240). Required information was gathered by the demographic questionnaire and Assessment of Repetitive Tasks (ART) method for repetitive task assessment. In addition, entropy was used to prioritize the risk factors based on the ergonomic control needs. The total exposure score based on the ART method calculated was equal to 30.07 ±12.43. Data analysis illustrated that 179 cases (74.6% of tasks) were in the high level of risk area and 13.8% were in the medium level of risk. ART- entropy results revealed that based on the weighted factors, higher value belongs to grip factor and the lowest value was related to neck and hand posture and duration. Based on the limited financial resources, it seems that MCDM in many challenging situations such as control procedures and priority approaches could be used successfully. Other MCDM methods for evaluating and prioritizing the ergonomic problems are recommended.

  12. Learning Intentions and Success Criteria: Learners' and Teachers' Views

    ERIC Educational Resources Information Center

    Crichton, Hazel; McDaid, Ann

    2016-01-01

    It is generally accepted that Assessment for Learning (AfL) strategies are effective in teaching and learning. Approaches within this framework include the use of formative feedback, self and peer assessment and setting and discussion of learning intentions (LIs) and success criteria (SC). There has been a great deal of research into AfL…

  13. Assessing Non-Technical Site Suitability Criteria for Stormwater Capture, Treatment and Recharge

    NASA Astrophysics Data System (ADS)

    Eisenstein, W.

    2016-12-01

    This presentation will describe a new method for assessing non-technical site suitability criteria for the siting of stormwater capture, treatment and recharge (or stormwater CTR) facilities in Sonoma County, California, USA. "Non-technical site suitability criteria" include issues such as community acceptance, aesthetics, nuisances and hazards, and compatibility with neighboring land uses, and are distinguished from "technical criteria" such as hydrology and soil characteristics that are the traditional subject of suitability analyses. Non-technical criteria are rarely, if ever, considered in formal siting suitability studies conducted by agencies and municipalities, yet can be fatal to the prospects of a given project's construction if not identified and mitigated. The researchers developed a new method for identifying and spatially characterizing relevant non-technical criteria through interviews and questionnaires with community stakeholders, and introducing those criteria into a spatial multi-criteria decision analysis framework that assesses site suitabilty across a study watershed (the Upper Petaluma River watershed in Sonoma County).

  14. Emotional and Spiritual Quotient Approach Improve Biology Education Students’ Acceptance of Evolution Theory

    NASA Astrophysics Data System (ADS)

    Darussyamsu, R.; Fadilah, M.; Putri, D. H.

    2018-04-01

    Emotional and spiritual aspect is one of main factors that influence students’ acceptance of a theory. This study aim to measure university students’ acceptance of evolution by learns evolution using emotional and spiritual quotient (ESQ) approach. This is a quasi-experimental research using one shot case study design with the subject 36 biology educational students at Biology Department, Faculty of Mathematics and Natural Science, Universitas Negeri Padang. Data collected using the MATE instrument by Rutledge and Warden (2000) after the students learn evolution for eight meetings since January until March 2017. The result showed that by learning evolution theory combine with ESQ aspects increase students acceptance from very low become moderate acceptance. It concluded that ESQ aspects can improve students’ acceptance of evolution. Any criteria depend on it are discussed.

  15. An Open Trial of Acceptance-based Separated Family Treatment (ASFT) for Adolescents with Anorexia Nervosa

    PubMed Central

    Timko, C. Alix; Zucker, Nancy L.; Herbert, James D.; Rodriguez, Daniel; Merwin, Rhonda M.

    2016-01-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12–18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed. PMID:25898341

  16. Defining Clinical Response Criteria and Early Response Criteria for Precision Oncology: Current State-of-the-Art and Future Perspectives.

    PubMed

    Subbiah, Vivek; Chuang, Hubert H; Gambhire, Dhiraj; Kairemo, Kalevi

    2017-02-15

    In this era of precision oncology, there has been an exponential growth in the armamentarium of genomically targeted therapies and immunotherapies. Evaluating early responses to precision therapy is essential for "go" versus "no go" decisions for these molecularly targeted drugs and agents that arm the immune system. Many different response assessment criteria exist for use in solid tumors and lymphomas. We reviewed the literature using the Medline/PubMed database for keywords "response assessment" and various known response assessment criteria published up to 2016. In this article we review the commonly used response assessment criteria. We present a decision tree to facilitate selection of appropriate criteria. We also suggest methods for standardization of various response assessment criteria. The relevant response assessment criteria were further studied for rational of development, key features, proposed use and acceptance by various entities. We also discuss early response evaluation and provide specific case studies of early response to targeted therapy. With high-throughput, advanced computing programs and digital data-mining it is now possible to acquire vast amount of high quality imaging data opening up a new field of "omics in radiology"-radiomics that complements genomics for personalized medicine. Radiomics is rapidly evolving and is still in the research arena. This cutting-edge technology is poised to move soon to the mainstream clinical arena. Novel agents with new mechanisms of action require advanced molecular imaging as imaging biomarkers. There is an urgent need for development of standardized early response assessment criteria for evaluation of response to precision therapy.

  17. The Discounted Method and Equivalence of Average Criteria for Risk-Sensitive Markov Decision Processes on Borel Spaces

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cavazos-Cadena, Rolando, E-mail: rcavazos@uaaan.m; Salem-Silva, Francisco, E-mail: frsalem@uv.m

    2010-04-15

    This note concerns discrete-time controlled Markov chains with Borel state and action spaces. Given a nonnegative cost function, the performance of a control policy is measured by the superior limit risk-sensitive average criterion associated with a constant and positive risk sensitivity coefficient. Within such a framework, the discounted approach is used (a) to establish the existence of solutions for the corresponding optimality inequality, and (b) to show that, under mild conditions on the cost function, the optimal value functions corresponding to the superior and inferior limit average criteria coincide on a certain subset of the state space. The approach ofmore » the paper relies on standard dynamic programming ideas and on a simple analytical derivation of a Tauberian relation.« less

  18. Feasibility and Acceptability of an Internet-Based, African Dance-Modified Yoga Program for African-American Women with or at Risk for Metabolic Syndrome

    PubMed Central

    Johnson, Candace C; Taylor, Ann Gill; Anderson, Joel G; Jones, Randy A; Whaley, Diane E

    2014-01-01

    African-American (AA) women are the segment of the population that experiences the highest mortality from metabolic syndrome (MetS). Yoga decreases risk of MetS, yet there have been no yoga studies of AA women with or at risk for MetS. The purpose of this 4-week study was to test the feasibility and acceptability of a culturally tailored, Internet-based intervention, yogic dance (YD), using digital videos in a sample of AA women (ages 35-64) at risk for or with MetS. The investigators examined the rates of accrual, attrition, and reasons for attrition; the feasibility of using the Internet to deliver the intervention; the acceptability of the intervention as structured; and any other benefits and/or limitations of YD. The study used a single-group, mixed-methods design underpinned by social constructivist theory and Pender's Health Promotion Model. Twenty-four women provided consent to enroll in the study. After completing in-person semi-structured interviews and Internet-based measures, including the Physical Activity Readiness Questionnaire, and the modified International Physical Activity Questionnaire, consented participants engaged in 4-weeks of the yogic dance intervention via daily video-based instructions located on the study Web site. After the intervention, four women participated in focus groups to voice their perceptions of barriers to and benefits from YD and the acceptability of using the YD intervention. The investigators analyzed focus group data using content/thematic analysis and validated themes with baseline semi-structured interviews. The majority of the women (79%) found YD acceptable. Themes that emerged from the descriptive data include: (1) Culture is an important aspect of yogic dance; and (2) Increased social support would enhance yogic dance participation. The integrated results from this feasibility study will inform research exploring the complex correlates that influence health behaviors in AA women. PMID:25593785

  19. UPDATE ON PEC ACTIVITIES INCLUDING NEW EVALUATION CRITERIA, THE APPLICATION COMPLETENESS CHECKLIST, AND STATUS OF THE WEBSITE DEVELOPMENT

    EPA Science Inventory

    US EPA's Pathogen Equivalency Committee (PEC) has updated the evaluation criteria it uses to make recommendations of equivalency (to processes acceptable under 40CFR503) on innovative or alternative sludge pathogen reduction processes. These criteria will be presented along with ...

  20. Continuity between DSM-5 Categorical Criteria and Traits Criteria for Borderline Personality Disorder.

    PubMed

    Bach, Bo; Sellbom, Martin

    2016-08-01

    Borderline personality disorder (BPD) includes a heterogeneous constellation of symptoms operationalized with 9 categorical criteria. As the field of personality disorder (PD) research moves to emphasize dimensional traits in its operationalization, it is important to delineate continuity between the 9 DSM-IV/Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorical criteria for BPD and the trait dimensions in DSM-5 Section III. To date, no study has attempted such validation. We examined the associations between the 9 categorical DSM-IV/DSM-5 criteria for BPD and the trait dimensions of the alternative DSM-5 model for PDs in consecutively recruited psychiatric outpatients (N = 142; 68% female; age: mean 29.02, SD 8.38). This was investigated by means of bivariate correlations, followed by multiple logistic regression analysis. The categorical BPD criteria were associated with conceptually related DSM-5 Section III traits (P > 0.001), except for the criterion of chronic feelings of emptiness. Consistent with the proposed traits criteria for BPD in DSM-5 Section III, we found Emotional lability, Anxiousness, Separation insecurity, Depressivity, Impulsivity, Risk taking, and Hostility to capture conceptually coherent BPD categorical criteria, while Suspiciousness was also strongly associated with BPD criteria. At the domain level, this applied to Negative affectivity, Disinhibition, and Psychoticism. Notably, Emotional lability, Impulsivity, and Suspiciousness emerged as unique predictors of BPD (P > 0.05). In addition to the proposed BPD traits criteria, Suspiciousness and features of Psychoticism also augment BPD features. Provided that these findings are replicated in forthcoming research, a modified traits operationalization of BPD is warranted. © The Author(s) 2016.

  1. Pathologic Outcomes in Men with Low-risk Prostate Cancer Who Are Potential Candidates for Contemporary, Active Surveillance Protocols.

    PubMed

    Kang, Ho Won; Lee, Joo Yong; Kwon, Jong Kyou; Jeh, Seong Uk; Jung, Hae Do; Cho, Kang Su; Ham, Won Sik; Choi, Young Deuk

    2015-07-01

    The purpose of this study was to determine whether contemporary active surveillance (AS) protocols could sufficiently discriminate significant from indolent tumors in men with low-risk prostate cancer. We retrospectively analyzed 312 patients with low-risk prostate cancer treated with radical prostatectomy. After exclusion of patients with fewer than 10 cores taken at biopsy and those who received neo-adjuvant treatment, 205 subjects satisfied the final inclusion criteria. Five widely accepted AS protocols were employed in this study. A total of 82.0% of the patients met the inclusion criteria of at least one protocol, and 18% did not meet any criteria of published AS protocols. A significant proportion of patients had non-organ-confined disease (8.6% to 10.6%) or a Gleason score of 7 or greater (18.6% to 23.9%) between the different AS criteria. Among patients who did not meet any AS criteria, 32.4% of patients had a pathologically insignificant cancer. Our results indicated a significant adverse pathology in patients who met the contemporary AS protocols. On the other hand, some patients in whom expectant management would be appropriate did not meet any criteria of published AS protocols. None of the clinical or histological criteria reported to date is able to sufficiently discriminate aggressive tumors from indolent ones.

  2. Use of multi-criteria decision analysis to identify potentially dangerous glacial lakes.

    PubMed

    Kougkoulos, Ioannis; Cook, Simon J; Jomelli, Vincent; Clarke, Leon; Symeonakis, Elias; Dortch, Jason M; Edwards, Laura A; Merad, Myriam

    2018-04-15

    Glacial Lake Outburst Floods (GLOFs) represent a significant threat in deglaciating environments, necessitating the development of GLOF hazard and risk assessment procedures. Here, we outline a Multi-Criteria Decision Analysis (MCDA) approach that can be used to rapidly identify potentially dangerous lakes in regions without existing tailored GLOF risk assessments, where a range of glacial lake types exist, and where field data are sparse or non-existent. Our MCDA model (1) is desk-based and uses freely and widely available data inputs and software, and (2) allows the relative risk posed by a range of glacial lake types to be assessed simultaneously within any region. A review of the factors that influence GLOF risk, combined with the strict rules of criteria selection inherent to MCDA, has allowed us to identify 13 exhaustive, non-redundant, and consistent risk criteria. We use our MCDA model to assess the risk of 16 extant glacial lakes and 6 lakes that have already generated GLOFs, and found that our results agree well with previous studies. For the first time in GLOF risk assessment, we employed sensitivity analyses to test the strength of our model results and assumptions, and to identify lakes that are sensitive to the criteria and risk thresholds used. A key benefit of the MCDA method is that sensitivity analyses are readily undertaken. Overall, these sensitivity analyses lend support to our model, although we suggest that further work is required to determine the relative importance of assessment criteria, and the thresholds that determine the level of risk for each criterion. As a case study, the tested method was then applied to 25 potentially dangerous lakes in the Bolivian Andes, where GLOF risk is poorly understood; 3 lakes are found to pose 'medium' or 'high' risk, and require further detailed investigation. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Potential Impact of Risk and Loss Aversion on the Process of Accepting Kidneys for Transplantation.

    PubMed

    Heilman, Raymond L; Green, Ellen P; Reddy, Kunam S; Moss, Adyr; Kaplan, Bruce

    2017-07-01

    Behavioral economic theory suggests that people make decisions based on maximizing perceived value; however, this may be influenced more by the risk of loss rather than of potential gain. Additionally, individuals may seek certainty over uncertainty. These are termed loss aversion and risk aversion, respectively. Loss aversion is particularly sensitive to how the decision is "framed." Thus, labeling a kidney as high Kidney Donor Profile Index results in higher discard rates because this creates a nonlinearity in perceived risk. There is also evidence that the perceived loss due to regulatory sanction results in increased organ discard rates. This may be due to the overuse of terminology that stresses regulatory sanctions and thus perpetuates fear of loss through a form of nudging. Our goal is to point out how these concepts of behavioral economics may negatively influence the decision process to accept these suboptimal organs. We hope to make the community more aware of these powerful psychological influences and thus potentially increase the utilization of these suboptimal organs. Further, we would urge regulatory bodies to avoid utilizing strategies that frame outcomes in terms of loss due to flagging and build models that are less prone to uncertain expected versus observed outcomes.

  4. Genetic testing for the risk of developing late effects among survivors of childhood cancer: Consumer understanding, acceptance, and willingness to pay.

    PubMed

    Georgiou, Gabrielle; Wakefield, Claire E; McGill, Brittany C; Fardell, Joanna E; Signorelli, Christina; Hanlon, Lucy; Tucker, Kathy; Patenaude, Andrea F; Cohn, Richard J

    2016-09-15

    Genetic testing to determine cancer survivors' risk of developing late effects from their cancer treatment will be increasingly used in survivorship care. This 2-stage study with 64 survivors of childhood cancer and their parents investigated the preferences and acceptability of testing among those who may be at risk of developing late effects. The first stage (Stage 1) identified the most commonly perceived benefits and concerns regarding genetic testing for the risk of late effects among 24 participants. In Stage 2, during interviews, 20 survivors (55% of whom were female; mean age, 26.0 years [range, 18-39 years]; standard deviation [SD], 0.80) and 20 parents (55% of whom were male; mean age of child survivor, 14.2 years [range, 10-19 years]; SD, 0.79) rated the 7 most common benefits and concerns from those identified in Stage 1. Interviews were transcribed verbatim and analyzed. Decisional balance ratios were calculated by dividing the participants' average concerns scores with the average benefits scores. Genetic testing for late effects was highly acceptable: 95% of participants leaned toward testing, and the majority (65.9%) would pay up to Australian $5000. The majority (97.2%) reported it was acceptable to wait for up to 6 months to receive results, and to be offered testing immediately after treatment or when the survivor reached adulthood (62.9%). Survivors and parents had a highly positive decisional balance (Mean (M), 0.5 [SD, 0.38] and M, 0.5 [SD, 0.39], respectively), indicating that perceived benefits outweighed concerns. Although to our knowledge clinical efficacy has yet to be clearly demonstrated, survivors and parents described positive interest in genetic testing for the risk of developing late effects. Perceived benefits outweighed harms, and the majority of participants would be willing to pay, and wait, for testing. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2876-2885. © 2016 American Cancer Society. © 2016 American

  5. Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model: Evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis.

    PubMed

    Hengartner, M P; Heekeren, K; Dvorsky, D; Walitza, S; Rössler, W; Theodoridou, A

    2017-09-01

    The aim of this study was to critically examine the prognostic validity of various clinical high-risk (CHR) criteria alone and in combination with additional clinical characteristics. A total of 188 CHR positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS) criteria, were followed over three years. The test battery included the Structured Interview for Prodromal Syndromes (SIPS), verbal IQ and many other screening tools. Conversion to psychosis was defined according to ICD-10 criteria for schizophrenia (F20) or brief psychotic disorder (F23). Altogether n=24 persons developed manifest psychosis within three years and according to Kaplan-Meier survival analysis, the projected conversion rate was 17.5%. The predictive accuracy of UHR was statistically significant but poor (area under the curve [AUC]=0.65, P<.05), whereas BS did not predict psychosis beyond mere chance (AUC=0.52, P=.730). Sensitivity and specificity were 0.83 and 0.47 for UHR, and 0.96 and 0.09 for BS. UHR plus BS achieved an AUC=0.66, with sensitivity and specificity of 0.75 and 0.56. In comparison, baseline antipsychotic medication yielded a predictive accuracy of AUC=0.62 (sensitivity=0.42; specificity=0.82). A multivariable prediction model comprising continuous measures of positive symptoms and verbal IQ achieved a substantially improved prognostic accuracy (AUC=0.85; sensitivity=0.86; specificity=0.85; positive predictive value=0.54; negative predictive value=0.97). We showed that BS have no predictive accuracy beyond chance, while UHR criteria poorly predict conversion to psychosis. Combining BS with UHR criteria did not improve the predictive accuracy of UHR alone. In contrast, dimensional measures of both positive symptoms and verbal IQ showed excellent prognostic validity. A critical re-thinking of binary at-risk criteria is necessary in order to improve the prognosis of psychotic disorders

  6. Opportunities and challenges of expanded criteria organs in liver and kidney transplantation as a response to organ shortage.

    PubMed

    Solomon, Harvey

    2011-01-01

    In 1989, there were 19,000 patients on the UNOS (United Network of Organ Sharing) wait list for organs compared to 110,000 today. Without an equivalent increase in donors, the patients awaiting these organs for transplant face increasing severity of illness and risk of dying without receiving a transplant. This disparity in supply and demand has led to acceptance of organs with lower than expected success rates compared to previous standard donors variously defined as extended criteria donors in order to increase transplantation. The reluctance to wider use of these types of organs is based on the less than expected transplant center graft and patient survival results associated with their use, as well as the increased resources required to care for the patients who receive these organs. The benefits need to be compared to the survival of not receiving a transplant and remaining on the waiting list rather than on outcomes of receiving a standard donor. A lack of a systematic risk outcomes adjustment is one of the most important factors preventing more extensive utilization as transplant centers are held to patient and graft survival statistics as a performance measure by multiple regulatory organizations and insurers. Newer classification systems of such donors may allow a more systematic approach to analyzing the specific risks to individualized patients. Due to changes in donor policies across the country, there has been an increase in Extended Criteria Donors (ECD) organs procured by organ procurement organizations (OPO) but their uneven acceptance by the transplant centers has contributed to an increase in discards and organs not being used. This is one of the reasons that wider sharing of organs is currently receiving much attention. Transplanting ECD organs presents unique challenges and innovative approaches to achieve satisfactory results. Improved logistics and information technology combined strategies for improving donor quality with may prevent discards

  7. What Is the Influence of Both Risk Donor and Risk Receiver on Simultaneous Pancreas-Kidney Transplantation?

    PubMed

    Sánchez-Hidalgo, J M; Salamanca-Bustos, J J; Arjona-Sánchez, Á; Campos-Hernández, J P; Ruiz Rabelo, J; Rodríguez-Benot, A; Requena-Tapia, M J; Briceño-Delgado, J

    2018-03-01

    Some factors affect the pancreas of a marginal donor, and although their influence on graft survival has been determined, there is an increasing consensus to accept marginal organs in a controlled manner to increase the pool of organs. Certain factors related to the recipient have also been proposed as having negative influence on graft prognosis. The objective of this study was to analyze the influence of these factors on the results of our simultaneous pancreas-kidney (SPK) transplantation series. Retrospective analysis of 126 SPK transplants. Donors and recipients were stratified in an optimal group (<2 expanded donor criteria) and a risk group (≥2 criteria). A pancreatic graft survival analysis was performed using a Kaplan-Meier test and log-rank test. Prognostic variables on graft survival were studied by Cox regression. Postoperative complications (graded by Clavien classification) were compared by χ 2 test or Fisher test. Median survival of pancreas was 66 months, with no significant difference between groups (P > .05). Multivariate analysis showed risk factors to be donor age, cold ischemia time, donor body mass index, receipt body mass index, and receipt panel-reactive antibody. In our series, the use of pancreatic grafts from donors with expanded criteria is safe and has increased the pool of grafts. Different variables, both donor and recipient, influence the survival of the pancreatic graft and should be taken into account in organ distribution systems. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Acceptability, Language, and Structure of Text Message-Based Behavioral Interventions for High-Risk Adolescent Females: A Qualitative Study

    PubMed Central

    Ranney, Megan L.; Choo, Esther K.; Cunningham, Rebecca M.; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J.; Morrow, Kathleen

    2014-01-01

    Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants’ needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. PMID:24559973

  9. [Evaluation of the risk related to repetitive work activities: testing of several methods proposed in the literature].

    PubMed

    Capodaglio, E M; Facioli, M; Bazzini, G

    2001-01-01

    Pathologies due to the repetitive activity of the upper limbs constitutes a growing part of the work-related musculo-skeletal disorders. At the moment, there are no universally accepted and validated methods for the description and assessment of the work-related risks. Yet, the criteria fundamentally characterizing the exposure are rather clear and even. This study reports a practical example of the application of some recent risk assessment methods proposed in the literature, combining objective and subjective measures obtained on the field, with the traditional activity analysis.

  10. In the queue for coronary artery bypass grafting: patients' perceptions of risk and 'maximal acceptable waiting time'.

    PubMed

    Llewellyn-Thomas, H; Thiel, E; Paterson, M; Naylor, D

    1999-04-01

    To elicit patients' maximal acceptable waiting times (MAWT) for non-urgent coronary artery bypass grafting (CABG), and to determine if MAWT is related to prior expectations of waiting times, symptom burden, expected relief, or perceived risks of myocardial infarction while waiting. Seventy-two patients on an elective CABG waiting list chose between two hypothetical but plausible options: a 1-month wait with 2% risk of surgical mortality, and a 6-month wait with 1% risk of surgical mortality. Waiting time in the 6-month option was varied up if respondents chose the 6-month/lower risk option, and down if they chose the 1-month/higher risk option, until the MAWT switch point was reached. Patients also reported their expected waiting time, perceived risks of myocardial infarction while waiting, current function, expected functional improvement and the value of that improvement. Only 17 (24%) patients chose the 6-month/1% risk option, while 55 (76%) chose the 1-month/2% risk option. The median MAWT was 2 months; scores ranged from 1 to 12 months (with two outliers). Many perceived high cumulative risks of myocardial infarction if waiting for 1 (upper quartile, > or = 1.45%) or 6 (upper quartile, > or = 10%) months. However, MAWT scores were related only to expected waiting time (r = 0.47; P < 0.0001). Most patients reject waiting 6 months for elective CABG, even if offered along with a halving in surgical mortality (from 2% to 1%). Intolerance for further delay seems to be determined primarily by patients' attachment to their scheduled surgical dates. Many also have severely inflated perceptions of their risk of myocardial infarction in the queue. These results suggest a need for interventions to modify patients' inaccurate risk perceptions, particularly if a scheduled surgical date must be deferred.

  11. Final NASA Panel Recommendations for Definition of Acceptable Risk of Injury Due to Spaceflight Dynamic Events

    NASA Technical Reports Server (NTRS)

    Somers, Jeffrey T.; Newby, Nate; Wells, Jessica

    2015-01-01

    A panel of experts was convened in 2010 to help define acceptable injury risk levels for space vehicle launches, landings, and abort scenarios. Classifications of spaceflight-relevant injuries were defined using four categories ranging from minor to severe injury. Limits for each injury category were agreed to, dependent on the expected number of crew exposures in a given vehicle and on whether the flight was considered nominal or off-nominal. Somers et al. captured the findings of this summit in a NASA technical memorandum. This panel was recently re-convened (December 1, 2014) to determine whether the previous recommended injury limits were applicable to newly-designed commercial space flight vehicles. In particular, previous limits were based in part on the number of crew exposures per vehicle and also were sensitive to a definition of nominal and off-nominal vehicle performance. Reconsideration of these aspects led to a new consensus on a definition of injury risk.

  12. Hot mix asphalt voids acceptance review of QC/QA data 2000 through 2004.

    DOT National Transportation Integrated Search

    2006-07-01

    This report analyzes the Quality Control/Quality Assurance (QC/QA) data for hot mix asphalt using voids acceptance as : the testing criteria for the years 2000 through 2004. Analysis of the overall quality of the HMA is accomplished by : reviewing th...

  13. Hot mix asphalt voids acceptance review of QC/QA data 2000 through 2010.

    DOT National Transportation Integrated Search

    2011-10-01

    This report analyzes the quality control/quality assurance (QC/QA) data for hot mix asphalt (HMA) using : voids acceptance as the testing criteria awarded in the years 2000 through 2010. Analysis of the overall : performance of the projects is accomp...

  14. Compiler Acceptance Criteria Guidebook

    DTIC Science & Technology

    1977-05-01

    further delineated in subseuent sub-charts. P.11 items in the sub-charts are discussed as to their relative merit...object modules) enafles cor’niler systers to rinirize their resource requirerents. Usually there is no major benefit in having the entire comnpiler core...system and for their reasonable specification to the vendina organization. The specification charts developed in Part 1 also provide a meaningful

  15. Comparison of the Between the Flags calling criteria to the MEWS, NEWS and the electronic Cardiac Arrest Risk Triage (eCART) score for the identification of deteriorating ward patients.

    PubMed

    Green, Malcolm; Lander, Harvey; Snyder, Ashley; Hudson, Paul; Churpek, Matthew; Edelson, Dana

    2018-02-01

    Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration. We sought to compare the Between the Flags (BTF) calling criteria to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic Cardiac Arrest Risk Triage (eCART) score. Multicenter retrospective analysis of electronic health record data from all patients admitted to five US hospitals from November 2008-August 2013. Cardiac arrest, ICU transfer or death within 24h of a score RESULTS: Overall accuracy was highest for eCART, with an AUC of 0.801 (95% CI 0.799-0.802), followed by NEWS, MEWS and BTF respectively (0.718 [0.716-0.720]; 0.698 [0.696-0.700]; 0.663 [0.661-0.664]). BTF criteria had a high risk (Red Zone) specificity of 95.0% and a moderate risk (Yellow Zone) specificity of 27.5%, which corresponded to MEWS thresholds of >=4 and >=2, NEWS thresholds of >=5 and >=2, and eCART thresholds of >=12 and >=4, respectively. At those thresholds, eCART caught 22 more adverse events per 10,000 patients than BTF using the moderate risk criteria and 13 more using high risk criteria, while MEWS and NEWS identified the same or fewer. An electronically generated eCART score was more accurate than commonly used paper based observation tools for predicting the composite outcome of in-hospital cardiac arrest, ICU transfer and death within 24h of observation. The outcomes of this analysis lend weight for a move towards an algorithm based electronic risk identification tool for deteriorating patients to ensure earlier detection and prevent adverse events in the hospital. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

    PubMed

    Timko, C Alix; Zucker, Nancy L; Herbert, James D; Rodriguez, Daniel; Merwin, Rhonda M

    2015-06-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. The Predictive Value of Selection Criteria in an Urban Magnet School

    ERIC Educational Resources Information Center

    Lohmeier, Jill Hendrickson; Raad, Jennifer

    2012-01-01

    The predictive value of selection criteria on outcome data from two cohorts of students (Total N = 525) accepted to an urban magnet high school were evaluated. Regression analyses of typical screening variables (suspensions, absences, metropolitan achievement tests, middle school grade point averages [GPAs], Matrix Analogies test scores, and…

  18. Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome: Review of the Literature and Suggested Diagnostic Criteria

    PubMed Central

    Valtonen, Ville

    2017-01-01

    A great variety of non-specific symptoms may occur in patients living or working in moisture-damaged buildings. In the beginning, these symptoms are usually reversible, mild, and present irritation of mucosa and increased morbidity due to respiratory tract infections and asthma-like symptoms. Later, the disease may become chronic and a patient is referred to a doctor where the assessment of dampness and mold hypersensitivity syndrome (DMHS) often presents diagnostic challenges. Currently, unanimously accepted laboratory tests are not yet available. Therefore, the diagnosis of DMHS is clinical and is based on the patient’s history and careful examination. In this publication, I reviewed contemporary knowledge on clinical presentations, laboratory methods, and clinical assessment of DMHS. From the literature, I have not found any proposed diagnostic clinical criteria. Therefore, I propose five clinical criteria to diagnose DMHS: (1) the history of mold exposure in water-damaged buildings, (2) increased morbidity to due infections, (3) sick building syndrome, (4) multiple chemical sensitivity, and (5) enhanced scent sensitivity. If all the five criteria are met, the patient has a very probable DMHS. To resolve the current problems in assigning correct DMHS diagnosis, we also need novel assays to estimate potential risks of developing DMHS. PMID:28848553

  19. Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome: Review of the Literature and Suggested Diagnostic Criteria.

    PubMed

    Valtonen, Ville

    2017-01-01

    A great variety of non-specific symptoms may occur in patients living or working in moisture-damaged buildings. In the beginning, these symptoms are usually reversible, mild, and present irritation of mucosa and increased morbidity due to respiratory tract infections and asthma-like symptoms. Later, the disease may become chronic and a patient is referred to a doctor where the assessment of dampness and mold hypersensitivity syndrome (DMHS) often presents diagnostic challenges. Currently, unanimously accepted laboratory tests are not yet available. Therefore, the diagnosis of DMHS is clinical and is based on the patient's history and careful examination. In this publication, I reviewed contemporary knowledge on clinical presentations, laboratory methods, and clinical assessment of DMHS. From the literature, I have not found any proposed diagnostic clinical criteria. Therefore, I propose five clinical criteria to diagnose DMHS: (1) the history of mold exposure in water-damaged buildings, (2) increased morbidity to due infections, (3) sick building syndrome, (4) multiple chemical sensitivity, and (5) enhanced scent sensitivity. If all the five criteria are met, the patient has a very probable DMHS. To resolve the current problems in assigning correct DMHS diagnosis, we also need novel assays to estimate potential risks of developing DMHS.

  20. The Acceptability of Online Courses as Criteria for Admission to Medical School

    PubMed Central

    Adams, Jonathan

    2009-01-01

    A national survey of medical school admissions administrators was used to assess the acceptability of applicants' qualifications that included degrees earned partly online, partly in a community college, or in a traditional program. A questionnaire was sent from The Florida State University in 2007 to admissions administrators in the 125 accredited allopathic medical schools in the United States. In each of three situations, the respondents were asked to select one of two hypothetical applicants to invite for an interview. The applicants with their coursework taken in a traditional-residential setting were overwhelmingly preferred over the applicant holding the degree earned partly online. Further analysis indicated that online courses were perceived as not presenting sufficient opportunity for students to develop important social skills through interaction with other students and mentors. PMID:21603401

  1. Risk assessment of consuming agricultural products irrigated with reclaimed wastewater: An exposure model

    NASA Astrophysics Data System (ADS)

    van Ginneken, Meike; Oron, Gideon

    2000-09-01

    This study assesses health risks to consumers due to the use of agricultural products irrigated with reclaimed wastewater. The analysis is based on a definition of an exposure model which takes into account several parameters: (1) the quality of the applied wastewater, (2) the irrigation method, (3) the elapsed times between irrigation, harvest, and product consumption, and (4) the consumers' habits. The exposure model is used for numerical simulation of human consumers' risks using the Monte Carlo simulation method. The results of the numerical simulation show large deviations, probably caused by uncertainty (impreciseness in quality of input data) and variability due to diversity among populations. There is a 10-orders of magnitude difference in the risk of infection between the different exposure scenarios with the same water quality. This variation indicates the need for setting risk-based criteria for wastewater reclamation rather than single water quality guidelines. Extra data are required to decrease uncertainty in the risk assessment. Future research needs to include definition of acceptable risk criteria, more accurate dose-response modeling, information regarding pathogen survival in treated wastewater, additional data related to the passage of pathogens into and in the plants during irrigation, and information regarding the behavior patterns of the community of human consumers.

  2. Combining criteria for delineating lahar- and flash-flood-prone hazard and risk zones for the city of Arequipa, Peru

    NASA Astrophysics Data System (ADS)

    Thouret, J.-C.; Enjolras, G.; Martelli, K.; Santoni, O.; Luque, J. A.; Nagata, M.; Arguedas, A.; Macedo, L.

    2013-02-01

    Arequipa, the second largest city in Peru, is exposed to many natural hazards, most notably earthquakes, volcanic eruptions, landslides, lahars (volcanic debris flows), and flash floods. Of these, lahars and flash floods, triggered by occasional torrential rainfall, pose the most frequently occurring hazards that can affect the city and its environs, in particular the areas containing low-income neighbourhoods. This paper presents and discusses criteria for delineating areas prone to flash flood and lahar hazards, which are localized along the usually dry (except for the rainy season) ravines and channels of the Río Chili and its tributaries that dissect the city. Our risk-evaluation study is based mostly on field surveys and mapping, but we also took into account quality and structural integrity of buildings, available socio-economic data, and information gained from interviews with risk-managers officials. In our evaluation of the vulnerability of various parts of the city, in addition to geological and physical parameters, we also took into account selected socio-economic parameters, such as the educational and poverty level of the population, unemployment figures, and population density. In addition, we utilized a criterion of the "isolation factor", based on distances to access emergency resources (hospitals, shelters or safety areas, and water) in each city block. By combining the hazard, vulnerability and exposure criteria, we produced detailed risk-zone maps at the city-block scale, covering the whole city of Arequipa and adjacent suburbs. Not surprisingly, these maps show that the areas at high risk coincide with blocks or districts with populations at low socio-economic levels. Inhabitants at greatest risk are the poor recent immigrants from rural areas who live in unauthorized settlements in the outskirts of the city in the upper parts of the valleys. Such settlements are highly exposed to natural hazards and have little access to vital resources. Our

  3. Wind/tornado design criteria, development to achieve required probabilistic performance goals

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ng, D.S.

    1991-06-01

    This paper describes the strategy for developing new design criteria for a critical facility to withstand loading induced by the wind/tornado hazard. The proposed design requirements for resisting wind/tornado loads are based on probabilistic performance goals. The proposed design criteria were prepared by a Working Group consisting of six experts in wind/tornado engineering and meteorology. Utilizing their best technical knowledge and judgment in the wind/tornado field, they met and discussed the methodologies and reviewed available data. A review of the available wind/tornado hazard model for the site, structural response evaluation methods, and conservative acceptance criteria lead to proposed design criteriamore » that has a high probability of achieving the required performance goals.« less

  4. Wind/tornado design criteria, development to achieve required probabilistic performance goals

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ng, D.S.

    This paper describes the strategy for developing new design criteria for a critical facility to withstand loading induced by the wind/tornado hazard. The proposed design requirements for resisting wind/tornado loads are based on probabilistic performance goals. The proposed design criteria were prepared by a Working Group consisting of six experts in wind/tornado engineering and meteorology. Utilizing their best technical knowledge and judgment in the wind/tornado field, they met and discussed the methodologies and reviewed available data. A review of the available wind/tornado hazard model for the site, structural response evaluation methods, and conservative acceptance criteria lead to proposed design criteriamore » that has a high probability of achieving the required performance goals.« less

  5. Acceptability of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy: Barriers and facilitators to PrEP uptake among at-risk Peruvian populations

    PubMed Central

    Galea, Jerome T.; Kinsler, Janni J.; Salazar, Ximena; Lee, Sung-Jae; Giron, Maziel; Sayles, Jennifer N.; Cáceres, Carlos; Cunningham, William E.

    2010-01-01

    This study examined Pre-Exposure Prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons, and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, p <0.001), followed by efficacy (21.4, p <0.001) and potential side effects (14.7, p <0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out if proven efficacious in ongoing clinical trials. PMID:21571973

  6. Vaginal delivery after Misgav-Ladach cesarean section--is the risk of uterine rupture acceptable?

    PubMed

    Hudić, Igor; Fatusić, Zlatan; Kamerić, Lejla; Misić, Mladen; Serak, Indira; Latifagić, Anela

    2010-10-01

    To evaluate whether the single-layer closure as is a routine by the Misgav-Ladach method compared to the double-layer closure as used by the Dörfler cesarean method is associated with an increased risk of uterine rupture in the subsequent pregnancy and delivery. The analysis is retrospective and is based on medical documentation of the Clinic for Gynecology and Obstetrics, University Clinical Centre, Tuzla, Bosnia and Herzegovina. All patients with one previous cesarean section who attempted vaginal birth following cesarean section were managed from 1 January 2002 to 31 December 2008. Exclusion criteria included multiple gestation, greater than one previous cesarean section, previous incision other than low transverse, gestational age at delivery less than 37 weeks and induction of delivery. We identified 448 patients who met inclusion criteria. We found that 303 patients had a single-layer closure (Misgav-Ladach) and 145 had a double-layer closure (Dörffler) of the previous uterine incision. There were 35 cases of uterine rupture. Of those patients with previous single-layer closure, 5.28% (16/303) had a uterine rupture compared to 13.11% (19/145) in the double-layer closure group (p<0.05). We have not found that a Misgav-Ladach cesarean section method (single-layer uterine closure) might be more likely to result in uterine rupture in women who attempted a vaginal birth after a previous cesarean delivery. This cesarean section method should find its confirmation in everyday clinical practice.

  7. Safe days in space with acceptable uncertainty from space radiation exposure.

    PubMed

    Cucinotta, Francis A; Alp, Murat; Rowedder, Blake; Kim, Myung-Hee Y

    2015-04-01

    The prediction of the risks of cancer and other late effects from space radiation exposure carries large uncertainties mostly due to the lack of information on the risks from high charge and energy (HZE) particles and other high linear energy transfer (LET) radiation. In our recent work new methods were used to consider NASA's requirement to protect against the acceptable risk of no more than 3% probability of cancer fatality estimated at the 95% confidence level. Because it is not possible that a zero-level of uncertainty could be achieved, we suggest that an acceptable uncertainty level should be defined in relationship to a probability distribution function (PDF) that only suffers from modest skewness with higher uncertainty allowed for a normal PDF. In this paper, we evaluate PDFs and the number or "safe days" in space, which are defined as the mission length where risk limits are not exceeded, for several mission scenarios at different acceptable levels of uncertainty. In addition, we briefly discuss several important issues in risk assessment including non-cancer effects, the distinct tumor spectra and lethality found in animal experiments for HZE particles compared to background or low LET radiation associated tumors, and the possibility of non-targeted effects (NTE) modifying low dose responses and increasing relative biological effectiveness (RBE) factors for tumor induction. Each of these issues skew uncertainty distributions to higher fatality probabilities with the potential to increase central values of risk estimates in the future. Therefore they will require significant research efforts to support space exploration within acceptable levels of risk and uncertainty. Copyright © 2015 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.

  8. Diagnostic criteria, severity classification and guidelines of localized scleroderma.

    PubMed

    Asano, Yoshihide; Fujimoto, Manabu; Ishikawa, Osamu; Sato, Shinichi; Jinnin, Masatoshi; Takehara, Kazuhiko; Hasegawa, Minoru; Yamamoto, Toshiyuki; Ihn, Hironobu

    2018-04-23

    We established diagnostic criteria and severity classification of localized scleroderma because there is no established diagnostic criteria or widely accepted severity classification of the disease. Also, there has been no clinical guideline for localized scleroderma, so we established its clinical guideline ahead of all over the world. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of localized scleroderma. © 2018 Japanese Dermatological Association.

  9. 75 FR 80544 - NUREG-1953, Confirmatory Thermal-Hydraulic Analysis To Support Specific Success Criteria in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... To Support Specific Success Criteria in the Standardized Plant Analysis Risk Models--Surry and Peach... Specific Success Criteria in the Standardized Plant Analysis Risk Models--Surry and Peach Bottom, Draft..., ``Confirmatory Thermal-Hydraulic Analysis to Support Specific Success Criteria in the Standardized Plant Analysis...

  10. A systematic review of diagnostic criteria for psoriasis in adults and children: evidence from studies with a primary aim to develop or validate diagnostic criteria.

    PubMed

    Burden-Teh, E; Phillips, R C; Thomas, K S; Ratib, S; Grindlay, D; Murphy, R

    2017-11-06

    The diagnosis of psoriasis in adults and children is made clinically, for both patient management and the selection of participants in research. Diagnostic criteria provide a structure for clinical assessment, which in turn helps standardize patient recruitment into clinical trials and case definitions in observational studies. The aim of this systematic review was to identify and critically appraise the published studies to date that had a primary research aim to develop or validate diagnostic criteria for psoriasis. A search of Ovid MEDLINE and Ovid Embase was conducted in October 2016. The primary objective was to record the sensitivity and specificity of diagnostic criteria for psoriasis. Secondary objectives included diagnostic recommendations, applicability to children and study characteristics. Diagnostic accuracy studies were critically appraised for risk of bias using the QUADAS-2 tool. Twenty-three studies met the inclusion criteria. None detailed clinical examination-based diagnostic criteria. The included criteria varied from genetic and molecular diagnostic models to skin imaging, histopathology, and questionnaire-based, computer-aided and traditional Chinese medicine criteria. High sensitivity and specificity (> 90%) were reported in many studies. However, the study authors often did not specify how the criteria would be used clinically or in research. This review identified studies with varying risk of bias, and due to each study developing separate criteria meta-analysis was not possible. Clinical examination-based diagnostic criteria are currently lacking for psoriasis. Future research could follow an international collaborative approach and employ study designs allowing high-quality diagnostic accuracy testing. Existing and newly developed criteria require validation. © 2017 British Association of Dermatologists.

  11. Most Scottish neurologists do not apply the 2010 McDonald criteria when diagnosing multiple sclerosis.

    PubMed

    Lumley, R; Davenport, R; Williams, A

    2015-03-01

    The diagnostic criteria for multiple sclerosis have evolved over time and currently the 2010 McDonald criteria are the most widely accepted. These criteria allow the diagnosis of multiple sclerosis to be made at the clinically isolated syndrome stage provided certain criteria are met on a single magnetic resonance brain scan. Our hypothesis was that neurologists in Scotland did not use these criteria routinely. We sent a SurveyMonkey questionnaire to all Scottish neurologists (consultants and trainees) regarding the diagnosis of multiple sclerosis. Our questionnaire response rate was 65/99 (66%). Most Scottish neurologists were aware of the criteria and 31/58 (53%) felt that they were using these routinely. However, in a clinical vignette designed to test the application of these criteria, only 5/57 (9%) of neurologists appeared to use them. Scottish neurologists' use of the 2010 McDonald criteria for diagnosis of multiple sclerosis varies from practitioners' perception of their use of these criteria.

  12. 46 CFR 12.03-1 - Coast Guard-accepted training other than approved courses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Guard-accepted training other than approved courses. (a) When the training and assessment of competence... assessment must meet the following requirements: (1) The training and assessment must have written, clearly defined objectives that emphasize specific knowledge, skills, and abilities, and that include criteria to...

  13. ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association.

    PubMed

    Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M; Patel, Manesh R; Raskin, Ira E; Hendel, Robert C; Bateman, Timothy M; Cerqueira, Manuel D; Gibbons, Raymond J; Gillam, Linda D; Gillespie, John A; Hendel, Robert C; Iskandrian, Ami E; Jerome, Scott D; Krumholz, Harlan M; Messer, Joseph V; Spertus, John A; Stowers, Stephen A

    2005-10-18

    Under the auspices of the American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC), an appropriateness review was conducted for radionuclide cardiovascular imaging (RNI), specifically gated single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI). The review assessed the risks and benefits of the imaging test for several indications or clinical scenarios and scored them based on a scale of 1 to 9, where the upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The mid range (4 to 6) implies that the test may be generally acceptable and may be a reasonable approach for the indication. The indications for this review were primarily drawn from existing clinical practice guidelines and modified based on discussion by the ACCF Appropriateness Criteria Working Group and the Technical Panel members who rated the indications. The method for this review was based on the RAND/UCLA approach for evaluating appropriateness, which blends scientific evidence and practice experience. A modified Delphi technique was used to obtain first- and second-round ratings of 52 clinical indications. The ratings were done by a Technical Panel with diverse membership, including nuclear cardiologists, referring physicians (including an echocardiographer), health services researchers, and a payer (chief medical officer). These results are expected to have a significant impact on physician decision making and performance, reimbursement policy, and future research directions. Periodic assessment and updating of criteria will be undertaken as needed.

  14. Review Article: Multi-criteria decision making for flood risk management: a survey of the current state-of-the-art

    NASA Astrophysics Data System (ADS)

    de Brito, M. M.; Evers, M.

    2015-11-01

    This paper provides a review of Multi-Criteria Decision Making (MCDM) applications to flood risk management, seeking to highlight trends and identify research gaps. Totally, 128 peer-reviewed papers published from 1995 to June 2015 were systematically analysed and classified into the following application areas: (1) ranking of alternatives for flood mitigation, (2) reservoir flood control, (3) susceptibility, (4) hazard, (5) vulnerability, (6) risk, (7) coping capacity, and (8) emergency management. Additionally, the articles were categorized based on the publication year, MCDM method, whether they were or were not carried out in a participatory process, and if uncertainty and sensitivity analysis were performed. Results showed that the number of flood MCDM publications has exponentially grown during this period, with over 82 % of all papers published since 2009. The Analytical Hierarchy Process (AHP) was the most popular technique, followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), and Simple Additive Weighting (SAW). Although there is greater interest on MCDM, uncertainty analysis remains an issue and is seldom applied in flood-related studies. In addition, participation of multiple stakeholders has been generally fragmented, focusing on particular stages of the decision-making process, especially on the definition of criteria weights. Based on the survey, some suggestions for further investigation are provided.

  15. Predicting nurses' use of healthcare technology using the technology acceptance model: an integrative review.

    PubMed

    Strudwick, Gillian

    2015-05-01

    The benefits of healthcare technologies can only be attained if nurses accept and intend to fully use them. One of the most common models utilized to understand user acceptance of technology is the Technology Acceptance Model. This model and modified versions of it have only recently been applied in the healthcare literature among nurse participants. An integrative literature review was conducted on this topic. Ovid/MEDLINE, PubMed, Google Scholar, and CINAHL were searched yielding a total of 982 references. Upon eliminating duplicates and applying the inclusion and exclusion criteria, the review included a total of four dissertations, three symposium proceedings, and 13 peer-reviewed journal articles. These documents were appraised and reviewed. The results show that a modified Technology Acceptance Model with added variables could provide a better explanation of nurses' acceptance of healthcare technology. These added variables to modified versions of the Technology Acceptance Model are discussed, and the studies' methodologies are critiqued. Limitations of the studies included in the integrative review are also examined.

  16. Systematic assessment of benefits and risks: study protocol for a multi-criteria decision analysis using the Analytic Hierarchy Process for comparative effectiveness research

    PubMed Central

    Singh, Sonal

    2013-01-01

    Background: Regulatory decision-making involves assessment of risks and benefits of medications at the time of approval or when relevant safety concerns arise with a medication. The Analytic Hierarchy Process (AHP) facilitates decision-making in complex situations involving tradeoffs by considering risks and benefits of alternatives. The AHP allows a more structured method of synthesizing and understanding evidence in the context of importance assigned to outcomes. Our objective is to evaluate the use of an AHP in a simulated committee setting selecting oral medications for type 2 diabetes.  Methods: This study protocol describes the AHP in five sequential steps using a small group of diabetes experts representing various clinical disciplines. The first step will involve defining the goal of the decision and developing the AHP model. In the next step, we will collect information about how well alternatives are expected to fulfill the decision criteria. In the third step, we will compare the ability of the alternatives to fulfill the criteria and judge the importance of eight criteria relative to the decision goal of the optimal medication choice for type 2 diabetes. We will use pairwise comparisons to sequentially compare the pairs of alternative options regarding their ability to fulfill the criteria. In the fourth step, the scales created in the third step will be combined to create a summary score indicating how well the alternatives met the decision goal. The resulting scores will be expressed as percentages and will indicate the alternative medications' relative abilities to fulfill the decision goal. The fifth step will consist of sensitivity analyses to explore the effects of changing the estimates. We will also conduct a cognitive interview and process evaluation.  Discussion: Multi-criteria decision analysis using the AHP will aid, support and enhance the ability of decision makers to make evidence-based informed decisions consistent with their values

  17. Systematic assessment of benefits and risks: study protocol for a multi-criteria decision analysis using the Analytic Hierarchy Process for comparative effectiveness research.

    PubMed

    Maruthur, Nisa M; Joy, Susan; Dolan, James; Segal, Jodi B; Shihab, Hasan M; Singh, Sonal

    2013-01-01

    Regulatory decision-making involves assessment of risks and benefits of medications at the time of approval or when relevant safety concerns arise with a medication. The Analytic Hierarchy Process (AHP) facilitates decision-making in complex situations involving tradeoffs by considering risks and benefits of alternatives. The AHP allows a more structured method of synthesizing and understanding evidence in the context of importance assigned to outcomes. Our objective is to evaluate the use of an AHP in a simulated committee setting selecting oral medications for type 2 diabetes.  This study protocol describes the AHP in five sequential steps using a small group of diabetes experts representing various clinical disciplines. The first step will involve defining the goal of the decision and developing the AHP model. In the next step, we will collect information about how well alternatives are expected to fulfill the decision criteria. In the third step, we will compare the ability of the alternatives to fulfill the criteria and judge the importance of eight criteria relative to the decision goal of the optimal medication choice for type 2 diabetes. We will use pairwise comparisons to sequentially compare the pairs of alternative options regarding their ability to fulfill the criteria. In the fourth step, the scales created in the third step will be combined to create a summary score indicating how well the alternatives met the decision goal. The resulting scores will be expressed as percentages and will indicate the alternative medications' relative abilities to fulfill the decision goal. The fifth step will consist of sensitivity analyses to explore the effects of changing the estimates. We will also conduct a cognitive interview and process evaluation.  Multi-criteria decision analysis using the AHP will aid, support and enhance the ability of decision makers to make evidence-based informed decisions consistent with their values and preferences.

  18. Low self-esteem as a risk factor for loneliness in adolescence: perceived - but not actual - social acceptance as an underlying mechanism.

    PubMed

    Vanhalst, Janne; Luyckx, Koen; Scholte, Ron H J; Engels, Rutger C M E; Goossens, Luc

    2013-10-01

    Low self-esteem has been shown to relate to concurrent and later feelings of loneliness in adolescence. However, it remains unclear why low self-esteem puts adolescents at risk for experiencing loneliness. Further, longitudinal research on the direction of effects between loneliness and self-esteem is virtually non-existent. The present study aims to fill these gaps in the literature. First, the direction of effects between loneliness and self-esteem was investigated in two independent longitudinal studies: a five-wave study sampling Dutch adolescents (M age = 15.22 years at T1; 47 % female; N = 428) and a three-wave study sampling Belgian adolescents (M age = 14.95 years at T1; 63 % female; N = 882). Second, the underlying role of social acceptance was investigated in the latter sample by applying a multi-method approach that included actual (i.e., peer-reported) and perceived (i.e., self-reported) social acceptance. Results indicated that self-esteem and loneliness influenced one another in a reciprocal manner. Furthermore, the dominant path from self-esteem to loneliness was partially mediated by perceived--but not actual--social acceptance. The importance of distinguishing actual from perceived social acceptance is discussed, and suggestions for future research are outlined.

  19. Peer Acceptance and Self-Concept of Students with Disabilities in Regular Education

    ERIC Educational Resources Information Center

    Pijl, Sip Jan; Frostad, Per

    2010-01-01

    This study addresses the relationship between the acceptance of students with disabilities by their peers and their self-concept. Research shows that level of acceptance and self-concept are moderately related. Students with disabilities not accepted by their peers in regular classrooms thus run the risk of developing low self-concept. It is…

  20. Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

    PubMed

    Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

    2015-06-01

    In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015

  1. Does sufficient evidence exist to support a causal association between vitamin D status and cardiovascular disease risk? An assessment using Hill's criteria for causality.

    PubMed

    Weyland, Patricia G; Grant, William B; Howie-Esquivel, Jill

    2014-09-02

    Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill's criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor.

  2. The Careful Puppet Master: Reducing risk and fortifying acceptance testing with Jenkins CI

    NASA Astrophysics Data System (ADS)

    Smith, Jason A.; Richman, Gabriel; DeStefano, John; Pryor, James; Rao, Tejas; Strecker-Kellogg, William; Wong, Tony

    2015-12-01

    Centralized configuration management, including the use of automation tools such as Puppet, can greatly increase provisioning speed and efficiency when configuring new systems or making changes to existing systems, reduce duplication of work, and improve automated processes. However, centralized management also brings with it a level of inherent risk: a single change in just one file can quickly be pushed out to thousands of computers and, if that change is not properly and thoroughly tested and contains an error, could result in catastrophic damage to many services, potentially bringing an entire computer facility offline. Change management procedures can—and should—be formalized in order to prevent such accidents. However, like the configuration management process itself, if such procedures are not automated, they can be difficult to enforce strictly. Therefore, to reduce the risk of merging potentially harmful changes into our production Puppet environment, we have created an automated testing system, which includes the Jenkins CI tool, to manage our Puppet testing process. This system includes the proposed changes and runs Puppet on a pool of dozens of RedHat Enterprise Virtualization (RHEV) virtual machines (VMs) that replicate most of our important production services for the purpose of testing. This paper describes our automated test system and how it hooks into our production approval process for automatic acceptance testing. All pending changes that have been pushed to production must pass this validation process before they can be approved and merged into production.

  3. Variability amongst radiographers in the categorization of clinical acceptability for digital trauma radiography

    NASA Astrophysics Data System (ADS)

    Decoster, Robin; Toomey, Rachel; Smits, Dirk; Mol, Harrie; Verhelle, Filip; Butler, Marie-Louise

    2016-03-01

    Introduction: Radiographers evaluate anatomical structures to judge clinical acceptability of a radiograph. Whether a radiograph is deemed acceptable for diagnosis or not depends on the individual decision of the radiographer. Individual decisions cause variation in the accepted image quality. To minimise these variations definitions of acceptability, such as in RadLex, were developed. On which criteria radiographers attribute a RadLex categories to radiographs is unknown. Insight into these criteria helps to further optimise definitions and reduce variability in acceptance between radiographers. Therefore, this work aims the evaluation of the correlation between the RadLex classification and the evaluation of anatomical structures, using a Visual Grading Analysis (VGA) Methods: Four radiographers evaluated the visibility of five anatomical structures of 25 lateral cervical spine radiographs on a secondary class display with a VGA. They judged clinical acceptability of each radiograph using RadLex. Relations between VGAS and RadLex category were analysed with Kendall's Tau correlation and Nagelkerke pseudo-R². Results: The overall VGA score (VGAS) and the RadLex score correlate (rτ= 0.62, p<0.01, R2=0.72) strongly. The observers' evaluation of contrast between bone, air (trachea) and soft tissue has low value in predicting (rτ=0.55, p<0.01, R2=0.03) the RadLex score. The reproduction of spinous processes (rτ=0.67, p<0.01, R2=0.31) and the evaluation of the exposure (rτ=0.65, p<0.01, R2=0.56) have a strong correlation with high predictive value for the RadLex score. Conclusion: RadLex scores and VGAS correlate positively, strongly and significantly. The predictive value of bony structures may support the use of these in the judgement of clinical acceptability. Considerable inter-observer variations in the VGAS within a certain RadLex category, suggest that observers use of observer specific cut

  4. Examining QRS amplitude criteria for electrocardiographic left ventricular hypertrophy in recommendations for screening criteria in athletes.

    PubMed

    Singla, Varun; Jindal, Akash; Pargaonkar, Vedant; Soofi, Muhammad; Wheeler, Matthew; Froelicher, Victor

    2015-01-01

    Current guidelines for interpretation of the ECGs of athletes recommend that isolated R and S wave amplitudes that exceed traditional criteria for left ventricular hypertrophy be accepted as a physiological response to exercise training. This is based on training and echocardiographic studies but not on long term follow up. Demonstration of the prognostic characteristics of the amplitude criteria in a non-athletic population could support the current guidelines. To evaluate the prognostic value of the R and S wave voltage criteria for electrocardiographic left ventricular hypertrophy (ECG-LVH) in an ambulatory clinical population. The target population consisted of 20,903 ambulatory subjects who had ECGs recorded between 1987 and 1999 and were followed for cardiovascular death until 2013. During the mean follow up of 17 years, there were 881 cardiovascular deaths. The mean age was 43 ± 10, 91% were male and 16% were African American. Of the 2482 (12%) subjects who met the Sokolow-Lyon criteria, 241 (1.2%) subjects with left ventricular (LV) strain had an HR of 5.4 (95% CI 4.1-7.2, p<0.001), while 2241 (11%) subjects without strain had an HR of 1.4 (95% CI 1.2-1.8, p<0.001). Of the 4836 (23%) subjects who met the Framingham voltage criteria, 350 (2%) subjects with LV strain had an HR of 5.1 (95% CI 4.0-6.5, p<0.001), while 4486 (22%) subjects without strain had an HR of 1.1 (95% CI 0.9-1.3, p=0.26). The individual components of the Romhilt-Estes had HRs ranging from 1.4 to 3.6, with only the voltage component not being significant (HR 1.1, 95% CI 0.9-1.5, p=0.35). This study demonstrates that the R and S wave voltage criteria components of most of the original classification schema for electrocardiographic left ventricular hypertrophy are not predictive of CV mortality. Our findings support the current guidelines for electrocardiographic screening of athletes. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. 37 CFR 1.803 - Acceptable depository.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Biological Material § 1.803 Acceptable depository. (a) A deposit shall be recognized for the purposes of... depository must: (i) Have a continuous existence; (ii) Exist independent of the control of the depositor... safety measures to minimize the risk of losing biological material deposited with it; (v) Be impartial...

  6. 37 CFR 1.803 - Acceptable depository.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Biological Material § 1.803 Acceptable depository. (a) A deposit shall be recognized for the purposes of... depository must: (i) Have a continuous existence; (ii) Exist independent of the control of the depositor... safety measures to minimize the risk of losing biological material deposited with it; (v) Be impartial...

  7. 37 CFR 1.803 - Acceptable depository.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Biological Material § 1.803 Acceptable depository. (a) A deposit shall be recognized for the purposes of... depository must: (i) Have a continuous existence; (ii) Exist independent of the control of the depositor... safety measures to minimize the risk of losing biological material deposited with it; (v) Be impartial...

  8. Basis for application of criteria for definition of Global Heritage Stone

    NASA Astrophysics Data System (ADS)

    Marker, Brian

    2013-04-01

    The Global Heritage Stone designation has been proposed to assist geoscientists, planners and the industry in explaining the importance of some types of stone in repair and maintenance of historic structures, new buildings and objects such as sculptures. The designation will have value only if rigorous criteria are used in accepting proposals and the designation is not used too liberally. Criteria proposed by the Heritage Stone Task Group relate, in brief, to wide use of stone either internationally or for major cultural monuments for a period of at least 50 years. However it is not always easy to determine what is truly international or what is of sufficient cultural or artistic merit. This contribution provides some examples of possible problems as a basis for discussion on the refinement of application of the criteria.

  9. Borderline Personality Disorder Diagnostic Criteria as Risk Factors for Suicidal Behavior Through the Lens of the Interpersonal Theory of Suicide.

    PubMed

    Rogers, Megan L; Joiner, Thomas E

    2016-01-01

    Borderline personality disorder diagnostic criteria, particularly affective dysregulation and behavioral dysregulation, are avenues through which suicide risk is conferred, though pathways are not well understood. The interpersonal theory of suicide may help elucidate these associations. The current study examined indirect relationships between affective and behavioral dysregulation and suicidal ideation through perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. 169 outpatients completed measures prior to their intake assessment. Perceived burdensomeness accounted for the relationship between affective dysregulation and suicidal ideation. The acquired capability did not explain the association between behavioral dysregulation and suicide attempt history. Affective and behavioral dysregulation may be key targets in treatment for reducing suicide risk.

  10. Frequency of whole breast radiation therapy after intraoperative radiation therapy due to criteria identified by lumpectomy.

    PubMed

    Mellon, Eric A; Orman, Amber; Joya, Luis E; Montejo, Michael E; Laronga, Christine; Hoover, Susan J; Lee, M Catherine; Khakpour, Nazanin; Kubal, Pamela F; Diaz, Roberto

    For selected early breast cancers, intraoperative radiation therapy (IORT) at the time of lumpectomy can be an efficient alternative to fractionated whole breast radiation therapy (WBRT). However, some patients are later recommended WBRT after IORT due to surgical pathologic findings. To understand risk factor identification rates triggering WBRT recommendation, we analyzed adverse prognostic features based on multiple international criteria for suitability for accelerated partial breast irradiation. We performed a single-institution retrospective review of all 200 nonrecurrent invasive breast carcinomas that received IORT in 20 Gy to the tumor cavity using a 50 kV photon applicator between January 2011 and December 2015. IORT eligibility was based on the 2009 accelerated partial breast irradiation Consensus Statement from the American Society for Radiation Oncology (ASTRO). IORT was offered as the sole radiation modality to patients meeting 0-1 "cautionary" and no "unsuitable" criteria before lumpectomy. WBRT was recommended after IORT when 2+ cautionary and/or 1+ unsuitable criteria were met after accounting for resection pathology. We recalculated WBRT recommendation rates using initial and reresection margins for ASTRO consensus, Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology recommendations, and TARGeted Intraoperative radioTherapy vs. Postoperative Radiotherapy trial "prepathology" stratum protocol. Depending on the selection criteria chosen, rates of WBRT recommendation can vary from 4.5% to 33%. WBRT recommendation rates of 30-33% after lumpectomy and IORT are observed when the WBRT indication is a single ASTRO cautionary/unsuitable, Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology intermediate/high-risk criterion, or TARGeted Intraoperative radioTherapy vs. postoperative radiotherapy trial protocol recommendation. Alternatively, allowing for re-excision to clear margins

  11. Affect and Acceptability: Exploring Teachers' Technology-Related Risk Perceptions

    ERIC Educational Resources Information Center

    Howard, Sarah K.

    2011-01-01

    Educational change, such as technology integration, involves risk. Teachers are encouraged to "take risks", but what risks they are asked to take and how do they perceive these risks? Developing an understanding of teachers' technology-related risk perceptions can help explain their choices and behaviours. This paper presents a way to…

  12. [Validity, reliability, and acceptability of the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population].

    PubMed

    Wang, W J; Dong, J; Ren, Z P; Chen, B; He, W; Li, W D; Hao, Z W

    2016-07-06

    To evaluate the validity, reliability, and acceptability of the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population (HILKAB), and provide scientific evidence for its usage. By convenient sampling, we selected 406 individuals at high risk for diabetes for survey using the HILKAB. Pearson correlation coefficient, factor analysis, independent sampling, and t-test for high- and low-score groups were used to evaluate the content validity, construct validity, and discriminant validity of the scale. Reliability of the scale was evaluated by internal consistency, which included Cronbach's α coefficient, θ coefficient, Ω coefficient, and split-half reliability. Scale acceptability was evaluated by acceptance rate and completion time of the survey. In this study, 366 questionnaires (90.1%) was qnalified and the completion time was (8.62±2.79) minutes. Scores for knowledge, attitude, and behavior were 10.60±3.73, 26.56±3.58, 17.09±9.74, respectively. The scale had good face validity and content validity. The correlation coefficient of items and the dimension to which they belong was between 0.25 and 0.97, and the correlation coefficient of three dimensions and the entire scale was between 0.64 and 0.91, all with P<0.001. Factor analysis of the scale extracted eight common factors. The cumulative variance contribution rate was 65.23%, thereby reaching the 50% approved standard. Of 30 items there were 29 items with factor loadings ≥0.40, indicating the scale had good construct validity. For the high-score group, scores for knowledge, attitude, and behavior dimensions were 13.89±2.55, 29.56± 2.46, 28.05 ± 2.93, respectively, which were higher than those for the low-score group (7.67 ± 2.78, 23.89 ± 3.35, 6.25 ± 3.13); t-values were 55.14, 119.40, 95.29, respectively, with P<0.001. The scale consisted of three dimensions: knowledge, attitude, and behavior. The Cronbach's α coefficient was between 0.84 and 0

  13. Radioactive waste management: review on clearance levels and acceptance criteria legislation, requirements and standards.

    PubMed

    Maringer, F J; Suráň, J; Kovář, P; Chauvenet, B; Peyres, V; García-Toraño, E; Cozzella, M L; De Felice, P; Vodenik, B; Hult, M; Rosengård, U; Merimaa, M; Szücs, L; Jeffery, C; Dean, J C J; Tymiński, Z; Arnold, D; Hinca, R; Mirescu, G

    2013-11-01

    In 2011 the joint research project Metrology for Radioactive Waste Management (MetroRWM)(1) of the European Metrology Research Programme (EMRP) started with a total duration of three years. Within this project, new metrological resources for the assessment of radioactive waste, including their calibration with new reference materials traceable to national standards will be developed. This paper gives a review on national, European and international strategies as basis for science-based metrological requirements in clearance and acceptance of radioactive waste. © 2013 Elsevier Ltd. All rights reserved.

  14. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation.

    PubMed

    Durand, François; Renz, John F; Alkofer, Barbara; Burra, Patrizia; Clavien, Pierre-Alain; Porte, Robert J; Freeman, Richard B; Belghiti, Jacques

    2008-12-01

    Because of organ shortage and a constant imbalance between available organs and candidates for liver transplantation, expanded criteria donors are needed. Experience shows that there are wide variations in the definitions, selection criteria, and use of expanded criteria donors according to different geographic areas and different centers. Overall, selection criteria for donors have tended to be relaxed in recent years. Consensus recommendations are needed. This article reports the conclusions of a consensus meeting held in Paris in March 2007 with the contribution of experts from Europe, the United States, and Asia. Definitions of expanded criteria donors with respect to donor variables (including age, liver function tests, steatosis, infections, malignancies, and heart-beating versus non-heart-beating, among others) are proposed. It is emphasized that donor quality represents a continuum of risk rather than "good or bad." A distinction is made between donor factors that generate increased risk of graft failure and factors independent of graft function, such as transmissible infectious disease or donor-derived malignancy, that may preclude a good outcome. Updated data concerning the risks associated with different donor variables in different recipient populations are given. Recommendations on how to safely expand donor selection criteria are proposed.

  15. On the Acceptability of Funding from Fossil Energy Companies

    NASA Astrophysics Data System (ADS)

    Frumhoff, P. C.; Goldman, G. T.

    2016-12-01

    Vigorous debates within the American Geophysical Union over the acceptability of funding from ExxonMobil sit within a broader societal debate over the climate responsibilities of fossil energy companies in a carbon constrained world. This has been fueled by recent evidence that leading companies have invested heavily in efforts to sow doubt about climate science in order to avoid regulation of their products. This talk examines the nature of this evidence and the ethical stances that AGU and other scientific societies and organizations might take toward acceptability of funding from fossil energy companies in light of it. The results of a climate responsibility scorecard, assessing a sample of leading oil, gas and coal companies against specific criteria for a more responsible fossil energy company, also will be presented.

  16. Demonstration of a modelling-based multi-criteria decision analysis procedure for prioritisation of occupational risks from manufactured nanomaterials.

    PubMed

    Hristozov, Danail; Zabeo, Alex; Alstrup Jensen, Keld; Gottardo, Stefania; Isigonis, Panagiotis; Maccalman, Laura; Critto, Andrea; Marcomini, Antonio

    2016-11-01

    Several tools to facilitate the risk assessment and management of manufactured nanomaterials (MN) have been developed. Most of them require input data on physicochemical properties, toxicity and scenario-specific exposure information. However, such data are yet not readily available, and tools that can handle data gaps in a structured way to ensure transparent risk analysis for industrial and regulatory decision making are needed. This paper proposes such a quantitative risk prioritisation tool, based on a multi-criteria decision analysis algorithm, which combines advanced exposure and dose-response modelling to calculate margins of exposure (MoE) for a number of MN in order to rank their occupational risks. We demonstrated the tool in a number of workplace exposure scenarios (ES) involving the production and handling of nanoscale titanium dioxide, zinc oxide (ZnO), silver and multi-walled carbon nanotubes. The results of this application demonstrated that bag/bin filling, manual un/loading and dumping of large amounts of dry powders led to high emissions, which resulted in high risk associated with these ES. The ZnO MN revealed considerable hazard potential in vivo, which significantly influenced the risk prioritisation results. In order to study how variations in the input data affect our results, we performed probabilistic Monte Carlo sensitivity/uncertainty analysis, which demonstrated that the performance of the proposed model is stable against changes in the exposure and hazard input variables.

  17. 38 CFR 41.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.530 Criteria for... the cognizant or oversight agency for audit. (b) The auditor's opinions on the financial statements...

  18. 38 CFR 41.530 - Criteria for a low-risk auditee.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.530 Criteria for... the cognizant or oversight agency for audit. (b) The auditor's opinions on the financial statements...

  19. Application of National Emergency X-Ray Utilizations Study low-risk c-spine criteria in high-risk geriatric falls.

    PubMed

    Evans, Daniel; Vera, Luis; Jeanmonod, Donald; Pester, Jonathan; Jeanmonod, Rebecca

    2015-09-01

    We sought to validate National Emergency X-Radiography Utilizations Study low-risk cervical spine (C spine) criteria in a geriatric trauma population. We sought to determine whether patients' own baseline mental status (MS) could substitute for Glasgow Coma Scale (GCS) to meet the criteria "normal alertness." We further sought to refine the definition of "distracting injury." This is a retrospective review of geriatric fall patients presenting to a level 1 trauma center and triaged to the trauma bay. We queried our database from 2008 to 2013. Abstractors recorded GCS, deviation from baseline MS, midline neck tenderness, intoxication, focal deficit, signs of trauma, and presence of other injury. Patients were considered at baseline MS if specific documentation was present on the chart, or if their GCS was 15. Six hundred sixty elderly fall patients were trauma alerts during the study period. Seventeen were excluded for incomplete records/death before imaging, leaving 647. The median age was 81 (interquartile range, 74-87). Fifty patients (8.0%) had C spine or cord injury. Two hundred ninety-four (44.5%) had baseline MS (including GCS 13-15), no spine tenderness, no intoxication, and no focal neurologic deficit. Of these, 18 had C-spine injury. Using physical findings of head trauma as the only "distracting injury," no injury would have been missed (sensitivity, 100% [confidence interval, 91.1-100]; specificity, 14.2%). Our study suggests that National Emergency X-Radiography Utilizations Study can be safely applied in elderly fall patients who are at their personal baseline MS. Furthermore, our data support a more narrow definition of distracting injury to include only patients with signs of trauma to the head. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. 13 CFR 120.333 - Are there any special credit criteria?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... LOANS Special Purpose Loans Energy Conservation § 120.333 Are there any special credit criteria? In addition to regular credit evaluation criteria, SBA shall weigh the greater risk associated with energy projects. SBA shall consider such factors as quality of the product or service, technical qualifications of...

  1. 13 CFR 120.333 - Are there any special credit criteria?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... LOANS Special Purpose Loans Energy Conservation § 120.333 Are there any special credit criteria? In addition to regular credit evaluation criteria, SBA shall weigh the greater risk associated with energy projects. SBA shall consider such factors as quality of the product or service, technical qualifications of...

  2. 13 CFR 120.333 - Are there any special credit criteria?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... LOANS Special Purpose Loans Energy Conservation § 120.333 Are there any special credit criteria? In addition to regular credit evaluation criteria, SBA shall weigh the greater risk associated with energy projects. SBA shall consider such factors as quality of the product or service, technical qualifications of...

  3. 13 CFR 120.333 - Are there any special credit criteria?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... LOANS Special Purpose Loans Energy Conservation § 120.333 Are there any special credit criteria? In addition to regular credit evaluation criteria, SBA shall weigh the greater risk associated with energy projects. SBA shall consider such factors as quality of the product or service, technical qualifications of...

  4. 13 CFR 120.333 - Are there any special credit criteria?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... addition to regular credit evaluation criteria, SBA shall weigh the greater risk associated with energy... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Are there any special credit criteria? 120.333 Section 120.333 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS...

  5. Sensitivity and Specificity of Polysomnographic Criteria for Defining Insomnia

    PubMed Central

    Edinger, Jack D.; Ulmer, Christi S.; Means, Melanie K.

    2013-01-01

    Study Objectives: In recent years, polysomnography-based eligibility criteria have been increasingly used to identify candidates for insomnia research, and this has been particularly true of studies evaluating pharmacologic therapy for primary insomnia. However, the sensitivity and specificity of PSG for identifying individuals with insomnia is unknown, and there is no consensus on the criteria sets which should be used for participant selection. In the current study, an archival data set was used to test the sensitivity and specificity of PSG measures for identifying individuals with primary insomnia in both home and lab settings. We then evaluated the sensitivity and specificity of the eligibility criteria employed in a number of recent insomnia trials for identifying primary insomnia sufferers in our sample. Design: Archival data analysis. Settings: Study participants' homes and a clinical sleep laboratory. Participants: Adults: 76 with primary insomnia and 78 non-complaining normal sleepers. Measurements and Results: ROC and cross-tabs analyses were used to evaluate the sensitivity and specificity of PSG-derived total sleep time, latency to persistent sleep, wake after sleep onset, and sleep efficiency for discriminating adults with primary insomnia from normal sleepers. None of the individual criteria accurately discriminated PI from normal sleepers, and none of the criteria sets used in recent trials demonstrated acceptable sensitivity and specificity for identifying primary insomnia. Conclusions: The use of quantitative PSG-based selection criteria in insomnia research may exclude many who meet current diagnostic criteria for an insomnia disorder. Citation: Edinger JD; Ulmer CS; Means MK. Sensitivity and specificity of polysomnographic criteria for defining insomnia. J Clin Sleep Med 2013;9(5):481-491. PMID:23674940

  6. IMPORTANCE OF MULTIPLE CRITERIA FOR PRIORITY SETTING OF HIV/AIDS INTERVENTIONS.

    PubMed

    Tromp, Noor; Prawiranegara, Rozar; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-01-01

    This study describes the views of various stakeholders on the importance of different criteria for priority setting of HIV/AIDS interventions in Indonesia. Based on a general list of criteria and a focus group discussion with stakeholders (n = 6), a list was developed of thirty-two criteria that play a role in priority setting in HIV/AIDS control in West-Java province. Criteria were categorized according to the World Health Organization's health system goals and building block frameworks. People living with HIV/AIDS (n = 49), healthcare workers (HCW) (n = 41), the general population (n = 43), and policy makers (n = 22) rated the importance of thirty-two criteria on a 5-point Likert-scale. Thereafter, respondents ranked the highest rated criteria to express more detailed preferences. Stakeholders valued the following criteria as most important for the priority setting of HIV/AIDS interventions: an intervention's impact on the HIV/AIDS epidemic, reduction of stigma, quality of care, effectiveness on individual level, and feasibility in terms of current capacity of the health system (i.e., HCW, product, information, and service requirements), financial sustainability, and acceptance by donors. Overall, stakeholders' preferences for the importance of criteria are similar. Our study design outlines an approach for other settings to identify which criteria are important for priority setting of health interventions. For Indonesia, these study results may be used in priority setting processes for HIV/AIDS control and may contribute to more transparent and systematic allocation of resources.

  7. Human Factors Process Task Analysis Liquid Oxygen Pump Acceptance Test Procedure for the Advanced Technology Development Center

    NASA Technical Reports Server (NTRS)

    Diorio, Kimberly A.

    2002-01-01

    A process task analysis effort was undertaken by Dynacs Inc. commencing in June 2002 under contract from NASA YA-D6. Funding was provided through NASA's Ames Research Center (ARC), Code M/HQ, and Industrial Engineering and Safety (IES). The John F. Kennedy Space Center (KSC) Engineering Development Contract (EDC) Task Order was 5SMA768. The scope of the effort was to conduct a Human Factors Process Failure Modes and Effects Analysis (HF PFMEA) of a hazardous activity and provide recommendations to eliminate or reduce the effects of errors caused by human factors. The Liquid Oxygen (LOX) Pump Acceptance Test Procedure (ATP) was selected for this analysis. The HF PFMEA table (see appendix A) provides an analysis of six major categories evaluated for this study. These categories include Personnel Certification, Test Procedure Format, Test Procedure Safety Controls, Test Article Data, Instrumentation, and Voice Communication. For each specific requirement listed in appendix A, the following topics were addressed: Requirement, Potential Human Error, Performance-Shaping Factors, Potential Effects of the Error, Barriers and Controls, Risk Priority Numbers, and Recommended Actions. This report summarizes findings and gives recommendations as determined by the data contained in appendix A. It also includes a discussion of technology barriers and challenges to performing task analyses, as well as lessons learned. The HF PFMEA table in appendix A recommends the use of accepted and required safety criteria in order to reduce the risk of human error. The items with the highest risk priority numbers should receive the greatest amount of consideration. Implementation of the recommendations will result in a safer operation for all personnel.

  8. Temperament and Externalizing Behavior: Social Preference and Perceived Acceptance as Protective Factors

    PubMed Central

    Berdan, Louise E.; Keane, Susan P.; Calkins, Susan D.

    2009-01-01

    The purpose of this study was to explore the role of social preference and perceived acceptance as moderators of the relation between child temperament and externalizing behavior. Participants included 399 children evaluated at pre-kindergarten and kindergarten assessments. Pre-kindergarten children characterized by high temperamental Surgency/Extraversion were more likely to exhibit hyperactivity and aggression in the kindergarten classroom. In addition, kindergarten perceived acceptance and social preference moderated the relation between pre-kindergarten Surgency/Extraversion and kindergarten hyperactivity for girls only. Girls who were characterized by high temperamental Surgency/Extraversion, high perceived acceptance, and low social preference were at risk for higher levels of teacher-reported and peer-nominated hyperactivity. In contrast, accurately high perceived acceptance was a protective factor for high temperamental Surgency/Extraversion. Findings are discussed in terms of risk and protective factors for externalizing behavior. PMID:18605827

  9. Assessing Acceptability of Self-Sampling Kits, Prevalence, and Risk Factors for Human Papillomavirus Infection in American Indian Women.

    PubMed

    Winer, Rachel L; Gonzales, Angela A; Noonan, Carolyn J; Cherne, Stephen L; Buchwald, Dedra S

    2016-10-01

    We evaluated the feasibility and acceptability of self-sampling for human papillomavirus (HPV) testing and calculated the prevalence of and risk factors for high-risk (hr) HPV infections in a community-based sample of American Indian women. To this end, we recruited 329 Hopi women aged 21-65 years to self-collect vaginal samples for hrHPV testing. Samples were tested by polymerase chain reaction for 14 hrHPV genotypes. We used Chi square tests to identify correlates of preference for clinician Pap testing versus HPV self-sampling, and age-adjusted Poisson regression to evaluate correlates of hrHPV prevalence. We found that satisfaction with HPV self-sampling was high, with 96 % of women reporting that the sample was easy to collect and 87 % reporting no discomfort. The majority (62 %) indicated that they preferred HPV self-sampling to receiving a Pap test from a clinician. Preference for Pap testing over HPV self-sampling was positively associated with adherence to Pap screening and employment outside the home. All samples evaluated were satisfactory for HPV testing, and 22 % were positive for hrHPV. HrHPV prevalence peaked in the late 20 s and declined with increasing age. HrHPV positivity was inversely associated with having children living the household. In conclusion, HPV self-sampling is feasible and acceptable to Hopi women, and could be effective in increasing rates of cervical cancer screening in Hopi communities. HrHPV prevalence was similar to estimates in the general United States population.

  10. First Update of the Criteria for Certification of Chest Pain Units in Germany: Facelift or New Model?

    PubMed

    Breuckmann, Frank; Rassaf, Tienush

    2016-03-01

    In an effort to provide a systematic and specific standard-of-care for patients with acute chest pain, the German Cardiac Society introduced criteria for certification of specialized chest pain units (CPUs) in 2008, which have been replaced by a recent update published in 2015. We reviewed the development of CPU establishment in Germany during the past 7 years and compared and commented the current update of the certification criteria. As of October 2015, 228 CPUs in Germany have been successfully certified by the German Cardiac Society; 300 CPUs are needed for full coverage closing gaps in rural regions. Current changes of the criteria mainly affect guideline-adherent adaptions of diagnostic work-ups, therapeutic strategies, risk stratification, in-hospital timing and education, and quality measures, whereas the overall structure remained unchanged. Benchmarking by participation within the German CPU registry is encouraged. Even though the history is short, the concept of certified CPUs in Germany is accepted and successful underlined by its recent implementation in national and international guidelines. First registry data demonstrated a high standard of quality-of-care. The current update provides rational adaptions to new guidelines and developments without raising the level for successful certifications. A periodic release of fast-track updates with shorter time frames and an increase of minimum requirements should be considered.

  11. Diagnostic performance of various familial hypercholesterolaemia diagnostic criteria compared to Dutch lipid clinic criteria in an Asian population.

    PubMed

    Abdul-Razak, Suraya; Rahmat, Radzi; Mohd Kasim, Alicezah; Rahman, Thuhairah Abdul; Muid, Suhaila; Nasir, Nadzimah Mohd; Ibrahim, Zubin; Kasim, Sazzli; Ismail, Zaliha; Abdul Ghani, Rohana; Sanusi, Abdul Rais; Rosman, Azhari; Nawawi, Hapizah

    2017-10-16

    Familial hypercholesterolaemia (FH) is a genetic disorder with a high risk of developing premature coronary artery disease that should be diagnosed as early as possible. Several clinical diagnostic criteria for FH are available, with the Dutch Lipid Clinic Criteria (DLCC) being widely used. Information regarding diagnostic performances of the other criteria against the DLCC is scarce. We aimed to examine the diagnostic performance of the Simon-Broom (SB) Register criteria, the US Make Early Diagnosis to Prevent Early Deaths (US MEDPED) and the Japanese FH Management Criteria (JFHMC) compared to the DLCC. Seven hundered fifty five individuals from specialist clinics and community health screenings with LDL-c level ≥ 4.0 mmol/L were selected and diagnosed as FH using the DLCC, the SB Register criteria, the US MEDPED and the JFHMC. The sensitivity, specificity, efficiency, positive and negative predictive values of individuals screened with the SB register criteria, US MEDPED and JFHMC were assessed against the DLCC. We found the SB register criteria identified more individuals with FH compared to the US MEDPED and the JFHMC (212 vs. 105 vs. 195; p < 0.001) when assessed against the DLCC. The SB Register criteria, the US MEDPED and the JFHMC had low sensitivity (51.1% vs. 25.3% vs. 47.0% respectively). The SB Register criteria showed better diagnostic performance than the other criteria with 98.8% specificity, 28.6% efficiency value, 98.1% and 62.3% for positive and negative predictive values respectively. The SB Register criteria appears to be more useful in identifying positive cases leading to genetic testing compared to the JFHMC and US MEDPED in this Asian population. However, further research looking into a suitable diagnosis criterion with high likelihood of positive genetic findings is required in the Asian population including in Malaysia.

  12. Risk Assessment and Management for Medically Complex Potential Living Kidney Donors: A Few Deontological Criteria and Ethical Values

    PubMed Central

    Petrini, Carlo

    2011-01-01

    A sound evaluation of every bioethical problem should be predicated on a careful analysis of at least two basic elements: (i) reliable scientific information and (ii) the ethical principles and values at stake. A thorough evaluation of both elements also calls for a careful examination of statements by authoritative institutions. Unfortunately, in the case of medically complex living donors neither element gives clear-cut answers to the ethical problems raised. Likewise, institutionary documents frequently offer only general criteria, which are not very helpful when making practical choices. This paper first introduces a brief overview of scientific information, ethical values, and institutionary documents; the notions of “acceptable risk” and “minimal risk” are then briefly examined, with reference to the problem of medically complex living donors. The so-called precautionary principle and the value of solidarity are then discussed as offering a possible approach to the ethical problem of medically complex living donors. PMID:22174982

  13. Does Sufficient Evidence Exist to Support a Causal Association between Vitamin D Status and Cardiovascular Disease Risk? An Assessment Using Hill’s Criteria for Causality

    PubMed Central

    Weyland, Patricia G.; Grant, William B.; Howie-Esquivel, Jill

    2014-01-01

    Serum 25-hydroxyvitamin D (25(OH)D) levels have been found to be inversely associated with both prevalent and incident cardiovascular disease (CVD) risk factors; dyslipidemia, hypertension and diabetes mellitus. This review looks for evidence of a causal association between low 25(OH)D levels and increased CVD risk. We evaluated journal articles in light of Hill’s criteria for causality in a biological system. The results of our assessment are as follows. Strength of association: many randomized controlled trials (RCTs), prospective and cross-sectional studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Consistency of observed association: most studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors in various populations, locations and circumstances. Temporality of association: many RCTs and prospective studies found statistically significant inverse associations between 25(OH)D levels and CVD risk factors. Biological gradient (dose-response curve): most studies assessing 25(OH)D levels and CVD risk found an inverse association exhibiting a linear biological gradient. Plausibility of biology: several plausible cellular-level causative mechanisms and biological pathways may lead from a low 25(OH)D level to increased risk for CVD with mediators, such as dyslipidemia, hypertension and diabetes mellitus. Experimental evidence: some well-designed RCTs found increased CVD risk factors with decreasing 25(OH)D levels. Analogy: the association between serum 25(OH)D levels and CVD risk is analogous to that between 25(OH)D levels and the risk of overall cancer, periodontal disease, multiple sclerosis and breast cancer. Conclusion: all relevant Hill criteria for a causal association in a biological system are satisfied to indicate a low 25(OH)D level as a CVD risk factor. PMID:25184368

  14. Characteristics and Psychiatric Symptoms of Internet Gaming Disorder among Adults Using Self-Reported DSM-5 Criteria.

    PubMed

    Kim, Na Ri; Hwang, Samuel Suk-Hyun; Choi, Jung-Seok; Kim, Dai-Jin; Demetrovics, Zsolt; Király, Orsolya; Nagygyörgy, Katalin; Griffiths, Mark D; Hyun, So Yeon; Youn, Hyun Chul; Choi, Sam-Wook

    2016-01-01

    The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria. Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses. The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001). The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments.

  15. Characteristics and Psychiatric Symptoms of Internet Gaming Disorder among Adults Using Self-Reported DSM-5 Criteria

    PubMed Central

    Kim, Na Ri; Hwang, Samuel Suk-Hyun; Choi, Jung-Seok; Kim, Dai-Jin; Demetrovics, Zsolt; Király, Orsolya; Nagygyörgy, Katalin; Griffiths, Mark. D.; Hyun, So Yeon; Youn, Hyun Chul

    2016-01-01

    Objective The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria. Methods Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses. Results The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001). Conclusion The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments. PMID:26766947

  16. A stochastic multicriteria model for evidence-based decision making in drug benefit-risk analysis.

    PubMed

    Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L; Postmus, Douwe

    2011-05-30

    Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multi-criteria model that fully takes into account the evidence on efficacy and adverse drug reactions. Our approach is based on the stochastic multi-criteria acceptability analysis methodology, which allows us to compute the typical value judgments that support a decision, to quantify decision uncertainty, and to compute a comprehensive BR profile. We construct a multi-criteria model for the therapeutic group of second-generation antidepressants. We assess fluoxetine and venlafaxine together with placebo according to incidence of treatment response and three common adverse drug reactions by using data from a published study. Our model shows that there are clear trade-offs among the treatment alternatives. Copyright © 2011 John Wiley & Sons, Ltd.

  17. The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.

    PubMed

    Day, Melissa A; Thorn, Beverly E

    2016-04-01

    This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy). A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N=24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted. Pain acceptance emerged as a significant mediator of the group-interference relation (p<.05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p<.05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference. Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Key acceptability attributes of orodispersible films.

    PubMed

    Scarpa, Mariagiovanna; Paudel, Amrit; Kloprogge, Frank; Hsiao, Wen Kai; Bresciani, Massimo; Gaisford, Simon; Orlu, Mine

    2018-04-01

    The features rendering orodispersible films (ODFs) patient-centric formulations are widely discussed in the scientific literature. However there is a lack of research studies exploring ODF characteristics with a potential impact on end-user acceptability. The aim of this study was to identify the key ODF characteristics affecting end-user acceptability by developing in vitro test methods for the prediction of ODFs acceptability and correlate these formulation characteristics with the data obtained from a human panel study. Four drug-free single-polymer films were prepared by solvent casting. Solutions of poly(vinyl) alcohol (PVOH) 39 KDa (P1), PVOH 197 KDa (P2), carboxymethylcellulose (CMC) 395 KDa (C1), and CMC 725 KDa (C2) were prepared. Texture analysis and Dynamic Mechanical Analysis (DMA) were used to assess film tack. Petri dish and drop methods were used to assess disintegration time. A human panel of 24 healthy young adults was employed to identify end-user acceptability criteria of the four study film samples. Texture analysis data of ODF tack were not found to be in agreement with the in vivo perceived stickiness in the mouth. However, measurement of the area under the adhesive force curve obtained by DMA correlated with in vivo perceived stickiness data for all samples. The disintegration times obtained by drop method were more comparable to human panel data than the petri dish method. Hence DMA and drop methods proved to be promising methodologies for the prediction of the end-user acceptability. The type and molecular weight of the film-forming polymer had a strong influence on stickiness perception, whereas only polymeric molecular weight influenced perceived disintegration time. The human panel study showed that Participant Reported Outcomes (PROs) for the perceived stickiness in the mouth and disintegration time of test films received significantly different scores between samples, and thus were identified as the key attributes with the

  19. A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease.

    PubMed

    Colecchia, Antonio; Ravaioli, Federico; Marasco, Giovanni; Colli, Agostino; Dajti, Elton; Di Biase, Anna Rita; Bacchi Reggiani, Maria Letizia; Berzigotti, Annalisa; Pinzani, Massimo; Festi, Davide

    2018-05-03

    Recently, Baveno VI guidelines suggested that esophagogastroduodenoscopy (EGD) can be avoided in patients with compensated advanced chronic liver disease (cACLD) who have a liver stiffness measurement (LSM) <20 kPa and platelet count >150,000/mm 3 . We aimed to: assess the performance of spleen stiffness measurement (SSM) in ruling out patients with high-risk varices (HRV); validate Baveno VI criteria in a large population and assess how the sequential use of Baveno VI criteria and SSM could safely avoid the need for endoscopy. We retrospectively analyzed 498 patients with cACLD who had undergone LSM/SSM by transient elastography (TE) (FibroScan®), platelet count and EGDs from 2012 to 2016 referred to our tertiary centre. The new combined model was validated internally by a split-validation method, and externally in a prospective multicentre cohort of 115 patients. SSM, LSM, platelet count and Child-Pugh-B were independent predictors of HRV. Applying the newly identified SSM cut-off (≤46 kPa) or Baveno VI criteria, 35.8% and 21.7% of patients in the internal validation cohort could have avoided EGD, with only 2% of HRVs being missed with either model. The combination of SSM with Baveno VI criteria would have avoided an additional 22.5% of EGDs, reaching a final value of 43.8% spared EGDs, with <5% missed HRVs. Results were confirmed in the prospective external validation cohort, as the combined Baveno VI/SSM ≤46 model would have safely spared (0 HRV missed) 37.4% of EGDs, compared to 16.5% when using the Baveno VI criteria alone. A non-invasive prediction model combining SSM with Baveno VI criteria may be useful to rule out HRV and could make it possible to avoid a significantly larger number of unnecessary EGDs compared to Baveno VI criteria only. Spleen stiffness measurement assessed by transient elastography, the most widely used elastography technique, is a non-invasive technique that can help the physician to better stratify the degree of portal

  20. Application fuzzy multi-attribute decision analysis method to prioritize project success criteria

    NASA Astrophysics Data System (ADS)

    Phong, Nguyen Thanh; Quyen, Nguyen Le Hoang Thuy To

    2017-11-01

    Project success is a foundation for project owner to manage and control not only for the current project but also for future potential projects in construction companies. However, identifying the key success criteria for evaluating a particular project in real practice is a challenging task. Normally, it depends on a lot of factors, such as the expectation of the project owner and stakeholders, triple constraints of the project (cost, time, quality), and company's mission, vision, and objectives. Traditional decision-making methods for measuring the project success are usually based on subjective opinions of panel experts, resulting in irrational and inappropriate decisions. Therefore, this paper introduces a multi-attribute decision analysis method (MADAM) for weighting project success criteria by using fuzzy Analytical Hierarchy Process approach. It is found that this method is useful when dealing with imprecise and uncertain human judgments in evaluating project success criteria. Moreover, this research also suggests that although cost, time, and quality are three project success criteria projects, the satisfaction of project owner and acceptance of project stakeholders with the completed project criteria is the most important criteria for project success evaluation in Vietnam.

  1. ANALYTICAL METHODS NECESSARY TO IMPLEMENT RISK-BASED CRITERIA FOR CHEMICALS IN MUNICIPAL SLUDGE

    EPA Science Inventory

    The Ambient Water Quality Criteria that were promulgated by the U.S. Environmental Protection Agency in 1980 included water concentration levels which, for many pollutants, were so low as to be unmeasurable by standard analytical methods. Criteria for controlling toxics in munici...

  2. Halal stunning and slaughter: Criteria for the assessment of dead animals.

    PubMed

    Fuseini, Awal; Knowles, Toby G; Hadley, Phil J; Wotton, Steve B

    2016-09-01

    The debate surrounding the acceptability of stunning for Halal slaughter is one that is likely to linger. Compared to a couple of decades or so ago, one may argue that pre-slaughter stunning is becoming a popular practice during Halal slaughter due to the increasing number of Muslim-majority countries who continue to issue religious rulings (Fatwa) to approve the practice. Concerns have often, however been raised about the likelihood of some animals dying as a result of stunning and whether there are mechanisms in place to identify and remove dead animals stunned with irreversible techniques before their necks are cut. This paper reviews literature about what makes meat Halal, considers the arguments put forward by proponents and opponents of pre-slaughter stunning for Halal production and examines the criteria used by Halal Certification Bodies to identify and reject animals that may die as a result of irreversible stunning and considers the specific risks of waterbath stunning (for poultry) from a Halal viewpoint. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Multi-criteria decision making in flood risk management: research progress and the challenge of handling uncertainty and stakeholder participation

    NASA Astrophysics Data System (ADS)

    Madruga de Brito, Mariana; Evers, Mariele

    2016-04-01

    Multi-Criteria Decision Making (MCDM) methods have received much attention from researchers and practitioners for solving flood risk management problems in the last decades due to its capacity to deal with multiple criteria, conflicting objectives as well as the knowledge arising from the participation of several actors. In order to consolidate recent research conducted in this area, this study presents a state-of-the-art literature review of MCDM applications to flood risk management, seeking to provide a better understanding of the current status of how participatory MCDM is being conducted and the way uncertainties are included in the decision-making process. Totally, 128 peer-reviewed papers published from 1995 to June 2015 in 72 different journals were systematically analyzed. Results indicated that the number of flood MCDM publications has exponentially grown during this period, with over 82% of all papers published since 2009. A wide range of application areas was identified, with most papers focusing on ranking alternatives for flood mitigation (22.78% of the total) followed by risk (21.11%) and vulnerability assessment (15%). The Analytical Hierarchy Process (AHP) was the most popular MCDM method (42.72%) followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) (13.33%) and Weighted Sum Method (WSM) (12.73%). Although significant improvements have been made over the last decades, shortcomings remain in handling the uncertainty. Only eight papers (6.25%) have conducted uncertainty analysis, suggesting that a general procedure for performing it in MCDM does not yet exist. Researchers have applied the Monte Carlo simulation, Taylor's series error propagation method or assessed the uncertainty in qualitative ways, by describing its main sources or analyzing the stakeholders' degree of confidence. In addition, 35 articles (27.34%) have performed a sensitivity analysis of the criteria weights. Three distinct approaches were

  4. Extended criteria donors in liver transplantation: adapting donor quality and recipient.

    PubMed

    Gastaca, M

    2009-04-01

    Despite the progressive increase in the number of liver transplantations, the mortality on the waiting list remains between 5% and 10%, and patients have to deal with longer waiting periods. Facing this situation, transplant centers have developed alternatives to increase the number of grafts by accepting donors who were previously considered to be inadequate, because they are at higher risk of initial poor function and graft failure or may cause disease transmission. Currently, some marginal donors are being routinely used: elderly donors, steatotic grafts, non-heart-beating donors, hepatitis C virus-positive (HCV+) or hepatitis B core antibody-positive donors. These so-called marginal or extended-criteria donors were initially used in high-risk or urgent recipients; however, the number of marginal grafts has significantly increased, forcing the transplant community toward their more rationale use to maintain excellent results of liver transplantation. In this new scenario, the adequacy between donor and recipient may be paramount. Advanced donor age seems to be related to a greater graft failure rate in HCV+ recipients. Early survival seems to be significantly reduced when steatotic grafts are used in recipients with high Model for End-stage Liver Disease (MELD) scores. Moreover, a decreased survival has been observed among high-risk patients receiving organs from marginal donors. No benefit seems to exist when high-donor risk index grafts are transplanted into recipients with low MELD Scores. The recognition of various donor groups according to their quality and the need for good donor and recipient selection must lead us to define new policies for organ allocation of marginal grafts that may come into conflict with current policies of organ allocation according to the risk of death among patients awaiting a liver transplantation.

  5. Acceptable Interventions to Reduce Syphilis Transmission Among High-Risk Men Who Have Sex With Men in Los Angeles

    PubMed Central

    Plant, Aaron; Javanbakht, Marjan; Cross, John; Montoya, Jorge A.; Bolan, Robert; Kerndt, Peter R.

    2015-01-01

    Objectives. We examined perceptions of and attitudes toward existing and potential syphilis interventions, including case management and Web-based programs, to increase syphilis testing among high-risk men who have sex with men (MSM). Methods. Between October 2010 and June 2011, we conducted in-depth interviews with 19 MSM in Los Angeles, California, with repeat early syphilis infections (primary, secondary, and early latent syphilis) within the previous 5 years. We analyzed the interviews inductively to determine the most acceptable potential interventions. Results. Experiences with health department and community-based standard of care case management were generally positive. The most popular interventions among respondents included a Web site providing information on syphilis and syphilis testing, automated Web reminders to test, being paid to test, free online home testing kits, and preexposure prophylactic medication. Respondents’ beliefs that they would continue to practice high-risk sexual behaviors reinforced their reasons for wanting increased accessibility and convenient testing strategies. Conclusions. Public health officials should consider participant responses to potential interventions for syphilis, which suggest that high-risk MSM would consider testing more often or using other interventions. PMID:25602881

  6. Analysis of local acceptance of a radioactive waste disposal facility.

    PubMed

    Chung, Ji Bum; Kim, Hong-Kew; Rho, Sam Kew

    2008-08-01

    Like many other countries in the world, Korea has struggled to site a facility for radioactive waste for almost 30 years because of the strong opposition from local residents. Finally, in 2005, Gyeongju was established as the first Korean site for a radioactive waste facility. The objectives of this research are to verify Gyeongju citizens' average level of risk perception of a radioactive waste disposal facility as compared to other risks, and to explore the best model for predicting respondents' acceptance level using variables related to cost-benefit, risk perception, and political process. For this purpose, a survey is conducted among Gyeongju residents, the results of which are as follows. First, the local residents' risk perception of an accident in a radioactive waste disposal facility is ranked seventh among a total of 13 risks, which implies that nuclear-related risk is not perceived very highly by Gyeongju residents; however, its characteristics are still somewhat negative. Second, the comparative regression analyses show that the cost-benefit and political process models are more suitable for explaining the respondents' level of acceptance than the risk perception model. This may be the result of the current economic depression in Gyeongju, residents' familiarity with the nuclear industry, or cultural characteristics of risk tolerance.

  7. Final waste forms project: Performance criteria for phase I treatability studies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gilliam, T.M.; Hutchins, D.A.; Chodak, P. III

    1994-06-01

    This document defines the product performance criteria to be used in Phase I of the Final Waste Forms Project. In Phase I, treatability studies will be performed to provide {open_quotes}proof-of-principle{close_quotes} data to establish the viability of stabilization/solidification (S/S) technologies. This information is required by March 1995. In Phase II, further treatability studies, some at the pilot scale, will be performed to provide sufficient data to allow treatment alternatives identified in Phase I to be more fully developed and evaluated, as well as to reduce performance uncertainties for those methods chosen to treat a specific waste. Three main factors influence themore » development and selection of an optimum waste form formulation and hence affect selection of performance criteria. These factors are regulatory, process-specific, and site-specific waste form standards or requirements. Clearly, the optimum waste form formulation will require consideration of performance criteria constraints from each of the three categories. Phase I will focus only on the regulatory criteria. These criteria may be considered the minimum criteria for an acceptable waste form. In other words, a S/S technology is considered viable only if it meet applicable regulatory criteria. The criteria to be utilized in the Phase I treatability studies were primarily taken from Environmental Protection Agency regulations addressed in 40 CFR 260 through 265 and 268; and Nuclear Regulatory Commission regulations addressed in 10 CFR 61. Thus the majority of the identified criteria are independent of waste form matrix composition (i.e., applicable to cement, glass, organic binders etc.).« less

  8. [Diagnostic criteria and risk assessment of complications after gastric cancer surgery in western countries].

    PubMed

    Wu, Zhouqiao; Wang, Qi; Shi, Jinyao; Cherry, Koh; Desiderio, Jacopo; Li, Ziyu; Ji, Jiafu

    2017-02-25

    , consuming much effort and time. On top of that, standardization of the complication registration is of critical and practical importance. We encourage all centers to register complications with the diagnostic criteria and following intervention. Based on this, the Clavien-Dindo classification can be properly justified, which has been widely accepted by most centers and should be routinely used as the standard evaluation system for postoperative complications in gastric tumor surgery.

  9. CERISE, a French radioprotection code, to assess the radiological impact and acceptance criteria of installations for material handling, and recycling or disposal of very low-level radioactive waste

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Santucci, P.; Guetat, P.

    1993-12-31

    This document describes the code CERISE, Code d`Evaluations Radiologiques Individuelles pour des Situations en Enterprise et dans l`Environnement. This code has been developed in the frame of European studies to establish acceptance criteria of very low-level radioactive waste and materials. This code is written in Fortran and runs on PC. It calculates doses received by the different pathways: external exposure, ingestion, inhalation and skin contamination. Twenty basic scenarios are already elaborated, which have been determined from previous studies. Calculations establish the relation between surface, specific and/or total activities, and doses. Results can be expressed as doses for an average activitymore » unit, or as average activity limits for a set of reference doses (defined for each scenario analyzed). In this last case, the minimal activity values and the corresponding limiting scenarios, are selected and summarized in a final table.« less

  10. Engineering risk reduction in satellite programs

    NASA Technical Reports Server (NTRS)

    Dean, E. S., Jr.

    1979-01-01

    Methods developed in planning and executing system safety engineering programs for Lockheed satellite integration contracts are presented. These procedures establish the applicable safety design criteria, document design compliance and assess the residual risks where non-compliant design is proposed, and provide for hazard analysis of system level test, handling and launch preparations. Operations hazard analysis identifies product protection and product liability hazards prior to the preparation of operational procedures and provides safety requirements for inclusion in them. The method developed for documenting all residual hazards for the attention of program management assures an acceptable minimum level of risk prior to program deployment. The results are significant for persons responsible for managing or engineering the deployment and production of complex high cost equipment under current product liability law and cost/time constraints, have a responsibility to minimize the possibility of an accident, and should have documentation to provide a defense in a product liability suit.

  11. Risk factors and preventive interventions for Alzheimer disease: state of the science.

    PubMed

    Daviglus, Martha L; Plassman, Brenda L; Pirzada, Amber; Bell, Carl C; Bowen, Phyllis E; Burke, James R; Connolly, E Sander; Dunbar-Jacob, Jacqueline M; Granieri, Evelyn C; McGarry, Kathleen; Patel, Dinesh; Trevisan, Maurizio; Williams, John W

    2011-09-01

    Numerous studies have investigated risk factors for Alzheimer disease (AD). However, at a recent National Institutes of Health State-of-the-Science Conference, an independent panel found insufficient evidence to support the association of any modifiable factor with risk of cognitive decline or AD. To present key findings for selected factors and AD risk that led the panel to their conclusion. An evidence report was commissioned by the Agency for Healthcare Research and Quality. It included English-language publications in MEDLINE and the Cochrane Database of Systematic Reviews from 1984 through October 27, 2009. Expert presentations and public discussions were considered. Study inclusion criteria for the evidence report were participants aged 50 years and older from general populations in developed countries; minimum sample sizes of 300 for cohort studies and 50 for randomized controlled trials; at least 2 years between exposure and outcome assessment; and use of well-accepted diagnostic criteria for AD. Included studies were evaluated for eligibility and data were abstracted. Quality of overall evidence for each factor was summarized as low, moderate, or high. Diabetes mellitus, hyperlipidemia in midlife, and current tobacco use were associated with increased risk of AD, and Mediterranean-type diet, folic acid intake, low or moderate alcohol intake, cognitive activities, and physical activity were associated with decreased risk. The quality of evidence was low for all of these associations. Currently, insufficient evidence exists to draw firm conclusions on the association of any modifiable factors with risk of AD.

  12. Variations in microbicide gel acceptability among young women in the USA and Puerto Rico

    PubMed Central

    Giguere, Rebecca; Carballo-Diéguez, Alex; Ventuneac, Ana; Mabragaña, Marina; Dolezal, Curtis; Chen, Beatrice A.; Kahn, Jessica A.; Zimet, Gregory D.; McGowan, Ian

    2011-01-01

    In a multi-site study of vaginal microbicide acceptability conducted with sexually active young women, quantitative assessments revealed significant differences in acceptability by site. Participants in Puerto Rico rated the gel more favourably than mainland US participants in terms of liking the gel and likelihood of future use. To explain these differences, we examined responses to qualitative behavioural assessments. Young women in the mainland USA associated gel leakage with uncomfortable sensations experienced during menstruation, while young women in Puerto Rico had positive associations of gel use with douching. These negative or positive associations affected assessments of the gel’s physical qualities. In addition, young women’s perceptions of primary partners’ support for microbicide use influenced sexual satisfaction with the gel and, ultimately, product acceptability. Finally, geographic HIV risk context contributed to heightened HIV risk perception, which influenced likelihood of future microbicide use, even for women in stated monogamous relationships. Future microbicide acceptability studies should take into account potential differences in acceptability by site such as HIV risk perception based on local HIV prevalence, popularity of vaginal hygiene products in a specific area, and male attitudes in different cultures concerning women’s use of HIV protection strategies. PMID:22084840

  13. Acceptance and Avoidance Processes at Different Levels of Psychological Recovery from Enduring Mental Illness.

    PubMed

    Siqueira, Vinicius R; Oades, Lindsay G

    2015-01-01

    Objective. This study examined the use of psychological acceptance and experiential avoidance, two key concepts of Acceptance and Commitment Therapy (ACT), in the psychological recovery process of people with enduring mental illness. Method. Sixty-seven participants were recruited from the metropolitan, regional, and rural areas of New South Wales, Australia. They all presented some form of chronic mental illness (at least 12 months) as reflected in DSM-IV Axis I diagnostic criteria. The Acceptance and Action Questionnaire (AAQ-19) was used to measure the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) was used to examine the levels of psychological recovery; and the Scales of Psychological Well-Being was used to observe if there are benefits in utilizing psychological acceptance and experiential avoidance in the recovery process. Results. An analysis of objectively quantifiable measures found no clear correlation between the use of psychological acceptance and recovery in mental illness as measured by the RAS. The data, however, showed a relationship between psychological acceptance and some components of recovery, thereby demonstrating its possible value in the recovery process. Conclusion. The major contribution of this research was the emerging correlation that was observed between psychological acceptance and positive levels of psychological well-being among individuals with mental illness.

  14. Attitudes of belgian students of medicine, philosophy, and law toward euthanasia and the conditions for its acceptance.

    PubMed

    Roelands, Marc; Van den Block, Lieve; Geurts, Sylvie; Deliens, Luc; Cohen, Joachim

    2015-01-01

    Euthanasia is legal in Belgium if due care criteria are met, which is judged by committees including physicians, ethicists, and jurists. We examined whether students in these disciplines differ in how they judge euthanasia as an acceptable act. A cross-sectional, anonymous e-mail survey revealed that they have similar attitudes and accept its legalization. Therefore, joint decision-making of physicians, ethicists, and lawyers regarding euthanasia seems to have a common attitudinal base in Belgium. However, they differ to some extent regarding the conditions they put forward for euthanasia being acceptable. Philosophy of life (religion) was an independent predictor of these attitudes.

  15. Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

    PubMed

    Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

    2012-01-01

    The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

  16. US EPA - A*Star Partnership - Accelerating the Acceptance of ...

    EPA Pesticide Factsheets

    The path for incorporating new alternative methods and technologies into quantitative chemical risk assessment poses a diverse set of scientific challenges. Some of these challenges include development of relevant and predictive test systems and computational models to integrate and extrapolate experimental data, and rapid characterization and acceptance of these systems and models. The series of presentations will highlight a collaborative effort between the U.S. Environmental Protection Agency (EPA) and the Agency for Science, Technology and Research (A*STAR) that is focused on developing and applying experimental and computational models for predicting chemical-induced liver and kidney toxicity, brain angiogenesis, and blood-brain-barrier formation. In addressing some of these challenges, the U.S. EPA and A*STAR collaboration will provide a glimpse of what chemical risk assessments could look like in the 21st century. Presentation on US EPA – A*STAR Partnership at international symposium on Accelerating the acceptance of next-generation sciences and their application to regulatory risk assessment in Singapore.

  17. Willingness-to-accept and purchase genetically modified rice with high folate content in Shanxi Province, China.

    PubMed

    De Steur, H; Gellynck, X; Storozhenko, S; Liqun, G; Lambert, W; Van Der Straeten, D; Viaene, J

    2010-02-01

    Neural-tube defects (NTDs) are considered to be the most common congenital malformations. As Shanxi Province, a poor region in the North of China, has one of the highest reported prevalence rates of NTDs in the world, folate fortification of rice is an excellent alternative to low intake of folate acid pills in this region. This paper investigates the relations between socio-demographic indicators, consumer characteristics (knowledge, consumer perceptions on benefits, risks, safety and price), willingness-to-accept and willingness-to-pay genetically modified (GM) rice. The consumer survey compromises 944 face-to-face interviews with rice consumers in Shanxi Province, China. Multivariate analyses consist of multinomial logistic regression and multiple regression. The results indicate that consumers generally are willing-to-accept GM rice, with an acceptance rate of 62.2%. Acceptance is influenced by objective knowledge and consumers' perceptions on benefits and risks. Willingness-to-pay GM rice is influenced by objective knowledge, risk perception and acceptance. Communication towards the use of GM rice should target mainly improving knowledge and consumers' perceptions on high-risk groups within Shanxi Province, in particular low educated women. 2009 Elsevier Ltd. All rights reserved.

  18. Performing the lockout/tagout risk assessment.

    PubMed

    Wallace, W Jon

    2007-03-01

    Lockout/tagout provides the greatest level routine, repetitive, and integral to the production process, a risk assessment should be performed. If the task performed poses an unacceptable risk, acceptable risk reduction methods should be implemented to reduce the risk to acceptable levels.

  19. Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia.

    PubMed

    Malfuson, Jean-Valère; Etienne, Anne; Turlure, Pascal; de Revel, Thierry; Thomas, Xavier; Contentin, Nathalie; Terré, Christine; Rigaudeau, Sophie; Bordessoule, Dominique; Vey, Norbert; Gardin, Claude; Dombret, Hervé

    2008-12-01

    There is a need for standardization of treatment decisions in older patients with acute myeloid leukemia. The aim of the present study was to analyze the decisional value of poor risk factors in 416 elderly patients treated in the ALFA-9803 trial in order to derive a decisional index. Standard multivariate analysis was used to identify risk factors for overall survival. Risk factors were then considered as good decision tools if associated with a frequency >10% and a false positive rate <10% in predicting overall survival as poor as observed after low-dose cytarabine therapy (25% survival or less at 12 months). Among six independent risk factors (age, performance status, white blood cell count, hematopoietic cell transplantation comorbidity index, infection at baseline, and cytogenetics), cytogenetics was the only potent, independent decision tool. High hematopoietic cell transplantation comorbidity index scores or infections were found too rarely to guide further decisions. The three other factors (age, performance status, and white cell count) needed to be combined to provide a good specificity. The proposed decisional index, therefore, included high-risk cytogenetics and/or the presence of at least two of the following criteria: age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L. This simple two-class decisional index, which was validated in an independent patient set, enabled us to discriminate 100 patients (24%) who had an estimated overall survival of only 19% at 12 months, with a good 9% false positive rate. We propose waiting for cytogenetic information before making treatment decisions in elderly patients with acute myeloid leukemia. Those patients with unfavorable cytogenetics, as well as patients with at least two of the following features, age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L, should not be considered for standard intensive chemotherapy (ClinicalTrials.gov identifier

  20. Consumer acceptance of food crops developed by genome editing.

    PubMed

    Ishii, Tetsuya; Araki, Motoko

    2016-07-01

    One of the major problems regarding consumer acceptance of genetically modified organisms (GMOs) is the possibility that their transgenes could have adverse effects on the environment and/or human health. Genome editing, represented by the CRISPR/Cas9 system, can efficiently achieve transgene-free gene modifications and is anticipated to generate a wide spectrum of plants. However, the public attitude against GMOs suggests that people will initially be unlikely to accept these plants. We herein explored the bottlenecks of consumer acceptance of transgene-free food crops developed by genome editing and made some recommendations. People should not pursue a zero-risk bias regarding such crops. Developers are encouraged to produce cultivars with a trait that would satisfy consumer needs. Moreover, they should carefully investigate off-target mutations in resultant plants and initially refrain from agricultural use of multiplex genome editing for better risk-benefit communication. The government must consider their regulatory status and establish appropriate regulations if necessary. The government also should foster communication between the public and developers. If people are informed of the benefits of genome editing-mediated plant breeding and trust in the relevant regulations, and if careful risk-benefit communication and sincere considerations for the right to know approach are guaranteed, then such transgene-free crops could gradually be integrated into society.

  1. Criteria for choosing clinically effective glaucoma treatment: A discussion panel consensus

    PubMed Central

    Thygesen, John; Burk, Reinhard; Carassa, Roberto; Crichton, Andrew; Goñi, Francisco Javier; Menage, Mitch; Miglior, Stefano; Montgomery, Donald; Nordmann, John-Philippe; Roberts, Tim; Singh, Kuldev

    2007-01-01

    Abstract Background: In the clinical management of patients at risk for or diagnosed with primary open-angle glaucoma (POAG), the aim of medical treatment is to reduce intraocular pressure (IOP) and then maintain it over time at a level that preserves both the structure and function of the optic nerve. Objective: The objective of this report was to establish a consensus on the criteria that should be used to determine the characteristics of IOP-lowering medication. Methods: Discussion was held among a panel of 12 physicians considered to be experts in glaucoma to develop a consensus on the criteria used by them to determine the characteristics of the IOP-lowering medication chosen for initial monotherapy and adjunctive treatment of ocular hypertension (OHT) or POAG. Consensus development combined available evidence and the impressions of these physicians regarding the clinical effectiveness of IOP-lowering medication for OHT and POAG. Once the panel identified the criteria, the order of priority and the relative importance of these criteria were then established in the setting of 3 risk categories (low, medium, and high) for a patient to experience significant visual disability from glaucoma over their expected life span. Results: The panel identified 5 criteria to determine the characteristics of IOP-lowering medication for OHT and POAG: IOP-lowering effect, systemic adverse events (AEs), ocular tolerability, compliance/administration, and cost of treatment. IOP-lowering effect was consistently ranked as the highest priority and cost as the lowest. The priority of compliance/administration did not vary by clinical situation. Systemic AEs and ocular tolerability were ranked as higher priorities in initial monotherapy than in adjunctive treatment and ranked lower as the risk for visual disability increased. The priority given to the criteria used to determine clinical effectiveness varied both with the risk for functional vision loss from glaucoma and whether

  2. FDI World Dental Federation - clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples.

    PubMed

    Hickel, Reinhard; Peschke, Arnd; Tyas, Martin; Mjör, Ivar; Bayne, Stephen; Peters, Mathilde; Hiller, Karl-Anton; Randall, Ross; Vanherle, Guido; Heintze, Siegward D

    2010-08-01

    In 2007, new clinical criteria were approved by the FDI World Dental Federation and simultaneously published in three dental journals. The criteria were categorized into three groups: esthetic parameters (four criteria), functional parameters (six criteria), and biological parameters (six criteria). Each criterion can be expressed with five scores, three for acceptable and two for non-acceptable (one for reparable and one for replacement). The criteria have been used in several clinical studies since 2007, and the resulting experience in their application has led to a requirement to modify some of the criteria and scores. The two major alterations involve staining and approximal contacts. As staining of the margins and the surface have different causes, both phenomena do not appear simultaneously. Thus, staining has been differentiated into marginal staining and surface staining. The approximal contact now appears under the name "approximal anatomic form" as the approximal contour is a specific, often non-esthetic issue that cannot be integrated into the criterion "esthetic anatomical form". In 2008, a web-based training and calibration tool called e-calib (www.e-calib.info) was made available. Clinical investigators and other research workers can train and calibrate themselves interactively by assessing clinical cases of posterior restorations, which are presented as high quality pictures. Currently, about 300 clinical cases are included in the database which is regularly updated. Training for 8 of the 16 clinical criteria is available in the program: "Surface luster"; "Staining (surface, margins)"; "Color match and translucency"; "Esthetic anatomical form"; "Fracture of material and retention"; "Marginal adaptation"; "Recurrence of caries, erosion, abfraction"; and "Tooth integrity (enamel cracks, tooth fractures)". Typical clinical cases are presented for each of these eight criteria and their corresponding five scores.

  3. 38 CFR 41.525 - Criteria for Federal program risk.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... at low-risk. (2) The phase of a Federal program in its life cycle at the Federal agency may indicate... program in its life cycle at the auditee may indicate risk. For example, during the first and last years... section, to identify risk in Federal programs. Also, as part of the risk analysis, the auditor may wish to...

  4. Acceptance of prenatal diagnosis for genetic disorders in Lebanon.

    PubMed

    Zahed, L; Nabulsi, M; Bou-Ghanim, M; Usta, I

    1999-12-01

    Acceptance of prenatal diagnosis and termination of pregnancy in the case of an affected fetus may vary from one country to another, depending on the health system, religious belief, cultural and educational backgrounds of the population. Following a previous study on couples at risk for a haemoglobin disorder in Lebanon, we have here interviewed 90 couples at risk for a variety of genetic disorders, in order to assess their acceptance of prenatal diagnosis and the variables that might influence their choice. Overall, 54 per cent of couples said they would request diagnosis in their next pregnancy, while 26 per cent were opposed to such a procedure. In 87. 5 per cent of cases, the reason for refusal was because of religious conviction against termination of pregnancy. Refusal of prenatal diagnosis was also related to a lower socio-economic background and poorer education. Only 12 per cent of couples were properly aware of their genetic risk. Therefore, for prevention of genetic disorders, the emphasis in countries such as Lebanon has probably to be placed on public awareness about genetic risks, the risks of consanguinity, availability of services, while taking into consideration the personal beliefs of the individuals. Copyright 1999 John Wiley & Sons, Ltd.

  5. Assessing Abuse Risk beyond Self-Report: Analog Task of Acceptability of Parent-Child Aggression

    ERIC Educational Resources Information Center

    Rodriguez, Christina M.; Russa, Mary Bower; Harmon, Nancy

    2011-01-01

    Objectives: The present investigation reports on the development and initial validation of a new analog task, the Parent-Child Aggression Acceptability Movie Task (P-CAAM), intended to assess respondents' acceptance of parent-child aggression, including both physical discipline and physical abuse. Methods: Two independent samples were utilized to…

  6. Inclusion Criteria for NCI Cancer Genetics Services Directory

    Cancer.gov

    Professionals who provide services related to cancer genetics (cancer risk assessment, genetic counseling, genetic susceptibility testing, and others) must meet these criteria before applying to be listed in the National Cancer Institute's Cancer Genetics Services Directory.

  7. Designing a Software for Flood Risk Assessment Based on Multi Criteria Desicion Analysis and Information Diffusion Methods

    NASA Astrophysics Data System (ADS)

    Musaoglu, N.; Saral, A.; Seker, D. Z.

    2012-12-01

    Flooding is one of the major natural disasters not only in Turkey but also in all over the world and it causes serious damage and harm. It is estimated that of the total economic loss caused by all kinds of disasters, 40% was due to floods. In July 1995, the Ayamama Creek in Istanbul was flooded, the insurance sector received around 1,200 claims notices during that period, insurance companies had to pay a total of $40 million for claims. In 2009, the same creek was flooded again and killed 31 people over two days and insurance firms paid for damages around cost €150 million for claims. To solve these kinds of problems modern tools such as GIS and Remote Sensing should be utilized. In this study, a software was designed for the flood risk analysis with Analytic Hierarchy Process (AHP) and Information Diffusion( InfoDif) methods.In the developed sofware, five evaluation criterias were taken into account, which were slope, aspect, elevation, geology and land use which were extracted from the satellite sensor data. The Digital Elevation Model (DEM) of the Ayamama River Basin was acquired from the SPOT 5 satellite image with 2.5 meter spatial resolution. Slope and aspect values of the study basin were extracted from this DEM. The land use of the Ayamama Creek was obtained by performing object-oriented nearest neighbor classification method by image segmentation on SPOT 5 image dated 2010. All produced data were used as an input for the part of Multi Criteria Desicion Analysis (MCDA) method of this software. Criterias and their each sub criteras were weighted and flood vulnerability was determined with MCDA-AHP. Also, daily flood data was collected from Florya Meteorological Station, between 1975 to 2009 years and the daily flood peak discharge was calculated with the method of Soil Conservation Service-Curve Number (SCS-CN) and were used as an input in the software for the part of InfoDif.Obtained results were verified using ground truth data and it has been clearly

  8. Nanomaterials: certain aspects of application, risk assessment and risk communication.

    PubMed

    Laux, Peter; Tentschert, Jutta; Riebeling, Christian; Braeuning, Albert; Creutzenberg, Otto; Epp, Astrid; Fessard, Valérie; Haas, Karl-Heinz; Haase, Andrea; Hund-Rinke, Kerstin; Jakubowski, Norbert; Kearns, Peter; Lampen, Alfonso; Rauscher, Hubert; Schoonjans, Reinhilde; Störmer, Angela; Thielmann, Axel; Mühle, Uwe; Luch, Andreas

    2018-01-01

    Development and market introduction of new nanomaterials trigger the need for an adequate risk assessment of such products alongside suitable risk communication measures. Current application of classical and new nanomaterials is analyzed in context of regulatory requirements and standardization for chemicals, food and consumer products. The challenges of nanomaterial characterization as the main bottleneck of risk assessment and regulation are presented. In some areas, e.g., quantification of nanomaterials within complex matrices, the establishment and adaptation of analytical techniques such as laser ablation inductively coupled plasma mass spectrometry and others are potentially suited to meet the requirements. As an example, we here provide an approach for the reliable characterization of human exposure to nanomaterials resulting from food packaging. Furthermore, results of nanomaterial toxicity and ecotoxicity testing are discussed, with concluding key criteria such as solubility and fiber rigidity as important parameters to be considered in material development and regulation. Although an analysis of the public opinion has revealed a distinguished rating depending on the particular field of application, a rather positive perception of nanotechnology could be ascertained for the German public in general. An improvement of material characterization in both toxicological testing as well as end-product control was concluded as being the main obstacle to ensure not only safe use of materials, but also wide acceptance of this and any novel technology in the general public.

  9. Implementation of the 3Rs (refinement, reduction, and replacement): validation and regulatory acceptance considerations for alternative toxicological test methods.

    PubMed

    Schechtman, Leonard M

    2002-01-01

    Toxicological testing in the current regulatory environment is steeped in a history of using animals to answer questions about the safety of products to which humans are exposed. That history forms the basis for the testing strategies that have evolved to satisfy the needs of the regulatory bodies that render decisions that affect, for the most part, virtually all phases of premarket product development and evaluation and, to a lesser extent, postmarketing surveillance. Only relatively recently have the levels of awareness of, and responsiveness to, animal welfare issues reached current proportions. That paradigm shift, although sluggish, has nevertheless been progressive. New and alternative toxicological methods for hazard evaluation and risk assessment have now been adopted and are being viewed as a means to address those issues in a manner that considers humane treatment of animals yet maintains scientific credibility and preserves the goal of ensuring human safety. To facilitate this transition, regulatory agencies and regulated industry must work together toward improved approaches. They will need assurance that the methods will be reliable and the results comparable with, or better than, those derived from the current classical methods. That confidence will be a function of the scientific validation and resultant acceptance of any given method. In the United States, to fulfill this need, the Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) and its operational center, the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM), have been constituted as prescribed in federal law. Under this mandate, ICCVAM has developed a process and established criteria for the scientific validation and regulatory acceptance of new and alternative methods. The role of ICCVAM in the validation and acceptance process and the criteria instituted toward that end are described. Also

  10. The QUANTEC criteria for parotid gland dose and their efficacy to prevent moderate to severe patient-rated xerostomia.

    PubMed

    Beetz, Ivo; Steenbakkers, Roel J H M; Chouvalova, Olga; Leemans, Charles R; Doornaert, Patricia; van der Laan, Bernard F A M; Christianen, Miranda E M C; Vissink, Arjan; Bijl, Henk P; van Luijk, Peter; Langendijk, Johannes A

    2014-05-01

    Recently, the Quantitative Analysis of Normal Tissue Effect in the Clinic (QUANTEC) Group defined dose-volume constraints for the parotid glands to avoid severe xerostomia. The aim of this study was to determine if application of these QUANTEC criteria also protected against moderate-to-severe patient-rated xerostomia. The study population consisted of 307 head and neck cancer patients treated with primary (chemo)radiotherapy, either with 3D-CRT (56%) or with IMRT (44%). All patients participated in a standard follow-up program in which radiation-induced toxicity and quality of life were prospectively assessed. Patients who met the QUANTEC criteria were classified as low risk and otherwise as high risk. In total, 41% of the patients (treated with 3D-CRT and IMRT) were classified as low risk patients. In the group treated with 3D-CRT and IMRT, it was possible to meet the QUANTEC criteria in 47% and 32% of the patients, respectively. Sparing the parotid glands with IMRT was considerably more difficult in patients with lymph node metastases and in patients with nasopharyngeal and oropharyngeal tumours. Low risk patients reported significantly less moderate-to-severe xerostomia than high risk patients. However, the predicted risk of elderly patients and patients with pre-existing minor patient-rated xerostomia at baseline was > 20%, even when the QUANTEC criteria were met. Significantly lower rates of radiation-induced patient-rated xerostomia were found among low risk patients treated according to the QUANTEC criteria, but these criteria do not completely protect against xerostomia. Particularly in elderly patients and patients already suffering from minor xerostomia at baseline, the QUANTEC criteria do not sufficiently protect against persistent, moderate-to-severe patient-rated xerostomia.

  11. Acceptance of drinking and driving and alcohol-involved driving crashes in California.

    PubMed

    MacLeod, Kara E; Karriker-Jaffe, Katherine J; Ragland, David R; Satariano, William A; Kelley-Baker, Tara; Lacey, John H

    2015-08-01

    Alcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one's residential city) were related to individual-level perceptions and behavior. Using data from a 2012 cross-sectional roadside survey of 1147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving. A non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home. The present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of these crashes may serve as an

  12. Acceptance of drinking and driving and alcohol-involved driving crashes in California

    PubMed Central

    Karriker-Jaffe, Katherine J.; Ragland, David R.; Satariano, William A.; Kelley-Baker, Tara; Lacey, John H.

    2016-01-01

    Background Alcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one's residential city) were related to individual-level perceptions and behavior. Methods Using data from a 2012 cross-sectional roadside survey of 1,147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving. Results A non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home. Discussion The present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of

  13. Acceptability of reactors in space

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Buden, D.

    1981-04-01

    Reactors are the key to our future expansion into space. However, there has been some confusion in the public as to whether they are a safe and acceptable technology for use in space. The answer to these questions is explored. The US position is that when reactors are the preferred technical choice, that they can be used safely. In fact, it dies not appear that reactors add measurably to the risk associated with the Space Transportation System.

  14. Feasibility, Acceptability, and Preliminary Efficacy of a Live-Chat Social Media Intervention to Reduce HIV Risk Among Young Men Who Have Sex With Men

    PubMed Central

    Pachankis, John E.; Gamarel, Kristi E.; Surace, Anthony; Golub, Sarit A.; Parsons, Jeffrey T.

    2014-01-01

    Given the popularity of social media among young men who have sex with men (YMSM), and in light of YMSM’s elevated and increasing HIV rates, we tested the feasibility, acceptability and preliminary efficacy of a live chat intervention delivered on Facebook in reducing condomless anal sex and substance use within a group of high risk YMSM in a pre-post design with no control group. Participants (N = 41; 18–29 years old) completed up to eight one-hour motivational interviewing and cognitive behavioral skills-based online live chat intervention sessions, and reported on demographic, psychosocial, and behavioral characteristics at baseline and immediately post-intervention. Analyses indicated that participation in the intervention (n = 31) was associated with reductions of days of drug and alcohol use in the past month and instances of anal sex without a condom (including under the influence of substances), as well as increases in knowledge of HIV-related risks at 3-month follow-up. This pilot study argues for the potential of this social media-delivered intervention to reduce HIV risk among a most vulnerable group in the United States, in a manner that was highly acceptable to receive and feasible to execute. A future randomized controlled trial could generate an intervention blueprint for providers to support YMSM’s wellbeing by reaching them regardless of their geographical location, at a low cost. PMID:25256808

  15. Conversion to dementia in mild cognitive impairment diagnosed with DSM-5 criteria and with Petersen's criteria.

    PubMed

    Marcos, G; Santabárbara, J; Lopez-Anton, R; De-la-Cámara, C; Gracia-García, P; Lobo, E; Pírez, G; Menchón, J M; Palomo, T; Stephan, B C M; Brayne, C; Lobo, A

    2016-05-01

    In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

    PubMed Central

    McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

    2014-01-01

    Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there

  17. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

    PubMed

    McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

    2014-12-01

    The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference

  18. Risk in fire management decisionmaking: techniques and criteria

    Treesearch

    Gail Blatternberger; William F. Hyde; Thomas J. Mills

    1984-01-01

    In the past, decisionmaking in wildland fire management generally has not included a full consideration of the risk and uncertainty that is inherent in evaluating alternatives. Fire management policies in some Federal land management agencies now require risk evaluation. The model for estimating the economic efficiency of fire program alternatives is the minimization...

  19. Photovoltaic system criteria documents. Volume 6: Criteria for auditing photovoltaic system applications and experiments. Revision A

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1980-01-01

    The criteria is defined for auditing photovoltaic system applications and experiments. The purpose of the audit is twofold: to see if the application is meeting its stated objectives and to measure the application's progress in terms of the National Photovoltaic Program's goals of performance, cost, reliability, safety, and socio-environmental acceptance. The information obtained from an audit will be used to assess the status of an application and to provide the Department of Energy with recommendations on the future conduct of the application. Those aspects are covered of a site audit necessary to produce a systematic method for the gathering of qualitative and quantitative data to measure the success of an application. A sequence of audit events and guidelines for obtaining the required information is presented.

  20. [Cardiovascular Prevention: Acceptance of Enhanced Occupational Health Care].

    PubMed

    Bleckwenn, M; Theisel, N; Mücke, M; Steudel, H

    2016-06-17

    Background: To date, prevention efforts of company medical officers and general practitioners are largely independent of each other. In a comprehensive model of healthcare management including both sets of doctors, the company doctor should determine the risk of cardiovascular disease in the employees of the company. In case increased risk is detected, there should be exchange of information between the 2 professional groups so that common preventive interventions can be decided upon. Aim: The aim of this pilot study was to determine how well cardiovascular risk assessment is accepted by employees of a midsize company and where prevention is needed. Materials and Methods: In a company with 660 employees, risk analysis was conducted among staff in the context of regular preventive measures. In addition to risk factors, primary care, agreement with an interdisciplinary exchange of information and motivation for health promotion activities were investigated. Results: 204 employees (4 females only) were examined. The average age of the participants was 42.9±10.3 years. In 27% (n=55), an increased overall risk was present. Employees with risk requiring medical intervention were under the care of primary care physician and most of them (70%) agreed to the transfer of information to these physicians. In the survey itself, employees showed sufficient motivation (VAS 6.4±2.8) for workplace health promotion. Conclusion: The examined company agreed to implementing further health promoting activities. Due to demographic changes, new concepts for effective prevention are needed. The high acceptance of the proposed prevention framework should motivate implementation of this concept. As a next step, studies must be conducted to examine the effectiveness of screening for risk carried out by company medical officers. © Georg Thieme Verlag KG Stuttgart · New York.