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.

Life-time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low-risk drinking guidelines.

PubMed

Shield, Kevin D; Gmel, Gerrit; Gmel, Gerhard; Mäkelä, Pia; Probst, Charlotte; Room, Robin; Rehm, Jürgen

2017-09-01

Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization. The variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men. If low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision. © 2017 Society for the Study of Addiction.

Effect of the Fukushima nuclear accident on the risk perception of residents near a nuclear power plant in China

PubMed Central

Huang, Lei; Zhou, Ying; Han, Yuting; Hammitt, James K.; Bi, Jun; Liu, Yang

2013-01-01

We assessed the influence of the Fukushima nuclear accident (FNA) on the Chinese public’s attitude and acceptance of nuclear power plants in China. Two surveys (before and after the FNA) were administered to separate subsamples of residents near the Tianwan nuclear power plant in Lianyungang, China. A structural equation model was constructed to describe the public acceptance of nuclear power and four risk perception factors: knowledge, perceived risk, benefit, and trust. Regression analysis was conducted to estimate the relationship between acceptance of nuclear power and the risk perception factors while controlling for demographic variables. Meanwhile, we assessed the median public acceptable frequencies for three levels of nuclear events. The FNA had a significant impact on risk perception of the Chinese public, especially on the factor of perceived risk, which increased from limited risk to great risk. Public acceptance of nuclear power decreased significantly after the FNA. The most sensitive groups include females, those not in public service, those with lower income, and those living close to the Tianwan nuclear power plant. Fifty percent of the survey respondents considered it acceptable to have a nuclear anomaly no more than once in 50 y. For nuclear incidents and serious incidents, the frequencies are once in 100 y and 150 y, respectively. The change in risk perception and acceptance may be attributed to the FNA. Decreased acceptance of nuclear power after the FNA among the Chinese public creates additional obstacles to further development of nuclear power in China and require effective communication strategies. PMID:24248341

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.

A practical approach to risk-benefit estimation in pediatric drug research.

PubMed

Koren, Gideon

2015-02-01

One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

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…

Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

PubMed Central

Barzyk, Timothy M.; Wilson, Sacoby; Wilson, Anthony

2015-01-01

Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1) planning, scoping, and problem formulation; (2) risk analysis and ranking, and (3) risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels. PMID:25918910

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.

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.

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

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.

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.

Chemical Mixtures and Epidemiologic Fundamentals for Risk Assessment Applications

EPA Science Inventory

Risk management options are increasingly being considered early in the risk assessment process to help scope the considerations and bound the inherent complexities related to potential exposures, risk and future clean-up decisions (including acceptable pollutant levels) related t...

Defense in Depth: Foundation for Secure and Resilient IT Enterprises

DTIC Science & Technology

2006-09-01

Quantifying risk means understanding the possibility of the risk existing or coming to fruition. Here the home user attempts to measure the...Management Process of assessing and quantifying risk and establishing an acceptable level of risk for the organization Risk can be mitigated, but

Incorporating Bioaccessibility into Human Health Risk Assessment of Heavy Metals in Rice ( Oryza sativa L.): A Probabilistic-Based Analysis.

PubMed

Li, Tianyuan; Song, Yinxian; Yuan, Xuyin; Li, Jizhou; Ji, Junfeng; Fu, Xiaowen; Zhang, Qiang; Guo, Shuhai

2018-06-06

A systematic investigation into total and bioaccessible heavy metal concentrations in rice grains harvested from heavy metal-contaminated regions was carried out to assess the potential health risk to local residents. Arsenic, Cr, Cu, Pb, and Zn concentrations were within acceptable levels while Cd and Ni concentrations appeared to be much higher than in other studies. The bioaccessibity of As, Cd, and Ni was high (>25%) and could be well predicted from their total concentrations. The noncarcinogenic risk posed by As and Cd was significant. The carcinogenic risk posed by all bioaccessible heavy metals at the fifth percentile was 10-fold higher than the acceptable level, and Cd and Ni were the major contributors. The contribution of each metal to the combined carcinogenic risk indicates that taking pertinent precautions for different types of cancer, aimed at individuals with different levels of exposure to heavy metals, will greatly reduce morbidity and mortality rates.

[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.

GO/NO-GO - When is medical hazard mitigation acceptable for launch?

NASA Technical Reports Server (NTRS)

Hamilton, Douglas R.; Polk, James D.

2005-01-01

Medical support of spaceflight missions is composed of complex tasks and decisions that dedicated to maintaining the health and performance of the crew and the completion of mission objectives. Spacecraft represent one of the most complex vehicles built by humans, and are built to very rigorous design specifications. In the course of a Flight Readiness Review (FRR) or a mission itself, the flight surgeon must be able to understand the impact of hazards and risks that may not be completely mitigated by design alone. Some hazards are not mitigated because they are never actually identified. When a hazard is identified, it must be reduced or waivered. Hazards that cannot be designed out of the vehicle or mission, are usually mitigated through other means to bring the residual risk to an acceptable level. This is possible in most engineered systems because failure modes are usually predictable and analysis can include taking these systems to failure. Medical support of space missions is complicated by the inability of flight surgeons to provide "exact" hazard and risk numbers to the NASA engineering community. Taking humans to failure is not an option. Furthermore, medical dogma is mostly comprised of "medical prevention" strategies that mitigate risk by examining the behaviour of a cohort of humans similar to astronauts. Unfortunately, this approach does not lend itself well for predicting the effect of a hazard in the unique environment of space. This presentation will discuss how Medical Operations uses an evidence-based approach to decide if hazard mitigation strategies are adequate to reduce mission risk to acceptable levels. Case studies to be discussed will include: 1. Risk of electrocution risk during EVA 2. Risk of cardiac event risk during long and short duration missions 3. Degraded cabin environmental monitoring on the ISS. Learning Objectives 1.) The audience will understand the challenges of mitigating medical risk caused by nominal and off-nominal mission events. 2.) The audience will understand the process by which medical hazards are identified and mitigated before launch. 3.) The audience will understand the roles and responsibilities of all the other flight control positions in participating in the process of reducing hazards and reducing medical risk to an acceptable level.

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.

Understanding and avoiding potential problems in implementing automation

NASA Astrophysics Data System (ADS)

Rouse, W. B.; Morris, N. M.

1985-11-01

Technology-driven efforts to implement automation often encounter problems due to lack of acceptance or begrudging acceptance by the personnel involved. It is argued in this paper that the level of automation perceived by an individual heavily influences whether or not the automation is accepted by that individual. The factors that appear to affect perceived level of automation are discussed. Issues considered include the impact of automation on the system and the individual, correlates of acceptance, problems and risks of automation, and factors influencing alienation. Based on an understanding of these issues, a set of eight guidelines is proposed as a possible means of avoiding problems in implementing automation.

Understanding and avoiding potential problems in implementing automation

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Morris, N. M.

1985-01-01

Technology-driven efforts to implement automation often encounter problems due to lack of acceptance or begrudging acceptance by the personnel involved. It is argued in this paper that the level of automation perceived by an individual heavily influences whether or not the automation is accepted by that individual. The factors that appear to affect perceived level of automation are discussed. Issues considered include the impact of automation on the system and the individual, correlates of acceptance, problems and risks of automation, and factors influencing alienation. Based on an understanding of these issues, a set of eight guidelines is proposed as a possible means of avoiding problems in implementing automation.

Relationships among trust in messages, risk perception, and risk reduction preferences based upon avian influenza in Taiwan.

PubMed

Fang, David; Fang, Chen-Ling; Tsai, Bi-Kun; Lan, Li-Chi; Hsu, Wen-Shan

2012-08-01

Improvements in communications technology enable consumers to receive information through diverse channels. In the case of avian influenza, information repeated by the mass media socially amplifies the consumer awareness of risks. Facing indeterminate risks, consumers may feel anxious and increase their risk perception. When consumers trust the information published by the media, their uncertainty toward avian influenza may decrease. Consumers might take some actions to reduce risk. Therefore, this study focuses on relationships among trust in messages, risk perception and risk reduction preferences. This study administered 525 random samples and consumer survey questionnaires in different city of Taiwan in 2007. Through statistical analysis, the results demonstrate: (1) the higher the trust consumers have in messages about avian influenza, the lower their risk perceptions are; (2) the higher the consumers' risk perceptions are and, therefore, the higher their desired level of risk reductive, the more likely they are to accept risk reduction strategies; (3) consumer attributes such as age, education level, and marital status correlate with significant differences in risk perception and risk reduction preferences acceptance. Gender has significant differences only in risk reduction preferences and not in risk perception.

Relationships among Trust in Messages, Risk Perception, and Risk Reduction Preferences Based upon Avian Influenza in Taiwan

PubMed Central

Fang, David; Fang, Chen-Ling; Tsai, Bi-Kun; Lan, Li-Chi; Hsu, Wen-Shan

2012-01-01

Improvements in communications technology enable consumers to receive information through diverse channels. In the case of avian influenza, information repeated by the mass media socially amplifies the consumer awareness of risks. Facing indeterminate risks, consumers may feel anxious and increase their risk perception. When consumers trust the information published by the media, their uncertainty toward avian influenza may decrease. Consumers might take some actions to reduce risk. Therefore, this study focuses on relationships among trust in messages, risk perception and risk reduction preferences. This study administered 525 random samples and consumer survey questionnaires in different city of Taiwan in 2007. Through statistical analysis, the results demonstrate: (1) the higher the trust consumers have in messages about avian influenza, the lower their risk perceptions are; (2) the higher the consumers’ risk perceptions are and, therefore, the higher their desired level of risk reductive, the more likely they are to accept risk reduction strategies; (3) consumer attributes such as age, education level, and marital status correlate with significant differences in risk perception and risk reduction preferences acceptance. Gender has significant differences only in risk reduction preferences and not in risk perception. PMID:23066394

MULTI-MEDIA MICROBIOLOGICAL RISK ASSESSMENT METHODOLOGY FOR MUNICIPAL WASTEWATER SLUDGES

EPA Science Inventory

In order to reduce the risk of municipal sludge to acceptable levels, the U.S. EPA has undertaken a regulatory program based on risk assessment and risk management. The key to such a program is the development of a methodology which allows the regulatory agency to quantify the re...

How to Assess the Biomechanical Risk Levels in Beekeeping.

PubMed

Maina, G; Rossi, F; Baracco, A

2016-01-01

Beekeepers are at particular risk of developing work-related musculoskeletal disorders, but many of the studies lack detailed exposure assessment. To evaluate the biomechanical overload exposure in a specific farming activity, a multitasking model has been developed through the characterization of 37 basic operational tasks typical of the beekeeping activity. The Occupational Repetitive Actions (OCRA) Checklist and the National Institute for Occupational Safety and Health (NIOSH) Lifting Index methodologies have been applied to these elementary tasks to evaluate the exposure, and the resulting risk indices have been time-weighted averaged. Finally, an easy access, computer-assisted toolkit has been developed to help the beekeepers in the biomechanical risk assessment process. The risk of biomechanical overload for the upper limbs ranges from acceptable (maintenance and recovery of woody material and honey packaging with dosing machine tasks) to high (distribution of the top supers) risk level. The risk for back injury is always borderline in women and increases with exposure time, whereas it ranges from acceptable to borderline in men. The definition of the biomechanical risk levels allows for planning of corrective actions aimed at preventing and reducing the risk of musculoskeletal disorders through engineering, administrative, and behavioral interventions. The methodology can be used for risk assessment in other mainly manual agricultural activities.

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.

Rationales for regulatory activity

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

Perhac, R.M.

1997-02-01

The author provides an outline which touches on the types of concerns about risk evaluation which are addressed in the process of establishing regulatory guides. Broadly he says regulatory activity serves three broad constituents: (1) Paternalism (private risk); (2) Promotion of social welfare (public risks); (3) Protection of individual rights (public risks). He then discusses some of the major issues encountered in reaching a decision on what is an acceptable level of risk within each of these areas, and how one establishes such a level.

Do beef risk perceptions or risk attitudes have a greater effect on the beef purchase decisions of Canadian consumers?

PubMed

Yang, Jun; Goddard, Ellen

2011-01-01

Cluster analysis is applied in this study to group Canadian households by two characteristics, their risk perceptions and risk attitudes toward beef. There are some similarities in demographic profiles, meat purchases, and bovine spongiform encephalopathy (BSE) media recall between the cluster that perceives beef to be the most risky and the cluster that has little willingness to accept the risks of eating beef. There are similarities between the medium risk perception cluster and the medium risk attitude cluster, as well as between the cluster that perceives beef to have little risk and the cluster that is most willing to accept the risks of eating beef. Regression analysis shows that risk attitudes have a larger impact on household-level beef purchasing decisions than do risk perceptions for all consumer clusters. This implies that it may be more effective to undertake policies that reduce the risks associated with eating beef, instead of enhancing risk communication to improve risk perceptions. Only for certain clusters with higher willingness to accept the risks of eating beef might enhancing risk communication increase beef consumption significantly. The different role of risk perceptions and risk attitudes in beef consumption needs to be recognized during the design of risk management policies.

Accounting for risk and responsibility associated with smoking among mothers of children with respiratory illness.

PubMed

Coxhead, Lauren; Rhodes, Tim

2006-01-01

Contemporary public health discourses construct individuals as rational, responsible and knowledgeable, and thus promote a self-controlled prudent response to risk. In the context of evidence emphasising risks to children's health associated with passive smoking, mothers of children with respiratory illness may knowingly place their children at increased risk should they continue to smoke in their presence. Drawing on an analysis of depth qualitative interview accounts with mothers who smoke and whose young child was recently admitted to hospital with respiratory illness, this study describes mothers' constructions of risk and responsibility associated with their smoking. Three forms of accounting style were identified: 'stories of acceptability'; 'denial of agency'; and 'reflections of guilt'. 'Stories of acceptability' either positioned the risk of passive smoking as contained and controlled to an acceptable level, or disputed the level of risk that passive smoke posed. 'Denial of agency' drew on discourses of addiction and shared responsibility to exonerate the mother of responsibility or blame. 'Reflections of guilt' were presented when contradictions arose within accounts, particularly in relation to discussions of agency and rationality in decision-making. The study illustrates how constructions of moral responsibility, especially in relation to being a 'good mother', framed mothers' accounts of smoking in the face of risk. The study concludes that far greater consideration be given to the way in which mothers rationalise their smoking to others if paediatric doctors are to foster risk reduction practices associated with passive smoking more effectively.

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.

Increasing Small Satellite Reliability- A Public-Private Initiative

NASA Technical Reports Server (NTRS)

Johnson, Michael A.; Beauchamp, Patricia; Schone, Harald; Sheldon, Doug; Fuhrman, Linda; Sullivan, Erica; Fairbanks, Tom; Moe, Miquel; Leitner, Jesse

2017-01-01

At present, CubeSat components and buses are generally not appropriate for missions where significant risk of failure, or the inability to quantify risk or confidence, is acceptable. However, in the future we anticipate that CubeSats will be used for missions requiring reliability of 1-3 years for Earth-observing missions and even longer for Planetary, Heliophysics, and Astrophysics missions. Their growing potential utility is driving an interagency effort to improve and quantify CubeSat reliability, and more generally, small satellite mission risk. The Small Satellite Reliability Initiative (SSRI)—an ongoing activity with broad collaborative participation from civil, DoD, and commercial space systems providers and stakeholders—targets this challenge. The Initiative seeks to define implementable and broadly-accepted approaches to achieve reliability and acceptable risk postures associated with several SmallSat mission risk classes—from “do no harm” missions, to those associated with missions whose failure would result in loss or delay of key national objectives. These approaches will maintain, to the extent practical, cost efficiencies associated with small satellite missions and consider constraints associated with supply chain elements, as appropriate. The SSRI addresses this challenge from two architectural levels—the mission- or system-level, and the component- or subsystem-level. The mission- or system-level scope targets assessment approaches that are efficient and effective, with mitigation strategies that facilitate resiliency to mission or system anomalies while the component- or subsystem-level scope addresses the challenge at lower architectural levels. The initiative does not limit strategies and approaches to proven and traditional methodologies, but is focused on fomenting thought on novel and innovative solutions. This paper discusses the genesis of and drivers for this initiative, how the public-private collaboration is being executed, findings and recommendations derived to date, and next steps towards broadening small satellite mission potential.

Methods for Calculating Frequency of Maintenance of Complex Information Security System Based on Dynamics of Its Reliability

NASA Astrophysics Data System (ADS)

Varlataya, S. K.; Evdokimov, V. E.; Urzov, A. Y.

2017-11-01

This article describes a process of calculating a certain complex information security system (CISS) reliability using the example of the technospheric security management model as well as ability to determine the frequency of its maintenance using the system reliability parameter which allows one to assess man-made risks and to forecast natural and man-made emergencies. The relevance of this article is explained by the fact the CISS reliability is closely related to information security (IS) risks. Since reliability (or resiliency) is a probabilistic characteristic of the system showing the possibility of its failure (and as a consequence - threats to the protected information assets emergence), it is seen as a component of the overall IS risk in the system. As it is known, there is a certain acceptable level of IS risk assigned by experts for a particular information system; in case of reliability being a risk-forming factor maintaining an acceptable risk level should be carried out by the routine analysis of the condition of CISS and its elements and their timely service. The article presents a reliability parameter calculation for the CISS with a mixed type of element connection, a formula of the dynamics of such system reliability is written. The chart of CISS reliability change is a S-shaped curve which can be divided into 3 periods: almost invariable high level of reliability, uniform reliability reduction, almost invariable low level of reliability. Setting the minimum acceptable level of reliability, the graph (or formula) can be used to determine the period of time during which the system would meet requirements. Ideally, this period should not be longer than the first period of the graph. Thus, the proposed method of calculating the CISS maintenance frequency helps to solve a voluminous and critical task of the information assets risk management.

Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China.

PubMed

Turdi, Muyessar; Yang, Linsheng

2016-09-23

Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element-induced health risk (including for DW adults) was higher than acceptable (10(-6)) and lower than priority risk levels (10(-4)) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10(-4), higher than acceptable and priority risk levels (10(-4)).

Management of the volcanic crises of Galeras volcano: Social, economic and institutional aspects

NASA Astrophysics Data System (ADS)

Cardona, Omar D.

1997-05-01

This paper presents a summary of the institutional management of the volcanic hazard and risk in the areas that surround Galeras volcano, Colombia, during its recent activity. The social and economic problems discussed have stemmed from difficulties in forecasting the behavior of the volcano and the inadequate management of the warnings by various government bodies and the media. The Galeras situation had economic, social, and psychological effects that contributed to resistance in implementing mitigation measures. Furthermore, the political authorities were reluctant to accept the volcanic risk. At regional and local levels, certain business organizations and a large part of the population also were inadequately prepared to accept the risk, despite the effort and insistence at the national level to implement a volcano emergency preparedness plan.

Risk Reduction for Use of Complex Devices in Space Projects

NASA Technical Reports Server (NTRS)

Berg, Melanie; Poivey, Christian; Friendlich, Mark; Petrick, Dave; LaBel, Kenneth; Stansberry, Scott

2007-01-01

We present guidel!nes to reduce risk to an acceptable level when using complex devices in space applications. Application to Virtex 4 Field Programmable Gate Array (FPGA) on Express Logistic Carrier (ELC) project is presented.

Recent Advances and Future Challenges in Risk-Based Radiation Engineering

NASA Technical Reports Server (NTRS)

Pellish, Jonathan A.

2016-01-01

We cover a top-level introduction to hardness assurance (HA) from a robotic space system perspective, starting at the piece-part level. We discuss error sources inherent to presently-accepted HA practices and why they cause us to be risk-averse. We conclude by reviewing current proposals that move towards more risk-tolerant system design approaches as well as future challenges that will require these advanced techniques.

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.

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

DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

NASA Technical Reports Server (NTRS)

Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John

2011-01-01

The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

Risk assessment in the North Caucasus ski resorts

NASA Astrophysics Data System (ADS)

Komarov, Anton Y.; Seliverstov, Yury G.; Glazovskaya, Tatyana G.; Turchaninova, Alla S.

2016-10-01

Avalanches pose a significant problem in most mountain regions of Russia. The constant growth of economic activity, and therefore the increased avalanche hazard, in the North Caucasus region lead to demand for the development of large-scale avalanche risk assessment methods. Such methods are needed for the determination of appropriate avalanche protection measures as well as for economic assessments.The requirement of natural hazard risk assessments is determined by the Federal Law of the Russian Federation (Federal Law 21.12.1994 N 68-FZ, 2016). However, Russian guidelines (SNIP 11-02-96, 2013; SNIP 22-02-2003, 2012) are not clearly presented concerning avalanche risk assessment calculations. Thus, we discuss these problems by presenting a new avalanche risk assessment approach, with the example of developing but poorly researched ski resort areas. The suggested method includes the formulas to calculate collective and individual avalanche risk. The results of risk analysis are shown in quantitative data that can be used to determine levels of avalanche risk (appropriate, acceptable and inappropriate) and to suggest methods to decrease the individual risk to an acceptable level or better. The analysis makes it possible to compare risk quantitative data obtained from different regions, analyze them and evaluate the economic feasibility of protection measures.

The Department of Defense and the Power of Cloud Computing: Weighing Acceptable Cost Versus Acceptable Risk

DTIC Science & Technology

2016-04-01

the DOD will put DOD systems and data at a risk level comparable to that of their neighbors in the cloud. Just as a user browses a Web page on the...proxy servers for controlling user access to Web pages, and large-scale storage for data management. Each of these devices allows access to the...user to develop applications. Acunetics.com describes Web applications as “computer programs allowing Website visitors to submit and retrieve data

Bisphenol A and Risk Management Ethics

PubMed Central

Resnik, David B.; Elliot, Kevin C.

2013-01-01

It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low-dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low-dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values. PMID:24471646

Bisphenol A and risk management ethics.

PubMed

Resnik, David B; Elliott, Kevin C

2015-03-01

It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low-dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low-dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values. © 2014 John Wiley & Sons Ltd.

Space Radiation Risks for Astronauts on Multiple International Space Station Missions

PubMed Central

Cucinotta, Francis A.

2014-01-01

Mortality and morbidity risks from space radiation exposure are an important concern for astronauts participating in International Space Station (ISS) missions. NASA’s radiation limits set a 3% cancer fatality probability as the upper bound of acceptable risk and considers uncertainties in risk predictions using the upper 95% confidence level (CL) of the assessment. In addition to risk limitation, an important question arises as to the likelihood of a causal association between a crew-members’ radiation exposure in the past and a diagnosis of cancer. For the first time, we report on predictions of age and sex specific cancer risks, expected years of life-loss for specific diseases, and probability of causation (PC) at different post-mission times for participants in 1-year or multiple ISS missions. Risk projections with uncertainty estimates are within NASA acceptable radiation standards for mission lengths of 1-year or less for likely crew demographics. However, for solar minimum conditions upper 95% CL exceed 3% risk of exposure induced death (REID) by 18 months or 24 months for females and males, respectively. Median PC and upper 95%-confidence intervals are found to exceed 50% for several cancers for participation in two or more ISS missions of 18 months or longer total duration near solar minimum, or for longer ISS missions at other phases of the solar cycle. However, current risk models only consider estimates of quantitative differences between high and low linear energy transfer (LET) radiation. We also make predictions of risk and uncertainties that would result from an increase in tumor lethality for highly ionizing radiation reported in animal studies, and the additional risks from circulatory diseases. These additional concerns could further reduce the maximum duration of ISS missions within acceptable risk levels, and will require new knowledge to properly evaluate. PMID:24759903

Space radiation risks for astronauts on multiple International Space Station missions.

PubMed

Cucinotta, Francis A

2014-01-01

Mortality and morbidity risks from space radiation exposure are an important concern for astronauts participating in International Space Station (ISS) missions. NASA's radiation limits set a 3% cancer fatality probability as the upper bound of acceptable risk and considers uncertainties in risk predictions using the upper 95% confidence level (CL) of the assessment. In addition to risk limitation, an important question arises as to the likelihood of a causal association between a crew-members' radiation exposure in the past and a diagnosis of cancer. For the first time, we report on predictions of age and sex specific cancer risks, expected years of life-loss for specific diseases, and probability of causation (PC) at different post-mission times for participants in 1-year or multiple ISS missions. Risk projections with uncertainty estimates are within NASA acceptable radiation standards for mission lengths of 1-year or less for likely crew demographics. However, for solar minimum conditions upper 95% CL exceed 3% risk of exposure induced death (REID) by 18 months or 24 months for females and males, respectively. Median PC and upper 95%-confidence intervals are found to exceed 50% for several cancers for participation in two or more ISS missions of 18 months or longer total duration near solar minimum, or for longer ISS missions at other phases of the solar cycle. However, current risk models only consider estimates of quantitative differences between high and low linear energy transfer (LET) radiation. We also make predictions of risk and uncertainties that would result from an increase in tumor lethality for highly ionizing radiation reported in animal studies, and the additional risks from circulatory diseases. These additional concerns could further reduce the maximum duration of ISS missions within acceptable risk levels, and will require new knowledge to properly evaluate.

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.

Risk of predation makes foragers less choosy about their food.

PubMed

Charalabidis, Alice; Dechaume-Moncharmont, François-Xavier; Petit, Sandrine; Bohan, David A

2017-01-01

Animals foraging in the wild have to balance speed of decision making and accuracy of assessment of a food item's quality. If resource quality is important for maximizing fitness, then the duration of decision making may be in conflict with other crucial and time consuming tasks, such as anti-predator behaviours or competition monitoring. Individuals facing the risk of predation and/or competition should adjust the duration of decision making and, as a consequence, their level of choosiness for resources. When exposed to predation, the forager could either maintain its level of choosiness for food items but accept a reduction in the amount of food items consumed or it could reduce its level of choosiness and accept all prey items encountered. Under competition risk, individuals are expected to reduce their level of choosiness as slow decision making exposes individuals to a higher risk of opportunity costs. To test these predictions, the level of choosiness of a seed-eating carabid beetle, Harpalus affinis, was examined under 4 different experimental conditions of risk: i) predation risk; ii) intraspecific competition; iii) interspecific competition; and, iv) control. All the risks were simulated using chemical cues from individual conspecifics or beetles of different species that are predatory or granivorous. Our results show that when foraging under the risk of predation, H. affinis individuals significantly reduce their level of choosiness for seeds. Reductions in level of choosiness for food items might serve as a sensible strategy to reduce both the total duration of a foraging task and the cognitive load of the food quality assessment. No significant differences were observed when individuals were exposed to competition cues. Competition, (i.e opportunity cost) may not be perceived as risk high enough to induce changes in the level of choosiness. Our results suggest that considering the amount of items consumed, alone, would be a misleading metric when assessing individual response to a risk of predation. Foraging studies should therefore also take in account the decision making process.

Reliability Based Design for a Raked Wing Tip of an Airframe

NASA Technical Reports Server (NTRS)

Patnaik, Surya N.; Pai, Shantaram S.; Coroneos, Rula M.

2011-01-01

A reliability-based optimization methodology has been developed to design the raked wing tip of the Boeing 767-400 extended range airliner made of composite and metallic materials. Design is formulated for an accepted level of risk or reliability. The design variables, weight and the constraints became functions of reliability. Uncertainties in the load, strength and the material properties, as well as the design variables, were modeled as random parameters with specified distributions, like normal, Weibull or Gumbel functions. The objective function and constraint, or a failure mode, became derived functions of the risk-level. Solution to the problem produced the optimum design with weight, variables and constraints as a function of the risk-level. Optimum weight versus reliability traced out an inverted-S shaped graph. The center of the graph corresponded to a 50 percent probability of success, or one failure in two samples. Under some assumptions, this design would be quite close to the deterministic optimum solution. The weight increased when reliability exceeded 50 percent, and decreased when the reliability was compromised. A design could be selected depending on the level of risk acceptable to a situation. The optimization process achieved up to a 20-percent reduction in weight over traditional design.

Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China

PubMed Central

Turdi, Muyessar; Yang, Linsheng

2016-01-01

Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element–induced health risk (including for DW adults) was higher than acceptable (10−6) and lower than priority risk levels (10−4) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10−4, higher than acceptable and priority risk levels (10−4). PMID:27669274

Using estimated risk to develop stimulation strategies for induced seismicity in enhanced geothermal systems

NASA Astrophysics Data System (ADS)

Douglas, John; Aochi, Hideo

2014-05-01

Enhanced Geothermal Systems (EGS) are an attractive source of low-carbon electricity and heating. Consequently, a number of tests of this technology have been made during the past couple of decades and various projects are being planned or under development. EGS work by the injection of fluid into deep boreholes to increase permeability and hence allow the circulation and heating of fluid through a geothermal reservoir. Permeability is irreversibly increased by the shearing of pre-existing factures or fault segments, and hence by the generation of microseismicity. One aspect of this technology that can cause public concern and consequently could limit the widespread adoption of EGS within populated areas is the risk of generating earthquakes that are sufficiently large to be felt (or even to cause building damage). Therefore, there is a need to balance stimulation and exploitation of the geothermal reservoir by injecting fluids against the pressing requirement to keep the earthquake risk below an acceptable level. Current strategies to balance these potentially conflicting requirements rely on a traffic light system based on the observed magnitudes of the triggered earthquakes and the measured peak ground velocities from these events. Douglas and Aochi (Pageoph, 2014) propose an alternative system that uses the actual risk of generating felt (or damaging) earthquake ground motions at a site of interest (e.g. a nearby town) to control the injection rate. This risk is computed by combining characteristics of the observed seismicity rate of the previous six hours, with a (potentially site-specific) ground-motion prediction equation to obtain a real-time seismic hazard curve, and then the convolution of this with the derivative of a (potentially site-specific) fragility curve. Based on the relation between computed risk and pre-defined acceptable risk thresholds the injection is: increased (if the risk is below the amber level), decreased (if the risk is between amber and red levels) or stopped completely (if the risk is above the red level). Based on simulations using a recently developed model of induced seismicity in geothermal systems (Aochi et al., GJI, 2014), which is validated here using observations from the Basel EGS in 2006, it is shown that the proposed procedure could lead to both acceptable levels of risk and increased permeability.

What's the Denominator? A Lesson on Risk

ERIC Educational Resources Information Center

Dougherty, Michael J.; McInerney, Joseph D.

2009-01-01

Mathematics is at the heart of all science and is central to the interpretation of research findings in settings ranging from the clinical application of new medications to personal decisions about acceptable levels of risk. Unfortunately, many Americans, including most students, have a poor grasp of mathematics, and rational risk analysis is one…

Game On: Diminishing Risks for Depressive Symptoms in Early Adolescence through Positive Involvement in Team Sports

ERIC Educational Resources Information Center

Boone, Erin M.; Leadbeater, Bonnie J.

2006-01-01

While research shows that low levels of social acceptance and elevated body dissatisfaction increase risks for depressive symptoms among both girls and boys, little is known about protective factors that can mediate these risks. We test the hypothesis that positive team sports involvement mediates the effects of these risks on depression in a…

Health-risk based approach to setting drinking water standards for long-term space missions

NASA Technical Reports Server (NTRS)

Macler, Bruce A.; Dunsky, Elizabeth C.

1992-01-01

In order to develop plausible and appropriate drinking water contaminant standards for longer-term NASA space missions, such as those planned for the Space Exploration Initiative, a human health risk characterization was performed using toxicological and exposure values typical of space operations and crew. This risk characterization showed that the greatest acute waterborne health concern was from microbial infection leading to incapacitating gastrointestinal illness. Ingestion exposure pathways for toxic materials yielded de minimus acute health risks unlikely to affect SEI space missions. Risks of chronic health problems were within acceptable public health limits. Our analysis indicates that current Space Station Freedom maximum contamination levels may be unnecessarily strict. We propose alternative environmental contaminant values consistent with both acceptable short and long-term crew health safety.

Application of the risk assessment paradigm to the induction of allergic contact dermatitis.

PubMed

Felter, Susan P; Ryan, Cindy A; Basketter, David A; Gilmour, Nicola J; Gerberick, G Frank

2003-02-01

The National Academy of Science (NAS) risk assessment paradigm has been widely accepted as a framework for estimating risk from exposure to environmental chemicals (NAS, 1983). Within this framework, quantitative risk assessments (QRAs) serve as the cornerstone of health-based exposure limits, and have been used routinely for both cancer and noncancer endpoints. These methods have focused primarily on the extrapolation of data from laboratory animals to establish acceptable levels of exposure for humans. For health effects associated with a threshold, uncertainty and variability inherent in the extrapolation process is generally dealt with by the application of "uncertainty factors (UFs)." The adaptation of QRA methods to address skin sensitization is a natural and desirable extension of current practices. Based on our chemical, cellular and molecular understanding of the induction of allergic contact dermatitis, one can conduct a QRA using established methods of identifying a NOAEL (No Observed Adverse Effect Level) or other point of departure, and applying appropriate UFs. This paper describes the application of the NAS paradigm to characterize risks from human exposure to skin sensitizers; consequently, this method can also be used to establish an exposure level for skin allergens that does not present an appreciable risk of sensitization. Copyright 2003 Elsevier Science (USA)

Barriers to pediatricians' adherence to American Academy of Pediatrics oral health referral guidelines: North Carolina general dentists' opinions.

PubMed

Long, C Marshall; Quinonez, Rocio B; Rozier, R Gary; Kranz, Ashley M; Lee, Jessica Y

2014-01-01

The purposes of this study were to: (1) assess knowledge, attitudes, and behaviors of North Carolina general dentists (GDs) regarding American Academy of Pediatrics (AAP) dental referral guidelines; and (2) determine factors that influence pediatricians' ability to comply with AAP guidelines. One thousand GDs were surveyed to determine barriers toward acceptance of physician referrals of infants and toddlers. The primary outcome using ordered logistic regression was GDs' acceptance of children described in five case scenarios, with different levels of risk and oral health status. GDs believed pediatricians should refer patients at risk for caries to a dentist. While 61 to 75 percent of GDs were willing to accept low caries risk referrals of infants and toddlers, only 35 percent would accept referrals when caries was present. Predictors of referral acceptance were correct knowledge about AAP guidelines (OR=2.0, 95%CI=1.2-3.3), confidence in providing preventive care to infants and toddlers (OR=2.6, 95%CI=1.3-4.9), and agreement that parents see importance in dental referrals (OR=2.1, 95% CI=1.2-3.6). This study identified factors influencing acceptance of pediatrician referrals for the age one dental visit among North Carolina GDs and highlighted challenges pediatricians face in referring young children for dental care.

Serum Lipid Levels and Dyslipidaemia Prevalence among 2–10 Year-Old Northern Mexican Children

PubMed Central

Bibiloni, Maria del Mar; Salas, Rogelio; Novelo, Hilda I.; Villarreal, Jesús Z.; Sureda, Antoni; Tur, Josep A.

2015-01-01

Background and Aims The increase in overweight and obese children may be linked to increased rates of dyslipidaemia. The aim was to assess the prevalence of dyslipidaemia and associated risk factors among the Northern Mexican child population. Methods and Results Four hundred and fifty-one subjects aged between 2 and 10 (47.5% girls) took part in the Nuevo León State Survey of Nutrition and Health 2011–2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, serum lipid levels (mg/dL) were categorized into three subgroups (acceptable, borderline-high/low or high/low) as follows: TChol: acceptable <170, borderline-high 170–199, high ≥200; LDL-chol: acceptable <110, borderline-high 110–129, high ≥130; non-HDL-chol: acceptable <120, borderline-high 120–144, high ≥145; HDL-chol: acceptable >45, borderline-low 40–45, low <40; and TG: acceptable <75, borderline-high 75–99, high ≥100 in ≤9 year-old children, and acceptable <90, borderline-high 90–129, and high ≥130 in 10 year-old children. The overall prevalence of borderline-high + high TG, non-HDL-chol, TChol, and LDL-chol was 63.0%, 44.1%, 43.5%, and 29.9%, respectively. The overall prevalence of borderline-low + low HDL-chol was 46.3%. The overall frequency of dyslipidaemia was 54.3%. Thirteen children (2.9%) had all five symptoms of dyslipidaemia. The most common dyslipidaemia was high TG in combination (26.2%) and in isolation (10.6%). Conclusions Half of the children had at least one abnormal lipid concentration. A high TG level was the most frequent dyslipidaemia. Obesity was associated with the occurrence of at least one abnormal lipid level. These findings emphasize the need to pay further attention to the prevention of cardiovascular disease and obesity from an early age. PMID:25793380

Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

EPA Science Inventory

Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific metho...

Risk analysis of heavy metal concentration in surface waters across the rural-urban interface of the Wen-Rui Tang River, China.

PubMed

Qu, Liyin; Huang, Hong; Xia, Fang; Liu, Yuanyuan; Dahlgren, Randy A; Zhang, Minghua; Mei, Kun

2018-06-01

Heavy metal pollution is a major concern in China because of its serious effects on human health. To assess potential human health and ecological risks of heavy metal pollution, concentration data for seven heavy metals (As, Pb, Cd, Cr, Hg, Cu, Zn) from 14 sites spanning the rural-urban interface of the Wen-Rui Tang River watershed in southeast China were collected from 2000 to 2010. The heavy metal pollution index (HPI), hazard index (HI) and carcinogenic risk (CR) metrics were used to assess potential heavy metal risks. Further, we evaluated the uncertainty associated with the risk assessment indices using Monte Carlo analysis. Results indicated that all HPI values were lower than the critical level of 100 suggesting that heavy metal levels posed acceptable ecological risks; however, one site having an industrial point-source input reached levels of 80-97 on several occasions. Heavy metal concentrations fluctuated over time, and the decrease after 2007 is due to increased wastewater collection. The HI suggested low non-carcinogenic risk throughout the study period (HI < 1); however, nine sites showed CR values above the acceptable level of 10 -4 for potential cancer risk from arsenic in the early 2000s. Uncertainty analysis revealed an exposure risk for As at all sites because some CR values exceeded the 10 -4 level of concern; levels of Cd near an old industrial area also exceeded the Cd exposure standard (2.6% of CR values > 10 -4 ). While most metrics for human health risk did not exceed critical values for heavy metals, there is still a potential human health risk from chronic exposure to low heavy metal concentrations due to long-term exposure and potential metal interactions. Results of this study inform water pollution remediation and management efforts designed to protect public health in polluted urban area waterways common in rapidly developing regions. Copyright © 2018 Elsevier Ltd. All rights reserved.

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-category assignments for naturalistic risk markers were well correlated. "Approximate mappings" between markers and categories appeared stable. In Stage 4, the interface design incorporated the "approximate mappings"-yet also incorporated a "tuning phase," for measuring and recording individual differences. The interface can capture individual differences in risk perception on two key dimensions (frequency and severity)-viewed in dynamic, naturalistic scenarios, where risk levels are increased.

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

Risk perception of aquatic pollution originated from chemical industry clusters in the coastal area of Jiangsu province, China.

PubMed

Yao, Hong; Liu, Bo; You, Zhen; Zhao, Li

2018-02-01

According to "the Layout Scheme of the Chemical Industry in Jiangsu Province From 2016 to 2030" and "the Development Planning in the Coastal Area of Jiangsu Province, China," several chemical industry clusters will be located in the coastal area of Jiangsu province, China, and the risk of surface water pollution will be inevitably higher in the densely populated region. To get to know the risk acceptance level of the residents near the clusters, public perception was analyzed from the five risk factors: the basic knowledge about the pollution, the negative effects on aquatic environment imposed by the clusters, the positive effects brought by the clusters, the trust of controlling aquatic pollution, and the acceptance of the clusters. Twenty-four statements were screened out to describe the five factors, and about 600 residents were covered in three typical clusters surveyed. On the whole, the youth showed a higher interest on the survey, and middle-aged people were likely to be more concerned about aquatic pollution incident. There was no significant difference on risk perception of the three clusters. The respondents investigated had good knowledge background on aquatic pollution and the residents identified with the benefits brought by the clusters. They were weak in risk awareness of pollution originated from the chemical enterprises' groups. Although the respondents regarded that chemical industry clusters did not expose all points of pollutants' generation to the public, they inclined to trust the administration agencies on controlling the pollution and welcome the construction of chemical clusters in their dwelling cities. Besides, risk perception showed obvious spatial distribution. The closer were the samples' sites to the clusters and the rivers receiving pollutants, the higher were the residents' perceived risk, benefit, and trust. However, there was no identical spatial difference on risk acceptance, which might be comprehensively influenced by various factors. Demographic variables on diverse risk acceptance levels were further illustrated, and some useful conclusions might be provided for managing the response of residents to aquatic pollution and helping identify effective precautionary measures in the vicinity of chemical industry clusters.

Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force.

PubMed

Strehl, Cindy; Bijlsma, Johannes W J; de Wit, Maarten; Boers, Maarten; Caeyers, Nele; Cutolo, Maurizio; Dasgupta, Bhaskar; Dixon, William G; Geenen, Rinie; Huizinga, Tom W J; Kent, Alison; de Thurah, Annette Ladefoged; Listing, Joachim; Mariette, Xavier; Ray, David W; Scherer, Hans U; Seror, Raphaèle; Spies, Cornelia M; Tarp, Simon; Wiek, Dieter; Winthrop, Kevin L; Buttgereit, Frank

2016-06-01

There is convincing evidence for the known and unambiguously accepted beneficial effects of glucocorticoids at low dosages. However, the implementation of existing recommendations and guidelines on the management of glucocorticoid therapy in rheumatic diseases is lagging behind. As a first step to improve implementation, we aimed at defining conditions under which long-term glucocorticoid therapy may have an acceptably low level of harm. A multidisciplinary European League Against Rheumatism task force group of experts including patients with rheumatic diseases was assembled. After a systematic literature search, breakout groups critically reviewed the evidence on the four most worrisome adverse effects of glucocorticoid therapy (osteoporosis, hyperglycaemia/diabetes mellitus, cardiovascular diseases and infections) and presented their results to the other group members following a structured questionnaire for final discussion and consensus finding. Robust evidence on the risk of harm of long-term glucocorticoid therapy was often lacking since relevant study results were often either missing, contradictory or carried a high risk of bias. The group agreed that the risk of harm is low for the majority of patients at long-term dosages of ≤5 mg prednisone equivalent per day, whereas at dosages of >10 mg/day the risk of harm is elevated. At dosages between >5 and ≤10 mg/day, patient-specific characteristics (protective and risk factors) determine the risk of harm. The level of harm of glucocorticoids depends on both dose and patient-specific parameters. General and glucocorticoid-associated risk factors and protective factors such as a healthy lifestyle should be taken into account when evaluating the actual and future risk. 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/

[Pollution characteristics and health risk assessment of heavy metals in PM(2.5) in Lanzhou].

PubMed

Wei, Q Z; Li, S; Jia, Q; Luo, B; Su, L M; Liu, Q; Yuan, X R; Wang, Y H; Ruan, Y; Niu, J P

2018-06-06

Objective: To understand the pollution characteristics and assess the pollution health risks of heavy metals in atmospheric PM(2.5) in Lanzhou. Methods: According to the regional characteristics of air pollution and industrial distribution characteristics in Lanzhou, atmospheric PM(2.5) was sampled monthly in Chengguan and Xigu Districts from January, 2015 to December, 2016. Detected the concentration of PM(2.5) and 12 kinds of elements (Sb, Al, As, Be, Cd, Cr, Hg, Pb, Mn, Ni, Se and Tl) by weighing method and inductively coupled plasma mass spectrometry. Enrichment factor and geo-accumulation index were used to describe the pollution characteristics, while health risk assessment was conducted using the recommended United States Environmental Protection Agency (USA EPA) model. The health risks of non-carcinogens were evaluated by non-cancer hazard quotient (HQ), the non-carcinogenic risk was considered to be negligible when HQ<1, HQ>1 meant a health risk. With a single contaminant cancer Risk value to evaluate the health risks of carcinogens, when the Risk value between 10(-6) to10(-4) as an acceptable level. Results: The daily average concentrations of PM(2.5) was 83.0 μg/m(3), 77.0 μg/m(3) in Chengguan and Xigu Districts, respectively, during the sampling periods, and the concentration of PM(2.5) in winter/spring was higher than summer/fall in both districts. The concentration of Al in PM(2.5) was the highest and other elements in descending order: Pb, Mn, As, Sb/Cd, Tl in both districts. Enrichment factor results showed that Al and Mn were mainly affected by natural factors, the rest of five elements were all typical man-made pollution elements and according to geo-accumulation index pollution level of Cd was the strongest in the winter. The results of health risk assessment showed that Mn had the highest non-cancer risks (HQ>1) and affected the health of the children seriously. HQ reached up to 2.44 and 1.79 in Chengguan and Xigu Districts, respectively. Pb, As, Sb, Cd had slight health impact (HQ<1), could be negligible. The cancer risks range of As, Cr were 6.33×10(-6) to 6.46×10(-5) between the acceptable level of risk (10(-6) to 10(-4)), which indicated that As and Cd had potential cancer-risks. Conclusions: The pollution level of atmospheric PM(2.5) and the heavy metals in it was still grim;the non-cancer risks caused by multiple metals on children deserved attention. Although the cancer risks of As and Cd were between the acceptable level of risk, the potential cancer risk still shall not be ignored.

Effect of risk aversion on prioritizing conservation projects.

PubMed

Tulloch, Ayesha I T; Maloney, Richard F; Joseph, Liana N; Bennett, Joseph R; Di Fonzo, Martina M I; Probert, William J M; O'Connor, Shaun M; Densem, Jodie P; Possingham, Hugh P

2015-04-01

Conservation outcomes are uncertain. Agencies making decisions about what threat mitigation actions to take to save which species frequently face the dilemma of whether to invest in actions with high probability of success and guaranteed benefits or to choose projects with a greater risk of failure that might provide higher benefits if they succeed. The answer to this dilemma lies in the decision maker's aversion to risk--their unwillingness to accept uncertain outcomes. Little guidance exists on how risk preferences affect conservation investment priorities. Using a prioritization approach based on cost effectiveness, we compared 2 approaches: a conservative probability threshold approach that excludes investment in projects with a risk of management failure greater than a fixed level, and a variance-discounting heuristic used in economics that explicitly accounts for risk tolerance and the probabilities of management success and failure. We applied both approaches to prioritizing projects for 700 of New Zealand's threatened species across 8303 management actions. Both decision makers' risk tolerance and our choice of approach to dealing with risk preferences drove the prioritization solution (i.e., the species selected for management). Use of a probability threshold minimized uncertainty, but more expensive projects were selected than with variance discounting, which maximized expected benefits by selecting the management of species with higher extinction risk and higher conservation value. Explicitly incorporating risk preferences within the decision making process reduced the number of species expected to be safe from extinction because lower risk tolerance resulted in more species being excluded from management, but the approach allowed decision makers to choose a level of acceptable risk that fit with their ability to accommodate failure. We argue for transparency in risk tolerance and recommend that decision makers accept risk in an adaptive management framework to maximize benefits and avoid potential extinctions due to inefficient allocation of limited resources. © 2014 Society for Conservation Biology.

75 FR 24549 - Merchant Marine Act and Magnuson-Stevens Fishery Conservation and Management Act (Magnuson...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... interests in other collateral to bring credit risk to acceptable levels. Such guarantees or collateral may... level fishermen.'' IFQ financing is fishery specific, and individual Fishery Management Councils (FMCs... ``small vessels'' and ``entry level fishermen''). Under the legislation, the FFP cannot initiate or...

Community influences on intimate partner violence in India: Women's education, attitudes towards mistreatment and standards of living.

PubMed

Boyle, Michael H; Georgiades, Katholiki; Cullen, John; Racine, Yvonne

2009-09-01

Intimate partner violence (IPV) directed towards women is a serious public health problem. Women's education may offer protection against IPV, but uncertainty exists over how it might reduce risk for IPV at the community and individual levels. The objectives of this study are to: (1) disentangle community from individual-level influences of women's education on risk for IPV; (2) quantify the moderating influence of communities on individual-level associations between women's education and IPV; (3) determine if women's attitudes towards mistreatment and living standards at the community and individual levels account for the protective influence of women's education; and (4) determine if the protective influence of education against IPV is muted among women living in communities exhibiting attitudes more accepting of mistreatment. Study information came from 68,466 married female participants in the National Family Health Survey conducted throughout India in 1998-1999. Multilevel logistic regression was used to address the study objectives. IPV showed substantial clustering at both the state (10.2%) and community levels (11.5%). At the individual level, there was a strong non-linear association between women's education and IPV, partially accounted for by household living standards. The strength of association between women's education and IPV varied from one community to the next with evidence that the acceptance of mistreatment at the community level mutes the protective influence of higher education. Furthermore, women's attitudes towards mistreatment and their standards of living accounted for community-level associations between women's education and IPV. Place of residence accounted for substantial variation in risk of IPV and also modified individual-level associations between IPV and women's education. At the community level, women's education appeared to exert much of its protective influence by altering population attitudes towards the acceptability of mistreatment. However, there was no residual association between women's education and IPV at the community level once living standards are taken into account. While women's education provides strong, independent leverage for reducing the risk of IPV, planners must keep in mind important community factors that modify its protective influence.

Perspectives of decision-making and estimation of risk in populations exposed to low levels of ionizing radiations

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

Fabrikant, J.I.

1979-01-01

The setting of any permissible radiation level or guide remains essentially an arbitrary procedure. Based on the radiation risk estimates derived, any lack of precision does not minimize either the need for setting public health policies nor the conclusion that such risks are extremely small when compared with those avialable of alternative options, and those normally accepted by society as the hazards of everyday life. When compared with the benefits that society has established as goals derived from the necessary activities of medical care and energy production, it is apparent that society must establish appropriate standards and seek appropriate controllingmore » procedures which continue to assure that its needs are being met with the lowest possible risks. This implies continuing decision-making processes in which risk-benefit and cost-effectiveness assessments must be taken into account. Much of the practical information necessary for determination of radiation protection standards for public health policy is still lacking. It is now assumed that any exposure to radiaion at low levels of dose carries some risk of deleterious effects. However, how low this level may be, or the probability, or magnitude of the risk, still are not known. Radiation and the public health becomes a societal and political problem and not solely a scientific one. Our best scientific knowledge and our best scientific advice are essential for the protection of the public health, for the effective application of new technologies in medicine, and for guidance in the production of energy in industry. Unless man wishes to dispense with those activities which inevitably involve exposure to low levels of ionizing radiations, he must recognize that some degree of risk, however small, exists. In the evaluation of such risks from radiation, it is necessary to limit the radiation exposure to a level at which the risk is acceptable both to the individual and to society.« less

Evaluation of Levels, Sources and Health Hazards of Road-Dust Associated Toxic Metals in Jalalabad and Kabul Cities, Afghanistan.

PubMed

Jadoon, Waqar Azeem; Khpalwak, Wahdatullah; Chidya, Russel Chrispine Garven; Abdel-Dayem, Sherif Mohamed Mohamed Ali; Takeda, Kazuhiko; Makhdoom, Masood Arshad; Sakugawa, Hiroshi

2018-01-01

This study was designed to investigate selected road-dust associated heavy metals, their relations with natural and anthropogenic sources, and potential human and environmental health risks. For this purpose, 42 and 36 road-dusts samples were collected from Jalalabad and Kabul cities (Afghanistan), respectively. The following elements were found in descending concentrations: Mn, Zn, Pb, Ni, Cu, Cr, Co, and Cd in Jalalabad; and Mn, Zn, Ni, Cu, Cr, Pb, Co, and Cd in Kabul. Except for Ni, all the elemental contents were less than the Canadian permissible limits in residential/parkland soils. Principle Component Analysis and enrichment of Cd, Cu, Ni, Pb, and Zn pointed to anthropogenic sources, whereas Co, Cr, and Mn indicated crustal inputs. Broadly, Cd monomial risk index ([Formula: see text]) was considerable; however, one site each in both cities showed high risk ([Formula: see text] ≥ 350). The potential ecological risk (RI) is mostly low; however, at some sites, the risk was considerable. Ingestion appeared to be the main exposure route (99%) for heavy metals and contributed > 90% to noncancerous (all residents), as well as 92% (children) and 75-89% (adults) cancerous risks. The noncancerous risks of all metals and their integrated risks for all residents were within acceptable levels. Moreover, potential cancer risks in children from Ni and Cr were slightly higher than the US-EPA safe levels but were within acceptable levels for adults. This study found higher risks to children and therefore recommends proper management and ways to control metals pollution load in these areas to decrease human health and RIs.

[Application of ICP-mS in the health risk assessment of heavy metals for drinking water sources in reservoirs].

PubMed

Gao, Bo; Li, Qiang; Zhou, Huai-Dong; Gao, Ji-Jun; Zou, Xiao-Wen; Yong, Huang

2014-05-01

The six heavy metal concentrations (Cr, Cr, As, Cd, Cu, Zn and Pb) in water samples collected from five reservoirs of Liao River Basin were studied. The health risk assessment for heavy metals pollution in reservoirs was conducted based on the environmental health risk assessment model recommended by U. S. Environmental Protection Agency. The results showed that the average concentrations of Cr, Cu, Zn, As, Cd and Pb in five reservoirs of Liao River Basin were 3.36, 1.03, 2. 70, 1.23, 0. 02 and 0. 03 microg L-1, respectively. In fact, these heavy metals concentrations were obviously lower than the Standard of National Drinking Water in China (GB 5749-2006). The results also showed that the metal carcinogenic risk was relatively high in this region. The order of the risk level of carcinogenic metals was Cr>As>Cd. The highest carcinogenic risk was from Cr, with the risk for adults ranging from 4. 50 X 10(-5) approximately 7. 53 X 10(-5) a-1' and the risk for children ranging from 6. 29 X 10(-5) to 1. 05 X 10(-4) a-1. The health risk levels caused by non-carcinogenic metals ranging from 10-13 to 10(-10) a-1 were lower than the acceptable range suggested by International Commission on Radiological Protection (ICRP) and the order of the risk level of non-carcinogenic metals was Cu>Zn>Pb. The total health risk of heavy metals for adults ranging from 1. 07X 10(-4) to 1. 72X 10(-4) a-1 and for children ranging from 1. 49 X 10(-4) to 2. 40 X 10(-4) a-1 exceeded the accepted level of 5 X 10(-5) a-1 as suggested by ICRP. The health risk levels of carcinogenic metals were significantly higher than those of non-carcinogenic metals in the reservoirs for Liao River Basin.

Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

NASA Astrophysics Data System (ADS)

Kristina, S.; Wijaya, B. M.

2017-12-01

This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

Development of a pest risk analysis for Phytophthora ramorum for the European Union; the key deliverable from the EU-Funded project RAPRA

Treesearch

Claire Sansford; Alan Inman; Joan Webber

2010-01-01

Pest Risk Analysis (PRA) is an internationally recognized, structured process of determining whether plant pests and pathogens that are absent from a country or area could enter, establish, and cause an economic or environmental risk that is deemed unacceptable. PRA is also used to help identify phytosanitary measures to reduce risks to an acceptable level. United...

The role of maternal acceptance in the relation between community violence exposure and child functioning.

PubMed

Bailey, Beth Nordstrom; Hannigan, John H; Delaney-Black, Virginia; Covington, Chandice; Sokol, Robert J

2006-02-01

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that "buffer" or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.

[Pollution Evaluation and Risk Assessment of Heavy Metals from Atmospheric Deposition in the Parks of Nanjing].

PubMed

Wang, Cheng; Qian, Xin; Li, Hui-ming; Sun, Yi-xuan; Wang, Jin-hua

2016-05-15

Contents of heavy metals involving As, Cd, Cr, Cu, Ni, Pb and Zn from atmospheric deposition in 10 parks of Nanjing were analyzed. The pollution level, ecological risk and health risk were evaluated using Geoaccumulation Index, Potential Ecological Risk Index and the US EPA Health Risk Assessment Model, respectively. The results showed that the pollution levels of heavy metals in Swallow Rock Park, Swallow Rock Park and Mochou Lake Park were higher than the others. Compared to other cities such as Changchun, Wuhan and Beijing, the contents of heavy metals in atmospheric deposition of parks in Nanjing were higher. The evaluation results of Geoaccumulation Index showed that Pb was at moderate pollution level, Zn and Cu were between moderate and serious levels, while Cd was between serious and extreme levels. The ecological risk level of Cd was high. The assessment results of Health Risk Assessment Model indicated that there was no non-carcinogenic risk for all the seven heavy metals. For carcinogenic risk, the risks of Cd, Cr and Ni were all negligible (Risk < 1 x 10⁻⁶), whereas As had carcinogenic risk possibility but was considered to be acceptable (10⁻⁶ < Risk < 10⁻⁴).

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.

Investing: reducing risks to enhance returns.

PubMed

West, J; Glickman, S; Seidner, A G

1996-09-01

The financial assets of a healthcare organization can present many opportunities for investment. In order to develop a profitable investment program that avoids risky speculation, however, healthcare financial managers must fully understand the nature and risks of their organizations' investments. They must define and monitor their investment objectives, limitations, levels of acceptable risk and policies and conditions through a statement of investment policy and comprehensive investment guidelines.

Probabilistic framework for assessing the arsenic exposure risk from cooked fish consumption.

PubMed

Ling, Min-Pei; Wu, Chiu-Hua; Chen, Szu-Chieh; Chen, Wei-Yu; Chio, Chia-Pin; Cheng, Yi-Hsien; Liao, Chung-Min

2014-12-01

Geogenic arsenic (As) contamination of groundwater is a major ecological and human health problem in southwestern and northeastern coastal areas of Taiwan. Here, we present a probabilistic framework for assessing the human health risks from consuming raw and cooked fish that were cultured in groundwater As-contaminated ponds in Taiwan by linking a physiologically based pharmacokinetics model and a Weibull dose-response model. Results indicate that As levels in baked, fried, and grilled fish were higher than those of raw fish. Frying resulted in the greatest increase in As concentration, followed by grilling, with baking affecting the As concentration the least. Simulation results show that, following consumption of baked As-contaminated fish, the health risk to humans is <10(-6) excess bladder cancer risk level for lifetime exposure; as the incidence ratios of liver and lung cancers are generally acceptable at risk ranging from 10(-6) to 10(-4), the consumption of baked As-contaminated fish is unlikely to pose a significant risk to human health. However, contaminated fish cooked by frying resulted in significant health risks, showing the highest cumulative incidence ratios of liver cancer. We also show that males have higher cumulative incidence ratio of liver cancer than females. We found that although cooking resulted in an increase for As levels in As-contaminated fish, the risk to human health of consuming baked fish is nevertheless acceptable. We suggest the adoption of baking as a cooking method and warn against frying As-contaminated fish. We conclude that the concentration of contaminants after cooking should be taken into consideration when assessing the risk to human health.

Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health.

PubMed

Betancourt, Theresa S; Brennan, Robert T; Rubin-Smith, Julia; Fitzmaurice, Garrett M; Gilman, Stephen E

2010-06-01

To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (b = -0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance (b = 1.93). Psychosocial interventions for former child soldiers may be more effective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended. 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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.

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.

Health benefits and potential risks related to consumption of fish or fish oil.

PubMed

Sidhu, Kirpal S

2003-12-01

The nutritional benefits of fish consumption relate to the utilization of proteins of high biological value, as well as certain minerals and vitamins that fish provide. Fish or fish oil contains omega-3 polyunsaturated fatty acids (PUFAs) that appear to play several useful roles for human health. Conversely, some carcinogenic contaminants are also stored in the adipose tissue of fish. The objective of this paper is to evaluate the potential health benefits and risks related to the consumption of fish or fish oil. Health benefits related to the consumption of fish or omega-3 PUFAs were obtained by an extensive literature search. Potential health risks related to carcinogenic contaminants (e.g., dioxin, PCB, etc.) in fish were estimated using the U.S. EPA-approved cancer risk assessment guidelines. Potential health risk estimates were evaluated by comparing them with the acceptable excess risk level of 10(-6)-10(-4). Scientific data indicate that the consumption of fish or fish oil containing omega-3 PUFAs reduces the risk of coronary heart disease, decreases mild hypertension, and prevents certain cardiac arrhythmias and sudden death. Risk estimates in humans for carcinogenic environmental contaminants in fish ranged from an excess risk level of 3x10(-6)-9x10(-4). These risk estimates appeared to meet the acceptable excess risk level criteria. Therefore, consumption of fish in accordance with the State of Michigan Fish Advisory Guidelines is safe and should be encouraged. The top 11 fish species [e.g., sardines, mackerel, herring (Atlantic and Pacific), lake trout, salmon (Chinook, Atlantic, and Sockeye), anchovy (European), sablefish, and bluefish] provide an adequate amount of omega-3 PUFAs (2.7-7.5g/meal) and appear to meet the nutritional recommendation of the American Heart Association.

Longitudinal Relations Between Adolescent and Parental Behaviors, Parental Knowledge, and Internalizing Behaviors Among Urban Adolescents

PubMed Central

Garthe, Rachel C.; Sullivan, Terri; Kliewer, Wendy

2018-01-01

High prevalence rates of depression and anxiety among adolescents underscore the importance of identifying parental and adolescent behaviors that may lessen the risk for these outcomes. Previous research has shown that parental acceptance, parental knowledge, and child disclosure are negatively associated with internalizing behaviors. It is also important to explore the impact of internalizing behaviors on these parental and child constructs. The current study examined longitudinal relationships between parental acceptance, parental knowledge, child disclosure, and internalizing symptoms across a one-year time period. Participants were 358 adolescents (54 % female) and their primary caregivers, who were primarily African American (92 %). Parents and adolescents provided data through face-to-face interviews. Results showed that parental knowledge and parental acceptance predicted child disclosure, and child disclosure predicted parental knowledge one year later. Higher levels of parental acceptance predicted lower levels of adolescent-reported depressive symptoms, while higher levels of parental report of adolescents’ internalizing symptoms predicted lower levels of parental knowledge. No differences in the strength of these relationships were found across grade or gender. These findings highlight the role of the adolescent’s perceived acceptance by parents in promoting children’s disclosure, and the benefits of parental acceptance in decreasing depressive symptoms over time. Overall, these results show the impact that both adolescent and parental behaviors and internalizing behaviors have on each other across time. PMID:24609843

Risk assessment in the upstream crude oil supply chain: Leveraging analytic hierarchy process

NASA Astrophysics Data System (ADS)

Briggs, Charles Awoala

For an organization to be successful, an effective strategy is required, and if implemented appropriately the strategy will result in a sustainable competitive advantage. The importance of decision making in the oil industry is reflected in the magnitude and nature of the industry. Specific features of the oil industry supply chain, such as its longer chain, the complexity of its transportation system, its complex production and storage processes, etc., pose challenges to its effective management. Hence, understanding the risks, the risk sources, and their potential impacts on the oil industry's operations will be helpful in proposing a risk management model for the upstream oil supply chain. The risk-based model in this research uses a three-level analytic hierarchy process (AHP), a multiple-attribute decision-making technique, to underline the importance of risk analysis and risk management in the upstream crude oil supply chain. Level 1 represents the overall goal of risk management; Level 2 is comprised of the various risk factors; and Level 3 represents the alternative criteria of the decision maker as indicated on the hierarchical structure of the crude oil supply chain. Several risk management experts from different oil companies around the world were surveyed, and six major types of supply chain risks were identified: (1) exploration and production, (2) environmental and regulatory compliance, (3) transportation, (4) availability of oil, (5) geopolitical, and (6) reputational. Also identified are the preferred methods of managing risks which include; (1) accept and control the risks, (2) avoid the risk by stopping the activity, or (3) transfer or share the risks to other companies or insurers. The results from the survey indicate that the most important risk to manage is transportation risk with a priority of .263, followed by exploration/production with priority of .198, with an overall inconsistency of .03. With respect to major objectives the most preferred risk management policy option based on the result of the composite score is accept and control risk with a priority of .446, followed by transfer or share risk with a priority of .303. The least likely option is to terminate or forgo activity with a priority of .251.

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.

Commercial launch systems: A risky investment?

NASA Astrophysics Data System (ADS)

Dupnick, Edwin; Skratt, John

1996-03-01

A myriad of evolutionary paths connect the current state of government-dominated space launch operations to true commercial access to space. Every potential path requires the investment of private capital sufficient to fund the commercial venture with a perceived risk/return ratio acceptable to the investors. What is the private sector willing to invest? Does government participation reduce financial risk? How viable is a commercial launch system without government participation and support? We examine the interplay between various forms of government participation in commercial launch system development, alternative launch system designs, life cycle cost estimates, and typical industry risk aversion levels. The boundaries of this n-dimensional envelope are examined with an ECON-developed business financial model which provides for the parametric assessment and interaction of SSTO design variables (including various operational scenarios with financial variables including debt/equity assumptions, and commercial enterprise burden rates on various functions. We overlay this structure with observations from previous ECON research which characterize financial risk aversion levels for selected industrial sectors in terms of acceptable initial lump-sum investments, cumulative investments, probability of failure, payback periods, and ROI. The financial model allows the construction of parametric tradeoffs based on ranges of variables which can be said to actually encompass the ``true'' cost of operations and determine what level of ``true'' costs can be tolerated by private capitalization.

The Mars Project: Avoiding Decompression Sickness on a Distant Planet

NASA Astrophysics Data System (ADS)

Conkin, Johnny

2000-05-01

A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

The Mars Project: Avoiding Decompression Sickness on a Distant Planet

NASA Technical Reports Server (NTRS)

Conkin, Johnny

2000-01-01

A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda.

PubMed

Abramsky, Tanya; Devries, Karen; Kiss, Ligia; Nakuti, Janet; Kyegombe, Nambusi; Starmann, Elizabeth; Cundill, Bonnie; Francisco, Leilani; Kaye, Dan; Musuya, Tina; Michau, Lori; Watts, Charlotte

2014-07-31

Intimate partner violence (IPV) and HIV are important and interconnected public health concerns. While it is recognized that they share common social drivers, there is limited evidence surrounding the potential of community interventions to reduce violence and HIV risk at the community level. The SASA! study assessed the community-level impact of SASA!, a community mobilization intervention to prevent violence and reduce HIV-risk behaviors. From 2007 to 2012 a pair-matched cluster randomized controlled trial (CRT) was conducted in eight communities (four intervention and four control) in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, 18- to 49-years old, were undertaken at baseline (n = 1,583) and four years post intervention implementation (n = 2,532). Six violence and HIV-related primary outcomes were defined a priori. An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up. The intervention was associated with significantly lower social acceptance of IPV among women (adjusted risk ratio 0.54, 95% confidence interval (CI) 0.38 to 0.79) and lower acceptance among men (0.13, 95% CI 0.01 to 1.15); significantly greater acceptance that a woman can refuse sex among women (1.28, 95% CI 1.07 to 1.52) and men (1.31, 95% CI 1.00 to 1.70); 52% lower past year experience of physical IPV among women (0.48, 95% CI 0.16 to 1.39); and lower levels of past year experience of sexual IPV (0.76, 95% CI 0.33 to 1.72). Women experiencing violence in intervention communities were more likely to receive supportive community responses. Reported past year sexual concurrency by men was significantly lower in intervention compared to control communities (0.57, 95% CI 0.36 to 0.91). This is the first CRT in sub-Saharan Africa to assess the community impact of a mobilization program on the social acceptability of IPV, the past year prevalence of IPV and levels of sexual concurrency. SASA! achieved important community impacts, and is now being delivered in control communities and replicated in 15 countries. ClinicalTrials.gov #NCT00790959.

Low-level lead exposure and the prevalence of gout: an observational study.

PubMed

Krishnan, Eswar; Lingala, Bharathi; Bhalla, Vivek

2012-08-21

Blood lead levels (BLLs) less than 1.21 µmol/L (<25 µg/dL) among adults are considered acceptable by current national standards. Lead toxicity can lead to gouty arthritis (gout), but whether the low lead exposure in the contemporary general population confers risk for gout is not known. To determine whether BLLs within the range currently considered acceptable are associated with gout. Population-based cross-sectional study. The National Health and Nutrition Examination Survey for 2005 through 2008. 6153 civilians aged 40 years or older with an estimated glomerular filtration rate greater than 10 mL/min per 1.73 m2. Outcome variables were self-reported physician diagnosis of gout and serum urate level. Blood lead level was the principal exposure variable. Additional data collected were anthropometric measures, blood pressure, dietary purine intake, medication use, medical history, and serum creatinine concentration. The prevalence of gout was 6.05% (95% CI, 4.49% to 7.62%) among patients in the highest BLL quartile (mean, 0.19 µmol/L [3.95 µg/dL]) compared with 1.76% (CI, 1.10% to 2.42%) among those in the lowest quartile (mean, 0.04 µmol/L [0.89 µg/dL]). Each doubling of BLL was associated with an unadjusted odds ratio of 1.74 (CI, 1.47 to 2.05) for gout and 1.25 (CI, 1.12 to 1.40) for hyperuricemia. After adjustment for renal function, diabetes, diuretic use, hypertension, race, body mass index, income, and education level, the highest BLL quartile was associated with a 3.6-fold higher risk for gout and a 1.9-fold higher risk for hyperuricemia compared with the lowest quartile. Blood lead level does not necessarily reflect the total body lead burden. Blood lead levels in the range currently considered acceptable are associated with increased prevalence of gout and hyperuricemia.

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.

Impact of community engagement on public acceptance towards waste-to-energy incineration projects: Empirical evidence from China.

PubMed

Liu, Yong; Sun, Chenjunyan; Xia, Bo; Cui, Caiyun; Coffey, Vaughan

2018-06-01

As one of the most popular methods for the treatment of municipal solid waste (MSW), waste-to-energy (WTE) incineration offers effective solutions to deal with the MSW surge and globe energy issues. Nevertheless, the construction of WTE facilities faces considerable and strong opposition from local communities due to the perceived potential risks. The present study aims to understand whether, and how, community engagement improves local residents' public acceptance towards waste-to-energy (WTE) incineration facilities using a questionnaire survey conducted with nearby residents of two selected WTE incineration plants located in Zhejiang province, China. The results of data analysis using Structural Equation Modeling (SEM) reveal that firstly, a lower level of public acceptance exists among local residents of over the age of 35, of lower education levels, living within 3 km from the WTE Plant and from WTE incineration Plants which are under construction. Secondly, the public trust of local government and other authorities was positively associated with the public acceptance of the WTE incineration project, both directly and indirectly based on perceived risk. Thirdly, community engagement can effectively enhance public trust in local government and other authorities related to the WTE incineration project. The findings contribute to the literature on MSW treatment policy-making and potentially hazardous facility siting, by exploring the determinants of public acceptance towards WTE incineration projects. Copyright © 2018 Elsevier Ltd. All rights reserved.

How Safe Is Safe Enough for Self-Driving Vehicles?

PubMed

Liu, Peng; Yang, Run; Xu, Zhigang

2018-05-21

Self-driving vehicles (SDVs) promise to considerably reduce traffic crashes. One pressing concern facing the public, automakers, and governments is "How safe is safe enough for SDVs?" To answer this question, a new expressed-preference approach was proposed for the first time to determine the socially acceptable risk of SDVs. In our between-subject survey (N = 499), we determined the respondents' risk-acceptance rate of scenarios with varying traffic-risk frequencies to examine the logarithmic relationships between the traffic-risk frequency and risk-acceptance rate. Logarithmic regression models of SDVs were compared to those of human-driven vehicles (HDVs); the results showed that SDVs were required to be safer than HDVs. Given the same traffic-risk-acceptance rates for SDVs and HDVs, their associated acceptable risk frequencies of SDVs and HDVs were predicted and compared. Two risk-acceptance criteria emerged: the tolerable risk criterion, which indicates that SDVs should be four to five times as safe as HDVs, and the broadly acceptable risk criterion, which suggests that half of the respondents hoped that the traffic risk of SDVs would be two orders of magnitude lower than the current estimated traffic risk. The approach and these results could provide insights for government regulatory authorities for establishing clear safety requirements for SDVs. © 2018 Society for Risk Analysis.

An Evidenced-Based Approach for Estimating Decompression Sickness Risk in Aircraft Operations

NASA Technical Reports Server (NTRS)

Robinson, Ronald R.; Dervay, Joseph P.; Conkin, Johnny

1999-01-01

Estimating the risk of decompression Sickness (DCS) in aircraft operations remains a challenge, making the reduction of this risk through the development of operationally acceptable denitrogenation schedules difficult. In addition, the medical recommendations which are promulgated are often not supported by rigorous evaluation of the available data, but are instead arrived at by negotiation with the aircraft operations community, are adapted from other similar aircraft operations, or are based upon the opinion of the local medical community. We present a systematic approach for defining DCS risk in aircraft operations by analyzing the data available for a specific aircraft, flight profile, and aviator population. Once the risk of DCS in a particular aircraft operation is known, appropriate steps can be taken to reduce this risk to a level acceptable to the applicable aviation community. Using this technique will allow any aviation medical community to arrive at the best estimate of DCS risk for its specific mission and aviator population and will allow systematic reevaluation of the decisions regarding DCS risk reduction when additional data are available.

Willingness of Hong Kong healthcare workers to accept pre-pandemic influenza vaccination at different WHO alert levels: two questionnaire surveys

PubMed Central

Chor, Josette S Y; Ngai, Karry LK; Goggins, William B; Wong, Martin C S; Wong, Samuel Y S; Lee, Nelson; Leung, Ting-fan; Rainer, Timothy H; Griffiths, Sian

2009-01-01

Objective To assess the acceptability of pre-pandemic influenza vaccination among healthcare workers in public hospitals in Hong Kong and the effect of escalation in the World Health Organization’s alert level for an influenza pandemic. Design Repeated cross sectional studies using self administered, anonymous questionnaires Setting Surveys at 31 hospital departments of internal medicine, paediatrics, and emergency medicine under the Hong Kong Hospital Authority from January to March 2009 and in May 2009 Participants 2255 healthcare workers completed the questionnaires in the two studies. They were doctors, nurses, or allied health professionals working in the public hospital system. Main outcome measures Stated willingness to accept pre-pandemic influenza vaccination (influenza A subtypes H5N1 or H1N1) and its associating factors. Results The overall willingness to accept pre-pandemic H5N1 vaccine was only 28.4% in the first survey, conducted at WHO influenza pandemic alert phase 3. No significant changes in the level of willingness to accept pre-pandemic H5N1 vaccine were observed despite the escalation to alert phase 5. The willingness to accept pre-pandemic H1N1 vaccine was 47.9% among healthcare workers when the WHO alert level was at phase 5. The most common reasons for an intention to accept were “wish to be protected” and “following health authority’s advice.” The major barriers identified were fear of side effects and doubts about efficacy. More than half of the respondents thought nurses should be the first priority group to receive the vaccines. The strongest positive associating factors were history of seasonal influenza vaccination and perceived risk of contracting the infection. Conclusions The willingness to accept pre-pandemic influenza vaccination was low, and no significant effect was observed with the change in WHO alert level. Further studies are required to elucidate the root cause of the low intention to accept pre-pandemic vaccination. PMID:19706937

Source apportionment and health risk assessment of heavy metals in soil for a township in Jiangsu Province, China.

PubMed

Jiang, Yanxue; Chao, Sihong; Liu, Jianwei; Yang, Yue; Chen, Yanjiao; Zhang, Aichen; Cao, Hongbin

2017-02-01

Human activities contribute greatly to heavy metal pollution in soils. Concentrations of 15 metal elements were detected in 105 soil samples collected from a typical rural-industrial town in southern Jiangsu, China. Among them, 7 heavy metals-lead, copper, zinc, arsenic, chromium, cadmium, and nickel-were considered in the health risk assessment for residents via soil inhalation, dermal contact, and/or direct/indirect ingestion. Their potential sources were quantitatively apportioned by positive matrix factorization using the data set of all metal elements, in combination with geostatistical analysis, land use investigation, and industrial composition analysis. Furthermore, the health risks imposed by sources of heavy metal in soil were estimated for the first time. The results indicated that Cr, Cu, Cd, Pb, Ni, and Co accumulated in the soil, attaining a mild pollution level. The total hazard index values were 3.62 and 6.11, and the total cancer risks were 9.78 × 10 -4 and 4.03 × 10 -4 for adults and children, respectively. That is, both non-carcinogenic and carcinogenic risks posed by soil metals were above acceptable levels. Cr and As require special attention because the health risks of Cr and As individually exceeded the acceptable levels. The ingestion of homegrown produce was predominantly responsible for the high risks. The potential sources were apportioned as: a) waste incineration and textile/dyeing industries (28.3%), b) natural sources (45.4%), c) traffic emissions (5.3%), and d) electroplating industries and livestock/poultry breeding (21.0%). Health risks of four sources accounted for 23.5%, 32.7%, 7.4%, and 36.4% of the total risk, respectively. Copyright © 2016. Published by Elsevier Ltd.

Crisis Management for Biobanks.

PubMed

Parry-Jones, Alison; Hansen, Jarle; Simeon-Dubach, Daniel; Bjugn, Roger

2017-06-01

All organizations are subject to risk and uncertainty. Adverse events may disrupt normal organizational activity and may even cause complete failure of business operations. Biorepositories are also at risk and there have been instances where multiple samples or entire collections have been destroyed. Biobank guidelines accordingly recommend the establishment of contingency plans to reduce risk to an acceptable level. In this review article, we will use general theory on risk management and illustrate how such principles can be used to establish a practical crisis management plan for any biobank organization.

Contamination and risk of heavy metals in soils and sediments from a typical plastic waste recycling area in North China.

PubMed

Tang, Zhenwu; Zhang, Lianzhen; Huang, Qifei; Yang, Yufei; Nie, Zhiqiang; Cheng, Jiali; Yang, Jun; Wang, Yuwen; Chai, Miao

2015-12-01

Plastic wastes are increasingly being recycled in many countries. However, available information on the metals released into the environment during recycling processes is rare. In this study, the contamination features and risks of eight heavy metals in soils and sediments were investigated in Wen'an, a typical plastic recycling area in North China. The surface soils and sediments have suffered from moderate to high metal pollution and in particular, high Cd and Hg pollution. The mean concentrations of Cd and Hg were 0.355 and 0.408 mg kg(-1), respectively, in the soils and 1.53 and 2.10 mg kg(-1), respectively, in the sediments. The findings suggested that there is considerable to high potential ecological risks in more than half of the soils and high potential ecological risk in almost all sediments. Although the health risk levels from exposure to soil metals were acceptable for adults, the non-carcinogenic risks to local children exceeded the acceptable level. Source assessment indicated that heavy metals in soils and sediments were mainly derived from inputs from poorly controlled plastic waste recycling operations in this area. The results suggested that the risks associated with heavy metal pollution from plastic waste recycling should be of great concern. Copyright © 2015 Elsevier Inc. All rights reserved.

76 FR 27030 - Intent To Prepare a Supplemental Environmental Impact Statement for the Indianapolis, White River...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... performance standards nor does it provide the level of protection for which the project was authorized. A full... consideration of all alternatives, the best plan will be selected to achieve acceptable risk levels. FOR FURTHER... identified alternatives, especially aesthetics, communities, economics, biological and cultural resources...

Health risk assessment of phthalate esters (PAEs) in drinking water sources of China.

PubMed

Wang, Wen-Long; Wu, Qian-Yuan; Wang, Chao; He, Tao; Hu, Hong-Ying

2015-03-01

Phthalate esters (PAEs) with endocrine disruption effects and carcinogenicity are widely detected in water environment. Occurrences of PAEs in source water and removal efficiencies of PAEs by drinking water treatment plants (DWTPs) in China were surveyed from publications in the last 10 years. Concentration of diethylhexyl phthalate (DEHP) in source water with median value of 1.3 μg/L was higher than that of dimethyl phthalate (DMP), diethyl phthalate (DEP), and di-n-butyl phthalate (DnBP). If the removal efficiencies of DEHP and DnBP reached 60 and 90 %, respectively, the calculated PAE concentration in drinking water can generally meet Standards for Drinking Water Quality in China. The health risks of PAEs, including non-carcinogenic and carcinogenic risks via the "water source-DWTP-oral ingestion/dermal permeation" pathway, were evaluated with Monte Carlo simulation and sensitivity analysis under certain removal efficiencies from 0 to 95 %. The carcinogenic risk of DEHP was lower than the upper acceptable carcinogenic risk level (10(-4)), while the probability of DEHP's carcinogenic risk between lower (10(-6)) and upper (10(-4)) acceptable carcinogenic risk level decreased from about 21.2 to 0.4 % through increasing DEHP removal efficiency from 0 to 95 %. The non-carcinogenic risk of DEHP was higher than that of DEP and DnBP. In all cases, the total non-carcinogenic risk of DEP, DnBP, and DEHP was lower than 1, indicating that there would be unlikely incremental non-carcinogenic risk to humans. Both carcinogenic risk and non-carcinogenic risk of PAEs in drinking water to female were a little higher than those to male.

Work Physiology Evaluation of Laundry Workers

NASA Astrophysics Data System (ADS)

Sari, A. D.; Suryoputro, M. R.; Pramaningtyas, M. D.; Putra, P. S.; Maulidyawati, S. B.

2016-01-01

This study aimed to assess cardiovascular strain during laundry operations in terms of physical workload, based on heart rate changes and level of pain complaints. Researchers measured resting and working heart rates and calculated cardiovascular load (%CVL), cardiovascular strain (%CVS), reserve heart rate (%RHR), energy expenditure, oxygen consumption, and measure level of pain complain in 6 laundry workers using Nordic Body Map questionnaire (NBM). Based on the result of %CVL and %CVS, the work in laundry was classified as acceptable level. Similarly, a high-level category was recorded for %RHR in moderate of energy expenditure. However, there are very pain level complain for hand using NBM questionnaire. Thus, there is a need to redesign the work content of equipment used and keep the physical workload in acceptable level, as this will increase their productivity and reduce their health risk.

My Family Medical History and Me: A pilot feasibility study of a cardiovascular risk reduction intervention

PubMed Central

Imes, Christopher C.; Lewis, Frances M.; Austin, Melissa A.; Dougherty, Cynthia M.

2014-01-01

Objective Evaluate the feasibility and acceptability of a behaviorally-focused intervention designed to increase perceived cardiovascular disease (CVD) and coronary heart disease (CHD) risk in young adults with a family history (FH) of CVD/CHD. Design Single group, pre-post-test design. Sample Fifteen, mostly female (n=13, 86.7%), White, young adults (mean age 20.8 years) with a minimum of a high school education with a FH of CVD/CHD. Measurements Feasibility examined the recruitment strategy, study procedures, appropriateness and quality of the study instruments, and problems that occurred during delivery of the intervention. Acceptability examined participants' engagement in the in person sessions and at home exercises and their feedback about the intervention. Intervention Two, in person sessions provided personalized, tailored messages about ten-year and lifetime CHD risk based on risk factors, FH from a three-generation pedigree, lipid levels, blood pressure, and smoking status, and brief counseling about how to engage in a healthy lifestyle to decrease CVD/CHD risk. Results The intervention was feasible and acceptable. Participants requested more information on healthy food choices, including which foods to avoid and which exercises most improve cardiovascular health. Conclusions Although requiring refinement, the intervention has potential public health implications and deserves further testing. PMID:24840334

Grid Inertial Response-Based Probabilistic Determination of Energy Storage System Capacity Under High Solar Penetration

DOE PAGES

Yue, Meng; Wang, Xiaoyu

2015-07-01

It is well-known that responsive battery energy storage systems (BESSs) are an effective means to improve the grid inertial response to various disturbances including the variability of the renewable generation. One of the major issues associated with its implementation is the difficulty in determining the required BESS capacity mainly due to the large amount of inherent uncertainties that cannot be accounted for deterministically. In this study, a probabilistic approach is proposed to properly size the BESS from the perspective of the system inertial response, as an application of probabilistic risk assessment (PRA). The proposed approach enables a risk-informed decision-making processmore » regarding (1) the acceptable level of solar penetration in a given system and (2) the desired BESS capacity (and minimum cost) to achieve an acceptable grid inertial response with a certain confidence level.« less

Acceptance and use of eight arsenic-safe drinking water options in Bangladesh.

PubMed

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option.

Acceptance and Use of Eight Arsenic-Safe Drinking Water Options in Bangladesh

PubMed Central

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B.; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option. PMID:23326477

Bioaccessibility of metals and human health risk assessment in community urban gardens.

PubMed

Izquierdo, M; De Miguel, E; Ortega, M F; Mingot, J

2015-09-01

Pseudo-total (i.e. aqua regia extractable) and gastric-bioaccessible (i.e. glycine+HCl extractable) concentrations of Ca, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn were determined in a total of 48 samples collected from six community urban gardens of different characteristics in the city of Madrid (Spain). Calcium carbonate appears to be the soil property that determines the bioaccessibility of a majority of those elements, and the lack of influence of organic matter, pH and texture can be explained by their low levels in the samples (organic matter) or their narrow range of variation (pH and texture). A conservative risk assessment with bioaccessible concentrations in two scenarios, i.e. adult urban farmers and children playing in urban gardens, revealed acceptable levels of risk, but with large differences between urban gardens depending on their history of land use and their proximity to busy areas in the city center. Only in a worst-case scenario in which children who use urban gardens as recreational areas also eat the produce grown in them would the risk exceed the limits of acceptability. Copyright © 2015 Elsevier Ltd. All rights reserved.

IWGT report on quantitative approaches to genotoxicity risk ...

EPA Pesticide Factsheets

This is the second of two reports from the International Workshops on Genotoxicity Testing (IWGT) Working Group on Quantitative Approaches to Genetic Toxicology Risk Assessment (the QWG). The first report summarized the discussions and recommendations of the QWG related to the need for quantitative dose–response analysis of genetic toxicology data, the existence and appropriate evaluation of threshold responses, and methods to analyze exposure-response relationships and derive points of departure (PoDs) from which acceptable exposure levels could be determined. This report summarizes the QWG discussions and recommendations regarding appropriate approaches to evaluate exposure-related risks of genotoxic damage, including extrapolation below identified PoDs and across test systems and species. Recommendations include the selection of appropriate genetic endpoints and target tissues, uncertainty factors and extrapolation methods to be considered, the importance and use of information on mode of action, toxicokinetics, metabolism, and exposure biomarkers when using quantitative exposure-response data to determine acceptable exposure levels in human populations or to assess the risk associated with known or anticipated exposures. The empirical relationship between genetic damage (mutation and chromosomal aberration) and cancer in animal models was also examined. It was concluded that there is a general correlation between cancer induction and mutagenic and/or clast

Quantifying women's stated benefit-risk trade-off preferences for IBS treatment outcomes.

PubMed

Johnson, F Reed; Hauber, A Brett; Ozdemir, Semra; Lynd, Larry

2010-01-01

The Food and Drug Administration, currently, is exploring quantitative benefit-risk methods to support regulatory decision-making. A scientifically valid method for assessing patients' benefit-risk trade-off preferences is needed to compare risks and benefits in a common metric. The study aims to quantify the maximum acceptable risk (MAR) of treatment-related adverse events (AEs) that women with diarrhea-predominant irritable bowel syndrome (IBS) are willing to accept in exchange for symptom relief. A stated-choice survey was used to elicit trade-off preferences among constructed treatment profiles, each defined by symptom severity and treatment-related AEs. Symptom attributes included frequency of abdominal pain and discomfort, frequency of diarrhea, and frequency of urgency. AE attributes included frequency of mild-to-moderate constipation and the risk of four possible serious AEs. A Web-enabled survey was administered to 589 female US residents at least 18 years of age with a self-reported diagnosis of diarrhea-predominant IBS. Preference weights and MAR were estimated using mixed-logit methods. SUBJECTS were willing to accept higher risks of serious AEs in return for treatments offering better symptom control. For an improvement from the lowest to the highest of four benefit levels, subjects were willing to tolerate a 2.65% increase in impacted-bowel risk, but only a 1.34% increase in perforated-bowel risk. Variation in MARs across AE types is consistent with the relative seriousness of the AEs. Stated-preference methods offer a scientifically valid approach to quantifying benefit-risk trade-off preferences that can be used to inform regulatory decision-making.

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.

Developing Crew Health Care and Habitability Systems for the Exploration Vision

NASA Technical Reports Server (NTRS)

Laurini, Kathy; Sawin, Charles F.

2006-01-01

This paper will discuss the specific mission architectures associated with the NASA Exploration Vision and review the challenges and drivers associated with developing crew health care and habitability systems to manage human system risks. Crew health care systems must be provided to manage crew health within acceptable limits, as well as respond to medical contingencies that may occur during exploration missions. Habitability systems must enable crew performance for the tasks necessary to support the missions. During the summer of 2005, NASA defined its exploration architecture including blueprints for missions to the moon and to Mars. These mission architectures require research and technology development to focus on the operational risks associated with each mission, as well as the risks to long term astronaut health. This paper will review the highest priority risks associated with the various missions and discuss NASA s strategies and plans for performing the research and technology development necessary to manage the risks to acceptable levels.

Microbial Impact on Success of Human Exploration Missions

NASA Technical Reports Server (NTRS)

Pierson, Duane L.; Ott, C. Mark; Groves, T. O.; Paloski, W. H. (Technical Monitor)

2000-01-01

The purpose of this study is to identify microbiological risks associated with space exploration and identify potential countermeasures available. Identification of microbial risks associated with space habitation requires knowledge of the sources and expected types of microbial agents. Crew data along with environmental data from water, surfaces, air, and free condensate are utilized in risk examination. Data from terrestrial models are also used. Microbial risks to crew health include bacteria, fungi, protozoa, and viruses. Adverse effects of microbes include: infections, allergic reactions, toxin production, release of volatiles, food spoilage, plant disease, material degradation, and environmental contamination. Risk is difficult to assess because of unknown potential changes in microbes (e.g., mutation) and the human host (e.g., immune changes). Prevention of adverse microbial impacts is preferred over remediation. Preventative measures include engineering measures (e.g., air filtration), crew microbial screening, acceptability standards, and active verification by onboard monitoring. Microbiological agents are important risks to human health and performance during space flight and risks increase with mission duration. Acceptable risk level must be defined. Prevention must be given high priority. Careful screening of crewmembers and payloads is an important element of any risk mitigation plan. Improved quantitation of microbiological risks is a high priority.

Effectuality of Cleaning Workers' Training and Cleaning Enterprises' Chemical Health Hazard Risk Profiling.

PubMed

Suleiman, Abdulqadir M; Svendsen, Kristin V H

2015-12-01

Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step.

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.

Scientific basis and regulatory aspects for the toxicology of plant protection products in the European Union.

PubMed

Anadón, A; Martínez-Larrañaga, M R; Martínez, M A

2001-10-01

Authorization of plant protection products/agrochemicals/pesticides in the European Union is done on the basis of their toxicological properties. This paper reviews the current legislation for placing an agrochemical on the market (ie a new substance or a existing active substance), and the toxicology studies needed for inclusion of a substance in any of the annexes of the Council Directive of the European Economic Community 91/414/ EEC. Risk analysis and its steps is discussed. The "threshold toxicity" employed to allow risk characterisation of plant protection products is described, such as acceptable daily intake, acceptable operator exposure level, acute reference dose, and maximum admissible concentration in water.

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.

Overcoming scepticism: Interacting influences of geographical location on perceived climate change adaptation measures to water resources in Spain

NASA Astrophysics Data System (ADS)

Iglesias, Ana; Garrote, Luis; Bardaji, Isabel; Iglesias, Pedro; Granados, Alfredo

2016-04-01

Though many climate adaptation efforts attempt to be defined with the participation of local communities, these strategies may be ineffective because among citizens affected equally, a local risk perception rather than scientific understanding largely drives adaptation choices. Further, the geographical location may polarize climate risk perceptions, making some adaptation efforts ineffective among sceptics. This study examines how the local degradation of the environment and water resources relates to adaption choices and in turn, climate change risk perception among a range of citizens in the Tagus basin, Spain (n = 300). We find respondents of less degraded areas have individualistic responses, and are significantly less likely to accept adaptation strategies than respondents in water stressed communities. The interaction between climate knowledge and adaptation choices is positively related to acceptance of adaptation choices in both groups, and had a stronger positive relationship among individualists. There is no statistical difference in acceptance of adaptation between individualists and communitarians at high levels of knowledge (top decile). Thus, education efforts specific to climate change may counteract divisions based geographical location and environmental stress.

CONTAMINANTS AND REMEDIAL OPTIONS AT WOOD PRESERVING SITES

EPA Science Inventory

This document provides information that facilitates characterization of the site and selection of treatment technologies at wood preserving sites, to meet the regulations’ acceptable cleanup levels. It does not provide risk-assessment information or policy guidance related to det...

"Sisters, Mothers, Daughters and Aunties": HIV vaccine acceptability among African, Caribbean and other Black women in Toronto.

PubMed

Weaver, James; Newman, Peter A; Williams, Charmaine C; Massaquoi, Notisha; Brown, Marsha

2013-08-20

Black women in Canada are at disproportionately high risk for HIV. We assessed HIV vaccine acceptability and correlates of acceptability among Black women from African and Caribbean communities in Toronto. "Sisters, Daughters, Mothers, and Aunties" was a community-based research project. Black women of African and Caribbean descent were recruited using venue-based sampling across diverse community organizations in Toronto. We used a structured questionnaire to collect data on socio-demographic characteristics and acceptability of 8 future HIV vaccines, each defined by a set of 7 dichotomous attributes. Conjoint analysis was used to quantify the relative impact of vaccine attributes on acceptability, with multiple regression to adjust for socio-demographic characteristics associated with overall acceptability. Mean vaccine acceptability was 58.8 (SD=17.2) on the 100-point scale. Efficacy had the greatest impact on acceptability, followed by side effects, cost, duration of protection, and number of doses. Acceptability of a high (99%) efficacy vaccine (70.1/100) was significantly greater than for a 50% efficacy vaccine (47.6/100). Vaccine acceptability was significantly higher among women of Caribbean versus African descent, ever married versus single women, and women with full-time versus part-time employment. Black women in Toronto indicated a modest level of acceptability for future HIV vaccines. Educational interventions that address the benefits of partially efficacious vaccines and clearly explain potential side effects, as well as vaccine cost subsidies may promote HIV vaccine uptake. Differences in acceptability within Black communities suggest that tailored multi-level interventions may mitigate barriers to uptake.

Comparing the feasibility, acceptability, clinical-, and cost-effectiveness of mental health e-screening to paper-based screening on the detection of depression, anxiety, and psychosocial risk in pregnant women: a study protocol of a randomized, parallel-group, superiority trial.

PubMed

Kingston, Dawn; McDonald, Sheila; Biringer, Anne; Austin, Marie-Paule; Hegadoren, Kathy; McDonald, Sarah; Giallo, Rebecca; Ohinmaa, Arto; Lasiuk, Gerri; MacQueen, Glenda; Sword, Wendy; Lane-Smith, Marie; van Zanten, Sander Veldhuyzen

2014-01-02

Stress, depression, and anxiety affect 15% to 25% of pregnant women. However, substantial barriers to psychosocial assessment exist, resulting in less than 20% of prenatal care providers assessing and treating mental health problems. Moreover, pregnant women are often reluctant to disclose their mental health concerns to a healthcare provider. Identifying screening and assessment tools and procedures that are acceptable to both women and service providers, cost-effective, and clinically useful is needed. The primary objective of this randomized, parallel-group, superiority trial is to evaluate the feasibility and acceptability of a computer tablet-based prenatal psychosocial assessment (e-screening) compared to paper-based screening. Secondary objectives are to compare the two modes of screening on: (1) the level of detection of prenatal depression and anxiety symptoms and psychosocial risk; (2) the level of disclosure of symptoms; (3) the factors associated with feasibility, acceptability, and disclosure; (4) the psychometric properties of the e-version of the assessment tools; and (5) cost-effectiveness. A sample of 542 women will be recruited from large, primary care maternity clinics and a high-risk antenatal unit in an urban Canadian city. Pregnant women are eligible to participate if they: (1) receive care at one of the recruitment sites; (2) are able to speak/read English; (3) are willing to be randomized to e-screening; and (4) are willing to participate in a follow-up diagnostic interview within 1 week of recruitment. Allocation is by computer-generated randomization. Women in the intervention group will complete an online psychosocial assessment on a computer tablet, while those in the control group will complete the same assessment in paper-based form. All women will complete baseline questionnaires at the time of recruitment and will participate in a diagnostic interview within 1 week of recruitment. Research assistants conducting diagnostic interviews and physicians will be blinded. A qualitative descriptive study involving healthcare providers from the recruitment sites and women will provide data on feasibility and acceptability of the intervention. We hypothesize that mental health e-screening in primary care maternity settings and high-risk antenatal units will be as or more feasible, acceptable, and capable of detecting depression, anxiety, and psychosocial risk compared to paper-based screening. ClinicalTrials.gov Identifier: NCT01899534.

Knowledge of Saudi female university students regarding cervical cancer and acceptance of the human papilloma virus vaccine

PubMed Central

Al-Shaikh, Ghadeer K.; Almussaed, Eman M.; Fayed, Amel A.; Khan, Farida H.; Syed, Sadiqa B.; Al-Tamimi, Tahani N.; Elmorshedy, Hala N.

2014-01-01

Objectives: To assess the level of knowledge regarding cervical cancer and the acceptance of the human papilloma virus (HPV) vaccine among Saudi female students in health colleges. Methods: This cross-sectional study of a convenient sample encompassed 1400 students in Health Colleges at Princess Nora Bint Abdul Rahman University, Riyadh, Saudi Arabia was conducted between December 2013 and February 2014. A self-administrated questionnaire was distributed to all participants. Data collected included socio-demographic data, knowledge of cervical cancer risk factors and clinical presentation, Pap smear, and HPV vaccine acceptance. The questionnaire reliability as tested by Cronbach’s alpha was 0.82. Results: The response rate was 89.9%, and data analysis revealed that 95.7% of students had poor knowledge level. The Pap smear was poorly recognized as a screening tool, with 46.7% of students having heard of the test. Senior and medical students had a significantly higher knowledge score. Father’s health profession, high monthly income, and presence of cervical cancer among family members or friends increased the level of knowledge. Vaccine acceptance is influenced by its price, approximately 80% of students thought that an affordable vaccine price should not exceed 300 Saudi Riyals. Perceived barriers to the vaccine were fear of injections and vaccine side effects. Conclusion: There is a lack of knowledge and misinformation regarding cervical cancer, Pap smear, and HPV as a major risk factor for cancer of the cervix. These data can be used as a benchmark to formulate effective awareness programs. PMID:25316467

[Evaluation of Suicide Risk Levels in Hospitals: Validity and Reliability Tests].

PubMed

Macagnino, Sandro; Steinert, Tilman; Uhlmann, Carmen

2018-05-01

Examination of in-hospital suicide risk levels concerning their validity and their reliability. The internal suicide risk levels were evaluated in a cross sectional study of in 163 inpatients. A reliability check was performed via determining interrater-reliability of senior physician, therapist and the responsible nurse. Within the scope of the validity check, we conducted analyses of criterion validity and construct validity. For the total sample an "acceptable" to "good" interrater-reliability (Kendalls W = .77) of suicide risk levels were obtained. Schizophrenic disorders showed the lowest values, for personality disorders we found the highest level of interrater-reliability. When examining the criterion validity, Item-9 of the BDI-II is substantial correlated to our suicide risk levels (ρ m  = .54, p < .01). Within the scope of construct validity check, affective disorders showed the highest correlation (ρ = .77), compatible also with "convergent validity". They differed with schizophrenic disorders which showed the least concordance (ρ = .43). In-hospital suicide risk levels may represent an important contribution to the assessment of suicidal behavior of inpatients experiencing psychiatric treatment due to their overall good validity and reliability. © Georg Thieme Verlag KG Stuttgart · New York.

Integrated Application of Active Controls (IAAC) Technology to an Advanced Subsonic Transport: Project Plan

NASA Technical Reports Server (NTRS)

1981-01-01

The state of the art of active controls technology (ACT) and a recommended ACT development program plan are reviewed. The performance benefits and cost of ownership of an integrated application of ACT to civil transport aircraft is to be assessed along with the risk and laboratory and/or flight experiments designed to reduce the technical risks to a commercially acceptable level.

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

Radiation Hardness Assurance (RHA): Challenges and New Considerations

NASA Technical Reports Server (NTRS)

Campola, Michael J.

2017-01-01

Radiation Hardness Assurance (RHA) challenges associated with the use of commercial-off-the-shelf (COTS) components and emerging technologies are cause for risk acceptance in space flight missions. The RHA flow includes environment definition, hazard evaluation, requirements definition, evaluation of design, and design trades to accommodate the risk a project or program takes. The varied missions profiles and environments don't necessarily benefit from the same risk reduction efforts or cost reduction attempts. The level of effort within the RHA flow can be tailored to minimize risk based on the environment or design criticality.

Organochlorines in urban soils from Central India: probabilistic health hazard and risk implications to human population.

PubMed

Kumar, Bhupander; Mishra, Meenu; Verma, V K; Rai, Premanjali; Kumar, Sanjay

2018-04-21

This study presents distribution of organochlorines (OCs) including HCH, DDT and PCBs in urban soils, and their environmental and human health risk. Forty-eight soil samples were extracted using ultrasonication, cleaned with modified silica gel chromatography and analyzed by GC-ECD. The observed concentrations of ∑HCH, ∑DDT and ∑PCBs in soils ranged between < 0.01-2.54, 1.30-27.41 and < 0.01-62.8 µg kg -1 , respectively, which were lower than the recommended soil quality guidelines. Human health risk was estimated following recommended guidelines. Lifetime average daily dose (LADD), non-cancer risk or hazard quotient (HQ) and incremental lifetime cancer risk (ILCR) for humans due to individual and total OCs were estimated and presented. Estimated LADD were lower than acceptable daily intake and reference dose. Human health risk estimates were lower than safe limit of non-cancer risk (HQ < 1.0) and the acceptable distribution range of ILCR (10 -6 -10 -4 ). Therefore, this study concluded that present levels of OCs (HCH, DDT and PCBs) in studied soils were low, and subsequently posed low health risk to human population in the study area.

[Distribution Characteristics of Heavy Metals in Environmental Samples Around Electroplating Factories and the Health Risk Assessment].

PubMed

Guo, Peng-ran; Lei, Yong-qian; Zhou, Qiao-li; Wang, Chang; Pan, Jia-chuan

2015-09-01

This study aimed to investigate the pollution degree and human health risk of heavy metals in soil and air samples around electroplating factories. Soil, air and waste gas samples were collected to measure 8 heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) in two electroplating factories, located in Baiyun district of Guangzhou city. Geoaccumulation index and USEPA Risk Assessment Guidance for Superfund (RAGS) were respectively carried out. Results showed that concentrations of Hg and Pb in waste gas and Cr in air samples were higher than limits of the corresponding quality standards, and concentrations of Cd, Hg and Zn in soil samples reached the moderate pollution level. The HQ and HI of exposure by heavy metals in air and soil samples were both lower than 1, indicating that there was no non-carcinogen risk. CRAs and CRCr in soil samples were beyond the maximum acceptable level of carcinogen risk (10(-4)), and the contribution rate of CRCr to TCR was over 81%. CRCr, CRNi and TCR in air samples were in range of 10(-6) - 10(-4), indicating there was possibly carcinogen risk but was acceptable risk. CR values for children were higher than adults in soils, but were higher for adults in air samples. Correlation analysis revealed that concentrations of heavy metals in soils were significantly correlated with these in waste gas samples, and PCA data showed pollution sources of Cd, Hg and Zn in soils were different from other metals.

Turning risk assessment and adaptation policy priorities into meaningful interventions and governance processes.

PubMed

Brown, Kathryn; DiMauro, Manuela; Johns, Daniel; Holmes, Gemma; Thompson, David; Russell, Andrew; Style, David

2018-06-13

The UK is one of the first countries in the world to have set up a statutory system of national climate risk assessments followed by a national adaptation programme. Having this legal framework has been essential for enabling adaptation at the government level in a challenging political environment. However, using this framework to create an improvement in resilience to climate change across the country requires more than publishing a set of documents; it requires careful thought about what interventions work, how they can be enabled and what level of risk acceptability individuals, organizations and the country should be aiming for.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

Turning risk assessment and adaptation policy priorities into meaningful interventions and governance processes

NASA Astrophysics Data System (ADS)

Brown, Kathryn; DiMauro, Manuela; Johns, Daniel; Holmes, Gemma; Thompson, David; Russell, Andrew; Style, David

2018-06-01

The UK is one of the first countries in the world to have set up a statutory system of national climate risk assessments followed by a national adaptation programme. Having this legal framework has been essential for enabling adaptation at the government level in a challenging political environment. However, using this framework to create an improvement in resilience to climate change across the country requires more than publishing a set of documents; it requires careful thought about what interventions work, how they can be enabled and what level of risk acceptability individuals, organizations and the country should be aiming for. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

Ergonomics intervention in a tile industry- case of manual material handling.

PubMed

Dormohammadi, Ali; Amjad Sardrudi, Hosein; Motamedzade, Majid; Dormohammadi, Reza; Musavi, Saeed

2012-12-13

Manual material handling is one of the major health and safety hazards in industry. This study aims to assess the lifting tasks, before and after intervention using NIOSH lifting equation and Manual Handling Assessment Charts (MAC). This interventional study was performed in 2011 in a tile manufacturing industry in Hamadan, located in the West of Iran. The prevalence of musculoskeletal discomfort was determined using Nordic musculoskeletal questionnaire. In order to assess the risk factors related to lifting and identify the high-risk activities, MAC and NIOSH lifting equation were used. In intervention phase, we designed a load-carrying cart with shelves capable of moving vertically up and down, similar to scissor lifts. After intervention, the reassessment of risk factors was conducted to determine the success of the intervention and to compare risk levels before and after intervention using t-test. The outputs of MAC and NIOSH lifting equation assessments before intervention revealed that all activities were at high-risk level. After intervention, the risk level decreased to average level. In conclusion, the results of intervention revealed a considerable decrease in risk level. It may be concluded that the given intervention was acceptable and favorably effective in preventing musculoskeletal disorders especially low back pain.

Determining your organization's 'risk capability'.

PubMed

Hannah, Bill; Hancock, Melinda

2014-05-01

An assessment of a provider's level of risk capability should focus on three key elements: Business intelligence, including sophisticated analytical models that can offer insight into the expected cost and quality of care for a given population. Clinical enterprise maturity, marked by the ability to improve health outcomes and to manage utilization and costs to drive change. Revenue transformation, emphasizing the need for a revenue cycle platform that allows for risk acceptance and management and that provides incentives for performance against defined objectives.

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.

Pesticide mixtures in the Swedish streams: Environmental risks, contributions of individual compounds and consequences of single-substance oriented risk mitigation.

PubMed

Gustavsson, Mikael; Kreuger, Jenny; Bundschuh, Mirco; Backhaus, Thomas

2017-11-15

This paper presents the ecotoxicological assessment and environmental risk evaluation of complex pesticide mixtures occurring in freshwater ecosystems in southern Sweden. The evaluation is based on exposure data collected between 2002 and 2013 by the Swedish pesticide monitoring program and includes 1308 individual samples, detecting mixtures of up to 53 pesticides (modal=8). Pesticide mixture risks were evaluated using three different scenarios for non-detects (best-case, worst-case and using the Kaplan-Meier method). The risk of each scenario was analyzed using Swedish Water Quality Objectives (WQO) and trophic-level specific environmental thresholds. Using the Kaplan-Meier method the environmental risk of 73% of the samples exceeded acceptable levels, based on an assessment using Concentration-Addition and WQOs for the individual pesticides. Algae were the most sensitive organism group. However, analytical detection limits, especially for insecticides, were insufficient to analyze concentrations at or near their WQO's. Thus, the risk of the analyzed pesticide mixtures to crustaceans and fish is systematically underestimated. Treating non-detects as being present at their individual limit of detection increased the estimated risk by a factor 100 or more, compared to the best-case or the Kaplan-Meier scenario. Pesticide mixture risks are often driven by only 1-3 compounds. However, the risk-drivers (i.e., individual pesticides explaining the largest share of potential effects) differ substantially between sites and samples, and 83 of the 141 monitored pesticides need to be included in the assessment to account for 95% of the risk at all sites and years. Single-substance oriented risk mitigation measures that would ensure that each individual pesticide is present at a maximum of 95% of its individual WQO, would also reduce the mixture risk, but only from a median risk quotient of 2.1 to a median risk quotient of 1.8. Also, acceptable total risk levels would still be exceeded in more than 70% of the samples. Copyright © 2017 Elsevier B.V. All rights reserved.

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".

Heavy metals (lead, cadmium, methylmercury, arsenic) in commonly imported rice grains (Oryza sativa) sold in Saudi Arabia and their potential health risk.

PubMed

Al-Saleh, Iman; Abduljabbar, Mai

2017-10-01

The levels of heavy metals (lead, cadmium, methylmercury and arsenic) were determined in 37 brands of imported rice commonly consumed in Saudi Arabia after soaking and rinsing with water, and their potential health risks to residents were estimated by three indices: hazard quotient (HQ), hazard index (HI) and cancer risk (CR). The mean levels of lead, cadmium, methylmercury and total arsenic in soaked (rinsed) rice grains were 0.034 (0.057), 0.015 (0.027), 0.004 (0.007) and 0.202 (0.183) μg/g dry weight, respectively. Soaking or rinsing rice grains with water decreased lead and cadmium levels in all brands to safe levels. All brands had total arsenic above the acceptable regulatory limits, irrespective of soaking or rinsing, and eight soaked and 12 rinsed brands contained methylmercury. The levels of all heavy metals except cadmium were above the acceptable regulatory limits when the rice was neither rinsed nor soaked. Weekly intakes of lead, cadmium, methylmercury and total arsenic from soaked (rinsed) grains were 0.638 (1.068), 0.279 (0.503), 0.271 (0.309) and 3.769 (3.407) μg/kg body weight (bw). The weekly intakes of lead and methylmercury from the consumption of one rinsed and two soaked rice brands respectively, exceeded the Provisional Tolerance Weekly Intake set by the Food and Agriculture Organization and the World Health Organization. The weekly intake of total arsenic for all brands was above the lowest benchmark dose lower confidence limit (BMDL 01 ) level of 0.3μg/kg bw/d for an increased cancer risk set by European Food Safety Authority. Either soaking or rinsing grains before consumption can minimize the non-carcinogenic health risks to residents from cadmium and lead (HQ<1). Our local consumers, though, may experience health consequences from rice contaminated mainly with arsenic (HQ>1 all brands) and to a lesser extent with methylmercury (HQ>1 in 4 brands), even when soaked or rinsed with water before consumption. The combined non-carcinogenic effect of all metals expressed as HI was >1, including soaked or rinsed rice, with total arsenic the major contributor followed by methylmercury. CR for total arsenic, whether consuming soaked, rinsed, un-soaked or unrinsed grains, exceeded the acceptable level of 10 -4 . Long-term consumption of rice contaminated with heavy metals, particularly arsenic, can pose potential health risks to the local population, especially vulnerable groups (pregnant women, children, elderly and patients). More attention should thus be given to contaminated rice and preventive measures should be taken. Copyright © 2017 Elsevier GmbH. All rights reserved.

EXPERIMENTAL AND MATHEMATICAL MODELING METHODS FOR THE INVESTIGATION OF TOXICOLOGICAL INTERACTIONS

EPA Science Inventory

While procedures have been developed and used for many years to assess risk and determine acceptable exposure levels to individual chemicals, most cases of environmental contamination can result in concurrent or sequential exposure to more than one chemical. Toxicological predict...

Health risk assessment of air emissions from a municipal solid waste incineration plant--a case study.

PubMed

Cangialosi, Federico; Intini, Gianluca; Liberti, Lorenzo; Notarnicola, Michele; Stellacci, Paolo

2008-01-01

A health risk assessment of long-term emissions of carcinogenic and non-carcinogenic air pollutants has been carried out for the municipal solid waste incinerator (MSWI) of the city of Taranto, Italy. Ground level air concentrations and soil deposition of carcinogenic (Polychlorinated Dibenzo-p-Dioxins/Furans and Cd) and non-carcinogenic (Pb and Hg) pollutants have been estimated using a well documented atmospheric dispersion model. Health risk values for air inhalation, dermal contact, soil and food ingestion have been calculated based on a combination of these concentrations and a matrix of environmental exposure factors. Exposure of the surrounding population has been addressed for different release scenarios based on four pollutants, four exposure pathways and two receptor groups (children and adults). Spatial risk distribution and cancer excess cases projected from plant emissions have been compared with background mortality records. Estimated results based on the MSWI emissions show: (1) individual risks well below maximum acceptable levels, (2) very small incremental cancer risk compared with background level.

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 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Dietitians employed by health care facilities preferred a HACCP system over irradiation or chemical rinses for reducing risk of foodborne disease.

PubMed

Giamalva, J N; Redfern, M; Bailey, W C

1998-08-01

To survey dietitians in health care facilities about the acceptability of alternative meat and poultry processing methods designed to reduce the risk of foodborne disease and their willingness to pay for these processes. A geographically representative sample of 600 members of The American Dietetic Association who work in health care facilities. The response rate was 250 completed questionnaires from 592 eligible subjects (42%). A mail survey was used to gather information on the acceptability of a Hazard Analysis and Critical Control Point (HACCP) system, chemical rinses, and irradiation for increasing the safety of food. Discrete choice contingent valuation was used to determine the acceptability at current prices and at 5, 10, and 25 cents per pound above current prices. Logistic regression was used to estimate mean willingness to pay (the maximum amount respondents are willing to pay) for each process. A simultaneous equations regression model was used to estimate the effects of other variables on acceptability. Respondents expressed a high level of concern for food safety in health care facilities. The estimated mean willingness to pay was highest for a HACCP system and lowest for chemical rinses. The successful adoption of alternative methods to increase food safety depends on their acceptance by foodservice professionals. The professionals sampled were most accepting of a HACCP system, somewhat less accepting of irradiation, and least accepting of new chemical rinses. Poultry and beef processors and government agencies concerned with food safety may want to take into account the attitudes of foodservice professionals.

Effects of dynamic workstation Oxidesk on acceptance, physical activity, mental fitness and work performance.

PubMed

Groenesteijn, L; Commissaris, D A C M; Van den Berg-Zwetsloot, M; Hiemstra-Van Mastrigt, S

2016-07-19

Working in an office environment is characterised by physical inactivity and sedentary behaviour. This behaviour contributes to several health risks in the long run. Dynamic workstations which allow people to combine desk activities with physical activity, may contribute to prevention of these health risks. A dynamic workstation, called Oxidesk, was evaluated to determine the possible contribution to healthy behaviour and the impact on perceived work performance. A field test was conducted with 22 office workers, employed at a health insurance company in the Netherlands. The Oxidesk was well accepted, positively perceived for fitness and the participants maintained their work performance. Physical activity was lower than the activity level required in the Dutch guidelines for sufficient physical activity. Although there was a slight increase in physical activity, the Oxidesk may be helpful in the reducing health risks involved and seems applicable for introduction to office environments.

Patient choice in opt-in, active choice, and opt-out HIV screening: randomized clinical trial.

PubMed

Montoy, Juan Carlos C; Dow, William H; Kaplan, Beth C

2016-01-19

What is the effect of default test offers--opt-in, opt-out, and active choice--on the likelihood of acceptance of an HIV test among patients receiving care in an emergency department? This was a randomized clinical trial conducted in the emergency department of an urban teaching hospital and regional trauma center. Patients aged 13-64 years were randomized to opt-in, opt-out, and active choice HIV test offers. The primary outcome was HIV test acceptance percentage. The Denver Risk Score was used to categorize patients as being at low, intermediate, or high risk of HIV infection. 38.0% (611/1607) of patients in the opt-in testing group accepted an HIV test, compared with 51.3% (815/1628) in the active choice arm (difference 13.3%, 95% confidence interval 9.8% to 16.7%) and 65.9% (1031/1565) in the opt-out arm (difference 27.9%, 24.4% to 31.3%). Compared with active choice testing, opt-out testing led to a 14.6 (11.1 to 18.1) percentage point increase in test acceptance. Patients identified as being at intermediate and high risk were more likely to accept testing than were those at low risk in all arms (difference 6.4% (3.4% to 9.3%) for intermediate and 8.3% (3.3% to 13.4%) for high risk). The opt-out effect was significantly smaller among those reporting high risk behaviors, but the active choice effect did not significantly vary by level of reported risk behavior. Patients consented to inclusion in the study after being offered an HIV test, and inclusion varied slightly by treatment assignment. The study took place at a single county hospital in a city that is somewhat unique with respect to HIV testing; although the test acceptance percentages themselves might vary, a different pattern for opt-in versus active choice versus opt-out test schemes would not be expected. Active choice is a distinct test regimen, with test acceptance patterns that may best approximate patients' true preferences. Opt-out regimens can substantially increase HIV testing, and opt-in schemes may reduce testing, compared with active choice testing. This study was supported by grant NIA 1RC4AG039078 from the National Institute on Aging. The full dataset is available from the corresponding author. Consent for data sharing was not obtained, but the data are anonymized and risk of identification is low.Trial registration Clinical trials NCT01377857. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Patient choice in opt-in, active choice, and opt-out HIV screening: randomized clinical trial

PubMed Central

Dow, William H; Kaplan, Beth C

2016-01-01

Study question What is the effect of default test offers—opt-in, opt-out, and active choice—on the likelihood of acceptance of an HIV test among patients receiving care in an emergency department? Methods This was a randomized clinical trial conducted in the emergency department of an urban teaching hospital and regional trauma center. Patients aged 13-64 years were randomized to opt-in, opt-out, and active choice HIV test offers. The primary outcome was HIV test acceptance percentage. The Denver Risk Score was used to categorize patients as being at low, intermediate, or high risk of HIV infection. Study answer and limitations 38.0% (611/1607) of patients in the opt-in testing group accepted an HIV test, compared with 51.3% (815/1628) in the active choice arm (difference 13.3%, 95% confidence interval 9.8% to 16.7%) and 65.9% (1031/1565) in the opt-out arm (difference 27.9%, 24.4% to 31.3%). Compared with active choice testing, opt-out testing led to a 14.6 (11.1 to 18.1) percentage point increase in test acceptance. Patients identified as being at intermediate and high risk were more likely to accept testing than were those at low risk in all arms (difference 6.4% (3.4% to 9.3%) for intermediate and 8.3% (3.3% to 13.4%) for high risk). The opt-out effect was significantly smaller among those reporting high risk behaviors, but the active choice effect did not significantly vary by level of reported risk behavior. Patients consented to inclusion in the study after being offered an HIV test, and inclusion varied slightly by treatment assignment. The study took place at a single county hospital in a city that is somewhat unique with respect to HIV testing; although the test acceptance percentages themselves might vary, a different pattern for opt-in versus active choice versus opt-out test schemes would not be expected. What this paper adds Active choice is a distinct test regimen, with test acceptance patterns that may best approximate patients’ true preferences. Opt-out regimens can substantially increase HIV testing, and opt-in schemes may reduce testing, compared with active choice testing. Funding, competing interests, data sharing This study was supported by grant NIA 1RC4AG039078 from the National Institute on Aging. The full dataset is available from the corresponding author. Consent for data sharing was not obtained, but the data are anonymized and risk of identification is low. Trial registration Clinical trials NCT01377857. PMID:26786744

Enhancing user acceptance of mandated mobile health information systems: the ePOC (electronic point-of-care project) experience.

PubMed

Burgess, Lois; Sargent, Jason

2007-01-01

From a clinical perspective, the use of mobile technologies, such as Personal Digital Assistants (PDAs) within hospital environments is not new. A paradigm shift however is underway towards the acceptance and utility of these systems within mobile-based healthcare environments. Introducing new technologies and associated work practices has intrinsic risks which must be addressed. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a best fit with end user needs. It is envisaged this research will lead to the development of a formalised user acceptance framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a mandated electronic point-of-care information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented.

"Unspoken Agreements": Perceived Acceptability of Couples HIV Testing and Counseling (CHTC) Among Cisgender Men with Transgender Women Partners.

PubMed

Reisner, Sari L; Menino, David; Leung, Kingsley; Gamarel, Kristi E

2018-06-23

Transgender women (TW) are one of the highest risk groups for HIV infection globally; however, the HIV testing needs of their cisgender (non-transgender) male partners remain largely unknown. This study sought to examine the perceived acceptability of couples HIV testing and counseling (CHTC) for TW-male dyads from the perspective of cisgender men who partner with TW. Between September 2016 and June 2017, 19 cisgender men (mean age = 40.1, SD = 12.8) who currently have, or have ever had a TW partner completed an in-depth semi-structured phone interview and brief survey to gather data on acceptability of CHTC, as well as perceived barriers and facilitators to CHTC for TW-male couples. Qualitative data were thematically analyzed and integrated with survey data. Acceptability of CHTC was high in the sample (89.5%) but was complex and largely contingent on: (1) monogamy and commitment as critical precursors to CHTC acceptability; (2) risk perception and level of comfort with CHTC; (3) understandings of sexual agreements; and (4) personal relationships versus other TW-male relationships. Findings have implications for culturally-adapting and implementing CHTC in real-world settings for TW-male couples, as well as for meeting the individual HIV testing needs of cisgender men who partner with TW.

Protection afforded by respirators when performing endotracheal intubation using a direct laryngoscope, GlideScope®, and i-gel® device: A randomized trial

PubMed Central

Lim, Tae Ho; Oh, Jaehoon; Lee, Juncheol; Shin, Hyungoo

2018-01-01

Emergency physicians are at risk of infection during invasive procedures, and wearing a respirator can reduce this risk. The aim of this study was to determine whether the protection afforded by a respirator during intubation is affected by the type of airway device used. In this randomized crossover study, 26 emergency physicians underwent quantitative fit tests for a N95 respirator (cup-type or fold-type) before and during intubation with a direct laryngoscope, GlideScope®, or i-gel® airway device. The primary outcome was the fit factor value of the respirator and the secondary outcome was the level of acceptable protection provided (percentage of fit factor scores above 100). Compared with the GlideScope and i-gel device, the fit factor values and level of acceptable protection provided were lower when physicians wore the cup-type respirator while intubating using the direct laryngoscope (200 fit factor [152–200] and 200 fit factor [121.25–200] versus 166 fit factor [70–200], 100% and 100% versus 75%, respectively; all P < 0.001). There were no significant differences in the fit factor value or level of acceptable protection provided when the physicians wore the fold-type respirator while intubating using any of the three airway devices (all P > 0.05). The type of airway device used for endotracheal intubation may influence the protective performance of some types of respirators. Emergency physicians should consider the effects of airway device types on fit factor of N95 respirators, when they perform intubation at risk of infection. PMID:29672533

Impact of natural gas extraction on PAH levels in ambient air.

PubMed

Paulik, L Blair; Donald, Carey E; Smith, Brian W; Tidwell, Lane G; Hobbie, Kevin A; Kincl, Laurel; Haynes, Erin N; Anderson, Kim A

2015-04-21

Natural gas extraction, often referred to as "fracking," has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10 000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health.

Impact of natural gas extraction on Pah levels in ambient air

PubMed Central

Paulik, L. Blair; Donald, Carey E.; Smith, Brian W.; Tidwell, Lane G.; Hobbie, Kevin A.; Kincl, Laurel; Haynes, Erin N.; Anderson, Kim A.

2015-01-01

Natural gas extraction, often referred to as “fracking,” has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10,000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health. PMID:25810398

A RE-LOOK AT THE US NRC SAFETY GOALS

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

mubayi v.

2013-09-22

Since they were adopted in 1986, the US NRC’s Safety Goals have played a valuable role as a de facto risk acceptance criterion against which the predicted performance of a commercial nuclear power reactor can be evaluated and assessed. The current safety goals are cast in terms of risk metrics called quantitative health objectives (QHOs), limiting numerical values of the risks of the early and latent health effects of accidental releases of radioactivity to the offsite population. However, while demonstrating compliance with current safety goals has been an important step in assessing the acceptance of the risk posed by LWRs,more » new or somewhat different goals may be needed that go beyond the current early fatality and latent cancer fatality QHOs in assessing reactor risk. Natural phenomena such as hurricanes seem to be suitable candidates for establishing a background rate to derive a risk goal as their order of magnitude cost of damages is similar to those estimated in severe accident Level 3 PRAs done for nuclear power plants. This paper obtains a risk goal that could have a wider applicability, compared to the current QHOs, as a technology-neutral goal applicable to future reactors and multi-unit sites.« less

Beyond gains and losses: the effect of need on risky choice in framed decisions.

PubMed

Mishra, Sandeep; Fiddick, Laurence

2012-06-01

Substantial evidence suggests people are risk-averse when making decisions described in terms of gains and risk-prone when making decisions described in terms of losses, a phenomenon known as the framing effect. Little research, however, has examined whether framing effects are a product of normative risk-sensitive cognitive processes. In 5 experiments, it is demonstrated that framing effects in the Asian disease problem can be explained by risk-sensitivity theory, which predicts that decision makers adjust risk acceptance on the basis of minimal acceptable thresholds, or need. Both explicit and self-determined need requirements eliminated framing effects and affected risk acceptance consistent with risk-sensitivity theory. Furthermore, negative language choice in loss frames conferred the perception of high need and led to the construction of higher minimal acceptable thresholds. The results of this study suggest that risk-sensitivity theory provides a normative rationale for framing effects based on sensitivity to minimal acceptable thresholds, or needs. 2012 APA, all rights reserved

[The significance of fenofibrate in the therapy of atherogenic dyslipoproteinaemia].

PubMed

Kucera, M; Oravec, S; Ocadlík, I

2010-08-01

There are accepted the lipid levels goals in all world, which are needed to achievement in primary and secondary prevention. Despite efficacy of current standards of care (including achievement of LDL-C, blood pressure and blood sugar goals), patients with atherogenic dyslipidemia (DLP) (high TG levels, low HDL-C, high apolipoprotein B and small dense LDL-particles), which is common in patients with diabetes melitus (DM), metabolic syndrome or cardiovascular diseases (KVD), remain exposed to a high residual risk of major cardiovascular events and microvascular complications. Statin therapy does not adequately address vascular risk asociated with elevated triglycerides (TG) and low HDL-C levels. As ACCORD lipid trial last time shows, the addition of lipid-modifying activity of fenofibrate to statin therapy benefited only certain subgroups of patients at increased cardiometabolic risk.

Giving Voice to Study Volunteers: Comparing views of mentally ill, physically ill, and healthy protocol participants on ethical aspects of clinical research

PubMed Central

Roberts, Laura Weiss; Kim, Jane Paik

2014-01-01

Motivation Ethical controversy surrounds clinical research involving seriously ill participants. While many stakeholders have opinions, the extent to which protocol volunteers themselves see human research as ethically acceptable has not been documented. To address this gap of knowledge, authors sought to assess views of healthy and ill clinical research volunteers regarding the ethical acceptability of human studies involving individuals who are ill or are potentially vulnerable. Methods Surveys and semi-structured interviews were used to query clinical research protocol participants and a comparison group of healthy individuals. A total of 179 respondents participated in this study: 150 in protocols (60 mentally ill, 43 physically ill, and 47 healthy clinical research protocol participants) and 29 healthy individuals not enrolled in protocols. Main outcome measures included responses regarding ethical acceptability of clinical research when it presents significant burdens and risks, involves people with serious mental and physical illness, or enrolls people with other potential vulnerabilities in the research situation. Results Respondents expressed decreasing levels of acceptance of participation in research that posed burdens of increasing severity. Participation in protocols with possibly life-threatening consequences was perceived as least acceptable (mean = 1.82, sd = 1.29). Research on serious illnesses, including HIV, cancer, schizophrenia, depression, and post-traumatic stress disorder, was seen as ethically acceptable across respondent groups (range of means = [4.0, 4.7]). Mentally ill volunteers expressed levels of ethical acceptability for physical illness research and mental illness research as acceptable and similar, while physically ill volunteers expressed greater ethical acceptability for physical illness research than for mental illness research. Mentally ill, physically ill, and healthy participants expressed neutral to favorable perspectives regarding the ethical acceptability of clinical research participation by potentially vulnerable subpopulations (difference in acceptability perceived by mentally ill - healthy=−0.04, CI [−0.46, 0.39]; physically ill – healthy= −0.13, CI [−0.62, −.36]). Conclusions Clinical research volunteers and healthy clinical research-“naive” individuals view studies involving ill people as ethically acceptable, and their responses reflect concern regarding research that poses considerable burdens and risks and research involving vulnerable subpopulations. Physically ill research volunteers may be more willing to see burdensome and risky research as acceptable. Mentally ill research volunteers and healthy individuals expressed similar perspectives in this study, helping to dispel a misconception that those with mental illness should be presumed to hold disparate views. PMID:24931849

Giving voice to study volunteers: comparing views of mentally ill, physically ill, and healthy protocol participants on ethical aspects of clinical research.

PubMed

Roberts, Laura Weiss; Kim, Jane Paik

2014-09-01

Ethical controversy surrounds clinical research involving seriously ill participants. While many stakeholders have opinions, the extent to which protocol volunteers themselves see human research as ethically acceptable has not been documented. To address this gap of knowledge, authors sought to assess views of healthy and ill clinical research volunteers regarding the ethical acceptability of human studies involving individuals who are ill or are potentially vulnerable. Surveys and semi-structured interviews were used to query clinical research protocol participants and a comparison group of healthy individuals. A total of 179 respondents participated in this study: 150 in protocols (60 mentally ill, 43 physically ill, and 47 healthy clinical research protocol participants) and 29 healthy individuals not enrolled in protocols. Main outcome measures included responses regarding ethical acceptability of clinical research when it presents significant burdens and risks, involves people with serious mental and physical illness, or enrolls people with other potential vulnerabilities in the research situation. Respondents expressed decreasing levels of acceptance of participation in research that posed burdens of increasing severity. Participation in protocols with possibly life-threatening consequences was perceived as least acceptable (mean = 1.82, sd = 1.29). Research on serious illnesses, including HIV, cancer, schizophrenia, depression, and post-traumatic stress disorder, was seen as ethically acceptable across respondent groups (range of means = [4.0, 4.7]). Mentally ill volunteers expressed levels of ethical acceptability for physical illness research and mental illness research as acceptable and similar, while physically ill volunteers expressed greater ethical acceptability for physical illness research than for mental illness research. Mentally ill, physically ill, and healthy participants expressed neutral to favorable perspectives regarding the ethical acceptability of clinical research participation by potentially vulnerable subpopulations (difference in acceptability perceived by mentally ill - healthy = -0.04, CI [-0.46, 0.39]; physically ill - healthy = -0.13, CI [-0.62, -.36]). Clinical research volunteers and healthy clinical research-"naïve" individuals view studies involving ill people as ethically acceptable, and their responses reflect concern regarding research that poses considerable burdens and risks and research involving vulnerable subpopulations. Physically ill research volunteers may be more willing to see burdensome and risky research as acceptable. Mentally ill research volunteers and healthy individuals expressed similar perspectives in this study, helping to dispel a misconception that those with mental illness should be presumed to hold disparate views. Copyright © 2014 Elsevier Ltd. All rights reserved.

Public perception and attitude towards chemical industry park in Dalian, Bohai Rim.

PubMed

He, Guizhen; Chen, Chunci; Zhang, Lei; Lu, Yonglong

2018-04-01

Recent decade has witnessed accelerating expansion of chemical industry and increasing conflicts between the local citizens, governmental authorities and project developers, especially in some coastal and port cities in China. Development and transformation of chemical industrial parks has been adopted as a national initiative recently. However, there is a paucity of research examining public perspectives on chemical industrial parks and their risks. Aiming to understand public perception, attitude, and response and the factors underlying the support/acceptance of chemical industry park, this paper investigated 418 residents neighboring to two chemical industrial parks, Dalian in Bohai Rim through face-to-face questionnaire survey. The results showed the knowledge of the respondents on the chemical industrial parks development was very limited. The respondents had complex perceptions on the environmental impacts, risks control, social-economic benefits, and problem awareness. The current levels of information disclosure and public participation were very low. The central governmental official (44.3%) was the most trustworthy group by the respondents. Only 5.5% and 23.2% of the respondents supported the construction of a new CIP nearby and far away their homes, whilst 13% thought new CIP project as acceptable. The spearman correlation analysis results showed a strong NIMBY effect (Not In My Backyard). Factor analysis results demonstrated five latent factors: knowledge, benefit, information, trust, and participation. Multiple linear regression analysis indicated how socio-demographic differences and five latent factors might impact on the support/acceptance of the chemical industrial parks. Education level, trust, information, and participation were significant predictors of public support/acceptance level. This study contributes to our limited knowledge and understanding of public sentiments to the chemical industry parks in China. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Economic analysis versus the principle of guaranteed safety in blood transfusion].

PubMed

Moatti, J P; Loubière, S; Rotily, M

2000-06-01

This article shows that policies aimed at reducing risks of infectious agents transmissible through blood unfortunately follow a law of 'diminishing returns': increasing marginal costs have to be devoted for limited reductions in the risks of contamination through blood donations. Therefore, the economic cost-effectiveness analysis is appropriate to identify screening strategies which may minimize costs to reach a certain level of safety. Moreover, economic analysis can contribute to public debates about the level of residual risk that society is willing to accept. Empirical results from French studies about screening for hepatitis C virus (HCV) in individuals who have received blood transfusions and in blood donations are presented to illustrate these points.

Acceptability of screening for early detection of liver disease in hazardous/harmful drinkers in primary care.

PubMed

Eyles, Caroline; Moore, Michael; Sheron, Nicholas; Roderick, Paul; O'Brien, Wendy; Leydon, Geraldine M

2013-08-01

It is estimated that one-quarter of adults in the UK drink at harmful/hazardous levels leading to increased mortality and alcohol liver disease (ALD). The Alcohol Liver Disease Detection Study (ALDDeS) aimed to test out in primary care the feasibility of alcohol misuse screening in adults, using the AUDIT questionnaire, and to assess screening harmful/hazardous alcohol users for ALD using newer non-invasive serum markers of fibrosis. To explore patients' experiences of taking part in ALDDeS and understanding of the delivery and process of screening for ALD using self-report questionnaires and feedback of liver fibrosis risk using levels of non-invasive serum markers. A nested qualitative study based in five primary care practices in the UK. From a sample of patients who were identified as drinking at harmful/hazardous levels, 30 participants were identified by maximum variation sampling for qualitative in-depth interviews. Using the principles of constant comparison the transcribed interviews were thematically analysed. Receiving a postal AUDIT questionnaire was viewed as acceptable by participants. For some completing the AUDIT increased awareness of their hazardous alcohol use and a positive blood test indicating liver fibrosis was a catalyst for behaviour change. For others, a negative blood test result provided a licence to continue drinking at hazardous levels. A limited understanding of safe drinking and of ALD was common. Educational and training needs of primary care professionals must be taken into account, so that patients with marker levels indicating low risk of fibrosis are correctly informed about the likely risks of continuing to drink at the same levels.

Occurrence and risk assessment of potentially toxic elements and typical organic pollutants in contaminated rural soils.

PubMed

Xu, Yongfeng; Dai, Shixiang; Meng, Ke; Wang, Yuting; Ren, Wenjie; Zhao, Ling; Christie, Peter; Teng, Ying

2018-07-15

The residual levels and risk assessment of several potentially toxic elements (PTEs), phthalate esters (PAEs) and polycyclic aromatic hydrocarbons (PAHs) in rural soils near different types of pollution sources in Tianjin, China, were studied. The soils were found to be polluted to different extents with PTEs, PAEs and PAHs from different pollution sources. The soil concentrations of chromium (Cr), nickel (Ni), di-n-butyl phthalate (DnBP), acenaphthylene (Any) and acenaphthene (Ane) were higher than their corresponding regulatory reference limits. The health risk assessment model used to calculate human exposure indicates that both non-carcinogenic and carcinogenic risks from selected pollutants were generally acceptable or close to acceptable. Different types of pollution sources and soil physicochemical properties substantially affected the soil residual concentrations of and risks from these pollutants. PTEs in soils collected from agricultural lands around industrial and residential areas and organic pollutants (PAEs and PAHs) in soils collected from agricultural areas around livestock breeding were higher than those from other types of pollution sources and merit long-term monitoring. Copyright © 2018 Elsevier B.V. All rights reserved.

Analysis of risk assessment factors of individuals in volcanic hazards: Review of the last decade

NASA Astrophysics Data System (ADS)

Favereau, Marcel; Robledo, Luis F.; Bull, Maria T.

2018-05-01

During the history of mankind, natural disasters have had severe repercussions on the different ecosystems, with volcanic eruptions being a clear example of this. This review is responsible for gathering the most important volatile hazards assessment research of the last decade with the objective of knowing the state of the art in relation to the studies of people's risk perception and acceptance in communities threatened by the danger of volcanic eruptions. In addition, this study includes the analysis of several cases across different countries. The results that this research offers serve as a frame of reference to determine and understand how resilient a community affected by the volatile hazards can be, since they are able to identify the main incident factors of risk that affect the communities to different degrees according to the context at the time of making the risk judgment. On the other hand, through this review, it is proposed as a future research topic to understand the levels of risk acceptance of individuals, due to the fact that the studies related to this subject are scarce.

Competence-based and integrity-based trust as predictors of acceptance of carbon dioxide capture and storage (CCS).

PubMed

Terwel, Bart W; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D L

2009-08-01

Public trust in organizations that are involved in the management and use of new technologies affects lay judgments about the risks and benefits associated with these technologies. In turn, judgments about risks and benefits influence lay attitudes toward these technologies. The validity of this (indirect) effect of trust on lay attitudes toward new technologies, which is referred to as the causal chain account of trust, has up till now only been examined in correlational research. The two studies reported in this article used an experimental approach to more specifically test the causal chain account of trust in the context of carbon dioxide capture and storage technology (CCS). Complementing existing literature, the current studies explicitly distinguished between two different types of trust in organizations: competence-based trust (Study 1) and integrity-based trust (Study 2). In line with predictions, results showed that the organizational position regarding CCS implementation (pro versus con) more strongly affected people's risk and benefit perceptions and their subsequent acceptance of CCS when competence-based trust was high rather than low. In contrast, the organizational position had a greater impact on people's level of CCS acceptance when integrity-based trust was low rather than high.

It’s a Process: Reactions to HIV Diagnosis and Engagement in HIV Care among High-Risk Heterosexuals

PubMed Central

Kutnick, Alexandra H.; Gwadz, Marya Viorst; Cleland, Charles M.; Leonard, Noelle R.; Freeman, Robert; Ritchie, Amanda S.; McCright-Gill, Talaya; Ha, Kathy; Martinez, Belkis Y.; Banfield, Angela

2017-01-01

After HIV diagnosis, heterosexuals in high-poverty urban areas evidence delays in linkage to care and antiretroviral therapy initiation compared to other groups. Yet barriers to/facilitators of HIV care among these high-risk heterosexuals are understudied. Under the theory of triadic influence, putative barriers to HIV care engagement include individual/attitudinal-level (e.g., fear, medical distrust), social-level (e.g., stigma), and structural-level influences (e.g., poor access). Participants were African-American/Black and Hispanic adults found newly diagnosed with HIV (N = 25) as part of a community-based HIV testing study with heterosexuals in a high-poverty, high-HIV-incidence urban area. A sequential explanatory mixed-methods design was used. We described linkage to HIV care and clinical outcomes [CD4 counts, viral load (VL) levels] over 1 year, and then addressed qualitative research questions about the experience of receiving a new HIV diagnosis, its effects on timely engagement in HIV care, and other barriers and facilitators. Participants were assessed five times, receiving a structured interview battery, laboratory tests, data extraction from the medical record, a post-test counseling session, and in-person/phone contacts to foster linkage to care. Participants were randomly selected for qualitative interviews (N = 15/25) that were recorded and transcribed, then analyzed using systematic content analysis. Participants were 50 years old, on average (SD = 7.2 years), mostly male (80%), primarily African-American/Black (88%), and low socioeconomic status. At the first follow-up, rates of engagement in care were high (78%), but viral suppression was modest (39%). Rates improved by the final follow-up (96% engaged, 62% virally suppressed). Two-thirds (69%) were adequately retained in care over 1 year. Qualitative results revealed multi-faceted responses to receiving an HIV diagnosis. Problems accepting and internalizing one’s HIV status were common. Reaching acceptance of one’s HIV-infected status was frequently a protracted and circuitous process, but acceptance is vital for engagement in HIV care. Fear of stigma and loss of important relationships were potent barriers to acceptance. Thus, partially as a result of difficulties accepting HIV status, delays in achieving an undetectable VL are common in this population, with serious potential negative consequences for individual and public health. Interventions to foster acceptance of HIV status are needed. PMID:28540287

[Manual material handling risk assessment and ergonomic improvement in foodstuff retailing company].

PubMed

Maso, S; Maccà, I; Simonetti, A; Scopa, P; Paruzzolo, P; Bonacci, A; Murgolo, I; Bartolucci, G B

2011-01-01

The aim of this study is to assess and reduce the risk due to manual material handling in a company involved in the foodstuff retailing. The risk assessment was performed by NIOSH Variable Lifing Index in 13 different occupational conditions. As result the risk was present in any case, with VLI values ranging from 2.12 to 2.81. A good risk reduction has been accomplished correcting properly the most important multiplier involved in the computation of the revised NIOSH Lifting equation (lifting frequency and weight of heavier products). Even if the performed risk reduction has been significant, the residual risk is still higher than the level of acceptability.

Long-term effects of a parenting preventive intervention on young adults' painful feelings about divorce.

PubMed

Christopher, Caroline; Wolchik, Sharlene; Tein, Jenn-Yun; Carr, Colleen; Mahrer, Nicole E; Sandler, Irwin

2017-10-01

This study examined whether the New Beginnings Program (NBP), a parenting preventive intervention for divorced mothers that was designed to reduce children's postdivorce mental health problems, reduced painful feelings about divorce in young adults whose families had participated 15 years earlier. This study also explored whether NBP participation reduced the relations between young adults' painful feelings about divorce and their concurrent internalizing, externalizing, and substance use problems. Participants (M = 25.6 years; 50% female; 88% Caucasian) were from 240 families that had been recruited into a randomized experimental trial (NBP vs. literature control). Data from the pretest and 15-year follow-up were used. NBP participants reported less feelings of seeing life through a filter of divorce (e.g., thinking about how the divorce causes continued struggles for them) than those in the control condition. Program effects on maternal blame and acceptance of the divorce were moderated by pretest risk, a composite of divorce-related stressors and externalizing problems. NBP participants with elevated risk at program entry had lower levels of maternal blame. Program participation was associated with higher acceptance for those with elevated risk at program entry but lower acceptance for those with low risk at program entry. Program participation decreased the relations between maternal blame, acceptance of the divorce and filter of divorce and some, but not all, of the adjustment outcomes. These findings suggest that programs designed to help families after divorce have benefits in terms of long-term feelings about parental divorce as well as their relations with adjustment problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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.

Where you live matters: Structural correlates of HIV risk behavior among young men who have sex with men in Metro Detroit

PubMed Central

Bauermeister, José A.; Eaton, Lisa; Andrzejewski, Jack; Loveluck, Jimena; VanHemert, William; Pingel, Emily S.

2017-01-01

Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18–29) living in Detroit Metro (N=328; 9% HIV-positive; 49% Black, 27% White, 15% Latino, 9% Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM’s HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM’s exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective. PMID:26334445

End User Acceptance - Requirements or Specifications, Certification, Testing

NASA Technical Reports Server (NTRS)

Jeevarajan, Judith

2013-01-01

NASA follows top level safety requirement of two-failure tolerance (t hree levels of controls or design for minimum risk) to all catastroph ic hazards in the design of safe li-ion batteries for space use. ? R igorous development testing at appropriate levels to credible offnominal conditions and review of test data. ? Implement robust design con trols based on test results and test again to confirm safety at the a ppropriate levels. ? Stringent testing of all (100%) flight batteries (from button cells to large batteries).

Threats to information security of real-time disease surveillance systems.

PubMed

Henriksen, Eva; Johansen, Monika A; Baardsgaard, Anders; Bellika, Johan G

2009-01-01

This paper presents the main results from a qualitative risk assessment of information security aspects for a new real-time disease surveillance approach in general, and for the Snow surveillance system in particular. All possible security threats and acceptable solutions, and the implications these solutions had to the design of the system, were discussed. Approximately 30 threats were identified. None of these got an unacceptable high risk level originally, but two got medium risk level, of which one was concluded to be unacceptable after further investigation. Of the remaining low risk threats, some have severe consequence, thus requiring particular assessment. Since it is very important to identify and solve all security threats before real-time solutions can be used in a wide scale, additional investigations are needed.

How do area-level socioeconomic status and gender norms affect partner violence against women? Evidence from Tanzania.

PubMed

Vyas, Seema; Heise, Lori

2016-11-01

To explore how area-level socioeconomic status and gender-related norms influence partner violence against women in Tanzania. We analysed data from the 2010 Tanzania Demographic and Health Survey and used multilevel logistic regression to estimate individual and community-level effects on women's risk of current partner violence. Prevalence of current partner violence was 36.1 %; however, variation in prevalence exists across communities. Twenty-nine percent of the variation in the logodds of partner violence is due to community-level influences. When adjusting for individual-level characteristics, this variation falls to 10 % and falls further to 8 % when adjusting for additional community-level factors. Higher levels of women's acceptance towards wife beating, male unemployment, and years of schooling among men were associated with higher risk of partner violence; however, higher levels of women in paid work were associated with lower risk. Area-level poverty and inequitable gender norms were associated with higher risk of partner violence. Empowerment strategies along with addressing social attitudes are likely to achieve reductions in rates of partner violence against women in Tanzania and in other similar low-income country settings.

A Human Mixture Risk Assessment for Neurodevelopmental Toxicity Associated with Polybrominated Diphenyl Ethers Used as Flame Retardants

PubMed Central

Martin, Olwenn V.; Evans, Richard M.; Faust, Michael

2017-01-01

Background: The European Food Safety Authority recently concluded that the exposure of small children (1–3 y old) to brominated diphenyl ether (BDE)-99 may exceed acceptable levels defined in relation to neurodevelopmental toxicity in rodents. The flame retardant BDE-209 may release BDE-99 and other lower brominated BDEs through biotic and abiotic degradation, and all age groups are exposed not only to BDE-209 and -99 but also to a cocktail of BDE congeners with evidence of neurodevelopmental toxicity. The possible risks from combined exposures to these substances have not been evaluated. Objectives: We performed a congener-specific mixture risk assessment (MRA) of human exposure to combinations of BDE-209 and other BDEs based on estimated exposures via diet and dust intake and on measured levels in biologic samples. Methods: We employed the Hazard Index (HI) method by using BDE congener-specific reference doses for neurodevelopmental toxicity. Results: Our HI analysis suggests that combined exposures to polybrominated diphenyl ethers (PBDEs) may exceed acceptable levels in breastfeeding infants (0–3 mo old) and in small children (1–3 y old), even for moderate (vs. high) exposure scenarios. Our estimates also suggest that acceptable levels of combined PBDEs may be exceeded in adults whose diets are high in fish. Small children had the highest combined exposures, with some estimated body burdens that were similar to body burdens associated with developmental neurotoxicity in rodents. Conclusions: Our estimates corroborate reports from several recent epidemiological studies of associations between PBDE exposures and neurobehavioral outcomes, and they support the inclusion of BDE-209 in the persistent organic pollutant (POP) convention as well as the need for strategies to reduce exposures to PBDE mixtures, including maximum residue limits for PBDEs in food and measures for limiting the release of PBDEs from consumer waste. https://doi.org/10.1289/EHP826 PMID:28886598

A combined microfinance and training intervention can reduce HIV risk behaviour in young female participants.

PubMed

Pronyk, Paul M; Kim, Julia C; Abramsky, Tanya; Phetla, Godfrey; Hargreaves, James R; Morison, Linda A; Watts, Charlotte; Busza, Joanna; Porter, John Dh

2008-08-20

To assess effects of a combined microfinance and training intervention on HIV risk behavior among young female participants in rural South Africa. : Secondary analysis of quantitative and qualitative data from a cluster randomized trial, the Intervention with Microfinance for AIDS and Gender Equity study. Eight villages were pair-matched and randomly allocated to receive the intervention. At baseline and after 2 years, HIV risk behavior was assessed among female participants aged 14-35 years. Their responses were compared with women of the same age and poverty group from control villages. Intervention effects were calculated using adjusted risk ratios employing village level summaries. Qualitative data collected during the study explored participants' responses to the intervention including HIV risk behavior. After 2 years of follow-up, when compared with controls, young participants had higher levels of HIV-related communication (adjusted risk ratio 1.46, 95% confidence interval 1.01-2.12), were more likely to have accessed voluntary counseling and testing (adjusted risk ratio 1.64, 95% confidence interval 1.06-2.56), and less likely to have had unprotected sex at last intercourse with a nonspousal partner (adjusted risk ratio 0.76, 95% confidence interval 0.60-0.96). Qualitative data suggest a greater acceptance of intrahousehold communication about HIV and sexuality. Although women noted challenges associated with acceptance of condoms by men, increased confidence and skills associated with participation in the intervention supported their introduction in sexual relationships. In addition to impacts on economic well being, women's empowerment and intimate partner violence, interventions addressing the economic and social vulnerability of women may contribute to reductions in HIV risk behavior.

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.

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.

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.

Parent and halogenated polycyclic aromatic hydrocarbons in rice and implications for human health in China.

PubMed

Ding, Chao; Ni, Hong-Gang; Zeng, Hui

2012-09-01

Rice is the staple food for approximate two thirds of the Chinese population. However, human exposure to parent and halogenated polycyclic aromatic hydrocarbons (PAHs) via rice consumption is still not clear for Chinese people so far. The goals of this work are to assess human exposure to PAHs and halogenated PAHs (HPAHs) via rice ingestion and the cancer risk for Chinese population. 16 PAHs and eight HPAHs were determined in rice samples collected from 18 provinces in China. In general terms, the general population in China was exposed to higher levels of PAHs via rice ingestion in comparison to that via cereals for other countries. The cancer risk values induced by exposure to PAHs and HPAHs for male and female on each age group were between the priority risk level (10(-4)) and the acceptable risk level (10(-6)). Children faced the highest cancer risk, followed by adolescents and adults. Copyright © 2012 Elsevier Ltd. All rights reserved.

The application of risk management in sport.

PubMed

Fuller, Colin; Drawer, Scott

2004-01-01

The process of risk management can be implemented as part of a best practice management system within the sport and leisure sector. The process enables risk factors that might lead to injuries to be identified and the levels of risk associated with activities to be estimated and evaluated. This information can be utilised proactively by sports governing bodies and participants to identify preventive and therapeutic interventions in order to reduce the frequency of occurrence and/or severity of injuries within their sports. The acceptability of risk within specific sports, however, is dependent on the perceptions of the participants involved. Copyright 2004 Adis Data Information BV

Risk and outbreak communication: lessons from alternative paradigms.

PubMed

Abraham, Thomas

2009-08-01

Risk communication guidelines widely used in public health are based on the psychometric paradigm of risk, which focuses on risk perception at the level of individuals. However, infectious disease outbreaks and other public health emergencies are more than public health events and occur in a highly charged political, social and economic environment. This study examines other sociological and cultural approaches from scholars such as Ulrich Beck and Mary Douglas for insights on how to communicate in such environments. It recommends developing supplemental tools for outbreak communication to deal with issues such as questions of blame and fairness in risk distribution and audiences who do not accept biomedical explanations of disease.

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...

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...

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...

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...

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...

Health risk assessment and personal exposure to Volatile Organic Compounds (VOCs) in metro carriages - A case study in Shanghai, China.

PubMed

Gong, Yu; Wei, Yijie; Cheng, Jinghui; Jiang, Tianyao; Chen, Ling; Xu, Bin

2017-01-01

Air pollution in transportation cabins has recently become a public concern. However, few studies assessed the exposure levels of suspected air pollutants including Volatile Organic Compounds (VOCs). This paper studied the exposure levels of in-carriage VOCs (benzene, toluene, ethylbenzene, xylene, styrene, formaldehyde, acetaldehyde, acetone and acrolein) in Shanghai, China and estimated the health risk in different conditions. The results indicated that VOCs concentrations in metro carriages varied from different train models, due to the difference in carriage size and ventilation system. The concentrations of aromatic VOCs in old metro carriage were 1-2 times higher than the new ones, as better paintings were used in new trains. Poor air circulation and ventilation in the underground track was likely to be the cause of higher VOCs levels (~10%) than the above-ground track. Lower aromatic compounds levels and higher carbonyls levels were observed in metro carriages at suburban areas than those at urban areas, likely due to less aromatic emission sources and more carbonyls emission sources in suburban areas. Acetone and acrolein were found to increase from 7.71 to 26.28μg/m 3 with number of commuters increasing from 40 to 200 in the carriages. According to the acceptable level proposed by the World Health Organization (1×10 -6 -1×10 -5 ), the life carcinogenic risk of commuters by subway (8.5×10 -6 -4.8×10 -5 ) was little above the acceptable level in Shanghai. Further application of our findings is possible to act as a reference in facilitating regulations for metro systems in other cities around world, so that in-carriage air quality might be improved. Copyright © 2016 Elsevier B.V. All rights reserved.

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-of-life scores were also associated with willingness to accept high risk. Conclusions and Relevance Most patients seeking WLS have high weight loss expectations and believe they need to lose substantial weight to derive any health benefits. Educational efforts may be necessary to align expectations with clinical reality. PMID:23553327

Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics.

PubMed

Baral, Stefan; Logie, Carmen H; Grosso, Ashley; Wirtz, Andrea L; Beyrer, Chris

2013-05-17

Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These factors are representative of social, economic, organizational and political inequities. Associated with an improved understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages. Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is often far more actionable than characterizing individual-level risks. We propose a modified social ecological model (MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM. The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic studies has traditionally been on describing individual-level risk factors, the future necessitates comprehensive epidemiologic data characterizing multiple levels of HIV risk.

Community Perceptions of Air Pollution and Related Health Risks in Nairobi Slums

PubMed Central

Egondi, Thaddaeus; Kyobutungi, Catherine; Ng, Nawi; Muindi, Kanyiva; Oti, Samuel; van de Vijver, Steven; Ettarh, Remare; Rocklöv, Joacim

2013-01-01

Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people’s response and acceptance of related policies. Therefore, understanding people’ perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were lowamong the residents indicating the need for promoting awareness on air pollution sources and related health risks. PMID:24157509

Emissions of Polycyclic Aromatic Hydrocarbons from Natural Gas Extraction into Air.

PubMed

Paulik, L Blair; Donald, Carey E; Smith, Brian W; Tidwell, Lane G; Hobbie, Kevin A; Kincl, Laurel; Haynes, Erin N; Anderson, Kim A

2016-07-19

Natural gas extraction, often referred to as "fracking", has increased rapidly in the United States in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. Levels of benzo[a]pyrene, phenanthrene, and carcinogenic potency of PAH mixtures were highest when samplers were closest to active wells. PAH levels closest to natural gas activity were comparable to levels previously reported in rural areas in winter. Sourcing ratios indicated that PAHs were predominantly petrogenic, suggesting that PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. At sites closest to active wells, the risk estimated for maximum residential exposure was 0.04 in a million, which is below the U.S. Environmental Protection Agency's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest from them. This work suggests that natural gas extraction is contributing PAHs to the air, at levels that would not be expected to increase cancer risk.

RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

PubMed Central

Wiedemann, Peter M.; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J.

2017-01-01

An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study’s multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the acceptance of base stations in their neighborhood. This underlines the value of exposure reduction for the acceptance of radio frequency electromagnetic field communication technologies. PMID:28594366

RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?

PubMed

Wiedemann, Peter M; Freudenstein, Frederik; Böhmert, Christoph; Wiart, Joe; Croft, Rodney J

2017-06-08

An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study's multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the acceptance of base stations in their neighborhood. This underlines the value of exposure reduction for the acceptance of radio frequency electromagnetic field communication technologies.

Improving organisational resilience through enterprise security risk management.

PubMed

Petruzzi, John; Loyear, Rachelle

Enterprise Security Risk Management (ESRM) is a new philosophy and method of managing security programmes through the use of traditional risk principles. As a philosophy and life cycle, ESRM is focused on creating a business partnership between security practitioners and business leaders to more effectively provide protection against security risks in line with acceptable risk tolerances as defined by business asset owners and stakeholders. This paper explores the basics of the ESRM philosophy and life cycle and also shows how embracing the ESRM philosophy and implementing a risk-based security management model in the business organisation can lead to higher levels of organisational resilience as desired by organisation leaders, executives and the board of directors.

Development of simulation-based learning programme for improving adherence to time-out protocol on high-risk invasive procedures outside of operating room.

PubMed

Jeong, Eun Ju; Chung, Hyun Soo; Choi, Jeong Yun; Kim, In Sook; Hong, Seong Hee; Yoo, Kyung Sook; Kim, Mi Kyoung; Won, Mi Yeol; Eum, So Yeon; Cho, Young Soon

2017-06-01

The aim of this study was to develop a simulation-based time-out learning programme targeted to nurses participating in high-risk invasive procedures and to figure out the effects of application of the new programme on acceptance of nurses. This study was performed using a simulation-based learning predesign and postdesign to figure out the effects of implementation of this programme. It was targeted to 48 registered nurses working in the general ward and the emergency department in a tertiary teaching hospital. Difference between acceptance and performance rates has been figured out by using mean, standard deviation, and Wilcoxon-signed rank test. The perception survey and score sheet have been validated through content validation index, and the reliability of evaluator has been verified by using intraclass correlation coefficient. Results showed high level of acceptance of high-risk invasive procedure (P<.01). Further, improvement was consistent regardless of clinical experience, workplace, or experience in simulation-based learning. The face validity of the programme showed over 4.0 out of 5.0. This simulation-based learning programme was effective in improving the recognition of time-out protocol and has given the participants the opportunity to become proactive in cases of high-risk invasive procedures performed outside of operating room. © 2017 John Wiley & Sons Australia, Ltd.

Peer Passenger Norms and Pressure: Experimental Effects on Simulated Driving Among Teenage Males.

PubMed

Bingham, C Raymond; Simons-Morton, Bruce G; Pradhan, Anuj K; Li, Kaigang; Almani, Farideh; Falk, Emily B; Shope, Jean T; Buckley, Lisa; Ouimet, Marie Claude; Albert, Paul S

2016-08-01

Serious crashes are more likely when teenage drivers have teenage passengers. One likely source of this increased risk is social influences on driving performance. This driving simulator study experimentally tested the effects of peer influence (i.e., risk-accepting compared to risk-averse peer norms reinforced by pressure) on the driving risk behavior (i.e., risky driving behavior and inattention to hazards) of male teenagers. It was hypothesized that peer presence would result in greater driving risk behavior (i.e., increased driving risk and reduced latent hazard anticipation), and that the effect would be greater when the peer was risk-accepting. Fifty-three 16- and 17-year-old male participants holding a provisional U.S., State of Michigan driver license were randomized to either a risk-accepting or risk-averse condition. Each participant operated a driving simulator while alone and separately with a confederate peer passenger. The simulator world included scenarios designed to elicit variation in driving risk behavior with a teen passenger present in the vehicle. Significant interactions of passenger presence (passenger present vs. alone) by risk condition (risk-accepting vs. risk-averse) were observed for variables measuring: failure to stop at yellow light intersections (Incident Rate Ratio (IRR)=2.16; 95% Confidence Interval [95CI]=1.06, 4.43); higher probability of overtaking (IRR=10.17; 95CI=1.43, 73.35); shorter left turn latency (IRR=0.43; 95CI=0.31,0.60); and, failure to stop at an intersection with an occluded stop sign (IRR=7.90; 95CI=2.06,30.35). In all cases, greater risky driving by participants was more likely with a risk-accepting passenger versus a risk-averse passenger present and a risk-accepting passenger present versus driving alone. Exposure of male teenagers to a risk-accepting confederate peer passenger who applied peer influence increased simulated risky driving behavior compared with exposure to a risk-averse confederate peer passenger or driving alone. These results are consistent with the contention that variability in teenage risky driving is in part explained by social influences.

Peer Passenger Norms and Pressure: Experimental Effects on Simulated Driving Among Teenage Males

PubMed Central

Bingham, C. Raymond; Simons-Morton, Bruce G.; Pradhan, Anuj K.; Li, Kaigang; Almani, Farideh; Falk, Emily B.; Shope, Jean T.; Buckley, Lisa; Ouimet, Marie Claude; Albert, Paul S.

2016-01-01

Objective Serious crashes are more likely when teenage drivers have teenage passengers. One likely source of this increased risk is social influences on driving performance. This driving simulator study experimentally tested the effects of peer influence (i.e., risk-accepting compared to risk-averse peer norms reinforced by pressure) on the driving risk behavior (i.e., risky driving behavior and inattention to hazards) of male teenagers. It was hypothesized that peer presence would result in greater driving risk behavior (i.e., increased driving risk and reduced latent hazard anticipation), and that the effect would be greater when the peer was risk-accepting. Methods Fifty-three 16- and 17-year-old male participants holding a provisional U.S., State of Michigan driver license were randomized to either a risk-accepting or risk-averse condition. Each participant operated a driving simulator while alone and separately with a confederate peer passenger. The simulator world included scenarios designed to elicit variation in driving risk behavior with a teen passenger present in the vehicle. Results Significant interactions of passenger presence (passenger present vs. alone) by risk condition (risk-accepting vs. risk-averse) were observed for variables measuring: failure to stop at yellow light intersections (Incident Rate Ratio (IRR)=2.16; 95% Confidence Interval [95CI]=1.06, 4.43); higher probability of overtaking (IRR=10.17; 95CI=1.43, 73.35); shorter left turn latency (IRR=0.43; 95CI=0.31,0.60); and, failure to stop at an intersection with an occluded stop sign (IRR=7.90; 95CI=2.06,30.35). In all cases, greater risky driving by participants was more likely with a risk-accepting passenger versus a risk-averse passenger present and a risk-accepting passenger present versus driving alone. Conclusions Exposure of male teenagers to a risk-accepting confederate peer passenger who applied peer influence increased simulated risky driving behavior compared with exposure to a risk-averse confederate peer passenger or driving alone. These results are consistent with the contention that variability in teenage risky driving is in part explained by social influences. PMID:27818610

Thoughts on Designing Things To NOT Break.

ERIC Educational Resources Information Center

Klajnscek, Rich

1998-01-01

Explains aspects of the design and loading of high-ropes courses and other challenge-course equipment. Discusses the engineer's factor of safety, determined by industry standards or the level of risk considered acceptable; definitions of terms for material strength; and the forces involved in loads sustained by belay ropes and cables. (SV)

MONITORED NATURAL ATTENUATION AND RISK MANAGEMENT OF MTBE IN GROUND WATER

EPA Science Inventory

Monitored natural attenuation (as U.S. EPA defines the term) is a remedy, where natural processes bring the concentration of MTBE to an acceptable level in a reasonable period of time. The longevity of the plume is its critical property. The rate of attenuation is typically con...

Geospatial analysis of bicycle network "level of traffic stress", bicycle mode choice behavior, and bicycle crashes for risk factor identification.

DOT National Transportation Integrated Search

2015-08-01

Small and medium-sized cities need publicly acceptable criteria for bicycle infrastructure improvements. This report explores the : effectiveness of one proposed system of bicycle infrastructure criteria using data from a state-of-the-art travel surv...

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.

Selenium and hazardous elements distribution in plant-soil-water system and human health risk assessment of Lower Cambrian, Southern Shaanxi, China.

PubMed

Du, Yajun; Luo, Kunli; Ni, Runxiang; Hussain, Rahib

2018-03-01

The natural selenium poisoning due to toxic Se levels in food chain had been observed in humans and animals in Lower Cambrian outcrop areas in Southern Shaanxi, China. To find out the distribution pattern of selenium and other hazardous elements in the plant, soil and water of Lower Cambrian in Southern Shaanxi, China, and their possible potential health risk, a total of 30 elements were analyzed and the health risk assessment of 18 elements was calculated. Results showed that the soil, plant and natural water of Lower Cambrian all had relatively high Se levels. In Lower Cambrian, the soil was enriched with Se, As, Ba, Cu, Mo, Ni, Zn, Ga, Cd and Cr (1.68 < I geo  < 4.48, I geo ; geo-accumulation index). In same plants, the contents of Se, Cd and Zn (except Cd in corn and rice, Zn in potato and corn) of Lower Cambrian were higher than that of the other strata. Ba and Ga in natural water were higher than that of the other strata, while K and Cs were opposite. The health risk assessment results showed that the people living in outcrop areas of Lower Cambrian had both high total non-carcinogenic risk of 18 elements (HI = 16.12, acceptable range: < 1) and carcinogenic risk of As (3.98E-04, acceptable range: 10 -6 -10 -4 ). High contents of Se, As, Mo and Tl of Lower Cambrian may pose a health risk to local people, and food intake was the major pathway. For minimizing potential health risk, the local inhabitants should use the mix-imported food with local growing foods.

Evaluating the Risk of Re-identification of Patients from Hospital Prescription Records.

PubMed

Emam, Khaled El; Dankar, Fida K; Vaillancourt, Régis; Roffey, Tyson; Lysyk, Mary

2009-07-01

Pharmacies often provide prescription records to private research firms, on the assumption that these records are de-identified (i.e., identifying information has been removed). However, concerns have been expressed about the potential that patients can be re-identified from such records. Recently, a large private research firm requested prescription records from the Children's Hospital of Eastern Ontario (CHEO), as part of a larger effort to develop a database of hospital prescription records across Canada. To evaluate the ability to re-identify patients from CHEO'S prescription records and to determine ways to appropriately de-identify the data if the risk was too high. The risk of re-identification was assessed for 18 months' worth of prescription data. De-identification algorithms were developed to reduce the risk to an acceptable level while maintaining the quality of the data. The probability of patients being re-identified from the original variables and data set requested by the private research firm was deemed quite high. A new de-identified record layout was developed, which had an acceptable level of re-identification risk. The new approach involved replacing the admission and discharge dates with the quarter and year of admission and the length of stay in days, reporting the patient's age in weeks, and including only the first character of the patient's postal code. Additional requirements were included in the data-sharing agreement with the private research firm (e.g., audit requirements and a protocol for notification of a breach of privacy). Without a formal analysis of the risk of re-identification, assurances of data anonymity may not be accurate. A formal risk analysis at one hospital produced a clinically relevant data set that also protects patient privacy and allows the hospital pharmacy to explicitly manage the risks of breach of patient privacy.

Human health risk assessment of DDTs and HCHs through dietary exposure in Nanjing, China.

PubMed

Zhang, Qianqian; Xia, Zhonghuan; Wu, Minmin; Wang, Liping; Yang, Hao

2017-06-01

In a market based study in Nanjing, a typical southeast city in China, the most common consumed 23 kinds of foods from eleven different categories (vegetable, fruit, fish, pork, livestock meat, chicken, egg, milk, oil, rice and flour) were sampled in November 2015. The concentrations of DDTs and HCHs in foods were analyzed using gas chromatography with mass spectrometer detector. The residual amounts of DDTs and HCHs in foods were 0.95-3.53 ng g -1 and 0.32-1.96 ng g -1 , respectively. The highest residual of ∑ 10 OCPs was 4.75 ng g -1 in livestock meat and the lowest was 1.31 ng g -1 in flour. Estimated daily intakes of both DDTs and HCHs for children were higher than other age groups regardless of the gender. With respect to food categories, the consumption of vegetables generated higher dietary exposure of DDTs and HCHs than other food categories for all age categories, which accounted for 20.21%-29.18% of the total. The daily intakes of γ-HCH and DDTs for all population groups were far below the acceptable amounts suggested by the Food and Agriculture Organization of the United Nations/World Health Organization. Health risk assessment indicated that there was no obvious non-cancer risk for local residents, whereas the cancer risk was estimated to be from 10 -6 ∼10 -4 , being higher than the acceptable risk level and lower than the priority risk level. Among residents of different gender and age, females showed higher risk than males in all age groups, and children were the most vulnerable age group to health risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Risk, Benefit, and Cost Thresholds for Emergency Department Testing: A Cross-sectional, Scenario-based Study.

PubMed

Meka, Arjun Prasad; Porath, Jonathan Douglas; Iyengar, Rahul; Morrow, Chelsea; Fagerlin, Angela; Meurer, William J

2017-06-01

While diagnostic testing is common in the emergency department, the value of some testing is questionable. The purpose of this study was to assess how varying levels of benefit, risk, and costs influenced an individual's desire to have diagnostic testing. A survey through Amazon Mechanical Turk presented hypothetical clinical situations: low-risk chest pain and minor traumatic brain injury. Each scenario included three given variables (benefit, risk, and cost), that was independently randomly varied over four possible values (0.1, 1, 5, and 10% for benefit and risk and $0, $100, $500, and $1,000 for the individual's personal cost for receiving the test). Benefit was defined as the probability of finding the target disease (traumatic intracranial hemorrhage or acute coronary syndrome). One-thousand unique respondents completed the survey. With an increased benefit from 0.1% to 10%, the percentage of respondents who accepted a diagnostic test went from 28.4% to 53.1%. (odds ratio [OR] = 3.42; 95% confidence interval [CI] = 2.57-4.54). As risk increased from 0.1% to 10%, this number decreased from 52.5% to 28.5%. (OR = 0.33; 95% CI = 0.25-0.44). Increasing cost from $0 to $1,000 had the greatest change of those accepting the test from 61.1% to 21.4%, respectively (OR = 0.15; 95% CI = 0.11-0.2). The desire for testing was strongly sensitive to the benefits, risks, and costs. Many participants wanted a test when there was no added cost, regardless of benefit or risk levels, but far fewer elected to receive the test as cost increased incrementally. This suggests that out-of-pocket costs may deter patients from undergoing diagnostic testing with low potential benefit. © 2016 by the Society for Academic Emergency Medicine.

State of the art in benefit-risk analysis: introduction.

PubMed

Verhagen, H; Tijhuis, M J; Gunnlaugsdóttir, H; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken, G; Pohjola, M V; Tuomisto, J T; Ueland, Ø; White, B C; Holm, F

2012-01-01

Risk-taking is normal in everyday life if there are associated (perceived) benefits. Benefit-Risk Analysis (BRA) compares the risk of a situation to its related benefits and addresses the acceptability of the risk. Over the past years BRA in relation to food and food ingredients has gained attention. Food, and even the same food ingredient, may confer both beneficial and adverse effects. Measures directed at food safety may lead to suboptimal or insufficient levels of ingredients from a benefit perspective. In BRA, benefits and risks of food (ingredients) are assessed in one go and may conditionally be expressed into one currency. This allows the comparison of adverse and beneficial effects to be qualitative and quantitative. A BRA should help policy-makers to make more informed and balanced benefit-risk management decisions. Not allowing food benefits to occur in order to guarantee food safety is a risk management decision much the same as accepting some risk in order to achieve more benefits. BRA in food and nutrition is making progress, but difficulties remain. The field may benefit from looking across its borders to learn from other research areas. The BEPRARIBEAN project (Best Practices for Risk-Benefit Analysis: experience from out of food into food; http://en.opasnet.org/w/Bepraribean) aims to do so, by working together with Medicines, Food Microbiology, Environmental Health, Economics & Marketing-Finance and Consumer Perception. All perspectives are reviewed and subsequently integrated to identify opportunities for further development of BRA for food and food ingredients. Interesting issues that emerge are the varying degrees of risk that are deemed acceptable within the areas and the trend towards more open and participatory BRA processes. A set of 6 'state of the art' papers covering the above areas and a paper integrating the separate (re)views are published in this volume. Copyright © 2011 Elsevier Ltd. All rights reserved.

Human Papillomavirus Infection and Vaccination: Awareness and Knowledge of HPV and Acceptability of HPV Vaccine among Mothers of Teenage Daughters in Weihai, Shandong, China

PubMed Central

Sun, Jiandong; Li, Ruiying; Li, Meilan; Wang, Jianguang; Zhang, Dongfeng; Xu, Aiqiang

2016-01-01

In preparation for the introduction of human papillomavirus (HPV) vaccine, we investigated awareness and knowledge of HPV/HPV vaccine and potential acceptability to HPV vaccine among mothers with a teenage daughter in Weihai, Shandong, China. A cross-sectional survey was conducted in 2013 with a sample of 1850 mothers who had a daughter (aged 9–17 years) attending primary, junior and senior high schools. In the final sample (N = 1578, response rate 85.30%), awareness of HPV was reported by 305 (19.32%) mothers. Awareness varied significantly by daughter’s age (P<0.01), mother’s education level (P<0.01), mother’s occupation (P<0.01), household income (P<0.01) and residence type (P<0.01). Knowledge about HPV/HPV vaccine was poor with a mean total score of 3.56 (SD = 2.40) out of a possible score of 13. Mothers with a higher education level reported higher levels of knowledge (P = 0.02). Slightly more than one-fourth (26.49%) of mothers expressed their potential acceptability of HPV vaccine for their daughters. Acceptability increased along with increased daughters’ age (P<0.01), household income (P<0.01) and knowledge level (P<0.01). House wives and unemployed mothers had the highest acceptability (P<0.01). The most common reasons for not accepting HPV vaccination were “My daughter is too young to have risk of cervical cancer (30.95%)”, “The vaccine has not been widely used, and the decision will be made after it is widely used (24.91%)”, “Worry about the safety of the vaccine (22.85%)”. Awareness and knowledge of HPV/HPV vaccines are poor and HPV vaccine acceptability is low among these Chinese mothers. These results may help inform appropriate health education programs in this population. PMID:26766565

Human Papillomavirus Infection and Vaccination: Awareness and Knowledge of HPV and Acceptability of HPV Vaccine among Mothers of Teenage Daughters in Weihai, Shandong, China.

PubMed

Yu, Yang; Xu, Minglei; Sun, Jiandong; Li, Ruiying; Li, Meilan; Wang, Jianguang; Zhang, Dongfeng; Xu, Aiqiang

2016-01-01

In preparation for the introduction of human papillomavirus (HPV) vaccine, we investigated awareness and knowledge of HPV/HPV vaccine and potential acceptability to HPV vaccine among mothers with a teenage daughter in Weihai, Shandong, China. A cross-sectional survey was conducted in 2013 with a sample of 1850 mothers who had a daughter (aged 9-17 years) attending primary, junior and senior high schools. In the final sample (N = 1578, response rate 85.30%), awareness of HPV was reported by 305 (19.32%) mothers. Awareness varied significantly by daughter's age (P<0.01), mother's education level (P<0.01), mother's occupation (P<0.01), household income (P<0.01) and residence type (P<0.01). Knowledge about HPV/HPV vaccine was poor with a mean total score of 3.56 (SD = 2.40) out of a possible score of 13. Mothers with a higher education level reported higher levels of knowledge (P = 0.02). Slightly more than one-fourth (26.49%) of mothers expressed their potential acceptability of HPV vaccine for their daughters. Acceptability increased along with increased daughters' age (P<0.01), household income (P<0.01) and knowledge level (P<0.01). House wives and unemployed mothers had the highest acceptability (P<0.01). The most common reasons for not accepting HPV vaccination were "My daughter is too young to have risk of cervical cancer (30.95%)", "The vaccine has not been widely used, and the decision will be made after it is widely used (24.91%)", "Worry about the safety of the vaccine (22.85%)". Awareness and knowledge of HPV/HPV vaccines are poor and HPV vaccine acceptability is low among these Chinese mothers. These results may help inform appropriate health education programs in this population.

Uncertainty analysis as essential step in the establishment of the dynamic Design Space of primary drying during freeze-drying.

PubMed

Mortier, Séverine Thérèse F C; Van Bockstal, Pieter-Jan; Corver, Jos; Nopens, Ingmar; Gernaey, Krist V; De Beer, Thomas

2016-06-01

Large molecules, such as biopharmaceuticals, are considered the key driver of growth for the pharmaceutical industry. Freeze-drying is the preferred way to stabilise these products when needed. However, it is an expensive, inefficient, time- and energy-consuming process. During freeze-drying, there are only two main process variables to be set, i.e. the shelf temperature and the chamber pressure, however preferably in a dynamic way. This manuscript focuses on the essential use of uncertainty analysis for the determination and experimental verification of the dynamic primary drying Design Space for pharmaceutical freeze-drying. Traditionally, the chamber pressure and shelf temperature are kept constant during primary drying, leading to less optimal process conditions. In this paper it is demonstrated how a mechanistic model of the primary drying step gives the opportunity to determine the optimal dynamic values for both process variables during processing, resulting in a dynamic Design Space with a well-known risk of failure. This allows running the primary drying process step as time efficient as possible, hereby guaranteeing that the temperature at the sublimation front does not exceed the collapse temperature. The Design Space is the multidimensional combination and interaction of input variables and process parameters leading to the expected product specifications with a controlled (i.e., high) probability. Therefore, inclusion of parameter uncertainty is an essential part in the definition of the Design Space, although it is often neglected. To quantitatively assess the inherent uncertainty on the parameters of the mechanistic model, an uncertainty analysis was performed to establish the borders of the dynamic Design Space, i.e. a time-varying shelf temperature and chamber pressure, associated with a specific risk of failure. A risk of failure acceptance level of 0.01%, i.e. a 'zero-failure' situation, results in an increased primary drying process time compared to the deterministic dynamic Design Space; however, the risk of failure is under control. Experimental verification revealed that only a risk of failure acceptance level of 0.01% yielded a guaranteed zero-defect quality end-product. The computed process settings with a risk of failure acceptance level of 0.01% resulted in a decrease of more than half of the primary drying time in comparison with a regular, conservative cycle with fixed settings. Copyright © 2016. Published by Elsevier B.V.

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, which again is vital for defining risk acceptance. Moreover, risk communication should be seen as an opportunity to demonstrate trustworthiness and an open, responsible and caring attitude. It is important for the wind industry to avoid accidents: In Winterwind 2017 (Ronsten)[10], the importance for the wind power community to proactively take safety measures for passers-by and service personnel was emphasized: Establishing good practices and communication routines is key to avoid accidents. Visually attractive ways of presenting the risk of ice throw are recommended.

Health benefit from decreasing exposure to heavy metals and metalloid after strict pollution control measures near a typical river basin area in China.

PubMed

Cao, Suzhen; Duan, Xiaoli; Ma, Yingqun; Zhao, Xiuge; Qin, Yanwen; Liu, Yan; Li, Sai; Zheng, Binghui; Wei, Fusheng

2017-10-01

The metal(loid) pollution still is a great concern due to the effects from urbanization and industrialization. While, the health risks from the toxic metal(loid)s could decrease if strict pollution control measures were adopted. However, few studies to date investigate the health risks of heavy metal(loid)s in a systematic river basin for the dependent residents, after taking pollution control measures. Thus, the contents of metal(loid)s (Cu, Pb, Zn, Cd, Mn, As) in surface water along a typical river basin were investigated in this study, and the potential non-carcinogenic and carcinogenic health risks posed to the residents were assessed. Although the soluble contents of Cu, Pb, Zn and Cd exceeded the respective thresholds in two sites located downstream the mine area, they were greatly decreased in comparison with previous contamination levels, and the soluble concentrations of all the metal(loid)s were within the relevant thresholds in the sites far away from the mining area. Moreover, the closer to the mining area, the higher the pollution levels of metal(loid)s. The total hazard index for non-carcinogenic risks of metal(loid)s were basically lower than the threshold (1) for the local population. Whereas, although the content of metal(loid)s were low (such as As), they could pose relative higher non-carcinogenic health risks. The result illustrated that pollution levels, toxicity of the contaminants and exposure behavior patterns all could contribute to the potential detrimental health risks. Additionally, the non-carcinogenic and carcinogenic risks from ingestion exposure were ∼2-∼4 orders of magnitude higher than those from dermal contact. The total carcinogenic risks were basically lower than the maximum tolerable levels (1.0 × 10 -4 ), indicating carcinogenic risks from most areas of the river could also be accepted. Among different population groups, heavy metal(loid)s posed relative higher non-carcinogenic and carcinogenic risks to the children in 0-5 years old. Fortunately, the surface water in most area of this basin is safe in usage for the local population and the health risks were basically acceptable in case exposed to the target metal(loid)s, after the river basin was in the charge of strict pollution control measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

PRA (Probabilistic Risk Assessments) Participation versus Validation

NASA Technical Reports Server (NTRS)

DeMott, Diana; Banke, Richard

2013-01-01

Probabilistic Risk Assessments (PRAs) are performed for projects or programs where the consequences of failure are highly undesirable. PRAs primarily address the level of risk those projects or programs posed during operations. PRAs are often developed after the design has been completed. Design and operational details used to develop models include approved and accepted design information regarding equipment, components, systems and failure data. This methodology basically validates the risk parameters of the project or system design. For high risk or high dollar projects, using PRA methodologies during the design process provides new opportunities to influence the design early in the project life cycle to identify, eliminate or mitigate potential risks. Identifying risk drivers before the design has been set allows the design engineers to understand the inherent risk of their current design and consider potential risk mitigation changes. This can become an iterative process where the PRA model can be used to determine if the mitigation technique is effective in reducing risk. This can result in more efficient and cost effective design changes. PRA methodology can be used to assess the risk of design alternatives and can demonstrate how major design changes or program modifications impact the overall program or project risk. PRA has been used for the last two decades to validate risk predictions and acceptability. Providing risk information which can positively influence final system and equipment design the PRA tool can also participate in design development, providing a safe and cost effective product.

Multilevel selected primary prevention of child maltreatment.

PubMed

Peterson, Lizette; Tremblay, George; Ewigman, Bernard; Saldana, Lisa

2003-06-01

Few treatment studies and even fewer primary prevention studies have demonstrated successful reduction of child maltreatment. Successful preventive interventions have often been lengthy and expensive; shorter programs have been didactic and ineffective. The present investigation relied on a 7-level model of successful parenting to mount a time-limited, "selected" prevention effort with high-risk mothers. This program included modeling, role-playing, Socratic dialogue, home practice, and home visits. The study demonstrated effective intervention at every level of the model, including improvements in (a) parenting skills, (b) developmentally appropriate interventions, (c) developmentally appropriate beliefs, (d) negative affect, (e) acceptance of a responsible parent role, (f) acceptance of a nurturing parent role, and (g) self-efficacy. Directions for future research are considered.

Method and system for assigning a confidence metric for automated determination of optic disc location

DOEpatents

Karnowski, Thomas P [Knoxville, TN; Tobin, Jr., Kenneth W.; Muthusamy Govindasamy, Vijaya Priya [Knoxville, TN; Chaum, Edward [Memphis, TN

2012-07-10

A method for assigning a confidence metric for automated determination of optic disc location that includes analyzing a retinal image and determining at least two sets of coordinates locating an optic disc in the retinal image. The sets of coordinates can be determined using first and second image analysis techniques that are different from one another. An accuracy parameter can be calculated and compared to a primary risk cut-off value. A high confidence level can be assigned to the retinal image if the accuracy parameter is less than the primary risk cut-off value and a low confidence level can be assigned to the retinal image if the accuracy parameter is greater than the primary risk cut-off value. The primary risk cut-off value being selected to represent an acceptable risk of misdiagnosis of a disease having retinal manifestations by the automated technique.

Effects of breast stimulation for spontaneous onset of labor on salivary oxytocin levels in low-risk pregnant women: A feasibility study

PubMed Central

Tadokoro, Yuriko; Shuo, Takuya; Sawano, Erika; Shinohara, Kazuyuki

2018-01-01

Objectives This preliminary study aimed to 1) determine changes in the salivary oxytocin (OT) level during breast stimulation for promoting the spontaneous onset of labor in low-risk term pregnancies, and 2) clarify the feasibility of the breast stimulation intervention protocol in terms of practicality and acceptability. Methods We used a single arm trial design. Sixteen low-risk pregnant women between 38 and 40 weeks of gestation with cephalic presentation participated. They performed breast stimulation for 3 days with an attendant midwife in a single maternity hospital. Each breast was stimulated for 15 minutes for a total of 1 hour per day. Saliva was collected 10 minutes before the intervention and 15, 30, 60, 75, and 90 minutes after the intervention, yielding 18 samples per woman. Results Among a total of 282 saliva samples from the 16 participants, OT level was measured in 142 samples (missing rate: 49.6%). The median OT level showed the highest values on day 3 of the breast stimulation, with a marked increase 30 min after the intervention. In the mixed models after multiple imputation for missing data, the OT level on the first day of intervention was significantly lower than that on the third day of intervention. Fatigue from breast stimulation decreased on subsequent days, and most of the women (75%) felt no discomfort with the protocol. Uterine hyperstimulation was not observed. Conclusion Following a 3-day breast stimulation protocol for spontaneous onset of labor, the mean OT level showed the highest values on day 3. The breast stimulation intervention protocol showed good feasibility in terms of practicality and acceptability among the pregnant women. Additional large-scale studies are warranted to confirm the protocol’s effectiveness. PMID:29447299

Effects of breast stimulation for spontaneous onset of labor on salivary oxytocin levels in low-risk pregnant women: A feasibility study.

PubMed

Takahata, Kaori; Horiuchi, Shigeko; Tadokoro, Yuriko; Shuo, Takuya; Sawano, Erika; Shinohara, Kazuyuki

2018-01-01

This preliminary study aimed to 1) determine changes in the salivary oxytocin (OT) level during breast stimulation for promoting the spontaneous onset of labor in low-risk term pregnancies, and 2) clarify the feasibility of the breast stimulation intervention protocol in terms of practicality and acceptability. We used a single arm trial design. Sixteen low-risk pregnant women between 38 and 40 weeks of gestation with cephalic presentation participated. They performed breast stimulation for 3 days with an attendant midwife in a single maternity hospital. Each breast was stimulated for 15 minutes for a total of 1 hour per day. Saliva was collected 10 minutes before the intervention and 15, 30, 60, 75, and 90 minutes after the intervention, yielding 18 samples per woman. Among a total of 282 saliva samples from the 16 participants, OT level was measured in 142 samples (missing rate: 49.6%). The median OT level showed the highest values on day 3 of the breast stimulation, with a marked increase 30 min after the intervention. In the mixed models after multiple imputation for missing data, the OT level on the first day of intervention was significantly lower than that on the third day of intervention. Fatigue from breast stimulation decreased on subsequent days, and most of the women (75%) felt no discomfort with the protocol. Uterine hyperstimulation was not observed. Following a 3-day breast stimulation protocol for spontaneous onset of labor, the mean OT level showed the highest values on day 3. The breast stimulation intervention protocol showed good feasibility in terms of practicality and acceptability among the pregnant women. Additional large-scale studies are warranted to confirm the protocol's effectiveness.

[The urgent problems of the improvement of the environment management system based on the analysis of health risk assessment].

PubMed

Avaliani, S L; Novikov, S M; Shashina, T A; Dodina, N S; Kislitsin, V A; Mishina, A L

2014-01-01

The lack of adequate legislative and regulatory framework for ensuring minimization of the health risks in the field of environmental protection is the obstacle for the application of the risk analysis methodology as a leading tool for administrative activity in Russia. "Principles of the state policy in the sphere of ensuring chemical and biological safety of the Russian Federation for the period up to 2025 and beyond", approved by the President of the Russian Federation on 01 November 2013, No PR-25 73, are aimed at the legal support for the health risk analysis methodology. In the article there have been supposed the main stages of the operative control of the environmental quality, which lead to the reduction of the health risk to the acceptable level. The further improvement of the health risk analysis methodology in Russia should contribute to the implementation of the state policy in the sphere of chemical and biological safety through the introduction of complex measures on neutralization of chemical and biological threats to the human health and the environment, as well as evaluation of the economic effectiveness of these measures. The primary step should be the legislative securing of the quantitative value for the term: "acceptable risk".

Spatial and seasonal variations, sources, air-soil exchange, and carcinogenic risk assessment for PAHs and PCBs in air and soil of Kutahya, Turkey, the province of thermal power plants.

PubMed

Dumanoglu, Yetkin; Gaga, Eftade O; Gungormus, Elif; Sofuoglu, Sait C; Odabasi, Mustafa

2017-02-15

Atmospheric and concurrent soil samples were collected during winter and summer of 2014 at 41 sites in Kutahya, Turkey to investigate spatial and seasonal variations, sources, air-soil exchange, and associated carcinogenic risks of polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs). The highest atmospheric and soil concentrations were observed near power plants and residential areas, and the wintertime concentrations were generally higher than ones measured in summer. Spatial distribution of measured ambient concentrations and results of the factor analysis showed that the major contributing PAH sources in Kutahya region were the coal combustion for power generation and residential heating (48.9%), and diesel and gasoline exhaust emissions (47.3%) while the major PCB sources were the coal (thermal power plants and residential heating) and wood combustion (residential heating) (45.4%), and evaporative emissions from previously used technical PCB mixtures (34.7%). Results of fugacity fraction calculations indicated that the soil and atmosphere were not in equilibrium for most of the PAHs (88.0% in winter, 87.4% in summer) and PCBs (76.8% in winter, 83.8% in summer). For PAHs, deposition to the soil was the dominant mechanism in winter while in summer volatilization was equally important. For PCBs, volatilization dominated in summer while deposition was higher in winter. Cancer risks associated with inhalation and accidental soil ingestion of soil were also estimated. Generally, the estimated carcinogenic risks were below the acceptable risk level of 10 -6 . The percentage of the population exceeding the acceptable risk level ranged from <1% to 16%, except, 32% of the inhalation risk levels due to PAH exposure in winter at urban/industrial sites were >10 -6 . Copyright © 2016 Elsevier B.V. All rights reserved.

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-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk. PMID:27494136

The scientific jigsaw puzzle: Fitting the pieces of the low-level radiation debate

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

Beyea, Jan

2012-05-01

Quantitative risk estimates from exposure to ionizing radiation are dominated by analysis of the one-time exposures received by the Japanese survivors at Hiroshima and Nagasaki. Three recent epidemiologic studies suggest that the risk from protracted exposure is no lower, and in fact may be higher, than from single exposures. There is near-universal acceptance that epidemiologic data demonstrates an excess risk of delayed cancer incidence above a dose of 0.1 sievert (Sv), which, for the average American, is equivalent to 40 years of unavoidable exposure from natural background radiation. Model fits, both parametric and nonparametric, to the atomic-bomb data support amore » linear no-threshold model, below 0.1 Sv. On the basis of biologic arguments, the scientific establishment in the United States and many other countries accepts this dose-model down to zero-dose, but there is spirited dissent. The dissent may be irrelevant for developed countries, given the increase in medical diagnostic radiation that has occurred in recent decades; a sizeable percentage of this population will receive cumulative doses from the medical profession in excess of 0.1 Sv, making talk of a threshold or other sublinear response below that dose moot for future releases from nuclear facilities or a dirty bomb. The risks from both medical diagnostic doses and nuclear accident doses can be computed using the linear dose-response model, with uncertainties assigned below 0.1 Sv in a way that captures alternative scientific hypotheses. Then, the important debate over low-level radiation exposures, namely planning for accident response and weighing benefits and risks of technologies, can proceed with less distraction. One of the biggest paradoxes in the low-level radiation debate is that an individual risk can be a minor concern, while the societal risk-the total delayed cancers in an exposed population-can be of major concern.« less

Development of a brief parent-report risk index for children following parental divorce.

PubMed

Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

2013-12-01

This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

"Like Holding an Umbrella Before It Rains": Acceptability of Future Rectal Microbicides Among Men Who Have Sex With Men in India-A Modified Technology Acceptance Model.

PubMed

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Mengle, Shruta; Nelson, Ruban; Rubincam, Clara; Kumar, Pushpesh

2017-07-01

Topical rectal microbicides (RMs) are a new prevention technology in development that aims to reduce the risk of HIV acquisition from anal sex. We examined RM acceptability among men who have sex with men (MSM) in India. We conducted a qualitative exploratory study guided by a modified Technology Acceptance Model, with 10 focus groups ( n = 61) of MSM and 10 key informant interviews. Data were explored using framework analysis. RM acceptability was influenced by technological contexts: perceived usefulness of RMs, perceived ease of use of RM and applicator, and habits around condom and lubricant use; individual and interpersonal contexts: perceived relevance and preferences for product formulation and dosing frequency; and MSM community/social contexts: perceived social approval, RM-related stigma, social support. Implementation of RMs for MSM in India may be supported by multi-level interventions that engage community-based organizations in destigmatizing and distributing RMs, ideally gel-based products that enable on-demand use before sex.

A Generalized Pivotal Quantity Approach to Analytical Method Validation Based on Total Error.

PubMed

Yang, Harry; Zhang, Jianchun

2015-01-01

The primary purpose of method validation is to demonstrate that the method is fit for its intended use. Traditionally, an analytical method is deemed valid if its performance characteristics such as accuracy and precision are shown to meet prespecified acceptance criteria. However, these acceptance criteria are not directly related to the method's intended purpose, which is usually a gurantee that a high percentage of the test results of future samples will be close to their true values. Alternate "fit for purpose" acceptance criteria based on the concept of total error have been increasingly used. Such criteria allow for assessing method validity, taking into account the relationship between accuracy and precision. Although several statistical test methods have been proposed in literature to test the "fit for purpose" hypothesis, the majority of the methods are not designed to protect the risk of accepting unsuitable methods, thus having the potential to cause uncontrolled consumer's risk. In this paper, we propose a test method based on generalized pivotal quantity inference. Through simulation studies, the performance of the method is compared to five existing approaches. The results show that both the new method and the method based on β-content tolerance interval with a confidence level of 90%, hereafter referred to as the β-content (0.9) method, control Type I error and thus consumer's risk, while the other existing methods do not. It is further demonstrated that the generalized pivotal quantity method is less conservative than the β-content (0.9) method when the analytical methods are biased, whereas it is more conservative when the analytical methods are unbiased. Therefore, selection of either the generalized pivotal quantity or β-content (0.9) method for an analytical method validation depends on the accuracy of the analytical method. It is also shown that the generalized pivotal quantity method has better asymptotic properties than all of the current methods. Analytical methods are often used to ensure safety, efficacy, and quality of medicinal products. According to government regulations and regulatory guidelines, these methods need to be validated through well-designed studies to minimize the risk of accepting unsuitable methods. This article describes a novel statistical test for analytical method validation, which provides better protection for the risk of accepting unsuitable analytical methods. © PDA, Inc. 2015.

Risk communication methods in hip fracture prevention: a randomised trial in primary care.

PubMed

Hudson, Ben; Toop, Les; Mangin, Dee; Pearson, John

2011-08-01

Treatment acceptance by patients is influenced by the way treatment effects are presented. Presentation of benefits using relative risk increases treatment acceptance compared to the use of absolute risk. It is not known whether this effect is modified by prior presentation of a patient's individualised risk estimate or how presentation of treatment harms by relative or absolute risk affects acceptance. To compare acceptance of a hypothetical treatment to prevent hip fracture after presentation of the treatment's benefit in relative or absolute terms in the context of a personal fracture risk estimate, and to reassess acceptance following subsequent presentation of harm in relative or absolute terms. Randomised controlled trial of patients recruited from 10 GPs' lists in Christchurch, New Zealand. Women aged ≥ 50 years were invited to participate. Participants were given a personal 10-year hip fracture risk estimate and randomised to receive information on a hypothetical treatment's benefit and harm in relative or absolute terms. Of the 1140 women invited to participate 393 (34%) took part. Treatment acceptance was greater following presentation of benefit using absolute terms than relative terms after adjustment forage, education, previous osteoporosis diagnosis, and self-reported risk (OR 1.73, 95% confidence interval [CI] = 1.10 to 2.73, P = 0.018). Presentation of the treatment's harmful effect in relative terms led to a greater proportion of participants declining treatment than did presentation in absolute terms (OR 4.89, 95% CI = 2.3 to 11.0, P<0.001). Presentation of treatment benefit and harm using absolute risk estimates led to greater treatment acceptance than presentation of the same information in relative terms.

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.

Design for Minimum Risk

NASA Technical Reports Server (NTRS)

Wetherholt, Jon; Heimann, Timothy J.

2010-01-01

Design for Minimum Risk (DFMR) is a term used by NASA programs as an expansion of the general hazard reduction process where if an identified hazard cannot be eliminated, the design is modified to reduce the associated mishap risk to an acceptable level. DFMR is a set of specific requirements to minimize risk. DFMR is not well understood and there are many misconceptions concerning the meaning and use. This paper will provide insight into the use of DFMR for space applications; it s comparison to other hazard mitigation strategies and examples of how the approach has been used in the past. It will also highlight documents used by NASA on various programs to determine DFMR.

Morbidity, mortality, and categorization of the risk of perioperative complications in lung cancer patients*

PubMed Central

Stanzani, Fabiana; Paisani, Denise de Moraes; de Oliveira, Anderson; de Souza, Rodrigo Caetano; Perfeito, João Aléssio Juliano; Faresin, Sonia Maria

2014-01-01

OBJECTIVE: To determine morbidity and mortality rates by risk category in accordance with the American College of Chest Physicians guidelines, to determine what role pulmonary function tests play in this categorization process, and to identify risk factors for perioperative complications (PCs). METHODS: This was a historical cohort study based on preoperative and postoperative data collected for cases of lung cancer diagnosed or suspected between 2001 and 2010. RESULTS: Of the 239 patients evaluated, only 13 (5.4%) were classified as being at high risk of PCs. Predicted postoperative FEV1 (FEV1ppo) was sufficient to define the risk level in 156 patients (65.3%); however, cardiopulmonary exercise testing (CPET) was necessary for identifying those at high risk. Lung resection was performed in 145 patients. Overall morbidity and mortality rates were similar to those reported in other studies. However, morbidity and mortality rates for patients at an acceptable risk of PCs were 31.6% and 4.3%, respectively, whereas those for patients at high risk were 83.3% and 33.3%. Advanced age, COPD, lobe resection, and lower FEV1ppo were correlated with PCs. CONCLUSIONS: Although spirometry was sufficient for risk assessment in the majority of the population studied, CPET played a key role in the identification of high-risk patients, among whom the mortality rate was seven times higher than was that observed for those at an acceptable risk of PCs. The risk factors related to PCs coincided with those reported in previous studies. PMID:24626266

Garnering an In-depth Understanding of Men Who Have Sex with Men in Chennai, India: A Qualitative Analysis of Sexual Minority Status and Psychological Distress

PubMed Central

Closson, Elizabeth F.; Thomas, Beena; Mayer, Kenneth H.; Betancourt, Theresa; Menon, Sunil; Safren, Steven A.

2015-01-01

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and havean HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n = 46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants' personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one's sexual minority identity to foster better psychosocial and overall health. PMID:25358949

Garnering an in-depth understanding of men who have sex with men in Chennai, India: a qualitative analysis of sexual minority status and psychological distress.

PubMed

Mimiaga, Matthew J; Closson, Elizabeth F; Thomas, Beena; Mayer, Kenneth H; Betancourt, Theresa; Menon, Sunil; Safren, Steven A

2015-10-01

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and have an HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n = 46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants' personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one's sexual minority identity to foster better psychosocial and overall health.

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 cancer risk relies on the three assumptions of linearity, additivity, and scaling along with the use of population averages. We describe uncertainty estimates for this model, and new experimental data that sheds light on the accuracy of the underlying assumptions. These methods make it possible to express risk management objectives in terms of quantitative metrics, i.e., the number of days in space without exceeding a given risk level within well defined confidence limits. The resulting methodology is applied to several human space exploration mission scenarios including lunar station, deep space outpost, and a Mars mission. Factors that dominate risk projection uncertainties and application of this approach to assess candidate mitigation approaches are described.

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 results suggest that the comparisons of the participating cities are easily understood, and defensible. The evaluation of the sources of El Salvador's risk, made before the January 13th earthquake, pointed to the vulnerability made visible by the earthquake: earthquake-induced landslides, and difficulties with emergency response.

Human exposure to trace elements through the skin by direct contact with clothing: Risk assessment

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

Rovira, Joaquim; Environmental Engineering Laboratory, Departament d'Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia; Nadal, Martí

Metals in textile products and clothing are used for many purposes, such as metal complex dyes, pigments, mordant, catalyst in synthetic fabrics manufacture, synergists of flame retardants, antimicrobials, or as water repellents and odour-preventive agents. When present in textile materials, heavy metals may mean a potential danger to human health. In the present study, the concentrations of a number of elements (Al, As, B, Ba, Be, Bi, Cd, Co, Cr, Cu, Fe, Hg, Mg, Mn, Mo, Ni, Pb, Sb, Sc, Se, Sm, Sn, Sr, Tl, V, and Zn) were determined in skin-contact clothes. Analysed clothes were made of different materials,more » colours, and brands. Interestingly, we found high levels of Cr in polyamide dark clothes (605 mg/kg), high Sb concentrations in polyester clothes (141 mg/kg), and great Cu levels in some green cotton fabrics (around 280 mg/kg). Dermal contact exposure and human health risks for adult males, adult females, and for <1-year-old children were assessed. Non-carcinogenic and carcinogenic risks were below safe (HQ<1) and acceptable (<10{sup −6}) limits, respectively, according to international standards. However, for Sb, non-carcinogenic risk was above 10% of the safety limit (HQ>0.1) for dermal contact with clothes. - Highlights: • We determined in skin-contact clothes the concentrations of a number of metals. • Dermal contact exposure and health risks for adults and for 1-year-old children were assessed. • Carcinogenic risks were considered as acceptable (<10{sup −6}). • For non-carcinogenic risks, only Sb exceeded a 10% of the HQ for dermal contact with clothes.« less

Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China.

PubMed

Cao, Suzhen; Duan, Xiaoli; Zhao, Xiuge; Chen, Yiting; Wang, Beibei; Sun, Chengye; Zheng, Binghui; Wei, Fusheng

2016-03-01

Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area. Copyright © 2016 Elsevier Ltd. All rights reserved.

Between Oais and Agile a Dynamic Data Management Approach

NASA Astrophysics Data System (ADS)

Bennett, V. L.; Conway, E. A.; Waterfall, A. M.; Pepler, S.

2015-12-01

In this paper we decribe an approach to the integration of existing archival activities which lies between compliance with the more rigid OAIS/TRAC standards and a more flexible "Agile" approach to the curation and preservation of Earth Observation data. We provide a high level overview of existing practice and discuss how these procedures can be extended and supported through the description of preservation state. The aim of which is to facilitate the dynamic controlled management of scientific data through its lifecycle. While processes are considered they are not statically defined but rather driven by human interactions in the form of risk management/review procedure that produce actionable plans, which are responsive to change. We then proceed by describing the feasibility testing of extended risk management and planning procedures which integrate current practices. This was done through the CEDA Archival Format Audit which inspected British Atmospheric Data Centre and NERC Earth Observation Data Centre Archival holdings. These holdings are extensive, comprising of around 2 Petabytes of data and 137 million individual files, which were analysed and characterised in terms of format, based risk. We are then able to present an overview of the format based risk burden faced by a large scale archive attempting to maintain the usability of heterogeneous environmental data sets We continue by presenting a dynamic data management information model and provide discussion of the following core model entities and their relationships: Aspirational entities, which include Data Entity definitions and their associated Preservation Objectives. Risk entities, which act as drivers for change within the data lifecycle. These include Acquisitional Risks, Technical Risks, Strategic Risks and External Risks Plan entities, which detail the actions to bring about change within an archive. These include Acquisition Plans, Preservation Plans and Monitoring plans which support responsive interactions with the community. The Result entities describe the outcomes of the plans. This includes Acquisitions. Mitigations and Accepted Risks. With risk acceptance permitting imperfect but functional solutions that can be realistically supported within an archives resource levels

Family Adversity, Positive Peer Relationships, and Children's Externalizing Behavior: A Longitudinal Perspective on Risk and Resilience

PubMed Central

Criss, Michael M.; Pettit, Gregory S.; Bates, John E.; Dodge, Kenneth A.; Lapp, Amie L.

2009-01-01

Peer acceptance and friendships were examined as moderators in the link between family adversity and child externalizing behavioral problems. Data on family adversity (i.e., ecological disadvantage, violent marital conflict, and harsh discipline) and child temperament and social information processing were collected during home visits from 585 families with 5-year-old children. Children's peer acceptance, friendship, and friends' aggressiveness were assessed with sociometric methods in kindergarten and grade 1. Teachers provided ratings of children's externalizing behavior problems in grade 2. Peer acceptance served as a moderator for all three measures of family adversity, and friendship served as a moderator for harsh discipline. Examination of regression slopes indicated that family adversity was not significantly associated with child externalizing behavior at high levels of positive peer relationships. These moderating effects generally were not qualified by child gender, ethnicity, or friends' aggressiveness, nor were they accounted for by child temperament or social information-processing patterns. The need for process-oriented studies of risk and protective factors is stressed. PMID:12146744

Contamination and health risks of heavy metals in street dust from a coal-mining city in eastern China.

PubMed

Tang, Zhenwu; Chai, Miao; Cheng, Jiali; Jin, Jing; Yang, Yufei; Nie, Zhiqiang; Huang, Qifei; Li, Yanhua

2017-04-01

We collected street dust from Huainan, a typical coal-mining city in China, to investigate the contamination features and health risks of heavy metals. Concentrations of Co, Cr, Cu, Pb, As, and Sb were generally low to moderate, while pollution levels of Cd and Hg were moderate to high. Concentrations of Cd and Hg were associated with considerable health risks at 64.3% and 58.6% of sites, respectively. In particular, about a fifth of samples had associated high risks as a result of Hg contamination levels. Relative to other urban areas, the street dust from the mining area had no more severe metal pollution, which might be partly attributed to the deposition of coal dust onto street dusts. A source assessment indicated that metals in dust form Huainan were mainly derived from vehicular-related activities, industrial emissions, weathering of coal dust and natural soils, and coal combustion. Although the health risk levels from exposure to individual metals in dusts were low, the non-carcinogenic risks from multiple metals to local children exceeded the acceptable level (1.0), suggesting that the overall risk from exposure to multiple metals in dust is concerning. Copyright © 2016 Elsevier Inc. All rights reserved.

Overview and Status of the Bioastronautics Critical Path Roadmap (BCPR)

NASA Technical Reports Server (NTRS)

Charles, John

2004-01-01

Viewgraphs on the status and overview of the Bioastronautics Critical Path Roadmap (BCPR) are presented. The topics include: 1) BCPR Objectives; 2) BCPR and OBPR Program Management; 3) BCPR Disciplines & Cross-Cutting Areas; 4) Characteristics of BCPR Reference Missions; 5) Bioastronautics Timetable (notional); 6) BCPR Processes Risk Identification, Assessment, and Management; 7) Types of BCPR Risks; 8) Enabling Questions Categories; 9) Risk Mitigation Status; 10) Defining Levels of Accepted Risk; 11) BCPR Integration; 12) BCPR Implementation, Integration, and Validation; 13) BCPR Refinement Schedule; 14) Academy Review; 15) Rating Bioastronautics Risks; 16) Risk Rating Exercises; 17) Human Health Risk Assessment Criteria (examples); 18) A Recent Risk Rating Exercise; 19) Consensus Workshop Background; 20) Consensus Workshop Rating Analysis; 21) Consensus Workshop Selected Preliminary Recommendations; and 22) Access to BCPR Content.

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.baselineeurope.eu) as described in the papers of this special issue. Such results show how to derive POs for specific food/biological hazard combinations selected among fish, egg, dairy, meat and plant products. Copyright © 2014 Elsevier B.V. All rights reserved.

Assessing the infection risk of enteropathogens from consumption of raw vegetables washed with contaminated water in Kathmandu Valley, Nepal.

PubMed

Shrestha, S; Haramoto, E; Shindo, J

2017-11-01

To assess diarrhoeal risks from enteropathogenic Escherichia coli, Giardia and Cryptosporidium from consuming raw spinach, cabbage, carrots and tomatoes in Kathmandu Valley, Nepal. The annual infection risk was quantified using the probabilistic Quantitative Microbial Risk Assessment approach, which considered 12 vegetable washing combinations. A new model was used to estimate dose of pathogens per exposure comprising parameters such as pathogen concentration in vegetable wash water before selling and eating, vegetable consumption rate, remaining pathogen ratio after washing, remaining water on vegetables after washing and water treatment removal efficiency. When all washing combinations were considered, high infection risks above the acceptable level of -4 log 10 infection per person per year were obtained, whereas the risk was reduced when other sources excluding river water were used. Assuming use of water treated with ceramic filters by all consumers, a 0-2 log 10 reduction in the estimated risks was obtained, which was insufficient to achieve the required risk level. High risk of diarrhoea prevails among raw vegetable consumers in the valley. It is needed to protect vegetable washing water sources and establish advanced water treatment methods to achieve the required level of public health risk. © 2017 The Society for Applied Microbiology.

[FMEA applied to the radiotherapy patient care process].

PubMed

Meyrieux, C; Garcia, R; Pourel, N; Mège, A; Bodez, V

2012-10-01

Failure modes and effects analysis (FMEA), is a risk analysis method used at the Radiotherapy Department of Institute Sainte-Catherine as part of a strategy seeking to continuously improve the quality and security of treatments. The method comprises several steps: definition of main processes; for each of them, description for every step of prescription, treatment preparation, treatment application; identification of the possible risks, their consequences, their origins; research of existing safety elements which may avoid these risks; grading of risks to assign a criticality score resulting in a numerical organisation of the risks. Finally, the impact of proposed corrective actions was then estimated by a new grading round. For each process studied, a detailed map of the risks was obtained, facilitating the identification of priority actions to be undertaken. For example, we obtain five steps in patient treatment planning with an unacceptable level of risk, 62 a level of moderate risk and 31 an acceptable level of risk. The FMEA method, used in the industrial domain and applied here to health care, is an effective tool for the management of risks in patient care. However, the time and training requirements necessary to implement this method should not be underestimated. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Gray water recycle: Effect of pretreatment technologies on low pressure reverse osmosis treatment

USDA-ARS?s Scientific Manuscript database

Gray water can be a valuable source of water when properly treated to reduce the risks associated with chemical and microbial contamination to acceptable levels for the intended reuse application. In this study, the treatment of gray water using low pressure reverse osmosis (RO) filtration after pre...

MONITORED NATURAL ATTENUATION AND RISK MANAGEMENT OF MTBE AND TBA IN GROUND WATER

EPA Science Inventory

Monitored natural attenuation (as U.S. EPA defines the term) is a remedy, where natural processes bring the concentration of MTBE or TBA to an acceptable level in a reasonable period of time. The longevity of the plume is its critical property. The rate of attenuation is typica...

Communicating Cardiovascular Disease Risk Due to Elevated Homocysteine Levels: Using the EPPM to Develop Print Materials

ERIC Educational Resources Information Center

McKay, Diane L.; Berkowitz, Judy M.; Blumberg, Jeffrey B.; Goldberg, Jeanne P.

2004-01-01

Improving the effectiveness of written information to promote compliance with therapeutic regimens is essential, particularly among older adults. Guiding their development and evaluating their effectiveness with an accepted communication theory or model may help. A preliminary test of written materials developed within the context of the Extended…

Gaining Acceptance for the use of in vitro Toxicity Assays and QIVIVE in Regulatory Risk Assessment

EPA Science Inventory

Testing strategies are anticipated to increasingly rely on in vitro data as a basis to characterize early steps or key events in toxicity at relevant dose levels in human tissues. This requires quantitative in vitro to in vivo extrapolation to characterize dose-response as a bas...

Cognitive-Based Compassion Training: A Promising Prevention Strategy for At-Risk Adolescents

ERIC Educational Resources Information Center

Reddy, Sheethal D.; Negi, Lobsang Tenzin; Dodson-Lavelle, Brooke; Ozawa-de Silva, Brendan; Pace, Thaddeus W. W.; Cole, Steve P.; Raison, Charles L.; Craighead, Linda W.

2013-01-01

Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a "mental health" approach feels…

Trace Metal Levels in Rainbow Trout (Oncorhynchus mykiss) Cultured in Net Cages in a Reservoir and Evaluation of Human Health Risks from Consumption.

PubMed

Varol, Memet; Kaya, Gülderen Kurt; Alp, Sumru Anık; Sünbül, Muhammet Raşit

2017-09-19

Although fish consumption has positive health effects, metals accumulated in fish can cause human health risks. In this study, the levels of ten metals in rainbow trout (Oncorhynchus mykiss) farmed in the Keban Dam Reservoir, which has the biggest rainbow trout production capacity in Turkey, were determined and compared with the maximum permissible levels (MPLs). Also, human health risks associated with rainbow trout consumption were assessed. The metal concentrations in rainbow trout were found below the MPLs. The estimated daily intake of each metal was much lower than the respective tolerable daily intake. The target hazard quotient (THQ) for individual metal and total THQ for combined metals did not exceed 1, indicating no health risk for consumers. The cancer risk (CR) value for inorganic arsenic was within the acceptable lifetime risk range of 10 -6 and 10 -4 . For carcinogenic and non-carcinogenic effects, the maximum allowable fish consumption rates were high enough to ensure the human health. According to these results, the consumption of rainbow trout farmed in the Keban Dam Reservoir does not pose a risk on human health.

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

Prevention of cerebral palsy in motor risk infants by treatment ad modum Vojta. A controlled study.

PubMed

Brandt, S; Lønstrup, H V; Marner, T; Rump, K J; Selmar, P; Schack, L K; d'Avignon, M; Norén, L; Arman, T

1980-05-01

The proposal by V. Vojta in 1974 to prevent development of cerebral palsy in "motor risk" infants by special treatment has been investigated in 11 Danish and 10 Swedish babies and compared with 30 control infants with similar risk, who were not given Vojta treatment. We found a tendency for "uncomplicated" cerebral palsy cases to accumulate in the control group, although the difference was non-significant on 1 5% level. Further controlled studies must be completed before it is possible to accept the prophylactive treatment of cerebral palsy recommended by Vojta.

Mission safety evaluation report for STS-35: Postflight edition

NASA Technical Reports Server (NTRS)

Hill, William C.; Finkel, Seymour I.

1991-01-01

Space Transportation System 35 (STS-35) safety risk factors that represent a change from previous flights that had an impact on this flight, and factors that were unique to this flight are discussed. While some changes to the safety risk baseline since the previous flight are included to highlight their significance in risk level change, the primary purpose is to insure that changes which were too late too include in formal changes through the Failure Modes and Effects Analysis/Critical Items List (FMEA/CIL) and Hazard Analysis process are documented along with the safety position, which includes the acceptance rationale.

Satellite voice broadcast. Volume 2: System study

NASA Technical Reports Server (NTRS)

Bachtell, E. E.; Bettadapur, S. S.; Coyner, J. V.; Farrell, C. E.

1985-01-01

The Technical Volume of the Satellite Broadcast System Study is presented. Designs are synthesized for direct sound broadcast satellite systems for HF-, VHF-, L-, and Ku-bands. Methods are developed and used to predict satellite weight, volume, and RF performance for the various concepts considered. Cost and schedule risk assessments are performed to predict time and cost required to implement selected concepts. Technology assessments and tradeoffs are made to identify critical enabling technologies that require development to bring technical risk to acceptable levels for full scale development.

Planning the Voyager spacecraft's mission to Uranus

NASA Technical Reports Server (NTRS)

Plagemann, Stephen H.

1987-01-01

The application of the systems engineering process to the planning of the Voyager spacecraft mission is described. The Mission Planning Office prepared guidelines that controlled the use of the project and multimission resources and spacecraft consumables in order to obtain valuable scientific data at an acceptable risk level. Examples of mission planning which are concerned with the design of the Deep Space Network antenna, the uplink window for transmitting computer command subsystem loads, and the contingency and risk assessment functions are presented.

Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial.

PubMed

Brugha, T S; Smith, J; Austin, J; Bankart, J; Patterson, M; Lovett, C; Morgan, Z; Morrell, C J; Slade, P

2016-01-01

Repeated epidemiological surveys show no decline in depression although uptake of treatments has grown. Universal depression prevention interventions are effective in schools but untested rigorously in adulthood. Selective prevention programmes have poor uptake. Universal interventions may be more acceptable during routine healthcare contacts for example antenatally. One study within routine postnatal healthcare suggested risk of postnatal depression could be reduced in non-depressed women from 11% to 8% by giving health visitors psychological intervention training. Feasibility and effectiveness in other settings, most notably antenatally, is unknown. We conducted an external pilot study using a cluster trial design consisting of recruitment and enhanced psychological training of randomly selected clusters of community midwives (CMWs), recruitment of pregnant women of all levels of risk of depression, collection of baseline and outcome data prior to childbirth, allowing time for women 'at increased risk' to complete CMW-provided psychological support sessions. Seventy-nine percent of eligible women approached agreed to take part. Two hundred and ninety-eight women in eight clusters participated and 186 termed 'at low risk' for depression, based on an Edinburgh Perinatal Depression Scale (EPDS) score of <12 at 12 weeks gestation, provided baseline and outcome data at 34 weeks gestation. All trial protocol procedures were shown to be feasible. Antenatal effect sizes in women 'at low risk' were similar to those previously demonstrated postnatally. Qualitative work confirmed the acceptability of the approach to CMWs and intervention group women. A fully powered trial testing universal prevention of depression in pregnancy is feasible, acceptable and worth undertaking.

Modelling of Radiological Health Risks from Gold Mine Tailings in Wonderfonteinspruit Catchment Area, South Africa.

PubMed

Mathuthu, Manny; Kamunda, Caspah; Madhuku, Morgan

2016-06-07

Mining is one of the major causes of elevation of naturally-occurring radionuclide material (NORM) concentrations on the Earth's surface. The aim of this study was to evaluate the human risk associated with exposure to NORMs in soils from mine tailings around a gold mine. A broad-energy germanium detector was used to measure activity concentrations of these NORMs in 66 soil samples (56 from five mine tailings and 10 from the control area). The RESidual RADioactivity (RESRAD) OFFSITE modeling program (version 3.1) was then used to estimate the radiation doses and the cancer morbidity risk of uranium-238 ((238)U), thorium-232 ((232)Th), and potassium-40 ((40)K) for a hypothetical resident scenario. According to RESRAD prediction, the maximum total effective dose equivalent (TEDE) during 100 years was found to be 0.0315 mSv/year at year 30, while the maximum total excess cancer morbidity risk for all the pathways was 3.04 × 10(-5) at year 15. The US Environmental Protection Agency considers acceptable for regulatory purposes a cancer risk in the range of 10(-6) to 10(-4). Therefore, results obtained from RESRAD OFFSITE code has shown that the health risk from gold mine tailings is within acceptable levels according to international standards.

Modelling of Radiological Health Risks from Gold Mine Tailings in Wonderfonteinspruit Catchment Area, South Africa

PubMed Central

Mathuthu, Manny; Kamunda, Caspah; Madhuku, Morgan

2016-01-01

Mining is one of the major causes of elevation of naturally-occurring radionuclide material (NORM) concentrations on the Earth’s surface. The aim of this study was to evaluate the human risk associated with exposure to NORMs in soils from mine tailings around a gold mine. A broad-energy germanium detector was used to measure activity concentrations of these NORMs in 66 soil samples (56 from five mine tailings and 10 from the control area). The RESidual RADioactivity (RESRAD) OFFSITE modeling program (version 3.1) was then used to estimate the radiation doses and the cancer morbidity risk of uranium-238 (238U), thorium-232 (232Th), and potassium-40 (40K) for a hypothetical resident scenario. According to RESRAD prediction, the maximum total effective dose equivalent (TEDE) during 100 years was found to be 0.0315 mSv/year at year 30, while the maximum total excess cancer morbidity risk for all the pathways was 3.04 × 10−5 at year 15. The US Environmental Protection Agency considers acceptable for regulatory purposes a cancer risk in the range of 10−6 to 10−4. Therefore, results obtained from RESRAD OFFSITE code has shown that the health risk from gold mine tailings is within acceptable levels according to international standards. PMID:27338424

Monitoring the level of government trust, risk perception and intention of the general public to adopt protective measures during the influenza A (H1N1) pandemic in The Netherlands.

PubMed

van der Weerd, Willemien; Timmermans, Daniëlle Rm; Beaujean, Desirée Jma; Oudhoff, Jurriaan; van Steenbergen, Jim E

2011-07-19

During the course of an influenza pandemic, governments know relatively little about the possibly changing influence of government trust, risk perception, and receipt of information on the public's intention to adopt protective measures or on the acceptance of vaccination. This study aims to identify and describe possible changes in and factors associated with public's intentions during the 2009 influenza A (H1N1) pandemic in the Netherlands. Sixteen cross-sectional telephone surveys were conducted (N = 8060) between April - November 2009. From these repeated measurements three consecutive periods were categorized based on crucial events during the influenza A (H1N1) pandemic. Time trends in government trust, risk perception, intention to adopt protective measures, and the acceptance of vaccination were analysed. Factors associated with an intention to adopt protective measures or vaccination were identified. Trust in the government was high, but decreased over time. During the course of the pandemic, perceived vulnerability and an intention to adopt protective measures increased. Trust and vulnerability were associated with an intention to adopt protective measures in general only during period one. Higher levels of intention to receive vaccination were associated with increased government trust, fear/worry, and perceived vulnerability. In periods two and three receipt of information was positively associated with an intention to adopt protective measures. Most respondents wanted to receive information about infection prevention from municipal health services, health care providers, and the media. The Dutch response to the H1N1 virus was relatively muted. Higher levels of trust in the government, fear/worry, and perceived vulnerability were all positively related to an intention to accept vaccination. Only fear/worry was positively linked to an intention to adopt protective measures during the entire pandemic. Risk and crisis communication by the government should focus on building and maintaining trust by providing information about preventing infection in close collaboration with municipal health services, health care providers, and the media.

Monitoring the level of government trust, risk perception and intention of the general public to adopt protective measures during the influenza A (H1N1) pandemic in the Netherlands

PubMed Central

2011-01-01

Background During the course of an influenza pandemic, governments know relatively little about the possibly changing influence of government trust, risk perception, and receipt of information on the public's intention to adopt protective measures or on the acceptance of vaccination. This study aims to identify and describe possible changes in and factors associated with public's intentions during the 2009 influenza A (H1N1) pandemic in the Netherlands. Methods Sixteen cross-sectional telephone surveys were conducted (N = 8060) between April - November 2009. From these repeated measurements three consecutive periods were categorized based on crucial events during the influenza A (H1N1) pandemic. Time trends in government trust, risk perception, intention to adopt protective measures, and the acceptance of vaccination were analysed. Factors associated with an intention to adopt protective measures or vaccination were identified. Results Trust in the government was high, but decreased over time. During the course of the pandemic, perceived vulnerability and an intention to adopt protective measures increased. Trust and vulnerability were associated with an intention to adopt protective measures in general only during period one. Higher levels of intention to receive vaccination were associated with increased government trust, fear/worry, and perceived vulnerability. In periods two and three receipt of information was positively associated with an intention to adopt protective measures. Most respondents wanted to receive information about infection prevention from municipal health services, health care providers, and the media. Conclusions The Dutch response to the H1N1 virus was relatively muted. Higher levels of trust in the government, fear/worry, and perceived vulnerability were all positively related to an intention to accept vaccination. Only fear/worry was positively linked to an intention to adopt protective measures during the entire pandemic. Risk and crisis communication by the government should focus on building and maintaining trust by providing information about preventing infection in close collaboration with municipal health services, health care providers, and the media. PMID:21771296

Development of a relative risk model for drinking water regulation and design recommendations for a peri urban region of Argentina.

PubMed

Rodriguez-Alvarez, María Soledad; Weir, Mark H; Pope, Joanna M; Seghezzo, Lucas; Rajal, Verónica B; Salusso, María Mónica; Moraña, Liliana B

2015-10-01

Argentina is a developing Latin American nation that has an aim of achieving the United Nations Millennium Development Goals for potable water supplies. Their current regulations however, limit the continued development of improved potable water quality and infrastructure from a microbiological viewpoint. This is since the current regulations are focused solely to pathogenic Eschericia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and fecal indicators. Regions of lower socioeconomic status such as peri-urban areas are particularly at risk due to lessened financial and political ability to influence their environmental quality and infrastructure needs. Therefore, a combined microbiological sampling, analysis and quantitative microbial risk assessment (QMRA) modeling effort were engaged for a peri-urban area of Salta Argentina. Drinking water samples from home taps were analyzed and a QMRA model was developed, results of which were compared against a general 1:10,000 risk level for lack of a current Argentinian standard. This QMRA model was able to demonstrate that the current regulations were being achieved for E. coli but were less than acceptable for P. aeruginosa in some instances. Appropriate health protections are far from acceptable for Giardia for almost all water sources. Untreated water sources were sampled and analyzed then QMRA modeled as well, since a significant number of the community (∼9%) still use them for potable water supplies. For untreated water E. coli risks were near 1:10,000, however, P. aeruginosa and Giardia risks failed to be acceptable in almost all instances. The QMRA model and microbiological analyses demonstrate the need for improved regulatory efforts for the peri-urban area along with improved investment in their water infrastructure. Copyright © 2015 Elsevier GmbH. All rights reserved.

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

[Run the risk: social disadvantage or capability?

PubMed

Muñoz-Duque, Luz Adriana

2018-05-10

This article discusses the notions of risk and risk acceptability from a social justice perspective, especially in light of the capability approach proposed by Amartya Sen. The article argues that risk can be the expression of restrictions on subjects' capabilities, deriving from social disadvantages that can be taken for granted in their daily realities. On the other hand, risk can be viewed as an expression of capability in cases where subjects have accepted or admitted the risk through the exercise of freedom, as long as the subjects that relate to the risk do so in keeping with their idea of a good life, the building of which implies the full development of capability for agency. The article concludes with some thoughts on the issues of risk and risk acceptability in the sphere of public health.

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.

7 CFR 2201.23 - Funding for the Program.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the Program and operate the Program accordingly. (b) Credit Risk Premium—(1) Establishment and approval. The Board may establish and approve the acceptance of credit risk premiums with respect to a..., credit risk premiums shall be accepted from a non-Federal source on behalf of a Borrower. (2) Credit risk...

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.

Usability Testing the "Personal Patient Profile-Prostate" in a Sample of African American and Hispanic Men.

PubMed

Wolpin, Seth; Halpenny, Barbara; Sorrentino, Erica; Stewart, Mark; McReynolds, Justin; Cvitkovic, Ivan; Chang, Peter; Berry, Donna

2016-07-01

Shared treatment decision making in a cancer setting requires a patient's understanding of the potential benefits and risks of each treatment option. Graphical display of risk information is one approach to improving understanding. Little is known about how patients engage with infographics in the context of health education materials and whether interactions vary with health literacy levels. We conducted an observational study, using an eye tracker device, of how men with newly diagnosed localized prostate cancer visually engaged with an on-screen infographic depicting risk information in the Personal Patient Profile-Prostate. Health literacy was measured with the Short Assessment of Health Literacy-English. Gaze patterns on an exemplar screens containing infographics about survival were analyzed and explored with respect to sociodemographic and health literacy data. Acceptability of Personal Patient Profile-Prostate was measured with the Acceptability E-scale. Twenty-six English-speaking men participated, and eye tracking data were collected for 12 men on the exemplar page of risk information that we analyzed. We found preliminary evidence of visual scanning and of participants with lower literacy focusing sooner on infographics versus text. Acceptability for Personal Patient Profile-Prostate was high. These findings suggest that infographics may be of higher relative value to participants with low health literacy. Eye trackers may provide valuable information on how people visually engage with infographics and may inform development of health education materials, although care must be taken to minimize data loss.

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.

Development and use of role model stories in a community level HIV risk reduction intervention.

PubMed Central

Corby, N H; Enguídanos, S M; Kay, L S

1996-01-01

A theory-based HIV prevention intervention was implemented as part of a five-city AIDS Community Demonstration Project for the development and testing of a community-level intervention to reduce AIDS risk among historically underserved groups. This intervention employed written material containing stories of risk-reducing experiences of members of the priority populations, in this case, injecting drug users, their female sex partners, and female sex workers. These materials were distributed to members of these populations by their peers, volunteers from the population who were trained to deliver social reinforcement for interest in personal risk reduction and the materials. The participation of the priority populations in the development and implementation of the intervention was designed to increase the credibility of the intervention and the acceptance of the message. The techniques involved in developing role-model stories are described in this paper. PMID:8862158

Ergonomic assessment for the task of repairing computers in a manufacturing company: A case study.

PubMed

Maldonado-Macías, Aidé; Realyvásquez, Arturo; Hernández, Juan Luis; García-Alcaraz, Jorge

2015-01-01

Manufacturing industry workers who repair computers may be exposed to ergonomic risk factors. This project analyzes the tasks involved in the computer repair process to (1) find the risk level for musculoskeletal disorders (MSDs) and (2) propose ergonomic interventions to address any ergonomic issues. Work procedures and main body postures were video recorded and analyzed using task analysis, the Rapid Entire Body Assessment (REBA) postural method, and biomechanical analysis. High risk for MSDs was found on every subtask using REBA. Although biomechanical analysis found an acceptable mass center displacement during tasks, a hazardous level of compression on the lower back during computer's transportation was detected. This assessment found ergonomic risks mainly in the trunk, arm/forearm, and legs; the neck and hand/wrist were also compromised. Opportunities for ergonomic analyses and interventions in the design and execution of computer repair tasks are discussed.

[Design of a risk matrix to assess sterile formulations at health care facilities].

PubMed

Martín de Rosales Cabrera, A M; López Cabezas, C; García Salom, P

2014-05-01

To design a matrix allowing classifying sterile formulations prepared at the hospital with different risk levels. i) Literature search and critical appraisal of the model proposed by the European Resolution CM/Res Ap(2011)1, ii) Identification of the risk associated to the elaboration process by means of the AMFE methodology (Modal Analysis of Failures and Effects), iii) estimation of the severity associated to the risks detected. After initially trying a model of numeric scoring, the classification matrix was changed to an alphabetical classification, grading each criterion from A to D.Each preparation assessed is given a 6-letter combination with three possible risk levels: low, intermediate, and high. This model was easier for risk assignment, and more reproducible. The final model designed analyzes 6 criteria: formulation process, administration route, the drug's safety profile, amount prepared, distribution, and susceptibility for microbiological contamination.The risk level obtained will condition the requirements of the formulation area, validity time, and storing conditions. The matrix model proposed may help health care institutions to better assess the risk of sterile formulations prepared,and provides information about the acceptable validity time according to the storing conditions and the manufacturing area. Its use will increase the safety level of this procedure as well as help in resources planning and distribution. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

A feasibility study for a clinical decision support system prompting HIV testing.

PubMed

Chadwick, D R; Hall, C; Rae, C; Rayment, Ml; Branch, M; Littlewood, J; Sullivan, A

2017-07-01

Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk-based prototype application to prompt HIV testing when patients undergo routine blood tests. Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection. The application was applied for a 3-month period in two areas, in a large London hospital and in general practices in Teesside/North Yorkshire. At the end of the evaluation period, HCWs were interviewed to assess the usability and acceptability of the prompt. Numbers of HIV tests ordered in the general practice areas were also compared before and after the prompt's introduction. The system was found to be both useable and generally acceptable to hospital doctors, general practitioners and nurse practitioners, with little evidence of prompt/alert fatigue. The issue of the prompt appearing late in the patient consultation did lead to some difficulties, particularly around discussion of the test and consent. In the general practices, around 1 in 10 prompts were accepted and there was a 6% increase in testing rates over the 3-month study period (P = 0.169). Using a CPOE-based clinical decision support application to prompt HIV testing appears both feasible and acceptable to HCWs. Refining the application to provide more accurate risk stratification is likely to make it more effective. © 2016 British HIV Association.

Analysis of Vibrio vulnificus Infection Risk When Consuming Depurated Raw Oysters.

PubMed

Deng, Kai; Wu, Xulei; Fuentes, Claudio; Su, Yi-Cheng; Welti-Chanes, Jorge; Paredes-Sabja, Daniel; Torres, J Antonio

2015-06-01

A beta Poisson dose-response model for Vibrio vulnificus food poisoning cases leading to septicemia was used to evaluate the effect of depuration at 15 °C on the estimated health risk associated with raw oyster consumption. Statistical variability sources included V. vulnificus level at harvest, time and temperature during harvest and transportation to processing plants, decimal reductions (SV) observed during experimental circulation depuration treatments, refrigerated storage time before consumption, oyster size, and number of oysters per consumption event. Although reaching nondetectable V. vulnificus levels (<30 most probable number per gram) throughout the year and a 3.52 SV were estimated not possible at the 95% confidence level, depuration for 1, 2, 3, and 4 days would reduce the warm season (June through September) risk from 2,669 cases to 558, 93, 38, and 47 cases per 100 million consumption events, respectively. At the 95% confidence level, 47 and 16 h of depuration would reduce the warm and transition season (April through May and October through November) risk, respectively, to 100 cases per 100 million consumption events, which is assumed to be an acceptable risk; 1 case per 100 million events would be the risk when consuming untreated raw oysters in the cold season (December through March).

The preferred magnetic resonance imaging planes in quantifying visceral adipose tissue and evaluating cardiovascular risk.

PubMed

Liu, K H; Chan, Y L; Chan, J C N; Chan, W B; Kong, M O; Poon, M Y

2005-09-01

Magnetic Resonance Imaging (MRI) is a well-accepted non-invasive method in the quantification of visceral adipose tissue. However, a standard method of measurement has not yet been universally agreed. The objectives of the present study were 2-fold, firstly, to identify the imaging plane in the Chinese population which gives the best correlation with total visceral adipose tissue volume and cardiovascular risk factors; and secondly to compare the correlations between single-slice and multiple-slice approach with cardiovascular risk factors. Thirty-seven Chinese subjects with no known medical history underwent MRI examination for quantifying total visceral adipose tissue volume. The visceral adipose tissue area at five axial imaging levels within abdomen and pelvis were determined. All subjects had blood pressure measured and fasting blood taken for analysis of cardiovascular risk factors. Framingham risk score for each subject was calculated. The imaging plane at the level of 'lower costal margin' (LCM) in both men and women had the highest correlation with total visceral adipose tissue volume (r = 0.97 and 0.99 respectively). The visceral adipose tissue area at specific imaging levels showed higher correlations with various cardiovascular risk factors and Framingham risk score than total visceral adipose tissue volume. The visceral adipose tissue area at 'umbilicus' (UMB) level in men (r = 0.88) and LCM level in women (r = 0.70) showed the best correlation with Framingham risk score. The imaging plane at the level of LCM is preferred for reflecting total visceral adipose tissue volume in Chinese subjects. For investigating the association of cardiovascular risk with visceral adipose tissue in MRI-obesity research, the single-slice approach is superior to the multiple-slice approach, with the level of UMB in men and LCM in women as the preferred imaging planes.

Assessing cancer risk in China from γ-hexachlorocyclohexane emitted from Chinese and Indian sources.

PubMed

Xu, Yue; Tian, Chongguo; Ma, Jianmin; Wang, Xiaoping; Li, Jun; Tang, Jianhui; Chen, Yingjun; Qin, Wei; Zhang, Gan

2013-07-02

Three models, including an atmospheric transport model, a multimedia exposure model, and a risk assessment model, were used to assess cancer risk in China caused by γ-HCH (gamma-hexachlorocyclohexane) emitted from Chinese and Indian sources. Extensive model investigations revealed the contribution of different sources to the cancer risk in China. Cancer risk in Eastern China was primarily attributable to γ-HCH contamination from Chinese sources, whereas cancer risk in Western China was caused mostly by Indian emissions. The contribution of fresh use of lindane in India to the cancer risk in China was almost 1 order of magnitude higher than that of the reemission of γ-HCH from Indian soils. Of total population, 58% (about 0.79 billion) residents in China were found to live in the environment with high levels of cancer risk exceeding the acceptable cancer risk of 10(-6), recommended by the United States Environmental Protection Agency (U.S. EPA). The cancer risk in China was mostly induced by the local contamination of γ-HCH emitted from Chinese sources, whereas fresh use of lindane in India will become a significant source of the cancer risk in China if Indian emissions maintain their current levels.

A comparison of cat-related risk perceptions and tolerance for outdoor cats in Florida and Hawaii.

PubMed

Wald, Dara M; Lohr, Cheryl A; Lepczyk, Christopher A; Jacobson, Susan K; Cox, Linda J

2016-12-01

Risk perceptions and attitudes toward animals often explain tolerance for wildlife and management preferences. However, little is understood about how these relationships vary across different geographic regions and stakeholder groups. To address this gap in knowledge, we compared differences in acceptance capacity, risk perceptions, perceived enjoyment from outdoor cats, and experiences with outdoor cats among 3 groups (general public, conservation community, and animal-welfare community) in Hawaii and Florida, two states with large conservation challenges. We combined independently collected data from Florida and Hawaii, to determine how perception of the risks presented by outdoor cats, group membership, and state of residence influenced people's tolerance for outdoor cats. Florida respondents were significantly more tolerant of outdoor cats and less concerned about cat-related risks than Hawaii respondents (p < 0.05). In both states, animal-welfare group members reported greater enjoyment seeing cats and perceived a smaller increase in the cat population and lower levels of risk than other groups (p < 0.05). All groups exhibited similar relationships between acceptance capacity and enjoyment and the perceived increase in the cat population. Our results suggest public tolerance for cats varied due to the influence of local or geographical concerns, but that strongly held beliefs, risk perceptions, and feelings about cats explained more of the variance in stakeholder tolerance. © 2016 Society for Conservation Biology.

Quantifying the Metrics That Characterize Safety Culture of Three Engineered Systems

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

Tucker, Julie; Ernesti, Mary; Tokuhiro, Akira

2002-07-01

With potential energy shortages and increasing electricity demand, the nuclear energy option is being reconsidered in the United States. Public opinion will have a considerable voice in policy decisions that will 'road-map' the future of nuclear energy in this country. This report is an extension of the last author's work on the 'safety culture' associated with three engineered systems (automobiles, commercial airplanes, and nuclear power plants) in Japan and the United States. Safety culture, in brief is defined as a specifically developed culture based on societal and individual interpretations of the balance of real, perceived, and imagined risks versus themore » benefits drawn from utilizing a given engineered systems. The method of analysis is a modified scale analysis, with two fundamental Eigen-metrics, time- (t) and number-scales (N) that describe both engineered systems and human factors. The scale analysis approach is appropriate because human perception of risk, perception of benefit and level of (technological) acceptance are inherently subjective, therefore 'fuzzy' and rarely quantifiable in exact magnitude. Perception of risk, expressed in terms of the psychometric factors 'dread risk' and 'unknown risk', contains both time- and number-scale elements. Various engineering system accidents with fatalities, reported by mass media are characterized by t and N, and are presented in this work using the scale analysis method. We contend that level of acceptance infers a perception of benefit at least two orders larger magnitude than perception of risk. The 'amplification' influence of mass media is also deduced as being 100- to 1000-fold the actual number of fatalities/serious injuries in a nuclear-related accident. (authors)« less

The Expected Net Present Value of Developing Weight Management Drugs in the Context of Drug Safety Litigation.

PubMed

Chawla, Anita; Carls, Ginger; Deng, Edmund; Tuttle, Edward

2015-07-01

Following withdrawals, failures, and significant litigation settlements, drug product launches in the anti-obesity category slowed despite a large and growing unmet need. Litigation concerns, a more risk-averse regulatory policy, and the difficulty of developing a product with a compelling risk-benefit profile in this category may have limited innovators' expected return on investment and restricted investment in this therapeutic area. The objective of the study was to estimate perceived manufacturer risk associated with product safety litigation and increased development costs vs. revenue expectations on anticipated return on investment and to determine which scenarios might change a manufacturer's investment decision. Expected net present value of a weight-management drug entering pre-clinical trials was calculated for a range of scenarios representing evolving expectations of development costs, revenue, and litigation risk over the past 25 years. These three factors were based on published estimates, historical data, and analogs from other therapeutic areas. The main driver in expected net present value calculations is expected revenue, particularly if one assumes that litigation risk and demand are positively correlated. Changes in development costs associated with increased regulatory concern with potential safety issues for the past 25 years likely did not impact investment decisions. Regulatory policy and litigation risk both played a role in anti-obesity drug development; however, product revenue-reflecting efficacy at acceptable levels of safety-was by far the most important factor. To date, relatively modest sales associated with recent product introductions suggest that developing a product that is sufficiently efficacious with an acceptable level of safety continues to be the primary challenge in this market.

Global mean temperature indicators linked to warming levels avoiding climate risks

NASA Astrophysics Data System (ADS)

Pfleiderer, Peter; Schleussner, Carl-Friedrich; Mengel, Matthias; Rogelj, Joeri

2018-06-01

International climate policy uses global mean temperature rise limits as proxies for societally acceptable levels of climate change. These limits are informed by risk assessments which draw upon projections of climate impacts under various levels of warming. Here we illustrate that indicators used to define limits of warming and those used to track the evolution of the Earth System under climate change are not directly comparable. Depending on the methodological approach, differences can be time-variant and up to 0.2 °C for a warming of 1.5 °C above pre-industrial levels. This might lead to carbon budget overestimates of about 10 years of continued year-2015 emissions, and about a 10% increase in estimated 2100 sea-level rise. Awareness of this definitional mismatch is needed for a more effective communication between scientists and decision makers, as well as between the impact and physical climate science communities.

An Assessment of Software Safety as Applied to the Department of Defense Software Development Process

DTIC Science & Technology

1992-12-01

provide program 5 managers some level of confidence that their software will operate at an acceptable level of risk. A number of structured safety...safety within the constraints of operational effectiveness, schedule, and cost through timely application of system safety management and engineering...Master of Science in Software Systems Management Peter W. Colan, B.S.E. Robert W. Prouhet, B.S. Captain, USAF Captain, USAF December 1992 Approved for

The future of capitation: the physician role in managing change in practice.

PubMed

Goodson, J D; Bierman, A S; Fein, O; Rask, K; Rich, E C; Selker, H P

2001-04-01

Capitation-based reimbursement significantly influences the practice of medicine. As physicians, we need to assure that payment models do not jeopardize the care we provide when we accept higher levels of personal financial risk. In this paper, we review the literature relevant to capitation, consider the interaction of financial incentives with physician and medical risk, and conclude that primary care physicians need to work to assure that capitated systems incorporate checks and balances which protect both patients and providers. We offer the following proposals for individuals and groups considering capitated contracts: (1) reimbursement for primary care physicians should recognize both individual patient encounters and the administrative work of patient care management; (2) reimbursement for subspecialists should recognize both access to subspecialty knowledge and expertise as well as patient care encounters, but in some situations, subspecialists may provide the majority of care to individual patients and will be reimbursed as primary care providers; (3) groups of physicians should accept financial risk for patient care only if they have the tools and resources to manage the care; (4) physicians sharing risk for patient care should meet regularly to discuss care and resource management; and (5) physicians must disclose the financial relationships they have with health plans and medical care organizations, and engage patients and communities in discussions about resource allocation. As a payment model, capitation offers opportunities for primary care physicians to influence the future of health care by improving the management of resources at a local level.

The psychology of drinking water quality: An exploratory study

NASA Astrophysics Data System (ADS)

Syme, Geoffrey J.; Williams, Katrina D.

1993-12-01

Perceptions of drinking water quality were measured for residents at four locations in Western Australia. The total dissolved solid levels for the locations varied. Four scales of drinking water satisfaction were measured: acceptability of water quality; water quality risk judgment; perception of neighborhood water quality; and attitudes toward fluoride as an additive. Responses to each of these scales did not appear to be highly related to total dissolved solids. The relationship between attitudes toward water quality and a variety of psychological, attitudinal, experiential, and demographic variables was investigated. It was found that responses to the acceptability of water quality and water quality risk judgment scales related to perceived credibility of societal institutions and feelings of control over water quality and environmental problems. For the remaining two scales few significant correlations were found. The results support those who advocate localized information and involvement campaigns on drinking water quality issues.

Parenting practices, interpretive biases, and anxiety in Latino children.

PubMed

Varela, R Enrique; Niditch, Laura A; Hensley-Maloney, Lauren; Moore, Kathryn W; Creveling, C Christiane

2013-03-01

A number of factors are believed to confer risk for anxiety development in children; however, cultural variation of purported risk factors remains unclear. We examined relations between controlling and rejecting parenting styles, parental modeling of anxious behaviors, child interpretive biases, and child anxiety in a mixed clinically anxious (n=27) and non-clinical (n=20) sample of Latino children and at least one of their parents. Families completed discussion-based tasks and questionnaires in a lab setting. Results indicated that child anxiety was: linked with parental control and child interpretative biases, associated with parental modeling of anxious behaviors at a trend level, and not associated with low parental acceptance. Findings that controlling parenting and child interpretive biases were associated with anxiety extend current theories of anxiety development to the Latino population. We speculate that strong family ties may buffer Latino children from detrimental effects of perceived low parental acceptance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Teacher Candidates' Perception Level of Environmental Pollutant and Their Risk Factors

ERIC Educational Resources Information Center

Oztas, Fulya; Kalipci, Erkan

2009-01-01

It is generally accepted that the environmental education deals with a wide range of environmental experiences, methods and processes. Teaching the subject of the environment should not be considered as an easy task. It should not only cover pure ecology education; but also include the citizenship responsibilities and the problems that are sourced…

Recovering marbled murrelets via corvid management: a population viability analysis approach

Treesearch

M. Zachariah Peery; R. William Henry

2010-01-01

The expansion of human activities into rural areas and natural landscapes has resulted in widespread increases in the abundance of synanthropic species that threaten rarer native species. Quantitative assessments of how much impacts need to be reduced to reach acceptable levels of risk to the affected species are rarely conducted prior to the implementation of control...

[Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].

PubMed

Fu, Gang; Zeng, Qiang; Zhao, Liang; Zhang, Yue; Feng, Bao-jia; Wang, Rui; Zhang, Lei; Wang, Yang; Hou, Chang-chun

2015-12-01

This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors.

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.

Cost-Benefit Analysis on Countermeasures for Health Risk by Exposure to Asbestos in Japan

NASA Astrophysics Data System (ADS)

Fujinaga, Aiichiro; Hihara, Hidemi; Tatsuno, Makoto

This study examines asbestos mitigation countermeasures by predicting air concentrations of asbestos, and then cost-benefit analyses is performed. A comparative study was conducted on three cases as follows; case one, demolition by machine & landfill, case two, demolition by hand & landfill, and case three demolition by hand & vitrification treatment. The results showed that if demolition by machine is continued, the risk is greater than 10-4 of upper acceptable risk for 2020. However, if demolition is conducted by hand, the risk is under 10-4 for 2010. And also, the risk will be less than 10-5 of the safety level for environmental standards until 2030. The results show that vitrification deletes the risk on future management at a landfill site, however at a higher cost.

Assessing and managing the health risk due to ingestion of inorganic arsenic from fish and shellfish farmed in blackfoot disease areas for general Taiwanese.

PubMed

Liang, Ching-Ping; Liu, Chen-Wuing; Jang, Cheng-Shin; Wang, Sheng-Wei; Lee, Jin-Jing

2011-02-15

This paper assesses health risks due to the ingestion of inorganic arsenic from fish and shellfish farmed in blackfoot disease areas by general public in Taiwan. The provisional tolerable weekly intake of arsenic set by FAO/WHO and the target cancer risk assessment model proposed by USEPA were integrated to evaluate the acceptable consumption rate. Five aquacultural species, tilapia (Oreochromis mossambicus), milkfish (Chanos chanos), mullet (Mugil cephalus), clam (Meretrix lusoria) and oyster (Crassostrea gigas) were included. Monte Carlo analysis was used to propagate the parameter uncertainty and to probabilistically assess the health risk associated with the daily intake of inorganic As from farmed fish and shellfish. The integrated risk-based analysis indicates that the associated 50th and 95th percentile health risk are 2.06×10(-5) and 8.77×10(-5), respectively. Moreover, the acceptable intakes of inorganic As are defined and illustrated by a two dimensional graphical model. According to the relationship between C(inorg) and IR(f) derived from this study, two risk-based curves are constructed. An acceptable risk zone is determined (risk ranging from 1×10(-5) to 6.07×10(-5)) which is recommended for acceptable consumption rates of fish and shellfish. To manage the health risk due to the ingestion of inorganic As from fish and shellfish in BFD areas, a risk-based management scheme is derived which provide a convenient way for general public to self-determine the acceptable seafood consumption rate. Copyright © 2010 Elsevier B.V. All rights reserved.

Aquatic risk assessment of a polycarboxylate dispersant polymer used in laundry detergents.

PubMed

Hamilton, J D; Freeman, M B; Reinert, K H

1996-09-01

Polycarboxylates enhance detergent soil removal properties and prevent encrustation of calcium salts on fabrics during washing. Laundry wastewater typically reaches wastewater treatment plants, which then discharge into aquatic environments. The yearly average concentration of a 4500 molecular weight (MW) sodium acrylate homopolymer reaching U.S. wastewater treatment plants will be approximately 0.7 mg/L. Publications showing the low to moderate acute aquatic toxicity of polycarboxylates are readily available. However, there are no published evaluations that estimate wastewater removal and characterize the probability of exceedance of acceptable chronic aquatic exposure. WW-TREAT can be used to estimate removal during wastewater treatment and PG-GRIDS can be applied to characterize risk for exceedance in wastewater treatment plant outfalls. After adjustments for the MW distribution of the homopolymer, WW-TREAT predicted that 6.5% will be removed in primary treatment plants and 60% will be removed in combined primary and activated sludge treatment plants. These estimates are consistent with wastewater fate tests, but underestimate homopolymer removal when homopolymer precipitation is included. Acceptable levels of chronic outfall (receiving water) exposure were based on aquatic toxicity testing in algae, fish, and Daphnia magna. PG-GRIDS predicted that no unreasonable risk for exceedance of acceptable chronic exposure will occur in the outfalls of U.S. wastewater plants. Future development of wastewater treatment models should consider polymer MW distribution and precipitation as factors that may alter removal of materials from wastewater.

Assessments of levels, potential ecological risk, and human health risk of heavy metals in the soils from a typical county in Shanxi Province, China.

PubMed

Pan, Libo; Ma, Jin; Hu, Yu; Su, Benying; Fang, Guangling; Wang, Yue; Wang, Zhanshan; Wang, Lei; Xiang, Bao

2016-10-01

A total of 128 surface soil samples were collected, and eight heavy metals, including As, Cd, Cr, Cu, Pb, Ni, Zn, and Hg, were analyzed for their concentrations, potential ecological risks, and human health risks. The mean concentrations of these eight metals were lower than the soil environmental quality standards in China, while they were slightly higher than the background values in Shanxi Province. The enrichment factor, coefficient variation, and potential ecological risk index were used to assess the pollution and eco-risk level of heavy metals, among which, Cd and Hg showed higher pollution levels and potential risks than the others in the studied area. Moreover, multivariate geostatistical analysis suggested that Hg originated mainly from point sources such as industrial emissions, while agricultural activity is the predominant factor for Cd. The human health risk assessment indicated that non-carcinogenic values were below the threshold values. The total carcinogenic risks due to As, Cr, and Ni were within the acceptable range for adults, while for children, they were higher than the threshold value (1.0E-04), indicating that children are facing higher threat to heavy metals in soils. These results provide basic information on heavy metal pollution control and human health risk assessment management in the study regions.

Acceptability of formulations and application methods for vaginal microbicides among drug-involved women: results of product trials in three cities.

PubMed

Hammett, T M; Mason, T H; Joanis, C L; Foster, S E; Harmon, P; Robles, R R; Finlinson, H A; Feudo, R; Vining-Bethea, S; Jeter, G; Mayer, K H; Doherty-Iddings, P; Seage, G R

2000-02-01

Female-controlled methods of HIV prevention, such as vaginal microbicides, are urgently needed, particularly among drug-involved women. Acceptability research is critical to product development. To assess the acceptability of forms and application methods for future microbicides. Eighty-four drug-involved women were introduced in groups to three lubricant products, asked to try each for 3 weeks, and scheduled for individual follow-up interviews. Participants and their partners felt positive about the products, and expressed willingness to use microbicides if they were shown to be effective against HIV. Women agreed on product characteristics that influenced their reactions (e.g. ease of insertion, degree of "messiness"), but often disagreed on whether their reactions to these characteristics were positive or negative. Development of acceptable and effective HIV-prevention products depends on understanding the interaction between characteristics of the products and the characteristics and perceptions of women. Levels of sexual risk and acceptability factors based on drug-use patterns, race and ethnicity, culture, age, and types and attitudes of male partners suggest that a "one size fits all" approach will not win broad acceptance among drug-involved women.

Eating nanomaterials: cruelty-free and safe? the EFSA guidance on risk assessment of nanomaterials in food and feed.

PubMed

Sauer, Ursula G

2011-12-01

Nanomaterials are increasingly being added to food handling and packaging materials, or directly, to human food and animal feed. To ensure the safety of such engineered nanomaterials (ENMs), in May 2011, the European Food Safety Authority (EFSA) published a guidance document on Risk assessment of the application of nanoscience and nanotechnologies in the food and feed chain. It states that risk assessment should be performed by following a step-wise procedure. Whenever human or animal exposure to nanomaterials is expected, the general hazard characterisation scheme requests information from in vitro genotoxicity, toxicokinetic and repeated dose 90-day oral toxicity studies in rodents. Numerous prevailing uncertainties with regard to nanomaterial characterisation and their hazard and risk assessment are addressed in the guidance document. This article discusses the impact of these knowledge gaps on meeting the goal of ensuring human safety. The EFSA's guidance on the risk assessment of ENMs in food and animal feed is taken as an example for discussion, from the point of view of animal welfare, on what level of uncertainty should be considered acceptable for human safety assessment of products with non-medical applications, and whether animal testing should be considered ethically acceptable for such products.

Minimizing forced outage risk in generator bidding

NASA Astrophysics Data System (ADS)

Das, Dibyendu

Competition in power markets has exposed the participating companies to physical and financial uncertainties. Generator companies bid to supply power in a day-ahead market. Once their bids are accepted by the ISO they are bound to supply power. A random outage after acceptance of bids forces a generator to buy power from the expensive real-time hourly spot market and sell to the ISO at the set day-ahead market clearing price, incurring losses. A risk management technique is developed to assess this financial risk associated with forced outages of generators and then minimize it. This work presents a risk assessment module which measures the financial risk of generators bidding in an open market for different bidding scenarios. The day-ahead power market auction is modeled using a Unit Commitment algorithm and a combination of Normal and Cauchy distributions generate the real time hourly spot market. Risk profiles are derived and VaRs are calculated at 98 percent confidence level as a measure of financial risk. Risk Profiles and VaRs help the generators to analyze the forced outage risk and different factors affecting it. The VaRs and the estimated total earning for different bidding scenarios are used to develop a risk minimization module. This module will develop a bidding strategy of the generator company such that its estimated total earning is maximized keeping the VaR below a tolerable limit. This general framework of a risk management technique for the generating companies bidding in competitive day-ahead market can also help them in decisions related to building new generators.

Investigation of levels in ambient air near sources of Polychlorinated Biphenyls (PCBs) in Kanpur, India, and risk assessment due to inhalation.

PubMed

Goel, Anubha; Upadhyay, Kritika; Chakraborty, Mrinmoy

2016-05-01

Polychlorinated biphenyls (PCBs) are a class of organic compounds listed as persistent organic pollutant and have been banned for use under Stockholm Convention (1972). They were used primarily in transformers and capacitors, paint, flame retardants, plasticizers, and lubricants. PCBs can be emitted through the primary and secondary sources into the atmosphere, undergo long-range atmospheric transport, and hence have been detected worldwide. Reported levels in ambient air are generally higher in urban areas. Active sampling of ambient air was conducted in Kanpur, a densely populated and industrialized city in the Indo-Gangetic Plain, for detection of 32 priority PCBs, with the aim to determine the concentration in gas/particle phase and assess exposure risk. More than 50 % of PCBs were detected in air. Occurrence in particles was dominated by heavier congeners, and levels in gas phase were below detection. Levels determined in this study are lower than the levels in Coastal areas of India but are at par with other Asian countries where majority of sites chosen for sampling were urban industrial areas. Human health risk estimates through air inhalation pathway were made in terms of lifetime average daily dose (LADD) and incremental lifetime cancer risks (ILCR). The study found lower concentrations of PCBs than guideline values and low health risk estimates through inhalation within acceptable levels, indicating a minimum risk to the adults due to exposure to PCBs present in ambient air in Kanpur.

The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain

PubMed Central

Cotler, Howard B; Chow, Roberta T; Hamblin, Michael R; Carroll, James

2015-01-01

Pain is the most common reason for physician consultation in the United States. One out of three Americans is affected by chronic pain annually. The number one reason for missed work or school days is musculoskeletal pain. Currently accepted therapies consist of non-steroidal anti-inflammatory drugs, steroid injections, opiate pain medications and surgery, each of which carries their own specific risk profiles. What is needed are effective treatments for pain which have an acceptably low risk-profile. For over forty years, low level laser (light) therapy (LLLT) and LED (light emitting diode) therapy (also known as photobiomodulation) has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies. The purpose of this paper is to review the use of LLLT for pain, the biochemical mechanisms of action, the dose response curves, and how LLLT may be employed by orthopedic surgeons to improve outcomes and reduce adverse events. With the predicted epidemic of chronic pain in developed countries, it is imperative to validate cost-effective and safe techniques for managing painful conditions which would allow people to live active and productive lives. Moreover the acceptance of LLLT (which is currently being used by many specialties around the world) into the armamentarium of the American health care provider would allow for additional treatment options for patients. A new cost-effective therapy for pain could elevate quality of life while reducing financial strains. PMID:26858986

Dose-response studies and 'no-effect-levels' of N-nitroso compounds: some general aspects.

PubMed

Preussmann, R

1980-01-01

One major problem in the evaluation of potential carcinogenic food additives and contaminants is that of thresholds or, better, of 'no-adverse-effect-levels'. Arguments in favor of the postulated 'irreversibility' of carcinogenic effects are based on dose-response studies, single dose and multigeneration experiments as well as on the concept of somatic mutation as the first step in carcinogenesis with subsequent transmittance of induced defects during cell replication. The problem of extrapolation of results of animal experiments using high doses to low exposure and low incidences in man is not yet solved satisfactorily. Possible practical consequences include zero tolerance, acceptable thresholds at low risk and safety factors. Acceptable intakes should never be considered constants but should be changeable as soon as new facts in regard to the safety evaluation are available.

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.

Feasibility and Acceptability of Global Positioning System (GPS) Methods to Study the Spatial Contexts of Substance Use and Sexual Risk Behaviors among Young Men Who Have Sex with Men in New York City: A P18 Cohort Sub-Study

PubMed Central

Duncan, Dustin T.; Kapadia, Farzana; Regan, Seann D.; Goedel, William C.; Levy, Michael D.; Barton, Staci C.; Friedman, Samuel R.; Halkitis, Perry N.

2016-01-01

Background No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population. Methods Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre- and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre- and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics. Results Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days. Conclusions Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors. PMID:26918766

Alarming levels of carboxyhemoglobin in banked blood.

PubMed

Ehlers, Melissa; Labaze, Georges; Hanakova, Marcela; McCloskey, David; Wilner, George

2009-06-01

To determine the level of carboxyhemoglobin found in banked blood in the Albany, NY region. A retrospective descriptive analysis of carboxyhemoglobin (COHb) levels in a series of packed red blood cell (PRBC) units. The blood bank of a university tertiary care hospital in Albany, NY. All PRBC units considered for possible use in pediatric cardiac surgery were first analyzed for levels of COHb. Only those units with COHb levels of <1.5% were deemed acceptable for use during pediatric cardiac surgery. A sample of blood drawn from the sample side arm of each PRBC unit was analyzed on a Chiron 855 Blood Gas Analyzer (Chiron Inc, Emeryville, CA, now Siemens/Bayer RapidLab 865) to determine the level of COHb. The average COHb level was 0.78% (standard deviation +/- 1.48%), and out of the 468 units tested, 48 (10.3%) had COHb levels of 1.5% or greater. The highest recorded COHb level was 12%. The transfusion of PRBC units may artificially elevate readings of COHb and cause confusion over possible causes. Certain high-risk populations (eg, cyanotic neonates undergoing cardiopulmonary bypass) may be especially at risk. Although levels of COHb in the US blood supply are dropping, institutions may want to consider analyzing COHb levels in their PRBC units before transfusion in these high-risk populations.

Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project.

PubMed

Redding, Colleen A; Jones, Deborah; Zulu, Robert; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen M

2015-12-01

Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation, and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors, and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance, and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs.

Assessment of Mercury Concentration in Turtles (Podocnemis unifilis) in the Xingu River Basin, Brazil.

PubMed

Pignati, Marina Teófilo; Pezzuti, Juarez Carlos Brito; Souza, Larissa Costa de; Lima, Marcelo de Oliveira; Pignati, Wanderlei Antonio; Mendes, Rosivaldo de Alcântara

2018-06-06

Many studies on mercury contamination in aquatic biota deal with the effect of consuming metal-contaminated organisms on human health. In this study, we examined the factors that cause mercury contamination in Podocnemis unifilis in the Xingu River Basin of Mato Grosso and Pará States, Brazil. We quantified by atomic absorption spectroscopy with cold vapor the total mercury (THg) content in the liver and muscle samples of 50 Podocnemis unifilis specimens collected from the basin. The liver and muscle samples contained 134.20 ± 119.30 ng g −1 THg and 24.86 ± 26.36 ng g −1 THg, respectively. Each chelonian or meal has, on average, 5.34× more Hg than the highest level established as acceptable. From the results it can be inferred that, given the weekly consumption of chelonians, the riverine and indigenous communities in the Xingu River Basin are at risk of chronic consumption of Hg in amounts beyond the acceptable limit. The potential high risk to the health of this population is evident; however, the risk classification needs to be further studied.

Implications of Bioremediation of Polycyclic Aromatic Hydrocarbon-Contaminated Soils for Human Health and Cancer Risk.

PubMed

Davie-Martin, Cleo L; Stratton, Kelly G; Teeguarden, Justin G; Waters, Katrina M; Simonich, Staci L Massey

2017-09-05

Bioremediation uses soil microorganisms to degrade polycyclic aromatic hydrocarbons (PAHs) into less toxic compounds and can be performed in situ, without the need for expensive infrastructure or amendments. This review provides insights into the cancer risks associated with PAH-contaminated soils and places bioremediation outcomes in a context relevant to human health. We evaluated which bioremediation strategies were most effective for degrading PAHs and estimated the cancer risks associated with PAH-contaminated soils. Cancer risk was statistically reduced in 89% of treated soils following bioremediation, with a mean degradation of 44% across the B2 group PAHs. However, all 180 treated soils had postbioremediation cancer risk values that exceeded the U.S. Environmental Protection Agency (USEPA) health-based acceptable risk level (by at least a factor of 2), with 32% of treated soils exceeding recommended levels by greater than 2 orders of magnitude. Composting treatments were most effective at biodegrading PAHs in soils (70% average reduction compared with 28-53% for the other treatment types), which was likely due to the combined influence of the rich source of nutrients and microflora introduced with organic compost amendments. Ultimately, bioremediation strategies, in the studies reviewed, were unable to successfully remove carcinogenic PAHs from contaminated soils to concentrations below the target cancer risk levels recommended by the USEPA.

Consumer acceptance of an extruded soy-based high-protein breakfast cereal.

PubMed

Yeu, K; Lee, Y; Lee, S-Y

2008-01-01

Studies have shown the beneficial effects of soy and high-protein diets on weight loss. The objective of this study was to determine consumer acceptance of a soy-based high-protein breakfast cereal developed to be utilized for weight loss and control. Four formulations with soy flour content of 41%, 47%, 54%, and 60% (w/w) were processed by extrusion. The formulations met the Food and Drug Administration (FDA) guidelines to claim the role of soy protein in reducing the risk of cardiovascular diseases and guidelines for high-protein and high-fiber foods. The effects of soy flour level, addition of cinnamon flavor, and evaluation with or without milk on acceptance were investigated. Overall acceptance of 3 of 8 cereal products was also compared to the acceptance of 5 commercial products in the "healthy" cereal category. Addition of up to 54% (w/w) soy flour resulted in comparable acceptance ratings to products with lower soy flour content. Addition of milk improved aroma and texture acceptance scores and addition of cinnamon flavor improved overall, aroma, and taste acceptance scores. Acceptance of the developed cereal products was not as high as the commercial products; however, it significantly increased when nutritional and cost information was presented. The results of this study demonstrated that with modification of the formulations, an acceptable high-protein soy-based cereal can be developed to increase protein consumption during breakfast meals, which can consequently aid in weight loss and control.

Early Adolescent Depressive Symptoms: Prediction from Clique Isolation, Loneliness, and Perceived Social Acceptance

PubMed Central

Witvliet, Miranda; Brendgen, Mara; van Lier, Pol A. C.; Vitaro, Frank

2010-01-01

This study examined whether clique isolation predicted an increase in depressive symptoms and whether this association was mediated by loneliness and perceived social acceptance in 310 children followed from age 11–14 years. Clique isolation was identified through social network analysis, whereas depressive symptoms, loneliness, and perceived social acceptance were assessed using self ratings. While accounting for initial levels of depressive symptoms, peer rejection, and friendlessness at age 11 years, a high probability of being isolated from cliques from age 11 to 13 years predicted depressive symptoms at age 14 years. The link between clique isolation and depressive symptoms was mediated by loneliness, but not by perceived social acceptance. No sex differences were found in the associations between clique isolation and depressive symptoms. These results suggest that clique isolation is a social risk factor for the escalation of depressive symptoms in early adolescence. Implications for research and prevention are discussed. PMID:20499155

Risk and Responsibility: Ethics, Grimes v Kennedy Krieger, and Public Health Research Involving Children

PubMed Central

Mastroianni, Anna C.; Kahn, Jeffrey P.

2002-01-01

The legal case of Grimes v. Kennedy Krieger Institute, Inc, has raised concerns in the public health research community regarding the acceptable level of risk in research involving children, parental authority for informed consent, and exploitation of research subjects for the benefit of public health. We provide an overview of the case and discuss the impact of the court's decision and its possible effect on future research protection policies and practices. (Am J Public Health. 2002;92:1073–1076) PMID:12084682

Avalanche risk assessment in Russia

NASA Astrophysics Data System (ADS)

Komarov, Anton; Seliverstov, Yury; Sokratov, Sergey; Glazovskaya, Tatiana; Turchaniniva, Alla

2017-04-01

The avalanche prone area covers about 3 million square kilometers or 18% of total area of Russia and pose a significant problem in most mountain regions of the country. The constant growth of economic activity, especially in the North Caucasus region and therefore the increased avalanche hazard lead to the demand of the large-scale avalanche risk assessment methods development. Such methods are needed for the determination of appropriate avalanche protection measures as well as for economic assessments during all stages of spatial planning of the territory. The requirement of natural hazard risk assessments is determined by the Federal Law of Russian Federation. However, Russian Guidelines (SP 11-103-97; SP 47.13330.2012) are not clearly presented concerning avalanche risk assessment calculations. A great size of Russia territory, vast diversity of natural conditions and large variations in type and level of economic development of different regions cause significant variations in avalanche risk values. At the first stage of research the small scale avalanche risk assessment was performed in order to identify the most common patterns of risk situations and to calculate full social risk and individual risk. The full social avalanche risk for the territory of country was estimated at 91 victims. The area of territory with individual risk values lesser then 1×10(-6) covers more than 92 % of mountain areas of the country. Within these territories the safety of population can be achieved mainly by organizational activities. Approximately 7% of mountain areas have 1×10(-6) - 1×10(-4) individual risk values and require specific mitigation measures to protect people and infrastructure. Territories with individual risk values 1×10(-4) and above covers about 0,1 % of the territory and include the most severe and hazardous mountain areas. The whole specter of mitigation measures is required in order to minimize risk. The future development of such areas is not recommended. The case studies of specific territories are performed using large-scale risk assessment methods. Thus, we discuss these problems by presenting an avalanche risk assessment approach on example of the developing but poorly researched ski resort areas in the North Caucasus. The suggested method includes the formulas to calculate collective and individual avalanche risk. The results of risk analysis are shown in quantitative data that can be used to determine levels of avalanche risk (acceptable, admissible and unacceptable) and to suggest methods to decrease the individual risk to acceptable level or better. It makes possible to compare risk quantitative data obtained from different mountain regions, analyze it and evaluate the economic feasibility of protection measures. At present, we are developing methods of avalanche risk assessment in economic performance. It conceder costs of objects located in avalanche prone area, traffic density values and probability of financial loss.

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.

Decontamination issues for chemical and biological warfare agents: how clean is clean enough?

PubMed

Raber, E; Jin, A; Noonan, K; McGuire, R; Kirvel, R D

2001-06-01

The objective of this assessment is to determine what level of cleanup will be required to meet regulatory and stakeholder needs in the case of a chemical and/or biological incident at a civilian facility. A literature review for selected, potential chemical and biological warfare agents shows that dose information is often lacking or controversial. Environmental regulatory limits or other industrial health guidelines that could be used to help establish cleanup concentration levels for such agents are generally unavailable or not applicable for a public setting. Although dose information, cleanup criteria, and decontamination protocols all present challenges to effective planning, several decontamination approaches are available. Such approaches should be combined with risk-informed decision making to establish reasonable cleanup goals for protecting health, property, and resources. Key issues during a risk assessment are to determine exactly what constitutes a safety hazard and whether decontamination is necessary or not for a particular scenario. An important conclusion is that cleanup criteria are site dependent and stakeholder specific. The results of a modeling exercise for two outdoor scenarios are presented to reinforce this conclusion. Public perception of risk to health, public acceptance of recommendations based on scientific criteria, political support, time constraints, and economic concerns must all be addressed in the context of a specific scenario to yield effective and acceptable decontamination.

[Quantitative evaluation of health risk associated with occupational inhalation exposure to vinyl chloride at production plants in Poland].

PubMed

Szymczak, W

1997-01-01

Vinyl chloride is classified by the IARC in group 1-human carcinogens. In Poland occupational exposure to vinyl chloride is found among workers employed in many branches of industry, among others in the industry of vinyl chloride synthesis and polymerization as well as in the plastics, footwear, rubber, pharmaceutical and metallurgical industries. Concentrations observed range from the noon-determinable level to 90 mg/m3, at the MAC value equal to 5 mg/m3. Neoplasm of liver is a major carcinogenic effect of vinyl chloride. Hence, the health assessment focused on this critical risk. Four different linear dose-response models, developed by several authors and based on results of different epidemiological studies, were used to characterise the extent of cancer risk depending on the level of vinyl chloride concentrations. The estimated risk related to a forty-year employment under exposure equal to MAC values (5 mg/m3) fell within the range from 2.9.10(-4) to 2.6.10(-3). As the figures depict it did not exceed the acceptable level (10(-3)).

Quantification of flood risk mitigation benefits: A building-scale damage assessment through the RASOR platform.

PubMed

Arrighi, Chiara; Rossi, Lauro; Trasforini, Eva; Rudari, Roberto; Ferraris, Luca; Brugioni, Marcello; Franceschini, Serena; Castelli, Fabio

2018-02-01

Flood risk mitigation usually requires a significant investment of public resources and cost-effectiveness should be ensured. The assessment of the benefits of hydraulic works requires the quantification of (i) flood risk in absence of measures, (ii) risk in presence of mitigation works, (iii) investments to achieve acceptable residual risk. In this work a building-scale is adopted to estimate direct tangible flood losses to several building classes (e.g. residential, industrial, commercial, etc.) and respective contents, exploiting various sources of public open data in a GIS environment. The impact simulations for assigned flood hazard scenarios are computed through the RASOR platform which allows for an extensive characterization of the properties and their vulnerability through libraries of stage-damage curves. Recovery and replacement costs are estimated based on insurance data, market values and socio-economic proxies. The methodology is applied to the case study of Florence (Italy) where a system of retention basins upstream of the city is under construction to reduce flood risk. Current flood risk in the study area (70 km 2 ) is about 170 Mio euros per year without accounting for people, infrastructures, cultural heritage and vehicles at risk. The monetary investment in the retention basins is paid off in about 5 years. However, the results show that although hydraulic works are cost-effective, a significant residual risk has to be managed and the achievement of the desired level of acceptable risk would require about 1 billion euros of investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

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...

Managing the unmanageable: the nature and impact of drug risk in physician groups.

PubMed

Lipton, Helene Levens; Agnew, Jonathan D; Stebbins, Marilyn R; Kuo, Angela; Dudley, R Adams

2005-08-01

As drug costs rose in the 1990s, health maintenance organizations (HMOs) began transferring risk for prescription drug expenditures to physician groups. With principal-agent theory as a framework for understanding drug-risk transfer, we used a multiple case-study design to examine the relationship between the level of drug risk that a physician group accepts and the physician group's adoption of drug-use management strategies. The data demonstrated that adoption of drug-use management innovations was not related to level of risk for pharmacy costs and that factors other than drug-risk level (e.g., contracting and data issues, financial and market factors, and physician group assessments of the fairness and incentives of risk contracts) can influence the principal-agent relationship. The data also revealed a novel form of information asymmetry between physicians and HMOs and unexpected failures of HMOs to fully enable their physician-agents. We believe these observations reflect the complexity of relationships in the health care system and have implications for the use of incentives. Based on principal-agent theory and our findings, we offer an alternative approach to drug-risk contracting that reduces physicians responsibility for aspects of drug use that are beyond their control while maintaining the incentives to manage drug costs and use that were the original intent of drug-risk contracting.

Comparison of Program Effects: The Use of Mastery Scores.

ERIC Educational Resources Information Center

Yeh, Jennie P.; Moy, Raymond

The setting of a cut-off score on a mastery test usually involves a consideration of one or more of the following elements: (1) the distribution of observed test scores; (2) the type of mastery criterion used; (3) the level of acceptable risks of mis-classification; (4) the loss of functions of mis-classifications; and (5) the distribution of true…

Dependent Youth in Juvenile Justice: Do Positive Peer Culture Programs Work for Victims of Child Maltreatment?

ERIC Educational Resources Information Center

Ryan, Joseph P.

2006-01-01

Objective: The purpose of this study is to identify and determine the individual and group-level factors associated with recidivism for children in a long-term Positive Peer Culture (PPC) program. The current study focuses specific attention on the role of child maltreatment in understanding the risk of recidivism. It is widely accepted that…

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

PubMed

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK – A Mixed Methods Study

PubMed Central

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Methods Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Results Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18–25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. Conclusion These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities. PMID:27093430

Comparative assessment of analytical approaches to quantify the risk for introduction of rare animal diseases: the example of avian influenza in Spain.

PubMed

Sánchez-Vizcaíno, Fernando; Perez, Andrés; Martínez-López, Beatriz; Sánchez-Vizcaíno, José Manuel

2012-08-01

Trade of animals and animal products imposes an uncertain and variable risk for exotic animal diseases introduction into importing countries. Risk analysis provides importing countries with an objective, transparent, and internationally accepted method for assessing that risk. Over the last decades, European Union countries have conducted probabilistic risk assessments quite frequently to quantify the risk for rare animal diseases introduction into their territories. Most probabilistic animal health risk assessments have been typically classified into one-level and multilevel binomial models. One-level models are more simple than multilevel models because they assume that animals or products originate from one single population. However, it is unknown whether such simplification may result in substantially different results compared to those obtained through the use of multilevel models. Here, data used on a probabilistic multilevel binomial model formulated to assess the risk for highly pathogenic avian influenza introduction into Spain were reanalyzed using a one-level binomial model and their outcomes were compared. An alternative ordinal model is also proposed here, which makes use of simpler assumptions and less information compared to those required by traditional one-level and multilevel approaches. Results suggest that, at least under certain circumstances, results of the one-level and ordinal approaches are similar to those obtained using multilevel models. Consequently, we argue that, when data are insufficient to run traditional probabilistic models, the ordinal approach presented here may be a suitable alternative to rank exporting countries in terms of the risk that they impose for the spread of rare animal diseases into disease-free countries. © 2012 Society for Risk Analysis.

Geostatistical applications in environmental remediation

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

Stewart, R.N.; Purucker, S.T.; Lyon, B.F.

1995-02-01

Geostatistical analysis refers to a collection of statistical methods for addressing data that vary in space. By incorporating spatial information into the analysis, geostatistics has advantages over traditional statistical analysis for problems with a spatial context. Geostatistics has a history of success in earth science applications, and its popularity is increasing in other areas, including environmental remediation. Due to recent advances in computer technology, geostatistical algorithms can be executed at a speed comparable to many standard statistical software packages. When used responsibly, geostatistics is a systematic and defensible tool can be used in various decision frameworks, such as the Datamore » Quality Objectives (DQO) process. At every point in the site, geostatistics can estimate both the concentration level and the probability or risk of exceeding a given value. Using these probability maps can assist in identifying clean-up zones. Given any decision threshold and an acceptable level of risk, the probability maps identify those areas that are estimated to be above or below the acceptable risk. Those areas that are above the threshold are of the most concern with regard to remediation. In addition to estimating clean-up zones, geostatistics can assist in designing cost-effective secondary sampling schemes. Those areas of the probability map with high levels of estimated uncertainty are areas where more secondary sampling should occur. In addition, geostatistics has the ability to incorporate soft data directly into the analysis. These data include historical records, a highly correlated secondary contaminant, or expert judgment. The role of geostatistics in environmental remediation is a tool that in conjunction with other methods can provide a common forum for building consensus.« less

Consensus guidelines for lumbar puncture in patients with neurological diseases.

PubMed

Engelborghs, Sebastiaan; Niemantsverdriet, Ellis; Struyfs, Hanne; Blennow, Kaj; Brouns, Raf; Comabella, Manuel; Dujmovic, Irena; van der Flier, Wiesje; Frölich, Lutz; Galimberti, Daniela; Gnanapavan, Sharmilee; Hemmer, Bernhard; Hoff, Erik; Hort, Jakub; Iacobaeus, Ellen; Ingelsson, Martin; Jan de Jong, Frank; Jonsson, Michael; Khalil, Michael; Kuhle, Jens; Lleó, Alberto; de Mendonça, Alexandre; Molinuevo, José Luis; Nagels, Guy; Paquet, Claire; Parnetti, Lucilla; Roks, Gerwin; Rosa-Neto, Pedro; Scheltens, Philip; Skårsgard, Constance; Stomrud, Erik; Tumani, Hayrettin; Visser, Pieter Jelle; Wallin, Anders; Winblad, Bengt; Zetterberg, Henrik; Duits, Flora; Teunissen, Charlotte E

2017-01-01

Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain. We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III). Our consensus guidelines address contraindications, as well as patient-related and procedure-related risk factors that can influence the development of post-LP complications. When an LP is performed correctly, the procedure is well tolerated and accepted with a low complication rate.

Risk assessment of heavy metals in honey consumed in Zhejiang province, southeastern China.

PubMed

Ru, Qiao-Mei; Feng, Qiang; He, Jin-Zhe

2013-03-01

The levels of copper (Cu), zinc (Zn), cadmium (Cd), lead (Pb), arsenic (As), and mercury (Hg) in eight types of honey collected in China were determined. The average concentrations of the six heavy metals in the honey samples were 46.18, 1329.5, 1.34, 33.98, 13.44, and 1.65 μg kg(-1), respectively. All these values were below the maximum allowable contaminant levels in foods (GB2762-2005) and honey (GB14963-2011) in China. The hazard quotients of individual heavy metals and the hazard index of all six heavy metals were far below one, indicating no chronic-toxic risk from these metals for the inhabitants of Zhejiang under the current consumption rates of honey. However, the carcinogenic risk of As for the female inhabitants in Zhejiang exceeded the acceptable level of 10(-4). Therefore, As is the most concerning heavy metal in honey. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

A brief, trauma-informed intervention increases safety behavior and reduces HIV risk for drug-involved women who trade sex.

PubMed

Decker, Michele R; Tomko, Catherine; Wingo, Erin; Sawyer, Anne; Peitzmeier, Sarah; Glass, Nancy; Sherman, Susan G

2017-08-01

Female sex workers (FSWs) are an important population for HIV acquisition and transmission. Their risks are shaped by behavioral, sexual network, and structural level factors. Violence is pervasive and associated with HIV risk behavior and infection, yet interventions to address the dual epidemics of violence and HIV among FSWs are limited. We used participatory methods to develop a brief, trauma-informed intervention, INSPIRE (Integrating Safety Promotion with HIV Risk Reduction), to improve safety and reduce HIV risk for FSWs. A quasi-experimental, single group pretest-posttest study evaluated intervention feasibility, acceptability and efficacy among FSWs in Baltimore, MD, most of whom were drug-involved (baseline n = 60; follow-up n = 39 [65%]; non-differential by demographics or outcomes). Qualitative data collected at follow-up contextualizes findings. Based on community partnership and FSW input, emergent goals included violence-related support, connection with services, and buffering against structural forces that blame FSWs for violence. Qualitative and quantitative results demonstrate feasibility and acceptability. At follow-up, improvements were seen in avoidance of client condom negotiation (p = 0.04), and frequency of sex trade under the influence of drugs or alcohol (p = 0.04). Women's safety behavior increased (p < 0.001). Participants improved knowledge and use of sexual violence support (p < 0.01) and use of intimate partner violence support (p < 0.01). By follow-up, most respondents (68.4%) knew at least one program to obtain assistance reporting violence to police. Over the short follow-up period, client violence increased. In reflecting on intervention acceptability, participants emphasized the value of a safe and supportive space to discuss violence. This brief, trauma-informed intervention was feasible and highly acceptable to FSWs. It prompted safety behavior, mitigated sex trade under the influence, and bolstered confidence in condom negotiation. INSPIRE influenced endpoints deemed valuable by community partners, specifically improving connection to support services and building confidence in the face of myths that falsely blame sex workers for violence. Violence persisted; prevention also requires targeting perpetrators, and longer follow-up durations as women acquire safety skills. This pilot study informs scalable interventions that address trauma and its impact on HIV acquisition and care trajectories for FSWs. Addressing violence in the context of HIV prevention is feasible, acceptable to FSWs, and can improve safety and reduce HIV risk, thus supporting FSW health and human rights.

Human health risk constrained naphthalene-contaminated groundwater remediation management through an improved credibility method.

PubMed

Li, Jing; Lu, Hongwei; Fan, Xing; Chen, Yizhong

2017-07-01

In this study, a human health risk constrained groundwater remediation management program based on the improved credibility is developed for naphthalene contamination. The program integrates simulation, multivariate regression analysis, health risk assessment, uncertainty analysis, and nonlinear optimization into a general framework. The improved credibility-based optimization model for groundwater remediation management with consideration of human health risk (ICOM-HHR) is capable of not only effectively addressing parameter uncertainties and risk-exceeding possibility in human health risk but also providing a credibility level that indicates the satisfaction of the optimal groundwater remediation strategies with multiple contributions of possibility and necessity. The capabilities and effectiveness of ICOM-HHR are illustrated through a real-world case study in Anhui Province, China. Results indicate that the ICOM-HHR would generate double remediation cost yet reduce approximately 10 times of the naphthalene concentrations at monitoring wells, i.e., mostly less than 1 μg/L, which implies that the ICOM-HHR usually results in better environmental and health risk benefits. And it is acceptable to obtain a better environmental quality and a lower health risk level with sacrificing a certain economic benefit.

[Medium-term forecast of solar cosmic rays radiation risk during a manned Mars mission].

PubMed

Petrov, V M; Vlasov, A G

2006-01-01

Medium-term forecasting radiation hazard from solar cosmic rays will be vital in a manned Mars mission. Modern methods of space physics lack acceptable reliability in medium-term forecasting the SCR onset and parameters. The proposed estimation of average radiation risk from SCR during the manned Mars mission is made with the use of existing SCR fluence and spectrum models and correlation of solar particle event frequency with predicted Wolf number. Radiation risk is considered an additional death probability from acute radiation reactions (ergonomic component) or acute radial disease in flight. The algorithm for radiation risk calculation is described and resulted risk levels for various periods of the 23-th solar cycle are presented. Applicability of this method to advance forecasting and possible improvements are being investigated. Recommendations to the crew based on risk estimation are exemplified.

Understanding risks in the light of uncertainty: low-probability, high-impact coastal events in cities

NASA Astrophysics Data System (ADS)

Abadie, Luis Maria; Galarraga, Ibon; Sainz de Murieta, Elisa

2017-01-01

A quantification of present and future mean annual losses due to extreme coastal events can be crucial for adequate decision making on adaptation to climate change in coastal areas around the globe. However, this approach is limited when uncertainty needs to be accounted for. In this paper, we assess coastal flood risk from sea-level rise and extreme events in 120 major cities around the world using an alternative stochastic approach that accounts for uncertainty. Probability distributions of future relative (local) sea-level rise have been used for each city, under three IPPC emission scenarios, RCP 2.6, 4.5 and 8.5. The approach allows a continuous stochastic function to be built to assess yearly evolution of damages from 2030 to 2100. Additionally, we present two risk measures that put low-probability, high-damage events in the spotlight: the Value at Risk (VaR) and the Expected Shortfall (ES), which enable the damages to be estimated when a certain risk level is exceeded. This level of acceptable risk can be defined involving different stakeholders to guide progressive adaptation strategies. The method presented here is new in the field of economics of adaptation and offers a much broader picture of the challenges related to dealing with climate impacts. Furthermore, it can be applied to assess not only adaptation needs but also to put adaptation into a timeframe in each city.

Pollution level and human health risk assessment of some pesticides and polychlorinated biphenyls in Nantong of Southeast China.

PubMed

Wang, Na; Yi, Li; Shi, Lili; Kong, Deyang; Cai, Daoji; Wang, Donghua; Shan, Zhengjun

2012-01-01

Food consumption is one of the key exposure routes of humans to contaminants. This article evaluated the residue levels of 51 pesticides and 16 polychlorinated biphenyls (PCBs) in selected fish and food items which were commonly consumed in the Nantong area of Jiangsu Province, Southeast China. The 51 pesticides and 16 PCBs were analyzed by highly sensitive gas chromatography-tandem mass spectrometry (GC-MS/MS). The results showed that organochlorine pesticides such as dichlorodiphenyltrichloroethanes (DDTs), hexachlorocyclohexanes (HCHs), hexachlorobenzene (HCB) and mirex and other pesticides including chlorpyrifos, pyrethroid pesticides, metolachlor, pyridaben and trifluralin were frequently detected in the samples, which was consistent with the accumulation level and characteristics of these toxic chemicals in human adipose tissue of people living in Nantong. Meanwhile, correlation of the residue level of toxic chemicals with their physical chemical properties and historic use pattern in Nantong area was observed. Combined with dietary survey results at the same sampling locations, human health risk assessment of ingestion through the dietary route was performed. The results suggested that the non-cancer risks of the chemicals investigated can be considered negligible in the Nantong area, however, the cancer risks from lifetime dietary exposure to DDTs and HCB have exceeded the acceptable levels.

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.

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

A global survey of HIV-positive people's attitudes towards cure research.

PubMed

Simmons, R; Kall, M; Collins, S; Cairns, G; Taylor, S; Nelson, M; Fidler, S; Porter, K; Fox, J

2017-02-01

Involvement of people living with HIV (PLHIV) in the design of HIV cure studies is important, given the potential risks to participants. We present results of an international survey of PLHIV to define these issues and inform cure research. PLHIV were recruited in June-November 2014 through HIV websites, advocacy forums, social media and 12 UK HIV clinics. The survey included questions concerning demographics, HIV disease history, the desirability of types of cure and the patient's willingness to accept potential toxicity and treatment interruption (TI). We examined factors associated with TI and willingness to accept substantial risks. A total of 982 PLHIV completed the survey; 87% were male, 79% white and 81% men who have sex with men (MSM). Fifty-one per cent were aged 25-44 years and 69% were UK residents. The median time since diagnosis was 7 years [interquartile range (IQR) 2-17 years]. Eighty-eight per cent were receiving antiretrovirals (91% reported undetectable viral load). Health/wellbeing improvements (96%) and an inability to transmit HIV (90%) were more desirable cure characteristics than testing HIV-negative (69%). Ninety-five per cent were interested in participating in cure studies, and 59% were willing to accept substantial risks. PLHIV with a low CD4 count [201-350 cells/μL vs. ≥ 350 cells/μL; odds ratio (OR) 2.11; 95% confidence interval (CI) 1.11-4.00] were more likely to accept risks, whereas those with limited knowledge of HIV treatments vs. excellent/good knowledge and those aged ≥ 65 years vs. 45-64 years were less likely to accept risks [OR 0.58 (95% CI 0.37-0.90) and OR 0.18 (95% CI 0.07-0.45), respectively]. TI was acceptable for 62% of participants, with the main concerns being becoming unwell (82%), becoming infectious (76%) and HIV spreading through the body (76%). Cure research was highly acceptable to the PLHIV surveyed. Most individuals would accept risks, including TI, even in the absence of personal benefit. An optimal cure would improve health and minimize onward transmission risk. © 2016 British HIV Association.

Poster - 47: A parametrized prediction model of rectal toxicity in focal SBRT of low risk prostate cancer

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

Stevens, Todd; Bauman, Glenn

There has been a recent trend towards watchful waiting in place of intervention for early stage prostate cancer (CaP). However, this approach can allow for disease progression, and subsequent whole-gland therapies such as prostatectomy and whole gland irradiation can result in functional deficits or rectal toxicities or both. A controversial alternative approach for this patient cohort is the use of focal therapy, where the treatment is focussed on an identified dominant index lesion (DIL). This work aims to investigate the treatment parameters for focal SBRT of the prostate under which clinically acceptable rectal NTCP levels can be achieved. For eachmore » of 25 low risk CaP patients, a hypothetical 2 cc DIL was modeled in the right-posterior quadrant of the prostate, and was used to build a PTV as the target for SBRT simulation. An SBRT prescriptions of 41 Gy and 37 Gy in 5 fractions were chosen, corresponding to the boost levels used in previous CaP dose escalation studies. DVH data were exported and used to calculate rectal NTCP values based on the Lyman-Kutcher-Burman (LKB) model using the QUANTEC reccommended model parameters. Rectal NTCP dependence on DIL-to-rectum separation, dose level, and DIL volume were investigated. The final goal of this ongoing work is to create a map of the maximum allowable prescription dose for a given patient geometry that achieves a clinically acceptable rectal NTCP level.« less

Cognitive simulation of incident risks in the structure of loading and transport enterprise

NASA Astrophysics Data System (ADS)

Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

2017-09-01

Organizational and technical system of a manufacturing enterprise was identified, which includes three subsystems: main production, industrial and social infrastructure. Based on the results of cognitive modeling, significant system concepts were identified that reduce the risks of incidents. The internal control influences formed in accordance with level of competence of heads of services, departments, sections, dispatchers, acting on the basis of regulations, job profiles. The second concept influencing the enterprise management system is personnel, which is assessed by the compliance of competencies of crane operators, loader operators, slingers, loaders, and acceptance/delivery agents to job responsibilities and labor functions. At a low level of professional competencies, the personnel does not fully comply with job duties and labor functions, the risk of an incident is maximal. The application of cognitive modeling allows us to identify the essential elements that ensure stable functioning of the system as a whole.

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.

Hg concentrations and related risk assessment in coral reef crustaceans, molluscs and fish from New Caledonia.

PubMed

Chouvelon, Tiphaine; Warnau, Michel; Churlaud, Carine; Bustamante, Paco

2009-01-01

There is a dramatic lack of data on Hg levels in marine organisms from tropical areas, and in particular from New Caledonia. For the first time, this study reports the total Hg concentrations in the tissues of several marine taxa from the New Caledonian lagoon. Seafood from both wild and farmed populations was considered. Hg concentrations varied over three orders of magnitudes according to factors including species, age (size/weight), trophic level, lifestyle and geographical origin. Taking into account the edible tissues, estimations of the amount of flesh that should be consumed by a 60-kg person to reach the Hg Provisional Tolerable Weekly Intake (PTWI) reveal acceptable risk for Human health in general. However, a risk was clearly identified in one site of the lagoon (i.e. Grande Rade) where high Hg concentrations were measured. These concentrations were higher than values reported in the current literature.

The strategy of training staff for a new type of helicopter as an element of raising the security level of flight operations.

PubMed

Gałązkowski, Robert; Wołkowski, Władysław; Mikos, Marcin; Szajda, Sławomir; Wejnarski, Arkadiusz; Świeżewski, Stanisław Paweł

2015-01-01

In 2008, the Polish Medical Air Rescue started replacing its fleet with modern EC135 machines. To ensure the maximum possible safety of the missions performed both in the period of implementing the change and later on, the management prepared a strategy of training its crews to use the new type of helicopter. The analysis of incidents that occurred during 2006-2009 showed that both the human and the technical factors must be carefully considered. Moreover, a risk analysis was conducted to reduce the risk both during general crew training and in the course of particular flight operations. A four-stage strategy of training pilots and crew members was worked out by weighing up all the risks. The analysis of data from 2010 to 2013 confirmed that the risk connected with flying and with all the activities involved in direct support aircraft operations is under control and lowered to an acceptable level.

Calibrating the response to health warnings: limiting both overreaction and underreaction with self-affirmation.

PubMed

Griffin, Dale W; Harris, Peter R

2011-05-01

Self-affirmation, reflecting on one's defining personal values, increases acceptance of threatening information, but does it do so at the cost of inducing undue alarm in people at low risk of harm? We contrast an alarm model, wherein self-affirmation simply increases response to threat, with a calibration model, wherein self-affirmation increases sensitivity to the self-relevance of health-risk information. Female seafood consumers (N = 165) completed a values self-affirmation or control task before reading a U.S. Food and Drug Administration brochure on mercury in seafood. Findings support the calibration model: Among frequent seafood consumers, self-affirmation generally increased concern (reports of depth of thought, personal message relevance, perceived risk, and negative affect) for those high in defensiveness and reduced it for those low in defensiveness. Among infrequent consumers of seafood, self-affirmation typically reduced concern. Thus, self-affirmation increased the sensitivity with which women at different levels of risk, and at different levels of defensiveness, responded cognitively and affectively to the materials.

The strategy of training staff for a new type of helicopter as an element of raising the security level of flight operations

PubMed Central

Gałązkowski, Robert; Wołkowski, Władysław; Mikos, Marcin; Szajda, Sławomir; Wejnarski, Arkadiusz; Świeżewski, Stanisław Paweł

2015-01-01

In 2008, the Polish Medical Air Rescue started replacing its fleet with modern EC135 machines. To ensure the maximum possible safety of the missions performed both in the period of implementing the change and later on, the management prepared a strategy of training its crews to use the new type of helicopter. The analysis of incidents that occurred during 2006–2009 showed that both the human and the technical factors must be carefully considered. Moreover, a risk analysis was conducted to reduce the risk both during general crew training and in the course of particular flight operations. A four-stage strategy of training pilots and crew members was worked out by weighing up all the risks. The analysis of data from 2010 to 2013 confirmed that the risk connected with flying and with all the activities involved in direct support aircraft operations is under control and lowered to an acceptable level. PMID:26694009

Application of a hazard and operability study method to hazard evaluation of a chemical unit of the power station.

PubMed

Habibi, E; Zare, M; Barkhordari, A; Mirmohammadi, Sj; Halvani, Ghh

2008-12-28

The aim of this study was to identify the hazards, evaluate their risk factors and determine the measure for promotion of the process and reduction of accidents in the chemical unit of the power station. In this case and qualitative study, HAZOP technique was used to recognize the hazards and problems of operations on the chemical section at power station. Totally, 126 deviations were documented with various causes and consequences. Ranking and evaluation of identified risks indicate that the majority of deviations were categorized as "acceptable" and less than half of that were "unacceptable". The highest calculated risk level (1B) related to both the interruption of acid entry to the discharge pumps and an increased density of the acid. About 27% of the deviations had the lowest risk level (4B). The identification of hazards by HAZOP indicates that it could, systemically, assess and criticize the process of consumption or production of acid and alkali in the chemical unit of power plant.

Toward a Safety Risk-Based Classification of Unmanned Aircraft

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2016-01-01

There is a trend of growing interest and demand for greater access of unmanned aircraft (UA) to the National Airspace System (NAS) as the ongoing development of UA technology has created the potential for significant economic benefits. However, the lack of a comprehensive and efficient UA regulatory framework has constrained the number and kinds of UA operations that can be performed. This report presents initial results of a study aimed at defining a safety-risk-based UA classification as a plausible basis for a regulatory framework for UA operating in the NAS. Much of the study up to this point has been at a conceptual high level. The report includes a survey of contextual topics, analysis of safety risk considerations, and initial recommendations for a risk-based approach to safe UA operations in the NAS. The next phase of the study will develop and leverage deeper clarity and insight into practical engineering and regulatory considerations for ensuring that UA operations have an acceptable level of safety.

Multi-Target Risk Assessment of Potentially Toxic Elements in Farmland Soil Based on the Environment-Ecological-Health Effect.

PubMed

Wang, Zhongyang; Meng, Bo; Zhang, Wei; Bai, Jinheng; Ma, Yingxin; Liu, Mingda

2018-05-28

There are potential impacts of Potentially Toxic Elements (PTEs) (e.g., Cd, Cr, Ni, Cu, As, Zn, Hg, and Pb) in soil from the perspective of the ecological environment and human health, and assessing the pollution and risk level of soil will play an important role in formulating policies for soil pollution control. Lingyuan, in the west of Liaoning Province, China, is a typical low-relief terrain of a hilly area. The object of study in this research is the topsoil of farmland in this area, of which 71 soil samples are collected. In this study, research methods, such as the Nemerow Index, Potential Ecological Hazard Index, Ecological Risk Quotient, Environmental Exposure Hazard Analysis, Positive Matrix Factorization Model, and Land Statistical Analysis, are used for systematical assessment of the pollution scale, pollution level, and source of PTEs, as well as the ecological environmental risks and health risks in the study area. The main conclusions are: The average contents of As, Cd, Cr, Cu, Hg, Zn, Ni, and Pb of the soil are 5.32 mg/kg, 0.31 mg/kg, 50.44 mg/kg, 47.05 mg/kg, 0.03 mg/kg, 79.36 mg/kg, 26.01 mg/kg, and 35.65 mg/kg, respectively. The contents of Cd, Cu, Zn, and Pb exceed the background value of local soil; Cd content of some study plots exceeds the National Soil Environmental Quality Standard Value (0.6 mg/kg), and the exceeding standard rate of study plots is 5.63%; the comprehensive potential ecological hazard assessment in the study area indicates that the PTEs are at a slight ecological risk; probabilistic hazard quotient assessment indicates that the influence of PTEs on species caused by Cu is at a slight level ( p = 10.93%), and Zn, Pb, and Cd are at an acceptable level. For the ecological process, Zn is at a medium level ( p = 25.78%), Cu is at a slight level (19.77%), and the influence of Cd and Pb are acceptable; human health hazard assessment states that the Non-carcinogenic comprehensive health hazard index HI = 0.16 < 1, indicating that PTEs in soil have no significant effect on people's health through exposure; the PMF model (Positive Matrix Factorization) shows that the contribution rates of agricultural source, industrial source, atmospheric dust source, and natural source are 13.15%, 25.33%, 18.47%, and 43.05%, respectively.

WE-AB-207B-01: Dose Tolerance for SBRT/SABR

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

Grimm, J

Purpose: Stereotactic body radiation therapy (SBRT) / stereotactic ablative body radiotherapy (SABR) is gaining popularity, but quantitative dose tolerance has still been lacking. To improve this, the April 2016 issue of Seminars in Radiation Oncology will have normal tissue complication probability (NTCP) models for 10 critical structures: optic pathway, cochlea, oral mucosa, esophagus, chestwall, aorta, bronchi, duodenum, small bowel, and spinal cord. Methods: The project included more than 1500 treatments in 1–5 fractions using CyberKnife, Gamma Knife, or LINAC, with 60 authors from 15 institutions. NTCP models were constructed from the 97 grade 2–3 complications, predominantly scored using the commonmore » terminology criteria for adverse events (CTCAEv4). Dose volume histogram (DVH) data from each institutional dataset was loaded into the DVH Evaluator software (DiversiLabs, LLC, Huntingdon Valley, Pa) for modeling. The current state of the literature for the critical structures was depicted using DVH Risk Maps: comparative graphs of dose tolerance limits that can include estimated risk levels, reported complications, DVH data for study patients, as well as high- and low-risk dose tolerance limits. Results: For relatively acceptable toxicity like grade 1–3 rib fractures and chestwall pain, the high-risk limits have 50% risk and the low-risk limits have 5% risk. Emami et al (IJROBP 1991 May 15;21(1):109–22) used 50% and 5% risk levels for all structures, whereas this effort used clinically acceptable ranges for each: in structures like aorta or spinal cord where complications must be avoided, the high- and low-risk limits have about 3% and 1% risk, respectively, in this issue of Seminars. These statistically based guidelines can help ensure plan quality for each patient. Conclusion: NTCP for SBRT is now becoming available. Hypofractionated dose tolerance can be dramatically different than extrapolations of conventional fractionation so NTCP analysis of the SBRT/SBRT data is important to ensure safe clinical practice. Dr. Grimm, designed and holds intellectual property rights to the DVH Evaluator software tool which is an FDA-cleared product in commercial use, and was used to analyze the data.« less

HPLC-ICP-MS speciation analysis and risk assessment of arsenic in Cordyceps sinensis.

PubMed

Zuo, Tian-Tian; Li, Yao-Lei; Jin, Hong-Yu; Gao, Fei; Wang, Qi; Wang, Ya-Dan; Ma, Shuang-Cheng

2018-01-01

Cordyceps sinensis , one of the most valued traditional herbal medicines in China, contains high amount of arsenic. Considering the adverse health effects of arsenic, this is of particular concern. The aim of this study was to determine and analyze arsenic speciation in C. sinensis , and to measure the associated human health risks. We used microwave extraction and high-performance liquid chromatography coupled with inductively coupled plasma mass spectrometry to determine and analyze the arsenic content in C. sinensis , and measured the associated human health risks according to the hazard index (HI), lifetime cancer risk (CR), and target hazard quotient (THQ). The main arsenic speciation in C. sinensis were not the four organic arsenic compounds, including dimethyl arsenic, monomethyl arsenic, arsenobetaine, and arsenocholine, but comprised inorganic arsenic and other unknown risk arsenic compounds. HI scores indicated that the risk of C. sinensis was acceptable. CR results suggested that the cancer risk was greater than the acceptable lifetime risk of 10 -5 , even at low exposure levels. THQ results indicated that at the exposure level < 2.0 months/year, the arsenic was not likely to harm human health during a lifetime; however, if the exposure rate was > 3.0 months/year, the systemic effects of the arsenic in C. sinensis was of great concern. The arsenic in C. sinensis might not be free of risks. The suggested C. sinensis consumption rate of 2.0 months/year provided important insights into the ways by which to minimize potential health risks. Our study not only played the role of "cast a brick to attract jade" by which to analyze arsenic speciation in C. sinensis but also offered a promising strategy of risk assessment for harmful residues in traditional herbal medicines.

Nuclear regulation: an evaluative study. [Monograph

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

Wood, W.C.

This paper gives an overview of nuclear regulation, followed by an account of the legislative rationale and the economic rationale for safety regulation of nuclear technology. It goes on to review the structure and safety programs of the Nuclear Regulatory Commission (NRC) and to show how many of the NRC's problems are unlike those facing other regulatory agencies. In assessing the results of nuclear regulation, it examines whether regulation has produced an acceptable level of safety and the nature of the evidence on acceptability. It concludes that the existing level of safety achievement is not cost-effective, and identifies some sourcesmore » of regulatory failure as a failure to make hard decisions on risk, diffuse responsibility for safety, and economic dissincentives to cost-effective safety. Recommendations for reforming NRC are to separate technical issues from social ones and to correct the incentives for safety. 153 references, 6 figures, 4 tables.« less

Pilot of a Tailored Dance Intervention to Support Function in People With Cognitive Impairment Residing in Long-Term Care: A Brief Report

PubMed Central

O’Rourke, Hannah M.; Sidani, Souraya; Chu, Charlene H.; Fox, Mary; McGilton, Katherine S.; Collins, Jhonna

2017-01-01

Older adults who live in long-term care settings are at risk for functional decline, which may be mitigated by regular exercise. Using a single-group repeated measures design, this pilot study explored the feasibility, acceptability, and preliminary effects of a Waltz-based dance intervention delivered to 13 Canadian, English-speaking, long-term care residents with mild to moderate cognitive impairment. The findings supported intervention feasibility, based on a high completion rate (93%), level of attendance (M = 7.15 of 10 sessions) and level of engagement during dance sessions (M = 1.75 to 1.97 out of 2.00). On average, residents perceived dance sessions positively, and staff and family participants (N = 26) rated them as somewhat acceptable overall (M = 2.37, 0 to 4 scale). Additional research is needed to assess intervention efficacy in a larger sample. PMID:29085863

Pilot of a Tailored Dance Intervention to Support Function in People With Cognitive Impairment Residing in Long-Term Care: A Brief Report.

PubMed

O'Rourke, Hannah M; Sidani, Souraya; Chu, Charlene H; Fox, Mary; McGilton, Katherine S; Collins, Jhonna

2017-01-01

Older adults who live in long-term care settings are at risk for functional decline, which may be mitigated by regular exercise. Using a single-group repeated measures design, this pilot study explored the feasibility, acceptability, and preliminary effects of a Waltz-based dance intervention delivered to 13 Canadian, English-speaking, long-term care residents with mild to moderate cognitive impairment. The findings supported intervention feasibility, based on a high completion rate (93%), level of attendance ( M = 7.15 of 10 sessions) and level of engagement during dance sessions ( M = 1.75 to 1.97 out of 2.00). On average, residents perceived dance sessions positively, and staff and family participants ( N = 26) rated them as somewhat acceptable overall ( M = 2.37, 0 to 4 scale). Additional research is needed to assess intervention efficacy in a larger sample.

Modeling nurses' attitude toward using automated unit-based medication storage and distribution systems: an extension of the technology acceptance model.

PubMed

Escobar-Rodríguez, Tomás; Romero-Alonso, María Mercedes

2013-05-01

This article analyzes the attitude of nurses toward the use of automated unit-based medication storage and distribution systems and identifies influencing factors. Understanding these factors provides an opportunity to explore actions that might be taken to boost adoption by potential users. The theoretical grounding for this research is the Technology Acceptance Model. The Technology Acceptance Model specifies the causal relationships between perceived usefulness, perceived ease of use, attitude toward using, and actual usage behavior. The research model has six constructs, and nine hypotheses were generated from connections between these six constructs. These constructs include perceived risks, experience level, and training. The findings indicate that these three external variables are related to the perceived ease of use and perceived usefulness of automated unit-based medication storage and distribution systems, and therefore, they have a significant influence on attitude toward the use of these systems.

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.

Spatiotemporal Characteristics and Health Risk Assessment of Heavy Metals in PM2.5 in Zhejiang Province

PubMed Central

Wang, Xiaofeng; He, Shengliang; Chen, Shuchang; Zhang, Yongli; Wang, Aihong; Luo, Jinbin; Ye, Xialiang; Mo, Zhe; Wu, Lizhi; Xu, Peiwei; Cai, Gaofeng; Chen, Zhijian; Lou, Xiaoming

2018-01-01

The spatiotemporal characteristics and human health risks of 12 heavy metals (Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb, Se, and Tl) in fine particulate matter (PM2.5) in Zhejiang Province were investigated. The annual average PM2.5 concentration was 58.83 µg/m3 in 2015 in Zhejiang. Element contents in PM2.5 varied greatly with the season and locations. Al, Pb, and Mn were the most abundant elements among the studied metal(loid)s in PM2.5. The non-carcinogenic risks of the 12 elements through inhalation and dermal contact exposure were lower than the safe level for children and adults. However, there were potential non-carcinogenic risks of Tl, As, and Sb for children and Tl for adults through ingestion exposure. The carcinogenic risks from As, Be, Cd, Cr, Pb, and Ni through inhalation exposure were less than the acceptable level (1 × 10−4) for children and adults. Pb may carry a potential carcinogenic risk for both children and adults through ingestion. More attention should be paid to alleviate non-carcinogenic and carcinogenic health risks posed by particle-bound toxic elements through ingestion exposure. PMID:29587346

Development of a Cost-Effective Educational Tool to Promote Acceptance of the HPV Vaccination by Hispanic Mothers.

PubMed

Brueggmann, Doerthe; Opper, Neisha; Felix, Juan; Groneberg, David A; Mishell, Daniel R; Jaque, Jenny M

2016-06-01

Although vaccination against the Human Papilloma Virus (HPV) reduces the risk of related morbidities, the vaccine uptake remains low in adolescents. This has been attributed to limited parental knowledge and misconceptions. In this cross sectional study, we assessed the (1) clarity of educational material informing Hispanic mothers about HPV, cervical cancer and the HPV vaccine, (2) determined vaccination acceptability and (3) identified predictors of vaccine acceptance in an underserved health setting. 418 Hispanic mothers received the educational material and completed an anonymous survey. 91 % of participants understood most or all of the information provided. 77 % of participants reported vaccine acceptance for their children; this increased to 84 % when only those with children eligible to receive vaccination were included. Significant positive predictors of maternal acceptance of the HPV vaccine for their children were understanding most or all of the provided information, older age and acceptance of the HPV vaccine for themselves. Concerns about safety and general dislike of vaccines were negatively associated with HPV vaccine acceptance. Prior knowledge, level of education, previous relevant gynecologic history, general willingness to vaccinate and other general beliefs about vaccines were not significantly associated with HPV vaccine acceptance. The majority of participants reported understanding of the provided educational material. Vaccine acceptability was fairly high, but was even higher among those who understood the information. This study documents a cost-effective way to provide Hispanic mothers with easy-to-understand HPV-related information that could increase parental vaccine acceptability and future vaccine uptake among their children.

Managing health and safety risks: Implications for tailoring health and safety management system practices.

PubMed

Willmer, D R; Haas, E J

2016-01-01

As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project

PubMed Central

Redding, Colleen A.; Jones, Deborah; Zulu, Robert; Chitalu, Ndashi; Cook, Ryan; Weiss, Stephen M

2015-01-01

Background Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. Purpose At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. Method Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. Results VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. Conclusions Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs. PMID:25896876

Concentrations and potential health risks of methyl tertiary-butyl ether (MTBE) in air and drinking water from Nanning, South China.

PubMed

Zhang, Li'e; Qin, Jian; Zhang, Zhiyong; Li, Qin; Huang, Jiongli; Peng, Xiaowu; Qing, Li; Liang, Guiqiang; Liang, Linhan; Huang, Yuman; Yang, Xiaobo; Zou, Yunfeng

2016-01-15

Levels of methyl tertiary-butyl ether (MTBE) in occupational air, ambient air, and drinking water in Nanning, South China, were investigated, and then their potential health risks to occupational workers and the general public were evaluated. Results show that the MTBE concentration in occupational air from 13 service stations was significantly higher than that in ambient air from residential areas (p<0.0001); both are far lower than the threshold limit value-time weighted average of MTBE regulated in the United States (US). The drinking water samples from household taps yielded detectable MTBE in the range of 0.04-0.33 μg/L, which is below the US drinking water standard of 20-40 μg/L. The non-carcinogenic risk of MTBE from air inhalation may be negligible because the calculated hazard quotient was less than 1. The mean MTBE lifetime cancer risk was within the acceptable limit of 1 × 10(-6) to 1 × 10(-4), but the lifetime cancer risk of refueling workers in the urban service station at the 95th percentile slightly exceeded the maximum acceptable carcinogen risk (1 × 10(-4)), indicating the potential carcinogenic health effects on the population highly exposed to MTBE in this region. The hazard index and carcinogenic risk of MTBE in drinking water were significantly lower than the safe limit of US Environmental Protection Agency, suggesting that drinking water unlikely poses significant health risks to the residents in Nanning. Copyright © 2015 Elsevier B.V. All rights reserved.

Polycyclic aromatic hydrocarbons in urban soil of Novi Sad, Serbia: occurrence and cancer risk assessment.

PubMed

Škrbić, Biljana D; Đurišić-Mladenović, Nataša; Tadić, Đorđe J; Cvejanov, Jelena Đ

2017-07-01

Contents of 16 polycyclic aromatic hydrocarbons were analyzed in 30 soil samples from 15 locations in Novi Sad, Serbia, assessing for the first time the corresponding health risks in the Serbian urban zone. Total concentrations were in the range of 22-2247 μg kg -1 , with a mean and median value of 363 and 200 μg kg -1 , respectively. Comparison with the relevant maximum allowed contents proposed by the Serbian government and with the Dutch target values implied that soils from the urban area of Novi Sad were "suitable as residential soils" and that no intervention would be needed if the current levels were retained. Seven diagnostic ratios were calculated, indicating the pyrogenic sources of PAHs as the dominant. Cancer risks in humans via accidental ingestion, inhalation of soil particles, and dermal contact with soil were estimated. Cancer risk for soil ingestion by children was the highest. The total lifetime carcinogenic risk as sum of individual cancer risks for seven carcinogenic polycyclic aromatic hydrocarbons was within the range 10 -4 to 10 -6 , indicating acceptable risks at 30 and 47% of sites for children and adults, respectively. However, for the rest of the samples, total lifetime cancer risk was >10 -4 indicating over the acceptable risk, even though the contents in soil were not of concern as the comparison with the environmental guidance previously showed. This could be explained by (a) the dominant concentrations of higher molecular weight compounds with 4 to 6 rings, among which there are compounds with higher toxicity equivalents, but also with (b) the extreme conditions used for the conservative risk assessment under maximal exposure frequency, exposure time, and ingestion rates.

Plasma Free Amino Acid Profiles Predict Four-Year Risk of Developing Diabetes, Metabolic Syndrome, Dyslipidemia, and Hypertension in Japanese Population

PubMed Central

Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko

2015-01-01

Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals’ future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120 min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120 min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120 min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880

Which young people accept a lift from a drunk or drugged driver?

PubMed

Calafat, A; Adrover-Roig, D; Blay, N; Juan, M; Bellis, M; Hughes, K; Mendes, F; Kokkevi, A

2009-07-01

Riding with a drunk and/or a drugged driver (RDD) is a risk behaviour that has received very little attention in spite of its potential dangers. Young people involved in the recreational nightlife context are especially at risk. 1363 regular users of recreational nightlife from nine European countries (mean age: 21.75; 51.5% women) filled out a self-administered and anonymous questionnaire (in 2006). 37.2% had practised RDD during the previous month. RDD is related to drunkenness and use of drugs, personality factors such as impulsivity, preferring to use a private car to get to nightlife venues, living in a southern European country and being unemployed. No significant influence was found for age, gender, educational level or socioeconomic status. It is important to raise awareness about the high prevalence of RDD. This lack of awareness can be related to its social acceptance among young people. The use of private cars for going to nightlife venues should be discouraged.

Helminth log reduction values for recycling water from sewage for the protection of human and stock health.

PubMed

Stevens, Daryl P; Surapaneni, Aravind; Thodupunuri, Rachna; O'Connor, Nicholas A; Smith, David

2017-11-15

The LRVs required to decrease HE concentrations in raw sewage to an acceptable level to manage the risk to human and livestock health were determined. An LRV of 3.0 was required to meet the HBT of 1 μDALY pppy in SE Australia where human helminth infections are not endemic. In comparison, a similar exposure volume and LRV in endemic regions would result in a HBT of 100 μDALY pppy. The risks posed by cattle- and pig-related helminths were also managed acceptably with the treatment of sewage providing an LRV of 3.0. New design equations were derived to determine LRVs based on hydraulic residence times (HRTs) in an activated sludge plant (ASP) and lagoons. The new equation for lagoons indicated that an LRV of 3.0 could be achieved with a HRT of 18 days or less. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Slowing the Tide of Alcohol Use Disorders.

PubMed

Chamsi-Pasha, Hassan; Chamsi-Pasha, Majed; Albar, Mohammed Ali

2016-09-28

Alcohol use disorders (AUDs)-a spectrum including at-risk drinking, alcohol abuse, dependence, and addiction-is a highly prevalent problem worldwide with a substantial economic impact. The toll of alcohol on individual health and healthcare systems is devastating. Alcohol is estimated to be the fifth leading risk factor for global disability-adjusted life years. Tackling the problem of AUD requires a comprehensive strategy that includes solid action on price, availability, and marketing of alcohol. Restricting or banning alcohol advertising may reduce exposure to the risk posed by alcohol at the individual and general population level. Warning labels about the cancer risks associated with drinking have a high degree of public support and may be an inexpensive and acceptable way to educate the public. Religiosity may reduce risk behaviors and contribute to health decision making related to alcohol use.

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.

Airline business continuity and IT disaster recovery sites.

PubMed

Haji, Jassim

2016-01-01

Business continuity is defined as the capability of the organisation to continue delivery of products or services at acceptable predefined levels following a disruptive incident. Business continuity is fast evolving to become a critical and strategic decision for any organisation. Transportation in general, and airlines in particular, is a unique sector with a specialised set of requirements, challenges and opportunities. Business continuity in the airline sector is a concept that is generally overlooked by the airline managements. This paper reviews different risks related to airline processes and will also propose solutions to these risks based on experiences and good industry practices.

Rape Prevention With College Men

PubMed Central

Stephens, Kari A.; George, William H.

2014-01-01

This study evaluates the effectiveness of a theoretically based rape prevention intervention with college men who were at high or low risk to perpetrate sexually coercive behavior. Participants (N = 146) are randomly assigned to the intervention or control group. Outcomes include rape myth acceptance, victim empathy, attraction to sexual aggression, sex-related alcohol expectancies, and behavioral indicators, measured across three time points. Positive effects are found for rape myth acceptance, victim empathy, attraction to sexual aggression, and behavioral intentions to rape. Only rape myth acceptance and victim empathy effects sustain at the 5-week follow-up. High-risk men are generally unaffected by the intervention although low-risk men produced larger effects than the entire sample. Results suggest rape prevention studies must assess risk status moderation effects to maximize prevention for high-risk men. More research is needed to develop effective rape prevention with men who are at high risk to rape. PMID:18591366

A comparison of network-based strategies for screening at-risk Hispanic/Latino adolescents and young adults for undiagnosed asymptomatic HIV infection.

PubMed

Boyer, Cherrie B; Robles-Schrader, Grisel M; Li, Su X; Miller, Robin L; Korelitz, James; Price, Georgine N; Rivera Torres, Carmen M; Chutuape, Kate S; Stines, Stephanie J; Straub, Diane M; Peralta, Ligia; Febo, Irma; Hightow-Weidman, Lisa; Gonin, René; Kapogiannis, Bill G; Ellen, Jonathan M

2014-12-01

Hispanic/Latino adolescents and young adults are disproportionately impacted by the HIV/AIDS epidemic; yet little is known about the best strategies to increase HIV testing in this group. Network-based approaches are feasible and acceptable means for screening at-risk adults for HIV infection, but it is unknown whether these approaches are appropriate for at-risk young Hispanics/Latinos. Thus, we compared an alternative venue-based testing (AVT) strategy with a social and sexual network-based interviewing and HIV testing (SSNIT) strategy. All participants were Hispanics/Latinos aged 13-24 years with self-reported HIV risk; they were recruited from 11 cities in the United States and Puerto Rico and completed an audio computer-assisted self-interview and underwent HIV screening. A total of 1,596 participants (94.5% of those approached) were enrolled: 784 (49.1%) through AVT and 812 (50.9%) through SSNIT. HIV infection was identified in three SSNIT (.37%) and four AVT (.51%) participants (p = .7213). Despite high levels of HIV risk, a low prevalence of HIV infection was identified with no differences by recruitment strategy. We found overwhelming support for the acceptability and feasibility of AVT and SSNIT for engaging and screening at-risk young Hispanics/Latinos. Further research is needed to better understand how to strategically implement such strategies to improve identification of undiagnosed HIV infection. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Influence of intramuscular fat content on the quality of pig meat - 2. Consumer acceptability of m. longissimus lumborum.

PubMed

Fernandez, X; Monin, G; Talmant, A; Mourot, J; Lebret, B

1999-09-01

The present study is part of a project which aimed to examine the influence of intramuscular fat (IMF) content on sensory attributes and consumer acceptability of pork. Two experiments were conducted to evaluate consumer acceptability of pork chops with varying IMF level in muscle Longissimus lumborum (LL). Each experiment used 32 castrated male pigs selected after slaughter either from 125 Duroc × Landrace (Experiment 1) or 102 Tia Meslan × Landrace (Experiment 2) crossbred animals, and showing large variability in LL IMF content: from <1.5 to >3.5% in Experiment 1 and from 1.25 to 3.25% in Experiment 2. A group of 56 consumers evaluated various items on rib-eye (LL muscle trimmed of backfat) (Experiment 1) and on entire chops trimmed of backfat (Experiment 2). Data from Experiment 1 indicate that an increase in IMF level is associated with an increase in visual perception of fat and a corresponding decrease in the willingness to eat and purchase the meat, when expressed before tasting. The latter effect disappeared after the consumers had tasted the meat, probably due to a positive effect of increase IMF, up to 3.5%, on the perception of texture and taste. In Experiment 2, where entire chops were evaluated, the perception of visible fat was not affected by IMF level, probably due to the lack of variation in the level of intermuscular fat between the four IMF groups. The willingness to eat and purchase the meat were unaffected by IMF level, whereas the perception of texture and taste was enhanced with increased IMF levels up to 3.25%. The present data suggest that the acceptability of pork may be improved by increasing IMF level but: (1) this effect disappeared for IMF levels higher than 3.5%, which are associated with a high risk of meat rejection due to visible fat and (2) the positive effect of increased IMF probably holds true as long as it is not associated with an increase in the level of intermuscular fat.

Imagery rescripting and cognitive dissonance: A randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder.

PubMed

Pennesi, Jamie-Lee; Wade, Tracey D

2018-05-01

This pilot study compared two brief online interventions, imagery rescripting and cognitive dissonance, to an assessment-only control condition in a sample of body-dissatisfied young women at risk of developing an eating disorder. We examined the degree to which each intervention reduced disordered eating and modified risk and protective factors for eating disorders. Female university students (N = 107, 17-28 years of age) completed a screening questionnaire, followed by random allocation to one of the three conditions, followed by a baseline assessment, body dissatisfaction induction, and brief online intervention. Participants in the active conditions then completed online daily home practice and a postintervention questionnaire. Findings provide qualified support for the imagery rescripting intervention, with participants reporting higher body image acceptance (Cohen's d = 0.49) than the cognitive dissonance condition, and higher self-compassion (d = 0.59) and lower levels of disordered eating (d = 0.59) than the control condition, at postintervention. There was no significant impact of cognitive dissonance on any factors. Change in body image acceptance and self-compassion mediated the relationship between allocated condition and change in disordered eating at postintervention. These findings provide preliminary support for the use of online-adapted imagery-based techniques (e.g., imagery rescripting) to reduce risk for the development of an eating disorder by strengthening protective factors (i.e., body image acceptance and self-compassion) and reducing disordered eating. Further exploration of the use of imagery strategies in the prevention of disordered eating is required, including prospective tests of the mechanisms of action. © 2018 Wiley Periodicals, Inc.

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.

Risk management: FIFA's approach for protecting the health of football players

PubMed Central

Fuller, Colin W; Junge, Astrid; Dvorak, Jiri

2012-01-01

Background Sport and exercise have long-term health benefits, but there is also a risk that participants will sustain injuries and/or ill health from these activities. For this reason, international sports governing bodies have a responsibility to identify the risks that exist within their sport and to provide guidance to participants and other stakeholders on how these risks can be controlled within acceptable levels. Purpose To demonstrate how Fédération Internationale de Football Association (FIFA), as football's governing body, uses a risk management framework to identify, quantify, mitigate and communicate the risks of injury and ill health in football for men, women and children in all environments. Method All the research papers published by FIFA's Medical Assessment and Research Centre (F-MARC) during the period 1994 to 2011 were reviewed and categorised according to an established sport-related risk management framework. Conclusions F-MARC investigated and mitigated 17 areas of risk to footballers' health in a coherent and consistent approach through the process of risk management. PMID:22143999

Risk management: FIFA's approach for protecting the health of football players.

PubMed

Fuller, Colin W; Junge, Astrid; Dvorak, Jiri

2012-01-01

Sport and exercise have long-term health benefits, but there is also a risk that participants will sustain injuries and/or ill health from these activities. For this reason, international sports governing bodies have a responsibility to identify the risks that exist within their sport and to provide guidance to participants and other stakeholders on how these risks can be controlled within acceptable levels. To demonstrate how Fédération Internationale de Football Association (FIFA), as football's governing body, uses a risk management framework to identify, quantify, mitigate and communicate the risks of injury and ill health in football for men, women and children in all environments. All the research papers published by FIFA's Medical Assessment and Research Centre (F-MARC) during the period 1994 to 2011 were reviewed and categorised according to an established sport-related risk management framework. F-MARC investigated and mitigated 17 areas of risk to footballers' health in a coherent and consistent approach through the process of risk management.

Quality by design I: Application of failure mode effect analysis (FMEA) and Plackett-Burman design of experiments in the identification of "main factors" in the formulation and process design space for roller-compacted ciprofloxacin hydrochloride immediate-release tablets.

PubMed

Fahmy, Raafat; Kona, Ravikanth; Dandu, Ramesh; Xie, Walter; Claycamp, Gregg; Hoag, Stephen W

2012-12-01

As outlined in the ICH Q8(R2) guidance, identifying the critical quality attributes (CQA) is a crucial part of dosage form development; however, the number of possible formulation and processing factors that could influence the manufacturing of a pharmaceutical dosage form is enormous obviating formal study of all possible parameters and their interactions. Thus, the objective of this study is to examine how quality risk management can be used to prioritize the number of experiments needed to identify the CQA, while still maintaining an acceptable product risk profile. To conduct the study, immediate-release ciprofloxacin tablets manufactured via roller compaction were used as a prototype system. Granules were manufactured using an Alexanderwerk WP120 roller compactor and tablets were compressed on a Stokes B2 tablet press. In the early stages of development, prior knowledge was systematically incorporated into the risk assessment using failure mode and effect analysis (FMEA). The factors identified using FMEA were then followed by a quantitative assessed using a Plackett-Burman screening design. Results show that by using prior experience, literature data, and preformulation data the number of experiments could be reduced to an acceptable level, and the use of FMEA and screening designs such as the Plackett Burman can rationally guide the process of reducing the number experiments to a manageable level.

ROLE OF MATERNAL CHILDHOOD TRAUMA ON PARENTING AMONG DEPRESSED MOTHERS OF PSYCHIATRICALLY ILL CHILDREN

PubMed Central

Zalewski, Maureen; Cyranowski, Jill M.; Cheng, Yu; Swartz, Holly A.

2015-01-01

Background Independently, maternal depression and maternal history of childhood abuse confer risk for impaired parenting. These associations may be compounded when depressed mothers with histories of childhood abuse are faced with the challenge of parenting offspring who themselves struggle with mental health problems. This study examined the relationships among maternal history of childhood abuse, maternal depression, and parenting style in the context of parenting a psychiatrically ill child, with an emphasis on examining maternal emotional abuse and neglect. We hypothesized that maternal childhood emotional abuse would be associated with maladaptive parenting strategies (lower levels of maternal acceptance and higher levels of psychological control), independent of maternal depression severity and other psychosocial risk factors. Method Ninety-five mother-child dyads (children ages 7–18) were recruited from child mental health centers where children were receiving treatment for at least one internalizing disorder. Participating mothers met DSM-IV criteria for major depressive disorder. Mothers reported on their own childhood abuse histories and children reported on their mothers’ parenting. Results Regression analyses demonstrated that maternal childhood emotional abuse was associated with child reports of lower maternal acceptance and greater psychological control, controlling for maternal depression severity, and other psychosocial risk factors. Conclusions When treating psychiatrically ill children, it is important for a child’s clinician to consider mothers’ childhood abuse histories in addition to their history of depression. These mothers appear to have additional barriers to effective parenting. PMID:23649503

Role of maternal childhood trauma on parenting among depressed mothers of psychiatrically ill children.

PubMed

Zalewski, Maureen; Cyranowski, Jill M; Cheng, Yu; Swartz, Holly A

2013-09-01

Independently, maternal depression and maternal history of childhood abuse confer risk for impaired parenting. These associations may be compounded when depressed mothers with histories of childhood abuse are faced with the challenge of parenting offspring who themselves struggle with mental health problems. This study examined the relationships among maternal history of childhood abuse, maternal depression, and parenting style in the context of parenting a psychiatrically ill child, with an emphasis on examining maternal emotional abuse and neglect. We hypothesized that maternal childhood emotional abuse would be associated with maladaptive parenting strategies (lower levels of maternal acceptance and higher levels of psychological control), independent of maternal depression severity and other psychosocial risk factors. Ninety-five mother-child dyads (children ages 7-18) were recruited from child mental health centers where children were receiving treatment for at least one internalizing disorder. Participating mothers met DSM-IV criteria for major depressive disorder. Mothers reported on their own childhood abuse histories and children reported on their mothers' parenting. Regression analyses demonstrated that maternal childhood emotional abuse was associated with child reports of lower maternal acceptance and greater psychological control, controlling for maternal depression severity, and other psychosocial risk factors. When treating psychiatrically ill children, it is important for a child's clinician to consider mothers' childhood abuse histories in addition to their history of depression. These mothers appear to have additional barriers to effective parenting. © 2013 Wiley Periodicals, Inc.

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.

Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

PubMed

Yu, Jing; Tian, Ai-Juan; Yuan, Xin; Cheng, Xiao-Xin

2016-01-01

Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH) increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression. The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH) levels exceeding 10 mIU/L. Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb) levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L. The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

A comparison of abused and non-abused women's definitions of domestic violence and attitudes to acceptance of male dominance.

PubMed

Faramarzi, M; Esmailzadeh, S; Mosavi, S

2005-10-01

To examine the effects of women's subjective definitions of wife abuse and of their general attitudes to acceptance of male dominance on the occurrence of domestic violence. A case-control survey was conducted in the public health center of Babol University of Medical Sciences from November 2002 to October 2003. The Abuse Assessment Screen Form was used to identify partner violence, and the Abuse Definition Form and Abuse Attitude Form were applied to measure how the women defined wife abuse and their attitudes to male dominance. Women with positive attitudes to male dominance had experienced more physical and emotional abuse than those with negative attitudes toward male dominance (p < 0.05). Although living in villages, low level of education, female unemployment, and low family income were important risk factors for domestic violence, the strongest predictor of physical abuse was a positive attitude to male dominance. A positive attitude of women to male dominance increases the acceptance and frequency of partner violence. This finding shows the need to raise the educational levels of women and raise their awareness of their rights. This could convert an attitude of male dominance to equality of men and women.

Development of a Premium Quality Plasma-derived IVIg (IQYMUNE®) Utilizing the Principles of Quality by Design-A Worked-through Case Study.

PubMed

Paolantonacci, Philippe; Appourchaux, Philippe; Claudel, Béatrice; Ollivier, Monique; Dennett, Richard; Siret, Laurent

2018-01-01

Polyvalent human normal immunoglobulins for intravenous use (IVIg), indicated for rare and often severe diseases, are complex plasma-derived protein preparations. A quality by design approach has been used to develop the Laboratoire Français du Fractionnement et des Biotechnologies new-generation IVIg, targeting a high level of purity to generate an enhanced safety profile while maintaining a high level of efficacy. A modular approach of quality by design was implemented consisting of five consecutive steps to cover all the stages from the product design to the final product control strategy.A well-defined target product profile was translated into 27 product quality attributes that formed the basis of the process design. In parallel, a product risk analysis was conducted and identified 19 critical quality attributes among the product quality attributes. Process risk analysis was carried out to establish the links between process parameters and critical quality attributes. Twelve critical steps were identified, and for each of these steps a risk mitigation plan was established.Among the different process risk mitigation exercises, five process robustness studies were conducted at qualified small scale with a design of experiment approach. For each process step, critical process parameters were identified and, for each critical process parameter, proven acceptable ranges were established. The quality risk management and risk mitigation outputs, including verification of proven acceptable ranges, were used to design the process verification exercise at industrial scale.Finally, the control strategy was established using a mix, or hybrid, of the traditional approach plus elements of the quality by design enhanced approach, as illustrated, to more robustly assign material and process controls and in order to securely meet product specifications.The advantages of this quality by design approach were improved process knowledge for industrial design and process validation and a clear justification of the process and product specifications as a basis for control strategy and future comparability exercises. © PDA, Inc. 2018.

Alcohol and cigarette use among Warsaw adolescents: Factors associated with risk and resilience

PubMed Central

Pisarska, Agnieszka; Eisman, Andria; Ostaszewski, Krzysztof; Zimmerman, Marc A.

2016-01-01

Background Youth in Poland are at notable risk for substance use. Guided by resiliency theory, we examine if developmental risk and promotive factors are associated with substance abuse risk. Objectives We examined the association between adolescent cigarette and alcohol use and related risk and promotive factors including maternal support, neighbours’ informal social control, friends’ acceptance of substance use, and alcohol and cigarette use by nonparental adults. Method Data were collected from a random sample of 13–14-year old students attending Warsaw middle schools (N=3029). We used hierarchical regression models and examined compensatory and protective models of resilience, controlling for sociodemograhic factors. Results Our results indicated that friends’ acceptance of substance use and perceived drug use among nonparental adults was associated with increased risk cigarette and alcohol use among youth. We found that maternal support moderated the relationship between friends’ acceptance of substance use and cigarette use (protective model of resilience). Thus, maternal support buffered the negative effects of friends’ acceptance of use on youths’ cigarette use. Neighbor’s informal social control and maternal support were associated with reduced risk of alcohol use (compensatory model of resilience). Conclusion Collectively, results of the study support compensatory and protective models of resilience in a large representative sample of Warsaw adolescents. PMID:27223142

Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China.

PubMed

Wang, Zixin; Lau, Joseph T F; Yang, Xueying; Cai, Yong; Gross, Danielle L; Ma, Tiecheng; Liu, Yan

2017-12-01

This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10-16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.

5 CFR 531.409 - Acceptable level of competence determinations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Acceptable level of competence... REGULATIONS PAY UNDER THE GENERAL SCHEDULE Within-Grade Increases § 531.409 Acceptable level of competence... delegated shall determine which employees are performing at an acceptable level of competence. (b) Basis for...

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

Big Software for SmallSats: Adapting cFS to CubeSat Missions

NASA Technical Reports Server (NTRS)

Cudmore, Alan P.; Crum, Gary Alex; Sheikh, Salman; Marshall, James

2015-01-01

Expanding capabilities and mission objectives for SmallSats and CubeSats is driving the need for reliable, reusable, and robust flight software. While missions are becoming more complicated and the scientific goals more ambitious, the level of acceptable risk has decreased. Design challenges are further compounded by budget and schedule constraints that have not kept pace. NASA's Core Flight Software System (cFS) is an open source solution which enables teams to build flagship satellite level flight software within a CubeSat schedule and budget. NASA originally developed cFS to reduce mission and schedule risk for flagship satellite missions by increasing code reuse and reliability. The Lunar Reconnaissance Orbiter, which launched in 2009, was the first of a growing list of Class B rated missions to use cFS.

Knowledge, Attitudes Toward, and Acceptability of Genetic Modification among Western Balkan University Students of Life Sciences (AGREE Study).

PubMed

Veličković, Vladica; Jović, Marko; Nalić, Ena; Višnjić, Aleksandar; Radulović, Olivera; Šagrić, Čedomir; Ćirić, Milan

2016-01-01

There are still no data on the attitudes and acceptance of genetic modification (GM) food in European developing countries, such as the Western Balkan countries. The aim of the study was to assess the knowledge, attitudes, and acceptance of GM but also to shed light on the multifactorial process leading to acceptance of genetic modifications among Western Balkan students of life sciences. In this cross-sectional study, the final study population sample was composed of 1251 university students. The instrument for data collection was a questionnaire consisting of 49 items composed of 5 sections taken from the literature. Attitudes toward GM were analyzed by using Q-mode factor analysis and principal component analysis was run for the assessment of perception of personal health risks. The acceptability of GM was analyzed in binary probit models assessing the acceptability of GM products in different areas of application with Q models, sociodemographic variables, perception of personal health risks factors, respondents' knowledge about biotechnology, gender, and age as explanatory variables. This study demonstrated that students of life sciences supported the implementation of GM in industry and medicine production but not in food production. Their acceptance was most influenced by 3 out of 5 attitude models that were identified (p < 0.0001). Regarding the perception of personal health risks, the factor "credence risks" was seen as a negative predictor of acceptance of GM in industry and food production (p < 0.05). The main knowledge predictor of rejecting GM was misconception, whereas real knowledge had no impact (p < 0.0001). The AGREE study provided the first rough picture of the knowledge, attitudes, and acceptance of GM in this area. Given the target population, it could be expected that the general population's acceptance of all observed elements, especially knowledge, would be lower.

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 which eventually led to its status as an accepted risk for ISS EVAs.

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.

Risks associated with clinical databases.

PubMed

Eleazar, P Y

1991-11-01

Providers will succeed who are evaluating themselves, and who are continuously striving to examine who they are and where they are going. Conscientious providers know that countless other agencies have them under the microscope and that they have to work to stay ahead in assessing their actions through their clinical database. "Medical care value purchasing" is what every employer and payor is looking for, and providers need to find ways to illustrate cost in relation to quality. The basics of data security and protection should be in place in order to concentrate on the bigger picture. The knowledge of the risk associated with individual hospital databases as well as the risk associated with comparative databases is critical. The hospital-level clinical database is the hub of the wheel. If the risk there can be minimized, the data headed for various investigative sites will have less inherent risk. When it is really recognized and accepted that all financial decisions are made based upon the clinical data generated at the site of care, then data integrity will become a strategic advantage for the industry. Clinical database goals will, over time, cause minimization of risk at all levels. As this occurs, variation in treatment will be explained artfully.

Organochlorine pesticide levels in Clarias gariepinus from polluted freshwater impoundments in South Africa and associated human health risks.

PubMed

Barnhoorn, I E J; van Dyk, J C; Genthe, B; Harding, W R; Wagenaar, G M; Bornman, M S

2015-02-01

There are increasing concerns regarding the safe human consumption of fish from polluted, freshwater impoundments. The aim of this study was to analyse the muscle tissue of the sharptooth catfish Clarias gariepinus for selected organo-chlorine pesticides (OCPs) and to perform a human health risk assessment using a standard protocol described by the United States Environmental Protection Agency (US EPA). Fish were collected from the polluted Roodeplaat-(RDPD), Rietvlei-(RVD) and Hartbeespoort (HBPD) Dam impoundments located in the north-eastern regions of South Africa. GC-MS analyses showed levels of various OCPs in fish muscle samples from all three impoundments. For fish collected from the RDPD, p,p'-DDE, endosulfan, lindane and β- and δ-HCH were the most prevalent OCPs detected, while p,p'-DDE and endosulfan were the most predominant in fish from the RVD. Lindane and β- and δ-HCH were the main OCPs detected in fish from the HBPD. Dieldrin was the only OCP detected at concentrations for which a cancer risk and a hazard index above the acceptable risk levels were estimated. This was the case for fish from both the RDPD and RVD impoundments. No toxic risk was estimated should fish from the HBPD be consumed. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Distribution characteristics and risk assessment of organochlorine pesticides in soil from Jiufeng Mountain Range in Fujian, China].

PubMed

Huang, Huan-Fang; Qi, Shi-Hua; Qu, Cheng-Kai; Li, Hui; Chen, Wen-Wen; Zhang, Li; Hu, Ting; Shi, Liao

2014-07-01

Totally 81 surface soil samples were collected from Jiufeng Mountain Range, and 8 compounds of organochlorine pesticides (OCPs) were determined by a Ni electron capture detector (GC-ECD) to investigate the distribution, composition, source and potential health risks of these compounds in the study region. The detection ratio of HCHs and DDTs' isomers ranged from 77.78% to 100.00%. Concentrations of HCHs and DDTs in surface soils ranged from 0.97 ng x g(-1) to 247.40 ng x g(-1) (mean 10.17 ng x g(-1)) and 0.01 ng x g(-1) to 384.75 ng x g(-1) (mean 18.91 ng x g(-1)), respectively. Compared with other regions, the pollution of OCPs in Jiufeng Mountain Range stayed at a low level. The residue level in different types of lands was in the order as: paddy field > vegetable land > tea land > woodland. Source analysis indicated that Lindane and dicofol might be used recently in this area. The incremental lifetime, cancer risks (ILCRs) of different age groups (children, youths, and adults) were all within the acceptable risk range of 10(-6) to 10(-4) recommended by USEPA for carcinogenic chemicals. The residue level of OCPs in soil may not cause cancer risk for local residents basically.

Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria

PubMed Central

2014-01-01

Background Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse. Methods The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick’s PPTS and PNTS scales. Results The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05. Conclusions The majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance. PMID:24885562

Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria.

PubMed

Van Damme-Ostapowicz, Katarzyna; Krajewska-Kułak, Elżbieta; Nwosu, Paul J C; Kułak, Wojciech; Sobolewski, Marek; Olszański, Romuald

2014-05-03

Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse. The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick's PPTS and PNTS scales. The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05. The majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance.

Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care

PubMed Central

Burns, Bridget F.; Bajunirwe, Francis; Kabakyenga, Jerome; Bwana, Mwebesa; Ng, Courtney; Kastner, Jasmine; Kembabazi, Annet; Sanyu, Naomi; Kusasira, Adrine; Haberer, Jessica E.; Bangsberg, David R.; Kaida, Angela

2017-01-01

Introduction We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda. Methods We recruited HIV-positive men and women on antiretroviral therapy (ART) (‘index’) from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner (‘partner’), HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP) for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision. Translated and transcribed data were analyzed using thematic analysis. Results 11/20 index participants were women, median age of 32.5 years, median of 2 living children, and 80% had HIV-RNA <400 copies/mL. Awareness of HIV prevention strategies beyond condoms and abstinence was limited and precluded opportunity to explore or validly assess acceptability or feasibility of safer conception methods. Four key partnership communication challenges emerged as primary barriers to engagement in safer conception care, including: (1) HIV-serostatus disclosure: Although disclosure was an inclusion criterion, partners commonly reported not knowing the index partner’s HIV status. Similarly, the partner’s HIV-serostatus, as reported by the index, was frequently inaccurate. (2) Childbearing intention: Many couples had divergent childbearing intentions and made incorrect assumptions about their partner’s desires. (3) HIV risk perception: Participants had disparate understandings of HIV transmission and disagreed on the acceptable level of HIV risk to meet reproductive goals. (4) Partnership commitment: Participants revealed significant discord in perceptions of partnership commitment. All four types of partnership miscommunication introduced constraints to autonomous reproductive decision-making, particularly for women. Such miscommunication was common, as only 2 of 20 partnerships in our sample were mutually-disclosed with agreement across all four communication themes. Conclusions Enthusiasm for safer conception programming is growing. Our findings highlight the importance of addressing gendered partnership communication regarding HIV disclosure, reproductive goals, acceptable HIV risk, and commitment, alongside technical safer conception advice. Failing to consider partnership dynamics across these domains risks limiting reach, uptake, adherence to, and retention in safer conception programming. PMID:28880892

Guidelines for pregnancy: what's an acceptable risk, and how is the evidence (finally) shaping up?

PubMed

O'Leary, Colleen M; Bower, Carol

2012-03-01

The lack of consensus about whether low to moderate levels of prenatal alcohol exposure are a risk factor for fetal development has generated considerable debate about what advice policies and guidelines should provide. This paper reviews the evidence from systematic reviews and meta-analyses examining the risk from low and moderate levels of prenatal alcohol exposure, along with the results of articles published 2009-2010, after the reviews. The reported significant effects from low levels of prenatal alcohol exposure are likely due to methodological issues such as confounding and/or misclassification of exposure or outcome and there is no strong research evidence of fetal effects from low levels of alcohol exposure. However, harm is well-documented with heavy exposure and moderate levels of exposure, 30-40 g per occasion and no more than 70 g per week, have been demonstrated to increase the risk of child behaviour problems. With such a small margin before there is increased risk to the fetus, it would be morally and ethically unacceptable for policies and guidelines to condone consumption of alcohol during pregnancy. Not all women will follow this advice and some women will inadvertently consume alcohol prior to pregnancy awareness requiring non-judgmental counselling and the provision of rational advice about the likelihood of risk to the fetus. The policy advice that 'the safest choice for pregnant women is to abstain from alcohol during pregnancy' should be maintained. However, the abstinence message needs to be presented in a balanced and rational manner to prevent unintended negative consequences. © 2011 Australasian Professional Society on Alcohol and other Drugs.

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.

Assessment of Tomato (Solanum lycopersicum L.) Producers' Exposure Level to Pesticides, in Kouka and Toussiana (Burkina Faso).

PubMed

Son, Diakalia; Zerbo, Fabrice K B; Bonzi, Schémaeza; Legreve, Anne; Somda, Irénée; Schiffers, Bruno

2018-01-25

To assess producers' exposure level to pesticides in vegetable production in Burkina Faso, a study was carried out in 2016 and 2017 among 30 tomato producers in the municipalities of Kouka and Toussiana. Eighteen (18) commercial formulations were identified, with more than 50% of pesticides destined for cotton production. Eleven active substances have been identified and the most frequently used are λ-cyhalothrin (35%), acetamiprid (22%) and profenofos (13%). The most commonly used chemical families are pyrethroids (28%) and organophosphates (18%). The study revealed a low level of training for producers, a high use of pesticides according to the Frequency Treatment Indicator, and a very low level of protection used by producers. The Health Risk Index shows that active substances such as methomyl, λ-cyhalothrin and profenofos present very high risk to operators' health. Based on the UK-POEM model, the predictive exposure levels obtained varied from 0.0105 mg/kg body weight/day to 1.7855 mg/kg body weight/day, which is several times higher than the Acceptable Operator Exposure Level. However, the study also shows that exposure can be greatly reduced if the required Personal Protective Equipment is worn. Producers' awareness and training on integrated pest management are necessary to reduce the risks linked to the pesticides use in Burkina Faso.

[Acceptability of the opportunistic search for human immunodeficiency virus infection by serology in patients recruited in Primary Care Centres in Spain].

PubMed

Puentes Torres, Rafael Carlos; Aguado Taberné, Cristina; Pérula de Torres, Luis Angel; Espejo Espejo, José; Castro Fernández, Cristina; Fransi Galiana, Luís

2016-01-01

To assess the acceptability of opportunistic search for human immunodeficiency virus (HIV). Cross-sectional, observational study. Primary Care Centres (PCC) of the Spanish National Health Care System. patients aged 18 to 65 years who had never been tested for HIV, and were having a blood test for other reasons. RECORDED VARIABLES: age, gender, stable partner, educational level, tobacco/alcohol use, reason for blood testing, acceptability of taking the HIV test, reasons for refusing to take the HIV test, and reasons for not having taken an HIV test previously. A descriptive, bivariate, multivariate (logistic regression) statistical analysis was performed. A total of 208 general practitioners (GPs) from 150 health care centres recruited 3,314 patients. Most (93.1%) of patients agreed to take the HIV test (95%CI: 92.2-93.9). Of these patients, 56.9% reported never having had an HIV test before because they considered not to be at risk of infection, whereas 34.8% reported never having been tested for HIV because their doctor had never offered it to them. Of the 6.9% who refused to take the HIV test, 73.9% considered that they were not at risk. According to the logistic regression analysis, acceptability was positively associated to age (higher among between 26 and 35 year olds, OR=1.79; 95%CI: 1.10-2.91) and non-smokers (OR=1.39; 95%CI: 1.01-1.93). Those living in towns with between 10,000 and 50,000 inhabitants showed less acceptance to the test (OR=0.57; 95%CI: 0.40-0.80). The HIV prevalence detected was 0.24% Acceptability of HIV testing is very high among patients having a blood test in primary care settings in Spain. Opportunistic search is cost-effective. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Balancing access to health data and privacy: a review of the issues and approaches for the future.

PubMed

Lane, Julia; Schur, Claudia

2010-10-01

There has been a dramatic increase in the types of microdata, and this holds great promise for health services research. However, legislative efforts to protect individual privacy have reduced the flow of health care data for research purposes and increased costs and delays, affecting the quality of analysis. This paper provides an overview of the challenges raised by concerns about data confidentiality in the context of health services research, the current methodologies used to ensure data security, and a description of one successful approach to balancing access and privacy. Materials and Methods. We analyze the issues of access and privacy using a conceptual framework based on balancing the risk of reidentification with the utility associated with data analysis. The guiding principle should be to generate released data that are as close to the maximum acceptable risk as possible. HIPAA and other privacy measures can perhaps be seen as having had the effect of lowering the "maximum acceptable risk" level and rendering some data unreleasable. We discuss the levels of risk and utility associated with different types of data used in health services research and the ability to link data from multiple sources as well as current models of data sharing and their limitations. One particularly compelling approach is to establish a remote access "data enclave," where statistical protections are applied to the data, technical protections ensure compliance with data-sharing requirements, and operational controls limit researchers' access to the data they need for their specific research questions. We recommend reducing delays in access to data for research, increasing the use of remote access data enclaves, and disseminating knowledge and promulgating standards for best practices related to data protection. © Health Research and Educational Trust.

A Multi-Level Approach to Outreach for Geologic Sequestration Projects

USGS Publications Warehouse

Greenberg, S.E.; Leetaru, H.E.; Krapac, I.G.; Hnottavange-Telleen, K.; Finley, R.J.

2009-01-01

Public perception of carbon capture and sequestration (CCS) projects represents a potential barrier to commercialization. Outreach to stakeholders at the local, regional, and national level is needed to create familiarity with and potential acceptance of CCS projects. This paper highlights the Midwest Geological Sequestration Consortium (MGSC) multi-level outreach approach which interacts with multiple stakeholders. The MGSC approach focuses on external and internal communication. External communication has resulted in building regional public understanding of CCS. Internal communication, through a project Risk Assessment process, has resulted in enhanced team communication and preparation of team members for outreach roles. ?? 2009 Elsevier Ltd. All rights reserved.

Are government-approved products containing new psychoactive substances perceived to be safer and more socially acceptable than alcohol, tobacco and illegal drugs? Findings from a survey of police arrestees in New Zealand.

PubMed

Rychert, Marta; Wilkins, Chris; Parker, Karl; Witten, Karen

2018-03-01

In July 2013, New Zealand passed the Psychoactive Substances Act (PSA), which established a legal regulated market for government-approved products containing new psychoactive substances (NPS). One of the aims of the PSA was to separate the market for approved NPS products from unapproved products and illegal drugs. The aim of this study was to explore perceived health risks and social acceptability of government-approved NPS compared to unapproved NPS and other drugs. About 834 police arrestees were surveyed about the health risks and social acceptability of regularly using nine drug types, including approved and unapproved synthetic cannabinoids (SC) and 'party pills' (PP) under the interim PSA regime. Statistical analyses included fitted analysis of variance and logistic ordinal regression models. Approved SC were considered riskier to health than (natural) cannabis, alcohol, approved and unapproved PP, tobacco and ecstasy, but safer than unapproved SC and methamphetamine. Younger participants (16-29 years) were more likely than older participants (30+ years) to give approved SC a high health-risk score. Approved SC were considered less socially acceptable than alcohol, tobacco and cannabis, but more socially acceptable than methamphetamine, unapproved SC and unapproved PP. Frequent SC users were more likely to rate the social acceptability of approved legal SC higher than other drug users. Approved PP received more positive health and social acceptability scores than approved SC. The PSA was partially successful at separating approved NPS from other drugs. High health-risk and low social acceptability scores for approved SC may reflect the absence of product testing during the interim PSA market. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Types of social support and parental acceptance among transfemale youth and their impact on mental health, sexual debut, history of sex work and condomless anal intercourse.

PubMed

Le, Victory; Arayasirikul, Sean; Chen, Yea-Hung; Jin, Harry; Wilson, Erin C

2016-01-01

Transfemale youth (TFY) are an underserved and understudied population at risk for numerous poor physical and mental health outcomes, most notably HIV. Research suggests that parental acceptance and social support may serve as protective factors against HIV and other risks for TFY; however, it is unclear whether TFY receive primary social support from parents with or without parental acceptance of their gender identity. This study examines differences in parental acceptance, mental health and the HIV risk factors of history of sex work, age at sexual debut and engagement in condomless anal intercourse between TFY with two types of primary social support - non-parental primary social support (NPPSS) and parental primary social support (PPSS). Cross-sectional data collected from 301 TFY from 2012 to 2014 in the San Francisco Bay Area were analyzed to determine differences in parental acceptance, mental health and HIV risk factors between youth with and without PPSS. Univariate statistics and chi-squared tests were conducted to determine if parental acceptance and health outcomes were correlated with type of social support. Two-hundred fifty-one participants (83.7%) reported having NPPSS, and 49 (16.3%) reported PPSS. Significantly more youth with PPSS reported affirmative responses on parental acceptance items than their NPPSS counterparts. For example, 87.8% of youth with PPSS reported that their parents believed they could have a happy future as a trans adult, compared with 51.6% of youth with NPPSS (p<0.001). Fewer participants with PPSS reported symptoms of psychological distress (2.0% vs. 12.5%, p=0.057), though this finding was not statistically significant; no significant associations were found between primary social support type and HIV risk factors. These results suggest that TFY with parental acceptance of their gender identity may be more likely to reach out to their parents as their primary source of social support. Interventions focused on parental acceptance of their child's gender identity may have the most promise for creating parental social support systems in the lives of TFY.

Types of social support and parental acceptance among transfemale youth and their impact on mental health, sexual debut, history of sex work and condomless anal intercourse

PubMed Central

Le, Victory; Arayasirikul, Sean; Chen, Yea-Hung; Jin, Harry; Wilson, Erin C

2016-01-01

Introduction Transfemale youth (TFY) are an underserved and understudied population at risk for numerous poor physical and mental health outcomes, most notably HIV. Research suggests that parental acceptance and social support may serve as protective factors against HIV and other risks for TFY; however, it is unclear whether TFY receive primary social support from parents with or without parental acceptance of their gender identity. This study examines differences in parental acceptance, mental health and the HIV risk factors of history of sex work, age at sexual debut and engagement in condomless anal intercourse between TFY with two types of primary social support – non-parental primary social support (NPPSS) and parental primary social support (PPSS). Methods Cross-sectional data collected from 301 TFY from 2012 to 2014 in the San Francisco Bay Area were analyzed to determine differences in parental acceptance, mental health and HIV risk factors between youth with and without PPSS. Univariate statistics and chi-squared tests were conducted to determine if parental acceptance and health outcomes were correlated with type of social support. Results Two-hundred fifty-one participants (83.7%) reported having NPPSS, and 49 (16.3%) reported PPSS. Significantly more youth with PPSS reported affirmative responses on parental acceptance items than their NPPSS counterparts. For example, 87.8% of youth with PPSS reported that their parents believed they could have a happy future as a trans adult, compared with 51.6% of youth with NPPSS (p<0.001). Fewer participants with PPSS reported symptoms of psychological distress (2.0% vs. 12.5%, p=0.057), though this finding was not statistically significant; no significant associations were found between primary social support type and HIV risk factors. Conclusions These results suggest that TFY with parental acceptance of their gender identity may be more likely to reach out to their parents as their primary source of social support. Interventions focused on parental acceptance of their child's gender identity may have the most promise for creating parental social support systems in the lives of TFY. PMID:27431467

Probabilistic risk assessment of Chinese residents' exposure to fluoride in improved drinking water in endemic fluorosis areas.

PubMed

Zhang, Li E; Huang, Daizheng; Yang, Jie; Wei, Xiao; Qin, Jian; Ou, Songfeng; Zhang, Zhiyong; Zou, Yunfeng

2017-03-01

Studies have yet to evaluate the effects of water improvement on fluoride concentrations in drinking water and the corresponding health risks to Chinese residents in endemic fluorosis areas (EFAs) at a national level. This paper summarized available data in the published literature (2008-2016) on water fluoride from the EFAs in China before and after water quality was improved. Based on these obtained data, health risk assessment of Chinese residents' exposure to fluoride in improved drinking water was performed by means of a probabilistic approach. The uncertainties in the risk estimates were quantified using Monte Carlo simulation and sensitivity analysis. Our results showed that in general, the average fluoride levels (0.10-2.24 mg/L) in the improved drinking water in the EFAs of China were lower than the pre-intervention levels (0.30-15.24 mg/L). The highest fluoride levels were detected in North and Southwest China. The mean non-carcinogenic risks associated with consumption of the improved drinking water for Chinese residents were mostly accepted (hazard quotient < 1), but the non-carcinogenic risk of children in most of the EFAs at the 95th percentile exceeded the safe level of 1, indicating the potential non-cancer-causing health effects on this fluoride-exposed population. Sensitivity analyses indicated that fluoride concentration in drinking water, ingestion rate of water, and the exposure time in the shower were the most relevant variables in the model, therefore, efforts should focus mainly on the definition of their probability distributions for a more accurate risk assessment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Proton pump inhibitor use for 12 months is not associated with changes in serum magnesium levels: a prospective open label comparative study.

PubMed

Bahtiri, Elton; Islami, Hilmi; Hoxha, Rexhep; Gashi, Afrim; Thaçi, Kujtim; Karakulak, Çağla; Thaçi, Shpetim; Qorraj Bytyqi, Hasime

2017-03-01

Proton pump inhibitors (PPIs) are a widely used class of drugs because of a generally acceptable safety profile. Among recently raised safety issues of the long-term use of PPIs is the increased risk of developing hypomagnesemia. As there have been very few prospective studies measuring serum magnesium levels before and after PPI therapy, we aimed to prospectively assess the potential association between PPI therapy for 12 months and the risk of hypomagnesemia as well as the incidence of new-onset hypomagnesemia during the study. In addition, the association of PPI therapy with the risk of hypocalcemia was assessed. The study included 250 patients with normal serum magnesium and total calcium levels, who underwent a long-term PPI treatment. Serum magnesium, total calcium, and parathormone (PTH) levels were measured at baseline and after 12 months. Of the 250 study participants, 209 completed 12 months of treatment and were included in the statistical analysis. The Wilcoxon signed rank test showed no statistically significant differences in serum magnesium levels between measurements at two different time points. However, there were statistically significant differences in serum total calcium and PTH levels in PPI users. Stable serum magnesium levels were demonstrated after 12 months and no association between PPI use and risk of hypomagnesemia was shown in the general population. Significant reductions of serum total calcium levels were demonstrated among PPI users; nevertheless, further research is required before recommending any serum calcium and PTH level monitoring in patients initiated on long-term PPI therapy.

Affective and cognitive factors influencing sensitivity to probabilistic information.

PubMed

Tyszka, Tadeusz; Sawicki, Przemyslaw

2011-11-01

In study 1 different groups of female students were randomly assigned to one of four probabilistic information formats. Five different levels of probability of a genetic disease in an unborn child were presented to participants (within-subject factor). After the presentation of the probability level, participants were requested to indicate the acceptable level of pain they would tolerate to avoid the disease (in their unborn child), their subjective evaluation of the disease risk, and their subjective evaluation of being worried by this risk. The results of study 1 confirmed the hypothesis that an experience-based probability format decreases the subjective sense of worry about the disease, thus, presumably, weakening the tendency to overrate the probability of rare events. Study 2 showed that for the emotionally laden stimuli, the experience-based probability format resulted in higher sensitivity to probability variations than other formats of probabilistic information. These advantages of the experience-based probability format are interpreted in terms of two systems of information processing: the rational deliberative versus the affective experiential and the principle of stimulus-response compatibility. © 2011 Society for Risk Analysis.

Estimating the risk of bladder and kidney cancer from exposure to low-levels of arsenic in drinking water, Nova Scotia, Canada.

PubMed

Saint-Jacques, Nathalie; Brown, Patrick; Nauta, Laura; Boxall, James; Parker, Louise; Dummer, Trevor J B

2018-01-01

Arsenic in drinking water impacts health. Highest levels of arsenic have been historically observed in Taiwan and Bangladesh but the contaminant has been affecting the health of people globally. Strong associations have been confirmed between exposure to high-levels of arsenic in drinking water and a wide range of diseases, including cancer. However, at lower levels of exposure, especially near the current World Health Organization regulatory limit (10μg/L), this association is inconsistent as the effects are mostly extrapolated from high exposure studies. This ecological study used Bayesian inference to model the relative risk of bladder and kidney cancer at these lower concentrations-0-2μg/L; 2-5μg/L and; ≥5μg/L of arsenic-in 864 bladder and 525 kidney cancers diagnosed in the study area, Nova Scotia, Canada between 1998 and 2010. The model included proxy measures of lifestyle (e.g. smoking) and accounted for spatial dependencies. Overall, bladder cancer risk was 16% (2-5μg/L) and 18% (≥5μg/L) greater than that of the referent group (<2μg/L), with posterior probabilities of 88% and 93% for these risks being above 1. Effect sizes for kidney cancer were 5% (2-5μg/L) and 14% (≥5μg/L) above that of the referent group (<2μg/L), with probabilities of 61% and 84%. High-risk areas were common in southwestern areas, where higher arsenic-levels are associated with the local geology. The study suggests an increased bladder cancer, and potentially kidney cancer, risk from exposure to drinking water arsenic-levels within the current the World Health Organization maximum acceptable concentration. Copyright © 2017 Elsevier Ltd. All rights reserved.

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...

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...

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...

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...

Model Uncertainty and Bayesian Model Averaged Benchmark Dose Estimation for Continuous Data

EPA Science Inventory

The benchmark dose (BMD) approach has gained acceptance as a valuable risk assessment tool, but risk assessors still face significant challenges associated with selecting an appropriate BMD/BMDL estimate from the results of a set of acceptable dose-response models. Current approa...

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...

Lead poisoning in children.

PubMed

Warniment, Crista; Tsang, Katrina; Galazka, Sim S

2010-03-15

The prevalence and severity of childhood lead poisoning have been greatly reduced since the removal of lead from paint and gasoline in the 1970s. Despite these efforts, approximately 310,000 U.S. children younger than five years have elevated blood lead levels. Health care professionals should perform targeted screening for lead poisoning in children who are Medicaid-enrolled or -eligible, foreign born, or identified as high risk by the Centers for Disease Control and Prevention (CDC) location-specific recommendations or by a personal risk questionnaire. Venous sampling is the preferred method for measuring blood lead levels, but a carefully collected finger-stick sample is an acceptable alternative. Capillary samples of elevated levels should be confirmed by a venous sample. The CDC recommends that the threshold for follow-up and intervention of lead poisoning be a blood lead level of 10 microg per dL or higher. Recommendations for treatment of elevated blood levels include a thorough environmental investigation, laboratory testing when appropriate, iron supplementation for iron-deficient children, and chelation therapy for blood lead levels of 45 microg per dL or more. Prevention consists of education and avoidance of lead-contaminated products.

Potential threat of heavy metals and PAHs in PM2.5 in different urban functional areas of Beijing

NASA Astrophysics Data System (ADS)

Gao, Yang; Guo, Xinyue; Ji, Hongbing; Li, Cai; Ding, Huaijian; Briki, Meryem; Tang, Lei; Zhang, Yan

2016-09-01

Beijing, as the capital of China, is one of the most populous cities in the world. With the fine particulate matter pollution being increasingly serious, daily exposure to hazardous ingredients caused more and more attention. Current research concerning risk evaluation in Beijing was relative less. In November, 2013, samples were collected in seven different functional areas of Beijing, so as to better understand the risk to human health caused by particle matter pollution in this region. PM2.5 pollution in rural and urban Beijing was relative high under haze-fog days in comparison with non haze-fog value. Zn and Ba showed the highest concentration levels among non-carcinogenic metals. The non-carcinogenic metal concentration at all the sites ranged in the same order: Ce, Pb, Cu, V and Sb. Higher ring PAHs (with four to six rings) were the dominant species and constituted more than 90% of the Σ14PAHs. Pb (4.34 × 10- 4 for men, 3.73 × 10- 4 for women) presented the maximum risk level for non-carcinogenic heavy metals in the whole study area. While, risk levels of Cr at residential areas, schools, Olympic Park and rural countryside exceeded the limit for adults. In haze-fog days, the carcinogenic PAH risk level in each functional area ranged in the order: rural countryside > inner suburban district > Olympic Park > city central > schools > ecological reserve > residential areas. To some extent, benzo(a)pyrene may had a potential risk to adults, and other carcinogenic PAHs were all under average risk acceptance.

Patient Navigators Connecting Patients to Community Resources to Improve Diabetes Outcomes.

PubMed

Loskutova, Natalia Y; Tsai, Adam G; Fisher, Edwin B; LaCruz, Debby M; Cherrington, Andrea L; Harrington, T Michael; Turner, Tamela J; Pace, Wilson D

2016-01-01

Despite the recognized importance of lifestyle modification in reducing risk of developing type 2 diabetes and in diabetes management, the use of available community resources by both patients and their primary care providers (PCPs) remains low. The patient navigator model, widely used in cancer care, may have the potential to link PCPs and community resources for reduction of risk and control of type 2 diabetes. In this study we tested the feasibility and acceptability of telephone-based nonprofessional patient navigation to promote linkages between the PCP office and community programs for patients with or at risk for diabetes. This was a mixed-methods interventional prospective cohort study conducted between November 2012 and August 2013. We included adult patients with and at risk for type 2 diabetes from six primary care practices. Patient-level measures of glycemic control, diabetes care, and self-efficacy from medical records, and qualitative interview data on acceptability and feasibility, were used. A total of 179 patients participated in the study. Two patient navigators provided services over the phone, using motivational interviewing techniques. Patient navigators provided regular feedback to PCPs and followed up with the patients through phone calls. The patient navigators made 1028 calls, with an average of 6 calls per patient. At follow-up, reduction in HbA1c (7.8 ± 1.9% vs 7.2 ± 1.3%; P = .001) and improvement in patient self-efficacy (3.1 ± 0.8 vs 3.6 ± 0.7; P < .001) were observed. Qualitative analysis revealed uniformly positive feedback from providers and patients. The patient navigator model is a promising and acceptable strategy to link patient, PCP, and community resources for promoting lifestyle modification in people living with or at risk for type 2 diabetes. © Copyright 2016 by the American Board of Family Medicine.

Site-specific probabilistic ecological risk assessment of a volatile chlorinated hydrocarbon-contaminated tidal estuary.

PubMed

Hunt, James; Birch, Gavin; Warne, Michael St J

2010-05-01

Groundwater contaminated with volatile chlorinated hydrocarbons (VCHs) was identified as discharging to Penrhyn Estuary, an intertidal embayment of Botany Bay, New South Wales, Australia. A screening-level hazard assessment of surface water in Penrhyn Estuary identified an unacceptable hazard to marine organisms posed by VCHs. Given the limitations of hazard assessments, the present study conducted a higher-tier, quantitative probabilistic risk assessment using the joint probability curve (JPC) method that accounted for variability in exposure and toxicity profiles to quantify risk (delta). Risk was assessed for 24 scenarios, including four areas of the estuary based on three exposure scenarios (low tide, high tide, and both low and high tides) and two toxicity scenarios (chronic no-observed-effect concentrations [NOEC] and 50% effect concentrations [EC50]). Risk (delta) was greater at low tide than at high tide and varied throughout the tidal cycle. Spatial distributions of risk in the estuary were similar using both NOEC and EC50 data. The exposure scenario including data combined from both tides was considered the most accurate representation of the ecological risk in the estuary. When assessing risk using data across both tides, the greatest risk was identified in the Springvale tributary (delta=25%)-closest to the source area-followed by the inner estuary (delta=4%) and the Floodvale tributary (delta=2%), with the lowest risk in the outer estuary (delta=0.1%), farthest from the source area. Going from the screening level ecological risk assessment (ERA) to the probabilistic ERA changed the risk from unacceptable to acceptable in 50% of exposure scenarios in two of the four areas within the estuary. The probabilistic ERA provided a more realistic assessment of risk than the screening-level hazard assessment. Copyright (c) 2010 SETAC.

Fault tree analysis for integrated and probabilistic risk analysis of drinking water systems.

PubMed

Lindhe, Andreas; Rosén, Lars; Norberg, Tommy; Bergstedt, Olof

2009-04-01

Drinking water systems are vulnerable and subject to a wide range of risks. To avoid sub-optimisation of risk-reduction options, risk analyses need to include the entire drinking water system, from source to tap. Such an integrated approach demands tools that are able to model interactions between different events. Fault tree analysis is a risk estimation tool with the ability to model interactions between events. Using fault tree analysis on an integrated level, a probabilistic risk analysis of a large drinking water system in Sweden was carried out. The primary aims of the study were: (1) to develop a method for integrated and probabilistic risk analysis of entire drinking water systems; and (2) to evaluate the applicability of Customer Minutes Lost (CML) as a measure of risk. The analysis included situations where no water is delivered to the consumer (quantity failure) and situations where water is delivered but does not comply with water quality standards (quality failure). Hard data as well as expert judgements were used to estimate probabilities of events and uncertainties in the estimates. The calculations were performed using Monte Carlo simulations. CML is shown to be a useful measure of risks associated with drinking water systems. The method presented provides information on risk levels, probabilities of failure, failure rates and downtimes of the system. This information is available for the entire system as well as its different sub-systems. Furthermore, the method enables comparison of the results with performance targets and acceptable levels of risk. The method thus facilitates integrated risk analysis and consequently helps decision-makers to minimise sub-optimisation of risk-reduction options.

Ecological pathways to prevention: How does the SASA! community mobilisation model work to prevent physical intimate partner violence against women?

PubMed

Abramsky, Tanya; Devries, Karen M; Michau, Lori; Nakuti, Janet; Musuya, Tina; Kiss, Ligia; Kyegombe, Nambusi; Watts, Charlotte

2016-04-16

Intimate partner violence (IPV) against women is a global public health concern. While community-level gender norms and attitudes to IPV are recognised drivers of IPV risk, there is little evidence on how interventions might tackle these drivers to prevent IPV at the community-level. This secondary analysis of data from the SASA! study explores the pathways through which SASA!, a community mobilisation intervention to prevent violence against women, achieved community-wide reductions in physical IPV. From 2007 to 2012 a cluster randomised controlled trial (CRT) was conducted in eight communities in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18-49, were undertaken at baseline (n = 1583) and 4 years post intervention implementation (n = 2532). We used cluster-level intention to treat analysis to estimate SASA!'s community-level impact on women's past year experience of physical IPV and men's past year perpetration of IPV. The mediating roles of community-, relationship- and individual-level factors in intervention effect on past year physical IPV experience (women)/perpetration (men) were explored using modified Poisson regression models. SASA! was associated with reductions in women's past year experience of physical IPV (0.48, 95 % CI 0.16-1.39), as well as men's perpetration of IPV (0.39, 95 % CI 0.20-0.73). Community-level normative attitudes were the most important mediators of intervention impact on physical IPV risk, with norms around the acceptability of IPV explaining 70 % of the intervention effect on women's experience of IPV and 95 % of the effect on men's perpetration. The strongest relationship-level mediators were men's reduced suspicion of partner infidelity (explaining 22 % of effect on men's perpetration), and improved communication around sex (explaining 16 % of effect on women's experience). Reduced acceptability of IPV among men was the most important individual-level mediator (explaining 42 % of effect on men's perpetration). These results highlight the important role of community-level norm-change in achieving community-wide reductions in IPV risk. They lend strong support for the more widespread adoption of community-level approaches to preventing violence. ClinicalTrials.gov, NCT00790959 . Registered 13th November 2008. The study protocol is available at: http://www.trialsjournal.com/content/13/1/96.

Limitations and implications of stream classification

USGS Publications Warehouse

Juracek, K.E.; Fitzpatrick, F.A.

2003-01-01

Stream classifications that are based on channel form, such as the Rosgen Level II classification, are useful tools for the physical description and grouping of streams and for providing a means of communication for stream studies involving scientists and (or) managers with different backgrounds. The Level II classification also is used as a tool to assess stream stability, infer geomorphic processes, predict future geomorphic response, and guide stream restoration or rehabilitation activities. The use of the Level II classification for these additional purposes is evaluated in this paper. Several examples are described to illustrate the limitations and management implications of the Level II classification. Limitations include: (1) time dependence, (2) uncertain applicability across physical environments, (3) difficulty in identification of a true equilibrium condition, (4) potential for incorrect determination of bankfull elevation, and (5) uncertain process significance of classification criteria. Implications of using stream classifications based on channel form, such as Rosgen's, include: (1) acceptance of the limitations, (2) acceptance of the risk of classifying streams incorrectly, and (3) classification results may be used inappropriately. It is concluded that use of the Level II classification for purposes beyond description and communication is not appropriate. Research needs are identified that, if addressed, may help improve the usefulness of the Level II classification.

Risk perception of tsunami in the community of Arauco, Chile - a contribution of risk perception to disaster risk management at local level

NASA Astrophysics Data System (ADS)

Kubisch, M. Sc. Susanne; Edilia Jaque Castillo, Dra.; Braun, JProf. Andreas Ch., ,, Dr.

2017-04-01

The research was carried out in the city center of the coastal community of Arauco, Central Chile. The community of Arauco was one of the most affected communities of the tsunami in Chile, the 27th of February 2010. For the data evaluation, the affected inhabitants of the community have been surveyed via standardized questionnaires. Furthermore experts of different fields, amongst others, Disaster Risk Management (DRM), risk education, urban and regional planning, as well as geology have been consulted in form of expert interviews. The results revealed a high risk perception part of the affected community and a weakness of DRM especially at local level, which opens a gap between the evaluation and treatment of risk by experts and risk perception of the affected community. The risk perception of the affected community, here, is predominantly determined by ecological vulnerability, expressed in direct and indirect experience of a tsunami and by institutional vulnerability, expressed among others by a weakness of DRM at local level and a mistrust in responsible institutions for DRM. Due to the institutional vulnerability and the mistrust in responsible institutions we recommend a Community Based Approach (CBA) to strengthen DRM at local level and to take advantage of the high risk perception and knowledge of the affected community. Involving the community in DRM, we assume to close the gap between risk evaluation of experts and risk perception of the inhabitants and to come up with the unique necessities and conditions at local level. Especially in centralized countries, DRM is less effective, because at the one hand, decisions are made distant from the affected communities, so that measures often do not come up with the unique conditions and necessities at local level, and on the other hand measures often do not find acceptance by the affected community. Furthermore centralized DRM is often not effective and quick in response in case of emergency. Another obstacle for an effective DRM, often forms the general mistrust in governmental institutions. In these cases the participation of the affected communities in form of CBAs are assumed to overcome these problems.

Occupational musculoskeletal and mental health: Significance of rationalization and opportunities to create sustainable production systems - A systematic review.

PubMed

Westgaard, R H; Winkel, J

2011-01-01

This literature review aims to identify occupational musculoskeletal and mental health effects of production system rationalization as well as organizational-level measures that may improve health outcome ("modifiers" in this review). A short review of the effect of ergonomic interventions is included as background and rationalization is discussed as a theoretical concept. Indicator variables for occupational musculoskeletal and mental health and related risk factors are presented. Variables with a generalized format were allowed in the literature searches (e.g., job satisfaction and absenteeism were accepted as risk factor and health indicator, respectively), suitable for the research fields of work sociology, organization science, human resource management (HRM) and economics research. One hundred and sixty-two studies of rationalization effects on health and risk factors and 72 organization-level modifier results were accepted into the final database. Entries were sorted by rationalization strategy and work life sector, and trends in outcome (positive, mixed, no effect, or negative effect on health and risk factors) were determined. Rationalizations have a dominant negative effect on health and risk factors (57% negative, 19% positive); the most negative effects were found for downsizing and restructuring rationalizations in general (71 studies negative, 13 positive) and for the health care sector in particular (36 studies negative, 2 positive). The rationalization strategy High Performance Work System (HPWS) was associated with the highest fraction positive outcome studies (6 of 10 studies). Other rationalization strategies (lean practices, parallel vs. serial production and mechanization level) reported intermediate results, in part dependent on work life sector, but also on the year when studies were carried out. Worker participation, resonant management style, information, support, group autonomy and procedural justice were modifiers with favourable influence on outcome. It is concluded that production system rationalization represents a pervasive work life intervention without a primary occupational health focus. It has considerable and mostly negative influence on worker health, but this can be reduced by attention to modifiers. The results create a basis for new priorities in ergonomic intervention research. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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...

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...

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...

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...

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...

A discrete choice experiment to explore patients' willingness to risk disease relapse from treatment withdrawal in psoriatic arthritis.

PubMed

Rothery, Claire; Bojke, Laura; Richardson, Gerry; Bojke, Chris; Moverley, Anna; Coates, Laura; Thorp, Liz; Waxman, Robin; Helliwell, Philip

2016-12-01

The objective of this study is to assess patient preferences for treatment-related benefits and risk of disease relapse in the management of low disease states of psoriatic arthritis (PsA). Focus groups with patients and a literature review were undertaken to determine the characteristics of treatment and symptoms of PsA important to patients. Patient preferences were assessed using a discrete choice experiment which compared hypothetical treatment profiles of the risk and benefits of treatment withdrawal. The risk outcome included increased risk of disease relapse, while benefit outcomes included reduced sickness/nausea from medication and changes in health-related quality of life. Each patient completed 12 choice sets comparing treatment profiles. Preference weights were estimated using a logic regression model, and the maximum acceptable risk in disease relapse for a given improvement in benefit outcomes was elicited. Final sample included 136 patients. Respondents attached the greatest importance to eliminating severe side effects of sickness/nausea and the least importance to a change in risk of relapse. Respondents were willing to accept an increase in the risk of relapse of 32.6 % in order to eliminate the side effects of sickness/nausea. For improvements in health status, the maximum acceptable risk in relapse was comparable to a movement from some to no sickness/nausea. The study suggests that patients in low disease states of PsA are willing to accept greater risks of relapse for improvements in side effects of sickness/nausea and overall health status, with the most important benefit attribute being the elimination of severe sickness or nausea.

Occurrence and human dietary assessment of fluoroquinolones antibiotics in cultured fish around tai lake, China.

PubMed

Song, Chao; Zhang, Cong; Kamira, Barry; Qiu, Liping; Fan, Limin; Wu, Wei; Meng, Shunlong; Hu, Gengdong; Chen, Jiazhang

2017-11-01

Fluoroquinolone antibiotics are widely used in the production of aquatic products and considered to be a significant contributing factor to the burden of both natural and aquaculture environments. However, the main types of fluoroquinolones present in aquaculture systems have not been determined. The objectives of the present study were to explore the occurrence of residual fluoroquinolone antibiotics in fish muscle tissues sampled from across the entire aquaculture season in the Tai Lake basin in China and to assess the dietary risks associated with the upcoming vendible fish in the last month of the aquaculture season. Fluoroquinolones were detected in 95.69% of all fish samples, and the concentrations ranged from the limit of quantification (LOQ) to 47 108.00 μg · kg -1 . Enrofloxacin contributed the most among the 9 fluoroquinolone antibiotics tested. Of the 4 fish species studied, enrofloxacin was present in bream at significant (p < 0.05) concentrations in August, with an average value of 321.45 μg · kg -1 , while enrofloxacin concentrations peaked in crab and shrimp in September, with average values of 6949.60 and 460.82 μg · kg -1 , respectively. However, different patterns were observed in perch, suggesting that other categories of antibiotics may be used in the production of this fish. Dietary risk assessment showed that the residual levels and estimated daily intake in bream, perch, and shrimp were far below the maximum residual level and acceptable daily intake. However, the average residual level in crab exceeded the maximum residual level, and the estimated daily intake value accounted for 78.49% of the acceptable daily intake, indicating potential consumption risk. In summary, the present study aims to guide the production and consumption of aquatic products. Environ Toxicol Chem 2017;36:2899-2905. © 2017 SETAC. © 2017 SETAC.

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

How reliable are Functional Movement Screening scores? A systematic review of rater reliability.

PubMed

Moran, Robert W; Schneiders, Anthony G; Major, Katherine M; Sullivan, S John

2016-05-01

Several physical assessment protocols to identify intrinsic risk factors for injury aetiology related to movement quality have been described. The Functional Movement Screen (FMS) is a standardised, field-expedient test battery intended to assess movement quality and has been used clinically in preparticipation screening and in sports injury research. To critically appraise and summarise research investigating the reliability of scores obtained using the FMS battery. Systematic literature review. Systematic search of Google Scholar, Scopus (including ScienceDirect and PubMed), EBSCO (including Academic Search Complete, AMED, CINAHL, Health Source: Nursing/Academic Edition), MEDLINE and SPORTDiscus. Studies meeting eligibility criteria were assessed by 2 reviewers for risk of bias using the Quality Appraisal of Reliability Studies checklist. Overall quality of evidence was determined using van Tulder's levels of evidence approach. 12 studies were appraised. Overall, there was a 'moderate' level of evidence in favour of 'acceptable' (intraclass correlation coefficient ≥0.6) inter-rater and intra-rater reliability for composite scores derived from live scoring. For inter-rater reliability of composite scores derived from video recordings there was 'conflicting' evidence, and 'limited' evidence for intra-rater reliability. For inter-rater reliability based on live scoring of individual subtests there was 'moderate' evidence of 'acceptable' reliability (κ≥0.4) for 4 subtests (Deep Squat, Shoulder Mobility, Active Straight-leg Raise, Trunk Stability Push-up) and 'conflicting' evidence for the remaining 3 (Hurdle Step, In-line Lunge, Rotary Stability). This review found 'moderate' evidence that raters can achieve acceptable levels of inter-rater and intra-rater reliability of composite FMS scores when using live ratings. Overall, there were few high-quality studies, and the quality of several studies was impacted by poor study reporting particularly in relation to rater blinding. 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/

Acceptability of cancer chemoprevention trials: impact of the design

PubMed Central

Maisonneuve, Anne-Sophie; Huiart, Laetitia; Rabayrol, Laetitia; Horsman, Doug; Didelot, Remi; Sobol, Hagay; Eisinger, Francois

2008-01-01

Background: Chemoprevention could significantly reduce cancer burden. Assessment of efficacy and risk/benefit balance is at best achieved through randomized clinical trials. Methods: At a periodic health examination center 1463 adults were asked to complete a questionnaire about their willingness to be involved in different kinds of preventive clinical trials. Results: Among the 851 respondents (58.2%), 228 (26.8%) agreed to participate in a hypothetical chemoprevention trial aimed at reducing the incidence of lung cancer and 116 (29.3%) of 396 women agreed to a breast cancer chemoprevention trial. Randomization would not restrain participation (acceptability rate: 87.7% for lung cancer and 93.0% for breast cancer). In these volunteers, short-term trials (1 year) reached a high level of acceptability: 71.5% and 73.7% for lung and breast cancer prevention respectively. In contrast long-term trials (5 years or more) were far less acceptable: 9.2% for lung cancer (OR=7.7 CI95% 4.4-14.0) and 10.5 % for breast cancer (OR=6.9 CI95% 3.2-15.8). For lung cancer prevention, the route of administration impacts on acceptability with higher rate 53.1% for a pill vs. 7.9% for a spray (OR=6.7 CI95% 3.6-12.9). Conclusion: Overall healthy individuals are not keen to be involved in chemo-preventive trials, the design of which could however increase the acceptability rate. PMID:18769562

Quantifying trace elements in the emitted particulate matter during cooking and health risk assessment.

PubMed

Gorjinezhad, Soudabeh; Kerimray, Aiymgul; Amouei Torkmahalleh, Mehdi; Keleş, Melek; Ozturk, Fatma; Hopke, Philip K

2017-04-01

Particulate matter (PM) measurements were conducted during heating corn oil, heating corn oil mixed with the table salt and heating low fat ground beef meat using a PTFE-coated aluminum pan on an electric stove with low ventilation. The main objectives of this study were to measure the size segregated mass concentrations, emission rates, and fluxes of 24 trace elements emitted during heating cooking oil or oil with salt and cooking meat. Health risk assessments were performed based on the resulting exposure to trace elements from such cooking activities. The most abundant elements (significantly different from zero) were Ba (24.4 ug m -3 ) during grilling meat and Ti during heating oil with salt (24.4 ug m -3 ). The health assessment indicates that the cooking with an electric stove with poor ventilation leading to chronic exposures may pose the risk of significant adverse health effects. Carcinogenic risk exceeded the acceptable level (target cancer risk 1 × 10 -6 , US EPA 2015) by four orders of magnitude, while non-carcinogenic risk exceeded the safe level (target HQ = 1, US EPA 2015) by a factor of 5-20. Cr and Co were the primary contributors to the highest carcinogenic and non-carcinogenic risks, respectively.

Where do uncertainties reside within environmental risk assessments? Testing UnISERA, a guide for uncertainty assessment.

PubMed

Skinner, Daniel J C; Rocks, Sophie A; Pollard, Simon J T

2017-06-01

A means for identifying and prioritising the treatment of uncertainty (UnISERA) in environmental risk assessments (ERAs) is tested, using three risk domains where ERA is an established requirement and one in which ERA practice is emerging. UnISERA's development draws on 19 expert elicitations across genetically modified higher plants, particulate matter, and agricultural pesticide release and is stress tested here for engineered nanomaterials (ENM). We are concerned with the severity of uncertainty; its nature; and its location across four accepted stages of ERAs. Using an established uncertainty scale, the risk characterisation stage of ERA harbours the highest severity level of uncertainty, associated with estimating, aggregating and evaluating expressions of risk. Combined epistemic and aleatory uncertainty is the dominant nature of uncertainty. The dominant location of uncertainty is associated with data in problem formulation, exposure assessment and effects assessment. Testing UnISERA produced agreements of 55%, 90%, and 80% for the severity level, nature and location dimensions of uncertainty between the combined case studies and the ENM stress test. UnISERA enables environmental risk analysts to prioritise risk assessment phases, groups of tasks, or individual ERA tasks and it can direct them towards established methods for uncertainty treatment. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of Knowledge on Attitude Formation and Change Toward Genetically Modified Foods.

PubMed

Zhu, Xiaoqin; Xie, Xiaofei

2015-05-01

In three waves, this study investigates the impact of risk and benefit knowledge on attitude formation toward genetically modified (GM) foods as well as the moderating effect of knowledge level on attitude change caused by receiving information. The data in Wave 1 (N = 561) demonstrate that both benefit and risk knowledge either directly contribute to attitude formation or indirectly affect attitudes through the mediating roles of benefit and risk perceptions. Overall, benefit and risk knowledge affect consumer attitudes positively and negatively, respectively. In Wave 2, 486 participants from Wave 1 were provided with information about GM foods, and their attitudes were assessed. Three weeks later, 433 of these participants again reported their attitudes. The results indicate that compared with the benefit and mixed information, risk information has a greater and longer lasting impact on attitude change, which results in lower acceptance of GM foods. Furthermore, risk information more strongly influences participants with a higher knowledge level. The moderating effect of knowledge on attitude change may result from these participants' better understanding of and greater trust in the information. These findings highlight the important role of knowledge in attitude formation and attitude change toward GM foods as well as the necessity of considering the determinants of attitude formation in attitude change studies. © 2014 Society for Risk Analysis.

Reducing production of taste and odor by deep-living cyanobacteria in drinking water reservoirs by regulation of water level.

PubMed

Su, Ming; Jia, Dongmin; Yu, Jianwei; Vogt, Rolf D; Wang, Jingshi; An, Wei; Yang, Min

2017-01-01

Abatement and control of algae, producing toxins and creating taste & odor (T&O) in drinking water sources, is a major challenge for water supply. In this study we proposed a strategy based on water level regulation for the control of odor-producing cyanobacteria in source water. Miyun Reservoir, the main surface water source for Beijing, has been suffering from 2-methylisoborneol (2-MIB) induced T&O problems caused by deep-living Planktothrix sp. since 2002. The biomass of deep-living Planktothrix in Miyun Reservoir was found to be mainly governed by the water depth above its sediment habitat. An algorithm for water level regulation aiming to minimize the risk for T&O in different types of reservoirs is proposed. The study demonstrates that risk for T&O can be minimized by increasing the water level in Miyun Reservoir. The high-risk area can be reduced by about 2.91% (0.61% to 5.76%) of surface area for each meter increase in the water level, when the water level is lower than 145m. More specifically, the water level needs to be raised to higher than 147.7ma.s.l. from 131.0m in order to obtain an acceptable risk level (ARL) of 10%. This management strategy to abate T&O problems is simpler and cheaper to implement compared to traditional physical, chemical and biological techniques. Moreover, it has no apparent negative impact on water quality and aquatic organisms. Copyright © 2016. Published by Elsevier B.V.

Heavy metals in cereals and pulses: health implications in Bangladesh.

PubMed

Islam, Md Saiful; Ahmed, Md Kawser; Habibullah-Al-Mamun, Md

2014-11-05

This research was conducted to evaluate the concentration of seven common heavy metals (Cr, Ni, Cu, Zn, As, Cd, and Pb) in cereals and pulses and associated health implications in Bangladesh. USEPA deterministic approaches were followed to assess the carcinogenic risk (CR) and noncarcinogenic risk which was measured by target hazard quotient (THQ) and hazard index (HI). Total THQ values for As and Pb were higher than 1, suggesting that people would experience significant health risks if they ingest As and Pb from cereals and pulses. However, the estimated HI value of 1.7 × 10(1) (>1) elucidates a potential noncarcinogenic risk to the consumers. Also, the estimation showed that the carcinogenic risk of As (5.8 × 10(-3)) and Pb (4.9 × 10(-5)) exceeded the USEPA accepted risk level of 1 × 10(-6). Thus, the carcinogenic risk of As and Pb with nutritional deficiency of essential elements for Bangladeshi people is a matter of concern.

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

Caregiver distress and patient health-related quality of life: psychosocial screening during pediatric cancer treatment.

PubMed

Pierce, Lisa; Hocking, Matthew C; Schwartz, Lisa A; Alderfer, Melissa A; Kazak, Anne E; Barakat, Lamia P

2017-10-01

Reports of acceptability of psychosocial screening are limited, and the utility of screening in identifying risk factors for health-related quality of life (HRQL) of children with cancer has not been established. This study aimed to assess acceptability of screening for parents and evaluate associations between family risk factors and patient HRQL in the first year post-diagnosis. Sixty-seven parents of children with cancer completed the Psychosocial Assessment Tool (family risk), Distress Thermometer (caregiver distress), Posttraumatic Stress Disorder Checklist-Civilian 6 (caregiver traumatic stress), PedsQL 4.0 (parent-proxy report of patient HRQL) and four acceptability questions via a tablet (iPad). Patients (Mage = 9.5 SD = 5.5 years) were equally distributed across major pediatric cancer diagnoses. The majority of parents endorsed electronic screening as acceptable (70%-97%). Patient gender, diagnosis, intensity of treatment and time since diagnosis were not significantly correlated with family risk, caregiver distress, traumatic stress, or patient HRQL. The full regression model predicting total HRQL was significant (R 2  = .42, F(4,64) = 10.7, p = .000). Age (older) was a significant covariate, family risk and caregiver distress were significant independent predictors of poorer total HRQL. The full regression models for physical and psychosocial HRQL were significant; age and caregiver distress were independent predictors of physical HRQL, and age and family risk were independent predictors of psychosocial HRQL. Screening is acceptable for families and important for identifying risk factors associated with poorer patient HRQL during childhood cancer treatment. Targeted interventions addressing family resource needs as well as parent distress identified through screening may be effective in promoting patient HRQL. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Association of Personality Traits and Risk of Internet Addiction in Adolescents.

PubMed

Öztürk, Candan; Bektas, Murat; Ayar, Dijle; Özgüven Öztornacı, Beste; Yağcı, Dilek

2015-06-01

This cross-sectional, descriptive study analyzes the association between personality traits and internet addiction in adolescents. The study was conducted with 328 adolescents attending two high schools in the Aegean region of Turkey. The data were collected using a sociodemographic information questionnaire, the Internet Addiction Scale and the Adjective Based Personality Scale from students who gave their informed consent to participate. Data were assessed by descriptive statistics, t tests, and logistic regression analysis, using SPSS software. The students had an average age of 16.43 ± 1.47 years and 40.5% were female. The percentage of subjects at risk of internet addiction was 15.9% (n = 52), and 42.4% (n = 22) of them reported that the amounts of time they spent online was acceptable. We found statistically significant differences in the average subdimensional scores for extraversion (t = 2.310, p < .050) and openness to experience (t = 3.35, p < .001), and between students at risk of internet addiction (n = 52) and those who were not (n = 276). Adolescents who were found to be at risk of internet addiction nevertheless reported on the survey questionnaires that the amount of time they spent online was acceptable. The study determined that participants' risk of internet addiction was associated with their levels of extraversion and openness to experience. Copyright © 2015. Published by Elsevier B.V.

Exposure monitoring and risk assessment of biphenyl in the workplace.

PubMed

Kim, Hyeon-Yeong; Shin, Sae-Mi; Ham, Miran; Lim, Cheol-Hong; Byeon, Sang-Hoon

2015-05-13

This study was performed to assess exposure to and the risk caused by biphenyl in the workplace. Biphenyl is widely used as a heat transfer medium and as an emulsifier and polish in industry. Vapor or high levels of dust inhalation and dermal exposure to biphenyl can cause eye inflammation, irritation of respiratory organs, and permanent lesions in the liver and nervous system. In this study, the workplace environment concentrations were assessed as central tendency exposure and reasonable maximum exposure and were shown to be 0.03 and 0.12 mg/m³, respectively. In addition, the carcinogenic risk of biphenyl as determined by risk assessment was 0.14 × 10⁻⁴ (central tendency exposure) and 0.56 × 10⁻⁴ (reasonable maximum exposure), which is below the acceptable risk value of 1.0 × 10⁻⁴. Furthermore, the central tendency exposure and reasonable maximum exposure hazard quotients were 0.01 and 0.06 for oral toxicity, 0.05 and 0.23 for inhalation toxicity, and 0.08 and 0.39 for reproduction toxicity, respectively, which are all lower than the acceptable hazard quotient of 1.0. Therefore, exposure to biphenyl was found to be safe in current workplace environments. Because occupational exposure limits are based on socioeconomic assessment, they are generally higher than true values seen in toxicity experiments. Based on the results of exposure monitoring of biphenyl, the current occupational exposure limits in Korea could be reviewed.

Virtual reality and paranoid ideations in people with an 'at-risk mental state' for psychosis.

PubMed

Valmaggia, Lucia R; Freeman, Daniel; Green, Catherine; Garety, Philippa; Swapp, David; Antley, Angus; Prescott, Corinne; Fowler, David; Kuipers, Elizabeth; Bebbington, Paul; Slater, Mel; Broome, Matthew; McGuire, Philip K

2007-12-01

Virtual reality provides a means of studying paranoid thinking in controlled laboratory conditions. However, this method has not been used with a clinical group. To establish the feasibility and safety of using virtual reality methodology in people with an at-risk mental state and to investigate the applicability of a cognitive model of paranoia to this group. Twenty-one participants with an at-risk mental state were assessed before and after entering a virtual reality environment depicting the inside of an underground train. Virtual reality did not raise levels of distress at the time of testing or cause adverse experiences over the subsequent week. Individuals attributed mental states to virtual reality characters including hostile intent. Persecutory ideation in virtual reality was predicted by higher levels of trait paranoia, anxiety, stress, immersion in virtual reality, perseveration and interpersonal sensitivity. Virtual reality is an acceptable experimental technique for use with individuals with at-risk mental states. Paranoia in virtual reality was understandable in terms of the cognitive model of persecutory delusions.

The hidden risks and subtleties of capitation or, what you were never told when you agreed to accept capitated risk.

PubMed

Prescott, F M

1998-01-01

For your physician practice to be successful under a capitated contract, you must understand the subtleties of the arrangement that can impact the practice's level of risk exposure. This means you must know the key questions to ask when negotiating the contract and capitation amount, as well as what should be monitored to ensure the contract is implemented correctly. How the capitated rate is calculated and whether or not it appropriately covers the risk of each benefit plan the practice will be servicing will determine the financial viability of the contractual agreement. In addition, after the contract becomes effective, you should make sure that the practice is providing and billing for services consistent with its contractual obligations, and that the reimbursement received is correct based on the practice's membership mix.

Health risk assessment for exposure to nitrate in drinking water from village wells in Semarang, Indonesia.

PubMed

Sadler, Ross; Maetam, Brooke; Edokpolo, Benjamin; Connell, Des; Yu, Jimmy; Stewart, Donald; Park, M-J; Gray, Darren; Laksono, Budi

2016-09-01

The levels of nitrate in 52 drinking water wells in rural Central Java, Indonesia were evaluated in April 2014, and the results were used for a health risk assessment for the local populations by using probabilistic techniques. The concentrations of nitrate in drinking water had a range of 0.01-84 mg/L, a mean of 20 mg/L and a medium of 14 mg/L. Only two of the 52 samples exceeded the WHO guideline values of 50 mg/L for infant methaemoglobinaemia. The hazard quotient values as evaluated against the WHO guideline value at the 50 and 95 percentile points were HQ50 at 0.42 and HQ95 at 1.2, respectively. These indicated a low risk of infant methaemoglobinaemia for the whole population, but some risk for the sensitive portion of the population. The HQ50 and HQ95 values based on WHO acceptable daily intake dose for adult male and female were 0.35 and 1.0, respectively, indicating a generally a low level of risk. A risk characterisation linking birth defects to nitrate levels in water consumed during the first three months of pregnancy resulted in a HQ50/50 values of 1.5 and a HQ95/5 value of 65. These HQ values indicated an elevated risk for birth defects, in particular for the more sensitive population. A sanitation improvement program in the study area had a positive effect in reducing nitrate levels in wells and the corresponding risk for public health. For example, the birth defect HQ50/50 values for a subset of wells surveyed in both 2014 and 2015 was reduced from 1.1 to 0.71. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

How does trust affect acceptance of a nuclear power plant (NPP): A survey among people living with Qinshan NPP in China

PubMed Central

Feldman, Marcus W.

2017-01-01

It is difficult to know whether different dimensions of trust have different effects on local residents’ acceptance of nuclear power plants (NPPs). In previous research such trust has been considered as a single dimensional concept. This paper divides trust into goodwill trust and competence trust, and we explore the ways in which trust affects acceptance of NPPs through structural equation modeling. A survey of 491 people was conducted in Haiyan County, China, where the Qinshan nuclear power plant is located. We find that goodwill trust is significantly correlated with competence trust, and each can indirectly promote residents’ acceptance of NPPs but by different paths. Goodwill trust improves acceptance of NPPs by decreasing risk perception, while competence trust improves acceptance of NPPs by increasing benefit perception. However, the associations between goodwill trust and benefit perception, competence trust and risk perception, are not significant. PMID:29176852

How does trust affect acceptance of a nuclear power plant (NPP): A survey among people living with Qinshan NPP in China.

PubMed

Xiao, Qunying; Liu, Huijun; Feldman, Marcus W

2017-01-01

It is difficult to know whether different dimensions of trust have different effects on local residents' acceptance of nuclear power plants (NPPs). In previous research such trust has been considered as a single dimensional concept. This paper divides trust into goodwill trust and competence trust, and we explore the ways in which trust affects acceptance of NPPs through structural equation modeling. A survey of 491 people was conducted in Haiyan County, China, where the Qinshan nuclear power plant is located. We find that goodwill trust is significantly correlated with competence trust, and each can indirectly promote residents' acceptance of NPPs but by different paths. Goodwill trust improves acceptance of NPPs by decreasing risk perception, while competence trust improves acceptance of NPPs by increasing benefit perception. However, the associations between goodwill trust and benefit perception, competence trust and risk perception, are not significant.

Acceptability of a Weight Management Intervention for Pregnant and Postpartum Women with BMI ≥30 kg/m2: A Qualitative Evaluation of an Individualized, Home-Based Service.

PubMed

Atkinson, Lou; Olander, Ellinor K; French, David P

2016-01-01

There have been recent calls for more evidence regarding effective antenatal and postnatal interventions to address the serious health risks of maternal obesity and associated childhood obesity. The Maternal and Early Years Healthy Weight Service (MAEYS) is an innovative service, delivered by specialist healthy weight advisors, for obese women (BMI ≥30 kg/m2) during pregnancy and up to 2 years after delivery. The service focuses on healthy gestational weight gain, postpartum weight loss and establishing healthy infant feeding and active play. MAEYS was adopted by six local health organizations in the U.K. as a 1 year pilot program. The aim of the present research was to assess the acceptability of this intervention among MAEYS participants. Semi-structured interviews with 20 women, with data analyzed thematically. High levels of acceptability were reported. The convenience and comfort of home visits, personalized advice on diet and physical activity, supportive approach of the healthy weight advisor and regular weight monitoring were all cited as advantages of the service. Service users suggested that more frequent contact with advisors and practical support such as recipes would improve the service. MAEYS is a novel, community-based intervention delivered in the home which has demonstrated acceptability to its recipients. It therefore shows promise as an early intervention to reduce the risks of maternal obesity and subsequently reduce childhood obesity. An evaluation of the efficacy of MAEYS in preventing excess gestational weight gain and losing weight postpartum is now needed.

Feasibility, Acceptability, and Predictive Validity of a Psychosocial Screening Program for Children and Youth Newly Diagnosed With Type 1 Diabetes

PubMed Central

Schwartz, David D.; Cline, Virginia Depp; Axelrad, Marni E.; Anderson, Barbara J.

2011-01-01

OBJECTIVE Psychosocial screening has been recommended for pediatric patients with newly diagnosed type 1 diabetes and their families. Our objective was to assess a psychosocial screening protocol in its feasibility, acceptability to families, and ability to predict early emerging complications, nonadherent family behavior, and use of preventive psychology services. RESEARCH DESIGN AND METHODS A total of 125 patients and their caregivers were asked to participate in a standardized screening interview after admission at a large urban children’s hospital with a new diagnosis of type 1 diabetes. Medical records were reviewed for subsequent diabetes-related emergency department (ED) admissions, missed diabetes clinic appointments, and psychology follow-up within 9 months of diagnosis. RESULTS Of 125 families, 121 (96.8%) agreed to participate in the screening, and a subsample of 30 surveyed caregivers indicated high levels of satisfaction. Risk factors at diagnosis predicted subsequent ED admissions with a sensitivity of 100% and a specificity of 98.6%. Children from single-parent households with a history of behavior problems were nearly six times more likely to be seen in the ED after diagnosis. Missed appointments were likeliest among African Americans, 65% of whom missed at least one diabetes-related appointment. Psychology services for preventive intervention were underutilized, despite the high acceptability of the psychosocial screening. CONCLUSIONS Psychosocial screening of newly diagnosed patients with type 1 diabetes is feasible, acceptable to families, and able to identify families at risk for early emerging complications and nonadherence. Challenges remain with regards to reimbursement and fostering follow-up for preventive care. PMID:21216856

[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: 2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR = 3.98, 95% CI: 2.81-5.65). Although a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.

Media and interpersonal persuasions in the polio eradication campaign in northern Nigeria.

PubMed

Ozohu-Suleiman, Yakubu

2010-09-01

This study is premised on the increasing global concerns over the widespread resistance to polio eradication campaign in northern Nigeria. It aims to determine the level of campaign acceptance and compare the influences of mass media and interpersonal communication sources in Zaria local government area, being one of the high-risk (WPV-endemic) areas in northern Nigeria, where campaign resistance is known to be high. By way of quantitative survey, the study utilized 10% sample of the populations of eight out of the thirteen Wards in Zaria local government area, with a response rate of 78.6%. Findings reveal close ranks between campaign acceptance and resistance in the local government area, thus further confirming the difficulties still faced in polio eradication campaign in the region. This study also indicates higher performance of Interpersonal than Mass Media sources in influencing campaign acceptance and resistance in the local communities. Contact with friends and relations was rated the most influential interpersonal sources in the acceptance and resistance decision of individuals, while newspapers and magazines were rated most influential media sources that influenced campaign resistance in the local communities. The study concludes that a polio eradication campaign, backed with competent and sufficient communication expertise that utilizes knowledge-based indigenous interpersonal communication strategies will likely result in greater community acceptance in northern Nigeria.

Recommended de minimis radiation dose rates for Canada. Report No. INFO-0355

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

Not Available

1990-01-01

A de minimis dose or dose rate as used in this report represents a level of risk which is generally accepted as being of no significance to an individual, or in the case of a population, of no significance to society. The report describes the risk of biological effects from radiation; radiation from natural and man-made sources; normal incidences of cancer and genetic defects; initiatives by other agencies in the U.S., the U.K. and internationally; the importance of collective dose and dose rate; assigning values to the de minimis dose rates; and application of the de minimis dose rates.

Point-of-Care Testing for Anemia, Diabetes, and Hypertension: A Pharmacy-Based Model in Lima, Peru.

PubMed

Saldarriaga, Enrique M; Vodicka, Elisabeth; La Rosa, Sayda; Valderrama, Maria; Garcia, Patricia J

Prevention and control of chronic diseases is a high priority for many low- and middle-income countries. This study evaluated the feasibility and acceptability of training pharmacy workers to provide point-of-care testing for 3 chronic diseases-hypertension, diabetes, and anemia-to improve disease detection and awareness through private pharmacies. We developed a multiphase training curriculum for pharmacists and pharmacy technicians to build capacity for identification of risk factors, patient education, point-of-care testing, and referral for abnormal results. We conducted a pre-post evaluation with participants and evaluated results using Student t test for proportions. We conducted point-of-care testing with pharmacy clients and evaluated acceptability by patient characteristics (age, gender, and type of patient) using multiple logistic regression. In total, 72 pharmacy workers (66%) completed the full training curriculum. Pretest scores indicated that pharmacists had more knowledge and skills in chronic disease risk factors, patient education, and testing than pharmacy technicians. All participants improved their knowledge and skills after the training, and post-test scores indicated that pharmacy technicians achieved the same level of competency as pharmacists (P < .01). Additionally, 698 clients received at least 1 test during the study; 53% completed the acceptability survey. Nearly 100% thought the pharmacy could provide faster results, faster and better attention, and better access to basic screening for hypertension, diabetes, and anemia than a traditional health center. Fast service was very important: 41% ranked faster results and 30% ranked faster attention as the most important factor for receiving diagnostic testing in the pharmacy. We found that it is both feasible for pharmacies and acceptable to clients to train pharmacy workers to provide point-of-care testing for anemia, diabetes, and hypertension. This innovative approach holds potential to increase early detection of risk factors and bolster disease prevention and management efforts in Peru and other low- and middle-income settings. Copyright © 2017. Published by Elsevier Inc.

Radiation protection recommendations as applied to the disposal of long-lived solid radioactive waste. A report of The International Commission on Radiological Protection.

PubMed

1998-01-01

(79) Waste, by definition, has no benefit. It should be viewed as one aspect of the beneficial practice that gave rise to it. Furthermore, radioactive waste management should be placed in the context of the management of society's waste in general. (80) A major issue in evaluating the acceptability of a disposal system for long-lived solid radioactive waste is that doses or risks may arise from exposures in the distant future. There is uncertainty surrounding any estimate of these doses or risks due to lack of knowledge about future conditions. Such exposures are treated as potential exposures as their magnitude depends on future processes and conditions that have probabilities associated with them. (81) Nevertheless, the Commission recognises a basic principle that individuals and populations in the future should be afforded at least the same level of protection from the action of disposing of radioactive waste today as is the current generation. This implies use of the current quantitative dose and risk criteria derived from considering associated health detriment. Therefore, protection of future generations should be achieved by applying these dose or risk criteria to the estimated future doses or risks in appropriately defined critical groups. These estimates should not be regarded as measures of health detriment beyond times of around several hundreds of years into the future. In the case of these longer time periods, they represent indicators of the protection afforded by the disposal system. (82 Constrained optimisation is the central approach to evaluating the radiological acceptability of a waste disposal system; dose or risk constraints are used rather than dose or risk limits. By this transition from limitation to optimisation, the needs of practical application of the radiological protection system to the disposal of long-lived solid waste disposal are met: determination of acceptability now for exposures that may occur in the distant future. Optimisation should be applied in an iterative manner during the disposal system development process and should particularly cover both site selection and repository design. (83) Two broad categories of exposure situations should be considered: natural processes and human intrusion. The latter only refers to intrusion that is inadvertent. The radiological implications of deliberate intrusion into a repository are the responsibility of the intruder. Assessed doses or risks arising from natural processes should be compared with a dose constraint of 0.3 mSv per year or its risk equivalent of around 10(-5) per year. With regard to human intrusion, the consequences from one or more plausible stylized scenarios should be considered in order to evaluate the resilience of the repository to such events. (84) The Commission considers that in circumstances where human intrusion could lead to doses to those living around the site sufficiently high that intervention on current criteria would almost always be justified, reasonable efforts should be made at the repository development stage to reduce the probability of human intrusion or to limit its consequences. In this respect, the Commission has previously advised that an existing annual dose of around 10 mSv per year may be used as a generic reference level below which intervention is not likely to be justifiable. Conversely, an existing annual dose of around 100 mSv per year may be used as a generic reference level above which intervention should be considered almost always justifiable. Similar considerations apply in situations where the thresholds for deterministic effects in relevant organs are exceeded. (85) Compliance with the constraints can be assessed by utilising either an aggregated risk-oriented approach, with a risk constraint, or a disaggregated dose/probability approach, with a dose constraint, or a combination of both. A similar level of protection can be achieved by any of these approaches; however, more information may

"I would rather be told than not know" - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy.

PubMed

Bentley, Faye; Swift, Judy Anne; Cook, Rachel; Redsell, Sarah A

2017-08-29

Risk assessment tools provide an opportunity to prevent childhood overweight and obesity through early identification and intervention to influence infant feeding practices. Engaging parents of infants is paramount for success however; the literature suggests there is uncertainty surrounding the use of such tools with concerns about stigmatisation, labelling and expressions of parental guilt. This study explores parents' views on identifying future risk of childhood overweight and obesity during infancy and communicating risk to parents. Semi-structured qualitative interviews were conducted with 23 parents and inductive, interpretive and thematic analysis performed. Three main themes emerged from the data: 1) Identification of infant overweight and obesity risk. Parents were hesitant about health professionals identifying infant overweight as believed they would recognise this for themselves, in addition parents feared judgement from health professionals. Identification of future obesity risk during infancy was viewed positively however the use of a non-judgemental communication style was viewed as imperative. 2) Consequences of infant overweight. Parents expressed immediate anxieties about the impact of excess weight on infant ability to start walking. Parents were aware of the progressive nature of childhood obesity however, did not view overweight as a significant problem until the infant could walk as viewed this as a point when any excess weight would be lost due to increased energy expenditure. 3) Parental attributions of causality, responsibility, and control. Parents articulated a high level of personal responsibility for preventing and controlling overweight during infancy, which translated into self-blame. Parents attributed infant overweight to overfeeding however articulated a reluctance to modify infant feeding practices prior to weaning. This is the first study to explore the use of obesity risk tools in clinical practice, the findings suggest that identification, and communication of future overweight and obesity risk is acceptable to parents of infants. Despite this positive response, findings suggest that parents' acceptance to identification of risk and implementation of behaviour change is time specific. The apparent level of parental responsibility, fear of judgement and self-blame also highlights the importance of health professionals approach to personalised risk communication so feelings of self-blame are negated and stigmatisation avoided.

Risk measures for power failures in transmission systems

NASA Astrophysics Data System (ADS)

Cassidy, Alex; Feinstein, Zachary; Nehorai, Arye

2016-11-01

We present a novel framework for evaluating the risk of failures in power transmission systems. We use the concept of systemic risk measures from the financial mathematics literature with models of power system failures in order to quantify the risk of the entire power system for design and comparative purposes. The proposed risk measures provide the collection of capacity vectors for the components in the system that lead to acceptable outcomes. Keys to the formulation of our measures of risk are two elements: a model of system behavior that provides the (distribution of) outcomes based on component capacities and an acceptability criterion that determines whether a (random) outcome is acceptable from an aggregated point of view. We examine the effects of altering the line capacities on energy not served under a variety of networks, flow manipulation methods, load shedding schemes, and load profiles using Monte Carlo simulations. Our results provide a quantitative comparison of the performance of these schemes, measured by the required line capacity. These results provide more complete descriptions of the risks of power failures than the previous, one-dimensional metrics.

Heavy metal pollution and health risk assessment in the Wei River in China.

PubMed

Yang, Xuefu; Duan, Jinming; Wang, Lei; Li, Wei; Guan, Jianling; Beecham, Simon; Mulcahy, Dennis

2015-03-01

From data collected monthly at 26 monitoring cross sections in the Wei River in the Shaanxi Region of China during the period 2008-2012, the temporal pollution characteristics of heavy metals (Hg, Cd, Cr(VI), Pb, and As) were analyzed based on a heavy metal pollution index (HPI). The monthly HPI values of the five heavy metals in the river fluctuated greatly in 2008 and then declined gradually with time. This general trend of reduction in HPI appears not to have a seasonal variation and most likely resulted from the continued improvement in heavy metal pollution control strategies implemented by local environmental agencies combined with a significant improvement in wastewater treatment capacities. Among the five heavy metals, Cd and Pb were below 0.1 and 3 μg L(-1), respectively, at all the sampling points in the studied areas in the year 2012. The detection rates of As, Hg, and Cr(VI) were in the order of Hg > Cr(VI) > As. Hg, Cr(VI), and As exceeded, in a month of the dry season in 2012, the standard limits for category III surface waters according to the China Environment Quality Standards for Surface Water (CEQSSW). Based on the assessment using the HPI method, the pollution status of these heavy metals in water of the Wei River in the Shaanxi Region was generally at an acceptable level, but exhibited distinctive characteristics between the main stream river and tributaries. Most of the tributaries were more seriously polluted than the main river. A health risk assessment was conducted based on the Human Health Risk Assessment (HHRA) method recommended by the United States Environmental Protection Agency (USEPA). Apart from As, the health risk for the five heavy metals in the region were at acceptable levels for drinking water sources (hazard quotient (HQ) < 1, carcinogenic risk (CR) ranged from 10(-4)-10(-6)) according to the Risk Assessment Guidance for Superfund (RAGS), USEPA. Arsenic was identified as the most important pollutant of concern among the five heavy metals; both its values of the HQ and CR indicated potentially adverse health risks for the local population.

The perceived health risks of indoor radon gas and overhead powerlines: a comparative multilevel approach.

PubMed

Poortinga, Wouter; Cox, Patrick; Pidgeon, Nick F

2008-02-01

Radon and overhead powerlines are two radiation risk cases that have raised varying levels of concern among the general public and experts. Despite both involving radiation-a typically feared and unseen health hazard-individuals' perceptions of the two risk cases may invoke rather different factors. We examined individual and geographic-contextual factors influencing public perceptions of the health risks of indoor radon gas and overhead powerlines in a comparative research design, utilizing a postal questionnaire with 1,528 members of the general public (response rate 28%) and multilevel modeling techniques. This study found that beliefs about the two risk cases mainly differed according to the level of "exposure"-defined here in terms of spatial proximity. We argue that there are two alternative explanations for this pattern of findings: that risk perception itself varies directly with proximity, or that risk is more salient to concerned people in the exposed areas. We also found that while people living in high radon areas are more concerned about the risks of indoor radon gas, they find these risks more acceptable and have more trust in authorities. These results might reflect the positive effects of successive radon campaigns in high radon areas, which may have raised awareness and concern, and at the same time may have helped to increase trust by showing that the government takes the health risks of indoor radon gas seriously, suggesting that genuine risk communication initiatives may have positive impacts on trust in risk management institutions.

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

Sanquist, Thomas F.; Mahy, Heidi A.; Morris, Fred A.

Understanding the issues surrounding public acceptance of homeland security systems is important for balancing security needs and potential civil liberties infringements. A psychometric survey was used to measure attitudes regarding homeland security systems. Psychometric rating data were obtained from 182 respondents on psychological attributes associated with 12 distinct types of homeland security systems. An inverse relationship was observed for the overall rating attributes of acceptability and risk of civil liberties infringement. Principal components analysis yielded a two factor solution, with the rating scale loading pattern suggesting factors of Perceived Effectiveness and Perceived Intrusiveness. These factors also showed an inverse relationship.more » The 12 different homeland security systems showed significantly different scores on the rating scales and PCA factors, which were used to rank the systems in terms of overall acceptability. Difference scores for the rating scales and PCA factors were used to compute a single acceptability value reflecting the relative weight of risks and benefits. Of the 12 systems studied, airport screening, canine detectors and radiation monitoring at borders were found to be relatively acceptable, i.e., the perceived benefits for homeland security outweighed the perceived risks to civil liberties. Students rated several systems as more effective than professionals, but the overall pattern of results for both types of subjects was similar. The data suggest that risk perception research and the psychometric paradigm are useful approaches for quantifying attitudes regarding homeland security systems and policies, and can be used to anticipate potentially significant public acceptance issues.« less

Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. Clinical Outcomes in Routine Evaluation-Outcome Measures.

PubMed

Barkham, M; Margison, F; Leach, C; Lucock, M; Mellor-Clark, J; Evans, C; Benson, L; Connell, J; Audin, K; McGrath, G

2001-04-01

To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.

Chemical Analysis of Suspected Unrecorded Alcoholic Beverages from the States of São Paulo and Minas Gerais, Brazil

PubMed Central

Soares Neto, Julino Assunção Rodrigues

2015-01-01

Our study analyzed 152 samples of alcoholic beverages collected from the states of São Paulo and Minas Gerais, Brazil, using gas chromatography with flame ionization detection (GC-FID) and mass spectrometry (GC-MS), Fourier transform infrared spectroscopy (FT-IR), and inductively coupled plasma atomic emission spectrometry (ICP-AES). The methanol content varied from 20 to 180 ppm in 28 samples, and the limit of the accepted level of 200 ppm was exceeded in only one sample. High content of cyanide derivatives and ethyl carbamate, above the accepted level of 150 ppb, was observed in 109 samples. Carbonyl compounds were also observed in 111 samples, showing hydroxy 2-propanone, 4-methyl-4-hepten-3-one, furfural, and 2-hydroxyethylcarbamate as main constituents. Copper was found at concentrations above 5 ppm in 26 samples; the maximum value observed was 28 ppm. This work evaluated the human health risk associated with the poor quality of suspected unrecorded alcohols beverages. PMID:26495155

Examining the Measurement Precision and Invariance of the Revised Get Ready to Read!

PubMed Central

Farrington, Amber L.; Lonigan, Christopher J.

2016-01-01

Children's emergent literacy skills are highly predictive of later reading abilities. To determine which children have weaker emergent literacy skills and are in need of intervention, it is necessary to assess emergent literacy skills accurately and reliably. In this study, 1,351 children were administered the Revised Get Ready to Read! (GRTR-R), and an item response theory analysis was used to evaluate the item-level reliability of the measure. Differential item functioning (DIF) analyses were conducted to examine whether items function similarly between subpopulations of children. The GRTR-R had acceptable reliability for children whose ability level was just below the mean. DIF for a small number of items was present for only two comparisons—children who were older versus younger and children who were White versus African American. These results demonstrate that the GRTR-R has acceptable reliability and limited DIF, enabling the screener to identify those at risk for developing reading problems. PMID:23851136

Predictors of Graduation of Readmitted "At Risk" College Students

ERIC Educational Resources Information Center

Berkovitz, Roslyn A.; O'Quin, Karen

2007-01-01

We conducted an archival study of at-risk students who had "stopped out" of college for many reasons (academic dismissal, financial problems, personal problems, etc.) and who later were accepted to return to school. Approximately 27% of the accepted students chose not to return. Those who returned had higher grade point averages, had completed…

29 CFR 2550.404c-5 - Fiduciary relief for investments in qualified default investment alternatives.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., liquidation or exchange fees, redemption fees and similar expenses charged in connection with the liquidation... accepted investment theories, is diversified so as to minimize the risk of large losses and that is... portfolio that applies generally accepted investment theories, is diversified so as to minimize the risk of...

29 CFR 2550.404c-5 - Fiduciary relief for investments in qualified default investment alternatives.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., liquidation or exchange fees, redemption fees and similar expenses charged in connection with the liquidation... accepted investment theories, is diversified so as to minimize the risk of large losses and that is... portfolio that applies generally accepted investment theories, is diversified so as to minimize the risk of...

29 CFR 2550.404c-5 - Fiduciary relief for investments in qualified default investment alternatives.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., liquidation or exchange fees, redemption fees and similar expenses charged in connection with the liquidation... accepted investment theories, is diversified so as to minimize the risk of large losses and that is... portfolio that applies generally accepted investment theories, is diversified so as to minimize the risk of...

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…

Sitagliptin/Simvastatin: a first combination tablet to treat type 2 diabetes and hypercholesterolemia – a review of its characteristics

PubMed Central

Ramadan, Wijdan H; Kabbara, Wissam K

2015-01-01

Background The purpose of this study was to review the current literature and information on the combination product Juvisync™ (sitagliptin + simvastatin), which was approved by the US Food and Drug Administration in October 2011. Methods PubMed (2001–2014) was searched for primary and review articles on sitagliptin, simvastatin, or the combination product. Drug manufacturing data and product labeling were also used. Studies of simvastatin, sitagliptin, or the combination were screened and analyzed to include relevant and recent papers. Selected English language trials were limited to those with human subjects and included both safety and efficacy outcomes. Results When compared with glipizide as add-on therapy to metformin, sitagliptin was noninferior but had lower rates of hypoglycemia and weight gain. In addition, when compared with insulin glargine, sitagliptin was less effective in decreasing glycosylated hemoglobin, but was associated with significantly lower rates of hypoglycemia. Further, trials have shown a beneficial effect of using statins in patients with diabetes mellitus with regard to decreasing cardiovascular risk, regardless of baseline lipid levels or the presence of a cardiac disease. Both medications have also demonstrated an acceptable side effect profile. However, caution is needed when coadministering with any drug that may increase simvastatin levels to reduce the risk of myopathy and rhabdomyolysis. Conclusion Juvisync should be used in patients requiring both sitagliptin and simvastatin. Both agents have shown good efficacy and acceptable safety profiles. Sitagliptin is a good option for diabetic patients to improve glycemic control with a lower risk of hypoglycemia and weight gain. PMID:25709467

[Pollution Level and Health Risk Assessment of Heavy Metals in Atmospheric PM₂.₅ in Nanjing Before and After the Youth Olympic Games].

PubMed

Zhang, Heng; Zhou, Zi-qiang; Zhao, Hai-yan; Xiong, Zheng-qin

2016-01-15

The influence of human activities on the atmospheric environment has attracted people's attention. This study reported the dynamic changes in PM₂.₅ concentration, its heavy metal compositions and health risk assessment from April to September, 2014 in Nanjing when the Youth Olympic Games ( YOG) was held. The results showed that the mass levels of PM₂.₅ ranged from 26.39 to 80.31 µg · m⁻³ from April to September. The mass levels of PM₂.₅ met the level II standard of ambient air quality in China (24 h average concentration, 75 µg · m⁻³) in months of April, May and July while met the level I standard (24 h average concentration, 35 µg · m⁻³) in August during the YOG. The average mass concentration of PM₂.₅ reached 76.14 µg · m⁻¹ after the YOG, showing resilience of air pollution. The variations of heavy metals were not consistent with each other throughout the observation period. Principal component analysis indicated that emission sources significantly affected the variations of PM₂.₅ and its heavy metals. PM₂.₅ and all of the heavy metals decreased to their minimum values during the YOG, indicating the effectiveness of those temporary measures for reducing atmospheric pollutant before and during the YOG. The health risks of Cd, Cu, Ni and Pb in PM₂.₅ via breathing and dermal contact exposure were all within the acceptable ranges, but potential carcinogenic risk existed for Cr in PM₂.₅. There was potential non-carcinogenic health risk for adult males via breathing of Mn and greater non-carcinogenic health risk for children via dermal contact exposures to all these 6 heavy metals.

Cost-oriented evaluation of ecosystem services under consideration of income risks and risk attitudes of farmers.

PubMed

Dörschner, T; Musshoff, O

2013-09-30

Agri-environmental measures are often not as accepted among farmers as is expected. The present study investigates whether changes in income risks and the individual risk attitudes of farmers may constitute an explanatory approach for the low acceptance of the measures. For this purpose, a normative model is developed that calculates the premia claimed by the farmers for adopting environmental measures under the consideration of income risks and different risk attitudes. We apply this model to environmental measures aiming at an increase of the faunistic diversity of species on grassland and showing that changes in income risks and the decision makers' risk attitudes can significantly influence farmers' minimum compensation claims. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

Is it real? Can we win? Is it worth doing? Managing risk and reward in an innovation portfolio.

PubMed

Day, George S

2007-12-01

Minor innovations make up most of a company's development portfolio, on average, but they never generate the growth companies seek. The solution, says Day--the Geoffrey T. Boisi Professor of Marketing and a codirector of the Mack Center for Technological Innovation at Wharton--is for companies to undertake a systematic, disciplined review of their innovation portfolios and increase the number of major innovations at an acceptable level of risk. Two tools can help them do this. The first, called the risk matrix, graphically reveals the distribution of risk across a company's entire innovation portfolio. The matrix allows companies to estimate each project's probability of success or failure, based on how big a stretch it is for the firm to undertake. The less familiar the product or technology and the intended market, the higher the risk. The second tool, dubbed the R-W-W (real-win-worth it) screen, allows companies to evaluate the risks and potential of individual projects by answering six fundamental questions about each one: Is the market real? Explores customers' needs, their willingness to buy, and the size of the potential market. Is the product real? Looks at the feasibility of producing the innovation. Can the product be competitive? and Can our company be competitive? Investigate how well suited the company's resources and management are to compete in the marketplace with the product. Will the product be profitable at an acceptable risk? Explores the financial analysis needed to assess an innovation's commercial viability. Last, Does launching the product make strategic sense? examines the project's fit with company strategy and whether management supports it.

Chosen risk factors for osteoporosis and the level of knowledge about the disease in peri- and postmenopausal women.

PubMed

Janiszewska, Mariola; Kulik, Teresa; Dziedzic, Małgorzata A; Żołnierczuk-Kieliszek, Dorota

2015-03-01

Osteoporosis as a chronic disease, affecting especially women in postmenopausal age, is an important, social and economic health problem especially of women of today's world. The aim of the study was to assess the level of knowledge of women in the peri- and postmenopausal period about the prevention of osteoporosis and show the influence of chosen risk factors on the level of this knowledge. A group of 300 women aged 45-65, being patients of healthcare centres in Chełm, Lublin and Zamość (Lublin voivodeship, south-eastern Poland) were included in the study. The purposive sampling was used. Osteoporosis Knowledge Test (OKT) 2011 was the research tool. Gathered material was subjected to descriptive and statistical analysis. Tukey's test, t-student test and variance analysis (ANOVA) were all applied. An accepted p materiality level was < 0.05 and p < 0.01. Respondents presented the average level of knowledge about the role of physical activity in the prevention of osteoporosis (M = 13.93) and a low level of knowledge about well-balanced diet rich in calcium (M = 9.77). The knowledge about risk factors, screening and treatment remained on the average level (M = 8.00). An influence of socio-demographic factors on the level of knowledge was shown. Also some behaviours, associated with the lifestyle indeed influenced the level of this knowledge. Professional educational programs on osteoporosis should be implemented in the population of Polish peri- and postmenopausal women.

Cystic fibrosis heterozygote screening in 5,161 pregnant women

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

Witt, D.R.; Hallam, P.; Blumberg, B.

A screening program for cystic fibrosis (CF) heterozygotes was conducted in a large HMO prenatal population, to evaluate the level of interest among eligible patients, the effectiveness of prescreening education, attitudes toward the screening process, psychological effects, and utilization of prenatal diagnosis and its outcomes. The heterozygote identification rate and frequency of specific CFTR mutations were also assessed. Identified carriers were offered genetic counseling and testing of male partners. Prenatal diagnosis was offered if both partners were identified as carriers. A total of 5,161 women underwent carrier testing; 947 others completed survey instruments only. The acceptance rate of screening wasmore » high (78%), and pretest education by videotape was generally effective. Adverse psychological effects were not reported. Participants generally found screening to be desirable and useful. Screening identified 142 female heterozygotes, 109 couples in which the male partner was not a carrier, and 7 high-risk couples. The incidence of R117H mutations was much higher than expected. The number of identified carriers was much lower in Hispanics than in Caucasians. We conclude that large-scale prenatal screening for CF heterozygotes in the absence of a family history of CF is an acceptable method for identifying couples at risk for affected fetuses. Sufficient pretest education can be accomplished efficiently, test insensitivity is well accepted, adverse psychological events are not observed, and general patient satisfaction is high. 66 refs., 1 fig., 8 tabs.« less

On The Value at Risk Using Bayesian Mixture Laplace Autoregressive Approach for Modelling the Islamic Stock Risk Investment

NASA Astrophysics Data System (ADS)

Miftahurrohmah, Brina; Iriawan, Nur; Fithriasari, Kartika

2017-06-01

Stocks are known as the financial instruments traded in the capital market which have a high level of risk. Their risks are indicated by their uncertainty of their return which have to be accepted by investors in the future. The higher the risk to be faced, the higher the return would be gained. Therefore, the measurements need to be made against the risk. Value at Risk (VaR) as the most popular risk measurement method, is frequently ignore when the pattern of return is not uni-modal Normal. The calculation of the risks using VaR method with the Normal Mixture Autoregressive (MNAR) approach has been considered. This paper proposes VaR method couple with the Mixture Laplace Autoregressive (MLAR) that would be implemented for analysing the first three biggest capitalization Islamic stock return in JII, namely PT. Astra International Tbk (ASII), PT. Telekomunikasi Indonesia Tbk (TLMK), and PT. Unilever Indonesia Tbk (UNVR). Parameter estimation is performed by employing Bayesian Markov Chain Monte Carlo (MCMC) approaches.

Risk models of dating aggression across different adolescent relationships: a developmental psychopathology approach.

PubMed

Williams, Tricia S; Connolly, Jennifer; Pepler, Debra; Craig, Wendy; Laporte, Lise

2008-08-01

The present study examined physical dating aggression in different adolescent relationships and assessed linear, threshold, and moderator risk models for recurrent aggressive relationships. The 621 participants (59% girls, 41% boys) were drawn from a 1-year longitudinal survey of Canadian high school youths ranging from Grade 9 through Grade 12. Approximately 13% of participants reported recurrent dating aggression across 2 different relationships. Using peer and dyadic risk factors from Time 1 of the study, the authors confirmed a linear risk model, such that adolescents in 2 different violent relationships had significantly more contextual risk factors than did adolescents in 1 or no violent relationship. Further, structural equation modeling assessing moderation of contextual risk factors indicated that, for adolescents with high acceptance of dating aggression, peer aggression and delinquency significantly predicted recurrent aggression in a new relationship. In comparison, for adolescents with low acceptance of dating aggression, negative relationship characteristics significantly predicted recurrent aggression. Acceptance did not moderate concurrent associations between risk factors and aggression in 1 relationship. Results support a developmental psychopathological approach to the understanding of recurrent aggression and its associated risk factors. Copyright 2008 APA, all rights reserved.

The assessment of spray drift damage for ten major crops in Belgium.

PubMed

de Schampheleire, M; Spanoghe, P; Steurbaut, W; Nuyttens, D; Sonck, B

2005-01-01

According to the Council Directive 91/414/EC pesticide damage should be assessed by considering the risk for persons arising from occupational, non-dietary exposure and risk to the environment. In this research an assessment for the pesticide damage by droplet spray drift was set up. The percentages of spray drift were estimated with the Ganzelmeier drift curves and the IMAG drift calculator. Knowing the percentages of drift and the applied doses of pesticide formulations in a given crop, the human and environmental exposures (water and bottom) were predicted. Thereupon risk indices were calculated for water organisms, soil organisms and bystanders. A risk index is the ratio of a predicted exposure to a toxicological reference value and gives an indication of the incidence and the severity of the adverse effects likely to occur. Considering the risk index it is possible to define the minimal width of an unsprayed field margin or "buffer zone" to reduce this risk at an acceptable level.

Risk assessment of oil and gas well drilling activities in Iran - a case study: human factors.

PubMed

Amir-Heidari, Payam; Farahani, Hadi; Ebrahemzadih, Mehrzad

2015-01-01

Oil and gas well drilling activities are associated with numerous hazards which have the potential to cause injury or harm for people, property and the environment. These hazards are also a threat for the reputation of drilling companies. To prevent accidents and undesired events in drilling operations it is essential to identify, evaluate, assess and control the attendant risks. In this work, a structured methodology is proposed for risk assessment of drilling activities. A case study is performed to identify, analyze and assess the risks arising from human factors in one of the on shore drilling sites in southern Iran. A total of 17 major hazards were identified and analyzed using the proposed methodology. The results showed that the residual risks of 100% of these hazards were in the acceptable or transitional zone, and their levels were expected to be lowered further by proper controls. This structured methodology may also be used in other drilling sites and companies for assessing the risks.

Different Choices of Drinking Water Source and Different Health Risks in a Rural Population Living Near a Lead/Zinc Mine in Chenzhou City, Southern China.

PubMed

Huang, Xiao; He, Liping; Li, Jun; Yang, Fei; Tan, Hongzhuan

2015-11-12

This study aimed to describe the households' choices of drinking water sources, and evaluate the risk of human exposure to heavy metals via different drinking water sources in Chenzhou City of Hunan Province, Southern China. A cross-sectional face-to-face survey of 192 householders in MaTian and ZhuDui village was conducted. The concentrations of heavy metals in their drinking water sources were analyzed. Carcinogenic and non-carcinogenic risk assessment was performed according to the method recommended by the United States Environmental Protection Agency. In total, 52.60% of the households used hand-pressed well water, and 34.89% used barreled water for drinking. In total, 6.67% of the water samples exceeded the Chinese drinking water standards. The total health risk of five metals is 5.20 × 10(-9)~3.62 × 10(-5). The total health risk of five metals was at acceptable levels for drinking water sources. However, the total risk of using hand-pressed well water's highest value is 6961 times higher than the risk of using tap water. Household income level was significantly associated with drinking water choices. Arsenic (As) and lead (Pb) are priority controlled pollutants in this region. Using safe drinking water (tap water, barreled water and so on) can remarkably reduce the risk of ingesting heavy metals.

Discrepancy among acute guideline levels for emergency response.

PubMed

Oberg, Mattias; Palmen, Nicole; Johanson, Gunnar

2010-12-15

Acute guidance values are tools for public health risk assessment and management during planning, preparedness and response related to sudden airborne release of hazardous chemicals. The two most frequently used values, i.e. Acute Exposure Guidance Levels (AEGL) and Emergency Response Planning Guideline (ERPG), were compared in qualitative and quantitative terms. There was no significant difference between the general level of AEGL and ERPG values, suggesting the two systems are equally precautious. However, the guidance values diverged by a factor of 3 or more for almost 40% of the substances, including many of high production volume. These deviations could be explained by differences in selection of critical effect or critical study and in a few cases differences in interpretation of the same critical study. Diverging guidance values may hamper proper risk communication and risk management. Key factors for broad international acceptance of harmonized values include transparency of the decision process, agreement on definition of toxicological tiers, and a target population including sensitive groups of the general population. In addition, development of purely health based values is encouraged. Risk management issues, such as land use and emergency response planning should be treated separately, as these rely on national legislation and considerations. Copyright © 2010 Elsevier B.V. All rights reserved.

Sexual Dating Aggression Across Grades 8 Through 12: Timing and Predictors of Onset

PubMed Central

Reyes, H. Luz McNaughton; Foshee, Vangie A.

2013-01-01

Investigators have identified a number of factors that increase risk for physical and psychological dating abuse perpetration during adolescence, but as yet little is known about the etiology of sexual dating aggression during this critical developmental period. This is an important gap in the literature given that research suggests that patterns of sexual dating violence that are established during this period may carry over into young adulthood. Using a sample of 459 male adolescents (76% White, 19% Black), the current study used survival analysis to examine the timing and predictors of sexual dating aggression perpetration onset across grades 8 through 12. Risk for sexual dating aggression onset increased across early adolescence, peaked in the 10th grade, and desisted thereafter. As predicted based on the Confluence Model of sexual aggression, associations between early physical aggression towards peers and dates and sexual aggression onset were stronger for teens reporting higher levels of rape myth acceptance. Contrary to predictions, inter-parental violence, prior victimization experiences, and parental monitoring knowledge did not predict sexual dating aggression onset. Findings support the notion that risk factors may work synergistically to predict sexual dating aggression and highlight the importance of rape myth acceptance as a construct that should be addressed by violence prevention programs. PMID:23180071

A Mixed-Methods Study on Acceptability, Tolerability, and Substitution of Brown Rice for White Rice to Lower Blood Glucose Levels among Nigerian Adults.

PubMed

Adebamowo, Sally N; Eseyin, Olabimpe; Yilme, Susan; Adeyemi, David; Willett, Walter C; Hu, Frank B; Spiegelman, Donna; Adebamowo, Clement A

2017-01-01

Whole-grain products such as brown rice have been associated with lower risk of metabolic disorders including diabetes. We examined the acceptability and tolerability of substituting brown rice for white rice and the feasibility of introducing brown rice into the diet through a long-term trial to lower the risk of type 2 diabetes. Fifty-one adults residing in Abuja, Nigeria, participated in this study. Using purposeful sampling for focus group discussions (FGDs), participants were enrolled based on their age (19-25 vs. 40-60 years) and body mass index (BMI) (normal weight vs. overweight/obese). Participants tasted four meals with different constitution of brown and white rice (25:75%, 50:50%, 75:25%, and 100% brown rice). Twelve FGDs were conducted, six before and six after the food tasting. Two-hour postprandial blood glucose was measured after consumption of each rice meal. The mean age of the participants was 39 (±14) years, their mean BMI was 25.6 (±5.2) and about half of them were male. Most of the participants (61%) reported that rice was their main source of carbohydrate and 67% consumed rice at least five times/week. Before the food tasting, participants considered white polished rice superior to brown rice with regard to quality, taste, and nutritional value. After the food tasting, most of the participants (49%) indicated a preference for the 100% brown rice, 19% preferred the 25% brown rice, 18% preferred the 50% brown rice, and 7% preferred the 75% brown rice meals. Factors that may affect the acceptability of brown rice include its appearance, longer cooking time, cost, limited availability, and poor appreciation of its nutritional value. In general, 2-h postprandial glucose levels were lower, after consumption of meals with higher proportion of brown rice. This study provides valuable insight into the acceptability of brown rice as a substitute for white rice in Nigeria. If confirmed in larger studies, these results highlight the importance of increasing awareness on the nutritional value of brown rice and support the rationale for conducting a large-scale intervention trial to examine the effect of brown rice consumption on blood sugar levels among Nigerians.

Assessment of Tomato (Solanum lycopersicum L.) Producers’ Exposure Level to Pesticides, in Kouka and Toussiana (Burkina Faso)

PubMed Central

Zerbo, Fabrice K. B.; Bonzi, Schémaeza; Legreve, Anne; Somda, Irénée; Schiffers, Bruno

2018-01-01

To assess producers’ exposure level to pesticides in vegetable production in Burkina Faso, a study was carried out in 2016 and 2017 among 30 tomato producers in the municipalities of Kouka and Toussiana. Eighteen (18) commercial formulations were identified, with more than 50% of pesticides destined for cotton production. Eleven active substances have been identified and the most frequently used are λ-cyhalothrin (35%), acetamiprid (22%) and profenofos (13%). The most commonly used chemical families are pyrethroids (28%) and organophosphates (18%). The study revealed a low level of training for producers, a high use of pesticides according to the Frequency Treatment Indicator, and a very low level of protection used by producers. The Health Risk Index shows that active substances such as methomyl, λ-cyhalothrin and profenofos present very high risk to operators’ health. Based on the UK-POEM model, the predictive exposure levels obtained varied from 0.0105 mg/kg body weight/day to 1.7855 mg/kg body weight/day, which is several times higher than the Acceptable Operator Exposure Level. However, the study also shows that exposure can be greatly reduced if the required Personal Protective Equipment is worn. Producers’ awareness and training on integrated pest management are necessary to reduce the risks linked to the pesticides use in Burkina Faso. PMID:29370136

Factors Potentially Influencing Student Acceptance of Biological Evolution

NASA Astrophysics Data System (ADS)

Wiles, Jason R.

This investigation explored scientific, religious, and otherwise nonscientific factors that may influence student acceptance of biological evolution and related concepts, how students perceived these factors to have influenced their levels of acceptance of evolution and changes therein, and what patterns arose among students' articulations of how their levels of acceptance of evolution may have changed. This exploration also measured the extent to which students' levels of acceptance changed following a treatment designed to address factors identified as potentially affecting student acceptance of evolution. Acceptance of evolution was measured using the MATE instrument (Rutledge and Warden, 1999; Rutledge and Sadler, 2007) among participants enrolled in a secondary-level academic program during the summer prior to their final year of high school and as they transitioned to the post-secondary level. Student acceptance of evolution was measured to be significantly higher than pre-treatment levels both immediately following and slightly over one year after treatment. Qualitative data from informal questionnaires, from formal course evaluations, and from semi-structured interviews of students engaged in secondary level education and former students at various stages of post-secondary education confirmed that the suspected factors were perceived by participants to have influenced their levels of acceptance of evolution. Furthermore, participant reports provided insight regarding the relative effects they perceived these factors to have had on their evolution acceptance levels. Additionally, many participants reported that their science teachers in public schools had avoided, omitted, or denigrated evolution during instruction, and several of these students expressed frustration regarding what they perceived to have been a lack of education of an important scientific principle. Finally, no students expressed feelings of being offended by having been taught about evolutionary science, and the overwhelming majority of the participants expressed enjoyment of the course and appreciation for having been taught about evolution.

Incorporating Known Genetic Variants Does Not Improve the Accuracy of PSA Testing to Identify High Risk Prostate Cancer on Biopsy

PubMed Central

Gilbert, Rebecca; Martin, Richard M.; Evans, David M.; Tilling, Kate; Davey Smith, George; Kemp, John P.; Lane, J. Athene; Hamdy, Freddie C.; Neal, David E.; Donovan, Jenny L.; Metcalfe, Chris

2015-01-01

Introduction Prostate-specific antigen (PSA) testing is a widely accepted screening method for prostate cancer, but with low specificity at thresholds giving good sensitivity. Previous research identified four single nucleotide polymorphisms (SNPs) principally associated with circulating PSA levels rather than with prostate cancer risk (TERT rs2736098, FGFR2 rs10788160, TBX3 rs11067228, KLK3 rs17632542). Removing the genetic contribution to PSA levels may improve the ability of the remaining biologically-determined variation in PSA to discriminate between high and low risk of progression within men with identified prostate cancer. We investigate whether incorporating information on the PSA-SNPs improves the discrimination achieved by a single PSA threshold in men with raised PSA levels. Materials and Methods Men with PSA between 3-10ng/mL and histologically-confirmed prostate cancer were categorised as high or low risk of progression (Low risk: Gleason score≤6 and stage T1-T2a; High risk: Gleason score 7–10 or stage T2C). We used the combined genetic effect of the four PSA-SNPs to calculate a genetically corrected PSA risk score. We calculated the Area under the Curve (AUC) to determine how well genetically corrected PSA risk scores distinguished men at high risk of progression from low risk men. Results The analysis includes 868 men with prostate cancer (Low risk: 684 (78.8%); High risk: 184 (21.2%)). Receiver operating characteristic (ROC) curves indicate that including the 4 PSA-SNPs does not improve the performance of measured PSA as a screening tool for high/low risk prostate cancer (measured PSA level AU C = 59.5% (95% CI: 54.7,64.2) vs additionally including information from the 4 PSA-SNPs AUC = 59.8% (95% CI: 55.2,64.5) (p-value = 0.40)). Conclusion We demonstrate that genetically correcting PSA for the combined genetic effect of four PSA-SNPs, did not improve discrimination between high and low risk prostate cancer in men with raised PSA levels (3-10ng/mL). Replication and gaining more accurate estimates of the effects of the 4 PSA-SNPs and additional variants associated with PSA levels and not prostate cancer could be obtained from subsequent GWAS from larger prospective studies. PMID:26431041

Feasibility and Acceptability of a Web-Based HIV/STD Prevention Program for Adolescent Girls Targeting Sexual Communication Skills

ERIC Educational Resources Information Center

Widman, L.; Golin, C. E.; Kamke, K.; Massey, J.; Prinstein, M. J.

2017-01-01

Adolescent girls are at substantial risk of sexually transmitted diseases including HIV. To reduce these risks, we developed Health Education And Relationship Training (HEART), a web-based intervention focused on developing sexual assertiveness skills and enhancing sexual decision-making. This study assessed the feasibility and acceptability of…

Environmental and biological monitoring of PAHs exposure in coke-oven workers at the Taranto plant compared to two groups from the general population of Apulia, Italy.

PubMed

Campo, Laura; Vimercati, L; Carrus, A; Bisceglia, Lucia; Pesatori, Angela Cecilia; Bertazzi, P A; Assennato, G; Fustinoni, Silvia

2012-01-01

Polycyclic aromatic hydrocarbons (PAHs) exposure in the coke industry poses a risk for workers' health as well as for subjects living in the plant vicinity. To assess PAHs exposure in coke-oven workers (CW) at the Taranto plant, Apulia, and in subjects from the general population living near (NC) and far away (FC) from the plant. Exposure was assessed by personal air sampling and urinary 1-hydroxypyrene (1-OHP) measured in 100 CW 18 NC and 15 FC. Median airborne benzo[a]pyrene (BaP) levels were 152, 1.5, and 3.6 ng/m3 in CW NC, and FC, respectively. In CW, median 1-OHP increased from 1.45 to 1.96 microg/g creatinine (crt) during the work shift (p > 0.05); in NC and FC, 1-OHP levels were 0.56 and 0.53 microg/g crt. No significant differences between NC and FC for both air and urinary indices were found. BaP exposure in CW exceeded the recently proposed German acceptable (70 ng/m3) and tolerable (700 ng/m3) risk-based limit values in 82 and 11% of subjects, respectively. In NC and FC, BaP exposure exceeded the European target value for ambient air (1 ng/m3) in 67 and 60% of subjects, respectively. Biomonitoring showed that 21% of CW had 1-OHP levels higher than the proposed biological limit value for the coke-oven industry (4.4 microg/g crt), while 93% of FC, and 88% of NC, had 1-OHP levels exceeding the Italian reference value (0.3 microg/g crt). Among non-smokers, a linear regression between 1-OHP and BaP (Pearson value r = 0.65, p < 0.05) allowed us to estimate levels of 1.2 and 1.9 microg/g crt for 1-OHP end-of-shift corresponding to acceptable and tolerable limit values. Although lower than in the past, PAHs exposure in the coke plant still poses a health risk for workers and the general population and requires further efforts to improve workplace conditions.

Preliminary risk assessment of the Mexican Spotted Owl under a spatially-weighted foraging regime at the Los Alamos National Laboratory

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

Gallegos, A.F.; Gonzales, G.J.; Bennett, K.D.

The Record of Decision on the Dual Axis Radiographic Hydrodynamic Test Facility at the Los Alamos National Laboratory requires that the Department of Energy takes special precautions to protect the Mexican Spotted Owl (Strix occidentalis lucida). In order to do so, risk to the owl presented by radiological and nonradiological contaminants must be estimated. A preliminary risk assessment on the Mexican Spotted Owl in two Ecological Exposure Units (EEUs) was performed using a modified Environmental Protection Agency Quotient method, the FORTRAN model ECORSK4, and a geographic information system. Estimated doses to the owl under a spatially-weighted foraging regime were comparedmore » against toxicological reference doses generating hazard indices (HIs) and hazard quotients (HQs) for three risk source types. The average HI was 0.20 for EEU-21 and 0.0015 for EEU-40. Under the risk parameter assumptions made, hazard quotient results indicated no unacceptable risk to the owl, including a measure of cumulative effects from multiple contaminants that assumes a linear additive toxicity type. An HI of 1.0 was used as the evaluative criteria for determining the acceptability of risk. This value was exceeded (1.06) in only one of 200 simulated potential nest sites. Cesium-137, Ni, {sup 239}Pu, Al and {sup 234}U we`re among the constituents with the highest partial HQs. Improving model realism by weighting simulated owl foraging based on distance from potential nest sites decreased the estimated risk by 72% (0.5 HI units) for EEU-21 and by 97.6% (6.3E-02 HI units) for EEU-40. Information on risk by specific geographical location was generated, which can be used to manage contaminated areas, owl habitat, facility siting, and/or facility operations in order to maintain risk from contaminants at acceptably low levels.« less

Nations at Risk-- Indicators of Fragility in States Susceptible to Terrorist Attacks

DTIC Science & Technology

2018-03-01

by the people ” (Fund for Peace, 2014). Conversely, higher values designate a fractious political class unable to overcome the discords of a society ... society and free expression and advocacy” (Fund for Peace, 2014, p. 7). In contrast, high values indicate a high level of group grievance, which leads to...accepted government that fails to represent the entire citizenry. Political structures that are not rooted in the majority of the society , thus lacking

Tanker Fuel Consolidation: Impact of Fuel Efficiency on ATO Resiliency

DTIC Science & Technology

2011-06-01

states, “Unnecessary risk comes without a commensurate return in terms of real benefits or available opportunities…The most logical choices for... bingo fuel‟ and is not made available to receiver aircraft. Almost all tankers in the problem set had „extra‟ fuel remaining above bingo fuel after...transfer fuel above its bingo fuel, ensuring its ability to return to its departure airfield. The receiving tanker will only accept fuel up to a level of

POP levels in blue crab (Callinectes sapidus) and edible fish from the eastern Mediterranean coast.

PubMed

Tekin, Serkan; Pazi, Idil

2017-01-01

Organochlorinated pesticides and Aroclors were measured in the muscle of two edible fish species (gray mullet, sea bream) and blue crab, collected from eastern Mediterranean coast in 2013. The concentration of organochlorinated pesticides (OCPs) and Aroclors in biota samples which were collected at six sites ranged from 1.0-8.6 and 9-47.5 ng g -1 wet weight, respectively. Total DDT concentrations in seafood samples were compared to tolerance level established by the US Food and Drug Administration (FDA); the concentrations were detected below the tolerence level. Health risk assessment was conducted related to the consumption of chemically contaminated seafood. The estimated daily intake of OCPs calculated by using the estimated daily fish consumption in Turkey was far below the acceptable daily intake as established by FAO/WHO. Our data indicated that consumption of blue crab, gray mullet, and sea bream collected from the Mediterranean coast of Turkey could pose "no risk" for human health in terms of OCPs.

Characterization of Evidence for Human System Risk Assessment

NASA Technical Reports Server (NTRS)

Steinberg, S. L.; Van Baalen, M.; Rossi, M.; Riccio, G.; Romero, E.; Francisco, D.

2016-01-01

Understanding the kinds of evidence available and using the best evidence to answer a question is critical to evidenced-based decision-making, and it requires synthesis of evidence from a variety of sources. Categorization of human system risks in spaceflight, in particular, focuses on how well the integration and interpretation of all available evidence informs the risk statement that describes the relationship between spaceflight hazards and an outcome of interest. A mature understanding and categorization of these risks requires: 1) sufficient characterization of risk, 2) sufficient knowledge to determine an acceptable level of risk (i.e., a standard), 3) development of mitigations to meet the acceptable level of risk, and 4) identification of factors affecting generalizability of the evidence to different design reference missions. In the medical research community, evidence is often ranked by increasing confidence in findings gleaned from observational and experimental research (e.g., "levels of evidence"). However, an approach based solely on aspects of experimental design is problematic in assessing human system risks for spaceflight. For spaceflight, the unique challenges and opportunities include: (1) The independent variables in most evidence are the hazards of spaceflight, such as space radiation or low gravity, which cannot be entirely duplicated in terrestrial (Earth-based) analogs, (2) Evidence is drawn from multiple sources including medical and mission operations, Lifetime Surveillance of Astronaut Health (LSAH), spaceflight research (LSDA), and relevant environmental & terrestrial databases, (3) Risk metrics based primarily on LSAH data are typically derived from available prevalence or incidence data, which may limit rigorous interpretation, (4) The timeframe for obtaining adequate spaceflight sample size (n) is very long, given the small population, (5) Randomized controlled trials are unattainable in spaceflight, (6) Collection of personal and environmental data on the astronaut population may create opportunities for advanced analytics and human-environment modeling that goes beyond that achieved in isolated experimental designs; and (7) Translation of relevant research to operations is a complex, transdisciplinary enterprise in which the approach must apply across the physical, biological, behavioral, and social sciences. The approach to synthesizing evidence must address both source and fidelity of data, and reflect the most general attributes of quality of evidence in science and engineering: reliability and validity. The authors are developing a two-factor approach which includes the various kinds of evidence required to understand risks and for the integrated interpretation of all evidence that is essential to develop standards and countermeasures. A unified framework for aggregating and assessing different kinds of evidence provides a consistent, traceable, evidence-based decision-making process to translate research to operations in an environment where engineers, scientists, physicians, and managers all engage in analyzing the trade space of vehicle design, standards, requirements and solutions for spaceflight.

Regional earthquake loss estimation in the Autonomous Province of Bolzano - South Tyrol (Italy)

NASA Astrophysics Data System (ADS)

Huttenlau, Matthias; Winter, Benjamin

2013-04-01

Beside storm events geophysical events cause a majority of natural hazard losses on a global scale. However, in alpine regions with a moderate earthquake risk potential like in the study area and thereupon connected consequences on the collective memory this source of risk is often neglected in contrast to gravitational and hydrological hazards processes. In this context, the comparative analysis of potential disasters and emergencies on a national level in Switzerland (Katarisk study) has shown that earthquakes are the most serious source of risk in general. In order to estimate the potential losses of earthquake events for different return periods and loss dimensions of extreme events the following study was conducted in the Autonomous Province of Bolzano - South Tyrol (Italy). The applied methodology follows the generally accepted risk concept based on the risk components hazard, elements at risk and vulnerability, whereby risk is not defined holistically (direct, indirect, tangible and intangible) but with the risk category losses on buildings and inventory as a general risk proxy. The hazard analysis is based on a regional macroseismic scenario approach. Thereby, the settlement centre of each community (116 communities) is defined as potential epicentre. For each epicentre four different epicentral scenarios (return periods of 98, 475, 975 and 2475 years) are calculated based on the simple but approved and generally accepted attenuation law according to Sponheuer (1960). The relevant input parameters to calculate the epicentral scenarios are (i) the macroseismic intensity and (ii) the focal depth. The considered macroseismic intensities are based on a probabilistic seismic hazard analysis (PSHA) of the Italian earthquake catalogue on a community level (Dipartimento della Protezione Civile). The relevant focal depth are considered as a mean within a defined buffer of the focal depths of the harmonized earthquake catalogues of Italy and Switzerland as well as earthquake data of the US Geological Survey (USGS). The asset database to identify the elements at risk is developed under consideration of an address dataset, the land-use plan, official building footprints, building heights based on a normalized digital surface model, official construction costs for different building types (buildings cross cubatures), official statistical data concerning households on community level and insurance data based mean inventory values. To analyse the structural vulnerability and consequently the potential structural losses, community specific mean damage ratios based on the EMS-98 approach and the historic development of the building stock within the individual communities are estimated. Inventory losses are assumed with 30 percent of the structural losses. Thus, for each epicentre a loss-frequency-relationship can be calculated and the most severe epicentral scenarios can be identified.

Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach

PubMed Central

Huang, Marilyn; Sun, Charlotte; Boyd-Rogers, Stephanie; Burzawa, Jennifer; Milbourne, Andrea; Keeler, Elizabeth; Yzquierdo, Rebecca; Lynch, Patrick; Peterson, Susan K.; Lu, Karen

2011-01-01

Background: Endometrial and colorectal cancers are the most common cancers in Lynch syndrome. Consensus guidelines recommend annual endometrial biopsy (EMB) and regular colonoscopies. We assessed the feasibility of concurrently performing EMB and colonoscopy and evaluated women's perception of pain, satisfaction, and acceptability. Methods: From July 2002 to December 2009, women who had a gene mutation for Lynch syndrome, met the Amsterdam II criteria, or had a high-risk situation that required screening were prospectively enrolled. After conscious sedation, the procedures were sequentially performed. Patients completed pre- and postprocedure questionnaires assessing pain, level of satisfaction, and acceptability. The Wilcoxon rank test and Mann-Whitney test were used to compare pain scores. Results: Forty-two women completed the study. Median age was 37 years (range, 25 to 73). Nineteen had previously had an EMB in the office setting. Women reported significantly lower median levels of pain in the combined procedure compared with previous office setting biopsies (P < .001). Regardless of parity, women reported significantly less pain for an EMB as part of the combined screen compared with an office EMB (parous, P = .003; nulliparous, P = .026). Women also reported a high level of satisfaction and more convenience in the combined procedure. All participants preferred combined to separately scheduled procedures and would recommend the combined procedure to their relatives. Conclusion: Combined colon and endometrial cancer screening is a patient-centered approach that is feasible, acceptable, and may improve adherence to Lynch syndrome screening recommendations. PMID:21532810

Does health status influence acceptance of illness in patients with chronic respiratory diseases?

PubMed

Kurpas, D; Mroczek, B; Brodowski, J; Urban, M; Nitsch-Osuch, A

2015-01-01

The level of illness acceptance correlates positively with compliance to the doctor's recommendations, and negatively with the frequency and intensity of complications of chronic diseases. The purpose of this study was to determine the influence of the clinical condition on the level of illness acceptance, and to find variables which would have the most profound effect on the level of illness acceptance in patients with chronic respiratory diseases. The study group consisted of 594 adult patients (mean age: 60 ± 15 years) with mixed chronic respiratory diseases, recruited from patients of 136 general practitioners. The average score in the Acceptance of Illness Scale was 26.2 ± 7.6. The low level of illness acceptance was noted in 174 (62.6 %) and high in 46 (16.6 %) patients. Analysis of multiple regressions was used to examine the influence of explanatory variables on the level of illness acceptance. The variables which shaped the level of illness acceptance in our patients included: improvement of health, intensity of symptoms, age, marital status, education level, place of residence, BMI, and the number of chronic diseases. All above mentioned variables should be considered during a design of prevention programs for patients with mixed chronic respiratory diseases.

Subarachnoid haemorrhage guidelines and clinical practice: a cross-sectional study of emergency department consultants' and neurospecialists' views and risk tolerances.

PubMed

Lansley, J; Selai, C; Krishnan, A S; Lobotesis, K; Jäger, H R

2016-09-15

To establish if emergency medicine and neuroscience specialist consultants have different risk tolerances for investigation of suspected spontaneous subarachnoid haemorrhage (SAH), and to establish if their risk-benefit appraisals concur with current guidelines. 4 major neuroscience centres in London. 58 consultants in emergency medicine and neuroscience specialities (neurology, neurosurgery and neuroradiology) participated in an anonymous survey. The primary outcome measure was the highest stated acceptable risk of missing SAH in the neurologically intact patient presenting with sudden onset headache. Secondary outcome measures included agreement with guideline recommendations, risk/benefit appraisal and required performance of diagnostic tests, including lumbar puncture. Emergency department clinicians accepted almost 3 times the risk of a missed SAH diagnosis compared with the neuroscience specialists (2.8% vs 1.1%; p=0.02), were more likely to accept a higher risk of missed diagnosis for the benefit of a non-invasive test (p=0.04) and were more likely to disagree with current published guidelines stipulating the need for LP in all CT-negative cases (p=0.001). Divergence from recognised procedures for SAH investigation is often criticised and attributed to a lack of knowledge of guidelines. This study indicates that divergence from guidelines may be explained by alternative risk-benefit appraisals made by doctors with their patients. Guideline recommendations may gain wider acceptance if they accommodate the requirements of the doctors and patients using them. Further study of clinical risk tolerance may help explain patterns of diagnostic test use and other variations in healthcare delivery. 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/

Risk of diarrhoea from shallow groundwater contaminated with enteropathogens in the Kathmandu Valley, Nepal.

PubMed

Shrestha, Sadhana; Haramoto, Eiji; Malla, Rabin; Nishida, Kei

2015-03-01

Shallow groundwater is the main water source among many alternatives in the Kathmandu Valley, Nepal, which has a rapidly growing population and intermittent piped water supply. Although human pathogens are detected in groundwater, its health effects are unclear. We estimated risk of diarrhoea from shallow groundwater use using quantitative microbial risk assessment. Escherichia coli, Giardia cyst and Cryptosporidium oocyst levels were analysed in dug and tube wells samples. E. coli concentrations were converted to those of enteropathogenic E. coli (EPEC). Risks from EPEC in dug wells and from Cryptosporidium and Giardia in both dug and tube wells were higher than the acceptable limit (<10⁻⁴ infections/person-year) for both drinking and bathing exposures. Risk from protozoan enteropathogens increased the total risk 10,000 times, indicating that ignoring protozoans could lead to serious risk underestimation. Bathing exposure considerably increased risk, indicating that it is an important pathway. Point-of-use (POU) water treatment decreased the risk six-fold and decreased risk overestimation. Because removal efficiency of POU water treatment has the largest impact on total risk, increasing the coverage and efficiency of POU water treatment could be a practical risk management strategy in the Kathmandu Valley and similar settings.

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…

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.

Risk assessment for pesticides' MRL non-compliances in Poland in the years 2011-2015.

PubMed

Struciński, Paweł; Ludwicki, Jan K; Góralczyk, Katarzyna; Czaja, Katarzyna; Hernik, Agnieszka; Liszewska, Monika

2015-01-01

Human exposure to trace levels of pesticide residues present in food of plant origin is inevitable as long as pesticides continue to be applied in agriculture. Since Maximum Residue Levels (MRL) are not toxicological endpoint values, their violation is not by default equivalent to health risk for consumers. However, its essential to provide a health- based risk assessment for each case of MRL non-compliance reported during monitoring and official control of foodstuffs. To assess the potential short-term risk associated with consumption of food products of plant origin containing pesticide residues above MRL values based on notifications forwarded by the National Contact Point for RASFF in Poland during 2011-2015. 115 notifications including 127 analytical results non-compliant with respective MRL values were forwarded to provide risk assessment. An internationally accepted deterministic approach based on conservative model assumptions for short-term exposure assessment was applied. The risk was characterized by comparing an estimated dietary intake with respective acute reference dose (ARfD). Black currant, tea, lettuce, Chinese cabbage and carrot were among the most frequently notified products in years 2011-2015. Among pesticides exceeding respective MRL values, over 90% belonged to fungicides and insecticides/acaricides such as acetamiprid, chlorpyrifos, dimethoate, imidacloprid, dithiocarbamates and procymidone. For 15 and 6 results noncompliant with respective MRL value, a predicted short-term intake exceeded ARfD for children and adults, respectively. Residue levels that could potentially pose a health threat are found incidentally. The science-based and transparent risk assessment process with regard to the data, methods and assumptions that are applied is essential to risk management authorities. risk assessment, pesticide residues, MRL, dietary intake, RASFF, food safety.

Are gastroenterologists less tolerant of treatment risks than patients? Benefit-risk preferences in Crohn's disease management.

PubMed

Johnson, F Reed; Hauber, Brett; Özdemir, Semra; Siegel, Corey A; Hass, Steven; Sands, Bruce E

2010-10-01

Crohn's disease is a serious and debilitating gastrointestinal disorder with a high, unmet need for new treatments. Biologic agents have the potential to alter the natural course of Crohn's disease but present known risks of potential serious adverse events (SAEs). Previous studies have shown that patients are willing to accept elevated SAE risks in exchange for clinical efficacy. Gastroenterologists and patients may have similar goals of maximizing treatment benefit while minimizing risk; however, gastroenterologists may assess the relative importance of risk differently than patients. To (a) understand how gastroenterologists caring for patients with Crohn's disease balance benefits and risks in their treatment decisions and (b) compare their treatment preferences with those of adult patients with Crohn's disease. Both patient and gastroenterologist treatment preferences were elicited using a web-based, choice-format conjoint survey instrument. The conjoint questions required subjects to choose between 2 hypothetical treatment options with differing levels of treatment attributes. Patients evaluated the treatment options for themselves, and gastroenterologists evaluated the treatment options for each of 3 hypothetical patient types: (a) female aged 25 years with no history of Crohn's disease surgery (young), (b) male aged 45 years with 1 Crohn's disease surgery (middleaged), and (c) female older than 70 years with 4 Crohn's disease surgeries (older). Treatment attributes represented the expected outcomes of treatment: severity of daily symptoms, frequency of flare-ups, serious disease complications, oral steroid use, and the risks of 3 potentially fatal SAEs - lymphoma, serious or opportunistic infections, and progressive multifocal leukoencephalopathy (PML) - during 10 years of treatment. Maximum acceptable risk (MAR), defined as the highest level of SAE risk that subjects would accept in return for a given improvement in efficacy (i.e., the increase in treatment risk that exactly offsets the hypothetical increase in treatment benefit), was calculated using preference weights (parameter marginal log odds ratios) that were estimated with conjoint analysis (random parameters logit models). Gastroenterologists' and patients' mean MARs for 3 SAE risks were calculated for 6 improvements in Crohn's disease symptoms, and gastroenterologists' preference weights for each of the 3 patient profiles were compared. Gastroenterologists' MARs for a hypothetical middle-aged patient were then compared with predicted MARs derived using data from the patient study for male patients aged 40 to 50 years with 1 surgery. After exclusion of nonrespondents (n = 4,021 of 4,422 gastroenterologists; n = 681 of 1,285 patients) and nonevaluable respondents (n = 86 gastroenterologists; n = 24 patients), 315 gastroenterologists and 580 patients were included in the final analytic samples. There were no statistically significant differences in gastroenterologists' preference weights for the middle-aged versus young patient profiles. However, preference weights indicated that gastroenterologists are more concerned about 5% side-effect risks for the older patient profile than for the middle-aged patient profile. For symptomatic improvements from severe symptoms to remission, gastroenterologists' highest MARs were for lymphoma: 6.21%, 8.99%, and 25.00% for the young, middle-aged, and older patient types, respectively. In analyses of improvements from severe to moderate symptoms and from moderate symptoms to remission for hypothetical middle-aged patients, gastroenterologists' 10-year risk tolerance ranged between 1.96% lymphoma risk in return for an improvement from moderate symptoms to remission and 4.93% lymphoma risk for an improvement from severe to moderate symptoms; patients' 10-year risk tolerance for middle-aged patients ranged between 1.52% PML risk in return for an improvement from severe to moderate symptoms and 5.86% infection risk for an improvement from moderate symptoms to remission. On average, gastroenterologists and patients disagreed about how much risk is tolerable for improvements in efficacy. In exchange for improvements from severe to moderate symptoms for the middle-aged patient profile, gastroenterologists were significantly more tolerant than patients of treatment risks of PML (P < 0.001) and serious infection (P = 0.001) but not lymphoma (P = 0.230). In contrast, in exchange for improvements from moderate symptoms to remission for the same patient profile, patients were significantly more tolerant than gastroenterologists of treatment risks for serious infection (P < 0.001) and lymphoma (P < 0.001) but not PML (P = 0.158). Gastroenterologists and patients have well-defined preferences among treatment attributes and are willing to accept tradeoffs between efficacy and treatment risks. However, risk tolerance varies depending on the type of patient for whom gastroenterologists are being asked to consider treatment. In rating treatment preferences for patients with a middle-aged profile, gastroenterologists are less tolerant of SAE risks than patients in exchange for improvement from moderate symptoms to remission.

The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

PubMed Central

Riedl, David; Rumpold, Gerhard; Schmidt, Annette; Zorowka, Patrick G.; Bliem, Harald R.; Moschen, Roland

2015-01-01

Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL) and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97). Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC) curves were used to calculate a cutoff score for the German “Tinnitus Acceptance Questionnaire” (CTAQ-G) and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with “low-to-mild tinnitus acceptance” and “moderate-to-high tinnitus acceptance.” Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress. PMID:26356381