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  1. Other High-Risk Factors for Young Drivers--How Graduated Licensing Does, Doesn't, or Could Address Them.

    ERIC Educational Resources Information Center

    Ferguson, Susan A.

    2003-01-01

    Examines the risk factors underlying the high crash rates of newly licensed drivers and assesses the extent to which existing graduated driver-licensing programs address these risks. Discusses such risks as driver fatigue, not using seat belts, high speeds, high-powered vehicles, and in-vehicle distractions. (Contains 66 references.) (AUTHOR/WFA)

  2. WISEWOMAN: addressing the needs of women at high risk for cardiovascular disease.

    PubMed

    Vaid, Isam; Wigington, Charles; Borbely, Deborah; Ferry, Patricia; Manheim, Diane

    2011-07-01

    In the United States, the cardiovascular health of women is affected by the disparate impact of cardiovascular diseases (CVDs) on many minority ethnic and racial groups. Women with low income also endure a disproportionate impact of the burden of CVD. The Centers for Disease Control and Prevention's (CDC's) Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Program was authorized by Congress in 1993 to extend the preventive health services offered to participants of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). These are low-income, uninsured, and underinsured women. The intent was to expand services of an existing federal program to address cardiovascular health concerns in this vulnerable, high-risk population. CDC funds 19 state health departments and 2 tribal organizations (both in Alaska) to implement WISEWOMAN. In the first 2 years of the current 5-year funding cycle, which began in June 2008, the WISEWOMAN grantees succeeded in providing almost 78,000 screenings, of which 46% were to women of minority racial and ethnic groups. The individual successes are important, and the WISEWOMAN Program also has achieved success in the broader arenas of healthcare and the communities in which WISEWOMAN is implemented. WISEWOMAN impacts clinical systems of care, provider education, physician extenders, and the broader community and will continue to play an important role in connecting low-income, uninsured, and underinsured women with clinical systems of care and other community resources that will result in the prevention, treatment, and management of their CVD risk.

  3. Addressing hidden financial risk.

    PubMed

    Kruger, Jan; Kruger, Jan

    2014-02-01

    Managing low-dollar, high-volume claim denials associated with outpatient procedures is a challenge for many hospitals because of the expense involved in manually reviewing such denials. These denials often are the source of "hidden loss" for hospitals. For some hospitals, the most practical, cost-effective approach for managing low-dollar, high-volume claim denials will include the use of automated systems to monitor and highlight denials and expose trends.

  4. Addressing career barriers for high risk adolescent girls: the PATHS curriculum intervention.

    PubMed

    Doren, Bonnie; Lombardi, Allison R; Clark, Julie; Lindstrom, Lauren

    2013-12-01

    The study evaluated a gender-specific comprehensive career development curriculum designed to target career barriers faced by high risk adolescent girls - those with disabilities and at risk for school failure. The goal of the curriculum was to promote social cognitive career and self determination outcomes associated with adaptive career development and adjustment. A pre-post control group design was used to evaluate the curriculum. Findings suggest that participation in the curriculum resulted in significant and large gains in autonomy and in disability and gender-related knowledge. Meaningful gains were noted in perceptions of social support and relevance of school. Participants in a high fidelity sample made significant and large gains in vocational skills self-efficacy and disability and gender-related knowledge. Meaningful improvements were noted in self-advocacy, autonomy, and vocational outcome expectations. The findings suggest that the curriculum can improve important indicators of positive career development and adjustment in high risk adolescent girls.

  5. Addressing the Health Needs of High-Risk Filipino Americans in the Greater Philadelphia Region.

    PubMed

    Bhimla, Aisha; Yap, Lauren; Lee, Minsun; Seals, Brenda; Aczon, Hermie; Ma, Grace X

    2017-04-01

    Filipino Americans represent one of the largest and most diverse immigrant populations in the United States. It has been established that chronic diseases are a significant public health issue affecting this population. We conducted a health needs assessment of 200 Filipino Americans aged 18 years or older residing in the greater Philadelphia region. Study participants were recruited from eight Filipino community-based organizations in the region. Information about demographic and acculturative characteristics, health behaviors, self-reported chronic health conditions, and chronic disease perception were collected. Participants were older and highly acculturated. With regards to health behaviors, several did not meet dietary fruit and vegetables intake and physical activity guidelines. The top five health conditions were high blood pressure (67.5 %), high blood cholesterol (57.1 %), arthritis (28.9 %), diabetes (21.8 %), and cancer (14.7 %). Majority of participants perceived high blood pressure, high blood cholesterol, and diabetes to be a concern in their community, and had high awareness of the risk factors associated with these diseases. Reported rates of hypertension, high cholesterol, and diabetes suggest that lifestyle interventions targeting diet and physical activity, in addition to health education, are needed in this population.

  6. Whole Neuraxis Irradiation to Address Central Nervous System Relapse in High-Risk Neuroblastoma

    SciTech Connect

    Croog, Victoria J.; Kramer, Kim; Cheung, Nai-Kong V.; Kushner, Brian H.; Modak, Shakeel; Souweidane, Mark M.; Wolden, Suzanne L.

    2010-11-01

    Background: As systemic control of high-risk neuroblastoma (NB) has improved, relapse in the central nervous system (CNS) is an increasingly recognized entity that carries a grim prognosis. This study describes the use of craniospinal irradiation (CSI) for CNS relapse and compares outcomes to patients who received focal radiotherapy (RT). Methods: A retrospective query identified 29 children with NB treated at Memorial Sloan-Kettering Cancer Center since 1987 who received RT for CNS relapse. At CNS relapse, 16 patients received CSI (median dose, 2160cGy), and 13 received focal RT. Of those who underwent CSI, 14 (88%) received intra-Ommaya (IO) radioimmunotherapy (RIT); one patient in the non-CSI cohort received IO-RIT. Results: Patient characteristics were similar between the groups. Time to CNS relapse was 20 and 17 months for the CSI and non-CSI cohorts, respectively. At a median follow-up of 28 months, 12 patients (75%) in the CSI group are alive without CNS disease, including two patients with isolated skeletal relapse. Another patient is alive without disease after a brain relapse was retreated with RT. Three patients died-one with no NB at autopsy, one of CNS disease, and one of systemic disease. The two patients who died of NB did not receive IO-RIT. All 13 patients in the non-CSI cohort died at a median of 8.8 months. Conclusions: Low-dose CSI together with IO-RIT provides durable CNS remissions and improved survival compared with focal RT and conventional therapies. Further evaluation of long-term NB survivors after CSI is warranted to determine the treatment consequences for this cohort.

  7. Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

    ERIC Educational Resources Information Center

    Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

    2013-01-01

    Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

  8. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

    PubMed Central

    2011-01-01

    Background Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s). Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. Methods The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. Discussion This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Trial registration Current Controlled Trials ISRCTN16131117 PMID:22017924

  9. Addressing Risks to Advance Mental Health Research

    PubMed Central

    Iltis, Ana S.; Misra, Sahana; Dunn, Laura B.; Brown, Gregory K.; Campbell, Amy; Earll, Sarah A.; Glowinski, Anne; Hadley, Whitney B.; Pies, Ronald; DuBois, James M.

    2015-01-01

    Objective Risk communication and management are essential to the ethical conduct of research, yet addressing risks may be time consuming for investigators and institutional review boards (IRBs) may reject study designs that appear too risky. This can discourage needed research, particularly in higher risk protocols or those enrolling potentially vulnerable individuals, such as those with some level of suicidality. Improved mechanisms for addressing research risks may facilitate much needed psychiatric research. This article provides mental health researchers with practical approaches to: 1) identify and define various intrinsic research risks; 2) communicate these risks to others (e.g., potential participants, regulatory bodies, society); 3) manage these risks during the course of a study; and 4) justify the risks. Methods As part of a National Institute of Mental Health (NIMH)-funded scientific meeting series, a public conference and a closed-session expert panel meeting were held on managing and disclosing risks in mental health clinical trials. The expert panel reviewed the literature with a focus on empirical studies and developed recommendations for best practices and further research on managing and disclosing risks in mental health clinical trials. IRB review was not required because there were no human subjects. The NIMH played no role in developing or reviewing the manuscript. Results Challenges, current data, practical strategies, and topics for future research are addressed for each of four key areas pertaining to management and disclosure of risks in clinical trials: identifying and defining risks, communicating risks, managing risks during studies, and justifying research risks. Conclusions Empirical data on risk communication, managing risks, and the benefits of research can support the ethical conduct of mental health research and may help investigators better conceptualize and confront risks and to gain IRB approval. PMID:24173618

  10. Global epigenetic screening technologies: a novel tool to address cancer health disparities in high-risk population groups.

    PubMed

    Guerrero-Preston, Rafael

    2008-12-01

    Racial, ethnic and class disparities in cancer incidence and mortality have been well documented. Disparities in the utilization of preventive, curative and treatment services among ethnic minorities have been reported. Screening can be effective at detecting cancer at treatable stages, but a large proportion of people at risk have not been screened or are not regularly screened, as recommended by the American Cancer Society's national guidelines. Early detection technologies have the potential of both influencing mortality from cancer, as well as enhancing primary prevention through detection and removal of lesions that could potentially develop into cancer. Cancer is an epigenetic disease characterized by the breakdown of DNA methylation and histones modification patterns. Epigenetic approaches may contribute to a reduction in cancer health disparities impacting early detection and increasing cancer treatment options. Epigenetic events represent important mechanism(s) by which gene function is selectively activated or inactivated, through genetic and non-genetic manifestations. Emerging evidence indicates that various epigenetic alterations, such as global histones modifications and DNA hypomethylation, common to most types of cancer, are modified by environmental exposures throughout the life course. A simple, easily explained and easy to understand non-invasive test, such as the DNA methylation index, that may screen for several cancer sites at once, may remove some of the existing barriers to cancer screening utilization, and contribute to the reduction of cancer disparities. Epigenetic approaches may also prove to be useful in identifying environmental and lifestyle factors that contribute to the prevalence of other chronic conditions in high risk populations, such as Puerto Rican populations in the United States and Puerto Rico.

  11. Data Safety Monitoring Boards and Other Study Methodologies that Address Subject Safety in "High-Risk" Therapeutic Trials in Youths

    ERIC Educational Resources Information Center

    Carandang, Carlo; Santor, Darcy; Gardner, David M.; Carrey, Normand; Kutcher, Stan

    2007-01-01

    The underlying proposition for any experimental/therapeutic trial is the uncertainty that the risks of treatment will be outweighed by its benefits. For some therapeutic interventions (e.g., exercise programs, vitamin supplementation), the potential for treatment-emergent adverse events may prima facie be low or negligible, whereas for others…

  12. Native Women at Risk: Addressing Cancer Prevention.

    ERIC Educational Resources Information Center

    Thiemann, Kay M. B.

    1994-01-01

    Discusses outcomes of a conference that brought together representatives from Indian tribes, state health departments, the Indian Health Service, the Mayo Clinic, and the American Cancer Society, to address the high rate of cervical cancer among American Indian women. Describes barriers to health care and plans to promote cancer screening among…

  13. Microplastics: addressing ecological risk through lessons learned.

    PubMed

    Syberg, Kristian; Khan, Farhan R; Selck, Henriette; Palmqvist, Annemette; Banta, Gary T; Daley, Jennifer; Sano, Larissa; Duhaime, Melissa B

    2015-05-01

    Plastic litter is an environmental problem of great concern. Despite the magnitude of the plastic pollution in our water bodies, only limited scientific understanding is available about the risk to the environment, particularly for microplastics. The apparent magnitude of the problem calls for quickly developing sound scientific guidance on the ecological risks of microplastics. The authors suggest that future research into microplastics risks should be guided by lessons learned from the more advanced and better understood areas of (eco) toxicology of engineered nanoparticles and mixture toxicity. Relevant examples of advances in these two fields are provided to help accelerate the scientific learning curve within the relatively unexplored area of microplastics risk assessment. Finally, the authors advocate an expansion of the "vector effect" hypothesis with regard to microplastics risk to help focus research of microplastics environmental risk at different levels of biological and environmental organization.

  14. Hydrocomplexity: Addressing water security and emergent environmental risks

    NASA Astrophysics Data System (ADS)

    Kumar, Praveen

    2015-07-01

    Water security and emergent environmental risks are among the most significant societal concerns. They are highly interlinked to other global risks such as those related to climate, human health, food, human migration, biodiversity loss, urban sustainability, etc. Emergent risks result from the confluence of unanticipated interactions from evolving interdependencies between complex systems, such as those embedded in the water cycle. They are associated with the novelty of dynamical possibilities that have significant potential consequences to human and ecological systems, and not with probabilities based on historical precedence. To ensure water security we need to be able to anticipate the likelihood of risk possibilities as they present the prospect of the most impact through cascade of vulnerabilities. They arise due to a confluence of nonstationary drivers that include growing population, climate change, demographic shifts, urban growth, and economic expansion, among others, which create novel interdependencies leading to a potential of cascading network effects. Hydrocomplexity aims to address water security and emergent risks through the development of science, methods, and practices with the potential to foster a "Blue Revolution" akin to the Green revolution for food security. It blends both hard infrastructure based solution with soft knowledge driven solutions to increase the range of planning and design, management, mitigation and adaptation strategies. It provides a conceptual and synthetic framework to enable us to integrate discovery science and engineering, observational and information science, computational and communication systems, and social and institutional approaches to address consequential water and environmental challenges.

  15. Addressing software security risk mitigations in the life cycle

    NASA Technical Reports Server (NTRS)

    Gilliam, David; Powell, John; Haugh, Eric; Bishop, Matt

    2003-01-01

    The NASA Office of Safety and Mission Assurance (OSMA) has funded the Jet Propulsion Laboratory (JPL) with a Center Initiative, 'Reducing Software Security Risk through an Integrated Approach' (RSSR), to address this need. The Initiative is a formal approach to addressing software security in the life cycle through the instantiation of a Software Security Assessment Instrument (SSAI) for the development and maintenance life cycles.

  16. Final results of a multicenter trial addressing role of CSF flow cytometric analysis in NHL patients at high risk for CNS dissemination.

    PubMed

    Benevolo, Giulia; Stacchini, Alessandra; Spina, Michele; Ferreri, Andrés J M; Arras, Marcella; Bellio, Laura; Botto, Barbara; Bulian, Pietro; Cantonetti, Maria; Depaoli, Lorella; Di Renzo, Nicola; Di Rocco, Alice; Evangelista, Andrea; Franceschetti, Silvia; Godio, Laura; Mannelli, Francesco; Pavone, Vincenzo; Pioltelli, Pietro; Vitolo, Umberto; Pogliani, Enrico M

    2012-10-18

    This prospective study compared diagnostic and prognostic value of conventional cytologic (CC) examination and flow cytometry (FCM) of baseline samples of cerebrospinal fluid (CSF) in 174 patients with newly diagnosed aggressive non-Hodgkin lymphoma (NHL). FCM detected a neoplastic population in the CSF of 18 of 174 patients (10%), CC only in 7 (4%; P < .001); 11 patients (14%) were discordant (FCM(+)/CC(-)). At a median follow-up of 46 months, there were 64 systemic progressions and 10 CNS relapses, including 2 patients with both systemic and CNS relapses. Two-year progression-free and overall survival were significantly higher in patients with FCM(-) CSF (62% and 72%) compared with those FCM(+) CSF (39% and 50%, respectively), with a 2-year CNS relapse cumulative incidence of 3% (95% confidence interval [CI], 0-7) versus 17% (95% CI, 0-34; P = .004), respectively. The risk of CNS progression was significantly higher in FMC(+)/CC(-) versus FCM(-)/CC(-) patients (hazard ratio = 8.16, 95% CI, 1.45-46). In conclusion, FCM positivity in the CSF of patients with high-risk NHL is associated with a significantly higher CNS relapse risk and poorer outcome. The combination of IV drugs with a higher CNS bioavailability and intrathecal chemotherapy is advisable to prevent CNS relapses in FCM(+) patients.

  17. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    SciTech Connect

    Schenberg, Tess; Mitchell, Gillian; Taylor, Donna; Saunders, Christobel

    2015-09-15

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

  18. Air toxics risk standards: are we addressing the real problems?

    SciTech Connect

    Laurie Miller; Richard Becker; Ted Cromwell

    2005-06-01

    Cost-effective risk reductions from major stationary emission sources have seen significant progress. EPA and state data demonstrate that their programs have dramatically reduced emissions and risk from these sources. Analyses indicate that the next generation of risk reductions for stationary sources will be provide little risk reduction, but will be much more costly and more challenging from a policy perspective. Facing these tough choices, EPA and state regulators should, with stakeholder input, be developing scientifically driven and cost-effective approaches to provide the public with honest answers and results. Air toxics risk policies and programs must prioritize and address significant remaining air toxics risks, educate and communicate to the public about the decision alternatives, build support for a holistic approach and openly communicate results. 6 refs.

  19. Climate change risk perception and communication: addressing a critical moment?

    PubMed

    Pidgeon, Nick

    2012-06-01

    Climate change is an increasingly salient issue for societies and policy-makers worldwide. It now raises fundamental interdisciplinary issues of risk and uncertainty analysis and communication. The growing scientific consensus over the anthropogenic causes of climate change appears to sit at odds with the increasing use of risk discourses in policy: for example, to aid in climate adaptation decision making. All of this points to a need for a fundamental revision of our conceptualization of what it is to do climate risk communication. This Special Collection comprises seven papers stimulated by a workshop on "Climate Risk Perceptions and Communication" held at Cumberland Lodge Windsor in 2010. Topics addressed include climate uncertainties, images and the media, communication and public engagement, uncertainty transfer in climate communication, the role of emotions, localization of hazard impacts, and longitudinal analyses of climate perceptions. Climate change risk perceptions and communication work is critical for future climate policy and decisions.

  20. Addressing Human System Risks to Future Space Exploration

    NASA Technical Reports Server (NTRS)

    Paloski, W. H.; Francisco, D. R.; Davis, J. R.

    2015-01-01

    assessed the likelihood and consequences of each risk against each DRM, using three levels of likelihood (Low: less than or equal to 0.1%; Medium: 0.1%–1.0%; High: greater than or equal to 1.0%) and four levels of consequence ranging from Very Low (temporary or insignificant) to High (death, loss of mission, or significant reduction to length or quality of life). Quantitative evidence from clinical, operational, and research sources were used whenever available. Qualitative evidence was used when quantitative evidence was unavailable. Expert opinion was used whenever insufficient evidence was available. Results: A set of 30 risks emerged that will require further mitigation efforts before being accepted by the Agency. The likelihood by consequence risk assessment process provided a means of prioritizing among the risks identified. For each of the high priority risks, a plan was developed to perform research, technology, or standards development thought necessary to provide suitable reduction of likelihood or consequence to allow agency acceptance. Conclusion: The HSRB process has successfully identified a complete set of risks to human space travelers on planned exploration missions based on the best evidence available today. Risk mitigation plans have been established for the highest priority risks. Each risk will be reassessed annually to track the progress of our risk mitigation efforts.

  1. Addressing Benefits, Risks and Consent in Next Generation Sequencing Studies

    PubMed Central

    Meller, R

    2016-01-01

    The sequencing of the human genome and technological advances in DNA sequencing have led to a revolution with respect to DNA sequencing and its potential to diagnose genetic disorders. However, requests for open access to genomic data must be balanced against the guiding principles of the Common Rule for human subject research. Unfortunately, the risks to patients involved in genomic studies are still evolving and as such may not be clear to learned and well-intentioned scientists. Central to this issue are the strategies that enable human participants in such studies to remain anonymous, or de-identified. The wealth of genomic data on the Internet in genomic data repositories and other databases has enabled de-identified data to be broken and research subjects to be identified. The security of de-identification neglects the fact that DNA itself is an identifying element. Therefore, it is questionable whether data security standards can ever truly protect the identity of a patient, under the current conditions or in the future. As Big Data methodologies advance, additional sources of data may enable the re-identification of patients enrolled in next-generation sequencing (NGS) studies. As such, it is time to re-evaluate the risks of sharing genomic data and establish new guidelines for good practices. In this commentary, I address the challenges facing federally funded investigators who need to strike a balance between compliance with federal (US) rules for human subjects and the recent requirement for open access/sharing of data from National Institute for Health (NIH)-funded studies involving human subjects. PMID:27375922

  2. Bridge to the Future. Addressing The Needs of Students At Risk during the High School Years. Technical Team Report. Submitted to the Commission for Students At Risk of School Failure.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This report analyzes practices and conditions that seek to prevent at-risk behaviors among adolescents. Discussion begins with a description of the developmental tasks that adolescents need to complete before they can assume productive adult roles in society. While two conflicting views of adolescence are noted, the capacity of young people to…

  3. An Overview. High Risk Series.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  4. How can ab initio simulations address risks in nanotech?

    PubMed

    Barnard, Amanda S

    2009-06-01

    Discussions of the potential risks and hazards associated with nanomaterials and nanoparticles tend to focus on the need for further experiments. However, theoretical and computational nanoscientists could also contribute by making their calculations more relevant to research into this area.

  5. Teachers' Risk Perception and Needs in Addressing Infectious Disease Outbreak

    ERIC Educational Resources Information Center

    Wong, Emmy M. Y.; Cheng, May M. H.; Lo, S.K.

    2010-01-01

    The outbreak of the Influenza A (H1N1) virus has led to numerous precautionary school closures in several countries. No research is available on the school teachers' perceptions as a health protective resource in controlling communicable disease outbreaks. The purposes of this study were to examine the risk perception, the perceived understanding…

  6. Addressing Risk in the Acquisition Lifecycle With Enterprise Simulation

    DTIC Science & Technology

    2012-04-30

    interactions ( Albino , Carbonara, & Giannoccaro, 2007). Organizational simulation seeks to model the behavior of people and firms in the context of...well as analysis of particular risks. References Albino , V., Carbonara, N., & Giannoccaro, I. (2007). Supply chain cooperation in industrial districts

  7. Traffic, air pollution, minority and socio-economic status: addressing inequities in exposure and risk.

    PubMed

    Pratt, Gregory C; Vadali, Monika L; Kvale, Dorian L; Ellickson, Kristie M

    2015-05-19

    Higher levels of nearby traffic increase exposure to air pollution and adversely affect health outcomes. Populations with lower socio-economic status (SES) are particularly vulnerable to stressors like air pollution. We investigated cumulative exposures and risks from traffic and from MNRiskS-modeled air pollution in multiple source categories across demographic groups. Exposures and risks, especially from on-road sources, were higher than the mean for minorities and low SES populations and lower than the mean for white and high SES populations. Owning multiple vehicles and driving alone were linked to lower household exposures and risks. Those not owning a vehicle and walking or using transit had higher household exposures and risks. These results confirm for our study location that populations on the lower end of the socio-economic spectrum and minorities are disproportionately exposed to traffic and air pollution and at higher risk for adverse health outcomes. A major source of disparities appears to be the transportation infrastructure. Those outside the urban core had lower risks but drove more, while those living nearer the urban core tended to drive less but had higher exposures and risks from on-road sources. We suggest policy considerations for addressing these inequities.

  8. Iudicium: An Educational Intervention for addressing Risk Perception of Alcohol Abuse in Adolescents.

    PubMed

    Bajac, Héctor; Feliu-Soler, Albert; Meerhoff, Diana; Latorre, Laura; Elices, Matilde

    2016-03-02

    Negative consequences of alcohol abuse during adolescence have been extensively described. Consequently, different interventions have been developed to address this issue. This article describes the implementation and evaluation of Iudicium, an educational drama-based intervention designed to increase risk perception of alcohol abuse. In this activity, high school students judge a case in which alcohol consumption had negative consequences (e.g., fights, unwanted pregnancy, and car accident). A trial is simulated and after that, a debriefing takes place during which the activity is discussed and informational materials on the effects of alcohol is provided and commented. A total of 318 students (55.7% females and 44.3% males) from five high schools participated in the study. Data regarding risk perception of alcohol abuse and adequacy of the activity was collected before and after the intervention. Results suggest that Iudicium was effective in increasing risk perception of abusive drinking, reaching a 34% of increase regarding risk perception. Participants highlighted the experiential component of Iudicium as a strength. The intervention was well-accepted, easy to understand and apparently an effective tool for increasing risk perception of alcohol abuse amongst high school students.

  9. Are health-based payments a feasible tool for addressing risk segmentation?

    PubMed

    Rogal, D L; Gauthier, A K

    1998-01-01

    As they attempt to increase health insurance coverage and improve the efficiency of the market, researchers, policymakers, and health plan representatives have been addressing the issue of risk segmentation. Many risk assessment tools and risk-adjusted payment methodologies have been developed and demonstrated for a variety of populations and payers experiencing various market constraints. The evidence shows that risk-adjusted payments are feasible for most populations receiving acute care, while technical obstacles, political issues, and some research gaps remain.

  10. [Detecting high risk pregnancy].

    PubMed

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  11. Achieving Success with More Students: Addressing the Problem of Students At Risk, K-12.

    ERIC Educational Resources Information Center

    Pennsylvania State Dept. of Education, Harrisburg.

    This resource book was developed to provide information that state and local leaders can use to stimulate discussion of the problem of students at risk and support the planning of initiatives that address the problem. An overview defines students at risk, summarizes the content of the book, and lists recent reports and publications on the problem…

  12. Addressing poverty as risk for disease: recommendations from CDC's consultation on microenterprise as HIV prevention.

    PubMed

    Stratford, Dale; Mizuno, Yuko; Williams, Kim; Courtenay-Quirk, Cari; O'leary, Ann

    2008-01-01

    In March 2006, the Centers for Disease Control and Prevention (CDC) convened a consultation meeting to explore microenterprise as a potential human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention intervention. The impulse to link microenterprise with HIV/AIDS prevention was driven by the fact that poverty is a significant factor contributing to the risk for infection. Because increasingly high rates of HIV infection are occurring among women, particularly among poor African American women in the southern United States, we focused the consultation on microenterprise as an intervention among that population. In the international arena, income generated by microenterprise has contributed to improving family and community health outcomes. This article summarizes the contributions made to the consultation by participants from the diverse fields of microenterprise, microfinance, women's studies, and public health. The article ends with recommendations for HIV/AIDS prevention and, by implication, addressing other public health challenges, through the development of multifaceted intervention approaches.

  13. Defense Acquisitions: CH-53K Helicopter Program has Addressed Early Difficulties and Adopted Strategies to Address Future Risks

    DTIC Science & Technology

    2011-04-01

    United States Government Accountability Office GAO Report to the Ranking Member, Subcommittee on Defense, Committee on...Appropriations, House of Representatives DEFENSE ACQUISITIONS CH-53K Helicopter Program Has Addressed Early Difficulties and Adopted Strategies to...S) AND ADDRESS(ES) U.S. Government Accountability Office,441 G Street NW,Washington,DC,20548 8. PERFORMING ORGANIZATION REPORT NUMBER 9

  14. Using risk management files to identify and address causative factors associated with adverse events in pediatrics

    PubMed Central

    Hain, Paul D; Pichert, James W; Hickson, Gerald B; Bledsoe, Sandra H; Hamming, David; Hathaway, Jacob; Nguyen, Carolyn

    2007-01-01

    We report a retrospective analysis of 84 consecutive pediatrics-related internal review files opened by a medical center’s risk managers between 1996 and 2001. The aims were to identify common causative factors associated with adverse events/adverse outcomes (AEs) in a Pediatrics Department, then suggest ways to improve care. The main outcome was identification of any patterns of factors that contributed to AEs so that interventions could be designed to address them. Cases were noted to have at least one apparent contributing problem; the most common were with communication (44% of cases), diagnosis and treatment (37%), medication errors (20%), and IV/Central line issues (17%). 45% of files involved a child with an underlying diagnosis putting her/him at high risk for an adverse outcome. All Pediatrics Departments face multiple challenges in assuring consistent quality care. The extent to which the data generalize to other institutions is unknown. However, the data suggest that systematic analysis of aggregated claims files may help identify and drive opportunities for improvement in care. PMID:18472985

  15. 76 FR 14413 - Risk Mitigation Strategies To Address Potential Procoagulant Activity in Immune Globulin...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-16

    ...) pathophysiology of arterial and venous thrombosis in this context; (3) research to identify specific procoagulant...) the role of activated Coagulation Factor XIa in IGIV-associated thrombosis; (6) test methods for... HUMAN SERVICES Food and Drug Administration Risk Mitigation Strategies To Address Potential...

  16. Molecular profiling--a tool for addressing emerging gaps in the comparative risk assessment of GMOs.

    PubMed

    Heinemann, Jack A; Kurenbach, Brigitta; Quist, David

    2011-10-01

    Assessing the risks of genetically modified organisms (GMOs) is required by both international agreement and domestic legislation. Many view the use of the "omics" tools for profiling classes of molecules as useful in risk assessment, but no consensus has formed on the need or value of these techniques for assessing the risks of all GMOs. In this and many other cases, experts support case-by-case use of molecular profiling techniques for risk assessment. We review the latest research on the applicability and usefulness of molecular profiling techniques for GMO risk assessment. As more and more kinds of GMOs and traits are developed, broader use of molecular profiling in a risk assessment may be required to supplement the comparative approach to risk assessment. The literature-based discussions on the use of profiling appear to have settled on two findings: 1. profiling techniques are reliable and relevant, at least no less so than other techniques used in risk assessment; and 2. although not required routinely, regulators should be aware of when they are needed. The dismissal of routine molecular profiling may be confusing to regulators who then lack guidance on when molecular profiling might be worthwhile. Molecular profiling is an important way to increase confidence in risk assessments if the profiles are properly designed to address relevant risks and are applied at the correct stage of the assessment.

  17. Traceability and Risk Analysis Strategies for Addressing Counterfeit Electronics in Supply Chains for Complex Systems.

    PubMed

    DiMase, Daniel; Collier, Zachary A; Carlson, Jinae; Gray, Robin B; Linkov, Igor

    2016-10-01

    Within the microelectronics industry, there is a growing concern regarding the introduction of counterfeit electronic parts into the supply chain. Even though this problem is widespread, there have been limited attempts to implement risk-based approaches for testing and supply chain management. Supply chain risk management tends to focus on the highly visible disruptions of the supply chain instead of the covert entrance of counterfeits; thus counterfeit risk is difficult to mitigate. This article provides an overview of the complexities of the electronics supply chain, and highlights some gaps in risk assessment practices. In particular, this article calls for enhanced traceability capabilities to track and trace parts at risk through various stages of the supply chain. Placing the focus on risk-informed decision making through the following strategies is needed, including prioritization of high-risk parts, moving beyond certificates of conformance, incentivizing best supply chain management practices, adoption of industry standards, and design and management for supply chain resilience.

  18. Perceptions of high risk sports.

    PubMed

    Pedersen, D M

    1997-10-01

    High risk sports were rated as to risk, appeal, and likelihood of participation by 282 men and 162 women. Ascending order of perceived risk was skiing, scuba diving, bungee jumping, rock climbing, motorcycle racing, hang gliding, cliff jumping, and skydiving. Profile analysis showed stated likelihood of participation to be directly related to appeal and inversely related to perceived risk.

  19. Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review.

    PubMed

    Lin, Stephanie; Ramulu, Pradeep; Lamoureux, Ecosse L; Sabanayagam, Charumathi

    2016-05-01

    The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of 'targeted mydriasis' for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.

  20. Addressing the Highest Risk: Environmental Programs at Los Alamos National Laboratory

    SciTech Connect

    Forbes, Elaine E

    2012-06-08

    Report topics: Current status of cleanup; Shift in priorities to address highest risk; Removal of above-ground waste; and Continued focus on protecting water resources. Partnership between the National Nuclear Security Administration's Los Alamos Site Office, DOE Carlsbad Field Office, New Mexico Environment Department, and contractor staff has enabled unprecedented cleanup progress. Progress on TRU campaign is well ahead of plan. To date, have completed 130 shipments vs. 104 planned; shipped 483 cubic meters of above-ground waste (vs. 277 planned); and removed 11,249 PE Ci of material at risk (vs. 9,411 planned).

  1. Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Edwards, J. Michelle

    2009-01-01

    The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

  2. Moving beyond regression techniques in cardiovascular risk prediction: applying machine learning to address analytic challenges.

    PubMed

    Goldstein, Benjamin A; Navar, Ann Marie; Carter, Rickey E

    2016-07-19

    Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches. To illustrate these challenges, as well as how different methods can address them, we consider trying to predicting mortality after diagnosis of acute myocardial infarction. We use data derived from our institution's electronic health record and abstract data on 13 regularly measured laboratory markers. We walk through different challenges that arise in modelling these data and then introduce different machine-learning approaches. Finally, we discuss general issues in the application of machine-learning methods including tuning parameters, loss functions, variable importance, and missing data. Overall, this review serves as an introduction for those working on risk modelling to approach the diffuse field of machine learning.

  3. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review

    PubMed Central

    McGinty, Emma E.; Baller, Julia; Azrin, Susan T.; Juliano-Bult, Denise; Daumit, Gail L.

    2016-01-01

    People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings. PMID:26221050

  4. Addressing the Needs of St. Louis Children At Risk. A Report to the Community from Project Respond.

    ERIC Educational Resources Information Center

    Patton, Richard H.; And Others

    This document reports the findings of Project Respond, a program designed to develop a model for assessing and addressing risk to children in the St. Louis community. Section A concerns: (1) a definition of risk; (2) effects of profound sociological risk on children; (3) social and economic costs of sociological risk. In Section B, the Project…

  5. Antipsychotics and Mortality: Adjusting for Mortality Risk Scores to Address Confounding by Terminal Illness

    PubMed Central

    Park, Yoonyoung; Franklin, Jessica M.; Schneeweiss, Sebastian; Levin, Raisa; Crystal, Stephen; Gerhard, Tobias; Huybrechts, Krista F.

    2014-01-01

    OBJECTIVES Earlier studies have documented a greater mortality risk associated with conventional compared with atypical antipsychotics. Concern remains that the association is not causal, but due to residual confounding by differences in underlying health. To address this concern, we evaluated whether adjustment for prognostic indices specifically developed fornursing home (NH) populations affected the magnitude of the previously observed associations. DESIGN Cohort study SETTING A merged dataset of Medicaid, Medicare, the Minimum Data Set (MDS), the Online Survey Certification and Reporting system (OSCAR), and the National Death Index in the US for 2001-2005 PARTICIPANTS Dual eligible subjects ≥ 65 years who initiated antipsychotic treatment in a NH (n=75,445). MEASUREMENTS Three mortality risk scores (MRIS, MMRI-R, and ADEPT) were derived for each patient using baseline MDS data, and their performance was assessed using c-statistics and goodness-of-fit tests. The impact of adjusting for these indices in addition to propensity scores (PS) on the antipsychotic-mortality association was evaluated using Cox models with and without adjustment for risk scores. RESULTS Each risk score showed moderate discrimination for 6-month mortality with c-statistics ranging from 0.61 to 0.63. There was no evidence of lack of fit. Imbalances in risk scores between conventional and atypical antipsychotic users in the full cohort, suggesting potential confounding, were greatly reduced within PS deciles. Accounting for each score in the Cox model did not change the relative risk estimates: 2.24 with PS only adjustment vs. 2.20, 2.20, 2.22 after further adjustment for the three risk scores. CONCLUSION Although causality cannot be proven based on non-randomized studies, this study adds to the body of evidence rejecting alternative explanations for the increased mortality risk associated with conventional antipsychotics. PMID:25752911

  6. For telehealth to succeed, privacy and security risks must be identified and addressed.

    PubMed

    Hall, Joseph L; McGraw, Deven

    2014-02-01

    The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with the patient's body to detect safety issues or medical emergencies may inadvertently transmit sensitive information about household activities. Similarly, routine data transmissions from an app or medical device, such as an insulin pump, may be shared with third-party advertisers. Without adequate security and privacy protections for underlying telehealth data and systems, providers and patients will lack trust in the use of telehealth solutions. Although some federal and state guidelines for telehealth security and privacy have been established, many gaps remain. No federal agency currently has authority to enact privacy and security requirements to cover the telehealth ecosystem. This article examines privacy risks and security threats to telehealth applications and summarizes the extent to which technical controls and federal law adequately address these risks. We argue for a comprehensive federal regulatory framework for telehealth, developed and enforced by a single federal entity, the Federal Trade Commission, to bolster trust and fully realize the benefits of telehealth.

  7. Communication strategies to address geohydrological risks: the POLARIS web initiative in Italy

    NASA Astrophysics Data System (ADS)

    Salvati, Paola; Pernice, Umberto; Bianchi, Cinzia; Marchesini, Ivan; Fiorucci, Federica; Guzzetti, Fausto

    2016-06-01

    Floods and landslides are common phenomena that cause serious damage and pose a severe threat to the population of Italy. The social and economic impact of floods and landslides in Italy is severe, and strategies to target the mitigation of the effects of these phenomena are needed. In the last few years, the scientific community has started to use web technology to communicate information on geohydrological hazards and the associated risks. However, the communication is often targeted at technical experts. In the attempt to communicate relevant information on geohydrological hazards with potential human consequences to a broader audience, we designed the POpoLazione A RISchio (POLARIS) website. POLARIS publishes accurate information on geohydrological risk to the population of Italy, including periodic reports on landslide and flood risk, analyses of specific damaging events and blog posts on landslide and flood events. By monitoring the access to POLARIS in the 21-month period between January 2014 and October 2015, we found that access increased during particularly damaging geohydrological events and immediately after the website was advertised by press releases. POLARIS demonstrates that the scientific community can implement suitable communication strategies that address different societal audiences, exploiting the role of mass media and social media. The strategies can help multiple audiences understand how risks can be reduced through appropriate measures and behaviours, contributing to increasing the resilience of the population to geohydrological risk.

  8. Patellofemoral Pain Syndrome and Modifiable Intrinsic Risk Factors; How to Assess and Address?

    PubMed Central

    Halabchi, Farzin; Mazaheri, Reza; Seif-Barghi, Tohid

    2013-01-01

    Patellofemoral pain syndrome (PFPS) is a very common disorder of the knee. Due to multiple forces influencing the patellofemoral joint, clinical management of this ailment is particularly intricate. Patellofemoral pain syndrome has a multifactorial nature and multiple parameters have been proposed as potential risk factors, classified as intrinsic or extrinsic. Some of the intrinsic risk factors are modifiable and may be approached in treatment. A number of modifiable risk factors have been suggested, including quadriceps weakness, tightness of hamstring, iliopsoas and gastrosoleus muscles, hip muscles dysfunction, foot overpronation, tightness of iliotibial band, generalised joint laxity, limb length discrepancy, patellar malalignment and hypermobility. In general, the routine approach of physicians to this problem does not include assessment and modification of these risk factors and therefore, it may negatively affect the management outcomes. Changing this approach necessitates an easy and practical protocol for assessment of modifiable risk factors and effective and feasible measures to address them. In this review, we aimed to introduce assessment and intervention packages appropriate for this purpose. PMID:23802050

  9. 76 FR 2369 - Priorities for Addressing Risks to the Reliability of the Bulk-Power System; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... Energy Regulatory Commission Priorities for Addressing Risks to the Reliability of the Bulk- Power System... related to reliability of the Bulk-Power System, including priorities for addressing risks to reliability.... The conference will be Webcast. Anyone with Internet access who desires to listen to this event can...

  10. Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

    PubMed

    Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare

    2016-01-07

    Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the

  11. Interventions addressing risk factors of ischaemic heart disease in sub-Saharan Africa: a systematic review

    PubMed Central

    Ebireri, Jennifer; Aderemi, Adewale V; Omoregbe, Nicholas; Adeloye, Davies

    2016-01-01

    Background Ischaemic heart disease (IHD) is currently ranked eighth among the leading causes of deaths in sub-Saharan Africa (sSA). Yet, effective population-wide preventive measures targeting risks in the region are still largely unavailable. We aimed to review population-wide and individual-level interventions addressing risk factors of IHD among adults in sSA. Methods A systematic search of MEDLINE, EMBASE, Global Health and AJOL was conducted to identify studies focusing on population-wide and individual-level interventions targeting risks of IHD among adults in sSA. We conducted a detailed synthesis of basic findings of selected studies. Results A total of 2311 studies were identified, with only 9 studies meeting our selection criteria. 3 broad interventions were identified: dietary modifications, physical activity and community-based health promotion measures on tobacco and alcohol cessation. 3 studies reported significant reduction in blood pressure (BP), and another study reported statistically significant reduction in mean total cholesterol. Other outcome measures observed ranged from mild to no reduction in BP, blood glucose, body mass index and total cholesterol, respectively. Conclusions We cannot specify with all certainty contextually feasible interventions that can be effective in modifying IHD risk factors in population groups across sSA. We recommend more research on IHD, particularly on the understanding of the burden, geared towards developing and/or strengthening preventive and treatment interventions for the disease in sSA. PMID:27381212

  12. Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals

    PubMed Central

    Dugas, Tammy R.; Lomnicki, Slawomir; Cormier, Stephania A.; Dellinger, Barry; Reams, Margaret

    2016-01-01

    Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant. PMID:27338429

  13. Addressing Emerging Risks: Scientific and Regulatory Challenges Associated with Environmentally Persistent Free Radicals.

    PubMed

    Dugas, Tammy R; Lomnicki, Slawomir; Cormier, Stephania A; Dellinger, Barry; Reams, Margaret

    2016-06-08

    Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm) and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant.

  14. Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors among Overweight/Obese Latino Smokers

    ERIC Educational Resources Information Center

    Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

    2015-01-01

    More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social…

  15. Risk newsboy: approach for addressing uncertainty in developing action levels and cleanup limits

    SciTech Connect

    Cooke, Roger; MacDonell, Margaret

    2007-07-01

    Site cleanup decisions involve developing action levels and residual limits for key contaminants, to assure health protection during the cleanup period and into the long term. Uncertainty is inherent in the toxicity information used to define these levels, based on incomplete scientific knowledge regarding dose-response relationships across various hazards and exposures at environmentally relevant levels. This problem can be addressed by applying principles used to manage uncertainty in operations research, as illustrated by the newsboy dilemma. Each day a newsboy must balance the risk of buying more papers than he can sell against the risk of not buying enough. Setting action levels and cleanup limits involves a similar concept of balancing and distributing risks and benefits in the face of uncertainty. The newsboy approach can be applied to develop health-based target concentrations for both radiological and chemical contaminants, with stakeholder input being crucial to assessing 'regret' levels. Associated tools include structured expert judgment elicitation to quantify uncertainty in the dose-response relationship, and mathematical techniques such as probabilistic inversion and iterative proportional fitting. (authors)

  16. Focusing Events and Constrains on Policy Addressing Long-Term Climate Change Risks

    NASA Astrophysics Data System (ADS)

    O'Donovan, K.

    2014-12-01

    When policy makers are aware of immediate and long-term risks to communities, what do they do to plan for and mitigate the effects of climate change? This paper addresses that question in two ways. First, as an organizing framework it presents an overview of the empirical evidence on focusing events. Focusing events are defined as sudden, rare events that reveal harm or the potential for future harm that the general public and policy makers become aware of simultaneously. These large-scale events are typically natural and disasters, crisis, or technological accidents. This paper considers the empirical evidence of the relationship between focusing events, the harm revealed by the event and policy change aimed at reducing future risk of harm. Second, this paper reviews the case of flood mitigation policy in the United States from 1968 to 2008. It considers the ways in which policy makers have and have not integrated future flood risks into mitigation policy and planning, particularly after large-scale floods. It analyzes the political, intergovernmental, demographic and geographic factors that have promoted and constrained long-term flood mitigation policy. This paper concludes with a discussion of the meaning and implications of potential focusing events and constrains on policy for long-term climate change concerns.

  17. NEW TECHNOLOGIES TO SOLVE OLD PROBLEMS AND ADDRESS ISSUES IN RISK ASSESSMENT

    EPA Science Inventory

    Appropriate utilization of data is an ongoing concern of the regulated industries and the agencies charged with assessing safety or risk. An area of current interest is the possibility that toxicogenomics will enhance our ability to develop higher or high-throughput models for pr...

  18. Development of an Internet Intervention to Address Behaviors Associated with Skin Cancer Risk among Young Adults

    PubMed Central

    Heckman, Carolyn; Darlow, Susan; Munshi, Teja; Caruso, Carolyn; Ritterband, Lee; Raivitch, Stephanie; Fleisher, Linda; Manne, Sharon

    2015-01-01

    Purpose Skin cancer is the most common cancer in the US, and its incidence is increasing. The major risk factor for skin cancer is exposure to ultraviolet radiation (UV). Young adults tend to expose themselves to large amounts of UV and engage in minimal skin protection, which increases their skin cancer risk. Interventions are needed to address risk behaviors among young adults that may lead to skin cancer. The nternet offers a cost-effective way to widely disseminate efficacious interventions. The current paper describes the development of an online skin cancer risk reduction intervention (UV4.me) for young adults. Procedures The iterative development process for UV4.me followed best-practice guidelines and included the following activities: individual interviews, focus groups, content development by the expert team, acceptability testing, cognitive interviewing for questionnaires, quality control testing, usability testing, and a pilot randomized controlled trial. Participant acceptability and usability feedback was assessed. Principal Results The development process produced an evidence-informed intervention that is individually-tailored, interactive, and multimedia in nature based on the Integrative Model of Behavior Prediction, a model for internet interventions, and other best-practice recommendations, expert input, as well as user acceptability and usability feedback gathered before, during, and after development. Major Conclusions Development of an acceptable intervention intended to have a significant public health impact requires a relatively large investment in time, money, expertise, and ongoing user input. Lessons learned and recommendations are discussed. The comprehensive process used may help prepare others interested in creating similar behavioral health interventions. PMID:26640776

  19. Near-Term Actions to Address Long-Term Climate Risk

    NASA Astrophysics Data System (ADS)

    Lempert, R. J.

    2014-12-01

    Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

  20. Research approaches to address uncertainties in the risk assessment of arsenic in drinking water

    SciTech Connect

    Hughes, Michael F. Kenyon, Elaina M.; Kitchin, Kirk T.

    2007-08-01

    Inorganic arsenic (iAs), an environmental drinking water contaminant, is a human toxicant and carcinogen. The public health community has developed recommendations and regulations that limit human exposure to iAs in drinking water. Although there is a vast amount of information available to regulators on the exposure, disposition and the health-related effects of iAs, there is still critical information about the toxicology of this metalloid that is needed. This necessary information includes identification of the chemical species of arsenic that is (are) the active toxicant(s), the mode(s) of action for its various toxicities and information on potentially susceptible populations. Because of these unknown factors, the risk assessment of iAs still incorporates default assumptions, leading to uncertainties in the overall assessment. The characteristics of a scientifically defensible risk assessment for iAs are that it must: (1) quantitatively link exposure and target tissue dose of active metabolites to key events in the mode of action for major health effects and (2) identify sources of variation in susceptibility to arsenic-induced health effects and quantitatively evaluate their impact wherever possible. Integration of research to address these goals will better protect the health of iAs-exposed populations.

  1. Addressing Human Variability in Next-Generation Human Health Risk Assessments of Environmental Chemicals

    PubMed Central

    Bois, Frederic Y.; Chiu, Weihsueh A.; Hattis, Dale; Rusyn, Ivan; Guyton, Kathryn Z.

    2012-01-01

    Background: Characterizing variability in the extent and nature of responses to environmental exposures is a critical aspect of human health risk assessment. Objective: Our goal was to explore how next-generation human health risk assessments may better characterize variability in the context of the conceptual framework for the source-to-outcome continuum. Methods: This review was informed by a National Research Council workshop titled “Biological Factors that Underlie Individual Susceptibility to Environmental Stressors and Their Implications for Decision-Making.” We considered current experimental and in silico approaches, and emerging data streams (such as genetically defined human cells lines, genetically diverse rodent models, human omic profiling, and genome-wide association studies) that are providing new types of information and models relevant for assessing interindividual variability for application to human health risk assessments of environmental chemicals. Discussion: One challenge for characterizing variability is the wide range of sources of inherent biological variability (e.g., genetic and epigenetic variants) among individuals. A second challenge is that each particular pair of health outcomes and chemical exposures involves combinations of these sources, which may be further compounded by extrinsic factors (e.g., diet, psychosocial stressors, other exogenous chemical exposures). A third challenge is that different decision contexts present distinct needs regarding the identification—and extent of characterization—of interindividual variability in the human population. Conclusions: Despite these inherent challenges, opportunities exist to incorporate evidence from emerging data streams for addressing interindividual variability in a range of decision-making contexts. PMID:23086705

  2. 76 FR 58813 - Guidance for Industry; Measures to Address the Risk for Contamination by Salmonella Species in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... Contamination by Salmonella Species in Food Containing a Pistachio- Derived Product as an Ingredient... Address the Risk for Contamination by Salmonella Species in Food Containing a Pistachio-Derived Product as...- derived product as an ingredient that there is a risk that Salmonella species may be present in...

  3. Neuroleptics under high risk conditions.

    PubMed

    Oyewumi, L K

    1983-08-01

    A critical review of various high risk situations in which neuroleptics could be used and have been used in clinical practice is presented. These high risk situations include: women of child bearing age (pregnant women, lactating and/or nursing mothers), the two extremes of life (children and the elderly), patients with sexual dysfunction, patients with tardive dyskinesia, non-psychotic psychiatric patients, physically ill and suicidal patients. The extraordinary applications of these drugs, such as for rapid tranquilization and megadose regimens are examined. The author provides guidelines for the use of neuroleptics in these clinical situations.

  4. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    PubMed

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales.

  5. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    PubMed Central

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  6. Safety nets can help address the risks to nutrition from increasing climate variability.

    PubMed

    Alderman, Harold

    2010-01-01

    Models of climate change predict increased variability of weather as well as changes in agro-ecology. The increased variability will pose special challenges for nutrition. This study reviews evidence on climate shocks and nutrition and estimates the economic consequences in terms of reduced schooling and economic productivity stemming from nutritional insults in childhood. Panel data covering up to 20 y indicate that that short-term climate shocks have long-term impacts on children that persist, often into their adult lives. Other studies document the potential for relief programs to offset these shocks providing that the programs can be implemented with flexible financing, rapid identification of those affected by the shock, and timely scale-up. The last of these presumes that programs are already in place with contingency plans drawn up. Arguably, direct food distribution, including that of ready-to-use therapeutic food, may be part of the overall strategy. Even if such programs are too expensive for sustainable widespread use in the prevention of malnutrition, scalable food distribution programs may be cost effective to address the heightened risk of malnutrition following weather-related shocks.

  7. Report: Lack of Final Guidance on Vapor Intrusion Impedes Efforts to Address Indoor Air Risks

    EPA Pesticide Factsheets

    Report #10-P-0042, December 14, 2009. EPA’s efforts to protect human health at sites where vapor intrusion risks may occur have been impeded by the lack of final Agency guidance on vapor intrusion risks.

  8. Addressing risk in the design of new healthcare services: a step-by-step methodology.

    PubMed

    Remus, Beth

    2008-01-01

    New service design can be done effectively through enterprise risk management (ERM) by identifying the clinical and administrative risks within the new service design. This article proposes a 10-step process describing the business team's tasks and integrating risk management, quality management and patient safety concepts.

  9. Potential enhancements to addressing programmatic risk in the tank waste remediation system (TWRS) program

    SciTech Connect

    Brothers, A.; Fassbender, L.; Bilyard, G.; Levine, L.

    1996-04-01

    Pacific Northwest National Laboratory (PNNL) conducted a Tank Waste Remediation System (TWRS) Risk Management methodology development task. The objective of this task was to develop risk management methodology focused on (1) the use of programmatic risk information in making TWRS architecture selection decisions and (2) the identification/evaluation/selection of TWRS risk-handling actions. Methods for incorporating programmatic risk/uncertainty estimates into trade studies are provided for engineers/analysts. Methods for identifying, evaluating, and selecting risk-handling actions are provided for managers. The guidance provided in this report is designed to help decision-makers make difficult judgments. Current approaches to architecture selection decisions and identification/evaluation/selection of risk-handling actions are summarized. Three categories of sources of programmatic risk (parametric, external, and organizational) are examined. Multiple analytical approaches are presented to enhance the current alternative generation and analysis (AGA) and risk-handling procedures. Appendix A describes some commercially available risk management software tools and Appendix B provides a brief introduction to quantification of risk attitudes. The report provides three levels of analysis for enhancing the AGA Procedure: (1) qualitative discussion coupled with estimated uncertainty ranges for scores in the alternatives-by-criteria matrix; (2) formal elicitation of probability distributions for the alternative scores; and (3) a formal, more structured, comprehensive risk analysis. A framework is also presented for using the AGA programmatic risk analysis results in making better decisions. The report also presents two levels of analysis for evaluation and selection of risk-handling actions: (1) qualitative analysis and judgmental rankings of alternative actions, and (2) Simple Multi-Attribute Rating Technique (SMART).

  10. ISSUES THAT MUST BE ADDRESSED FOR RISK ASSESSMENT OF MIXED EXPOSURES: THE EPA EXPERIENCE WITH AIR QUALITY

    EPA Science Inventory

    Issues that Must be Addressed for Risk Assessment of Mixed Exposures: The EPA Experience with Air Quality

    Daniel L. Costa, Sc.D.

    Abstract
    Humans are routinely exposed to a complex mixture of air pollutants in both their outdoor and indoor environments. The wide...

  11. Identifying risk factors for healthcare-associated infections from electronic medical record home address data

    PubMed Central

    2010-01-01

    Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample) with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37%) to 12,549 records (83.91%). Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64%) to 1,379 (9.22%). Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs. PMID:20849635

  12. Building Successful Programs to Address Chemical Risks in Schools: A Workbook with Templates, Tips, and Techniques

    ERIC Educational Resources Information Center

    US Environmental Protection Agency, 2008

    2008-01-01

    Outdated, unknown, or unneeded amounts of dangerous or inappropriate chemicals are often found in K-12 schools across the nation, potentially putting students and staff at risk. Because of the nature of some of the chemicals, even small amounts may present a risk. Thus, dangerous chemicals represent one of the critical environmental health and…

  13. Averting the perfect storm: addressing youth substance use risk from social media use.

    PubMed

    Salimian, Parissa K; Chunara, Rumi; Weitzman, Elissa R

    2014-10-01

    Adolescents are developmentally sensitive to pathways that influence alcohol and other drug (AOD) use. In the absence of guidance, their routine engagement with social media may add a further layer of risk. There are several potential mechanisms for social media use to influence AOD risk, including exposure to peer portrayals of AOD use, socially amplified advertising, misinformation, and predatory marketing against a backdrop of lax regulatory systems and privacy controls. Here the authors summarize the influences of the social media world and suggest how pediatricians in everyday practice can alert youth and their parents to these risks to foster conversation, awareness, and harm reduction.

  14. Towards a common oil spill risk assessment framework – Adapting ISO 31000 and addressing uncertainties.

    PubMed

    Sepp Neves, Antonio Augusto; Pinardi, Nadia; Martins, Flavio; Janeiro, Joao; Samaras, Achilleas; Zodiatis, George; De Dominicis, Michela

    2015-08-15

    Oil spills are a transnational problem, and establishing a common standard methodology for Oil Spill Risk Assessments (OSRAs) is thus paramount in order to protect marine environments and coastal communities. In this study we firstly identified the strengths and weaknesses of the OSRAs carried out in various parts of the globe. We then searched for a generic and recognized standard, i.e. ISO 31000, in order to design a method to perform OSRAs in a scientific and standard way. The new framework was tested for the Lebanon oil spill that occurred in 2006 employing ensemble oil spill modeling to quantify the risks and uncertainties due to unknown spill characteristics. The application of the framework generated valuable visual instruments for the transparent communication of the risks, replacing the use of risk tolerance levels, and thus highlighting the priority areas to protect in case of an oil spill.

  15. Especially for daughters: parent education to address alcohol and sex-related risk taking among urban young adolescent girls.

    PubMed

    O'Donnell, Lydia; Myint-U, Athi; Duran, Richard; Stueve, Ann

    2010-05-01

    This study evaluates the Especially for Daughters intervention, which aims to provide urban Black and Latino parents with information and skills to support their daughters in delaying sexual initiation and alcohol use. In a randomized field trial, 268 families with sixth-graders were recruited from New York City public schools and assigned either to the intervention, a set of audio CDs mailed home; an attention-controlled condition (print materials); or controls. Girls completed classroom baseline and three follow-up surveys, and telephone surveys were conducted with parents. At follow-up, girls in the intervention reported fewer sexual risks (adjusted odds ratio [AOR] = 0.39, confidence interval [CI] = 0.17-0.88) and less drinking (AOR = 0.38, CI = 0.15-0.97, p < .05). Their parents reported greater self-efficacy to address alcohol and sex and more communication on these topics. This gender-specific parent education program was for communities with high rates of HIV, where early sexual onset is common and often fueled by alcohol.

  16. Intent, Capability and Opportunity: A Holistic Approach to Addressing Proliferation as a Risk Management Issue

    SciTech Connect

    Amanda Rynes; Trond Bjornard

    2011-07-01

    Currently, proliferation risk assessment models are designed to evaluate only a portion of the overall risk, focusing exclusively on either technological or social factors to determine the extent of a threat. Many of these models are intended to act as a means of predicting proliferation potential rather than assessing the system as a whole, ignoring the ability to enhance mitigating factors and manage, rather just establish the presence of, the threat. While the information garnered through these forms of analysis is necessary, it remains incomplete. By incorporating political, social, economic and technical capabilities as well as human factors such as intent into a single, multi-faceted risk management model, proliferation risk can be evaluated more effectively. Framing this information around how to improve and expand the Regime already in place and establishing where there are gaps in the system allows for a more complete approach to risk management, mitigation and resource allocation. The research conducted here seeks to combine all three elements (intent, capability and opportunity) in a comprehensive evaluation which incorporates an assessment of state-level variables, possible proliferation pathways and technical capability. Each portion of the analysis is carried out independently then combined to illustrate the full scope of a State's nuclear infrastructure while showing areas of weakness in the institutional framework.

  17. Event-Specific Prevention: Addressing College Student Drinking During Known Windows of Risk

    PubMed Central

    Neighbors, Clayton; Walters, Scott T.; Lee, Christine M.; Vader, Amanda M.; Vehige, Tamara; Szigethy, Thomas; DeJong, William

    2007-01-01

    The unique drinking patterns of college students call for Event-Specific Prevention (ESP) strategies that address college student drinking associated with peak times and events. Despite limited research evaluating ESP, many college campuses are currently implementing programming for specific events. The present paper provides a review of existing literature related to ESP and offers practical guidance for research and practice. The prevention typology proposed by DeJong and Langford (2002) provides a framework for strategic planning, suggesting that programs and policies should address problems at the individual, group, institution, community, state, and society level, and that these interventions should focus on knowledge change, environmental change, health protection, and intervention and treatment services. From this typology, specific examples are provided for comprehensive program planning related to orientation/beginning of school year, homecoming, 21st birthday celebrations, spring break, and graduation. In addition, the University of Connecticut’s efforts to address problems resulting from its annual Spring Weekend are described as an illustration of how advance planning by campus and community partners can produce a successful ESP effort. PMID:17616260

  18. Advising Financially At-Risk Students: Detecting and Addressing Premature Affluence

    ERIC Educational Resources Information Center

    Shaffer, Leigh S.

    2014-01-01

    Academic advisors likely will encounter financially at-risk (FAR) students who jeopardize their chances of completing a college education and compromise their economic futures by accruing burdensome debt. Students may use loans and credit cards to pay for the necessities of a college education, but many also generate personal debt by financing…

  19. Evaluating Health Risks from Inhaled Polychlorinated Biphenyls: Research Needs for Addressing Uncertainty

    EPA Science Inventory

    Indoor air polychlorinated biphenyl (PCB) concentrations in some U.S. schools are one or more orders of magnitude higher than background levels. In response to this, efforts have been made to assess the potential health risk posed by inhaled PCBs. These efforts are hindered by un...

  20. The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

    PubMed

    McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

    2014-01-01

    This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.

  1. Addressing Beacon re-identification attacks: quantification and mitigation of privacy risks.

    PubMed

    Raisaro, Jean Louis; Tramèr, Florian; Ji, Zhanglong; Bu, Diyue; Zhao, Yongan; Carey, Knox; Lloyd, David; Sofia, Heidi; Baker, Dixie; Flicek, Paul; Shringarpure, Suyash; Bustamante, Carlos; Wang, Shuang; Jiang, Xiaoqian; Ohno-Machado, Lucila; Tang, Haixu; Wang, XiaoFeng; Hubaux, Jean-Pierre

    2017-02-20

    The Global Alliance for Genomics and Health (GA4GH) created the Beacon Project as a means of testing the willingness of data holders to share genetic data in the simplest technical context-a query for the presence of a specified nucleotide at a given position within a chromosome. Each participating site (or "beacon") is responsible for assuring that genomic data are exposed through the Beacon service only with the permission of the individual to whom the data pertains and in accordance with the GA4GH policy and standards.While recognizing the inference risks associated with large-scale data aggregation, and the fact that some beacons contain sensitive phenotypic associations that increase privacy risk, the GA4GH adjudged the risk of re-identification based on the binary yes/no allele-presence query responses as acceptable. However, recent work demonstrated that, given a beacon with specific characteristics (including relatively small sample size and an adversary who possesses an individual's whole genome sequence), the individual's membership in a beacon can be inferred through repeated queries for variants present in the individual's genome.In this paper, we propose three practical strategies for reducing re-identification risks in beacons. The first two strategies manipulate the beacon such that the presence of rare alleles is obscured; the third strategy budgets the number of accesses per user for each individual genome. Using a beacon containing data from the 1000 Genomes Project, we demonstrate that the proposed strategies can effectively reduce re-identification risk in beacon-like datasets.

  2. Towards high-resolution retinal prostheses with direct optical addressing and inductive telemetry

    NASA Astrophysics Data System (ADS)

    Ha, Sohmyung; Khraiche, Massoud L.; Akinin, Abraham; Jing, Yi; Damle, Samir; Kuang, Yanjin; Bauchner, Sue; Lo, Yu-Hwa; Freeman, William R.; Silva, Gabriel A.; Cauwenberghs, Gert

    2016-10-01

    Objective. Despite considerable advances in retinal prostheses over the last two decades, the resolution of restored vision has remained severely limited, well below the 20/200 acuity threshold of blindness. Towards drastic improvements in spatial resolution, we present a scalable architecture for retinal prostheses in which each stimulation electrode is directly activated by incident light and powered by a common voltage pulse transferred over a single wireless inductive link. Approach. The hybrid optical addressability and electronic powering scheme provides separate spatial and temporal control over stimulation, and further provides optoelectronic gain for substantially lower light intensity thresholds than other optically addressed retinal prostheses using passive microphotodiode arrays. The architecture permits the use of high-density electrode arrays with ultra-high photosensitive silicon nanowires, obviating the need for excessive wiring and high-throughput data telemetry. Instead, the single inductive link drives the entire array of electrodes through two wires and provides external control over waveform parameters for common voltage stimulation. Main results. A complete system comprising inductive telemetry link, stimulation pulse demodulator, charge-balancing series capacitor, and nanowire-based electrode device is integrated and validated ex vivo on rat retina tissue. Significance. Measurements demonstrate control over retinal neural activity both by light and electrical bias, validating the feasibility of the proposed architecture and its system components as an important first step towards a high-resolution optically addressed retinal prosthesis.

  3. Model or Myopia? Exploiting Water Markets to Address Population and Drought Risks in a Changing World

    NASA Astrophysics Data System (ADS)

    Reed, P. M.

    2012-12-01

    Climate change, population demands, and evolving land-use represent strong risks to the sustainable development and stability of world-wide urban water supplies. There is a growing consensus that non-structural supply management instruments such as water markets have significant potential to reduce the risks and vulnerabilities in complex urban water systems. This paper asks a common question, what are the tradeoffs for a city using water market supply instruments?. This question emerges quickly in policy and management, but its answer is deceptively difficult to attain using traditional planning tools and management frameworks. This research demonstrates new frameworks that facilitate rapid evaluation of hypotheses on the reliability, resiliency, adaptability, and cost-effectiveness of urban water supply systems. This study considers a broader exploration of the issues of "nonstationarity" and "uncertainty" in urban water planning. As we invest in new information and prediction frameworks for the coupled human-natural systems that define our water, our problem definitions (i.e., objectives, constraints, preferences, and hypotheses) themselves evolve. From a formal mathematical perspective, this means that our management problems are structurally uncertain and nonstationary (i.e., the definition of optimality changes across regions, times, and stakeholders). This uncertainty and nonstationarity in our problem definitions needs to be more explicitly acknowledged in adaptive management and integrated water resources management. This study demonstrates the potential benefits of exploring these issues in the context of a city in the Lower Rio Grande Valley (LRGV) of Texas, USA determining how to use its regional water market to manage population and drought risks.

  4. Addressable electrode array device with IDA electrodes for high-throughput detection.

    PubMed

    Ino, Kosuke; Saito, Wataru; Koide, Masahiro; Umemura, Taizo; Shiku, Hitoshi; Matsue, Tomokazu

    2011-02-07

    An electrochemical device is proposed for high-throughput electrochemical detection that consists of 32 row and 32 column electrodes on a single glass substrate. The row and column electrodes are connected to interdigitated array (IDA) electrodes to form 1024 (32 × 32) addressable sensor points in the device. Electrochemical responses from each of the 1024 sensors were successfully acquired on the device within 1 min using redox cycling at individual IDA electrodes, which ensures application of the device to comprehensive, high-throughput electrochemical detection for enzyme-linked immunosorbent assay (ELISA), reporter gene assay for monitoring gene expressions, and DNA analysis.

  5. Genetic insights into age-related macular degeneration: controversies addressing risk, causality, and therapeutics.

    PubMed

    Gorin, Michael B

    2012-08-01

    Age-related macular degeneration (AMD) is a common condition among the elderly population that leads to the progressive central vision loss and serious compromise of quality of life for its sufferers. It is also one of the few disorders for whom the investigation of its genetics has yielded rich insights into its diversity and causality and holds the promise of enabling clinicians to provide better risk assessments for individuals as well as to develop and selectively deploy new therapeutics to either prevent or slow the development of disease and lessen the threat of vision loss. The genetics of AMD began initially with the appreciation of familial aggregation and increase risk and expanded with the initial association of APOE variants with the disease. The first major breakthroughs came with family-based linkage studies of affected (and discordant) sibs, which identified a number of genetic loci and led to the targeted search of the 1q31 and 10q26 loci for associated variants. Three of the initial four reports for the CFH variant, Y402H, were based on regional candidate searches, as were the two initial reports of the ARMS2/HTRA1 locus variants. Case-control association studies initially also played a role in discovering the major genetic variants for AMD, and the success of those early studies have been used to fuel enthusiasm for the methodology for a number of diseases. Until 2010, all of the subsequent genetic variants associated with AMD came from candidate gene testing based on the complement factor pathway. In 2010, several large-scale genome-wide association studies (GWAS) identified genes that had not been previously identified. Much of this historical information is available in a number of recent reviews (Chen et al., 2010b; Deangelis et al., 2011; Fafowora and Gorin, 2012b; Francis and Klein, 2011; Kokotas et al., 2011). Large meta analysis of AMD GWAS has added new loci and variants to this collection (Chen et al., 2010a; Kopplin et al., 2010; Yu et

  6. Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

    PubMed Central

    Elwyn, Glyn; Dannenberg, Michelle; Blaine, Arianna; Poddar, Urbashi; Durand, Marie-Anne

    2016-01-01

    Objective Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. Design Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing interest policies and disclosure forms. Results We contacted 25 organisations likely to meet the inclusion criteria. 12 eligible organisations provided data. 11 organisations did not reply and 2 declined to participate. Most patient decision aid developers recognise the need to consider the issue of competing interests. Assessment processes vary widely and, for the most part, are insufficiently robust to minimise the risk of competing interests. Only half of the 12 organisations had competing interest policies. Some considered disclosure to be sufficient, while others imposed differing levels of exclusion. Conclusions Patient decision aid developers do not have a consistent approach to managing competing interests. Some have developed policies and procedures, while others pay no attention to the issue. As is the case for clinical practice guidelines, increasing attention will need to be given to how the competing interests of contributors of evidence-based publications may influence materials, especially if they are designed for patient use. PMID:27612542

  7. Nutrition interventions to address cardiovascular outcomes in chronic kidney disease.

    PubMed

    Beto, Judith A; Bansal, Vinod K

    2004-10-01

    The high mortality in chronic kidney disease has been linked to cardiovascular risk and these patients are considered at high risk. Dietary intervention can directly address nutritional risk factors in lipid management, calcium-phorphorus balance, and body composition to reduce risk of cardiovascular disease. Nutrient intake can also indirectly address less overt risks of dental health, nutritional supplements, and compliance issues.

  8. High-fidelity spatial addressing of 43Ca+ qubits using near-field microwave control

    NASA Astrophysics Data System (ADS)

    Prado Lopes Aude Craik, Diana; Linke, Norbert; Allcock, David; Sepiol, Martin; Harty, Thomas; Ballance, Christopher; Stacey, Derek; Steane, Andrew; Lucas, David

    2016-05-01

    Individual addressing of qubits is essential for scalable quantum computation. Spatial addressing allows unlimited numbers of qubits to share the same frequency, whilst enabling arbitrary parallel operations. We present the latest experimental results obtained using a two-zone microfabricated surface trap designed to perform spatial, near-field microwave addressing of long-lived 43Ca+ ``atomic clock'' qubits held in separate trap zones (each of which feature four integrated microwave electrodes). Microwave near fields generated by multi-electrode chip ion traps are often difficult to faithfully simulate and a simple method of characterizing and testing trap chips before placement under ultra-high vacuum would significantly speed up trap design optimization. We describe a printed circuit board antenna for use in mapping microwave near-fields generated by ion-trap electrodes. The antenna is designed to measure fields down to 100 μ m away from trap electrodes and to be impedance matched at a desired spot frequency for an improved signal to noise ratio in field measurements. This work is supported by the US Army Research Office, EPSRC (UK) and the UK National Quantum Technologies Programme.

  9. Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure

    PubMed Central

    Moan, Johan; Porojnicu, Alina Carmen; Dahlback, Arne; Setlow, Richard B.

    2008-01-01

    Solar radiation is the main cause of skin cancers. However, it also is a main source of vitamin D for humans. Because the optimal status of vitamin D protects against internal cancers and a number of other diseases, a controversy exists: Will increased sun exposure lead to net health benefits or risks? We calculated the relative yield of vitamin D photosynthesis as a function of latitude with a radiative transfer model and cylinder geometry for the human skin surface. The annual yield of vitamin D is 3.4 and 4.8 times larger below the equator than in the U.K. and Scandinavia, respectively. In populations with similar skin types, there are clear latitude gradients of all major forms of skin cancer, indicating a north–south gradient in real sun exposure. Surprisingly, the incidence rates of major internal cancers also increase from north to south. However, the survival prognosis also improves significantly from north to south. Reasons for these findings are discussed in view of the role of vitamin D. In Norway, melanoma rates increased by a factor of 6 from 1960 to 1990, while the prognosis improved in the same period. After 1990, melanoma rates have remained constant or even decreased in age groups <50 years, whereas the prognosis has not improved further. These data, together with those for internal cancers and the beneficial effects of an optimal vitamin D status, indicate that increased sun exposure may lead to improved cancer prognosis and, possibly, give more positive than adverse health effects. PMID:18180454

  10. REVIEW OF VARIOUS APPROACHES TO ADDRESS HIGH CURRENTS IN SRF ELECTRON LINACS.

    SciTech Connect

    BEN-ZVI, I.

    2005-07-10

    The combination of high-brightness electron sources and high-current SRF Energy Recovery Linacs (ERL) leads to a new emerging technology: High-power, high-brightness electron beams. This technology enables extremely high average power Free-Electron Lasers, a new generation of extreme brightness light sources, electron coolers of high-energy hadron storage rings, polarized electron-hadron colliders of very high luminosity, compact Thomson scattering X-ray sources, terahertz radiation generators and much more. What is typical for many of these applications is the need for very high current, defined here as over 100 mA average current, and high brightness, which is charge dependant, but needs to be in the range of between sub micron up to perhaps 50 microns, usually the lower--the better. Suffice it to say that while there are a number of projects aiming at this level of performance, none is anywhere near it. This work will review the problems associated with the achievement of such performance and the various approaches taken in a number of laboratories around the world to address the issues.

  11. Availability of High School Extracurricular Sports Programs and High-Risk Behaviors

    ERIC Educational Resources Information Center

    Cohen, Deborah A.; Taylor, Stephanie L.; Zonta, Michela; Vestal, Katherine D.; Schuster, Mark A.

    2007-01-01

    Background: The Surgeon General has called for an expansion of school-based extracurricular sports programs to address the obesity epidemic. However, little is known about the availability of and participation in high school extracurricular sports and how participation in these sports is related to high-risk behaviors. Methods: We surveyed Los…

  12. Addressable multi-nozzle electrohydrodynamic jet printing with high consistency by multi-level voltage method

    NASA Astrophysics Data System (ADS)

    Pan, Yanqiao; Huang, YongAn; Guo, Lei; Ding, Yajiang; Yin, Zhouping

    2015-04-01

    It is critical and challenging to achieve the individual jetting ability and high consistency in multi-nozzle electrohydrodynamic jet printing (E-jet printing). We proposed multi-level voltage method (MVM) to implement the addressable E-jet printing using multiple parallel nozzles with high consistency. The fabricated multi-nozzle printhead for MVM consists of three parts: PMMA holder, stainless steel capillaries (27G, outer diameter 400 μm) and FR-4 extractor layer. The key of MVM is to control the maximum meniscus electric field on each nozzle. The individual jetting control can be implemented when the rings under the jetting nozzles are 0 kV and the other rings are 0.5 kV. The onset electric field for each nozzle is ˜3.4 kV/mm by numerical simulation. Furthermore, a series of printing experiments are performed to show the advantage of MVM in printing consistency than the "one-voltage method" and "improved E-jet method", by combination with finite element analyses. The good dimension consistency (274μm, 276μm, 280μm) and position consistency of the droplet array on the hydrophobic Si substrate verified the enhancements. It shows that MVM is an effective technique to implement the addressable E-jet printing with multiple parallel nozzles in high consistency.

  13. The risk factors for elevated blood pressure and how to address cardiovascular risk factors: a review in paediatric populations.

    PubMed

    Monyeki, Kd; Kemper, Hcg

    2008-07-01

    This paper examines the epidemiology of hypertension and management strategies of cardiovascular diseases (CVDs) in paediatric populations in sub-Saharan Africa and other parts of the world in the 21st century. A computerized literature search was carried out using Medline, Evidence-Based Child Health (A Cochrane Review Journal), the Cochrane Library and Cochrane Child Health Field. A manual search in the African Journal for physical, health education, recreation and dance, the South African Journal for Research in Sports, Physical Education and Recreation and a few individuals in the area were requested to send some of their recent unpublished and published reports in the field. High prevalence rates and high odds ratios for high blood pressure (BP) were recorded in children aged 5-17 years. There is a need for health ministries to improve the public health sector so as to close the gap between the rich and the poor. Although personal and parental responsibility remain crucial, it also falls on the government to help control powerful environmental factors that are leading our children to premature ill-health and mortality. Equally, health professionals are increasingly recognized that they have a significant role to play in delivering medical treatment of hypertension in children.

  14. An approach to addressing ethical issues in a community-based risk assessment for HIV: a case from Chennai, India.

    PubMed

    Sivaram, Sudha; Srikrishnan, Aylur Kailasom; Murgavel, Kailapuri G; Mayer, Kenneth H; Anand, S; Celentano, David D; Solomon, Suniti

    2005-06-01

    Community-based assessment of HIV prevalence and behavioural risk factors is the basis for deciding priorities of prevention and care programmes. Here, upholding the human rights of participants in assessment is of utmost importance. The objective of the paper was to describe the process of implementation of an epidemiological survey to assess HIV-related behavioural and biological factors in Chennai city in South India and to suggest an ethical framework for conducting similar assessment activities in developing-country settings. A survey was conducted with participation from residents (n=1,659) of low-income urban communities (slums) as part of a community-based HIV/STD-prevention trial. Administration of the survey was preceded by extensive community contact and household visits to inform community members about the trial and assessment activities. Formative research further strengthened rapport with community, highlighted community concerns, and identified HIV-related risk behaviours that informed questionnaire design. The process of obtaining informed consent began before assessment activities and provided an opportunity for individuals to discuss participation with their families and friends. Privacy during assessment, comprehensive follow-up care for those who tested positive for HIV/STDs, such as nutritional and prevention counselling, referral services for opportunistic infections, and antenatal-care options for pregnant women increased trust and credibility of the project. The sustained availability of trial staff to facilitate access to resources to address non-HIV/STD-related felt-needs further strengthened participation of the community members. These resources included liaison services with local government to obtain public services, such as water and electricity and resources, to address concerns, such as alcohol abuse and domestic violence. Based on this experience, an ethical framework is suggested for conducting HIV epidemiological risk assessment

  15. SSME - Materials and Methods for Addressing High-Pressure Hydrogen Embrittlement

    NASA Technical Reports Server (NTRS)

    Matejczk, Daniel; Russell, Dale; Frandsen, Jon; Swanson, Greg

    2010-01-01

    From the humid, corrosion-friendly atmosphere of KSC, to the extreme heat of ascent, to the cold vacuum of space, the Space Shuttle faced one hostile environment after another. One of those harsh environments the hydrogen environment existed within the shuttle itself. Liquid hydrogen was the fuel that powered the shuttle s complex, powerful, and reusable main engine. Hydrogen provided the high specific impulse the bang per pound of fuel needed to perform the shuttle s heavy lifting duties. Hydrogen, however, was also a potential threat to the very metal of the propulsion system that used it. The diffusion of hydrogen atoms into a metal can make it more brittle and prone to cracking a process called hydrogen embrittlement. This effect can reduce the toughness of carefully selected and prepared materials. A concern that exposure to hydrogen might encourage crack growth was present from the beginning of the Space Shuttle Program, but the rationale for using hydrogen was compelling. This paper outlines the material characterization, anomaly resolution, and path to understanding of hydrogen embrittlement on superalloys through the course of the SSME program. Specific examples of nickel alloy turbine housings and single crystal turbine blades are addressed. The evolution of fracture mechanics analytical methods is also addressed.

  16. High-speed addressable confocal microscopy for functional imaging of cellular activity.

    PubMed

    Bansal, Vivek; Patel, Saumil; Saggau, Peter

    2006-01-01

    Due to cellular complexity, studying fast signaling in neurons is often limited by: 1. the number of sites that can be simultaneously probed with conventional tools, such as patch pipettes, and 2. the recording speed of imaging tools, such as confocal or multiphoton microscopy. To overcome these spatiotemporal limitations, we develop an addressable confocal microscope that permits concurrent optical recordings from multiple user-selected sites of interest at high frame rates. Our system utilizes acousto-optic deflectors (AODs) for rapid positioning of a focused laser beam and a digital micromirror device (DMD) for addressable spatial filtering to achieve confocality. A registration algorithm synchronizes the AODs and DMD such that point illumination and point detection are always colocalized in conjugate image planes. The current system has an adjustable spatial resolution of approximately 0.5 to 1 microm. Furthermore, we show that recordings can be made at an aggregate frame rate of approximately 40 kHz. The system is capable of optical sectioning; this property is used to create 3-D reconstructions of fluorescently labeled test specimens and visualize neurons in brain slices. Additionally, we use the system to record intracellular calcium transients at several sites in hippocampal neurons using the fluorescent calcium indicator Oregon Green BAPTA-1.

  17. Addressing Information Security Risk

    ERIC Educational Resources Information Center

    Qayoumi, Mohammad H.; Woody, Carol

    2005-01-01

    Good information security does not just happen--and often does not happen at all. Resources are always in short supply, and there are always other needs that seem more pressing. Why? Because information security is hard to define, the required tasks are unclear, and the work never seems to be finished. However, the loss to the organization can be…

  18. Environmental Influences and Perinatal Risk Factors in High Risk Children.

    ERIC Educational Resources Information Center

    Lindgren, Scott D.; And Others

    Children in a longitudinal high-risk infant follow-up program were evaluated at age 5 to determine whether they demonstrated behavior problems or cognitive deficits exceeding expectations based on conditions in their home environments. Normal expectations were determined through regression analyses on a group of age-matched controls. All high-risk…

  19. Teaching Art to High Risk Groups.

    ERIC Educational Resources Information Center

    Rossol, Monona

    The role of art therapy is considered in working with such high risk groups as the institutionalized, mentally retarded, elderly, visually impaired, physically handicapped, asthmatic, hyper- and hypo-active children, hearing impaired, and patients on mind altering drugs. The special risks of infectious diseases (such as serum hepatitis), and…

  20. Followup Audit: DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle

    DTIC Science & Technology

    2016-04-29

    Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled Vehicle A P R I L...Results in Brief Followup Audit : DLA Officials Took Appropriate Actions to Address Concerns With Repair Parts for the High Mobility Multipurpose Wheeled...and Maritime Paid Too Much for High Mobility Multipurpose Wheeled Vehicle Repair Parts,” (HMMWV) was issued on April 4, 2014. The audit

  1. Understand Your Risk for High Cholesterol

    MedlinePlus

    ... Aortic Aneurysm More Understand Your Risk for High Cholesterol Updated:Apr 1,2016 LDL (bad) cholesterol is ... content was last reviewed on 04/21/2014. Cholesterol Guidelines: Putting the pieces together Myth vs. Truth – ...

  2. Microsurgery robots: addressing the needs of high-precision surgical interventions.

    PubMed

    Mattos, Leonardo S; Caldwell, Darwin G; Peretti, Giorgio; Mora, Francesco; Guastini, Luca; Cingolani, Roberto

    2016-01-01

    Robotics has a significant potential to enhance the overall capacity and efficiency of healthcare systems. Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life. In particular, robotics can have a significant impact on microsurgery, which presents stringent requirements for superhuman precision and control of the surgical tools. Microsurgery is, in fact, expected to gain importance in a growing range of surgical specialties as novel technologies progressively enable the detection, diagnosis and treatment of diseases at earlier stages. Within such scenarios, robotic microsurgery emerges as one of the key components of future surgical interventions, and will be a vital technology for addressing major surgical challenges. Nonetheless, several issues have yet to be overcome in terms of mechatronics, perception and surgeon-robot interfaces before microsurgical robots can achieve their full potential in operating rooms. Research in this direction is progressing quickly and microsurgery robot prototypes are gradually demonstrating significant clinical benefits in challenging applications such as reconstructive plastic surgery, ophthalmology, otology and laryngology. These are reassuring results offering confidence in a brighter future for high-precision surgical interventions.

  3. Jupiter Exploration: High Risk and High Rewards

    NASA Astrophysics Data System (ADS)

    Kite, Edwin S.

    2004-12-01

    Jupiter exploration is big science, and only the United States can afford self-contained missions to the gas giant and its four planet-sized moons. The Galileo spacecraft, which was recently flown into Jupiter to prevent it from contaminating Europa's ocean, cost $1.6 billion. Despite the failure of its High Gain Antenna (HGA), Galileo discovered briny, subsurface oceans on Europa, Ganymede, and Callisto; globally mapped all four Galilean moons; monitored Io's volcanic activity; carried out a 7-year study of the Jovian magnetosphere; and dropped an atmospheric probe into Jupiter's upper cloud layer. Of these achievements, the most significant is the indirect detection of a deep subsurface liquid-water layer on Europa [Pappalardo et al., 1999; Kivelson et al., 2000]. The case for a Europan ecosystem can be made [e.g., Marion et al., 2004], although it is important to remember the energetic and biogeochemical limits on putative Europan life [e.g., Soare et al., 2002]. Europa's low moment of inertia (0.346 +/- 0.005 MR2) suggests a silicate mantle below the ocean, permitting chemical exchanges between ocean and silicates, as occurs on Earth. Europa's surface is geologically young, likely emplaced 20-180 million years ago. Any recycling of surficial icy crust into the ocean could add oxygen, sulfur, and organic compounds, either impact-delivered or generated in situ by UV irradiation and the implantation of ionized particles from Jupiter's radiation belts.

  4. The Psychosis High-Risk State

    PubMed Central

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  5. A Minority Report for Social Work? The Predictive Risk Model (PRM) and the Tuituia Assessment Framework in addressing the needs of New Zealand's Vulnerable Children.

    PubMed

    Oak, Eileen

    2016-07-01

    This article examines the viability of the Risk Predictor Model (RPM) and its counterpart the actuarial risk assessment (ARA) tool in the form of the Tuituia Assessment Framework to address child vulnerability in New Zealand. In doing so, it suggests that these types of risk-assessment tools fail to address issues of contingency and complexity at the heart of the relationship-based nature of social work practice. Such developments have considerable implications for the capacity to enhance critical reflexive practice skills, whilst the introduction of these risk tools is occurring at a time when the reflexive space is being eroded as a result of the increased regulation of practice and supervision. It is further asserted that the primary aim of such instruments is not so much to detect risk, but rather to foster professional conformity with these managerialist risk-management systems so prevalent in contemporary Western societies.

  6. A Minority Report for Social Work? The Predictive Risk Model (PRM) and the Tuituia Assessment Framework in addressing the needs of New Zealand's Vulnerable Children

    PubMed Central

    Oak, Eileen

    2016-01-01

    This article examines the viability of the Risk Predictor Model (RPM) and its counterpart the actuarial risk assessment (ARA) tool in the form of the Tuituia Assessment Framework to address child vulnerability in New Zealand. In doing so, it suggests that these types of risk-assessment tools fail to address issues of contingency and complexity at the heart of the relationship-based nature of social work practice. Such developments have considerable implications for the capacity to enhance critical reflexive practice skills, whilst the introduction of these risk tools is occurring at a time when the reflexive space is being eroded as a result of the increased regulation of practice and supervision. It is further asserted that the primary aim of such instruments is not so much to detect risk, but rather to foster professional conformity with these managerialist risk-management systems so prevalent in contemporary Western societies. PMID:27559223

  7. Addressing Disaster Risk Management and Adaptation to Climate Change in the Context of Sustainable Development in Africa

    NASA Astrophysics Data System (ADS)

    Osman Elasha, B. M. E.

    2015-12-01

    The IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX) demonstrates that an extreme event which used to occur infrequently and perceived today as abnormal will be tomorrow's 'normal' weather. For example the drought events in the African Sahel which once came every decade could now come every couple of years bringing a new challenge and leading to severe disturbances and rapid environmental changes. The report identified and analyzed the problems associated with extreme climatic events, and examined how human responses to these events and the consequent disasters could contribute to adaptation objectives, and how adaptation to climate change could become better integrated with Disasters Risk Management (DRM) practices. Moreover, a number of studies explored the linkages and interactions between disasters and development and clearly demonstrates how the exposure to extremes and vulnerability to climate change can hinder development efforts, emphasizing the need for much smarter development and economic policies that consider managing disaster risk and implement adaptation measures as main components of sustainable development. The proposed presentation will provide an overview of findings from IPCC reports and other studies and will draw on existing experiences and lessons learned to explore the linkages between disaster risk management, adaptation and economic development in Africa. It will also shed light on some of the regional and global interventions which aim at mitigating the impacts of extremes and disasters in African countries characterized by high exposure & vulnerability and low adaptive capacity. It concludes by highlighting the need for broader cooperation and partnership between development partners and agencies working on disaster risk management & climate change adaptation including the private sector, bilateral and multilateral agencies in order to ensure sustainable development.

  8. High risk of permafrost thaw

    SciTech Connect

    Schuur, E.A.G.; Abbott, B.; Koven, C.D,; Riley, W.J.; Subin, Z.M.; al, et

    2011-11-01

    In the Arctic, temperatures are rising fast, and permafrost is thawing. Carbon released to the atmosphere from permafrost soils could accelerate climate change, but the likely magnitude of this effect is still highly uncertain. A collective estimate made by a group of permafrost experts, including myself, is that carbon could be released more quickly than models currently suggest, and at levels that are cause for serious concern. While our models of carbon emission from permafrost thaw are lacking, experts intimately familiar with these landscapes and processes have accumulated knowledge about what they expect to happen, based on both quantitative data and qualitative understanding of these systems. We (the authors of this piece) attempted to quantify this expertise through a survey developed over several years, starting in 2009. Our survey asked experts what percentage of surface permafrost they thought was likely to thaw, how much carbon would be released, and how much of that would be methane, for three time periods and under four warming scenarios that are part of the new IPCC Fifth Assessment Report.

  9. Management of high-risk pregnancy.

    PubMed

    Coco, L; Giannone, T T; Zarbo, G

    2014-08-01

    Today, 88% of pregnancies has a physiological course during which just basic care, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific. The approach that should be used is that of supervision in all pregnant women considering their potential to have a normal pregnancy until there is no clear evidence to the contrary. Pregnancy is considered at risk if there are medical conditions that may affect maternal or fetal health or life of the mother, fetus or both. Among the risk factors for pregnancy there is first the woman's age, in fact the increase in high-risk pregnancies in the last 20 years is attributable to the increase in the average age of women who face pregnancy. In addition, the diet is very important during pregnancy and diabetes or autoimmune diseases often lead to the failure of a pregnancy. Risk factors for pregnancy, also, are the complications that occur during its course as hypertension during pregnancy, and infectious diseases. Fears and anxieties typical of a high-risk pregnancy prevent the couple to live happily in the months of gestation. Effective communication, control and early detection are important tools that doctors must be able to ensure that women in order to plan the best treatment strategies and to minimize the risks of maternal and / or fetal.

  10. Not all risks are equal: the risk taking inventory for high-risk sports.

    PubMed

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  11. Emerging technologies for the prevention of dental caries. Are current methods of prevention sufficient for the high risk patient?

    PubMed Central

    Bretz, Walter A; Rosa, Odila P S

    2011-01-01

    Fluorides and chlorhexidine are technologies that are 65 and 40 yeas old, respectively. This overview argues that current methods of caries prevention are not effective for the high caries risk patient. In this review examples, arguments and recommendations are provided to address the high caries risk patient that include: failure of comprehensive chemical modalities treatments to address the high caries risk patient; ecological alteration - would this be an effective approach?; and biomaterials and oral microbiome research to address the high caries risk patient. PMID:21726223

  12. Healthy me: A gender-specific program to address body image concerns and risk factors among preadolescents.

    PubMed

    McCabe, Marita P; Connaughton, Catherine; Tatangelo, Gemma; Mellor, David; Busija, Lucy

    2017-03-01

    This study evaluated a gender-specific, school-based program to promote positive body image and address risk factors for body dissatisfaction. In total, 652 children aged 8-10 years participated (335 intervention, 317 wait-list control). Children participated in four 60min sessions and a recap session at three months post-intervention. The broad content areas were body image, peer relationships, media awareness, healthy diet, and exercise. The activities and examples for each session were gender specific. The recap session was an overview of the four sessions. Assessment measures were completed at pre-intervention, post-intervention, and after the recap. Boys and girls in the intervention demonstrated higher muscle esteem and vegetable intake at post-intervention, compared to children in the control condition. Boys and girls demonstrated higher body esteem, muscle esteem and fruit and vegetable intake at the recap. Boys in the intervention demonstrated less investment in masculine gender norms at post-intervention and at recap.

  13. Addressing water resources risk in England and Wales: Long term infrastructure planning in a private, regulated industry

    NASA Astrophysics Data System (ADS)

    Turner, Sean

    2015-04-01

    Water resources planning is a complex and challenging discipline in which decision makers must deal with conflicting objectives, contested socio-economic values and vast uncertainties, including long term hydrological variability. The task is arguably more demanding in England and Wales, where private water companies must adhere to a rigid set of regulatory planning guidelines in order to justify new infrastructural investments. These guidelines prescribe a "capacity expansion" approach to planning: ensure that a deterministic measure of supply, known as "Deployable Output," meets projected demand over a 25-year planning horizon. Deployable Output is derived using a method akin to yield analysis and is commensurate with the maximum rate of supply that a water resources system can sustain without incurring failure under a simulation of historical recorded hydrological conditions. This study examines whether Deployable Output analysis is fit to serve an industry in which: water companies are seeking to invest in cross-company water transfer schemes to deal with loss of water availability brought about by European environmental legislation and an increase in demand driven by population growth; water companies are expected address potential climate change impacts through their planning activities; and regulators wish to benchmark water resource system performance across the separate companies. Of particular interest, then, is the adequacy of Deployable Output analysis as a means to measuring current and future water shortage risk and comparing across supply systems. Data from the UK National River Flow Archive are used to develop a series of hypothetical reservoir systems in two hydrologically contrasting regions -- northwest England/north Wales and Southeast England. The systems are varied by adjusting the draft ratio (ratio of target annual demand to mean annual inflow), the inflow diversity (covariance of streamflow sequences supplying the system), the strength of

  14. Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study

    PubMed Central

    Alcaide, Maria L; Rodriguez, Violeta J; Fischl, Margaret A; Jones, Deborah L; Weiss, Stephen M

    2017-01-01

    Intravaginal practices (IVPs), include intravaginal cleansing (cleansing the inside of the vagina) or intravaginal insertion of products for hygiene, health or sexuality reasons. IVPs are associated with adverse female health outcomes, development of bacterial vaginosis, HIV acquisition and transmission. A mixed methods approach was used in this study to examine the prevalence of IVP, assess reasons for engagement, and perceptions of IVP among a sample of minority (African-American and Hispanic) women infected, or at-risk, for HIV in Miami, USA, a city with increasing numbers of sexually transmitted infections (STIs) and HIV. Three focus groups (total n=20) and quantitative assessments (n=72) were conducted with women infected or uninfected with HIV. In the qualitative assessments, most women reported engaging in both intravaginal cleansing and intravaginal insertion, and stated the main motivation for IVP was hygiene. The quantitative assessments confirmed that cleansing with water alone, soap with water or using commercial douches was common, as well as intravaginal insertion using a cloth or a rag in both HIV-infected and uninfected women. Women with HIV infection reported less use of water and water and soap for IVPs, and reported learning about the potential harm of IVP from their HIV health care providers. Despite their health risks, IVP appeared common in both HIV-infected and at-risk minority women, and interventions to decrease IVP could have important health implications among populations with high rates of IVP, STIs and HIV. PMID:28280394

  15. Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study.

    PubMed

    Alcaide, Maria L; Rodriguez, Violeta J; Fischl, Margaret A; Jones, Deborah L; Weiss, Stephen M

    2017-01-01

    Intravaginal practices (IVPs), include intravaginal cleansing (cleansing the inside of the vagina) or intravaginal insertion of products for hygiene, health or sexuality reasons. IVPs are associated with adverse female health outcomes, development of bacterial vaginosis, HIV acquisition and transmission. A mixed methods approach was used in this study to examine the prevalence of IVP, assess reasons for engagement, and perceptions of IVP among a sample of minority (African-American and Hispanic) women infected, or at-risk, for HIV in Miami, USA, a city with increasing numbers of sexually transmitted infections (STIs) and HIV. Three focus groups (total n=20) and quantitative assessments (n=72) were conducted with women infected or uninfected with HIV. In the qualitative assessments, most women reported engaging in both intravaginal cleansing and intravaginal insertion, and stated the main motivation for IVP was hygiene. The quantitative assessments confirmed that cleansing with water alone, soap with water or using commercial douches was common, as well as intravaginal insertion using a cloth or a rag in both HIV-infected and uninfected women. Women with HIV infection reported less use of water and water and soap for IVPs, and reported learning about the potential harm of IVP from their HIV health care providers. Despite their health risks, IVP appeared common in both HIV-infected and at-risk minority women, and interventions to decrease IVP could have important health implications among populations with high rates of IVP, STIs and HIV.

  16. The role of high frequency monitoring in understanding nutrient pollution processes to address catchment management issues

    NASA Astrophysics Data System (ADS)

    Quinn, Paul; Jonczyk, Jennine; Owen, Gareth; Barber, Nick; Adams, Russell; ODonnell, Greg; EdenDTC Team

    2015-04-01

    light of improved data, particularly in the representation of storm driven flow pathways. Hence the aggregation and the impact of any management or mitigation will rely on having confidence that local activities are beneficial, that a basket of measures merit pursuing, and are worthy of funding. A novel set of data driven risk-based indices, impact models and new experiments are needed to show the worth of catchment scale management. The high frequency data have been useful to build knowledge but a quantifiable cause and effect remains an elusive goal at the catchment scale.

  17. Electroconvulsive therapy during high-risk pregnancy.

    PubMed

    Walker, R; Swartz, C M

    1994-09-01

    Pregnancy increases the risk of injury associated with mental illness. The varieties of malnutrition, substance abuse, and aggression that may accompany mental illness can injure the unborn child in more severe ways than the patient herself. Dangers associated with illness-related behavior can outweight the risks of pharmacotherapy, but no psychotropic drug is approved for use during pregnancy. Failure to produce a prompt or lasting remission of psychiatric symptoms also is a significant possibility with medication. The morbidity from continued illness and the incompletely described adverse effects of psychotropic drugs increases the attractiveness of ECT for severely depressed pregnant patients, especially with associated high-risk conditions. This paper discusses physiologic changes occurring during pregnancy and ECT and reviews contemporary monitors of maternal and fetal well-being. Guidelines are suggested for ECT during regular and high-risk pregnancies. The authors conclude that using additional precautions with high-risk pregnant patients permits ECT to be given with relative safety; medical and obstetric risk factors need not prevent its use.

  18. Addressing the Needs of Adolescents with Autism Spectrum Disorder: Considerations and Complexities for High School Interventions

    ERIC Educational Resources Information Center

    Kucharczyk, Suzanne; Reutebuch, Colleen K.; Carter, Erik W.; Hedges, Susan; El Zein, Farah; Fan, Hannah; Gustafson, Jenny R.

    2015-01-01

    The outcomes of students with autism spectrum disorder (ASD) are driving the field to address how secondary education might be optimally designed and delivered. We conducted 28 focus groups across four states to explore the contexts, considerations, and complexities associated with delivering and combining evidence-based interventions to meet the…

  19. Religious Expression in High School Valedictory Addresses: Guidry v. Calcasieu Parish School Board.

    ERIC Educational Resources Information Center

    Vile, John R.

    1989-01-01

    Summarizes court cases bearing on religion in the school setting and the use of the three-part "Lemon" test in Establishment Clause cases; and examines a Louisiana District Court decision that affirmed the action of a school principal prohibiting a religiously oriented valedictory address. (MLF)

  20. [Cardiovascular polypill in high risk patients].

    PubMed

    Lafeber, Melvin; Spiering, Wilko; Bots, Michiel L; de Valk, Vincent; Visseren, Frank L J; Grobbee, Diederick E

    2011-01-01

    The initial theoretical concept of a polypill was a fixed-dosed combination pill containing an antiplatelet agent, a cholesterol-lowering agent and multiple blood pressure-lowering agents aimed at the prevention of atherosclerotic vascular disease in the population aged 55 years and up. The reduction in the risk of cardiovascular disease does not depend on the cholesterol level and blood pressure at the start of treatment. The pharmacological reduction in risk factors in individuals with a high risk of atherosclerotic vascular disease is often suboptimal, partly due to the complexity of the guidelines and low adherence to the therapy. A polypill may offer opportunities for improvement. Research has shown that the use of combination products leads to a greater reduction in risk factors than the use of separate substances, possibly through improved adherence to the therapy. The use of a polypill in the prevention of vascular disease in high-risk patients may lead to a more effective reduction in risk, a decrease in costs and a reduction in pharmacological expenditure.

  1. Determination of high-risk cargo

    NASA Astrophysics Data System (ADS)

    Morris, Leo A.; Smith, Douglas E.; Khan, Siraj M.

    1994-10-01

    The approach and methodology used in the determination of the type of cargo containing concealments of commercial quantities of narcotics such as cocaine and heroin is described. This high-risk cargo enters the United States through border crossings at land, seaports and airports. The volume and variety of cargos make it a complex and challenging task for the U.S. Customs Service.

  2. High-Risk Workers: The Eczematous Hand

    PubMed Central

    Barber, Kirk A.

    1989-01-01

    The hand is the most commonly involved site in occupation — related skin disease, and contact eczema is the most common diagnosis. The identification of workers at high risk for this condition is possible and will help in their management and assessment. ImagesFigure 1Figure 2Figure 3 PMID:21248925

  3. Micronutrient requirements of high-risk infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Micronutrient requirements are well-established for healthy full-term infants. However, few such recommendations exist for high-risk infants, including full-term infants with a variety of medical disorders or very preterm infants. Key micronutrients considered in this review are calcium, phosphorus,...

  4. Hurricane risk mitigation - High Pressure Gas Facility

    NASA Technical Reports Server (NTRS)

    2008-01-01

    A worker pours concrete as part of a nitrogen risk mitigation project at the High Pressure Gas Facility at Stennis Space Center. The concrete slab will provide the foundation needed to place new pumps at the site and is part of ongoing hurricane-related mitigation work at Stennis.

  5. Innovative Materials for High Risk ABE Students.

    ERIC Educational Resources Information Center

    Connett, Dian; Rathburn, Rene

    This resource book contains innovative group activities, units of instruction, writing packets, and math activities that were developed to serve high-risk adult basic education (ABE) students. Included in the first section are units of study dealing with the following topics: Oregon history, personal health issues, controversial issues in science,…

  6. Shining India?: Assessing and addressing the risks from an unsustainable trajectory of climate, water, food, energy and income inequity

    NASA Astrophysics Data System (ADS)

    Lall, U.

    2012-12-01

    Climate and demographics are primary drivers of regional resource sustainability. In today's global economy, increasing trade has provided a mechanism to alleviate regional stresses. However, increasing regional income promotes consumption, aggravating regional and global resource pressures. South Asia, has the highest population density at a sub-continent scale. Given its monsoonal climate, and high intensity of agriculture it faces perhaps the most severe population weighted water stress in the world. Rapidly declining groundwater tables and the associated high energy use for pumping for irrigated agriculture translate into unsustainable energy imports and expenditure that contributed to the two largest blackouts in global history in summer 2012. Access to water has been progressively declining for both rural and urban populations for the last 3 decades. The increasing energy imports and poor grid reliability translate into limits to the growth of manufacturing and exports of goods and services. The growing income inequity within the population and across national borders, and the impacts of floods and droughts on access to water, food and energy collectively suggest a very high risk for social unrest and a conflict flashpoint. I present a scenario analysis that establishes this case for the emergence of internal and external strife in the region as an outcome of the current resource and natural disaster management policies in the region. Prospects for strategic policy changes for water and energy management and the design of a food procurement and distribution system that could lead to a better future are discussed.

  7. 76 FR 7187 - Priorities for Addressing Risks to the Reliability of the Bulk-Power System; Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... protecting against sophisticated and fast-moving threats? What role do you expect Smart Grid to play in the... grid reliability under Smart Grid applications? If not, how should NERC address these issues? c. Will Smart Grid applications have non-cyber reliability implications that need to be addressed? d. What...

  8. Early Identification of Educationally High Potential and High Risk Children.

    ERIC Educational Resources Information Center

    Keogh, Barbara K.; Smith, Carol E.

    Early identification of educationally high potential and high risk children was investigated by following the same 49 children from kindergarten entrance through grade five of a regular school program. Kindergarten predictive measures were the Bender Gestalt Test and teachers' evaluations; follow-up measures were yearly standard achievement test…

  9. High-risk HPV types and head and neck cancer.

    PubMed

    Michaud, Dominique S; Langevin, Scott M; Eliot, Melissa; Nelson, Heather H; Pawlita, Michael; McClean, Michael D; Kelsey, Karl T

    2014-10-01

    Although HPV16 has been strongly implicated in oropharyngeal carcinogenesis, the role of other high-risk HPV types in the etiology of head and neck cancer remains unclear. To date, few data exist addressing the nature of the association between antibodies to oncogenic proteins of non-HPV16 HPVs in relation to head and neck cancer. We examined the relationship between multiple HPV types (HPV6, 11, 16, 18, 31, 33, 45, 52, 58) and head and neck squamous cell carcinoma (HNSCC) in a large population-based case-control study (1069 cases and 1107 controls). Serological measures for HPV types included antibodies to L1, E6 and/or E7. In a secondary analysis, we excluded HPV16 seropositive subjects to examine independent associations with other high-risk HPVs. All analyses were adjusted for age, race, sex, education, smoking and alcohol consumption. Statistically significant associations were observed for HPV16, 18, 33 and 52 and risk of HNSCC after mutually adjusting for HPV types. Among HPV16 seronegative subjects, elevated risks of HNSCC were observed for HPV18 E6 (OR = 4.19, 95% CI = 1.26-14.0), HPV33 E6 (OR = 7.96, 95% CI = 1.56-40.5) and HPV52 E7 (OR = 3.40, 95% CI = 1.16-9.99). When examined by tumor type, associations with HPV18 and HPV33 remained statistically significant for oropharyngeal cancer, and HPV52 was associated with oral cancer. In addition, magnitude of associations for HNSCC increased markedly with increasing number of seropositive high-risk HPV infections. High-risk HPV types, other than HPV16, are likely to be involved in the etiology of HNSCC.

  10. [Labor monitoring in high-risk situations].

    PubMed

    Houfflin-Debarge, V; Closset, E; Deruelle, P

    2008-02-01

    Intrapartum asphyxia is increased in several situations such as intrauterine growth retardation, preterm labor, postdate pregnancy or maternal diabetes. In all these cases, fetal heart rate monitoring should be preferred to intermittent auscultation. Fetal scalp blood pH or lactates can be used to identify fetuses at risk of intrapartum asphyxia. However, fetal scalp blood sampling should not delay delivery in case of severe abnormal fetal heart rate as fetal asphyxia could occur rapidly in theses high-risk pregnancies. Data is insufficient to recommend fetal pulse oximetry or ECG analysis. Research should be undertaken to evaluate their performance in these situations.

  11. A Risk Analysis Methodology to Address Human and Organizational Factors in Offshore Drilling Safety: With an Emphasis on Negative Pressure Test

    NASA Astrophysics Data System (ADS)

    Tabibzadeh, Maryam

    According to the final Presidential National Commission report on the BP Deepwater Horizon (DWH) blowout, there is need to "integrate more sophisticated risk assessment and risk management practices" in the oil industry. Reviewing the literature of the offshore drilling industry indicates that most of the developed risk analysis methodologies do not fully and more importantly, systematically address the contribution of Human and Organizational Factors (HOFs) in accident causation. This is while results of a comprehensive study, from 1988 to 2005, of more than 600 well-documented major failures in offshore structures show that approximately 80% of those failures were due to HOFs. In addition, lack of safety culture, as an issue related to HOFs, have been identified as a common contributing cause of many accidents in this industry. This dissertation introduces an integrated risk analysis methodology to systematically assess the critical role of human and organizational factors in offshore drilling safety. The proposed methodology in this research focuses on a specific procedure called Negative Pressure Test (NPT), as the primary method to ascertain well integrity during offshore drilling, and analyzes the contributing causes of misinterpreting such a critical test. In addition, the case study of the BP Deepwater Horizon accident and their conducted NPT is discussed. The risk analysis methodology in this dissertation consists of three different approaches and their integration constitutes the big picture of my whole methodology. The first approach is the comparative analysis of a "standard" NPT, which is proposed by the author, with the test conducted by the DWH crew. This analysis contributes to identifying the involved discrepancies between the two test procedures. The second approach is a conceptual risk assessment framework to analyze the causal factors of the identified mismatches in the previous step, as the main contributors of negative pressure test

  12. Stabilization of high-risk plaques

    PubMed Central

    Takata, Kohei; Zhang, Bo; Miura, Shin-ichiro; Saku, Keijiro

    2016-01-01

    The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization. PMID:27500090

  13. Major Risk Factors for Heart Disease: High Blood Cholesterol

    MedlinePlus

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  14. Report: EPA Is Documenting How It Addresses Time-Critical Public Health Risks Under Its Superfund Authority

    EPA Pesticide Factsheets

    Report #16-P-0059, December 9, 2015. We found that the EPA can provide documentation that imminent and substantial endangerment threats to public health at Superfund time-critical removal sites have been addressed.

  15. A Risk Management Framework to Characterize Black Swan Risks: A Case Study of Lightning Effects on Insensitive High Explosives

    NASA Astrophysics Data System (ADS)

    Sanders, Gary A.

    Effective and efficient risk management processes include the use of high fidelity modeling and simulation during the concept exploration phase as part of the technology and risk assessment activities, with testing and evaluation tasks occurring in later design development phases. However, some safety requirements and design architectures may be dominated by the low probability/high consequence "Black Swan" vulnerabilities that require very early testing to characterize and efficiently mitigate. Failure to address these unique risks has led to catastrophic systems failures including the space shuttle Challenger, Deepwater Horizon, Fukushima nuclear reactor, and Katrina dike failures. Discovering and addressing these risks later in the design and development process can be very costly or even lead to project cancellation. This paper examines the need for risk management process adoption of early hazard phenomenology testing to inform the technical risk assessment, requirements definition and conceptual design. A case study of the lightning design vulnerability of the insensitive high explosives being used in construction, mining, demolition, and defense industries will be presented to examine the impact of this vulnerability testing during the concept exploration phase of the design effort. While these insensitive high explosives are far less sensitive to accidental initiation by fire, impact, friction or even electrical stimuli, their full range of sensitivities have not been characterized and ensuring safe engineering design and operations during events such as lightning storms requires vulnerability testing during the risk assessment phase.

  16. Policies and initiatives aimed at addressing research misconduct in high-income countries.

    PubMed

    Resnik, David B; Master, Zubin

    2013-01-01

    David Resnik and Zubin Master review current policies and initiatives for preventing and managing research misconduct in high-income countries, summarize some high profile cases of misconduct, and make suggestions on ways forward.

  17. Gang masculinity and high-risk sexual behaviours.

    PubMed

    Dickson-Gomez, Julia; Quinn, Katherine; Broaddus, Michelle; Pacella, Maria

    2017-02-01

    High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang members from six different gangs to explore the role of powerful socialising peer groups that set gender, sexual and relationship roles and expectations for their male and female members. High-risk sexual behaviours among gang members included sex with multiple partners and group sex. Gang norms included the belief that male members were sexually insatiable with multiple sexual partners and that female gang members should be sexually available to male members. Alcohol and drugs were seen to have a large influence on sexual desire and the inability to use condoms. Much sexual behaviour with gangs, such as group sex, was viewed with ambivalence and seen as somewhat coercive. Finally, gendered sexual expectations (boys as sexually insatiable and girls as sexually available) made forming long-term romantic relationships problematic for gang members. The influence of gang norms such as these must be addressed in future programmes and interventions with gang members.

  18. A High-Risk Screen for Psychiatric Discharge Planning.

    ERIC Educational Resources Information Center

    Christ, Winifred R.; And Others

    1994-01-01

    Tested ability of 16-item high-risk screening list to accurately predict high-risk status by comparing admission and discharge high-risk scores for 448 patients with range of psychiatric disorders. Sixty-six percent of patients rated high risk at admission were identically rated at discharge. (Author/NB)

  19. High-Risk Series: An Update

    DTIC Science & Technology

    2015-02-01

    Interests a • Improving Federal Oversight of Food Safety a • Protecting Public Health through Enhanced Oversight of Medical Products a • Transforming...255 Improving Federal Oversight of Food Safety 262 Protecting Public Health through Enhanced Oversight of Medical Products 268 Contents...has been sufficient for us to narrow the scope of the high-risk issue. Specifically, the Food and Drug Administration (FDA) made progress by

  20. A Systematic Review of Training Interventions Addressing Sexual Violence against Marginalized At-Risk Groups of Women

    ERIC Educational Resources Information Center

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-01-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with…

  1. Regulatory approaches to obesity prevention: A systematic overview of current laws addressing diet-related risk factors in the European Union and the United States.

    PubMed

    Sisnowski, Jana; Handsley, Elizabeth; Street, Jackie M

    2015-06-01

    High prevalence of overweight and obesity remains a significant international public health problem. Law has been identified as a tool for obesity prevention and selected high-profile measures have been reported. However, the nature and extent of enacted legislation internationally are unclear. This research provides an overview of regulatory approaches enacted in the United States, the European Union, and EU Member States since 2004. To this end, relevant databases of primary and secondary legislation were systematically searched to identify and explore laws addressing dietary risk factors for obesity. Across jurisdictions, current regulatory approaches to obesity prevention are limited in reach and scope. Target groups are rarely the general population, but instead sub-populations in government-supported settings. Consumer information provision is preferred over taxation and marketing restrictions other than the regulation of health and nutrition claims. In the EU in particular, product reformulation with industry consent has also emerged as a popular small-scale measure. While consistent and widespread use of law is lacking, governments have employed a range of regulatory measures in the name of obesity prevention, indicating that there is, in principle, political will. Results from this study may serve as a starting point for future research and policy development.

  2. Convocation address.

    PubMed

    Kakodkar, A

    1999-07-01

    This convocation addressed by Dr. Anil Kakodkar focuses on the challenges faced by graduating students. In his speech, he emphasized the high level of excellence achieved by the industrial sector; however, he noted that there has been a loss of initiative in maximizing value addition, which was worsened by an increasing population pressure. In facing a stiff competition in the external and domestic markets, it is imperative to maximize value addition within the country in a competitive manner and capture the highest possible market share. To achieve this, high-quality human resources are central. Likewise, family planning programs should become more effective and direct available resources toward national advantage. To boost the domestic market, he suggests the need to search for strengths to achieve leadership position in those areas. First, an insight into the relationship between the lifestyles and the needs of our people and the natural resource endowment must be gained. Second, remodeling of the education system must be undertaken to prepare the people for adding the necessary innovative content in our value addition activities. Lastly, Dr. Kakodkar emphasizes the significance of developing a strong bond between parents and children to provide a sound foundation and allow the education system to grow upon it.

  3. Diabetes and Amoebiasis: a high risk encounter.

    PubMed

    Bredin, C; Margery, J; Bordier, L; Mayaudon, H; Dupuy, O; Vergeau, B; Bauduceau, B

    2004-02-01

    Amoebiasis is the second most common parasitic disease worldwIde. It occurs mainly in developing countries. A high percentage of people in countries where it is endemic are asymptomatic carriers. It results in severe disease that can be fatal in rare cases. Diabetics are at increased risk of exposure as travel to countries where it is endemic becomes more frequent, as indicated by the present case. This patient suffered from amoebiasis that produced an amoeboma which is most rare in cases of colonic amoebiasis. The clinical picture was that of an occluding gut tumor, but it was treated only with drugs. Retrospective studies show that diabetics are at increased risk of suffering severe complications after amoebic infection. The frequency and severity of this diabetes-amoeba association requires patients to take prophylactic measures, especially when travelling in developing countries.

  4. Mid-childhood outcomes of infant siblings at familial high-risk of autism spectrum disorder.

    PubMed

    Shephard, Elizabeth; Milosavljevic, Bosiljka; Pasco, Greg; Jones, Emily J H; Gliga, Teodora; Happé, Francesca; Johnson, Mark H; Charman, Tony

    2016-11-29

    Almost one-in-five infants at high familial risk for autism spectrum disorder (ASD), due to having an older sibling with an ASD diagnosis, develop ASD themselves by age 3 years. Less is known about the longer-term outcomes of high-risk infants. To address this issue, we examined symptoms of ASD and associated developmental conditions (attention-deficit/hyperactivity disorder (ADHD); anxiety), language, IQ, and adaptive behaviour at age 7 years in high- and low-risk children studied from infancy. We compared outcomes between high-risk children who met criteria for ASD at age 7, high-risk children without ASD, and low-risk control children. Diagnostic stability between 3 and 7 years was moderate. High-risk siblings with ASD showed elevated levels of ADHD and anxiety symptoms and lower adaptive behaviour than low-risk control children. High-risk siblings without ASD had higher repetitive behaviours, lower adaptive functioning, and elevated scores on one anxiety subscale (Separation Anxiety) compared to low-risk controls. The findings indicate that the difficulties experienced by high-risk siblings at school age extend beyond ASD symptoms. Better understanding of these difficulties may improve models of the development of co-occurring problems seen in children with ASD. Autism Res 2016. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

  5. High-risk sex offenders may not be high risk forever.

    PubMed

    Hanson, R Karl; Harris, Andrew J R; Helmus, Leslie; Thornton, David

    2014-10-01

    This study examined the extent to which sexual offenders present an enduring risk for sexual recidivism over a 20-year follow-up period. Using an aggregated sample of 7,740 sexual offenders from 21 samples, the yearly recidivism rates were calculated using survival analysis. Overall, the risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offense-free in the community. This pattern was particularly strong for the high-risk sexual offenders (defined by Static-99R scores). Whereas the 5-year sexual recidivism rate for high-risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offense-free in the community for 10 years. The recidivism rates of the low-risk offenders were consistently low (1%-5%) for all time periods. The results suggest that offense history is a valid, but time-dependent, indicator of the propensity to sexually reoffend. Further research is needed to explain the substantial rate of desistance by high-risk sexual offenders.

  6. Discussing spent nuclear fuel in high school classrooms: addressing public fears through early education

    SciTech Connect

    Winkel, S.; Sullivan, J.; Jones, S.; Sullivan, K.; Hyland, B.; Pencer, J.; Colton, A.

    2013-07-01

    The Inreach program combines the Deep River Science Academy (DRSA) 'learning through research' approach with state of the art communication technology to bring scientific research to high school classrooms. The Inreach program follows the DRSA teaching model where a university student tutor works on a research project with scientific staff at AECL's Chalk River Laboratories. Participating high school classes are located across Canada. The high school students learn about the ongoing research activities via weekly web conferences. In order to engage the students and encourage participation in the conferences, themed exercises linked to the research project are provided to the students. The DRSA's Inreach program uses a cost-effective internet technology to reach a wide audience, in an interactive setting, without anyone leaving their desks or offices. An example Inreach research project is presented here: an investigation of the potential of the Canadian supercritical water cooled reactor (SCWR) concept to burn transuranic elements (Np, Pu, Am, Cm) to reduce the impact of used nuclear fuel. During this project a university student worked with AECL (Atomic Energy of Canada Limited) researchers on technical aspects of the project, and high school students followed their progress and learned about the composition, hazards, and disposition options for used nuclear fuel. Previous projects included the effects of tritium on cellular viability and neutron diffraction measurement of residual stresses in automobile engines.

  7. James Clerk Maxwell Prize Address: High Intensity Laser Propagation and Interactions

    NASA Astrophysics Data System (ADS)

    Sprangle, Phillip

    2013-10-01

    High intensity laser radiation sources cover a wide range of parameters, e.g., peak powers from tera to peta watts, pulse lengths from pico to femto seconds, repetition rates ranging from kilo to mega hertz and average powers of many tens of watts. This talk will cover, among other things, some of the unique physical processes which result when high intensity laser radiation interacts with gases and plasmas. One of the interesting topics to be discussed is the propagation of these laser pulses in a turbulent atmosphere which results in a multitude of coupled linear and nonlinear processes including filamentation and scintillation. Phase conjugation techniques to reduce the effects of atmospheric turbulence (scintillation) will be described. This talk will also discuss a range of potential applications of these high intensity lasers, including: electron acceleration in spatially periodic and tapered plasma channels, detection of radioactive material using electromagnetic signatures, atmospheric lasing of N2 molecules, as well as incoherent and coherent x-ray generation mechanisms. Research supported by NRL, ONR and UMD.

  8. High numerical aperture (NA = 092) objective lens for imaging and addressing of cold atoms

    NASA Astrophysics Data System (ADS)

    Robens, Carsten; Brakhane, Stefan; Alt, Wolfgang; Kleißler, Felix; Meschede, Dieter; Moon, Geol; Ramola, Gautam; Alberti, Andrea

    2017-03-01

    We have designed, built, and characterized a high-resolution objective lens that is compatible with an ultra-high vacuum environment. The lens system exploits the principle of the Weierstrass-sphere solid immersion lens to reach a numerical aperture (NA) of 0.92. Tailored to the requirements of optical lattice experiments, the objective lens features a relatively long working distance of 150 micrometers. Our two-lens design is remarkably insensitive to mechanical tolerances in spite of the large NA. Additionally, we demonstrate the application of a tapered optical fiber tip, as used in scanning near-field optical microscopy, to measure the point spread function of a high NA optical system. From the point spread function, we infer the wavefront aberration for the entire field of view of about 75 micrometers. Pushing the NA of an optical system to its ultimate limit enables novel applications in quantum technologies such as quantum control of atoms in optical microtraps with an unprecedented spatial resolution and photon collection efficiency.

  9. Specifying the Concept of Future Generations for Addressing Issues Related to High-Level Radioactive Waste.

    PubMed

    Kermisch, Celine

    2016-12-01

    The nuclear community frequently refers to the concept of "future generations" when discussing the management of high-level radioactive waste. However, this notion is generally not defined. In this context, we have to assume a wide definition of the concept of future generations, conceived as people who will live after the contemporary people are dead. This definition embraces thus each generation following ours, without any restriction in time. The aim of this paper is to show that, in the debate about nuclear waste, this broad notion should be further specified and to clarify the related implications for nuclear waste management policies. Therefore, we provide an ethical analysis of different management strategies for high-level waste in the light of two principles, protection of future generations-based on safety and security-and respect for their choice. This analysis shows that high-level waste management options have different ethical impacts across future generations, depending on whether the memory of the waste and its location is lost, or not. We suggest taking this distinction into account by introducing the notions of "close future generations" and "remote future generations", which has important implications on nuclear waste management policies insofar as it stresses that a retrievable disposal has fewer benefits than usually assumed.

  10. A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

    PubMed

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-12-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence.

  11. School Counsellors' Perceptions on Working with Student High-Risk Behaviour

    ERIC Educational Resources Information Center

    Harris, Gregory E.; Jeffery, Gary

    2010-01-01

    The current exploratory-descriptive study used a survey design method to examine guidance counsellors' and educational psychologists' perceptions of their preparation, motivation, and effectiveness in preventing, assessing, and intervening into student high-risk behaviour. The study also explored training associated with addressing high-risk…

  12. The economic impact of addressing the organ shortage with clinically high-risk allografts.

    PubMed

    Lentine, Krista L; Schnitzler, Mark A

    2011-01-01

    Expanding gaps between the number of patients awaiting transplantation and the number who receive organs in the United States has been associated with heightened disease severity among transplant candidates and more common use of organs from non-standard donors. We summarize data on the economic consequences of liver and renal allograft quality in contemporary practice. Policy makers and providers must work together to ensure that financial disincentives do not lead to wastage of lifesaving organs.

  13. Recommended minimal requirements and development guidelines for exposure setups of bio-experiments addressing the health risk concern of wireless communications.

    PubMed

    Kuster, N; Schönborn, F

    2000-10-01

    The evidence currently available on the potential health effects from electromagnetic field (EMF) exposure has been largely judged as being too tentative and inadequate to meet criteria for assessing health risks. Some of the main reasons for these shortcomings lie in the incomplete description of the exposure and poorly characterized dosimetry. Well-defined exposure conditions are essential to obtain reproducible and scientifically valuable results. To facilitate the development of optimized setups for specific bio-experiments, this paper lists basic requirements and provides development guidelines for evaluation, optimization, construction, and verification of exposure. In addition, definitions of minimum performance requirements for setups addressing the health risk concern of wireless communications are suggested.

  14. High risk factors of pancreatic carcinoma.

    PubMed

    Camara, Soriba Naby; Yin, Tao; Yang, Ming; Li, Xiang; Gong, Qiong; Zhou, Jing; Zhao, Gang; Yang, Zhi-Yong; Aroun, Tajoo; Kuete, Martin; Ramdany, Sonam; Camara, Alpha Kabinet; Diallo, Aissatou Taran; Feng, Zhen; Ning, Xin; Xiong, Jiong-Xin; Tao, Jing; Qin, Qi; Zhou, Wei; Cui, Jing; Huang, Min; Guo, Yao; Gou, Shan-Miao; Wang, Bo; Liu, Tao; Olivier, Ohoya Etsaka Terence; Conde, Tenin; Cisse, Mohamed; Magassouba, Aboubacar Sidiki; Ballah, Sneha; Keita, Naby Laye Moussa; Souare, Ibrahima Sory; Toure, Aboubacar; Traore, Sadamoudou; Balde, Abdoulaye Korse; Keita, Namory; Camara, Naby Daouda; Emmanuel, Dusabe; Wu, He-Shui; Wang, Chun-You

    2016-06-01

    Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

  15. LCA of emerging technologies: addressing high uncertainty on inputs' variability when performing global sensitivity analysis.

    PubMed

    Lacirignola, Martino; Blanc, Philippe; Girard, Robin; Pérez-López, Paula; Blanc, Isabelle

    2017-02-01

    In the life cycle assessment (LCA) context, global sensitivity analysis (GSA) has been identified by several authors as a relevant practice to enhance the understanding of the model's structure and ensure reliability and credibility of the LCA results. GSA allows establishing a ranking among the input parameters, according to their influence on the variability of the output. Such feature is of high interest in particular when aiming at defining parameterized LCA models. When performing a GSA, the description of the variability of each input parameter may affect the results. This aspect is critical when studying new products or emerging technologies, where data regarding the model inputs are very uncertain and may cause misleading GSA outcomes, such as inappropriate input rankings. A systematic assessment of this sensitivity issue is now proposed. We develop a methodology to analyze the sensitivity of the GSA results (i.e. the stability of the ranking of the inputs) with respect to the description of such inputs of the model (i.e. the definition of their inherent variability). With this research, we aim at enriching the debate on the application of GSA to LCAs affected by high uncertainties. We illustrate its application with a case study, aiming at the elaboration of a simple model expressing the life cycle greenhouse gas emissions of enhanced geothermal systems (EGS) as a function of few key parameters. Our methodology allows identifying the key inputs of the LCA model, taking into account the uncertainty related to their description.

  16. HIGH-RISK PROGRAM: Information on Selected High-Risk Areas.

    DTIC Science & Technology

    2007-11-02

    United States General Accounting Office GAO Information for House MajorityLeader Richard Armey and Representative Pete Sessions May 1997 GH-RISK ID...Information on Selected High-Risk Areas Corporate Author Or Publisher: General Accounting Office, GAO, Washington, DC 20548 Report Number: GAO/IHR-97-30 Report...Library: 000001 Record ID: 45053 GAO United States General Accounting OfficeWashington, D.C. 20548 Accounting and Information Management Division May

  17. Implications of turbulence interactions: A path toward addressing very high Reynolds number flows

    SciTech Connect

    Zhou, Y

    2006-05-15

    The classical 'turbulence problem' is narrowed down and redefined for scientific and engineering applications. From an application perspective, accurate computation of large-scale transport of the turbulent flows is needed. In this paper, a scaling analysis that allows for the large-scales of very high Reynolds number turbulent flows - to be handled by the available supercomputers is proposed. Current understanding of turbulence interactions of incompressible turbulence, which forms the foundation of our argument, is reviewed. Furthermore, the data redundancy in the inertial range is demonstrated. Two distinctive interactions, namely, the distance and near-grid interactions, are inspected for large-scale simulations. The distant interactions in the subgrid scales in an inertial range can be effectively modelled by an eddy damping. The near-grid interactions must be carefully incorporated.

  18. Addressing Health Literacy Challenges with a Cutting-Edge Infectious Disease Curriculum for the High School Biology Classroom

    ERIC Educational Resources Information Center

    Jacque, Berri; Koch-Weser, Susan; Faux, Russell; Meiri, Karina

    2016-01-01

    This study reports the secondary analysis of evaluation data from an innovative high school biology curriculum focused on infectious disease (ID) to examine the health literacy implications of teaching claims evaluation, data interpretation, and risk assessment skills in the context of 21st-Century health science. The curriculum was implemented…

  19. 2010 SSS Presidential Address: The Devolution of Risk and the Changing Life Course in the United States

    ERIC Educational Resources Information Center

    O'Rand, Angela M.

    2011-01-01

    Recent patterns of labor exit in late life in the United States are increasingly heterogeneous. This heterogeneity stems from diverse employment careers that are emerging in the workplace where job security is declining. Individuals' structural locations in the labor market expose them to diverse risks for employment and income security at older…

  20. Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

    PubMed

    Brinkley-Rubinstein, Lauren; Cloud, David H; Davis, Chelsea; Zaller, Nickolas; Delany-Brumsey, Ayesha; Pope, Leah; Martino, Sarah; Bouvier, Benjamin; Rich, Josiah

    2017-03-13

    Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

  1. Presidential address.

    PubMed

    Vohra, U

    1993-07-01

    The Secretary of India's Ministry of Health and Family Welfare serves as Chair of the Executive Council of the International Institute for Population Sciences in Bombay. She addressed its 35th convocation in 1993. Global population stands at 5.43 billion and increases by about 90 million people each year. 84 million of these new people are born in developing countries. India contributes 17 million new people annually. The annual population growth rate in India is about 2%. Its population size will probably surpass 1 billion by the 2000. High population growth rates are a leading obstacle to socioeconomic development in developing countries. Governments of many developing countries recognize this problem and have expanded their family planning programs to stabilize population growth. Asian countries that have done so and have completed the fertility transition include China, Japan, Singapore, South Korea, and Thailand. Burma, Malaysia, North Korea, Sri Lanka, and Vietnam have not yet completed the transition. Afghanistan, Bangladesh, Iran, Nepal, and Pakistan are half-way through the transition. High population growth rates put pressure on land by fragmenting finite land resources, increasing the number of landless laborers and unemployment, and by causing considerable rural-urban migration. All these factors bring about social stress and burden civic services. India has reduced its total fertility rate from 5.2 to 3.9 between 1971 and 1991. Some Indian states have already achieved replacement fertility. Considerable disparity in socioeconomic development exists among states and districts. For example, the states of Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh have female literacy rates lower than 27%, while that for Kerala is 87%. Overall, infant mortality has fallen from 110 to 80 between 1981 and 1990. In Uttar Pradesh, it has fallen from 150 to 98, while it is at 17 in Kerala. India needs innovative approaches to increase contraceptive prevalence rates

  2. Identifying Successful Strategies Implemented by Teachers in High Performing, High Poverty Schools to Address the Diverse Needs of Economically Disadvantaged Students

    ERIC Educational Resources Information Center

    Taylor-Statom, Yolanda

    2012-01-01

    This research study sought to identify the successful strategies used by teachers in high performing, high poverty schools to address the needs of economically disadvantaged students. The study examined teacher perceptions, motivation factors, and instructional strategies as they relate to the improvement of the academic progress of economically…

  3. Out on the town: an evaluation of brief motivational interventions to address the risks associated with problematic alcohol use.

    PubMed

    Sharp, Douglas; Atherton, Susie R

    2006-10-01

    Alcohol has long been identified as a significant contributory factor in crime and anti social behaviour, yet there is a dearth of effective treatment available for those individuals whose drinking contributes significantly to their criminality, and subsequently the health risks and the economic and wider social implications associated with it. The literature on treatment programmes is drawn almost exclusively from medical experience but indicates that brief interventions are at least as effective as more intensive programmes in reducing alcohol consumption in at-risk groups. This research was undertaken to evaluate projects based in the West Midlands, United Kingdom, providing brief motivational interventions to offenders arrested for offences where alcohol is identified as a significant contributory factor. The evaluation indicates that an arrest referral scheme as developed in the West Midlands can achieve good levels of identification and referral, acceptable attendance, retention rates, and effective outcomes in terms of attitude and behaviour change.

  4. Addressing the “Risk Environment” for Injection Drug Users: The Mysterious Case of the Missing Cop

    PubMed Central

    Burris, Scott; Blankenship, Kim M; Donoghoe, Martin; Sherman, Susan; Vernick, Jon S; Case, Patricia; Lazzarini, Zita; Koester, Stephen

    2004-01-01

    Ecological models of the determinants of health and the consequent importance of structural interventions have been widely accepted, but using these models in research and practice has been challenging. Examining the role of criminal law enforcement in the “risk environment” of injection drug users (IDUs) provides an opportunity to apply structural thinking to the health problems associated with drug use. This article reviews international evidence that laws and law enforcement practices influence IDU risk. It argues that more research is needed at four levels—laws; management of law enforcement agencies; knowledge, attitudes, beliefs, and practices of frontline officers; and attitudes and experiences of IDUs—and that such research can be the basis of interventions within law enforcement to enhance IDU health. PMID:15016246

  5. Pilot evaluation of the Making Employment Needs [MEN] count intervention: addressing behavioral and structural HIV risks in heterosexual black men.

    PubMed

    Raj, Anita; Dasgupta, Anindita; Goldson, Irvienne; Lafontant, Dumas; Freeman, Elmer; Silverman, Jay G

    2014-02-01

    Few community-based HIV interventions exist for Black men at heterosexual risk for HIV. None focus on structural HIV risks such as unemployment and unstable housing. This study involved a pilot evaluation of the MEN (Making Employment Needs) Count HIV intervention, a three session peer counselor-delivered program of HIV risk reduction and gender-equity counseling, and employment and housing case management. A single-arm intervention trial of MEN Count was conducted with Black men recruited from a community men's clinic and social services program. Eligible men were those who reported two or more sex partners in the past six months and current unemployment and/or recent homelessness. Most participants (68%) had a history of incarceration. Participants (N = 50) were surveyed on outcomes at baseline (Time 1), posttest (Time 2; 60-90 days after baseline), and two-month follow-up (Time 3). The majority of participants were retained in the program (86%) and the final follow-up survey (76%). McNemar tests revealed significant reductions in the past 30-day unprotected sex from Time 1 (74%) to Time 2 (47%) and to Time 3 (47%), and in homelessness from Time 1 (58%) to Time 3 (32%). Significant increases in employment from Time 1 (8%) to Time 2 (29%) and Time 3 (32%) were also seen. Participants completed a brief participant satisfaction survey at posttest. Most (n=28, 65%) rated the program as excellent, and an additional 10 (23%) rated it as good. Although there was no significant reduction in multiple sex partners, a trend was observed from Time 1 (56%) to Time 2 (44%) and Time 3 (42%). Findings suggest that the MEN Count model is a feasible and promising HIV prevention program for Black men at heterosexual risk for HIV. Larger scale implementation and more rigorous evaluation of MEN Count are needed to confirm the study findings.

  6. Reducing sexual risk behavior among high risk couples in Northern India

    PubMed Central

    Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M.

    2013-01-01

    Purpose This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self efficacy, knowledge, conflict resolution and coping among high risk heterosexual couples in Northern India. Method This pilot study was conducted at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in one month of 3 weekly gender concordant behavioral intervention groups and were individually administered assessments pre- and post-intervention. The intervention was tailored to the Northern Indian context, and addressed sexual barrier use, HIV/STI transmission and cognitive behavioral skill building focusing on sexual negotiation and communication. Results Participants were a mean age of 32 (men) and 29 (women) years, and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (<100% of the time) (64% of women, 59% of men). Post-intervention, nearly all participants reported consistent use (100% of the time) (100% of men, 97% of women). Participants also reported decreased verbal aggression, increased self efficacy and increased HIV-related knowledge, and women increased their use of positive coping tactics. Conclusions Results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high risk couples may be an important adjunct to preventing the development of a generalized epidemic in India. PMID:22648338

  7. Integrating Professional and Folk Models of HIV Risk: YMSM's Perceptions of High-Risk Sex

    ERIC Educational Resources Information Center

    Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

    2008-01-01

    Risks associated with HIV are well documented in research literature. Although a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the "professional" and "folk" models of HIV risk based on…

  8. Youth Risk Behavior Surveillance National Alternative High School Youth Risk Behavior Survey, United States, 1998.

    ERIC Educational Resources Information Center

    Grunbaum, Jo Anne; Kann, Laura; Kinchen, Steven A.; Ross, James G.; Gowda, Vani R.; Collins, Janet L.; Kolbe, Lloyd J.

    2000-01-01

    The 1998 National Alternative High School Youth Risk Behavior Survey measured health risk behaviors at alternative high schools. Many alternative students engaged in behaviors that made them high-risk for serious problems (e.g., motor vehicle safety, violence, nutrition, sexuality, exercise, and substance abuse). Their prevalence of high risk…

  9. Procedures for addressing uncertainty and variability in exposure to characterize potential health risk from trichloroethylene contaminated groundwater at Beale Air Force Base in California

    SciTech Connect

    Bogen, K T; Daniels, J I; Hall, L C

    1999-09-01

    This study was designed to accomplish two objectives. The first was to provide to the US Air Force and the regulatory community quantitative procedures that they might want to consider using for addressing uncertainty and variability in exposure to better characterize potential health risk. Such methods could be used at sites where populations may now or in the future be faced with using groundwater contaminated with low concentrations of the chemical trichloroethylene (TCE). The second was to illustrate and explain the application of these procedures with respect to available data for TCE in ground water beneath an inactive landfill site that is undergoing remediation at Beale Air Force Base in California. The results from this illustration provide more detail than the more traditional conservative deterministic, screening-level calculations of risk, also computed for purposes of comparison. Application of the procedures described in this report can lead to more reasonable and equitable risk-acceptability criteria for potentially exposed populations at specific sites.

  10. Eating disorders "mental health literacy" in low risk, high risk and symptomatic women: implications for health promotion programs.

    PubMed

    Mond, Jonathan M; Hay, Phillipa J; Paxton, Susan J; Rodgers, Bryan; Darby, Anita; Nillson, Jodi; Quirk, Frances; Owen, Cathy

    2010-01-01

    Attitudes and beliefs concerning the nature and treatment of bulimia nervosa (BN) were compared among young adult women at low risk of an eating disorder (n = 332), at high risk (n = 83), or already showing symptoms (n = 94). Participants completed a self-report questionnaire that included a measure of eating disorder symptoms. A vignette of a fictional person suffering from BN was presented, followed by a series of questions addressing the nature and treatment of the problem described. High-risk and symptomatic participants were more likely than low-risk participants to report that they would not approach anyone for advice or help, were they to have BN or a similar problem, because they would not want anyone to know. Symptomatic participants were more likely to believe that someone with BN would be discriminated against, more likely to consider bulimic behaviors to be acceptable, and more likely to view BN as being common among women in the community, than low-risk participants, participants in the high-risk group being intermediate on each of these questions. The findings suggest that the attitudes and beliefs of individuals with eating disorder symptoms differ systematically from those of individuals at high risk, but who do not yet have symptoms, and from those at low risk. They also indicate specific attitudes and beliefs that may need to be addressed in prevention and early intervention programs. The potential benefits of assessing individuals' attitudes and beliefs concerning the nature and treatment of eating-disordered behaviour and tailoring program content accordingly may be worthy of investigation.

  11. Counseling women at high risk for breast cancer.

    PubMed

    Stefanek, M E

    1990-01-01

    Cancer risk analysis is a relatively new clinical service that has developed as more precise information has become available regarding specific risk factors. Both epidemiological and genetic factors contribute substantially to the identification of women at higher risk for developing breast cancer. The definition of what constitutes risk, an understanding of which factors influence risk, and the ability to present risk information clearly are critical features. In addition to providing information about risk and assessing each woman's perception of risk, the emotional issues must be addressed. The focus of intervention should center upon the benefits of early detection, assessment of breast self-examination skills, individualized breast cancer screening recommendations, such as mammography and physical exams, and recommendations for life style changes for possible prevention.

  12. Advanced Risk Analysis for High-Performing Organizations

    DTIC Science & Technology

    2006-01-01

    using traditional risk analysis techniques. Mission Assurance Analysis Protocol (MAAP) is one technique that high performers can use to identify and mitigate the risks arising from operational complexity....The operational environment for many types of organizations is changing. Changes in operational environments are driving the need for advanced risk ... analysis techniques. Many types of risk prevalent in today’s operational environments (e.g., event risks, inherited risk) are not readily identified

  13. Welcome Address

    NASA Astrophysics Data System (ADS)

    Kiku, H.

    2014-12-01

    Ladies and Gentlemen, It is an honor for me to present my welcome address in the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3), as the president of Kanto Gakuin University. Particularly to those from abroad more than 17 countries, I am very grateful for your participation after long long trips from your home to Yokohama. On the behalf of the Kanto Gakuin University, we certainly welcome your visit to our university and stay in Yokohama. First I would like to introduce Kanto Gakuin University briefly. Kanto Gakuin University, which is called KGU, traces its roots back to the Yokohama Baptist Seminary founded in 1884 in Yamate, Yokohama. The seminary's founder was Albert Arnold Bennett, alumnus of Brown University, who came to Japan from the United States to establish a theological seminary for cultivating and training Japanese missionaries. Now KGU is a major member of the Kanto Gakuin School Corporation, which is composed of two kindergartens, two primary schools, two junior high schools, two senior high schools as well as KGU. In this university, we have eight faculties with graduate school including Humanities, Economics, Law, Sciences and Engineering, Architecture and Environmental Design, Human and Environmental Studies, Nursing, and Law School. Over eleven thousands students are currently learning in our university. By the way, my major is the geotechnical engineering, and I belong to the faculty of Sciences and Engineering in my university. Prof. T. Yamada, here, is my colleague in the same faculty. I know that the nuclear physics is one of the most active academic fields in the world. In fact, about half of the participants, namely, more than 50 scientists, come from abroad in this conference. Moreover, I know that the nuclear physics is related to not only the other fundamental physics such as the elementary particle physics and astrophysics but also chemistry, medical sciences, medical cares, and radiation metrology

  14. Reducing need and demand for medical services in high-risk persons. A health education approach.

    PubMed Central

    Fries, J F; McShane, D

    1998-01-01

    We undertook this study to identify persons with high medical use to target them for health promotion and self-management interventions specific to their problems. We compared the reductions in cost and health risk of a health education program aimed at high-risk persons with a similar program addressed to all risk levels. We compared health risk and use in 2,586 high-risk persons with those of employee (N = 50,576) and senior (N = 39,076) groups and contrasted results in specific high-risk disease or behavior categories (modules)--arthritis, back pain, high blood pressure, diabetes mellitus, heart disease, smoking, and obesity--against each other, using validated self-report measures, over a 6-month period. Interventions were a standard generic health education program and a similar program directed at high risk individuals (Healthtrac). Health risk scores improved by 11% in the overall high-risk group compared with 9% in the employee group and 6% in the senior group. Physician use decreased by 0.8 visits per 6 months in the high-risk group compared with 0.05 and 0.15 visits, respectively, per 6 months in the employee and senior groups. Hospital stays decreased by 0.2 days per 6 months in the high-risk group compared with 0.05 days in the comparison groups. The duration of illness or confinement to home decreased by 0.9 days per 6 months in the high-risk group and 0.15 and 0.25, respectively, in the employee and senior groups. Using imputed costs of $130 per physician visit, $1,000 per hospital day, and $200 per sick day, previous year costs were $1,138 in direct costs for the high-risk groups compared with $352 and $995 in the employee and senior groups, respectively. At 6 months, direct costs were reduced by $304 in the high-risk group compared with $57 and $70 in the comparison groups. Total costs were reduced $484 in the high-risk groups compared with $87 in the employee group and $120 in the senior group. The return on investment was about 6:1 in the high-risk

  15. Uncovering Clinical Principles and Techniques to Address Minority Stress, Mental Health, and Related Health Risks Among Gay and Bisexual Men

    PubMed Central

    Pachankis, John E.

    2014-01-01

    Gay and bisexual men disproportionately experience depression, anxiety, and related health risks at least partially because of their exposure to sexual minority stress. This paper describes the adaptation of an evidence-based intervention capable of targeting the psychosocial pathways through which minority stress operates. Interviews with key stakeholders, including gay and bisexual men with depression and anxiety and expert providers, suggested intervention principles and techniques for improving minority stress coping. These principles and techniques are consistent with general cognitive behavioral therapy approaches, the empirical tenets of minority stress theory, and professional guidelines for LGB-affirmative mental health practice. If found to be efficacious, the psychosocial intervention described here would be one of the first to improve the mental health of gay and bisexual men by targeting minority stress. PMID:25554721

  16. Young Children Living in Risky Circumstances. Addressing the Needs of At Risk Students during the Early Learning Years. Technical Team Report. Submitted to the Commission for Students At Risk of School Failure.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This report addresses the conditions of at-risk children and builds a case for changing the odds so that they favor such children. The introduction summarizes nearly a decade of education reform efforts related to disadvantaged youth. It underscores the need to intervene early. Four subsequent sections: (1) describe the developmental…

  17. Addressing the Antibiotic Resistance Problem with Probiotics: Reducing the Risk of Its Double-Edged Sword Effect

    PubMed Central

    Imperial, Ivan C. V. J.; Ibana, Joyce A.

    2016-01-01

    Antibiotic resistance is a global public health problem that requires our attention. Indiscriminate antibiotic use is a major contributor in the introduction of selective pressures in our natural environments that have significantly contributed in the rapid emergence of antibiotic-resistant microbial strains. The use of probiotics in lieu of antibiotic therapy to address certain health conditions in both animals and humans may alleviate these antibiotic-mediated selective pressures. Probiotic use is defined as the actual application of live beneficial microbes to obtain a desired outcome by preventing diseased state or improving general health. Multiple studies have confirmed the beneficial effects of probiotic use in the health of both livestock and humans. As such, probiotics consumption is gaining popularity worldwide. However, concerns have been raised in the use of some probiotics strains that carry antibiotic resistance genes themselves, as they have the potential to pass the antibiotic resistance genes to pathogenic bacteria through horizontal gene transfer. Therefore, with the current public health concern on antibiotic resistance globally, in this review, we underscore the need to screen probiotic strains that are used in both livestock and human applications to assure their safety and mitigate their potential in significantly contributing to the spread of antibiotic resistance genes in our natural environments. PMID:28018315

  18. Addressing Burnout in Oncology: Why Cancer Care Clinicians Are At Risk, What Individuals Can Do, and How Organizations Can Respond.

    PubMed

    Hlubocky, Fay J; Back, Anthony L; Shanafelt, Tait D

    2016-01-01

    Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.

  19. Addressing Health Literacy Challenges With a Cutting-Edge Infectious Disease Curriculum for the High School Biology Classroom.

    PubMed

    Jacque, Berri; Koch-Weser, Susan; Faux, Russell; Meiri, Karina

    2016-02-01

    This study reports the secondary analysis of evaluation data from an innovative high school biology curriculum focused on infectious disease (ID) to examine the health literacy implications of teaching claims evaluation, data interpretation, and risk assessment skills in the context of 21st-Century health science. The curriculum was implemented between 2010 and 2013 in Biology II classes held in four public high schools (three in Massachusetts and one in Ohio), plus a private school in Virginia. A quasi-experimental design was used in which student participants (n = 273) were compared to an age-matched, nonparticipant, peer group (N = 125). Participants in each school setting demonstrated increases in conceptual content knowledge (Cohen's d > 1.89) as well as in understanding how to apply scientific principles to health claims evaluation and risk assessment (Cohen's d > 1.76) and in self-efficacy toward learning about ID (Cohen's d > 2.27). Participants also displayed enhanced communication about ID within their social networks relative to the comparison group (p < .05). The data show that integrating the claims evaluation, data interpretation, and risk assessment skills critical for 21st-century health literacy health into high school biology classrooms is effective at fostering both the skills and self-efficacy pertinent to health literacy learning in diverse populations.

  20. Identifying patients at high risk of breast cancer recurrence: strategies to improve patient outcomes

    PubMed Central

    Martei, Yehoda M; Matro, Jennifer M

    2015-01-01

    Identifying patients at high risk of breast cancer recurrence has important implications not only for enabling the ability to provide accurate information to patients but also the potential to improve patient outcomes. Patients at high recurrence risk can be offered appropriate treatment to improve the overall survival. However, the major challenge is identifying patients with early-stage breast cancer at lower risk who may be spared potentially toxic therapy. The successful integration of molecular assays into clinical practice may address the problem of overtreatment and improve overall patient outcomes. PMID:26504408

  1. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

    Though President Barack Obama has rarely made healthcare references in his State of the Union addresses, health policy experts are hoping he changes that strategy this year. "The question is: Will he say anything? You would hope that he would, given that that was the major issue he started his presidency with," says Dr. James Weinstein, left, of the Dartmouth-Hitchcock health system.

  2. Addressing the Intersection of HIV and Intimate Partner Violence Among Women with or at Risk for HIV in the United States.

    PubMed

    McCree, Donna Hubbard; Koenig, Linda J; Basile, Kathleen C; Fowler, Dawnovise; Green, Yvonne

    2015-05-01

    In 2012, the White House established a working group in recognition of the need to understand and address the intersection of human immunodeficiency virus (HIV) infection and violence against women and girls. This report describes the Centers for Disease Control and Prevention (CDC)'s efforts for addressing intimate partner violence and HIV among women and provides suggestions for future prevention efforts. CDC's current efforts are focused on understanding these often co-occurring public health problems, identifying effective interventions, and ensuring that states and communities have the capacity and resources to implement prevention approaches based on the best available evidence. Additional research is needed on effective strategies for integrating violence prevention and HIV programming into health services targeting adolescent girls and women who experience intimate partner violence or are at risk for HIV.

  3. A highly addressable static droplet array enabling digital control of a single droplet at pico-volume resolution.

    PubMed

    Jeong, Heon-Ho; Lee, Byungjin; Jin, Si Hyung; Jeong, Seong-Geun; Lee, Chang-Soo

    2016-04-26

    Droplet-based microfluidics enabling exquisite liquid-handling has been developed for diagnosis, drug discovery and quantitative biology. Compartmentalization of samples into a large number of tiny droplets is a great approach to perform multiplex assays and to improve reliability and accuracy using a limited volume of samples. Despite significant advances in microfluidic technology, individual droplet handling in pico-volume resolution is still a challenge in obtaining more efficient and varying multiplex assays. We present a highly addressable static droplet array (SDA) enabling individual digital manipulation of a single droplet using a microvalve system. In a conventional single-layer microvalve system, the number of microvalves required is dictated by the number of operation objects; thus, individual trap-and-release on a large-scale 2D array format is highly challenging. By integrating double-layer microvalves, we achieve a "balloon" valve that preserves the pressure-on state under released pressure; this valve can allow the selective releasing and trapping of 7200 multiplexed pico-droplets using only 1 μL of sample without volume loss. This selectivity and addressability completely arranged only single-cell encapsulated droplets from a mixture of droplet compositions via repetitive selective trapping and releasing. Thus, it will be useful for efficient handling of miniscule volumes of rare or clinical samples in multiplex or combinatory assays, and the selective collection of samples.

  4. Multifunctional shape memory electrodes for dielectric elastomer actuators enabling high holding force and low-voltage multisegment addressing

    NASA Astrophysics Data System (ADS)

    McCoul, David; Rosset, Samuel; Besse, Nadine; Shea, Herbert

    2017-02-01

    Dielectric elastomer actuators (DEAs) are an attractive form of electromechanical transducer, possessing high energy densities, an efficient design, mechanical flexibility, high speed, and noiseless operation. They have been incorporated into a variety of elegant devices, such as microfluidic devices, tunable optics, haptic displays, and minimum-energy grippers. Dielectric elastomer minimum energy structures (DEMESs) take advantage of the prestretch of the DEA to bend a non-stretchable but flexible component to perform mechanical work. The gripper is perhaps the most intuitive type of DEMES, capable of grasping objects but with only small to moderate forces. We present a novel configuration of a DEA using electrodes made of a conductive shape-memory polymer (SMP), incorporated into the design of a gripper. The SMP electrodes allow the DEA to be rigid in the cold state, offering greater holding force than a conventional gripper. Joule heating applied to the SMP electrodes softens them, allowing for electrostatic actuation. Cooling then locks in the actuated position without the need for continued power to be supplied. Additionally, the Joule heating voltage is at least one order of magnitude less than electrostatic actuation voltages, allowing for addressing of multiple actuator elements using commercially available transistors. The shape memory gripper incorporates this addressing into its design, enabling the three segments of each finger to be controlled independently.

  5. Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

    PubMed

    Balcazar, H; Alvarado, M; Ortiz, G

    2011-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

  6. Tenth Warren K. Sinclair keynote address-the Fukushima nuclear power plant accident and comprehensive health risk management.

    PubMed

    Yamashita, Shunichi

    2014-02-01

    Just two years have passed since the Tokyo Electric Power Company-Fukushima Daiichi Nuclear Power Plant (NPP) accident, a multidimensional disaster that combined to destroy the local infrastructure on which the safety system depended and gave a serious impact to the world. Countermeasures including evacuation, sheltering, and control of the food chain were implemented in a timely manner by the Japanese government. However, there is a clear need for improvement, especially in the areas of nuclear safety and protection and also in the management of the radiation health risk during and even after the accident. To date there have been no acute radiation injuries. The radiation-related physical health consequences to the general public, including evacuees, are likely to be much lower than those arising from the Chernobyl nuclear reactor accident, because the radiation fallout and the subsequent environmental contamination were much more limited. However, the social, psychological, and economic impacts of the Fukushima NPP accident are expected to be considerable. Currently, continued monitoring and characterization of the levels of radioactivity in the environment and foods in Fukushima are vital for obtaining informed consent to the decisions on living in the areas already radiocontaminated and returning back to the evacuated areas once re-entry is permitted; it is also important to perform a realistic assessment of the radiation doses on the basis of measurements. We are currently implementing the official plans of the Fukushima Health Management Survey, which includes a basic survey for the estimation of the external doses that were received during the first 4 mo after the accident and four more detailed surveys (thyroid ultrasound examination, comprehensive health check-up, mental health and life-style survey, and survey of pregnant women and nursing mothers), with the aim to take care of the health of all of the residents of the Fukushima Prefecture for a long time

  7. Keynote address

    SciTech Connect

    Cheney, D.

    1997-12-31

    March 10th is an anniversary date for Dick Cheney. Eight years ago today President Bush asked him to be his Secretary of Defense. He was his second choice. John Tower was his first. On March 17, 1989, Cheney was confirmed and sworn into the office of Secretary of Defense. He quickly began closing down his office on Capital Hill and he reported to work on March 18. Much changed for him that day, but not everything. He still had constituents. But instead of the residents of Wyoming, he represented the entire Armed forces of the United States of America. For this convention, he was asked to discuss the worldwide reserves and associated development risks, the risks and rewards in the US industry and 21st Century vision for energy within the US. He discusses the Halliburton view on the natural gas energy future, the US role, implications for a new business model, and political risk.

  8. Modeling biotic habitat high risk areas

    USGS Publications Warehouse

    Despain, D.G.; Beier, P.; Tate, C.; Durtsche, B.M.; Stephens, T.

    2000-01-01

    Fire, especially stand replacing fire, poses a threat to many threatened and endangered species as well as their habitat. On the other hand, fire is important in maintaining a variety of successional stages that can be important for approach risk assessment to assist in prioritizing areas for allocation of fire mitigation funds. One example looks at assessing risk to the species and biotic communities of concern followed by the Colorado Natural Heritage Program. One looks at the risk to Mexican spottled owls. Another looks at the risk to cutthroat trout, and a fourth considers the general effects of fire and elk.

  9. Potential application of population models in the European ecological risk assessment of chemicals. II. Review of models and their potential to address environmental protection aims.

    PubMed

    Galic, Nika; Hommen, Udo; Baveco, J M Hans; van den Brink, Paul J

    2010-07-01

    Whereas current chemical risk assessment (RA) schemes within the European Union (EU) focus mainly on toxicity and bioaccumulation of chemicals in individual organisms, most protection goals aim at preserving populations of nontarget organisms rather than individuals. Ecological models are tools rarely recommended in official technical documents on RA of chemicals, but are widely used by researchers to assess risks to populations, communities and ecosystems. Their great advantage is the relatively straightforward integration of the sensitivity of species to chemicals, the mode of action and fate in the environment of toxicants, life-history traits of the species of concern, and landscape features. To promote the usage of ecological models in regulatory risk assessment, this study tries to establish whether existing, published ecological modeling studies have addressed or have the potential to address the protection aims and requirements of the chemical directives of the EU. We reviewed 148 publications, and evaluated and analyzed them in a database according to defined criteria. Published models were also classified in terms of 5 areas where their application would be most useful for chemical RA. All potential application areas are well represented in the published literature. Most models were developed to estimate population-level responses on the basis of individual effects, followed by recovery process assessment, both in individuals and at the level of metapopulations. We provide case studies for each of the proposed areas of ecological model application. The lack of clarity about protection goals in legislative documents made it impossible to establish a direct link between modeling studies and protection goals. Because most of the models reviewed here were not developed for regulatory risk assessment, there is great potential and a variety of ecological models in the published literature.

  10. Creating a strategy for science-based national policy: Addressing conflicting views on the health risk of low-level ionizing radiation. Final report, Wingspread Conference

    SciTech Connect

    McClellan, Roger O.; Apple, Martin A.

    1998-03-03

    Significant cancer risk for adults exposed to more than 100 millisieverts (10 REM) of ionizing radiation. More research on low-level ionizing radiation is needed in molecular and cellular mechanisms of injury and ongoing exposed populations. Implementation costs should be considered in regulating low-level ionizing radiation. Comparative risk assessment is a powerful tool for risk-based policy formation, and conflicting legal statutes should become harmonized for radiation regulation. More public dialog on low-level radiation is needed. A high level commission should evaluate radiation hazard control practices.

  11. [Keynote address: Climate change

    SciTech Connect

    Forrister, D.

    1994-12-31

    Broadly speaking, the climate issue is moving from talk to action both in the United States and internationally. While few nations have adopted strict controls or stiff new taxes, a number of them are developing action plans that are making clear their intention to ramp up activity between now and the year 2000... and beyond. There are sensible, economically efficient strategies to be undertaken in the near term that offer the possibility, in many countries, to avoid more draconian measures. These strategies are by-and-large the same measures that the National Academy of Sciences recommended in a 1991 report called, Policy Implications of Greenhouse Warming. The author thinks the Academy`s most important policy contribution was how it recommended the nations act in the face of uncertain science and high risks--that cost effective measures are adopted as cheap insurance... just as nations insure against other high risk, low certainty possibilities, like catastrophic health insurance, auto insurance, and fire insurance. This insurance theme is still right. First, the author addresses how the international climate change negotiations are beginning to produce insurance measures. Next, the author will discuss some of the key issues to watch in those negotiations that relate to longer-term insurance. And finally, the author will report on progress in the United States on the climate insurance plan--The President`s Climate Action Plan.

  12. Early Molecular Stratification of High-risk Primary Biliary Cholangitis.

    PubMed

    Hardie, Claire; Green, Kile; Jopson, Laura; Millar, Ben; Innes, Barbara; Pagan, Sarah; Tiniakos, Dina; Dyson, Jessica; Haniffa, Muzlifah; Bigley, Venetia; Jones, David E; Brain, John; Walker, Lucy J

    2016-12-01

    High-risk primary biliary cholangitis (PBC), defined by inadequate response at one year to Ursodeoxycholic acid (UDCA), is associated with disease progression and liver transplantation. Stratifying high-risk patients early would facilitate improved approaches to care. Using long-term follow-up data to define risk at presentation, 6 high-risk PBC patients and 8 low-risk patients were identified from biopsy, transplant and biochemical archival records. Formalin-fixed paraffin-embedded (FFPE) liver biopsies taken at presentation were graded (Scheuer and Nakanuma scoring) and gene expression analysed using the NanoString® nCounter PanCancer Immunity 770-gene panel. Principle component analysis (PCA) demonstrated discrete gene expression clustering between controls and high- and low-risk PBC. High-risk PBC was characterised by up-regulation of genes linked to T-cell activation and apoptosis, INF-γ signalling and leukocyte migration and down-regulation of those linked to the complement pathway. CDKN1a, up-regulated in high-risk PBC, correlated with significantly increased expression of its gene product, the senescence marker p21(WAF1/Cip), by biliary epithelial cells. Our findings suggest high- and low-risk PBC are biologically different from disease outset and senescence an early feature in high-risk disease. Identification of a high-risk 'signal' early from standard FFPE tissue sections has clear clinical utility allowing for patient stratification and second-line therapeutic intervention.

  13. High Pain Tolerance Tied to 'Silent' Heart Attack Risk

    MedlinePlus

    ... 162666.html High Pain Tolerance Tied to 'Silent' Heart Attack Risk Unusual symptoms include upper back or jaw ... be at increased risk of having a "silent" heart attack, a new study hints. Chest pain is one ...

  14. Procedures for addressing uncertainty and variability in exposure to characterize potential health risk from trichloroethylene contaminated ground water at Beale Air Force Base in California

    SciTech Connect

    Daniels, J I; Bogen, K T; Hall, L C

    1999-10-05

    Conservative deterministic, screening-level calculations of exposure and risk commonly are used in quantitative assessments of potential human-health consequences from contaminants in environmental media. However, these calculations generally are based on multiple upper-bound point estimates of input parameters, particularly for exposure attributes, and can therefore produce results for decision makers that actually overstate the need for costly remediation. Alternatively, a more informative and quantitative characterization of health risk can be obtained by quantifying uncertainty and variability in exposure. This process is illustrated in this report for a hypothetical population at a specific site at Beale Air Force Base in California, where there is trichloroethylene (TCE) contaminated ground water and a potential for future residential use. When uncertainty and variability in exposure were addressed jointly for this case, the 95th-percentile upper-bound value of individual excess lifetime cancer risk was a factor approaching 10 lower than the most conservative deterministic estimate. Additionally, the probability of more than zero additional cases of cancer can be estimated, and in this case it is less than 0.5 for a hypothetical future residential population of up to 26,900 individuals present for any 7.6-y interval of a 70-y time period. Clearly, the results from application of this probabilistic approach can provide reasonable and equitable risk-acceptability criteria for a contaminated site.

  15. Risk Management in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Cinnamon, Jerry

    This paper outlines management guidelines for outdoor adventure pursuits based on analysis of accident case studies in the literature. Managing risk, to a large degree, involves managing human errors related to natural environmental hazards. The knowledge needed to manage risk may be gained through personal experience (the most dangerous way),…

  16. The Healthy African American Families' risk communications initiative: using community partnered participatory research to address preterm birth at the local level.

    PubMed

    Jones, Loretta; Wright, Kynna; Wright, Aziza; Brown, Neysa Dillon; Broussard, Marsha; Hogan, Vijaya

    2010-01-01

    Preterm birth is the leading cause of infant death for African Americans and is significantly associated with lifelong morbidity. Primary prevention efforts using medical strategies to reduce the rates of preterm birth have been unsuccessful. Using community partnered participatory processes, the Healthy African American Families project in Los Angeles developed a multilevel, risk communications strategy to promote awareness about preterm birth in the local community. Participants included community members, community-based organizations, local government, healthcare providers, and national-level advocates. The initiative focused on increasing social support for pregnant women, providing current information on preterm birth risks, and improving quality of health services. The initiative includes components addressing community education, mass media, provider education, and community advocacy. Products include 100 Intentional Acts of Kindness toward a Pregnant Woman, a doorknob brochure on signs and symptoms of preterm labor, and an education manual on preterm birth and other African American health issues. Cooperation, affiliation, and community self-help were key aspects of the planning process and the health promotion products. Additional community benefits included increased leadership and skills development. The process and products described here may be useful in other communities and for addressing other health outcomes in communities of color.

  17. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    PubMed Central

    Joly, Lauren E.; Connolly, Jennifer

    2016-01-01

    Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45) of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61) of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability. PMID:26840336

  18. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  19. Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

    Cancer.gov

    Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

  20. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation

    PubMed Central

    Abud, Tulio B.; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation. PMID:28299010

  1. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation.

    PubMed

    Abud, Tulio B; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  2. AlGaInN laser diode bar and array technology for high power and individually addressable applications

    NASA Astrophysics Data System (ADS)

    Najda, Stephen P.; Perlin, Piotr; Suski, Tadek; Marona, Lucja; Boćkowski, Mike; Leszczyński, Mike; Wisniewski, Przemek; Czernecki, Robert; Kucharski, Robert; Targowski, Grzegorz

    2015-05-01

    The AlGaInN material system allows for laser diodes to be fabricated over a very wide range of wavelengths from u.v., ~380nm, to the visible ~530nm, by tuning the indium content of the laser GaInN quantum well. Low defectivity and high uniformity GaN substrates allows arrays and bars of AlGaInN lasers with up to 20 emitters to be fabricated to obtain optical powers up to 4W at 395nm. AlGaInN laser bars are suitable for optical pumps and novel extended cavity systems for a wide range of applications. An alternative package configuration for AlGaInN laser arrays allows for each individual laser to be addressed individually allowing complex free-space and/or fibre optic system integration with a very small form-factor.

  3. Direct social support for young high risk children: relations with behavioral and emotional outcomes across time.

    PubMed

    Appleyard, Karen; Egeland, Byron; Sroufe, L Alan

    2007-06-01

    This study is unique in addressing developmental correlates of direct social support for young children in a high risk sample, in contrast to previous studies addressing social support for caregivers. Participants were drawn from a prospective, longitudinal study of at-risk children. Social support was rated from maternal interviews throughout early childhood. Support from the mother was assessed from mother-child observations. Outcomes included internalizing and externalizing behavior problems measured from first through tenth grades. The most common support providers were biological fathers, followed by grandparents and other providers. Using multilevel modeling, higher quantity, higher quality, and lower disruption of support predicted lower starting levels of behavior problems, controlling for support from the mother. Disruption was associated with change in slope. Gender differences were found for externalizing behavior intercepts. Social support provides a promotive factor for young high risk children. Implications include involving children's social support providers in prevention and intervention programs.

  4. An analysis of content in comprehensive cancer control plans that address chronic hepatitis B and C virus infections as major risk factors for liver cancer.

    PubMed

    Momin, Behnoosh; Richardson, Lisa

    2012-08-01

    Chronic hepatitis B and hepatitis C virus (HBV and HCV) infections are among the leading causes of preventable death worldwide. Chronic viral hepatitis is the cause of most primary liver cancer, which is the third leading cause of cancer deaths globally and the ninth leading cause of cancer deaths in the United States. The extent to which comprehensive cancer control (CCC) programs in states, tribal governments and organizations, territories, and Pacific Island jurisdictions address chronic hepatitis B and/or hepatitis C infections as risk factors for liver cancer or recommend interventions for liver cancer prevention in their CCC plans remains unknown. We searched CCC plans for this information using the search tool at http://www.cdc.gov/cancer/ncccp/ to access the content of plans for this information. A combination of key search terms including "liver cancer", "hepatitis", "chronic alcohol", and "alcohol abuse" were used to identify potential content regarding liver cancer risk factors and prevention. Relevant content was abstracted for further review and classification. Of 66 (Although CDC funds 65 programs, one of the Pacific Island Jurisdiction grantees is the Federated States of Micronesia (FSM). This national program supports four FSM states, each of which submits a cancer plan to CDC for a total of 69 plans. During this time period, 66 plans were available on the website.) CCC plans, 27% (n = 18) addressed liver cancer using the above-mentioned search terms. In the 23 plans that addressed HBV and/or HCV, there were 25 goals, objectives, strategies, and outcomes aimed at reducing the incidence or prevalence of HBV and/or HCV infection. While nearly a third of CCC programs identify at least one goal, objective, strategy, outcome, or prevention program to reduce cancer burden in their CCC plans, few plans discuss specific actions needed to reduce the burden of liver cancer.

  5. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks

    PubMed Central

    Petkova, Elisaveta P.; Ebi, Kristie L.; Culp, Derrin; Redlener, Irwin

    2015-01-01

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades. PMID:26270669

  6. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks.

    PubMed

    Petkova, Elisaveta P; Ebi, Kristie L; Culp, Derrin; Redlener, Irwin

    2015-08-11

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region's coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region's unique vulnerabilities, and outlines recommendations for improving the region's ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  7. Review of chemoradiotherapy for high-risk prostate cancer.

    PubMed

    Sanfilippo, Nicholas; Hardee, Matthew E; Wallach, Jonathan

    2011-01-01

    While most newly-diagnosed prostate cancers are well-differentiated tumors that have high probability of cure, there is a subset of patients that present with aggressive malignancies that have significant potential for recurrence and metastasis. Single-modality treatment approaches have demonstrated relatively high failure rates, and multimodality therapy (radiation therapy and hormonal ablation therapy) has become standard of care for these patients. These treatments are not without toxicity, and a significant percentage of patients will become refractory to hormonal therapy. Historically, radiation therapy of prostate cancer was associated with significant genitourinary and gastrointestinal morbidity. With advances in radiation therapy techniques and delivery, the potential for safe dose-escalation has emerged. Further, there is an opportunity for chemotherapeutic agents to play an important syngergistic role in radiosensitizing the tumor cells at the primary site while also addressing micrometastatic disease. Concurrent chemoradiation therapy has become standard treatment for many types of locally advanced tumors, including lung, cervical, esophageal, rectal, and anal malignancies. We present a review of clinical trials examining the role of chemoradiation therapy in high-risk prostate cancer.

  8. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods

    PubMed Central

    Bruins, Maaike J.; Mugambi, Gladys; Verkaik-Kloosterman, Janneke; Hoekstra, Jeljer; Kraemer, Klaus; Osendarp, Saskia; Melse-Boonstra, Alida; Gallagher, Alison M.; Verhagen, Hans

    2015-01-01

    Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR) and above the Tolerable Upper Intake Level (UL) are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods. PMID:25630617

  9. AlGaInN laser diode bar and array technology for high-power and individual addressable applications

    NASA Astrophysics Data System (ADS)

    Najda, S. P.; Perlin, P.; Suski, T.; Marona, L.; Boćkowski, M.; Leszczyński, M.; Wisniewski, P.; Czernecki, R.; Kucharski, R.; Targowski, G.

    2016-04-01

    The AlGaInN material system allows for laser diodes to be fabricated over a very wide range of wavelengths from u.v., ~380nm, to the visible ~530nm, by tuning the indium content of the laser GaInN quantum well, giving rise to new and novel applications for medical, industrial, display and scientific purposes. Ridge waveguide laser diode structures are fabricated to achieve single mode operation with high optical powers of >100mW with high reliability. Low defectivity and highly uniform GaN substrates allow arrays and bars of nitride lasers to be fabricated. We demonstrate the operation of monolithic AlGaInN laser bars with up to 20 emitters giving optical powers up to 4W cw at ~395nm with a common contact configuration. These bars are suitable for optical pumps and novel extended cavity systems. An alternative package configuration for AlGaInN laser arrays allows for each individual laser to be individually addressable allowing complex free-space and/or fibre optic system integration within a very small form-factor.

  10. Very high risk localized prostate cancer: definition and outcomes

    PubMed Central

    Sundi, Debasish; Wang, Vinson M.; Pierorazio, Phillip M.; Han, Misop; Bivalacqua, Trinity J.; Ball, Mark W.; Antonarakis, Emmanuel S.; Partin, Alan W.; Schaeffer, Edward M.; Ross, Ashley E.

    2013-01-01

    Purpose Outcomes in men with NCCN high-risk prostate cancer (PCa) can vary substantially--some will have excellent cancer-specific survival, whereas others will experience early metastasis even after aggressive local treatments. Current nomograms, which yield continuous risk probabilities, do not separate high-risk PCa into distinct sub-strata. Here we derive a binary definition of very-high-risk (VHR) localized PCa to aid in risk stratification at diagnosis and selection of therapy. Materials and Methods We queried the Johns Hopkins radical prostatectomy database to identify 753 men with NCCN high-risk localized PCa (Gleason sum 8–10, PSA >20 ng/ml, or clinical stage ≥T3). 28 alternate permutations of adverse grade, stage, and cancer volume were compared by their hazard ratios for metastasis and cancer-specific mortality. VHR criteria with top-ranking hazard ratios were further evaluated by multivariable analyses and inclusion of a clinically meaningful proportion of the high-risk cohort. Results The VHR cohort was best defined by primary pattern 5 present on biopsy, or ≥5 cores with Gleason sum 8–10, or multiple NCCN high-risk features. These criteria encompassed 15.1% of the NCCN high-risk cohort. Compared to other high-risk men, VHR men were at significantly higher risk for metastasis (H.R. 2.75) and cancer-specific mortality (H.R. 3.44) (p <0.001 for both). Among high-risk men, VHR men also had significantly worse 10-year metastasis-free survival (37% vs 78%) and cancer-specific survival (62% vs 90%). Conclusions Men who meet VHR criteria form a subgroup within the current NCCN high-risk classification who have particularly poor oncologic outcomes. Use of these characteristics to distinguish VHR localized PCa may help in counseling and selection optimal candidates for multimodal treatments or clinical trials. PMID:24189998

  11. Who takes risks in high-risk sports? A typological personality approach.

    PubMed

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-12-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing mountaineering rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and conscientiousness. Results showed that personality types with a configuration of low conscientiousness combined with high extraversion and/or high neuroticism (impulsive, hedonistic, insecure) were greater risk-takers. Conversely, personality types with a configuration of high conscientiousness combined with low extraversion and/or high extraversion (skeptic, brooder, entrepreneur) were lower risk-takers. Results are discussed in the context of typology and other approaches to understanding who takes risks in high-risk domains.

  12. Inaugural address

    NASA Astrophysics Data System (ADS)

    Joshi, P. S.

    2014-03-01

    From jets to cosmos to cosmic censorship P S Joshi Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, India E-mail: psj@tifr.res.in 1. Introduction At the outset, I should like to acknowledge that part of the title above, which tries to capture the main flavour of this meeting, and has been borrowed from one of the plenary talks at the conference. When we set out to make the programme for the conference, we thought of beginning with observations on the Universe, but then we certainly wanted to go further and address deeper questions, which were at the very foundations of our inquiry, and understanding on the nature and structure of the Universe. I believe, we succeeded to a good extent, and it is all here for you in the form of these Conference Proceedings, which have been aptly titled as 'Vishwa Mimansa', which could be possibly translated as 'Analysis of the Universe'! It is my great pleasure and privilege to welcome you all to the ICGC-2011 meeting at Goa. The International Conference on Gravitation and Cosmology (ICGC) series of meetings are being organized by the Indian Association for General Relativity and Gravitation (IAGRG), and the first such meeting was planned and conducted in Goa in 1987, with subsequent meetings taking place at a duration of about four years at various locations in India. So, it was thought appropriate to return to Goa to celebrate the 25 years of the ICGC meetings. The recollections from that first meeting have been recorded elsewhere here in these Proceedings. The research and teaching on gravitation and cosmology was initiated quite early in India, by V V Narlikar at the Banares Hindu University, and by N R Sen in Kolkata in the 1930s. In course of time, this activity grew and gained momentum, and in early 1969, at the felicitation held for the 60 years of V V Narlikar at a conference in Ahmedabad, P C Vaidya proposed the formation of the IAGRG society, with V V Narlikar being the first President. This

  13. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents

    PubMed Central

    Brown, Matthew R. G.; Benoit, James R. A.; Juhás, Michal; Dametto, Ericson; Tse, Tiffanie T.; MacKay, Marnie; Sen, Bhaskar; Carroll, Alan M.; Hodlevskyy, Oleksandr; Silverstone, Peter H.; Dolcos, Florin; Dursun, Serdar M.; Greenshaw, Andrew J.

    2015-01-01

    High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14–17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents. PMID:26483645

  14. Opening Address

    NASA Astrophysics Data System (ADS)

    Yamada, T.

    2014-12-01

    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  15. Considering psychoeducation on structural dissociation for dialectical behavior therapy patients experiencing high-risk dissociative behaviors.

    PubMed

    Shabb, Olivia

    2016-01-01

    Dialectical behavioral therapy (DBT) programs, particularly for low-functioning individuals at the safety and stabilization phase of therapy, work with a variety of high-risk and often complex cases, with a curriculum consisting primarily of concrete skill acquisition and application. A significant subset of individuals in DBT programs, however, may suffer high-risk dissociative episodes in which skill application may be less available to them, contributing to further destabilization, demoralization, and thoughts of self-inefficacy in treatment. This article evaluates the potential benefits of complementing traditional DBT with psychoeducation on structural dissociation for such patients, acknowledging and addressing some of the concerns that might accompany such a consideration.

  16. Prevalence of High-Risk Human Papillomavirus Among Older Women

    PubMed Central

    Lindau, Stacy Tessler; Drum, Melinda L.; Gaumer, Elyzabeth; Surawska, Hanna; Jordan, Jeanne A.

    2009-01-01

    Objective To estimate the prevalence, genotypes, and individual-level correlates of high-risk human papillomavirus (HPV) among women aged 57–85. Methods Community-residing women (n=1550), aged 57–85, were drawn from a nationally-representative probability sample. In-home interviews and biomeasures, including a self-collected vaginal specimen, were obtained between 2005 and 2006. Specimens were analyzed for high-risk HPV DNA using probe hybridization and signal amplification (hc2); of 1,028 specimens provided, 1,010 were adequate for analysis. All samples testing positive were analyzed for HPV DNA by L1 consensus polymerase chain reaction followed by type-specific hybridization. Results The overall population-based weighted estimate of high-risk HPV prevalence by hc2 was 6.0% (95% confidence interval [CI] = 4.5 to 7.9). Current marital and smoking status, frequency of sexual activity, history of cancer, and hysterectomy were associated with high-risk HPV positivity. Among high-risk HPV+ women, 63% had multiple type infections. HPV 16 or 18 was present in 17.4% of all high-risk HPV+ women. The most common high-risk genotypes among high-risk HPV+ women were HPV 61 (19.1%), 31 (13.1%), 52 (12.9%), 58 (12.5%), 83 (12.3%), 66(12.0%), 51 (11.7%), 45 (11.2%), 56 (10.3%), 53 (10.2%), 16 (9.7%), and 62 (9.2%). Being married and having an intact uterus were independently associated with lower prevalence of high-risk HPV. Among unmarried women, current sexual activity and smoking were independently and positively associated with high-risk HPV infection. Conclusions In this nationally representative population, nearly 1 in 16 women aged 57–85 were found to have high-risk HPV and prevalence was stable across older age groups. PMID:18978096

  17. Opportunity, risk, and success recognizing, addressing, and balancing multiple factors crucial to the success of a project management system deployed to support multi-lateral decommissioning programs

    SciTech Connect

    Funk, Greg; Longsworth, Paul

    2007-07-01

    This paper addresses the factors involved in effectively implementing a world-class program/project management information system funded by multiple nations. Along with many other benefits, investing in and utilizing such systems improves delivery and drive accountability for major expenditures. However, there are an equally large number of impediments to developing and using such systems. To be successful, the process requires a dynamic combining of elements and strategic sequencing of initiatives. While program/project-management systems involve information technologies, software and hardware, they represent only one element of the overall system.. Technology, process, people and knowledge must all be integrated and working in concert with one another to assure a fully capable system. Major system implementations occur infrequently, and frequently miss established targets in relatively small organizations (with the risk increasing with greater complexity). The European Bank of Reconstruction (EBRD) is midway through just such an implementation. The EBRD is using funds from numerous donor countries to sponsor development of an overarching program management system. The system will provide the Russian Federation with the tools to effectively manage prioritizing, planning, and physically decommissioning assets{sub i}n northwest Russia to mitigate risks associated the Soviet era nuclear submarine program. Project-management delivery using world-class techniques supported by aligned systems has been proven to increase the probability of delivering on-time and on-budget, assuring those funding such programs optimum value for money. However, systems deployed to manage multi-laterally funded projects must be developed with appropriate levels of consideration given to unique aspects such as: accommodation of existing project management methods, consideration for differences is management structures and organizational behaviors, incorporation of unique strengths, and

  18. High Density Individually Addressable Nanowire Arrays Record Intracellular Activity from Primary Rodent and Human Stem Cell Derived Neurons.

    PubMed

    Liu, Ren; Chen, Renjie; Elthakeb, Ahmed T; Lee, Sang Heon; Hinckley, Sandy; Khraiche, Massoud L; Scott, John; Pre, Deborah; Hwang, Yoontae; Tanaka, Atsunori; Ro, Yun Goo; Matsushita, Albert K; Dai, Xing; Soci, Cesare; Biesmans, Steven; James, Anthony; Nogan, John; Jungjohann, Katherine L; Pete, Douglas V; Webb, Denise B; Zou, Yimin; Bang, Anne G; Dayeh, Shadi A

    2017-04-10

    We report a new hybrid integration scheme that offers for the first time a nanowire-on-lead approach, which enables independent electrical addressability, is scalable, and has superior spatial resolution in vertical nanowire arrays. The fabrication of these nanowire arrays is demonstrated to be scalable down to submicrometer site-to-site spacing and can be combined with standard integrated circuit fabrication technologies. We utilize these arrays to perform electrophysiological recordings from mouse and rat primary neurons and human induced pluripotent stem cell (hiPSC)-derived neurons, which revealed high signal-to-noise ratios and sensitivity to subthreshold postsynaptic potentials (PSPs). We measured electrical activity from rodent neurons from 8 days in vitro (DIV) to 14 DIV and from hiPSC-derived neurons at 6 weeks in vitro post culture with signal amplitudes up to 99 mV. Overall, our platform paves the way for longitudinal electrophysiological experiments on synaptic activity in human iPSC based disease models of neuronal networks, critical for understanding the mechanisms of neurological diseases and for developing drugs to treat them.

  19. High-risk pregnancy and the rheumatologist.

    PubMed

    Soh, May Ching; Nelson-Piercy, Catherine

    2015-04-01

    Rheumatologists are increasingly involved in the care of young women who, in the age of biologic therapy, are now gaining control of their rheumatic diseases and attempting pregnancy. With careful planning, most women with rheumatic diseases have successful pregnancies. This article focuses specifically on the highest-risk pregnancies and controversial areas. We discuss the women at risk of complications, the types of maternal and fetal complications, the treatments that can be used in pregnancy (and breastfeeding) and longer-term outcomes that could affect the mother. SLE, RA, ANCA-associated vasculitides, large vessel vasculitis (e.g. Takayasu's) and other CTDs (e.g. scleroderma) are among the conditions covered. The evidence and controversies regarding the recommendations for the use of biologics in pregnancy are discussed. The role of the rheumatologist in pregnancy planning and caring for the pregnant and post-partum woman as part of the multidisciplinary team is discussed.

  20. A Prevention Program for Middle-School High Risk Youth.

    ERIC Educational Resources Information Center

    Gittman, Elizabeth; Cassata, Marian

    A 5-year federally funded substance abuse prevention program targeted 426 high risk middle-school youth from 4 school districts in Nassau County, New York. Combining a child-centered model with a systemic approach, the program's goal was to prevent or delay the onset of alcohol and other drug use. High-risk youth were identified by school…

  1. Serving Teenage Mothers and Their High-Risk Infants

    ERIC Educational Resources Information Center

    Levenson, Phyllis; And Others

    1978-01-01

    Describes the program of the Demonstration and Training Center for High Risk or Mentally Retarded Infants of Teenage Mothers (ITAM), which aims at providing stimulation to the high-risk infant in order to enhance his/her development, and to offer educational and supportive programs for the teenage mother. (CM)

  2. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false High risk recipients. 35.6790 Section 35.6790 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  3. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  4. Choice of hospital for delivery: a comparison of high-risk and low-risk women.

    PubMed Central

    Phibbs, C S; Mark, D H; Luft, H S; Peltzman-Rennie, D J; Garnick, D W; Lichtenberg, E; McPhee, S J

    1993-01-01

    OBJECTIVE. This article tests whether or not the factors that affect hospital choice differ for selected subgroups of the population. DATA SOURCES. 1985 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts and hospital financial data were used. STUDY DESIGN. Models for hospital choice were estimated using McFadden's conditional logit model. Separate models were estimated for high-risk and low-risk patients, and for high-risk and low-risk women covered either by private insurance or by California Medicaid. The model included independent variables to control for quality, price, ownership, and distance to the hospital. DATA EXTRACTION. Data covered all maternal deliveries in the San Francisco Bay Area in 1985 (N = 61,436). ICD-9 codes were used to classify patients as high-risk or low-risk. The expected payment code on the discharge abstract was used to identify insurance status. PRINCIPAL FINDINGS. The results strongly reject the hypothesis that high-risk and low-risk women have the same choice process. Hospital quality tended to be more important for high-risk than low-risk women. These results also reject the hypothesis that factors influencing choice of hospital are the same for women covered by private insurance as for those covered by Medicaid. Further, high-risk women covered by Medicaid were less likely than high-risk women covered by private insurance to deliver in hospitals with newborn intensive care units. CONCLUSIONS. The results show that the choice factors vary across several broadly defined subgroups of patients with a specific condition. Thus, estimates aggregating all patients may be misleading. Specifically, such estimates will understate actual patient response to quality of care indicators, since patient sensitivity to quality of care varies with the patients' risk status. PMID:8514500

  5. Connecting with Students to Limit High-Risk Behaviors.

    ERIC Educational Resources Information Center

    Mendler, Allen N.

    2002-01-01

    Many youth use substances and engage in other high-risk behaviors in an attempt to allay the emptiness accompanying broken belongings. Schools can play important roles in fostering connections and creating the natural high that comes from success. (Author)

  6. Breast reconstruction after bilateral prophylactic mastectomy in women at high risk for breast cancer.

    PubMed

    Eldor, Liron; Spiegel, Aldona

    2009-01-01

    Several studies have shown the effectiveness of bilateral prophylactic mastectomies (BPM) at reducing the risk of developing breast cancer in women by more than 90%. A growing number of women at high risk for breast cancer are electing to undergo prophylactic mastectomy as part of a risk reduction strategy. This unique group of women frequently chooses to undergo reconstructive surgery as a part of their immediate treatment plan. Breast reconstruction after BPM has profound physiological and emotional impact on body image, sexuality, and quality of life. These factors should be taken into consideration and addressed when consulting the patient prior to BPM and reconstructive surgery. The timing of reconstructive surgery, the type of mastectomy performed, the reconstructive modalities available, and the possibility to preserve the nipple-areola complex, should all be discussed with the patient prior to surgery. In this article, we review our experience and the current existing literature on breast reconstruction for high-risk women after BPM.

  7. Offshore finfish aquaculture in the United States: An examination of federal laws that could be used to address environmental and occupational public health risks.

    PubMed

    Fry, Jillian P; Love, David C; Shukla, Arunima; Lee, Ryan M

    2014-11-19

    Half of the world's edible seafood comes from aquaculture, and the United States (US) government is working to develop an offshore finfish aquaculture industry in federal waters. To date, US aquaculture has largely been regulated at the state level, and creating an offshore aquaculture industry will require the development of a new regulatory structure. Some aquaculture practices involve hazardous working conditions and the use of veterinary drugs, agrochemicals, and questionable farming methods, which could raise environmental and occupational public health concerns if these methods are employed in the offshore finfish industry in the US. This policy analysis aims to inform public health professionals and other stakeholders in the policy debate regarding how offshore finfish aquaculture should be regulated in the US to protect human health; previous policy analyses on this topic have focused on environmental impacts. We identified 20 federal laws related to offshore finfish aquaculture, including 11 that are relevant to preventing, controlling, or monitoring potential public health risks. Given the novelty of the industry in the US, myriad relevant laws, and jurisdictional issues in an offshore setting, federal agencies need to work collaboratively and transparently to ensure that a comprehensive and functional regulatory structure is established that addresses the potential public health risks associated with this type of food production.

  8. Offshore Finfish Aquaculture in the United States: An Examination of Federal Laws That Could be Used to Address Environmental and Occupational Public Health Risks

    PubMed Central

    Fry, Jillian P.; Love, David C.; Shukla, Arunima; Lee, Ryan M.

    2014-01-01

    Half of the world’s edible seafood comes from aquaculture, and the United States (US) government is working to develop an offshore finfish aquaculture industry in federal waters. To date, US aquaculture has largely been regulated at the state level, and creating an offshore aquaculture industry will require the development of a new regulatory structure. Some aquaculture practices involve hazardous working conditions and the use of veterinary drugs, agrochemicals, and questionable farming methods, which could raise environmental and occupational public health concerns if these methods are employed in the offshore finfish industry in the US. This policy analysis aims to inform public health professionals and other stakeholders in the policy debate regarding how offshore finfish aquaculture should be regulated in the US to protect human health; previous policy analyses on this topic have focused on environmental impacts. We identified 20 federal laws related to offshore finfish aquaculture, including 11 that are relevant to preventing, controlling, or monitoring potential public health risks. Given the novelty of the industry in the US, myriad relevant laws, and jurisdictional issues in an offshore setting, federal agencies need to work collaboratively and transparently to ensure that a comprehensive and functional regulatory structure is established that addresses the potential public health risks associated with this type of food production. PMID:25415208

  9. Individually addressable microelectrode arrays fabricated with gold-coated pencil graphite particles for multiplexed and high sensitive impedance immunoassays.

    PubMed

    Zhang, Yun; Wang, Hua; Nie, Jinfang; Zhang, Yuwei; Shen, Guoli; Yu, Ruqin

    2009-09-15

    A renewable, site-selective immobilization platform of microelectrode array (MEA) for multiplexed immunoassays has been initially developed using pencil graphite particles coated with gold layers as microelectrodes. The graphite particles available on the common pencil were utilized for directing the electro-deposition of gold layers with uniform microstructures which displayed a well-defined sigmoidal voltammetric response. In the concept-of-proof experiments, the resulting MEA platform was modified with functionalized monolayer, on which anti-human IgG antibodies could be stably immobilized in a site-selective way through binding chemistry to selectively capture human IgG antigens from the sample media. The subsequent introduction of anti-human IgG antibodies conjugated with 15 nm electro-active gold nanoparticles to recognize the captured IgG proteins resulted in a significant decrease in the interfacial electron-transfer resistance. High sensitive electrochemical quantification by gold nanoparticle-amplified impedance responses could thus be achieved. Experimental results show that the developed MEA sensor can allow for the detection of human IgG with wide linear range (0.05-100 ng ml(-1)) and sensitivity over 10(3) larger than that of the conventional, bulk gold electrode. The rapid regeneration of the used MEA platform can additionally be realized by a simple electrochemical treatment. The high selectivity of four individually addressable MEA platforms for multiple antigens in a single sample has been further demonstrated in the multiplexed immunoassay experiments. Such a site-selective immobilization strategy of MEA platform may open a new door towards the development of various simple, sensitive, cost-effective, and reusable biological sensors and biochips.

  10. Rates of violence in patients classified as high risk by structured risk assessment instruments

    PubMed Central

    Singh, Jay P.; Fazel, Seena; Gueorguieva, Ralitza; Buchanan, Alec

    2014-01-01

    Background Rates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies. Aims To analyse the variation in rates of violence in individuals identified as high risk by SRAIs. Method A systematic search of databases (1995-2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity. Results Information was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study. Conclusions After controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety. PMID:24590974

  11. Simulation-extrapolation method to address errors in atomic bomb survivor dosimetry on solid cancer and leukaemia mortality risk estimates, 1950-2003.

    PubMed

    Allodji, Rodrigue S; Schwartz, Boris; Diallo, Ibrahima; Agbovon, Césaire; Laurier, Dominique; de Vathaire, Florent

    2015-08-01

    Analyses of the Life Span Study (LSS) of Japanese atomic bombing survivors have routinely incorporated corrections for additive classical measurement errors using regression calibration. Recently, several studies reported that the efficiency of the simulation-extrapolation method (SIMEX) is slightly more accurate than the simple regression calibration method (RCAL). In the present paper, the SIMEX and RCAL methods have been used to address errors in atomic bomb survivor dosimetry on solid cancer and leukaemia mortality risk estimates. For instance, it is shown that using the SIMEX method, the ERR/Gy is increased by an amount of about 29 % for all solid cancer deaths using a linear model compared to the RCAL method, and the corrected EAR 10(-4) person-years at 1 Gy (the linear terms) is decreased by about 8 %, while the corrected quadratic term (EAR 10(-4) person-years/Gy(2)) is increased by about 65 % for leukaemia deaths based on a linear-quadratic model. The results with SIMEX method are slightly higher than published values. The observed differences were probably due to the fact that with the RCAL method the dosimetric data were partially corrected, while all doses were considered with the SIMEX method. Therefore, one should be careful when comparing the estimated risks and it may be useful to use several correction techniques in order to obtain a range of corrected estimates, rather than to rely on a single technique. This work will enable to improve the risk estimates derived from LSS data, and help to make more reliable the development of radiation protection standards.

  12. Survival of high-risk pediatric neuroblastoma patients in a developing country.

    PubMed

    Easton, Joseph C; Gomez, Sergio; Asdahl, Peter H; Conner, J Michael; Fynn, Alcira B; Ruiz, Claudia; Ojha, Rohit P

    2016-09-01

    Little information is available about survival of high-risk pediatric neuroblastoma patients in developing countries. We aimed to assess survival among high-risk pediatric neuroblastoma patients in La Plata, Argentina. Individuals eligible for our cohort were aged <20 yr when diagnosed with high-risk neuroblastoma and received cancer-directed therapy including stem cell transplantation at Hospital de Niños Sor Maria Ludovica between February 1999 and February 2015. We estimated overall survival probabilities using an extended Kaplan-Meier approach. Our study population comprised 39 high-risk neuroblastoma patients, of whom 39% were aged >4 yr at diagnosis, 54% were male, and 62% had adrenal neuroblastoma. We observed 18 deaths, and the median survival time of our study population was 1.7 yr. The five-yr overall survival probability was 24% (95% CL: 10%, 41%). In contrast, five-yr survival of high-risk neuroblastoma patients ranges between 23% and 76% in developed countries. Survival among high-risk neuroblastoma patients is generally poor regardless of geographic location, but our results illustrate dramatically worse survival for patients in a developing country. We speculate that the observed survival differences could be attenuated or eliminated with improvements in treatment and supportive care, but addressing these issues will require creative solutions because of resource limitations.

  13. Preoperative patient assessment: Identifying patients at high risk.

    PubMed

    Boehm, O; Baumgarten, G; Hoeft, A

    2016-06-01

    Postoperative mortality remains alarmingly high with a mortality rate ranging between 0.4% and 4%. A small subgroup of multimorbid and/or elderly patients undergoing different surgical procedures naturally confers the highest risk of complications and perioperative death. Therefore, preoperative assessment should identify these high-risk patients and stratify them to individualized monitoring and treatment throughout all phases of perioperative care. A "tailored" perioperative approach might help further reduce perioperative morbidity and mortality. This article aims to elucidate individual morbidity-specific risks. It further suggests approaches to detect patients at the risk of perioperative complications.

  14. 'High-health, high-performance' horses: risk mitigation strategies for OIE-listed diseases.

    PubMed

    Dominguez, M; Münstermann, S; Murray, G; Timoney, P

    2015-12-01

    The 'high-health, high-performance' (HHP) horse concept has been developed by the World Organisation for Animal Health (OIE) together with the F6ddration Equestre Internationale and the International Federation of Horseracing Authorities. This concept is outlined in the OIE Terrestrial Animal Health Code (Chapter 4.16). It aims to address impediments to the international movement of competition horses through a harmonised, practically feasible, globally applicable framework based on simplified certification requirements for the temporary importation of HHP horses and for their return to their country of usual residence. Based on the principle of compartmentalisation, the high health status of these horses would be established by the application, at all times, of stringent health management practices and biosecurity measures to create and maintain a functional separation between horses within the defined compartment and all other equids. These provisions are intended to mitigate the risk of disease spread for most OIE-listed diseases. For six OIE-listed diseases (African horse sickness, equine influenza, equine infectious anaemia, equine piroplasmosis, glanders and Venezuelan equine encephalomyelitis), the OIE recommends disease-specific mitigation measures, which have been included in a model HHP Veterinary Certificate, to provide additional guarantees to mitigate the risk of disease spread. This article presents the HH P disease risk mitigation strategy. It demonstrates how continuous observance of the HHP biosecurity measures and health management practices provides a scientific rationale for limiting the list of diseases for which HHP horses should be screened with respect to their temporary importation for competition purposes.

  15. Incisional Reinforcement in High-Risk Patients

    PubMed Central

    Feldmann, Timothy F.; Young, Monica T.; Pigazzi, Alessio

    2014-01-01

    Hernia formation after surgical procedures continues to be an important cause of surgical morbidity. Incisional reinforcement at the time of the initial operation has been used in some patient populations to reduce the risk of subsequent hernia formation. In this article, reinforcement techniques in different surgical wounds are examined to identify situations in which hernia formation may be prevented. Mesh use for midline closure, pelvic floor reconstruction, and stoma site reinforcement is discussed. Additionally, the use of retention sutures, closure of the open abdomen, and reinforcement after component separation are examined using current literature. Although existing studies do not support the routine use of mesh reinforcement for all surgical incisions, certain patient populations appear to benefit from reinforcement with lower rates of subsequent hernia formation. The identification and characterization of these groups will guide the future use of mesh reinforcement in surgical incisions. PMID:25435823

  16. President's Address

    PubMed Central

    Craig, Maurice

    1928-01-01

    Conditions which experience has proved conducive to mental disturbance considered.—Suggestions as to their treatment.—A weakened inhibition, rather than any positive condition, is probably the most important factor in the production of the exhaustion psycho-neuroses or psychoses. This view is supported by the prophylactic value of giving for prolonged periods small doses of bromide to hypersensitive children or to highly-strung persons exposed to stress or tropical climate, etc.—Pavlov's work on the conditioned reflexes in dogs quoted in support of the author's clinical experience: Pavlov states that bromides should not be regarded as sedatives, diminishing the excitability of the central nervous system, but as simply regulating the nervous system by strengthening the intensity of internal inhibition. This agrees with the author's clinical experience, as small doses of bromide taken regularly over a period of many years do not diminish the mental powers but in fact increase them. Question of sleeplessness considered with regard to the way in which sedatives act. Most of these do not act as so-called “sleeping draughts”; research may ultimately show that their action is to strengthen a weakened inhibition and that sleep is only a secondary benefit.—Value of sedatives before and after surgical operation. Importance of toxæmia in the production of mental disorder; insomnia often precedes a toxic process and permits it to become active. The theory of weakened inhibition explains many problems; e.g., why certain brilliant children or adults break down and why at first there is no interference with their normal mental activity which only becomes involved as sleep and other bodily functions become affected; why a toxæmia may affect the nervous system of certain people; why a breakdown may follow over-stimulation or occur with advancing years; why some persons relapse when certain treatment is discontinued; why treatment should at times be continuous, and why

  17. High-fidelity spatial and polarization addressing of +43Ca qubits using near-field microwave control

    NASA Astrophysics Data System (ADS)

    Aude Craik, D. P. L.; Linke, N. M.; Sepiol, M. A.; Harty, T. P.; Goodwin, J. F.; Ballance, C. J.; Stacey, D. N.; Steane, A. M.; Lucas, D. M.; Allcock, D. T. C.

    2017-02-01

    Individual addressing of qubits is essential for scalable quantum computation. Spatial addressing allows unlimited numbers of qubits to share the same frequency, while enabling arbitrary parallel operations. We demonstrate addressing of long-lived +43Ca "atomic clock" qubits held in separate zones (960 μ m apart) of a microfabricated surface trap with integrated microwave electrodes. Such zones could form part of a "quantum charge-coupled device" architecture for a large-scale quantum information processor. By coherently canceling the microwave field in one zone we measure a ratio of Rabi frequencies between addressed and nonaddressed qubits of up to 1400, from which we calculate a spin-flip probability on the qubit transition of the nonaddressed ion of 1.3 ×10-6 . Off-resonant excitation then becomes the dominant error process, at around 5 ×10-3 . It can be prevented either by working at higher magnetic field, or by polarization control of the microwave field. We implement polarization control with error 2 ×10-5 , which would suffice to suppress off-resonant excitation to the ˜10-9 level if combined with spatial addressing. Such polarization control could also enable fast microwave operations.

  18. Risk Factors for High Blood Pressure

    MedlinePlus

    ... to achieve target blood pressure goals with treatment. Overweight You are more likely to develop prehypertension or high blood pressure if you’re overweight or obese . The terms “overweight” and “obese” refer ...

  19. Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review

    PubMed Central

    Kastner, Monika; Perrier, Laure; Hamid, Jemila; Tricco, Andrea C; Cardoso, Roberta; Ivers, Noah M; Liu, Barbara; Marr, Sharon; Holroyd-Leduc, Jayna; Wong, Geoff; Graves, Lisa; Straus, Sharon E

    2015-01-01

    Introduction The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions. Methods and analysis We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies. Ethics and dissemination Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders

  20. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    PubMed Central

    Muralidhar, Vinayak; Xiang, Michael; Orio, Peter F.; Martin, Neil E.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.

    2016-01-01

    Purpose Recent retrospective data suggest that brachytherapy (BT) boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA < 10 ng/ml or T1c, Gleason 6, PSA > 20 ng/ml). Material and methods We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT) only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258), and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022). Conclusions Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease. PMID:26985191

  1. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    ERIC Educational Resources Information Center

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  2. Predicting the Unpredictable? Identifying High-Risk versus Low-Risk Parents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McGaw, Sue; Scully, Tamara; Pritchard, Colin

    2010-01-01

    Objectives: This study set out to identify risk factors affecting parents with intellectual disabilities (IDs) by determining: (i) whether perception of family support differs between parents with IDs, referring professionals, and a specialist parenting service; (ii) whether multivariate familial and demographic factors differentiates "high-risk"…

  3. A Preventive Dental Program for "High Risk" Children

    ERIC Educational Resources Information Center

    Meskin, Lawrence H.; And Others

    1977-01-01

    A dental health program in an elementary school succeeded in identifying children considered to be "high risk" in oral health and, through treatment and education, significantly improved their dental health. (JD)

  4. Treating Patients with High-Risk Smoldering Myeloma

    Cancer.gov

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  5. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    PubMed Central

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-01-01

    Introduction National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the ‘high risk’ patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Methods Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien–Dindo classification. Results The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien–Dindo grade 2–3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4–5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Discussion Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. Conclusions In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient. PMID:26468369

  6. Assessment of high cardiovascular risk profiles for the clinician.

    PubMed

    Whayne, Thomas F

    2013-07-01

    Diabetes mellitus (DM) is a major cardiovascular (CV) risk factor. General Framingham Risk Profile (GFRP) and World Health Organization/International Society of Hypertension (WHO/ISH) charts were used to assess CV risk in DM in Oman. The GFRP identified more patients with medium-risk DM; GFRP and WHO/ISH identified essentially equal numbers at very high risk. These were then used to evaluate statin usage in Oman, including economics. Google lists innumerable tools from organizations, hospitals, practitioners, magazines, societies, clinics, and medical associations. The GFRP and WHO/ISH calculations provided useful DM assessment of populations in Oman. Other major risk models are Adult Treatment Panel III, based on Framingham, and Reynolds Risk Score; the latter incorporates other factors such as family history, high-sensitivity C-reactive protein, and hemoglobin A(1c) (in DM). These models are useful in assessing specific populations. Individual practitioners with limited time may just evaluate patients as low, medium, and high CV risk based on general knowledge and then treat.

  7. Review of screening for pancreatic cancer in high risk individuals.

    PubMed

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-05-21

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  8. Review of screening for pancreatic cancer in high risk individuals

    PubMed Central

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results. PMID:21633635

  9. Identifying Patients at Risk of High Healthcare Utilization

    PubMed Central

    Sheets, Lincoln; Popejoy, Lori; APRN, GCNS-BC; Khalilia, Mohammed; Petroski, Greg; Parker, Jerry C.

    2016-01-01

    Objective. To develop a systematic and reproducible way to identify patients at increased risk for higher healthcare costs. Methods. Medical records were analyzed for 9,581 adults who were primary care patients in the University of Missouri Health System and who were enrolled in Medicare or Medicaid. Patients were categorized into one of four risk tiers as of October 1, 2013, and the four tiers were compared on demographic characteristics, number of healthcare episodes, and healthcare charges in the year before and the year after cohort formation. Results. The mean number of healthcare episodes and the sum of healthcare charges in the year following cohort formation were higher for patients in the higher-risk tiers. Conclusions. Retrospective information that is easily extracted from medical records can be used to create risk tiers that provide highly useful information about the prospective risk of healthcare utilization and costs. PMID:28269910

  10. [Epidemiology of high risk pregnancy in Sousse, Tunisia].

    PubMed

    Bouafia, N; Mahjoub, M; Nouira, A; Ben Aissa, R; Saïdi, H; Guedana, N; Njah, M

    2013-05-01

    This descriptive study assessed the frequency of selected risk factors for high risk pregnancy (HRP) among women in Sousse region. All pregnant women (beyond 28 weeks gestation) giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factorwere enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 (25.6%) had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 (SD 5.4) years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women (59.3%) had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age >35 years, parity >4, previous low birth weight and neonatal death, excessive fundal height and anaemia.

  11. Telomerase activation by genomic rearrangements in high-risk neuroblastoma.

    PubMed

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L; Sand, Frederik; Heuckmann, Johannes M; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Gloeckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R; Savelyeva, Larissa; Watkins, Simon C; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H; Herrmann, Carl; O'Sullivan, Roderick J; Westermann, Frank; Thomas, Roman K; Fischer, Matthias

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours.

  12. Cumulative Experiences of Violence among High-Risk Urban Youth

    ERIC Educational Resources Information Center

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  13. Best self visualization method with high-risk youth.

    PubMed

    Schussel, Lorne; Miller, Lisa

    2013-08-01

    The healing process of the Best Self Visualization Method (BSM) is described within the framework of meditation, neuroscience, and psychodynamic theory. Cases are drawn from the treatment of high-risk youth, who have histories of poverty, survival of sexual and physical abuse, and/or current risk for perpetrating abuse. Clinical use of BSM is demonstrated in two case illustrations, one of group psychotherapy and another of individual therapy.

  14. HIFU therapy for patients with high risk prostate cancer

    NASA Astrophysics Data System (ADS)

    Solovov, V. A.; Vozdvizhenskiy, M. O.; Matysh, Y. S.

    2017-03-01

    Objectives. Patients with high-risk prostate cancer undergoing radical prostatectomy, external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) or ADT alone. The widely accepted definition of high-risk prostate was first proposed by D'Amico based on a pretreatment Gleason score of ≥8, clinical stage T3, PSA level ≥20 ng/mL. There is no trial that compares traditional methods of treatment of such patients with HIFU therapy. Here we explored the effectiveness of the HIFU in multimodal treatment for patients with high risk prostate cancer. Materials & Methods. 701 patients with high risk prostate cancer were treated in our center between September 2007 and December 2013. Gleason score were 8-10, stage T3N0M0, age 69 (58-86) years, mean PSA before treatment 43.3 (22.1-92.9) ng/ml, mean prostate volume - 59.3 (38-123) cc. 248 patients were treated by HIFU. We compare this group of patients with patients who undertook EBRT: number 196, and ADT: number 257. Mean follow-up time 58 months (6-72). Results. The 5-year overall survival rates in patients after HIFU were 73.8 %, after EBRT - 63.0 % and after ADT - 18.1%. Conclusions. Our experience showed that HIFU therapy in combined treatment were successful for high risk prostate cancer.

  15. Beyond sensation seeking: affect regulation as a framework for predicting risk-taking behaviors in high-risk sport.

    PubMed

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-10-01

    Sensation seeking has been widely studied when investigating individual differences in the propensity for taking risks. However, risk taking can serve many different goals beyond the simple management of physiological arousal. The present study is an investigation of affect self-regulation as a predictor of risk-taking behaviors in high-risk sport. Risk-taking behaviors, negative affectivity, escape self-awareness strategy, and sensation seeking data were obtained from 265 high-risk sportsmen. Moderated hierarchical regression analysis revealed significant main and interaction effects of negative affectivity and escape self-awareness strategy in predicting risk-taking behaviors: high-risk sportsmen's negative affectivity leads them to adopt risk-taking behaviors only if they also use escape self-awareness strategy. Furthermore, the affective model remained significant when controlling for sensation seeking. The present study contributes to an in-depth understanding of risk taking in high-risk sport.

  16. Risk factor distribution for cardiovascular diseases among high school boys and girls of urban Dibrugarh, Assam

    PubMed Central

    Ekta, Gupta; Tulika, Mahanta Goswami

    2016-01-01

    Introduction: Chronic noncommunicable diseases (NCDs) including cardiovascular diseases (CVDs) are the leading cause of death in the world, and their incidence is rising rapidly due to increasing rates of risk factors such as hypertension, dyslipidemia, diabetes, obesity, physical inactivity, and tobacco use. These risk factors track from childhood to adulthood, and their distribution varies among males and females; hence, there is a need to determine risk factor prevalence among adolescent age group so as to plan preventive strategies. Objective: To determine the distribution of risk factors of CVDs amongst high school boys and girls of urban Dibrugarh, Assam. Subjects and Methods: A cross-sectional study was conducted from October 2012 to June 2013 in the schools of urban Dibrugarh, Assam wherein data was collected from 1000 students of Class 8–10 using multistage random sampling and risk factors were assessed using WHO steps methodology. Statistical Analysis: Statistical analysis was done using SPSS 16 software and test of differences used were Chi-square test and t-test. Results: The prevalence of ever tobacco use was 32.3% among boys and 6.6% among girls (P < 0.001) while ever alcohol use was reported by 11.9% boys and 1% girls (P < 0.001). Prevalence of overweight and hypertension was found to be higher among girls (11.7% and 24.1%) as compared to boys (6.8% and 18.1%). Prevalence of hypercholesterolemia was higher among boys while high triglycerides levels were more prevalent among girls. Conclusion: The study revealed a high prevalence of various risk factors among boys and girls. There is a need to reduce the risk factor prevalence of CVD among this group of the population to address the future epidemic of NCD. Different health promotional activities need to be implemented to target boys and girls as the risk factor distribution among these groups is different. PMID:27453853

  17. Applying the lessons of high risk industries to health care

    PubMed Central

    Hudson, P

    2003-01-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  18. The cardiovascular polypill in high-risk patients.

    PubMed

    Lafeber, Melvin; Spiering, Wilko; Singh, Kavita; Guggilla, Rama K; Patil, Vinodvenkatesh; Webster, Ruth

    2012-12-01

    Atherosclerotic cardiovascular diseases remain the leading cause of morbidity and mortality in both developed and developing countries. Adequate treatment of vascular risk factors, such as low-density lipoprotein cholesterol and systolic blood pressure are known to reduce the future risk of cardiovascular disease in these patients. However currently, large treatment gaps exist among high-risk individuals, in whom the guidelines recommend concomitant treatment with aspirin, statin, and blood-pressure lowering agents. Combining aspirin, cholesterol, and blood-pressure lowering agents into a single pill called the cardiovascular polypill has been proposed as complementary care in the prevention of cardiovascular diseases in both intermediate- and high-risk patient populations. It is now a decade since the first recommendations to develop and trial cardiovascular polypills. The major scientific debate has been about the appropriate initial target population. This review article focuses on the potential role of fixed-dose combination therapy in different patient populations, outlines the pros and cons of combination therapy, and emphasizes the rationale for trialing their use. Current and planned future cardiovascular polypill trials are summarized and the pre-requisites for implementation of the polypill strategy in both primary and secondary prevention are described. The recent development of combination pills containing off-patent medications holds promise for highly affordable and effective treatment and evidence is emerging on the use of this strategy in high-risk populations.

  19. High-Risk Stress Fractures: Diagnosis and Management.

    PubMed

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures.

  20. Genomic analysis of high-risk smoldering multiple myeloma

    PubMed Central

    López-Corral, Lucía; Mateos, María Victoria; Corchete, Luis A.; Sarasquete, María Eugenia; de la Rubia, Javier; de Arriba, Felipe; Lahuerta, Juan-José; García-Sanz, Ramón; San Miguel, Jesús F.; Gutiérrez, Norma C.

    2012-01-01

    Smoldering myeloma is an asymptomatic plasma cell dyscrasia with a heterogeneous propensity to progress to active myeloma. In order to investigate the biology of smoldering myeloma patients with high risk of progression, we analyzed the genomic characteristics by FISH, SNP-arrays and gene expression profile of a group of patients with high-risk smoldering myeloma included in a multicenter randomized trial. Chromosomal abnormalities detected by FISH and SNP-arrays at diagnosis were not associated to risk of progression to symptomatic myeloma. However, the overexpression of four SNORD genes (SNORD25, SNORD27, SNORD30 and SNORD31) was correlated with shorter time to progression (P<0.03). When plasma cells from high-risk smoldering patients who progressed to symptomatic myeloma were sequentially analyzed, newly acquired lesions together with an increase in the proportion of plasma cells carrying a given abnormality were observed. These findings suggest that gene expression profiling is a valuable technique to identify smoldering myeloma patients with high risk of progression. (Clinical Trials NCT00443235) PMID:22331267

  1. Selecting high-risk micro-scale enterprises using a qualitative risk assessment method.

    PubMed

    Kim, Hyunwook; Park, Dong-Uk

    2006-01-01

    Micro-scale enterprises (MSEs) with less than 5 employees are subject to be covered by the scheme of the regular workplace environmental inspection and medical health examination from 2002 in Korea. Due to limited resources as well as vast number of enterprises to be covered, there is an urgent need to focus these efforts to only those high-risk MSEs. To identify them, a qualitative risk assessment methodology was developed combining the hazardous nature of chemicals and exposure potentials as modeled by the HSE and the risk categorization technique by the AIHA. Risk Index (RI) was determined by combining characteristics specific to chemicals and scale of use of the chemicals. The method was applied to 514 MSEs that were selected from a random sample of 4000 MSEs. A total of 170 out of 514 MSEs studied were included in the final analysis. Current status and characteristics of MSEs were identified and RI was assigned to chemicals in each industry. Based on the distribution of RIs, the high-risk MSEs were selected. These include: wood and products of wood, chemicals and chemical products, basic metals, other machinery and equipment, motor vehicles, trailer and semi-trailer manufacturing, and furniture manufacturing. Since these MSEs are high-risk ones, more attentions should be focused on them. This method can be applied to other workplaces with no previous history of quantitative workplace inspections.

  2. Toward core inter-professional health promotion competencies to address the non-communicable diseases and their risk factors through knowledge translation: Curriculum content assessment

    PubMed Central

    2014-01-01

    Background To increase the global impact of health promotion related to non-communicable diseases, health professionals need evidence-based core competencies in health assessment and lifestyle behavior change. Assessment of health promotion curricula by health professional programs is a first step. Such program assessment is a means of 1. demonstrating collective commitment across health professionals to prevent non-communicable diseases; 2. addressing the knowledge translation gap between what is known about non-communicable diseases and their risk factors consistent with ‘best’ practice; and, 3. establishing core health-based competencies in the entry-level curricula of established health professions. Discussion Consistent with the World Health Organization’s definition of health (i.e., physical, emotional and social wellbeing) and the Ottawa Charter, health promotion competencies are those that support health rather than reduce signs and symptoms primarily. A process algorithm to guide the implementation of health promotion competencies by health professionals is described. The algorithm outlines steps from the initial assessment of a patient’s/client’s health and the indications for health behavior change, to the determination of whether that health professional assumes primary responsibility for implementing health behavior change interventions or refers the patient/client to others. An evidence-based template for assessment of the health promotion curriculum content of health professional education programs is outlined. It includes clinically-relevant behavior change theory; health assessment/examination tools; and health behavior change strategies/interventions that can be readily integrated into health professionals’ practices. Summary Assessment of the curricula in health professional education programs with respect to health promotion competencies is a compelling and potentially cost-effective initial means of preventing and reversing non

  3. How to ensure that the results of climate risk analysis make a difference? - Experience from applied research addressing the challenges of climate change

    NASA Astrophysics Data System (ADS)

    Schneiderbauer, Stefan; Zebisch, Marc; Becker, Daniel; Pedoth, Lydia; Renner, Kathrin; Kienberger, Stefan

    2016-04-01

    Changing climate conditions may have beneficial or adverse effects on the social-ecological systems we are living in. In any case, the possible effects result from complex and interlinked physical and social processes embedded in these systems. Traditional research addresses these bio-physical and societal issues in a separate way. Therefore, in general, studies on risks related to climate change are still mono-disciplinary in nature with an increasing amount of work following a multi-disciplinary approach. The quality and usefulness of the results of such research for policy or decision making in practice may further be limited by study designs that do not acknowledge appropriately the significance of integrating or at least mixing qualitative and quantitative information and knowledge. Finally, the acceptance of study results - particularly when containing some kind of assessments - is often endangered by insufficient and / or late involvement of stakeholders and users. The above mentioned limitations have often been brought up in the recent past. However, despite that a certain consensus could be achieved in the last years recognising the need to tackle these issues, little progress has been made in terms of implementation within the context of (research) studies. This paper elaborates in detail on reasons that hamper the application of - interdisciplinary (i.e. natural and social science), - trans-disciplinary (i.e. co-production of knowledge) and - integrative (i.e. combining qualitative and quantitative approaches) work. It is based on the experience gained through a number of applied climate change vulnerability studies carried out within the context of various GIZ-financed development cooperation projects, a consultancy project for the German Environment Agency as well as the workshop series INQUIMUS, which tackles particularly the issues of mixing qualitative and quantitative research approaches. Potentials and constraints of possible attempts for

  4. The National Cross-Site Evaluation of High-Risk Youth Programs: Understanding Risk, Protection, and Substance Use among High-Risk Youth. Monograph Series.

    ERIC Educational Resources Information Center

    Springer, J. Fred; Sambrano, Soledad; Sale, Elizabeth; Kasim, Rafa; Hermann, Jack

    This document summarizes findings from the Center for Substance Abuse Prevention's National Cross-Site Evaluation of High-Risk Youth Programs, which identified characteristics associated with strong substance abuse prevention outcomes in 48 prevention programs. Major findings include: as youth age, levels of risk and protection shift considerably,…

  5. The Violence Risk Scale: Predictive Validity and Linking Changes in Risk with Violent Recidivism in a Sample of High-Risk Offenders with Psychopathic Traits

    ERIC Educational Resources Information Center

    Lewis, Kathy; Olver, Mark E.; Wong, Stephen C. P.

    2013-01-01

    The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals…

  6. Management of high-risk localized prostate cancer.

    PubMed

    Marciscano, Ariel E; Hardee, Matthew E; Sanfilippo, Nicholas

    2012-01-01

    Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM). The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control.

  7. Humanized birth in high risk pregnancy: barriers and facilitating factors.

    PubMed

    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Leduc, Nicole; Misago, Chizuru

    2010-02-01

    The medical model of childbearing assumes that a pregnancy always has the potential to turn into a risky procedure. In order to advocate humanized birth in high risk pregnancy, an important step involves the enlightenment of the professional's preconceptions on humanized birth in such a situation. The goal of this paper is to identify the professionals' perception of the potential obstacles and facilitating factors for the implementation of humanized care in high risk pregnancies. Twenty-one midwives, obstetricians, and health administrator professionals from the clinical and academic fields were interviewed in nine different sites in Japan from June through August 2008. The interviews were audio taped, and transcribed with the participants' consent. Data was subsequently analyzed using content analysis qualitative methods. Professionals concurred with the concept that humanized birth is a changing and promising process, and can often bring normality to the midst of a high obstetric risk situation. No practice guidelines can be theoretically defined for humanized birth in a high risk pregnancy, as there is no conflict between humanized birth and medical intervention in such a situation. Barriers encountered in providing humanized birth in a high risk pregnancy include factors such as: the pressure of being responsible for the safety of the mother and the fetus, lack of the women's active involvement in the decision making process and the heavy burden of responsibility on the physician's shoulders, potential legal issues, and finally, the lack of midwifery authority in providing care at high risk pregnancy. The factors that facilitate humanized birth in a high risk include: the sharing of decision making and other various responsibilities between the physicians and the women; being caring; stress management, and the fact that the evolution of a better relationship and communication between the health professional and the patient will lead to a stress

  8. Use of an Authentic, Industrially Situated Virtual Laboratory Project to Address Engineering Design and Scientific Inquiry in High Schools

    ERIC Educational Resources Information Center

    Gilbuena, Debra M.; Kirsch, F. Adam; Koretsky, Milo D.

    2012-01-01

    This paper is intended for engineering educators, high school curriculum designers, and high school teachers interested in integrating authentic, project-based learning experiences into their classes. These types of projects may appear complex, but have many advantages. We characterize the successful implementation of one such project, the…

  9. Assessing Individual Risk for High-Risk Colorectal Adenoma at First-Time Screening Colonoscopy

    PubMed Central

    Cao, Yin; Rosner, Bernard A.; Ma, Jing; Tamimi, Rulla M.; Chan, Andrew T.; Fuchs, Charles S.

    2015-01-01

    Assessing risk of colorectal adenoma at first-time colonoscopy that are of higher likelihood of developing advanced neoplasia during surveillance could help tailor first-line colorectal cancer screening. We developed prediction models for high-risk colorectal adenoma (at least one adenoma ≥1 cm, or with advanced histology, or ≥3 adenomas) among 4,881 asymptomatic white men and 17,970 women who underwent colonoscopy as their first-time screening for colorectal cancer in two prospective U.S. studies using logistic regressions. C-statistics and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration. Ten-fold cross-validation was used for internal validation. A total of 330 (6.7%) men and 678 (3.8%) women were diagnosed with high-risk adenoma at first-time screening colonoscopy. The model for men included age, family history of colorectal cancer, BMI, smoking, sitting watching TV/VCR, regular aspirin/NSAID use, physical activity, and a joint term of multivitamin and alcohol. For women, the model included age, family history of colorectal cancer, BMI, smoking, alcohol, beef/pork/lamb as main dish, regular aspirin/NSAID, calcium, and oral contraceptive use. The C-statistic of the model for men was 0.67 and 0.60 for women (0.64 and 0.57 in cross-validation). Both models calibrated well. The predicted risk of high-risk adenoma for men in the top decile was 15.4% vs 1.8% for men in the bottom decile (Odds Ratio[OR]=9.41), and 6.6% vs 2.1% for women (OR=3.48). In summary, we developed and internally validated an absolute risk assessment tool for high-risk colorectal adenoma among the U.S. population that may provide guidance for first-time colorectal cancer screening. PMID:25820865

  10. Assessing individual risk for high-risk colorectal adenoma at first-time screening colonoscopy.

    PubMed

    Cao, Yin; Rosner, Bernard A; Ma, Jing; Tamimi, Rulla M; Chan, Andrew T; Fuchs, Charles S; Wu, Kana; Giovannucci, Edward L

    2015-10-01

    Assessing risk of colorectal adenoma at first-time colonoscopy that are of higher likelihood of developing advanced neoplasia during surveillance could help tailor first-line colorectal cancer screening. We developed prediction models for high-risk colorectal adenoma (at least one adenoma ≥1 cm, or with advanced histology, or ≥3 adenomas) among 4,881 asymptomatic white men and 17,970 women who underwent colonoscopy as their first-time screening for colorectal cancer in two prospective US studies using logistic regressions. C-statistics and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration. Ten-fold cross-validation was used for internal validation. A total of 330 (6.7%) men and 678 (3.8%) women were diagnosed with high-risk adenoma at first-time screening colonoscopy. The model for men included age, family history of colorectal cancer, BMI, smoking, sitting watching TV/VCR, regular aspirin/NSAID use, physical activity, and a joint term of multivitamin and alcohol. For women, the model included age, family history of colorectal cancer, BMI, smoking, alcohol, beef/pork/lamb as main dish, regular aspirin/NSAID, calcium, and oral contraceptive use. The C-statistic of the model for men was 0.67 and 0.60 for women (0.64 and 0.57 in cross-validation). Both models calibrated well. The predicted risk of high-risk adenoma for men in the top decile was 15.4% vs. 1.8% for men in the bottom decile (Odds Ratio [OR] = 9.41), and 6.6% vs. 2.1% for women (OR = 3.48). In summary, we developed and internally validated an absolute risk assessment tool for high-risk colorectal adenoma among the US population that may provide guidance for first-time colorectal cancer screening.

  11. Commentary: How can family-based quasi-experimental designs and national registers be used to address confounding in risk factor studies of psychopathology? A reflection on Obel et al. (2016).

    PubMed

    Larsson, Henrik

    2016-04-01

    Standard observational studies have reported a robust correlation between maternal smoking during pregnancy and risk of ADHD in offspring. In the accompanying article, Obel et al. used sibling-comparisons to explore the extent to which unmeasured familial confounding explains this association. This commentary highlights three important implications of the study. At a general level, Obel et al. illustrates how (1) family-based quasi-experimental designs and (2) national registers can be used to address confounding in risk factor studies of psychopathology. At a more specific level, the study suggests that maternal smoking during pregnancy is probably not a causal risk factor for ADHD.

  12. Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf

    PubMed Central

    Alsayegh, Faisal; Al-Jassar, Waleed; Wani, Salima; Tahlak, Muna; Al-Bahar, Awatef; Al-Kharusi, Lamya; Al-Tamimi, Halima; El-Taher, Faten; Mahmood, Naeema; Al-Zakwani, Ibrahim

    2016-01-01

    Objectives: To estimate the prevalence of venous thromboembolism (VTE) risk factors in pregnancy and the proportion of pregnancies at risk of VTE that received the recommended prophylaxis according to the American College of Chest Physicians (ACCP) 2012 published guidelines in antenatal clinics in the Arabian Gulf. Methods: The evaluation of venous thromboembolism (EVE)-Risk project was a non-interventional, cross-sectional, multi-centre, multi-national study of all eligible pregnant women (≥17 years) screened during antenatal clinics from 7 centres in the Arabian Gulf countries (United Arab Emirates, Kuwait, Bahrain, Qatar and Oman). Pregnant women were recruited during a 3-month period between September and December 2012. Results: Of 4,131 screened pregnant women, 32% (n=1,337) had ≥1 risk factors for VTE. Common VTE risk factors included obesity (76%), multiparity (33%), recurrent miscarriages (9.1%), varicose veins (6.9%), thrombophilia (2.6%), immobilization (2.0%), sickle cell disease (2.8%) and previous VTE (1.6%). Only 8.3% (n=111) of the high risk patients were on the recommended VTE prophylaxis. Enoxaparin was used in 80% (n=89) of the cases followed by tinzaparin (4%; n=4). Antiplatelet agents were prescribed in 11% (n=149) of pregnant women. Of those on anticoagulants (n=111), 59% (n=66) were also co-prescribed antiplatelet agents. Side effects (mainly local bruising at the injection site) were reported in 12% (n=13) of the cases. Conclusion: A large proportion of pregnant women in the Arabian Gulf countries have ≥1 VTE risk factor with even a smaller fraction on prophylaxis. VTE risk assessment must be adopted to identify those at risk who would need VTE prophylaxis. PMID:26517701

  13. Risk factors for FEV1 decline in mild COPD and high-risk populations

    PubMed Central

    Chen, Shujing; Wang, Changhui; Li, Bing; Shi, Guochao; Li, Huiping; Zhang, Jing; Gu, Yutong; Zhou, Jian; Song, Yuanlin; Bai, Chunxue

    2017-01-01

    Background Early diagnosis of COPD is often not achieved due to limited recognition and limited access to the pulmonary function test. Our hypothesis was that lung function decline may be different between populations with mild COPD and those who are at high risk and do not receive treatment. Patients and methods Subjects with mild COPD and those from a high-risk COPD population were recruited from a community-based COPD epidemiological study after obtaining consent. Baseline clinical characteristics, symptom questionnaire, spirometry, low-dose computed tomography (LDCT) chest scan, and blood plasma biomarker data were collected initially and then 1 year later. Results A total of 617 participants were recruited, and 438 eventually completed the first-year follow-up visit; 72 participants (46 males) were in the mild COPD group, and 225 participants (165 males) were in the high-risk group. The mean forced expiratory volume in the first second of expiration (FEV1) decline in the mild COPD group was 129 mL, which was significantly higher than the 30 mL decline in the high-risk population group (P=0.005). Group category (odds ratio [OR] =0.230) and COPD Assessment Test (CAT) score (OR =9.912) were independent risk factors for an FEV1% predicted decline of >15% for all participants. In the mild COPD group, patients with a higher CAT (OR =5.310) and Emphysema Index (OR =5.681) were associated with a FEV1% predicted decline of >15% at the first-year follow-up. No factor showed a significantly predictive effect on FEV1 decline in the high-risk COPD group. Conclusion Group category was an independent influential factor associated with FEV1 decline. PMID:28184155

  14. High-altitude illnesses: physiology, risk factors, prevention, and treatment.

    PubMed

    Taylor, Andrew T

    2011-01-01

    High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

  15. Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

    PubMed Central

    Ergün, Recai; Çalışkan, Taner; Aydın, Kutlay; Tokur, Murat Emre; Cömert, Bilgin

    2016-01-01

    Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients. PMID:28025592

  16. Perceptions of Community HIV/STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates.

    PubMed

    Blackstock, Oni J; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L; Justman, Jessica; Golin, Carol E; Haley, Danielle F; Kuo, Irene; Adimora, Adaora A; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B

    2015-08-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community's HIV/STI risk. We explored perceptions of community HIV/STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women's HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/STI risk driven by structural factors.

  17. Human health and the environment can't wait for reform: current opportunities for the federal government and states to address chemical risks under the Toxic Substances Control Act.

    PubMed

    Trevisan, Lauren

    2011-01-01

    Expressing its concern about growing rates of cancer and other diseases, coupled with the lack of data about the effect of the thousands of chemicals used in U.S. society, in 1976 Congress enacted the Toxic Substances Control Act (TSCA). Congress intended for TSCA to shed new light on chemical risks and provide the U.S. Environmental Protection Agency (EPA) with a set of tools to address those risks and protect human health and the environment. In the years since TSCA's passage, the procedural hurdles and the difficult-to-meet legal standards built into the statute, along with a court decision rejecting EPA's use of its authority to ban dangerous chemicals, have impeded EPA's ability to regulate chemical use and manufacture. This Comment argues that both the EPA and state governments have the authority to act now to address the risks posed by dangerous chemicals. By utilizing certain sections of the statute in new and aggressive ways, EPA can effectively address chemical risks. Further, this Comment argues that TSCA's preemption provision affords states leeway to continue to regulate the use of chemicals within their borders. Though reform of TSCA is necessary, EPA and states can effectively protect against chemical risks in the near-term by using the full extent of their authority under the current law.

  18. ORGANOPHOSPHATE PESTICIDE EXPOSURES - WHERE ARE THE HIGH RISK CHILDREN?

    EPA Science Inventory

    Methods to identify children at high-risk for organophosphate (OP) pesticide exposure are difficult to develop because biological markers reflect only recent "snapshots" of exposure due to the short half-life of OP compounds (generally about 24 hours). We conducted a series of p...

  19. Intervening with High-Risk Families via Infant Daycare.

    ERIC Educational Resources Information Center

    Ramey, Craig T.; Farran, Dale C.

    A longitudinal study was conducted at the Frank Porter Graham Center NC to explore the use of educational day care and related services as a mechanism for preparing socially disadvantaged children for success in later public schooling. Infant children of mothers who met a criterion score on a high risk index were randomly assigned to either an…

  20. The High-Risk (Disturbed and Disturbing) College Student

    ERIC Educational Resources Information Center

    Hollingsworth, Kathy R.; Dunkle, John H.; Douce, Louise

    2009-01-01

    The disturbed and disturbing college student causes the most vexing concerns for student affairs administrators. The Assessment-Intervention of Student Problems (AISP) model offers a useful and easily understood framework for dealing with the various challenges of this high-risk student population. This chapter focuses on changes that have…

  1. High VWF, low ADAMTS13 puts women at risk.

    PubMed

    Bender, Markus

    2012-02-09

    In this issue of Blood, Andersson and colleagues reveal in a case-control study that highVWF and low ADAMTS13 plasma levels are each a risk factor for ischemic stroke and myocardial infarction, and that the combination of both results in a joint effect.

  2. Process Writing for High-Risk and Learning Disabled Students.

    ERIC Educational Resources Information Center

    Zaragoza, Nina

    1987-01-01

    Discusses the major elements of writing process instruction and the positive influence they have on learning-disabled and inner-city high-risk students. Argues that such process-writing programs might serve as a preventative measure for children likely to be categorized as learning disabled in the future. (HTH)

  3. Big Books from Little Voices: Reaching High Risk Beginning Readers.

    ERIC Educational Resources Information Center

    Trachtenburg, Phyllis; Ferruggia, Ann

    1989-01-01

    Discusses how interactive, whole class techniques (using a student-generated Big Book adaptation of "Corduroy") improved the reading skills of high risk first grade readers. Describes several activities, including sight word strategies, decoding techniques, and word processing, and suggests 27 Big Books for use with these activities. (MM)

  4. Staying Alive! Training High-Risk Teams for Self Correction

    NASA Technical Reports Server (NTRS)

    Slack, Kelley; Noe, Raymond; Weaver, Sallie

    2011-01-01

    Research examining teams working in high-risk operations has been lacking. The present symposium showcases research on team training that helps to optimize team performance in environments characterized by life or death situations arising spontaneously after long periods of mundane activity by pulling experts from diverse areas of industry: space flight, health care, and medical simulation.

  5. High Risk Drinking among Non-Affiliated College Students

    ERIC Educational Resources Information Center

    Smith, Margaret; Finneran, John; Droppa, Marj

    2014-01-01

    This study investigated the high risk drinking practices of unaffiliated college students who are not involved in formal athletics, fraternities, or sororities. Using a qualitative research design, the investigators interviewed students at a northeast public college in fall 2010 to learn about unaffiliated students' drinking experiences and their…

  6. Cyberbullying and Its Risk Factors among Chinese High School Students

    ERIC Educational Resources Information Center

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  7. A Bridge Course for High-Risk Freshman: Evaluating Outcomes.

    ERIC Educational Resources Information Center

    Hardy, Dorothy C.; Karathanos, Demetrius

    1992-01-01

    Examines outcomes of a "bridge" course for first-year college students that emphasizes personal and psychological adjustment to the university experience to enhance the likelihood of academic success. Findings from 59 high-risk students who completed course suggest that goal of enhancing likelihood of academic success for such students was…

  8. Programs for At-risk High School Students.

    ERIC Educational Resources Information Center

    Ohio State Legislative Office of Education Oversight, Columbus.

    In this report the Ohio Legislative Office of Education Oversight discusses five Ohio programs designed to serve at-risk high school students and examines their possible overlap. The report describes the goals, strategies, and structure of the following programs: (1) Occupational Work Experience (OWE), a 1-year vocational program of classroom…

  9. Troubled Relationships: High-Risk Latina Adolescents and Nonresident Fathers

    ERIC Educational Resources Information Center

    Lopez, Vera; Corona, Rosalie

    2012-01-01

    This qualitative study explored 18 high-risk adolescent Latinas' perceptions of their relationships with nonresident fathers. A number of interrelated factors--early childhood memories, mothers' interpretations, and fathers' behaviors--shaped girls' perceptions, which in turn, influenced how they interacted with fathers. Some girls struggled to…

  10. Explorations in High-Risk Stimulation: Two Modalities in Mothering.

    ERIC Educational Resources Information Center

    Gochman, Eva R. Grubler; Aisenstein, Clara

    An exploratory study of high-risk mothers' interactions with their infants studied modalities of stimulation; vestibular and auditory. It was hypothesized that stimulation would be lower for non-paranoid than for paranoid types, and than for control mothers. Mothers recruited from inner city gynecological clinics were screened for probable…

  11. America's Promise Alliance Dropout Prevention Summits: Mobilizing Action to Address the High School Dropout Crisis Across the Nation

    ERIC Educational Resources Information Center

    Gifford, Beth; Evans, Kelly

    2011-01-01

    In this final evaluation of the America's Promise Dropout Prevention Summits, the evaluation reveals that the Summits not only served as the catalyst for the creation of new programs and collaborative efforts around ending the high school dropout crisis, but strengthened existing work, political and public awareness, and funding at the state,…

  12. Addressing the Language and Literacy Needs of Aboriginal High School VET Students Who Speak SAE as an Additional Language

    ERIC Educational Resources Information Center

    Oliver, Rhonda; Grote, Ellen; Rochecouste, Judith; Exell, Mike

    2012-01-01

    Vocational Education and Training (VET) in high schools has had positive effects on the retention of Indigenous students, providing important pathways into further education and the workforce. However, low-level literacy (and numeracy) skills can make successful completion difficult, especially for students who speak Standard Australian English as…

  13. Quality of tuberculosis care in high burden countries: the urgent need to address gaps in the care cascade.

    PubMed

    Cazabon, Danielle; Alsdurf, Hannah; Satyanarayana, Srinath; Nathavitharana, Ruvandhi; Subbaraman, Ramnath; Daftary, Amrita; Pai, Madhukar

    2017-03-01

    Despite the high coverage of directly observed treatment short-course (DOTS), tuberculosis (TB) continues to affect 10.4 million people each year, and kills 1.8 million. High TB mortality, the large number of missing TB cases, the emergence of severe forms of drug resistance, and the slow decline in TB incidence indicate that merely expanding the coverage of TB services is insufficient to end the epidemic. In the era of the End TB Strategy, we need to think beyond coverage and start focusing on the quality of TB care that is routinely offered to patients in high burden countries, in both public and private sectors. In this review, current evidence on the quality of TB care in high burden countries, major gaps in the quality of care, and some novel efforts to measure and improve the quality of care are described. Based on systematic reviews on the quality of TB care or surrogates of quality (e.g., TB diagnostic delays), analyses of TB care cascades, and newer studies that directly measure quality of care, it is shown that the quality of care in both the public and private sector falls short of international standards and urgently needs improvement. National TB programs will therefore need to systematically measure and improve quality of TB care and invest in quality improvement programs.

  14. Quality of tuberculosis care in high burden countries: the urgent need to address gaps in the care cascade

    PubMed Central

    Cazabon, Danielle; Alsdurf, Hannah; Satyanarayana, Srinath; Nathavitharana, Ruvandhi; Subbaraman, Ramnath; Daftary, Amrita; Pai, Madhukar

    2016-01-01

    Despite the high coverage of DOTS, tuberculosis (TB) continues to affect 10.4 million people each year, and kills 1.8 million. High TB mortality, the large number of missing TB cases, the emergence of severe forms of drug-resistance, and the slow decline in TB incidence indicate that merely expanding the coverage of TB services is insufficient to end the epidemic. In the era of the End TB Strategy, we need to think beyond coverage and start focusing on the quality of TB care that is routinely offered to patients in high burden countries, in both public and private sectors. In this review, we describe current evidence on the quality of TB care in high burden countries, major gaps in the quality of care, and some novel efforts to measure and improve the quality of care. Based on systematic reviews on the quality of TB care or surrogates of quality (e.g. TB diagnostic delays), analyses of TB care cascades, and newer studies that directly measure quality of care, we show that the quality of care in both the public and private sectors falls short of international standards and urgently needs improvement. National TB programs will therefore need to systematically measure and improve quality of TB care, and invest in quality improvement programs. PMID:27794468

  15. 2002 Carolyn Sherif Award Address: Gender, Race, and Generation in a Midwest High School: Using Ethnographically Informed Methods in Psychology.

    ERIC Educational Resources Information Center

    Stewart, Abigail J.

    2003-01-01

    Suggests the value of ethnographically informed methods in the psychology of women, emphasizing the role of generation in psychology. Examines evidence from an ongoing, ethnographically informed study of high school graduates in the mid-1950s and late-1960s. The two generations of graduates have distinctive accounts of their experiences, with the…

  16. Environmental risk factors associated with bovine tuberculosis among cattle in high-risk areas

    PubMed Central

    Winkler, B.; Mathews, F.

    2015-01-01

    Our research shows that environmental features are important predictors of bovine tuberculosis (bTB) in British cattle herds in high-prevalence regions. Data from 503 case and 808 control farms included in the randomized badger culling trial (RBCT) were analysed. bTB risk increased in larger herds and on farms with greater areas of maize, deciduous woodland and marsh, whereas a higher percentage of boundaries composed of hedgerows decreased the risk. The model was tested on another case–control study outside RBCT areas, and here it had a much smaller predictive power. This suggests that different infection dynamics operate outside high-risk areas, although it is possible that unknown confounding factors may also have played a role. PMID:26559511

  17. Environmental risk factors associated with bovine tuberculosis among cattle in high-risk areas.

    PubMed

    Winkler, B; Mathews, F

    2015-11-01

    Our research shows that environmental features are important predictors of bovine tuberculosis (bTB) in British cattle herds in high-prevalence regions. Data from 503 case and 808 control farms included in the randomized badger culling trial (RBCT) were analysed. bTB risk increased in larger herds and on farms with greater areas of maize, deciduous woodland and marsh, whereas a higher percentage of boundaries composed of hedgerows decreased the risk. The model was tested on another case-control study outside RBCT areas, and here it had a much smaller predictive power. This suggests that different infection dynamics operate outside high-risk areas, although it is possible that unknown confounding factors may also have played a role.

  18. Biological Markers of Pseudomonas aeruginosa Epidemic High-Risk Clones

    PubMed Central

    Mulet, Xavier; Cabot, Gabriel; Ocampo-Sosa, Alain A.; Domínguez, M. Angeles; Zamorano, Laura; Juan, Carlos; Tubau, Fe; Rodríguez, Cristina; Moyà, Bartolomé; Peña, Carmen; Martínez-Martínez, Luis

    2013-01-01

    A limited number of Pseudomonas aeruginosa genotypes (mainly ST-111, ST-175, and ST-235), known as high-risk clones, are responsible for epidemics of nosocomial infections by multidrug-resistant (MDR) or extensively drug-resistant (XDR) strains worldwide. We explored the potential biological parameters that may explain the success of these clones. A total of 20 isolates from each of 4 resistance groups (XDR, MDR, ModR [resistant to 1 or 2 classes], and MultiS [susceptible to all antipseudomonals]), recovered from a multicenter study of P. aeruginosa bloodstream infections performed in 10 Spanish hospitals, were analyzed. A further set of 20 XDR isolates belonging to epidemic high-risk clones (ST-175 [n = 6], ST-111 [n = 7], and ST-235 [n = 7]) recovered from different geographical locations was also studied. When unknown, genotypes were documented through multilocus sequence typing. The biological parameters evaluated included twitching, swimming, and swarming motility, biofilm formation, production of pyoverdine and pyocyanin, spontaneous mutant frequencies, and the in vitro competition index (CI) obtained with a flow cytometry assay. All 20 (100%) XDR, 8 (40%) MDR, and 1 (5%) ModR bloodstream isolate from the multicenter study belonged to high-risk clones. No significant differences were observed between clonally diverse ModR and MultiS isolates for any of the parameters. In contrast, MDR/XDR high-risk clones showed significantly increased biofilm formation and mutant frequencies but significantly reduced motility (twitching, swimming, and swarming), production of pyoverdine and pyocyanin, and fitness. The defined biological markers of high-risk clones, which resemble those resulting from adaptation to chronic infections, could be useful for the design of specific treatment and infection control strategies. PMID:23979744

  19. Fetal and umbilical Doppler ultrasound in high-risk pregnancies

    PubMed Central

    Alfirevic, Zarko; Stampalija, Tamara; Gyte, Gillian ML

    2014-01-01

    Background Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible false positive Doppler ultrasound findings could encourage inappropriate early delivery. Objectives The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared to no Doppler ultrasound. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Main results Eighteen completed studies involving just over 10,000 women were included. The trials were generally of unclear quality with some evidence of possible publication bias. The use of Doppler ultrasound in high-risk pregnancy was associated a reduction in perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, numbers needed to treat = 203; 95%CI 103 to 4352). There were also fewer inductions of labour (average RR 0.89, 95% CI 0.80 to 0.99, 10 studies, 5633 women, random effects) and fewer caesarean sections (RR 0.90, 95% CI 0.84 to 0.97, 14 studies, 7918 women). No difference was found in operative vaginal births (RR 0.95, 95% CI 0.80 to 1.14, four studies, 2813 women) nor in Apgar scores less than seven at five minutes (RR 0.92, 95% CI 0.69 to 1.24, seven studies, 6321 babies). Authors’ conclusions Current evidence suggests that the use of Doppler ultrasound in high-risk pregnancies reduced the risk of perinatal deaths and resulted in less

  20. Addressing viral resistance through vaccines

    PubMed Central

    Laughlin, Catherine; Schleif, Amanda; Heilman, Carole A

    2015-01-01

    Antimicrobial resistance is a serious healthcare concern affecting millions of people around the world. Antiviral resistance has been viewed as a lesser threat than antibiotic resistance, but it is important to consider approaches to address this growing issue. While vaccination is a logical strategy, and has been shown to be successful many times over, next generation viral vaccines with a specific goal of curbing antiviral resistance will need to clear several hurdles including vaccine design, evaluation and implementation. This article suggests that a new model of vaccination may need to be considered: rather than focusing on public health, this model would primarily target sectors of the population who are at high risk for complications from certain infections. PMID:26604979

  1. Embedded CMs work with high-risk patients.

    PubMed

    2014-01-01

    Care managers embedded in primary care clinics work with patients with high-risk diagnoses and multiple visits to the emergency department or hospital. Patients are identified though risk assessments, suggestions from inpatient case management, and requests from primary care clinicians. Care managers call patients before their clinic visits, look for gaps in care and find out patients' questions and concerns, sharing the information with the treating clinicians. Care managers follow patients for four weeks after their visit, helping them meet their health care goals and follow their treatment plan.

  2. Air pollution exposure: Who is at high risk?

    NASA Astrophysics Data System (ADS)

    Peled, Ronit

    2011-04-01

    This article reviews the sub-population groups who are at high risk and first to be harmed by air pollution coming from anthropogenic combustions. Epidemiological studies from the last few decades contributed to the understanding of the different levels of susceptibility to air pollution. Older people and young infants, people who suffer from allergies, pulmonary and heart diseases, pregnant women and newborn babies, and deprived populations that suffer from low socio-economic status have all been described as populations at risk. A better understanding of the role of air pollution on large as well as specific populations' health, will promote a better protection policy.

  3. Radical prostatectomy in high-risk prostate cancer.

    PubMed

    Ischia, Joseph; Gleave, Martin

    2013-03-01

    One consistent finding in the studies regarding treating men with prostate cancer is that men with high-risk disease have the most to gain from treatment with curative intent. Men with high-risk or locally-advanced prostate cancer require treatment to the primary cancer or risk dying prematurely from their disease. Increasingly, combined androgen deprivation therapy + radiation treatment is seen as the standard treatment as a result of prospective studies in this space, and the perceived increased morbidity of radical prostatectomy in the setting of a "low" cure rate as monotherapy. In the absence of a well-conducted randomized trial, there is no definite evidence that one treatment is superior to the other. The advantages of radical prostatectomy are that it provides excellent local control of the primary tumor without an increase in morbidity, accurately stages the disease to guide further therapy, and removes benign sources of prostate-specific antigen so that failures can be promptly identified and subsequent treatment can be initiated in a timely manner. Although several guidelines recommend radiation treatment over radical prostatectomy as first-line treatment, there is no evidence that surgery is inferior and radical prostatectomy should remain part of any informed discussion regarding treatment options for men with high-risk prostate cancer.

  4. Wandering spleen: 'presentation in adolescent with high thrombotic risk'.

    PubMed

    Tchidjou, Hyppolite K; Castelluzzo, Maria A; Messia, Virginia; Luciani, Matteo; Monti, Lidia; Grimaldi, Chiara; Bernardi, Stefania; D'Argenio, Patrizia

    2014-07-01

    The term 'wandering spleen' refers to an abnormal hypermobility of the spleen, which may be congenital or acquired. The absence or abnormal laxity of splenic ligaments combined with an abnormally long and mobile vascular pedicle predispose to complications such as torsion of the splenic pedicle, infarction and splenic vein thrombosis. The clinical presentation of such disease is highly variable. In this case, we describe an asymptomatic case of wandering spleen in high thrombotic risk patients with cavernoma of splenic vein and infarction of the spleen. Physical examination was normal except the enlarged and no tender consistency spleen palpable at left iliac fossa. Ultrasonography revealed enlarged spleniform mass below its normal position suggesting vascular impairment and subsequently has been confirmed by colour Doppler ultrasound and computed tomography. The family history was positive for ischemic thrombotic vascular diseases and the screening for thrombotic risk has revealed hyperhomocysteinemia, thrombophilic homozygous gene mutations for factor V (H1299R) and MTHFR (C677T). For high thrombotic risk, prophylaxis postsplenectomy was suggested according to the international recommendations with subcutaneous low molecular weight heparin, associated with a preventive treatment with acetyl salicylic acid and folic acid along with B-vitamin. This case report may be helpful for clinicians involved in the care of splenectomized patients, because it has shown the importance of an appropriate pre and postoperative antithrombotic management to reduce as soon as possible the risk of thrombotic events in such patients after splenectomy.

  5. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

    PubMed

    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  6. Addressing capability computing challenges of high-resolution global climate modelling at the Oak Ridge Leadership Computing Facility

    NASA Astrophysics Data System (ADS)

    Anantharaj, Valentine; Norman, Matthew; Evans, Katherine; Taylor, Mark; Worley, Patrick; Hack, James; Mayer, Benjamin

    2014-05-01

    During 2013, high-resolution climate model simulations accounted for over 100 million "core hours" using Titan at the Oak Ridge Leadership Computing Facility (OLCF). The suite of climate modeling experiments, primarily using the Community Earth System Model (CESM) at nearly 0.25 degree horizontal resolution, generated over a petabyte of data and nearly 100,000 files, ranging in sizes from 20 MB to over 100 GB. Effective utilization of leadership class resources requires careful planning and preparation. The application software, such as CESM, need to be ported, optimized and benchmarked for the target platform in order to meet the computational readiness requirements. The model configuration needs to be "tuned and balanced" for the experiments. This can be a complicated and resource intensive process, especially for high-resolution configurations using complex physics. The volume of I/O also increases with resolution; and new strategies may be required to manage I/O especially for large checkpoint and restart files that may require more frequent output for resiliency. It is also essential to monitor the application performance during the course of the simulation exercises. Finally, the large volume of data needs to be analyzed to derive the scientific results; and appropriate data and information delivered to the stakeholders. Titan is currently the largest supercomputer available for open science. The computational resources, in terms of "titan core hours" are allocated primarily via the Innovative and Novel Computational Impact on Theory and Experiment (INCITE) and ASCR Leadership Computing Challenge (ALCC) programs, both sponsored by the U.S. Department of Energy (DOE) Office of Science. Titan is a Cray XK7 system, capable of a theoretical peak performance of over 27 PFlop/s, consists of 18,688 compute nodes, with a NVIDIA Kepler K20 GPU and a 16-core AMD Opteron CPU in every node, for a total of 299,008 Opteron cores and 18,688 GPUs offering a cumulative 560

  7. High wall shear stress and high-risk plaque: an emerging concept.

    PubMed

    Eshtehardi, Parham; Brown, Adam J; Bhargava, Ankit; Costopoulos, Charis; Hung, Olivia Y; Corban, Michel T; Hosseini, Hossein; Gogas, Bill D; Giddens, Don P; Samady, Habib

    2017-01-10

    In recent years, there has been a significant effort to identify high-risk plaques in vivo prior to acute events. While number of imaging modalities have been developed to identify morphologic characteristics of high-risk plaques, prospective natural-history observational studies suggest that vulnerability is not solely dependent on plaque morphology and likely involves additional contributing mechanisms. High wall shear stress (WSS) has recently been proposed as one possible causative factor, promoting the development of high-risk plaques. High WSS has been shown to induce specific changes in endothelial cell behavior, exacerbating inflammation and stimulating progression of the atherosclerotic lipid core. In line with experimental and autopsy studies, several human studies have shown associations between high WSS and known morphological features of high-risk plaques. However, despite increasing evidence, there is still no longitudinal data linking high WSS to clinical events. As the interplay between atherosclerotic plaque, artery, and WSS is highly dynamic, large natural history studies of atherosclerosis that include WSS measurements are now warranted. This review will summarize the available clinical evidence on high WSS as a possible etiological mechanism underlying high-risk plaque development.

  8. Prediction of Psychosis in Youth at High Clinical Risk

    PubMed Central

    Cannon, Tyrone D.; Cadenhead, Kristin; Cornblatt, Barbara; Woods, Scott W.; Addington, Jean; Walker, Elaine; Seidman, Larry J.; Perkins, Diana; Tsuang, Ming; McGlashan, Thomas; Heinssen, Robert

    2011-01-01

    Context Early detection and prospective evaluation of individuals who will develop schizophrenia or other psychotic disorders are critical to efforts to isolate mechanisms underlying psychosis onset and to the testing of preventive interventions, but existing risk prediction approaches have achieved only modest predictive accuracy. Objectives To determine the risk of conversion to psychosis and to evaluate a set of prediction algorithms maximizing positive predictive power in a clinical high-risk sample. Design, Setting, and Participants Longitudinal study with a 2½-year follow-up of 291 prospectively identified treatment-seeking patients meeting Structured Interview for Prodromal Syndromes criteria. The patients were recruited and underwent evaluation across 8 clinical research centers as part of the North American Prodrome Longitudinal Study. Main Outcome Measure Time to conversion to a fully psychotic form of mental illness. Results The risk of conversion to psychosis was 35%, with a decelerating rate of transition during the 2½-year follow-up. Five features assessed at baseline contributed uniquely to the prediction of psychosis: a genetic risk for schizophrenia with recent deterioration in functioning, higher levels of unusual thought content, higher levels of suspicion/paranoia, greater social impairment, and a history of substance abuse. Prediction algorithms combining 2 or 3 of these variables resulted in dramatic increases in positive predictive power (ie, 68%–80%) compared with the prodromal criteria alone. Conclusions These findings demonstrate that prospective ascertainment of individuals at risk for psychosis is feasible, with a level of predictive accuracy comparable to that in other areas of preventive medicine. They provide a benchmark for the rate and shape of the psychosis risk function against which standardized preventive intervention programs can be compared. PMID:18180426

  9. 48 CFR 1352.237-70 - Security processing requirements-high or moderate risk contracts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... requirements for Non-IT Service Contracts are: (i) High Risk—Background Investigation (BI). (ii) Moderate Risk...) High Risk IT—Background Investigation (BI). (ii) Moderate Risk IT—Background Investigation (BI). (b)...

  10. 48 CFR 1352.237-70 - Security processing requirements-high or moderate risk contracts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... requirements for Non-IT Service Contracts are: (i) High Risk—Background Investigation (BI). (ii) Moderate Risk...) High Risk IT—Background Investigation (BI). (ii) Moderate Risk IT—Background Investigation (BI). (b)...

  11. HILAT a multi-experiment satellite addressing the dynamics of irregularity formation in the high-latitude ionosphere

    NASA Astrophysics Data System (ADS)

    Fremouw, E. J.

    A combined beacon, in-situ, and optical satellite mission is being prepared for definitive investigation of the formation, development, and decay of plasma-density irregularities in the high-latitude ionosphere. The satellite, named HILAT (P83-1), will carry a VHF-UHF-L-Band coherent beacon for scintillation and TEC measurements, three payloads for in-situ and ionospheric/magnetospheric coupling observations, and a vacuum-ultraviolet imager for meso-scale recording of dayside and nightside auroras and emissions from the F layer. Observations are planned at northern latitudes ranging from the plasmapause to the pole, employing beacon receiving stations which also will decode telemetry from the other payloads. Launch is planned for the boreal summer of 1983.

  12. Prediabetes: A high-risk state for developing diabetes

    PubMed Central

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  13. Great expectations: different high-risk activities satisfy different motives.

    PubMed

    Barlow, Matthew; Woodman, Tim; Hardy, Lew

    2013-09-01

    Research on people's motives for engaging in high-risk activities has typically been viewed through the single-focused lens of sensation seeking. We provide evidence that comprehensively challenges that view. First, we develop and confirm the structure of a 3-factor measure of motives: the Sensation Seeking, Emotion Regulation, and Agency Scale (SEAS; Study 1). We then use the SEAS to provide evidence of differential motives for 2 high-risk activities: skydiving and mountaineering. The motive for skydiving is strongly associated with sensation seeking; the motive for mountaineering is strongly associated with emotion regulation and agency but not with sensation seeking (Study 2). We also show that these conclusions cannot be drawn from existing measures of personality and sensation seeking (Study 3). Finally, individuals who are motivated by emotion regulation and agency needs also have greater expectations regarding their emotion regulation and agency. It is these greater expectations that most successfully discriminate mountaineers from skydivers and control participants (Study 4). It is concluded that researchers should no longer consider risk takers as a homogenous sensation-seeking group and that they should consider risk taking as a potential model of human endeavor. The SEAS can be used as a measure of motives for behavior whenever sensation seeking, agency, or emotion regulation is thought to be at the core of such motives, and the results are discussed in the context of encouraging personality researchers to consider the specific spontaneous behaviors that motivate different people.

  14. Concurrent chemoradiation for high-risk prostate cancer.

    PubMed

    Cooper, Benjamin T; Sanfilippo, Nicholas J

    2015-08-10

    There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients that are likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/dL. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.

  15. The increasing threat of Pseudomonas aeruginosa high-risk clones.

    PubMed

    Oliver, Antonio; Mulet, Xavier; López-Causapé, Carla; Juan, Carlos

    2015-01-01

    The increasing prevalence of chronic and hospital-acquired infections produced by multidrug-resistant (MDR) or extensively drug-resistant (XDR) Pseudomonas aeruginosa strains is associated with significant morbidity and mortality. This growing threat results from the extraordinary capacity of this pathogen for developing resistance through chromosomal mutations and from the increasing prevalence of transferable resistance determinants, particularly those encoding carbapenemases or extended-spectrum β-lactamases (ESBLs). P. aeruginosa has a nonclonal epidemic population structure, composed of a limited number of widespread clones which are selected from a background of a large quantity of rare and unrelated genotypes that are recombining at high frequency. Indeed, recent concerning reports have provided evidence of the existence of MDR/XDR global clones, denominated high-risk clones, disseminated in hospitals worldwide; ST235, ST111, and ST175 are likely those more widespread. Noteworthy, the vast majority of infections by MDR, and specially XDR, strains are produced by these and few other clones worldwide. Moreover, the association of high-risk clones, particularly ST235, with transferable resistance is overwhelming; nearly 100 different horizontally-acquired resistance elements and up to 39 different acquired β-lactamases have been reported so far among ST235 isolates. Likewise, MDR internationally-disseminated epidemic strains, such as the Liverpool Epidemic Strain (LES, ST146), have been noted as well among cystic fibrosis patients. Here we review the population structure, epidemiology, antimicrobial resistance mechanisms and virulence of the P. aeruginosa high-risk clones. The phenotypic and genetic factors potentially driving the success of high-risk clones, the aspects related to their detection in the clinical microbiology laboratory and the implications for infection control and public health are also discussed.

  16. Very large arrays of individually addressable high-power single-mode laser arrays in the 800- to 1000-nm wavelength range obtained by quantum well intermixing techniques

    NASA Astrophysics Data System (ADS)

    Najda, Stephen P.; Bacchin, Gianluca; Qiu, Bocang C.; Smith, Chris J. M.; Vassalli, O.; Toury, Marion; McDougall, Stewart D.; Hamilton, Craig J.; Marsh, John H.

    2005-04-01

    Quantum well intermixing (QWI) of the facet regions of a semiconductor laser can significantly improve the COD of the device giving high kink power and high reliability. A novel epitaxy design incorporating a graded 'V-profile' layer allows for a reduced vertical far-field and simultaneously suppresses higher order modes to give high power operation. Furthermore, the 'V-profile' layer provides a robust design to improve the ridge etch tolerance to give excellent device performance uniformity across an array. Very large arrays of individually addressable lasers (up to 100 elements) are reported with small pitch size (~100 μm), high single mode power (up to 300 mW) and high uniformity.

  17. Identification of Risk Factors for Recurrence in High-Risk Stage II Colon Cancer

    PubMed Central

    Hatano, Satoshi; Ishida, Hideyuki; Ishibashi, Keiichiro; Kumamoto, Kensuke; Haga, Norihiro; Miura, Ichiro

    2013-01-01

    To identify risk factors for recurrence in patients with stage II colon cancer, Cox proportional hazards regression analysis was performed in 194 patients with stage II colon cancer who underwent curative surgery between April 1997 and December 2008. Thirteen clinical and pathologic factors, including use of fluoropyrimidine-based adjuvant chemotherapy in 113 of the patients (58.2%), were assessed. By multivariate analysis, only obstruction, perforation, and T4-level invasion were identified as independent risk factors affecting disease-free survival (DFS) (P < 0.01). The 5-year DFS rate was 70.6% in patients with one or more risk factors (n = 68) and 96.0% in patients with no risk factors (n = 126) (P < 0.01). These results suggest that obstruction, perforation, and T4-level invasion are suitable candidates for prediction of tumor recurrence in patients with stage II colon cancer. The oxaliplatin-based adjuvant chemotherapy, which has been reported to be effective in stage III colon cancer patients, may improve the prognosis in high-risk stage II colon cancer patients. PMID:23701145

  18. [Combined Antihypertensive Therapy in Patients at High Risk].

    PubMed

    Lyamina, N P; Kotelnikova, E V; Nalivaeva, A V

    2015-10-01

    Presents opportunities to increase the effectiveness of combination antihypertensive therapy (AHT) in patients with arterial hypertension (AH) and high cardiovascular risk. Displaying increase in the proportion of patients with target blood pressure up to 82.4%; high commitment combined AHT (96%) and medical recommendations for lifestyle changes (54%) using the power of information computer technology (ICT) in order to carry out continuous monitoring of blood pressure and other risk factors (RF), commitment to the patients drug and non-drug assignments. Thus, ICT can be seen as a tool that can give a real idea of the scale and nature of the deviation from the medical recommendations that can serve as a basis for personalized AHT.

  19. Management of High-Risk Localized Prostate Cancer

    PubMed Central

    Marciscano, Ariel E.; Hardee, Matthew E.; Sanfilippo, Nicholas

    2012-01-01

    Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM). The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control. PMID:22110494

  20. Dual mobility total hip replacement in a high risk population

    PubMed Central

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  1. Threatened and Placed at Risk: High Achieving African American Males in Urban High Schools

    ERIC Educational Resources Information Center

    McGee, Ebony O.

    2013-01-01

    This study investigated the risk and protective factors of 11 high-achieving African American males attending 4 urban charter high schools in a Midwestern city to determine what factors account for their resilience and success in mathematics courses, and in high school more generally. This research was guided by a Phenomenological Variant of…

  2. Failure to acknowledge high suicide risk among veterinarians.

    PubMed

    Skipper, Gregory E; Williams, Jerome B

    2012-01-01

    A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (p<.01). Female veterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (p<.001), and 4% of all respondents indicated "definitely not being happy with their career." It is of concern that veterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.

  3. Learning rate and temperament in a high predation risk environment

    USGS Publications Warehouse

    DePasquale, C.; Wagner, Tyler; Archard, G.A.; Ferguson, B.; Braithwaite, V.A.

    2014-01-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration—collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  4. Learning rate and temperament in a high predation risk environment.

    PubMed

    DePasquale, C; Wagner, T; Archard, G A; Ferguson, B; Braithwaite, V A

    2014-11-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration-collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  5. [HTLV-I infection in a high-risk group].

    PubMed

    Pujol, E; Ollero, M; Gimeno, A; Colchero, J; Alcoucer, R; Márquez, P

    1990-07-01

    The aim of this study is to detect the presence of HTLV-1 in a high-risk population in west Andalusia. We studied 267 samples of serum from 255 patients: 179 of these patients being intravenous drug-users, 14 had ADVP sexual partners, 16 were inhalation drug-users, 4 were hemophiliacs, 9 had other high-risk habits and 25 hematological patients afflicted with leukemia or lymphoma. All of them were tested for antibodies against HTLV-1 by means of an in vitro qualitative ELISA technique (ELISA Du Pont HTLV-1). The positive results were confirmed by the Western blot technique. Additionally, the p24 antigen and the antibodies against VIH-1 and VIH-2 (ENV/CORE) were analysed, except in the 25 hematological patients. We found 20 serum samples positive to HTLV-1 by ELISA (7.4%), but only 1 (0.3%) was confirmed by the Western blot technique. The prevalence of VIH-1 was 46%; 9% had p24 VIH antigen and 26% had false positive ELISA to VIH-2. We found a statistically significant relationship (p = 0.0005) between positive ELISA to HTLV-1 and antibodies against VIH. We conclude that HTLV-1 has penetrated into the high-risk population of west Andalusia , although not yet to a great degree, and point out the need for seric epidemiological surveillance to prevent the spread of the retrovirus in these groups.

  6. Addressing Environmental Health Inequalities

    PubMed Central

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), “Addressing Environmental Health Inequalities—Proceedings from the ISEE Conference 2015”, we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  7. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    PubMed Central

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  8. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW

    PubMed Central

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-01-01

    Background: Sexual behavior is a complex activity affecting all aspects of human’s life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. Methods: we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of “risky sexual behavior assessment”, “sexual risk assessment”, “high risk sexual behavior”, “sexual risk taking”. By reviewing references of the articles, some complementary studies were added. Results: Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Conclusion: Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended. PMID:27047267

  9. Case Management Reduces Drinking During Pregnancy among High Risk Women

    PubMed Central

    May, Philip A.; Marais, Anna-Susan; Gossage, J. Phillip; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Hendricks, Natalie; Roux, Sumien; Blom, Annalien; Steenekamp, Jeanetta; Alexander, Theresa; Andreas, Romena; Human, Suzanne; Snell, Cudore; Seedat, Soraya; Parry, Charles C.; Kalberg, Wendy O.; Buckley, David; Blankenship, Jason

    2014-01-01

    Aim Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Design Women were recruited from antenatal clinics and engaged in 18 months of CM. Setting A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Participants Forty-one women who were high risk for bearing a child with FASD. Measures Statistical analysis of trends in drinking and other risk factors. Findings At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p < .001) and 18 months (p < .001). For participants completing 18 months of CM, AUDIT scores improved significantly by 6-month follow-up (from 19.8 to 9.7, p = .000), and even though rising at 12 and 18 months, AUDIT scores indicate that problematic drinking remained statistically significantly lower than baseline throughout CM. Happiness scale scores correlated significantly with reduced drinking in most time periods. Conclusions An enduring change in drinking behavior is difficult in this social setting. Yet, CM provided by skilled and empathic case managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus. PMID:24729823

  10. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    NASA Astrophysics Data System (ADS)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  11. [Home care for the high-risk newborn infant].

    PubMed

    Puddu, M

    2010-06-01

    With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

  12. Non-traditional risk factors for atherosclerosis in high risk children.

    PubMed

    Blieden, L C; Kuberger, N; Goez, R; Abramov, N; Laron, Z; Weizman, A; Gil-Ad, I

    1996-12-01

    Non-traditional risk factors for atherosclerosis were examined in children whose fathers suffered from myocardial infarction up to age 48. Factors examined were hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five cases (9%) and hypoinsulinemia in two. Insulin output following glucose load was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low density lipoprotein in 6 cases. Increased fibrinogen and positive correlation with insulin abnormality was present in 29% (76% females) (P >0.02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holter monitoring pattern was sympathetic in 39% and parasympathetic in 47% of cases. Thus a number of non-traditional risk factors were found to be higher than normal in a relatively large number of children at high risk for atherosclerosis, with 25 children having more than three risk factors.

  13. Using risk to target HPV vaccines in high-risk, low-resource organizations.

    PubMed

    Small, Stephanie L; Sampselle, Carolyn M; Martyn, Kristy K; Dempsey, Amanda F

    2013-05-01

    Organizations in developed countries with limited financial resources may find it difficult to determine whether it is preferable to use these resources for HPV vaccination, management of HPV-related diseases, or a "hybrid" strategy, such as vaccinating only the highest risk individuals. We determined the organizational costs and clinical impacts of three different organizational approaches to female HPV vaccination in a low-resource setting, including vaccinating everyone, vaccinating no one, or vaccinating only those considered high-risk. To determine patients at highest risk, HPV risk factors were identified using information routinely gathered at the annual preventive maintenance visit. The three vaccination strategies were then compared using a decision tree analysis. The three strategies demonstrated very little difference in cost. However, the least expensive strategy was to vaccinate no one. In contrast, the strategy with the best clinical outcomes was for the organization to vaccinate everyone. Organizations with limited resources must decide how to best allocate these funds to provide the greatest clinical benefits. This study showed little difference in costs but improved clinical outcomes when using the universal HPV vaccination strategy. Thus, the improvement in clinical outcomes when vaccinating everyone may be worth the relatively small increase in cost of vaccinating everyone.

  14. Substance use and sexual risk behaviors among Mississippi public high school students.

    PubMed

    McGuire, James; Wang, Bo; Zhang, Lei

    2012-10-01

    This study describes the patterns of substance use and sexual risk behaviors and examines the relationships among a representative sample of Mississippi public high school students. Data were obtained from the 2009 Mississippi Youth Risk Behavior Survey. Multiple logistic regression analyses were performed. We found 61% of the participants ever had sexual intercourse and 13.4% engaged in early sexual initiation (< or = 12 years). Nearly a quarter had four or more lifetime sexual partners. One-third did not use a condom during their last sexual intercourse. Two-thirds drank alcohol. Over one-third used marijuana. Older age, being a black, drinking alcohol, or using marijuana or other drugs were associated with early sexual initiation and having multiple sexual partners. Heavy smoking was associated with early sexual initiation. Using marijuana or other drugs was associated with unprotected sex. Findings highlight the extensive substance use and engagement of sexual risk behaviors among Mississippi adolescents. Interventions that address both substance use and sexual risk behaviors may have a great impact in preventing teen pregnancy and HIV/STD transmission and curtailing substance abuse problems among Mississippi adolescents.

  15. Implications of Public Reporting of Risk-Adjusted Mortality Following Percutaneous Coronary Intervention: Misperceptions and Potential Consequences for High-Risk Patients Including Nonsurgical Patients.

    PubMed

    Gupta, Anuj; Yeh, Robert W; Tamis-Holland, Jacqueline E; Patel, Shalin H; Guyton, Robert A; Klein, Lloyd W; Rab, Tanveer; Kirtane, Ajay J

    2016-10-24

    Assessment of clinical outcomes such as 30-day mortality following coronary revascularization procedures has historically been used to spur quality improvement programs. Public reporting of risk-adjusted outcomes is already mandated in several states, and proposals to further expand public reporting have been put forward as a means of increasing transparency and potentially incentivizing high quality care. However, for public reporting of outcomes to be considered a useful surrogate of procedural quality of care, several prerequisites must be met. First, the reporting measure must be truly representative of the quality of the procedure itself, rather than be dominated by other underlying factors, such as the overall level of illness of a patient. Second, to foster comparisons among physicians and institutions, the metric requires accurate ascertainment of and adjustment for differences in patient risk profiles. This is particularly relevant for high-risk clinical patient scenarios. Finally, the potential deleterious consequences of public reporting of a quality metric should be considered prior to expanding the use of public reporting more broadly. In this viewpoint, the authors review in particular the characterization of high-risk patients currently treated by percutaneous coronary interventional procedures, assessing the adequacy of clinical risk models used in this population. They then expand upon the limitations of 30-day mortality as a quality metric for percutaneous coronary intervention, addressing the strengths and limitations of this metric, as well as offering suggestions to enhance its future use in public reporting.

  16. Population-based genetic risk prediction and stratification for ovarian cancer: views from women at high risk.

    PubMed

    Rahman, Belinda; Meisel, Susanne F; Fraser, Lindsay; Side, Lucy; Gessler, Sue; Wardle, Jane; Lanceley, Anne

    2015-03-01

    There is an opportunity to improve outcomes for ovarian cancer (OC) through advances in risk stratification, early detection and diagnosis. A population-based OC genetic risk prediction and stratification program is being developed. A previous focus group study with individuals from the general population showed support for the proposed program. This qualitative interview study explores the attitudes of women at high risk of OC. Eight women participated in one-on-one, in-depth, semi-structured interviews to explore: experiences of learning of OC risk, risk perceptions, OC knowledge and awareness, and opinions on risk stratification approach. There was evidence of strong support for the proposed program. Benefits were seen as providing reassurance to women at low risk, and reducing worry in women at high risk through appropriate clinical management. Stratification into 'low' and 'high' risk groups was well-received. Participants were more hesitant about stratification to the 'intermediate' risk group. The data suggest formats to effectively communicate OC risk estimates will require careful thought. Interactions with GPs were highlighted as a barrier to OC risk assessment and diagnosis. These results are encouraging for the possible introduction and uptake of a risk prediction and stratification program for OC in the general population.

  17. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    ERIC Educational Resources Information Center

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  18. Extreme risk taker who wants to continue taking part in high risk sports after serious injury.

    PubMed

    Pain, M; Kerr, J H

    2004-06-01

    The case is reported of a 40 year old male high risk sport athlete who had seriously injured himself several times and as a result was partially physically disabled and had trouble with mental tasks requiring concentration such as spelling, reading numbers, and writing. The athlete was referred to a sports psychologist. In consultations, it became clear that he was having difficulty reconciling the difference between his life as it used to be and as it would be in the future. Part of his difficulty was dealing with the frustration and anger "outbursts" which resulted from not being able to perform straightforward everyday motor skills. In spite of his injuries and disability, the patient badly wanted to continue participating in extreme sports. Reversal theory is used in the discussion to provide theoretical explanations of the motivation for his extreme risk taking behaviour.

  19. Family psychosocial screening: should we focus on high-risk settings?

    PubMed

    Kemper, K J; Osborn, L M; Hansen, D F; Pascoe, J M

    1994-10-01

    The objective of this study was to address the question of whether or not psychosocial screening should be focused on "high-risk" populations. A cross-sectional survey of mothers of young children was conducted in various clinics: 758 in teaching clinics, 444 in private practices, and 202 at a military clinic. The self-administered questionnaire covered demographic factors, problems in mothers family of origin, maternal depression, and substance abuse. Mothers in the teaching clinics were younger and had less education and lower incomes than mothers in private practices, with intermediate levels in the military clinic. However, a substantial proportion of mothers seen in all sites reported psychosocial problems. Approximately 20% of mothers in all sites reported a family history of alcoholism. Positive screens for maternal depression ranged from about 15% to 35%. Binge drinking was reported by 10% to 20% at different sites. Psychosocial problems were common even among families seen in "low-risk" settings. Focusing screening only on high-risk clinics would miss many families with psychosocial problems.

  20. High-risk corneal allografts: A therapeutic challenge

    PubMed Central

    Yu, Tian; Rajendran, Vijayalakshmi; Griffith, May; Forrester, John V; Kuffová, Lucia

    2016-01-01

    address the worldwide problem of corneal blindness in both “low-risk” and “high-risk” hosts. PMID:27011902

  1. Proteomic profiling of high risk medulloblastoma reveals functional biology.

    PubMed

    Staal, Jerome A; Lau, Ling San; Zhang, Huizhen; Ingram, Wendy J; Hallahan, Andrew R; Northcott, Paul A; Pfister, Stefan M; Wechsler-Reya, Robert J; Rusert, Jessica M; Taylor, Michael D; Cho, Yoon-Jae; Packer, Roger J; Brown, Kristy J; Rood, Brian R

    2015-06-10

    Genomic characterization of medulloblastoma has improved molecular risk classification but struggles to define functional biological processes, particularly for the most aggressive subgroups. We present here a novel proteomic approach to this problem using a reference library of stable isotope labeled medulloblastoma-specific proteins as a spike-in standard for accurate quantification of the tumor proteome. Utilizing high-resolution mass spectrometry, we quantified the tumor proteome of group 3 medulloblastoma cells and demonstrate that high-risk MYC amplified tumors can be segregated based on protein expression patterns. We cross-validated the differentially expressed protein candidates using an independent transcriptomic data set and further confirmed them in a separate cohort of medulloblastoma tissue samples to identify the most robust proteogenomic differences. Interestingly, highly expressed proteins associated with MYC-amplified tumors were significantly related to glycolytic metabolic pathways via alternative splicing of pyruvate kinase (PKM) by heterogeneous ribonucleoproteins (HNRNPs). Furthermore, when maintained under hypoxic conditions, these MYC-amplified tumors demonstrated increased viability compared to non-amplified tumors within the same subgroup. Taken together, these findings highlight the power of proteomics as an integrative platform to help prioritize genetic and molecular drivers of cancer biology and behavior.

  2. Gender Differences in Risk Behaviors Among High School Youth

    PubMed Central

    Haque laz, Tabassum; Rahman, Mahbubur; Berenson, Abbey B.

    2013-01-01

    The US Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System (YRBSS) demonstrates that American youth engage in a wide variety of risky behaviors.1 The frequency and type of these behaviors often differ by a number of factors, such as socioeconomic status, race, and ethnicity. For example, results of the 2011 YRBSS revealed that white high school students were most likely to have texted or e-mailed while driving or been bullied on school property, while black high school students were most likely to have engaged in risky sexual behaviors, to have been physically inactive, and to be obese.1 Conversely, Hispanic high school students were most likely to have ridden with a driver who had been drinking alcohol; to have ever used cocaine, inhalants, or ecstasy; and to have failed to use protection to prevent pregnancy during last sexual intercourse.1 However, it is difficult to discern whether differences in risk-taking behaviors between and among ethnic groups can actually be attributed to differences in group norms, socioeconomic status, or cultural beliefs regarding acceptance or rejection of such behaviors,1 suggesting a need for more comprehensive regional investigations. PMID:24416689

  3. High-potency cannabis and the risk of psychosis

    PubMed Central

    Di Forti, Marta; Morgan, Craig; Dazzan, Paola; Pariante, Carmine; Mondelli, Valeria; Marques, Tiago Reis; Handley, Rowena; Luzi, Sonija; Russo, Manuela; Paparelli, Alessandra; Butt, Alexander; Stilo, Simona A.; Wiffen, Ben; Powell, John; Murray, Robin M.

    2009-01-01

    Background People who use cannabis have an increased risk of psychosis, an effect attributed to the active ingredient Δ9-tetrahydrocannabinol (Δ9-THC). There has recently been concern over an increase in the concentration of Δ9-THC in the cannabis available in many countries. Aims To investigate whether people with a first episode of psychosis were particularly likely to use high-potency cannabis. Method We collected information on cannabis use from 280 cases presenting with a first episode of psychosis to the South London & Maudsley National Health Service (NHS) Foundation Trust, and from 174 healthy controls recruited from the local population. Results There was no significant difference between cases and controls in whether they had ever taken cannabis, or age at first use. However, those in the cases group were more likely to be current daily users (OR = 6.4) and to have smoked cannabis for more than 5 years (OR = 2.1). Among those who used cannabis, 78% of the cases group used high-potency cannabis (sinsemilla, ‘skunk’) compared with 37% of the control group (OR 6.8). Conclusions The finding that people with a first episode of psychosis had smoked higher-potency cannabis, for longer and with greater frequency, than a healthy control group is consistent with the hypothesis that Δ9-THC is the active ingredient increasing risk of psychosis. This has important public health implications, given the increased availability and use of high-potency cannabis. PMID:19949195

  4. [Residual risk: The roles of triglycerides and high density lipoproteins].

    PubMed

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target.

  5. Protecting military personnel from high risk dietary supplements.

    PubMed

    Deuster, Patricia A; Lieberman, Harris R

    2016-01-01

    It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

  6. Pathologic High-risk Lesions, Diagnosis and Management.

    PubMed

    Murray, Melissa

    2016-12-01

    Percutaneous imaging-guided core needle biopsy (CNB) is a less invasive and less expensive alternative to surgical biopsy for the evaluation of breast lesions. After a CNB the radiologist determine if there is concordance between the pathology, imaging, and clinical findings. Patient management after CNB diagnosis of high-risk breast lesion varies. Surgical excision is warranted for lesions yielding a CNB diagnosis of ADH; however controversy exists regarding the need for surgical excision after CNB diagnosis of radial scar, papillary lesion, atypical lobular hyperplasia (ALH), or lobular carcinoma in situ (LCIS). Repeat CNB or surgical excision is warranted if histologic findings and imaging findings are discordant.

  7. Teamwork in high-risk environments analogous to space

    NASA Technical Reports Server (NTRS)

    Kanki, Barbara G.

    1990-01-01

    Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

  8. Understanding high magnitude flood risk: evidence from the past

    NASA Astrophysics Data System (ADS)

    MacDonald, N.

    2009-04-01

    The average length of gauged river flow records in the UK is ~25 years, which presents a problem in determining flood risk for high-magnitude flood events. Severe floods have been recorded in many UK catchments during the past 10 years, increasing the uncertainty in conventional flood risk estimates based on river flow records. Current uncertainty in flood risk has implications for society (insurance costs), individuals (personal vulnerability) and water resource managers (flood/drought risk). An alternative approach is required which can improve current understanding of the flood frequency/magnitude relationship. Historical documentary accounts are now recognised as a valuable resource when considering the flood frequency/magnitude relationship, but little consideration has been given to the temporal and spatial distribution of these records. Building on previous research based on British rivers (urban centre): Ouse (York), Trent (Nottingham), Tay (Perth), Severn (Shrewsbury), Dee (Chester), Great Ouse (Cambridge), Sussex Ouse (Lewes), Thames (Oxford), Tweed (Kelso) and Tyne (Hexham), this work considers the spatial and temporal distribution of historical flooding. The selected sites provide a network covering many of the largest river catchments in Britain, based on urban centres with long detailed documentary flood histories. The chronologies offer an opportunity to assess long-term patterns of flooding, indirectly determining periods of climatic variability and potentially increased geomorphic activity. This research represents the first coherent large scale analysis undertaken of historical multi-catchment flood chronologies, providing an unparalleled network of sites, permitting analysis of the spatial and temporal distribution of historical flood patterns on a national scale.

  9. Addressing the question of disorder-specific risk factors of internet addiction: a comparison of personality traits in patients with addictive behaviors and comorbid internet addiction.

    PubMed

    Müller, K W; Koch, A; Dickenhorst, U; Beutel, M E; Duven, E; Wölfling, K

    2013-01-01

    Uncontrolled use of the internet has been reported to affect the lives of some users in a negative way. According to epidemiological studies, about 1% of the general population is showing signs of internet addiction. Since internet addiction is becoming a growing health concern, research on potential risk factors is becoming more important in order to develop strategies for prevention and to adopt therapeutic treatment. Although there are some studies investigating personality traits in internet addiction, most of these studies are based on samples of healthy subjects. In this research project, we compared personality profiles of a sample of patients in different rehabilitation centers. 70 patients with an addiction disorder that additionally met the criteria for internet addiction were compared to 48 patients suffering from alcohol dependence. Besides Big Five personality traits, we also assessed depressive symptoms. It was shown that patients with comorbid internet addiction can be discriminated from other patients by higher neuroticism and lower extraversion as well as lower conscientiousness. After controlling for depressive symptoms, lower conscientiousness especially turned out to be a disorder-specific risk factor. As internet addiction is related to unique patterns of personality traits and can be discriminated from alcohol dependence, treatment approaches are needed that meet the specific requirements of patients with internet addiction.

  10. Integration of satellite-derived precipitation estimates and GeoNode capabilities for addressing the risk of flooding to local communities

    NASA Astrophysics Data System (ADS)

    Isotta Cristofori, Elena; Camilo Camaro, Walther; Balbo, Simone; Pasquali, Paolo

    2015-04-01

    Natural hazards such as flood and drought are one of the main cause of economic losses and casualties over Africa. A number of initiatives are being implemented at a global and a local scale to reduce the risk of natural disasters. These initiatives often relies on the use and the efficient sharing of open source EO datasets in order to enable policy-makers and the public to have access to the right information in an easy and timely manner. While the commonly used datasets often include Geographic Information System (GIS) based information for the disaster monitoring and damage impact assessment, the integration with EO data of impending hazards is still at an early stage. The aim of this paper is to illustrate a methodology for combining satellite-derived precipitation estimates and spatial analysis capabilities for the production of extreme rainfall warning maps, through the use of GeoNode, a Web platform for the management and publication of geospatial data. In particular the methodology is presented for a case study over Malawi, in the framework of the Malawi Spatial Data Platform (MASDAP), a GeoNode-based platform promoted by the Government of Malawi in order to support development of the country and build resilience against natural hazards. This approach is considered to be particularly valuable in order to enable communities to better understand the risk of extreme precipitation and to have a tool for effectively evaluate main areas where flooding may develop rapidly causing significant damages, such as seasonal rivers.

  11. Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

    PubMed Central

    Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

    2010-01-01

    Background Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically-defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment; where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions and research efforts. Methods We describe the results of a segmentation analysis of those individuals who self-report consuming five or more drinks per drinking episode at least twice in the last 30-days. The study used the proprietary PRIZM™ audience segmentation database merged with Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top ten of the 66 PRIZM™ audience segments for this risky drinking pattern are described. For five of these segments we provide additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers reside. Results The top ten audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge drinking behavior is referred to as the “Cyber Millenials.” This cluster is characterized as “the nation's tech-savvy singles

  12. Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

    PubMed Central

    Wang, Tao; Luo, Hao; Yan, Hong-tao; Zhang, Guo-hu; Liu, Wei-hui; Tang, Li-jun

    2017-01-01

    Objective Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia. Methods To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study. Results The preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317–0.920; P=0.023) and lithotrity (OR: 0.150; 95% CI: 0.023–0.965; P=0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (P=0.016; 95% CI: 0.553–0.854). Conclusion PCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones. PMID:28138229

  13. Methods for Addressing Uncertainty and Variability to Characterize Potential Health Risk from Trichloroethylene-Contaminated Ground Water at Beale Air Force Base in California:Integration of Uncertainty and Variability in Pharmacokinetics and Dose-Response

    SciTech Connect

    Bogen, K T

    2001-05-24

    Traditional estimates of health risk are typically inflated, particularly if cancer is the dominant endpoint and there is fundamental uncertainty as to mechanism(s) of action. Risk is more realistically characterized if it accounts for joint uncertainty and interindividual variability within a systematic probabilistic framework to integrate the joint effects on risk of distributed parameters of all (linear as well as nonlinear) risk-extrapolation models involved. Such a framework was used to characterize risks to potential future residents posed by trichloroethylene (TCE) in ground water at an inactive landfill site on Beale Air Force Base in California. Variability and uncertainty were addressed in exposure-route-specific estimates of applied dose, in pharmacokinetically based estimates of route-specific metabolized fractions of absorbed TCE, and in corresponding biologically effective doses estimated under a genotoxic/linear (MA{sub G}) vs. a cytotoxic/nonlinear (MA{sub c}) mechanistic assumption for TCE-induced cancer. Increased risk conditional on effective dose was estimated under MA{sub G} based on seven rodent-bioassay data sets, and under MA{sub c} based on mouse hepatotoxicity data. Mean and upper-bound estimates of combined risk calculated by the unified approach were <10{sup -6} and 10{sup -4}, respectively, while corresponding estimates based on traditional deterministic methods were >10{sup -5} and 10{sup -4}, respectively. It was estimated that no TCE-related harm is likely to occur due to any plausible residential exposure scenario involving the site. The systematic probabilistic framework illustrated is particularly suited to characterizing risks that involve uncertain and/or diverse mechanisms of action.

  14. The Allure of High-Risk Rewards in Huntington’s disease

    PubMed Central

    van Wouwe, Nelleke C.; Kanoff, Kristen E.; Claassen, Daniel O.; Ridderinkhof, K. Richard; Hedera, Peter; Harrison, Madaline B.; Wylie, Scott A.

    2017-01-01

    Objectives Huntington’s disease (HD) is a neurodegenerative disorder that produces a bias toward risky, reward-driven decisions in situations where the outcomes of decisions are uncertain and must be discovered. However, it is unclear whether HD patients show similar biases in decision-making when learning demands are minimized and prospective risks and outcomes are known explicitly. We investigated how risk decision-making strategies and adjustments are altered in HD patients when reward contingencies are explicit. Methods HD (N = 18) and healthy control (HC; N = 17) participants completed a risk-taking task in which they made a series of independent choices between a low-risk/low reward and high-risk/high reward risk options. Results Computational modeling showed that compared to HC, who showed a clear preference for low-risk compared to high-risk decisions, the HD group valued high-risks more than low-risk decisions, especially when high-risks were rewarded. The strategy analysis indicated that when high-risk options were rewarded, HC adopted a conservative risk strategy on the next trial by preferring the low-risk option (i.e., they counted their blessings and then played the surer bet). In contrast, following a rewarded high-risk choice, HD patients showed a clear preference for repeating the high-risk choice. Conclusions These results indicate a pattern of high-risk/high-reward decision bias in HD that persists when outcomes and risks are certain. The allure of high-risk/high-reward decisions in situations of risk certainty and uncertainty expands our insight into the dynamic decision-making deficits that create considerable clinical burden in HD. PMID:26708084

  15. Study of Delinquent, Diverted, and High-Risk Adolescent Girls: Implications for Mental Health Intervention

    ERIC Educational Resources Information Center

    Ruffolo, Mary C.; Sarri, Rosemary; Goodkind, Sara

    2004-01-01

    This study examines risk and protective factors for delinquent, diverted, and high-risk adolescent girls to inform the development of effective mental health prevention and intervention programs. Delinquent, diverted, and high-risk adolescent girls (N = 159) involved or at risk of involvement with the juvenile justice system, who were receiving…

  16. Smell identification in individuals at clinical high risk for schizophrenia.

    PubMed

    Gill, Kelly Elizabeth; Evans, Elizabeth; Kayser, Jürgen; Ben-David, Shelly; Messinger, Julie; Bruder, Gerard; Malaspina, Dolores; Corcoran, Cheryl Mary

    2014-12-15

    Smell identification deficits exist in schizophrenia, and may be associated with its negative symptoms. Less is known about smell identification and its clinical correlates in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders. We examined smell identification, symptoms and IQ in 71 clinical high-risk (CHR) subjects and 36 healthy controls. Smell identification was assessed using both the 40-item University of Pennsylvania Smell Identification Test (UPSIT; Doty, R.L., Shaman, P., Kimmelman, C.P., Dann, M.S., 1984. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176-178) and its extracted 12-item Brief Smell Identification Test (Goudsmit, N., Coleman, E., Seckinger, R.A., Wolitzky, R., Stanford, A.D., Corcoran, C., Goetz, R.R., Malaspina, D., 2003. A brief smell identification test discriminates between deficit and non-deficit schizophrenia. Psychiatry Research 120, 155-164). Smell identification did not significantly differ between CHR subjects and controls. Among CHR subjects, smell identification did not predict schizophrenia (N=19; 27%) within 2 years, nor was it associated with negative or positive symptoms. This is the third prospective cohort study to examine smell identification in CHR subjects, and overall, findings are inconclusive, similar to what is found for other disorders in adolescents, such as autism spectrum, attention deficit and anxiety disorders. Smell identification deficit may not have clear utility as a marker of emergent schizophrenia and related psychotic disorders.

  17. Personality differences in high risk sports amateurs and instructors.

    PubMed

    Watson, Alison E; Pulford, Briony D

    2004-08-01

    This study investigated the personality differences of 21 amateurs and 20 instructors who participated in the high risk sports of skydiving, hang-gliding, paragliding, scuba diving, microlighting, and rock climbing, versus those who did not. 38 men and 28 women (M age=32.6 yr., SD= 10.0) were assessed using the Eysenck Personality Questionnaire-Revised, the General Health Questionnaire, the Generalised Self-efficacy Scale, and a Type A/B personality measure. Instructors and Amateurs scored significantly higher on Extroversion and lower on Neuroticism than Nonparticipants; however, they differed from each other on the General Health Questionnaire and Type A/B personality scores. Amateurs scored significantly higher on Psychoticism and Self-efficacy than Instructors and Nonparticipants. In conclusion, these test scores suggest that people who are attracted to high risk sports tend to be at the extroverted and emotionally stable end of the scale, with a tendency to exhibit Type A characteristics; however, Instructors' scores on Psychoticism and Self-efficacy are more akin to those of Nonparticipants.

  18. Neurophysiology for Detection of High Risk for Psychosis

    PubMed Central

    2016-01-01

    Schizophrenia is a complex and often disabling disorder that is characterized by a wide range of social, emotional, and cognitive deficits. Increasing research suggests that the greatest social and cognitive therapeutic impact comes from early identification. The present study applied a well-established neurophysiological paradigm in the schizophrenia literature, mismatch negativity (MMN), to college students identified as high risk (HR) for psychosis to investigate MMN as a potential biomarker for the onset of psychosis. The hypothesis was that HR would exhibit attenuated MMN amplitudes compared to controls, as has been established in individuals with chronic schizophrenia. Participants (N = 121) were separated into Group 1 (controls) (n1 = 72) and Group 2 (HR) (n2 = 49) based on the established cutoff score of the 16-item Prodromal Questionnaire. Participants then completed a time based MMN paradigm during which brain activity was recorded with EEG. For all electrode locations, controls demonstrated significantly more negative amplitudes than HR (Cz: F(1,119) = 8.09, p = .005; Fz: F(1, 119) = 5.74, p = .018; Pz: F(1,119) = 5.88, p = .017). Results suggested that MMN may assist in identifying those who appear high-functioning but may be at risk for later development of psychosis or cognitive and psychological difficulties associated with psychosis. PMID:27579180

  19. Neurophysiology for Detection of High Risk for Psychosis.

    PubMed

    Pantlin, Lara N; Davalos, Deana

    2016-01-01

    Schizophrenia is a complex and often disabling disorder that is characterized by a wide range of social, emotional, and cognitive deficits. Increasing research suggests that the greatest social and cognitive therapeutic impact comes from early identification. The present study applied a well-established neurophysiological paradigm in the schizophrenia literature, mismatch negativity (MMN), to college students identified as high risk (HR) for psychosis to investigate MMN as a potential biomarker for the onset of psychosis. The hypothesis was that HR would exhibit attenuated MMN amplitudes compared to controls, as has been established in individuals with chronic schizophrenia. Participants (N = 121) were separated into Group 1 (controls) (n 1 = 72) and Group 2 (HR) (n 2 = 49) based on the established cutoff score of the 16-item Prodromal Questionnaire. Participants then completed a time based MMN paradigm during which brain activity was recorded with EEG. For all electrode locations, controls demonstrated significantly more negative amplitudes than HR (Cz: F(1,119) = 8.09, p = .005; Fz: F(1, 119) = 5.74, p = .018; Pz: F(1,119) = 5.88, p = .017). Results suggested that MMN may assist in identifying those who appear high-functioning but may be at risk for later development of psychosis or cognitive and psychological difficulties associated with psychosis.

  20. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    PubMed Central

    Tummers, Bart; Van Der Burg, Sjoerd H.

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review. PMID:26008697

  1. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh.

    PubMed

    Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel

    2012-03-01

    Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

  2. Social Network Strategies to Address HIV Prevention and Treatment Continuum of Care Among At-risk and HIV-infected Substance Users: A Systematic Scoping Review.

    PubMed

    Ghosh, Debarchana; Krishnan, Archana; Gibson, Britton; Brown, Shan-Estelle; Latkin, Carl A; Altice, Frederick L

    2017-04-01

    Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.

  3. 2017 Taiwan lipid guidelines for high risk patients.

    PubMed

    Li, Yi-Heng; Ueng, Kwo-Chang; Jeng, Jiann-Shing; Charng, Min-Ji; Lin, Tsung-Hsien; Chien, Kuo-Liong; Wang, Chih-Yuan; Chao, Ting-Hsing; Liu, Ping-Yen; Su, Cheng-Huang; Chien, Shih-Chieh; Liou, Chia-Wei; Tang, Sung-Chun; Lee, Chun-Chuan; Yu, Tse-Ya; Chen, Jaw-Wen; Wu, Chau-Chung; Yeh, Hung-I

    2017-04-01

    In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG) levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins), cholesterol absorption inhibitors (ezetimibe), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, nicotinic acids (niacin), fibric acids derivatives (fibrates), and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS) and stable CAD, LDL-C < 70 mg/dL is the major target. A lower target of LDL-C <55 mg/dL can be considered in ACS patients with DM. After treating LDL-C to target, non-HDL-C can be considered as a secondary target for patients with TG ≥ 200 mg/dL. The suggested non-HDL-C target is < 100 mg/dL in ACS and CAD patients. For patients with ischemic stroke or transient ischemic attack presumed to be of atherosclerotic origin, statin therapy is beneficial and LDL-C < 100 mg/dL is the suggested target. For patients with symptomatic carotid stenosis or intracranial arterial stenosis, in addition to antiplatelets and blood pressure control, LDL

  4. Adolescents demonstrate improvement in obesity risk behaviors following completion of Choice, Control, and Change, a curriculum addressing personal agency and autonomous motivation

    PubMed Central

    Koch, Pamela A.; Lee, Heewon; Calabrese-Barton, A

    2010-01-01

    Background The rapid increase of obesity and diabetes risk beginning in youth, particularly those from disadvantaged communities, calls for prevention efforts. Objective To examine the impact of a curriculum intervention, Choice, Control, and Change (C3), on the adoption of the energy balance related behaviors of decreasing sweetened drinks, packaged snacks, fast food, and leisure screen time, and increasing water, fruits and vegetables, and physical activity, and on potential psychosocial mediators of the behaviors. Design Ten middle schools in low-income New York City neighborhoods were randomly assigned within matched pairs to either intervention or comparison/ delayed control conditions during the 2007–2008 school year. Participants 562 inner city seventh grade students in the intervention condition, and 574 in the comparison condition. Intervention Students received the 24 C3 lessons that used science inquiry-based investigations to enhance motivation for action, and social cognitive and self-determination theories to increase personal agency and autonomous motivation to take action. Main outcome measures Self-report instruments to measure energy balance related behaviors targeted by the curriculum, and potential psychosocial mediators of the behaviors. Analyses ANCOVA with group (intervention/control) as a fixed factor and pre-test as covariate. Results Students in intervention schools compared to the delayed intervention controls reported consumption of significantly fewer sweetened drinks and packaged snacks, smaller sizes of fast food, increased intentional walking for exercise, and decreased leisure screen-time, but showed no increases in their intakes of water, fruits, and vegetables. They showed significant increases in positive outcome expectations about the behaviors, self-efficacy, goal intentions, competence, and autonomy. Conclusions The C3 curriculum was effective in improving many of the specifically targeted behaviors related to reducing

  5. Youth High-Risk Behaviors: Survey and Results.

    ERIC Educational Resources Information Center

    Stevens, Patricia; Griffin, Juree

    2001-01-01

    This article presents results from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. Results, which may assist in developing appropriate intervention/prevention programs, indicate a critical age for involvement in risk behaviors, gradual increase in risk behaviors over time, and gender differences in risk behaviors. (BF)

  6. At-risk high school seniors: Science remediation for Georgia's High School Graduation Test

    NASA Astrophysics Data System (ADS)

    Carroll, Carolyn M.

    State departments of education have created a system of accountability for the academic achievement of students under the mandate of the No Child Left Behind Act of 2001. The Georgia Department of Education established the Georgia High School Graduation Test (GHSGT) as their method of evaluating the academic achievement of high school students. The GHSGT consist of five sections and students must pass all five sections before students they are eligible to receive a diploma. The purpose of the study was to examine the effects of teacher-lead and computer based remediation for a group of high school seniors who have been unsuccessful in passing the science portion of the GHSGT. The objectives of this study include (a) Identify the most effective method of remediation for at-risk students on the science section of the GHSGT, and (b) evaluate the methods of remediation for at-risk students on the science section of GHSGT available to high school students. The participants of this study were at-risk seniors enrolled in one high school during the 2007-2008 school year. The findings of this research study indicated that at-risk students who participated in both types of remediation, teacher-led and computer-based, scored significantly higher than the computer-based remediation group alone. There was no significant relationship between the test scores and the number of times the students were tested.

  7. Mother-Child Interactions in Depressed Children and Children at High Risk and Low Risk for Future Depression

    ERIC Educational Resources Information Center

    Dietz, Laura J.; Birmaher, Boris; Williamson, Douglas E.; Silk, Jennifer S.; Dahl, Ronald E.; Axelson, David A.; Ehmann, Mary; Ryan, Neal D.

    2008-01-01

    A study to investigate the differences in mother and child interactions of depressed children and adolescents, nondepressed high-risk youths, and healthy controls was conducted. Results revealed increased family discord with depressed children whereas intermediate levels of control and disengagement were seen in families with high-risk children.

  8. A history of the working group to address Los Alamos community health concerns - A case study of community involvement and risk communication

    SciTech Connect

    Harry Otway; Jon Johnson

    2000-01-01

    In May 1991, at a Department of Energy (DOE) public hearing at Los Alamos, New Mexico, a local artist claimed there had been a recent brain tumor cluster in a small Los Alamos neighborhood. He suggested the cause was radiation from past operations of Los Alamos National Laboratory. Data from the Laboratory's extensive environmental monitoring program gave no reason to believe this charge to be true but also could not prove it false. These allegations, reported in the local and regional media, alarmed the community and revealed an unsuspected lack of trust in the Laboratory. Having no immediate and definitive response, the Laboratory offered to collaborate with the community to address this concern. The Los Alamos community accepted this offer and a joint Community-Laboratory Working Group met for the first time 29 days later. The working group set as its primary goal the search for possible carcinogens in the local environment. Meanwhile, the DOE announced its intention to fund the New Mexico Department of Health to perform a separate and independent epidemiological study of all Los Alamos cancer rates. In early 1994, after commissioning 17 environmental studies and meeting 34 times, the working group decided that the public health concerns had been resolved to the satisfaction of the community and voted to disband. This paper tells the story of the artist and the working group, and how the media covered their story. It summarizes the environmental studies directed by the working group and briefly reviews the main findings of the epidemiology study. An epilogue records the present-day recollections of some of the key players in this environmental drama.

  9. Alcohol consumption and high risk sexual behaviour among female sex workers in Uganda.

    PubMed

    Mbonye, Martin; Rutakumwa, Rwamahe; Weiss, Helen; Seeley, Janet

    2014-01-01

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1027 women selected from 'hot spots' in the suburbs of Kampala city. We conducted 3 in-depth interviews with 40 female sex workers between 2010 and 2011. Data were analysed thematically, focusing on alcohol use within the context of sex work. Alcohol consumption was very high with only seven women reporting that they did not drink. Alcohol consumption was driven by the emotional and economic needs of the participants, but also promoted by clients who encouraged consumption. Many sex workers only started drinking alcohol when they joined sex work on the advice of more experienced peers, as a way to cope with the job. Alcohol was blamed for unsafe sex, acts of violence and poor decision making which increased sexual and physical violence. Alcohol was reported to affect medication adherence for HIV-positive women who forgot to take medicine. The findings suggest that the drivers of alcohol consumption are multifaceted in this group and require both individual and structural interventions. Alcohol reduction counselling can be supportive at the individual level and should be an integral part of HIV prevention programmes for female sex workers and others such as patrons in bars. The counselling should be addressed in a sensitive manner to bar owners and managers.

  10. Report: Some States Cannot Address Assessment Needs and Face Limitations in Meeting Future Superfund Cleanup Requirements

    EPA Pesticide Factsheets

    Report #2004-P-00027, September 1, 2004. The five States have established hazardous waste site cleanup programs that address contaminated sites posing human health and environmental risks ranging from low to high.

  11. Sexual and physical violence victimization among senior high school students in Ghana: Risk and protective factors.

    PubMed

    Ohene, Sally-Ann; Johnson, Kiana; Atunah-Jay, Sarah; Owusu, Andrew; Borowsky, Iris Wagman

    2015-12-01

    Violence in all forms poses a concern because of associations with multiple adverse effects including injuries and mental health problems. There is however limited data on violence in general and youth violence in particular in Ghana. To explore the nature and scope of youth violence in Ghana, we used the nationwide Global School-based Health Survey, conducted among senior high school students in Ghana, to explore risk and protective factors at the individual, family, and environmental levels associated with sexual and physical violence victimization. A fifth of these students reported being forced to have sex in their lifetime while two out of five had been a victim of a physical attack in the year preceding the survey. In final multivariate analysis, for sexual violence victimization, history of sexual activity with or without condom use at last sex, feeling sad or hopeless, and being a victim of bullying and electronic bullying were identified as risk factors, while having friends who were not sexually active was protective. Independent risk factors for physical violence victimization were attempting suicide in the last year, alcohol use in the past month, and bullying other students in the past month. Parent respect for privacy just reached significance as a protective factor for physical violence victimization in the final model. Recognition of the magnitude of violence victimization among Ghanaian students and associated factors must be used to guide development and implementation of appropriate concrete measures to prevent and address the problem.

  12. High Doses of Vitamin D Fail to Cut Cancer Risk, Study Finds

    MedlinePlus

    ... gov/news/fullstory_164325.html High Doses of Vitamin D Fail to Cut Cancer Risk, Study Finds ... March 28, 2017 (HealthDay News) -- High doses of vitamin D supplements may not lower older women's risk ...

  13. Risk assessment of desert pollution on composite high voltage insulators

    PubMed Central

    El-Shahat, Mohammed; Anis, Hussein

    2013-01-01

    Transmission lines located in the desert are subjected to desert climate, one of whose features is sandstorms. With long accumulation of sand and with the advent of moisture from rain, ambient humidity and dew, a conductive layer forms and the subsequent leakage current may lead to surface discharge, which may shorten the insulator life or lead to flashover thus interrupting the power supply. Strategically erected power lines in the Egyptian Sinai desert are typically subject to such a risk, where sandstorms are known to be common especially in the spring. In view of the very high cost of insulator cleaning operation, composite (silicon rubber) insulators are nominated to replace ceramic insulators on transmission lines in Sinai. This paper examines the flow of leakage current on sand-polluted composite insulators, which in turn enables a risk assessment of insulator failure. The study uses realistic data compiled and reported in an earlier research project about Sinai, which primarily included grain sizes of polluting sand as well as their salinity content. The paper also uses as a case study an ABB-designed composite insulator. A three-dimensional finite element technique is used to simulate the insulator and seek the potential and electric field distribution as well as the resulting leakage current flow on its polluted surface. A novel method is used to derive the probabilistic features of the insulator’s leakage current, which in turn enables a risk assessment of insulator failure. This study is expected to help in critically assessing – and thus justifying – the use of this type of insulators in Sinai and similar critical areas. PMID:25685525

  14. Risk assessment of desert pollution on composite high voltage insulators.

    PubMed

    El-Shahat, Mohammed; Anis, Hussein

    2014-09-01

    Transmission lines located in the desert are subjected to desert climate, one of whose features is sandstorms. With long accumulation of sand and with the advent of moisture from rain, ambient humidity and dew, a conductive layer forms and the subsequent leakage current may lead to surface discharge, which may shorten the insulator life or lead to flashover thus interrupting the power supply. Strategically erected power lines in the Egyptian Sinai desert are typically subject to such a risk, where sandstorms are known to be common especially in the spring. In view of the very high cost of insulator cleaning operation, composite (silicon rubber) insulators are nominated to replace ceramic insulators on transmission lines in Sinai. This paper examines the flow of leakage current on sand-polluted composite insulators, which in turn enables a risk assessment of insulator failure. The study uses realistic data compiled and reported in an earlier research project about Sinai, which primarily included grain sizes of polluting sand as well as their salinity content. The paper also uses as a case study an ABB-designed composite insulator. A three-dimensional finite element technique is used to simulate the insulator and seek the potential and electric field distribution as well as the resulting leakage current flow on its polluted surface. A novel method is used to derive the probabilistic features of the insulator's leakage current, which in turn enables a risk assessment of insulator failure. This study is expected to help in critically assessing - and thus justifying - the use of this type of insulators in Sinai and similar critical areas.

  15. Methods for Addressing Uncertainty and Variability to Characterize Potential Health Risk From Trichloroethylene-Contaminated Ground Water Beale Air Force Base in California: Integration of Uncertainty and Variability in Pharmacokinetics and Dose-Response

    SciTech Connect

    Bogen, K.T.

    1999-09-29

    Traditional estimates of health risk are typically inflated, particularly if cancer is the dominant endpoint and there is fundamental uncertainty as to mechanism(s) of action. Risk is more realistically characterized if it accounts for joint uncertainty and interindividual variability after applying a unified probabilistic approach to the distributed parameters of all (linear as well as nonlinear) risk-extrapolation models involved. Such an approach was applied to characterize risks to potential future residents posed by trichloroethylene (TCE) in ground water at an inactive landfill site on Beale Air Force Base in California. Variability and uncertainty were addressed in exposure-route-specific estimates of applied dose, in pharmacokinetically based estimates of route-specific metabolized fractions of absorbed TCE, and in corresponding biologically effective doses estimated under a genotoxic/linear (MA{sub g}) vs. a cytotoxic/nonlinear (MA{sub c}) mechanistic assumption for TCE-induced cancer. Increased risk conditional on effective dose was estimated under MA{sub G} based on seven rodent-bioassay data sets, and under MA, based on mouse hepatotoxicity data. Mean and upper-bound estimates of combined risk calculated by the unified approach were <10{sup -6} and <10{sup -4}, respectively, while corresponding estimates based on traditional deterministic methods were >10{sup -5} and >10{sup -4}, respectively. It was estimated that no TCE-related harm is likely occur due any plausible residential exposure scenario involving the site. The unified approach illustrated is particularly suited to characterizing risks that involve uncertain and/or diverse mechanisms of action.

  16. Optically Addressable Silicon Vacancy-Related Spin Centers in Rhombic Silicon Carbide with High Breakdown Characteristics and ENDOR Evidence of Their Structure.

    PubMed

    Soltamov, V A; Yavkin, B V; Tolmachev, D O; Babunts, R A; Badalyan, A G; Davydov, V Yu; Mokhov, E N; Proskuryakov, I I; Orlinskii, S B; Baranov, P G

    2015-12-11

    We discovered a family of uniaxially oriented silicon vacancy-related centers with S=3/2 in a rhombic 15R-SiC crystalline matrix. We demonstrate that these centers exhibit unique characteristics such as optical spin alignment up to the temperatures of 250°C. Thus, the range of robust optically addressable vacancy-related spin centers is extended to the wide class of rhombic SiC polytypes. To use these centers for quantum applications it is essential to know their structure. Using high frequency electron nuclear double resonance, we show that the centers are formed by negatively charged silicon vacancies V_{Si}^{-} in the paramagnetic state with S=3/2 that is noncovalently bonded to the neutral carbon vacancy V_{C}^{0} in the nonparamagnetic state, located on the adjacent site along the SiC symmetry c axis.

  17. Exposure to high altitude: a risk factor for venous thromboembolism?

    PubMed

    Gupta, Neha; Ashraf, Mohammad Z

    2012-03-01

    There are several genetic and acquired risk factors for venous thromboembolism. Exposure to high altitude (HA), either during air travel, ascension of mountains, or while engaging in sports activities, has been observed to result in a hypercoagulable state, thus predisposing to thromboembolic events. Although several previous studies have suggested that conditions present at HAs contribute to establish a prothrombotic milieu, published reports are contradictory and the exact underlying mechanism remains poorly understood. Results from HA studies also show that environmental conditions at HA such as hypoxia, dehydration, hemoconcentration, low temperature, use of constrictive clothing as well as enforced stasis due to severe weather, would support the occurrence of thrombotic disorders. The three leading factors of Virchow triad, that is, venous stasis, hypercoagulability, and vessel-wall injury, all appear to be present at HA. In synthesis, the large list of environmental variables suggests that a single cause of HA-induced thromboembolic disorders (TED) may not exist, so that this peculiar phenomenon should be seen as a complex or multifactorial trait. Further investigation is needed to understand the risk of TED at HA as well as the possible underlying mechanisms.

  18. High-risk biodegradable waste processing by alkaline hydrolysis.

    PubMed

    Kalambura, Sanja; Voća, Neven; Krička, Tajana; Sindrak, Zoran; Spehar, Ana; Kalambura, Dejan

    2011-09-01

    Biodegradable waste is by definition degraded by other living organisms. Every day, meat industry produces large amounts of a specific type of biodegradable waste called slaughterhouse waste. Traditionally in Europe, this waste is recycled in rendering plants which produce meat and bone meal and fat. However, feeding animals with meat and bone meal has been banned since the outbreaks of bovine spongiform encephalopathy (BSE). In consequence, new slaughterhouse waste processing technologies have been developed, and animal wastes have now been used for energy production. Certain parts of this waste, such as brains and spinal cord, are deemed high-risk substances, because they may be infected with prions. Their treatment is therefore possible only in strictly controlled conditions. One of the methods which seems to bear acceptable health risk is alkaline hydrolysis. This paper presents the results of an alkaline hydrolysis efficiency study. It also proposes reuse of the obtained material as organic fertiliser, as is suggested by the analytical comparison between meat and bone meal and hydrolysate.

  19. Correlates of hopelessness in the high suicide risk police occupation

    PubMed Central

    Violanti, John M.; Andrew, Michael E.; Mnatsakanova, Anna; Hartley, Tara A.; Fekedulegn, Desta; Burchfiel, Cecil M.

    2015-01-01

    Police officers are chronically exposed to work stress. We examined specific stressors that may be associated with hopelessness, a possible risk factor for suicide in this high suicide risk population. The study included 378 officers (276 men and 102 women) with complete data. Analysis of variance was used to estimate mean levels of hopelessness scores as associated with stress, adjusted for age, gender, and race/ ethnicity. Posttraumatic symptoms were tested as a modifier of the association between stress and hopelessness. Increasing stress of administrative practices and lack of support were significantly associated with increasing hopelessness among officers (p < .006 – hopelessness range: 1.64–2.65; and p < .001 – hopelessness range 1.60–2.80, respectively). Posttraumatic stress disorder (PTSD) symptoms significantly modified the association between lack of organizational support and hopelessness (p < .010) with significant association only among individuals with higher PTSD symptoms (p < .001). Results suggest that hopelessness is associated with specific stressors in police work, and this is modified by posttraumatic symptomatology. PMID:26752981

  20. Professional drivers: protection needed for a high-risk occupation.

    PubMed Central

    Baker, S P; Wong, J; Baron, R D

    1976-01-01

    "On the job" motor vehicle deaths number more than 4,000 annually in the U.S. and comprise nearly one-third of all work-related deaths. Yet the Department of Labor has set no standards relating to on-the-road safety of the millions of workers whose jobs entail large amounts of driving, and Department of Transportation standards affecting occupational safety cover only drivers in interstate commerce. Drivers of some commercial vehicles, such as heavy trucks, are at special risk of injury because trucks have usually been exempted for many years from federal motor vehicle safety standards--such as standards for brakes and seatbelts--designed to prevent crashes or protect occupants in crashes. Observations based on a series of 150 fatal crashes involving tractor trailers illustrate the need for better protection of this large population of high-risk workers. Clarification of responsibility within the various federal agencies and application of available knowledge and technology are essential. PMID:937611

  1. In the Middle. Addressing the Needs of At Risk Students during the Middle Learning Years. Technical Team Report. Submitted to the Commission for Students At Risk of School Failure.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This report explores contributions that schools, communities, and families can make toward preventing and intervening in behavior that places young adolescents at risk. The first part of the report considers characteristics of early adolescents and an environmental balance that capitalizes on the diversity of adolescents to minimize their risk of…

  2. Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

    PubMed Central

    Kucirka, Lauren M.; Sarathy, Harini; Govindan, Priyanka; Wolf, Joshua H.; Ellison, Trevor A.; Hart, Leah J.; Montgomery, Robert A.; Ros, R. Lorie; Segev, Dorry L.

    2011-01-01

    The OPTN classifies high infectious risk donors (HRDs) based on criteria originally intended to identify people at risk for HIV infection. These donors are sometimes referred to as "CDC high risk donors" in reference to the CDC-published guidelines adopted by the OPTN. However, these guidelines are also being used to identify deceased donors at increased risk of window period (WP) hepatitis C virus (HCV) infection, although not designed for this purpose. The actual risk of WP HCV infection in HRDs is unknown.We performed a systematic review of 3,476 abstracts and identified 37 eligible estimates of HCV incidence in HRD populations in the United States/Canada. Pooled HCV incidence was derived and used to estimate the risk of WP infection for each HRD category. Risks ranged from 0.26–300.6 per 10,000 donors based on WP for ELISA and 0.027–32.4 based on nucleic acid testing (NAT). Injection drug users were at highest risk (32.4 per 10,000 donors by NAT WP), followed by commercial sex workersand donors exhibiting high risk sexual behavior (12.3:10,000),men who have sex with men (3.5:10,000), incarcerated donors (0.8:10,000), donors exposed to HIV infected blood (0.4:10,000), and hemophiliacs (0.027:10,000). NAT reduced WP risk by approximately 10-fold in each category. PMID:21401874

  3. Pertussis immunization in a high-risk postpartum population.

    PubMed

    Healy, C Mary; Rench, Marcia A; Castagnini, Luis A; Baker, Carol J

    2009-09-18

    We provided CDC recommended postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization to medically underserved, uninsured women in Houston through a standing order protocol. From January 7-April 30, 2008, 1129 of 1570 (72%) postpartum women (93% Hispanic; 11% < or = 19 years) received Tdap before hospital discharge. Tdap uptake was 96.2% in women without self-reported contraindications. Recall of immunization history was inaccurate in 32% of unimmunized women who reported receiving antepartum immunization. Black women refused Tdap more often than other ethnicities (24% versus 8%; P=0.003). Postpartum Tdap immunization was successfully implemented in a high-risk population through a standing order protocol. Barriers to postpartum immunization include inaccurate immunization history and the need for ongoing targeted education.

  4. Cyberbullying in those at Clinical High Risk for psychosis

    PubMed Central

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2012-01-01

    Aim Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called ‘cyberbullying’. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Methods Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Results Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. Conclusion It is possible that cyberbullying may be a problem for those at CHR of psychosis and due to the vulnerable nature of these young people, may have longitudinal implications. PMID:23343259

  5. Preoperative IABP in high risk patients undergoing CABG.

    PubMed

    Theologou, T; Field, M L

    2011-01-01

    A recent international consensus conference on the reduction in mortality in cardiac anesthesia and intensive care included intraoperative aortic balloon pump among the ancillary (i.e. non-surgical) drugs/techniques/strategies that might influence survival rates in patients undergoing cardiac surgery. The consensus conferences state that "Pre-operative intraoperative aortic balloon pump might reduce 30-day mortality in elective high risk patients undergoing coronary artery bypass surgery unless specifically contraindicated". The authors of this "expert opinion" presents their insights into the use of the preoperative intraoperative aortic balloon pump and conclude that based on available limited randomized controlled trials and clinical experience preoperative intraoperative aortic balloon pump saves lives in unstable patients.

  6. Monitoring of newborns at high risk for brain injury.

    PubMed

    Pisani, Francesco; Spagnoli, Carlotta

    2016-05-14

    Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders.Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor phenomena, hypoxic-ischaemic encephalopathy, white matter injury of prematurity and stroke require specific approaches to diagnosis. In this review we will describe the characteristics, aims, indications and limitations of routinely available diagnostic techniques such as conventional and amplitude-integrated EEG, evoked potentials, cranial ultrasound and brain MRI. We will conclude by briefly outlining potential future perspectives from research studies.

  7. Empowering High-Risk Clients to Attain a Better Quality of Life: A Career Resiliency Framework

    ERIC Educational Resources Information Center

    Rickwood, Rory R.; Roberts, Jillian; Batten, Suzanne; Marshall, Anne; Massie, Kendra

    2004-01-01

    Career counselors frequently encounter clients who are at high risk for career and life development difficulties. Research suggests there is a connection between resiliency and successful career development in high-risk clients. Many high-risk individuals have poor decision-making skills and lack motivation to succeed in life and career…

  8. Weekly Community Interviews With High-Risk Participants: Operational Issues

    ERIC Educational Resources Information Center

    Schubert, Carol A.; Mulvey, Edward P.; Lidz, Charles W.; Gardner, William P.; Skeem, Jennifer L.

    2005-01-01

    To address several key questions in social science research, repeated interviews of individuals drawn from difficult populations are required. This article describes an approach for addressing the challenges associated with longitudinal interview studies, including locating research participants, obtaining reliable and valid interview data over…

  9. Comparison of different combined treatment processes to address the source water with high concentration of natural organic matter during snowmelt period.

    PubMed

    Lin, Pengfei; Zhang, Xiaojian; Wang, Jun; Zeng, Yani; Liu, Shuming; Chen, Chao

    2015-01-01

    The source water in one forest region of the Northeast China had very high natural organic matter (NOM) concentration and heavy color during snowmelt period. The efficiency of five combined treatment processes was compared to address the high concentration of NOM and the mechanisms were also analyzed. Conventional treatment can hardly remove dissolved organic carbon (DOC) in the source water. KMnO4 pre-oxidization could improve the DOC removal to 22.0%. Post activated carbon adsorption improved the DOC removal of conventional treatment to 28.8%. The non-sufficient NOM removal could be attributed to the dominance of large molecular weight organic matters in raw water, which cannot be adsorbed by the micropore upon activated carbon. O3+activated carbon treatment are another available technology for eliminating the color and UV254 in water. However, its performance of DOC removal was only 36.4%, which could not satisfy the requirement for organic matter. The limited ozone dosage is not sufficient to mineralize the high concentration of NOM. Magnetic ion-exchange resin combined with conventional treatment could remove 96.2% of color, 96.0% of UV254 and 87.1% of DOC, enabling effluents to meet the drinking water quality standard. The high removal efficiency could be explained by the negative charge on the surface of NOM which benefits the static adsorption of NOM on the anion exchange resin. The results indicated that magnetic ion-exchange resin combined with conventional treatment is the best available technology to remove high concentration of NOM.

  10. Addressing barriers to the prevention, diagnosis and treatment of hepatitis B and C in the face of persisting fiscal constraints in Europe: report from a high level conference.

    PubMed

    Papatheodoridis, G; Thomas, H C; Golna, C; Bernardi, M; Carballo, M; Cornberg, M; Dalekos, G; Degertekin, B; Dourakis, S; Flisiak, R; Goldberg, D; Gore, C; Goulis, I; Hadziyannis, S; Kalamitsis, G; Kanavos, P; Kautz, A; Koskinas, I; Leite, B R; Malliori, M; Manolakopoulos, S; Matičič, M; Papaevangelou, V; Pirona, A; Prati, D; Raptopoulou-Gigi, M; Reic, T; Robaeys, G; Schatz, E; Souliotis, K; Tountas, Y; Wiktor, S; Wilson, D; Yfantopoulos, J; Hatzakis, A

    2016-02-01

    In the WHO-EURO region, around 28 million people are currently living with chronic viral hepatitis, and 120,000 people die every year because of it. Lack of awareness and understanding combined with the social stigma and discrimination exacerbate barriers related to access to prevention, diagnosis and treatment services for those most in need. In addition, the persisting economic crisis has impacted on public health spending, thus posing challenges on the sustainable investment in promotion, primary and secondary prevention, diagnosis and treatment of viral hepatitis across European countries. The Hepatitis B and C Public Policy Association in cooperation with the Hellenic Center for Disease Prevention and Control together with 10 partner organizations discussed at the Athens High Level Meeting held in June 2014 recent policy developments, persisting and emerging challenges related to the prevention and management of viral hepatitis and the need for a de minimis framework of urgent priorities for action, reflected in a Call to Action (Appendix S1). The discussion confirmed that persisting barriers do not allow the full realisation of the public health potential of diagnosing and preventing hepatitis B and C, treating hepatitis B and curing hepatitis C. Such barriers are related to (a) lack of evidence-based knowledge of hepatitis B and C, (b) limited access to prevention, diagnosis and treatment services with poor patient pathways, (c) declining resources and (d) the presence of social stigma and discrimination. The discussion also confirmed the emerging importance of fiscal constraints on the ability of policymakers to adequately address viral hepatitis challenges, particularly through increasing coverage of newer therapies. In Europe, it is critical that public policy bodies urgently agree on a conceptual framework for addressing the existing and emerging barriers to managing viral hepatitis. Such a framework would ensure all health systems share a common

  11. Vocational Assessment of At-Risk Hispanic High School Students.

    ERIC Educational Resources Information Center

    Sexton-Radek, Kathy; Paul, Patrice

    Holland's Self-Directed Search (SDS) protocols were used with at-risk Hispanic female and male adolescents were examined to determine their sensitivity to this population. The SDS was completed by 89 at-risk Hispanic students (49 females and 33 males) in grade 9 at a nontraditional school for students who have been deemed at risk for gang and…

  12. The EnRiCH Community Resilience Framework for High-Risk Populations

    PubMed Central

    O'Sullivan, Tracey L.; Kuziemsky, Craig E.; Corneil, Wayne; Lemyre, Louise; Franco, Zeno

    2014-01-01

    Introduction: Resilience has been described in many ways and is inherently complex. In essence, it refers to the capacity to face and do well when adversity is encountered. There is a need for empirical research on community level initiatives designed to enhance resilience for high-risk groups as part of an upstream approach to disaster management. In this study, we address this issue, presenting the EnRiCH Community Resilience Framework for High-Risk Populations. Methods: The framework presented in this paper is empirically-based, using qualitative data from focus groups conducted as part of an asset-mapping intervention in five communities in Canada, and builds on extant literature in the fields of disaster and emergency management, health promotion, and community development. Results: Adaptive capacity is placed at the centre of the framework as a focal point, surrounded by four strategic areas for intervention (awareness/communication, asset/resource management, upstream-oriented leadership, and connectedness/engagement). Three drivers of adaptive capacity (empowerment, innovation, and collaboration) cross-cut the strategic areas and represent levers for action which can influence systems, people and institutions through expansion of asset literacy. Each component of the framework is embedded within the complexity and culture of a community. Discussion: We present recommendations for how this framework can be used to guide the design of future resilience-oriented initiatives with particular emphasis on inclusive engagement across a range of functional capabilities. PMID:25642373

  13. Electrophysiological correlates of decision-making in high-risk versus low-risk conditions of a gambling game.

    PubMed

    Yang, Juan; Zhang, Qinglin

    2011-10-01

    The majority of studies investigating risky decision making focus on the high-conflict condition, and very few consider the low-conflict condition in which there is either a very high or a very low probability of risk. Even though the high-risk condition and low-risk condition are both considered low-conflict decision scenarios and both behavioral outcomes are highly predictable, these conditions still differ in terms of the probabilities of reward and punishment. In the following study, we investigated both behavioral and electrophysiological correlates associated with high- and low-risk conditions within the low-conflict scenario, as well as high-conflict condition, in a modified gambling game. The behavioral results showed that, within the low-conflict scenario, the participants took more time to make the decision in the high-risk condition compared to the low-risk condition. The event-related potentials (ERP) data showed that, during the decision making, the high-risk condition evoked a more negative ERP deflection than did the low-risk condition in the time window of 300-500 ms (N400), which had a frontocentral focus of scalp distribution. The results suggested that the high-risk condition was associated with a higher conflict between the participants' "motivationally based" tendency to want to receive cards and the task instructions, which stated that the face value of the first two cards will strongly predict a low probability of success. It was further speculated that the N400 in the present study might be associated with anticipation of negative rewards, which was functionally equivalent to the FRN (feedback-related negativity) to negative outcomes.

  14. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    ERIC Educational Resources Information Center

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  15. Electrostatically focused addressable field emission array chips (AFEA's) for high-speed massively parallel maskless digital E-beam direct write lithography and scanning electron microscopy

    DOEpatents

    Thomas, Clarence E.; Baylor, Larry R.; Voelkl, Edgar; Simpson, Michael L.; Paulus, Michael J.; Lowndes, Douglas H.; Whealton, John H.; Whitson, John C.; Wilgen, John B.

    2002-12-24

    Systems and methods are described for addressable field emission array (AFEA) chips. A method of operating an addressable field-emission array, includes: generating a plurality of electron beams from a pluralitly of emitters that compose the addressable field-emission array; and focusing at least one of the plurality of electron beams with an on-chip electrostatic focusing stack. The systems and methods provide advantages including the avoidance of space-charge blow-up.

  16. High risk alcohol-related trauma among the Aboriginal and Torres Strait Islanders in the Northern Territory

    PubMed Central

    2012-01-01

    High risk drinking is linked with high rates of physical harm. The reported incidence of alcohol - related trauma among Aboriginal and Torres Strait Islander people in the Northern Territory is the highest in the world. Facial fractures are common among young Aboriginal and Torres Strait Islanders. They are often linked with misuse of alcohol in the Northern Territory and are frequently secondary to assault. This review focuses on alcohol-related trauma in the Territory and draws attention to an urgent need for preventative health approach to address this critical issue. PMID:22862897

  17. Why ultra high performance liquid chromatography produces more tailing peaks than high performance liquid chromatography, why it does not matter and how it can be addressed.

    PubMed

    Petersson, Patrik; Forssen, Patrik; Edström, Lena; Samie, Farzad; Tatterton, Stephen; Clarke, Adrian; Fornstedt, Torgny

    2011-09-28

    The purpose of this study is to demonstrate, with experiments and with computer simulations based on a firm chromatographic theory, that the wide spread perception of that the United States Pharmacopeia tailing factor must be lower than 2 (T(f)<2) is questionable when using the latest generation of LC equipment. It is shown that highly efficient LC separations like those obtained with sub-2 μm porous and 2.7 μm superficially porous particles (UHPLC) produce significantly higher T(f)-values than the corresponding separation based on 3 μm porous particles (HPLC) when the same amount of sample is injected. Still UHPLC separations provide a better resolution to adjacent peaks. Expressions have been derived that describe how the T(f)-value changes with particle size or number of theoretical plates. Expressions have also been derived that can be used to scale the injection volume based on particle size or number of theoretical plates to maintain the T(f)-value when translating a HPLC separation to the corresponding UHPLC separation. An aspect that has been ignored in previous publications. Finally, data obtained from columns with different age/condition indicate that T(f)-values should be complemented by a peak width measure to provide a more objective quality measure.

  18. Sex Differences in Children with Autism Spectrum Disorder Identified within a High-Risk Infant Cohort

    ERIC Educational Resources Information Center

    Zwaigenbaum, Lonnie; Bryson, Susan E.; Szatmari, Peter; Brian, Jessica; Smith, Isabel M.; Roberts, Wendy; Vaillancourt, Tracy; Roncadin, Caroline

    2012-01-01

    Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4%) and 28 of 143 girls (19.6%), implying…

  19. Ownership of High-Risk ("Vicious") Dogs as a Marker for Deviant Behaviors: Implications for Risk Assessment

    ERIC Educational Resources Information Center

    Barnes, Jaclyn E.; Boat, Barbara W.; Putnam, Frank W.; Dates, Harold F.; Mahlman, Andrew R.

    2006-01-01

    This study examined the association between ownership of high-risk ("vicious") dogs and the presence of deviant behaviors in the owners as indicated by court convictions. We also explored whether two characteristics of dog ownership (abiding licensing laws and choice of breed) could be useful areas of inquiry when assessing risk status…

  20. Evaluating the Paper-to-Screen Translation of Participant-Aided Sociograms with High-Risk Participants

    PubMed Central

    Hogan, Bernie; Melville, Joshua R.; Philips, Gregory Lee; Janulis, Patrick; Contractor, Noshir; Mustanski, Brian S.; Birkett, Michelle

    2016-01-01

    While much social network data exists online, key network metrics for high-risk populations must still be captured through self-report. This practice has suffered from numerous limitations in workflow and response burden. However, advances in technology, network drawing libraries and databases are making interactive network drawing increasingly feasible. We describe the translation of an analog-based technique for capturing personal networks into a digital framework termed netCanvas that addresses many existing shortcomings such as: 1) complex data entry; 2) extensive interviewer intervention and field setup; 3) difficulties in data reuse; and 4) a lack of dynamic visualizations. We test this implementation within a health behavior study of a high-risk and difficult-to-reach population. We provide a within–subjects comparison between paper and touchscreens. We assert that touchscreen-based social network capture is now a viable alternative for highly sensitive data and social network data entry tasks. PMID:28018995

  1. Academic Achievement Trajectories of Homeless and Highly Mobile Students: Resilience in the Context of Chronic and Acute Risk

    PubMed Central

    Cutuli, J. J.; Desjardins, Christopher David; Herbers, Janette E.; Long, Jeffrey D.; Heistad, David; Chan, Chi-Keung; Hinz, Elizabeth; Masten, Ann S.

    2012-01-01

    Analyses examined academic achievement data across 3rd through 8th grades (N = 26,474), comparing students identified as homeless or highly mobile (HHM) to other students in the federal free meal program (FM), reduced-price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General > RM > FM > HHM). Achievement gaps appeared stable or widened between HHM students and lower-risk groups. Math and reading achievement were lower and growth in math was slower in years of HHM identification, suggesting acute consequences of residential instability. Nonetheless, 45% of HHM students scored within or above the average range, suggesting academic resilience. Results underscore the need for research on risk and resilience processes among HHM students to address achievement disparities. PMID:23110492

  2. Biochemical Recurrence Prediction in High-Risk Prostate Cancer Patients, Following Robot-Assisted Radical Prostatectomy

    PubMed Central

    Yamaguchi, Noriya; Yumioka, Tetsuya; Iwamoto, Hideto; Masago, Toshihiko; Morizane, Shuichi; Honda, Masashi; Sejima, Takehiro; Takenaka, Atsushi

    2016-01-01

    Background High-risk prostate cancer treatment has been controversial. Some high-risk prostate cancer patients fail to respond to radical prostatectomy only. Thus, we aimed to investigate the predictive factors for biochemical recurrence (BCR) and identify patients who could achieve sufficient therapeutic effect by radical prostatectomy only. Methods Of 264 medical records reviewed, 141 low-intermediate-risk and 100 high-risk prostate cancer patients, excluding those who had received neoadjuvant hormone therapy, were analyzed. BCR was defined as the first increase in prostate-specific antigen levels (≥ 0.2 ng/mL), with levels not decreasing to undetectable limits, after radical prostatectomy. Log-rank test and Cox proportional hazards regression analyses were performed to determine the prognostic factors. We investigated the perioperative predictive factors for BCR and BCR-free survival rates, with the number of National Comprehensive Cancer Network (NCCN) high-risk factors for high-risk prostate cancer patients who underwent robot-assisted radical prostatectomy. Results Multivariate analyses showed that clinical T3 was significantly associated with BCR [hazard ratio (HR) = 4.052; 95% confidence interval (CI), 1.26–12.99; P = 0.019]. Of the 100 patients, 77 had 1 high-risk factor and 23 had ≥ 2 high-risk factors; the 1-year BCR-free survival rate of patients with 1 high-risk factor and those with ≥ 2 high-risk factors was 94.8% and 69.6%, respectively. Patients with ≥ 2 high-risk factors were significantly associated with BCR (P = 0.002). No difference in BCR rate between patients with 1 high-risk factor and those with low- and intermediate-risk was found. Conclusion High-risk prostate cancer patients with 1 NCCN high-risk factor can be considered for robot-assisted radical prostatectomy treatment only. PMID:28070166

  3. High risk and little knowledge: Overdose experiences and knowledge among young adult nonmedical prescription opioid users

    PubMed Central

    Frank, David; Mateu-Gelabert, Pedro; Guarino, Honoria; Bennett, Alex; Wendel, Travis; Jessell, Lauren; Teper, Anastasia

    2014-01-01

    Background Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Yet few studies have examined the overdose knowledge and experience of nonmedical PO users. Methods In depth, semi-structured, audio-recorded interviews were conducted with 46 New York City young adults (ages 18–32) who reported using POs nonmedically within the past 30 days. Verbatim interview transcripts were coded for key themes in an analytic process informed by grounded theory. Results Despite significant experience with overdose (including overdose deaths), either personally or within opioid-using networks, participants were relatively uninformed about overdose awareness, avoidance and response strategies, in particular the use of naloxone. Overdose experiences typically occurred when multiple pharmaceuticals were used (often in combination with alcohol) or after participants had transitioned to heroin injection. Participants tended to see themselves as distinct from traditional heroin users, and were often outside of the networks reached by traditional opioid safety/overdose prevention services. Consequently, they were unlikely to utilize harm reduction services, such as syringe exchange programs (SEPs), that address drug users' health and safety. Conclusions These findings suggest that many young adult nonmedical PO users are at high risk of both fatal and non-fatal overdose. There is a pressing need to develop innovative outreach strategies and overdose prevention programs to better reach and serve young PO users and their network contacts. Prevention efforts addressing risk for accidental overdose, including opioid safety/overdose reversal education and naloxone distribution, should be tailored for and targeted to this vulnerable group. PMID:25151334

  4. Further development of a robust workup process for solution-phase high-throughput library synthesis to address environmental and sample tracking issues.

    PubMed

    Kuroda, Noritaka; Hird, Nick; Cork, David G

    2006-01-01

    During further improvement of a high-throughput, solution-phase synthesis system, new workup tools and apparatus for parallel liquid-liquid extraction and evaporation have been developed. A combination of in-house design and collaboration with external manufacturers has been used to address (1) environmental issues concerning solvent emissions and (2) sample tracking errors arising from manual intervention. A parallel liquid-liquid extraction unit, containing miniature high-speed magnetic stirrers for efficient mixing of organic and aqueous phases, has been developed for use on a multichannel liquid handler. Separation of the phases is achieved by dispensing them into a newly patented filter tube containing a vertical hydrophobic porous membrane, which allows only the organic phase to pass into collection vials positioned below. The vertical positioning of the membrane overcomes the hitherto dependence on the use of heavier-than-water, bottom-phase, organic solvents such as dichloromethane, which are restricted due to environmental concerns. Both small (6-mL) and large (60-mL) filter tubes were developed for parallel phase separation in library and template synthesis, respectively. In addition, an apparatus for parallel solvent evaporation was developed to (1) remove solvent from the above samples with highly efficient recovery and (2) avoid the movement of individual samples between their collection on a liquid handler and registration to prevent sample identification errors. The apparatus uses a diaphragm pump to achieve a dynamic circulating closed system with a heating block for the rack of 96 sample vials and an efficient condenser to trap the solvents. Solvent recovery is typically >98%, and convenient operation and monitoring has made the apparatus the first choice for removal of volatile solvents.

  5. Risky Business: The Science and Art of Radiation Risk Communication in the High Risk Context of Space Travel

    NASA Technical Reports Server (NTRS)

    Elgart, Shona Robin; Shavers, Mark; Huff, Janice; Patel, Zarana; Semones, Edward

    2016-01-01

    Successfully communicating the complex risks associated with radiation exposure is a difficult undertaking; communicating those risks within the high-risk context of space travel is uniquely challenging. Since the potential risks of space radiation exposure are not expected to be realized until much later in life, it is hard to draw comparisons between other spaceflight risks such as hypoxia and microgravity-induced bone loss. Additionally, unlike other spaceflight risks, there is currently no established mechanism to mitigate the risks of incurred radiation exposure such as carcinogenesis. Despite these challenges, it is the duty of the Space Radiation Analysis Group (SRAG) at NASA's Johnson Space Center to provide astronauts with the appropriate information to effectively convey the risks associated with exposure to the space radiation environment. To this end, astronauts and their flight surgeons are provided with an annual radiation risk report documenting the astronaut's individual radiation exposures from space travel, medical, and internal radiological procedures throughout the astronaut's career. In an effort to improve this communication and education tool, this paper critically reviews the current report style and explores alternative report styles to define best methods to appropriately communicate risk to astronauts, flight surgeons, and management.

  6. Integrating Professional and Folk Models of HIV Risk: YMSM’s Perceptions of High-Risk Sex

    PubMed Central

    Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

    2009-01-01

    Risks associated with HIV are well documented in research literature. While a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the “professional’ and “folk” models of HIV-risk based on YMSM’s understanding of high-risk sex and where and how they gathered their understanding of HIV-risk behaviors. The findings reported here emerged from the quantitative and qualitative interviews from the Healthy Young Men’s Study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can increase YMSM’s knowledge of sexual behavior and help them build solid foundations of sexual health education to protect them from STI and HIV infection. PMID:18558819

  7. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

    PubMed

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

    2013-09-22

    In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

  8. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources

    PubMed Central

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W.

    2013-01-01

    In this paper, we attempt to understand hunter–gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey. PMID:23884091

  9. Establishing a program for individuals at high risk for breast cancer.

    PubMed

    Cadiz, Fernando; Kuerer, Henry M; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

    2013-01-01

    Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining "high risk"; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk.

  10. Individually-addressable flip-chip AlInGaN micropixelated light emitting diode arrays with high continuous and nanosecond output power.

    PubMed

    Zhang, H X; Massoubre, D; McKendry, J; Gong, Z; Guilhabert, B; Griffin, C; Gu, E; Jessop, P E; Girkin, J M; Dawson, M D

    2008-06-23

    Micropixelated blue (470 nm) and ultraviolet (370 nm) AlInGaN light emitting diode ('micro-LED') arrays have been fabricated in flip-chip format with different pixel diameters (72 microm and 30 microm at, respectively, 100 and 278 pixels/mm(2)). Each micro-LED pixel can be individually-addressed and the devices possess a specially designed n-common contact incorporated to ensure uniform current injection and consequently uniform light emission across the array. The flip-chip micro-LEDs show, per pixel, high continuous output intensity of up to 0.55 microW/microm(2) (55 W/cm(2)) at an injection current density of 10 kA/cm(2) and can sustain continuous injection current densities of up to 12 kA/cm(2) before breakdown. We also demonstrate that nanosecond pulsed output operation of these devices with per pixel onaxis average peak intensity up to 2.9 microW/microm(2) (corresponding to energy of 45pJ per 22ns optical pulse) can be achieved. We investigate the pertinent performance characteristics of these arrays for micro-projection applications, including the prospect of integrated optical pumping of organic semiconductor lasers.

  11. Eye-Tracking Measurements of Language Processing: Developmental Differences in Children at High Risk for ASD

    PubMed Central

    Arunachalam, Sudha; Nelson, Charles A.; Tager-Flusberg, Helen

    2016-01-01

    To explore how being at high risk for autism spectrum disorder (ASD), based on having an older sibling diagnosed with ASD, affects word comprehension and language processing speed, 18-, 24- and 36-month-old children, at high and low risk for ASD were tested in a cross- sectional study, on an eye gaze measure of receptive language that measured how accurately and rapidly the children looked at named target images. There were no significant differences between the high risk ASD group and the low risk control group of 18- and 24-month-olds. However, 36-month-olds in the high risk for ASD group performed significantly worse on the accuracy measure, but not on the speed measure. We propose that the language processing efficiency of the high risk group is not compromised, but other vocabulary acquisition factors might have lead to the high risk 36-month-olds to comprehend significantly fewer nouns on our measure. PMID:26109246

  12. Evolution of social learning when high expected payoffs are associated with high risk of failure.

    PubMed

    Arbilly, Michal; Motro, Uzi; Feldman, Marcus W; Lotem, Arnon

    2011-11-07

    In an environment where the availability of resources sought by a forager varies greatly, individual foraging is likely to be associated with a high risk of failure. Foragers that learn where the best sources of food are located are likely to develop risk aversion, causing them to avoid the patches that are in fact the best; the result is sub-optimal behaviour. Yet, foragers living in a group may not only learn by themselves, but also by observing others. Using evolutionary agent-based computer simulations of a social foraging game, we show that in an environment where the most productive resources occur with the lowest probability, socially acquired information is strongly favoured over individual experience. While social learning is usually regarded as beneficial because it filters out maladaptive behaviours, the advantage of social learning in a risky environment stems from the fact that it allows risk aversion to be circumvented and the best food source to be revisited despite repeated failures. Our results demonstrate that the consequences of individual risk aversion may be better understood within a social context and suggest one possible explanation for the strong preference for social information over individual experience often observed in both humans and animals.

  13. The antigenic repertoire of premalignant and high-risk lesions.

    PubMed

    Marquez, Juan Pablo; Stanton, Sasha E; Disis, Mary L

    2015-04-01

    Prophylactic vaccines have been a major advance in preventing the development of infections after exposure to pathogens. When contemplating an effective approach to cancer prevention, vaccines offer unique advantages over other more standard approaches: First, once appropriately stimulated, antigen-specific T cells will travel to all sites of disease and eradicate cells bearing the proteins to which the T cells have been primed by vaccination. Second, successful immunization will further result in the development of immunologic memory, providing lifelong immunologic surveillance. There is evidence of an adaptive tumor immune infiltrate even at the earliest stages of breast and colon cancer development. Furthermore, there is measurable immunity to lesion-associated antigens present in patients who will eventually develop malignancy even before cancer is clinically evident. Recent studies are beginning to unmask the preinvasive antigenic repertoire for these two malignancies. Preliminary experiments in transgenic mouse models of mammary and intestinal tumors suggest that immunization against antigens expressed in preinvasive and high-risk lesions may be effective in preventing the development of invasive malignancy.

  14. Global risk of pharmaceutical contamination from highly populated developing countries.

    PubMed

    Rehman, Muhammad Saif Ur; Rashid, Naim; Ashfaq, Muhammad; Saif, Ameena; Ahmad, Nasir; Han, Jong-In

    2015-11-01

    Global pharmaceutical industry has relocated from the west to Asian countries to ensure competitive advantage. This industrial relocation has posed serious threats to the environment. The present study was carried out to assess the possible pharmaceutical contamination in the environment of emerging pharmaceutical manufacturing countries (Bangladesh, China, India and Pakistan). Although these countries have made tremendous progress in the pharmaceutical sector but most of their industrial units discharge wastewater into domestic sewage network without any treatment. The application of untreated wastewater (industrial and domestic) and biosolids (sewage sludge and manure) in agriculture causes the contamination of surface water, soil, groundwater, and the entire food web with pharmaceutical compounds (PCs), their metabolites and transformed products (TPs), and multidrug resistant microbes. This pharmaceutical contamination in Asian countries poses global risks via product export and international traveling. Several prospective research hypotheses including the development of new analytical methods to monitor these PCs/TPs and their metabolites, highly resistant microbial strains, and mixture toxicity as a consequence of pharmaceutical contamination in these emerging pharmaceutical exporters have also been proposed based on the available literature.

  15. Too Few High-Risk Women Tested for Breast Cancer Gene: Survey

    MedlinePlus

    ... html Too Few High-Risk Women Tested for Breast Cancer Gene: Survey Only half got BRCA screen, and ... News) -- Though testing for two genes that raise breast cancer risk has been around for decades, a new ...

  16. Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

    Cancer.gov

    Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

  17. Prophylactic liver transplantation for high-risk recurrent hepatocellular carcinoma

    PubMed Central

    Yang, Po-Chih; Ho, Cheng-Maw; Hu, Rey-Heng; Ho, Ming-Chih; Wu, Yao-Ming; Lee, Po-Huang

    2016-01-01

    time goes by. Regarding tumor-related factors, histopathological features of the resected specimen are used mostly for determining the prognosis of early HCC recurrences. Such prognostic factors include the presence of microvascular invasion, poor tumor differentiation, the presence of microsatellites, the presence of multiple tumors, and the presence of the gene-expressing signature associated with aggressive HCC. These prognostic factors might be used as a selection tool for SLT or prophylactic LT, while remaining mindful of the fact that most of them are also prognostic factors for post-transplant HCC recurrence. Regarding underlying liver disease-related factors, progression of chronic viral hepatitis and high viral load may contribute to the development of late (de novo) HCC recurrence as a consequence of sustained inflammatory reaction. However, correlation between the severity of liver fibrosis and tumor recurrence is still controversial. Some prognostic scoring systems that integrate these three factors have been proposed to predict recurrence patterns after LR for HCC. Theoretically, after excluding patients with high risk of post-transplant HCC recurrence, either by observation of a cancer-free period or by measurement of biological factors (such as alpha fetoprotein), prophylactic LT following curative resection of HCC could be considered for selected patients with high risk of recurrence to provide longer survival. PMID:27872682

  18. A dynamic flow simulation code benchmark study addressing the highly heterogeneous properties of the Stuttgart formation at the Ketzin pilot site

    NASA Astrophysics Data System (ADS)

    Kempka, Thomas; Class, Holger; Görke, Uwe-Jens; Norden, Ben; Kolditz, Olaf; Kühn, Michael; Walter, Lena; Wang, Wenqing; Zehner, Björn

    2013-04-01

    CO2 injection at the Ketzin pilot site located in Eastern Germany (Brandenburg) about 25 km west of Berlin is undertaken since June 2008 with a scheduled total amount of about 70,000 t CO2 to be injected into the saline aquifer represented by the Stuttgart Formation at a depth of 630 m to 650 m until the end of August 2013. The Stuttgart Formation is of fluvial origin determined by high-permeablity sandstone channels embedded in a floodplain facies of low permeability indicating a highly heterogeneous distribution of reservoir properties as facies distribution, porosity and permeability relevant for dynamic flow simulations. Following the dynamic modelling activities discussed by Kempka et al. (2010), a revised geological model allowed us to history match CO2 arrival times in the observation wells and reservoir pressure with a good agreement (Martens et al., 2012). Consequently, the validated reservoir model of the Stuttgart Formation at the Ketzin pilot site enabled us to predict the development of reservoir pressure and the CO2 plume migration in the storage formation by dynamic flow simulations. A benchmark study of industrial (ECLIPSE 100 as well as ECLIPSE 300 CO2STORE and GASWAT) and scientific dynamic flow simulations codes (TOUGH2-MP/ECO2N, OpenGeoSys and DuMuX) was initiated to address and compare the simulator capabilities considering a highly complex reservoir model. Hence, our dynamic flow simulations take into account different properties of the geological model such as significant variation of porosity and permeability in the Stuttgart Formation as well as structural geological features implemented in the geological model such as seven major faults located at the top of the Ketzin anticline. Integration of the geological model into reservoir models suitable for the different dynamic flow simulators applied demonstrated that a direct conversion of reservoir model discretization between Finite Volume and Finite Element flow simulators is not feasible

  19. Evaluation of the personalized bar-code identification card to verify high-risk, high-alert medications.

    PubMed

    Thomas, Maria

    2013-09-01

    An effective intervention to decrease medication errors related to high-risk, high-alert medications is to implement double checks and second verification using the five rights of medication administration. To evaluate the effectiveness and use of the Personalized Bar-Code Identification card in verifying high-risk, high-alert medications, the High-Risk, High-Alert Medication Verification Audit Tool was used to collect data from the medical records of patients who received high-risk, high-alert medications in four ICUs. Data were collected for administered high-risk, high-alert medication, primary registered nurses who administered the high-risk, high-alert medication, and secondary registered nurses who verified the medication. The percentage of medications that were "not verified," "Personalized Bar-Code Identification verified," and "verified" using a method other than the Personalized Bar-Code Identification was calculated and compared using Z tests for two proportions. The percentage of Personalized Bar-Code Identification-verified medications (83.5%) was significantly higher than the percentage of medications that were not verified (10.9%) (Z = 38.43, P < .05). Also, the difference between the proportion of the Personalized Bar-Code Identification-verified medications and those that were verified using another method (5.6%) was significant (Z = 41.42, P < .05). The results show that nurses generally tend to follow the standardized procedure for verifying high-risk, high-alert medications in the four ICUs.

  20. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    PubMed Central

    Wada, Akinori; Kohno, Naoaki

    2017-01-01

    Purpose To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED) ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR) brachytherapy in combination with external beam radiotherapy (EBRT) and short-term androgen deprivation therapy (ADT). Material and methods From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT). The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%), 61 patients with 2 high-risk factors (43%), and 22 patients with 3 high-risk factors (15%) including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS) rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF) rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS) rate of 97.2%, and an overall survival (OS) rate of 95.5%. Conclusions High-dose (BED ≥ 220 Gy) radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further. PMID:28344597

  1. Comprehensive brain MRI segmentation in high risk preterm newborns.

    PubMed

    Yu, Xintian; Zhang, Yanjie; Lasky, Robert E; Datta, Sushmita; Parikh, Nehal A; Narayana, Ponnada A

    2010-11-08

    Most extremely preterm newborns exhibit cerebral atrophy/growth disturbances and white matter signal abnormalities on MRI at term-equivalent age. MRI brain volumes could serve as biomarkers for evaluating the effects of neonatal intensive care and predicting neurodevelopmental outcomes. This requires detailed, accurate, and reliable brain MRI segmentation methods. We describe our efforts to develop such methods in high risk newborns using a combination of manual and automated segmentation tools. After intensive efforts to accurately define structural boundaries, two trained raters independently performed manual segmentation of nine subcortical structures using axial T2-weighted MRI scans from 20 randomly selected extremely preterm infants. All scans were re-segmented by both raters to assess reliability. High intra-rater reliability was achieved, as assessed by repeatability and intra-class correlation coefficients (ICC range: 0.97 to 0.99) for all manually segmented regions. Inter-rater reliability was slightly lower (ICC range: 0.93 to 0.99). A semi-automated segmentation approach was developed that combined the parametric strengths of the Hidden Markov Random Field Expectation Maximization algorithm with non-parametric Parzen window classifier resulting in accurate white matter, gray matter, and CSF segmentation. Final manual correction of misclassification errors improved accuracy (similarity index range: 0.87 to 0.89) and facilitated objective quantification of white matter signal abnormalities. The semi-automated and manual methods were seamlessly integrated to generate full brain segmentation within two hours. This comprehensive approach can facilitate the evaluation of large cohorts to rigorously evaluate the utility of regional brain volumes as biomarkers of neonatal care and surrogate endpoints for neurodevelopmental outcomes.

  2. High Risk of Depressive Disorders in Patients With Gout

    PubMed Central

    Changchien, Te-Chang; Yen, Yung-Chieh; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-01-01

    Abstract Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders. In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval. Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients. Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk. PMID:26717394

  3. Molecular genotyping of HPV L1 gene in low-risk and high-risk populations in Bangkok

    PubMed Central

    Leaungwutiwong, Pornsawan; Bamrungsak, Busara; Jittmittraphap, Akanitt; Maneekan, Pannamas; Kosoltanapiwat, Nathamon; Kalambaheti, Thareerat; Kelley, James F.

    2015-01-01

    Background Human papillomavirus (HPV) infections in Thailand are a public health concern but information on HPV infection in sex workers and men who have sex with men (MSM) is limited. The aim of this study was to measure the prevalence and genotype distribution of HPV among low- and high-risk, HIV-negative populations. Methods A total of 300 participants were categorized as general women, female sex workers, MSM, and MSM sex workers. HPV infections were identified by the Papanicolaou (Pap) test and nested-PCR. A phylogenetic analysis of partial HPV L1 genes was performed. Results Abnormal cytology was found in 5% of general women, 10% of female sex workers, 24% of MSM and 28% of MSM sex workers. HPV was detected in 9% of general women, 13% of female sex workers and 30% in both MSM and the MSM sex workers. The prevalence of HPV high-risk genotypes was significantly higher in female sex workers and MSM while low-risk genotypes and genital warts were significantly higher in MSM sex workers. Significantly more patients with genital warts and CIN I/AIN I harbored low-risk genotypes while those with CIN II/AIN II harbored high-risk genotypes. Conclusion High- and low-risk HPV genotypes persist in high-risk groups in Bangkok. Some genotypes infecting at-risk populations are not vaccine-preventable. These findings may help to elucidate the prevalence of HPV infections in Thailand and serve as the basis for additional investigations into risk factors for these populations. PMID:25763674

  4. [Accident risk perception in high-voltage electrical maintenance workers].

    PubMed

    Micheli, M; Zanaletti, W; Giorgi, I; Argentero, P; Candura, S M

    2006-01-01

    Promoting safety at work represents a fundamental task for achieving improvement in the quality of working life and preventing accidental injuries at work. Nevertheless, over the last few decades injuries at work have continued to constitute a significant problem. The aim of this study was to examine accident risk perception in a sample of 45 subjects employed in the electricity sector and to relate their risk perception to personality characteristics, cognitive functioning, and personal and professional history. The instruments used were: "Cognitive Behavioral Assessment 2.0", the "Workplace safety questionnaire" (an Italian questionnaire on safety at work), and a battery of neuropsychological tests. Findings show that electricity (current variability) was perceived as the most serious risk factor, while the most frequent perceived risk factors for accidents were accidental falls, cuts and bruises. The subjects of our sample showed a good awareness of risk perception, and good mood response and augmented psychophysiological activation during accidental injuries.

  5. Establishing a Program for Individuals at High Risk for Breast Cancer

    PubMed Central

    Cadiz, Fernando; Kuerer, Henry M.; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

    2013-01-01

    Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining “high risk”; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk. PMID:23833688

  6. Do couples at high risk of relationship problems attend premarriage education?

    PubMed

    Halford, W Kim; O'Donnell, Charlotte; Lizzio, Alf; Wilson, Keithia L

    2006-03-01

    The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education.

  7. [The Discursive Analysis of Mental Health Promotion Efforts Targeting Community-Dwelling Young Adults at High Risk of Mental Illness].

    PubMed

    Hsiung, Der-Yun; Yang, Tzu-Ching; Ma, Wei-Fen

    2015-08-01

    The mental health of adolescents and young adults is an issue of concern worldwide due to the increase in violent incidents that have been perpetrated by members of this age group. Young people at high-risk of mental disability are easily ignored. Therefore, social tensions in society have increased due to safety issues arising from the problems that are associated with mental disabilities in this population. This paper discusses the importance of early identification and early prevention of mental disabilities in high-risk young people, defines high-risk mental illness, and identifies the various subcategories of mental diseases. Based on our review of the literature, the present paper suggests targeting young people in high-risk categories with health promotion that addresses the following six health-promotion lifestyle habits: engaging in regular exercise, eating a balanced diet, managing stress, engaging in social relationships, taking responsibility for personal health, and fulfilling self-actualization. This discursive analysis discusses these strategies as safe and sustained interventions for adolescents and young adults that may improve self-awareness and thus maintain health and enhance opportunities to promote an ideal health status.

  8. Risk reduction treatment of high-risk psychopathic offenders: the relationship of psychopathy and treatment change to violent recidivism.

    PubMed

    Olver, Mark E; Lewis, Kathy; Wong, Stephen C P

    2013-04-01

    The relationships of psychopathy, therapeutic change, and violent recidivism were examined in a sample of 152 high-risk violent offenders treated in a high-intensity violence reduction program at the Regional Psychiatric Centre (RPC) in Saskatoon, SK. The Violence Risk Scale (VRS; Wong & Gordon, 1999-2003) and Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003) were rated on the sample. As an extension on a prior psychometric study of the VRS (Lewis, Olver, & Wong, 2012), the associations of therapeutic change scores, obtained from pre- and posttreatment ratings of VRS dynamic items, and violent recidivism were examined among high-risk psychopathic offenders (mean PCL-R >25) over approximately 5 years' follow-up. Positive therapeutic change correlated negatively with the PCL-R, particularly Factor 1 and the Affective facet, and was significantly associated with reductions in violent recidivism after controlling for psychopathy. The association of change to violent outcome decreased, however, when controlling for the Affective facet. Taken together, the present results suggest that risk-related treatment changes demonstrated by high-risk psychopathic offenders can be predictive of reductions in violent recidivism, and that reliable measurements of therapeutic change may be informative about treatment outcome in a high-risk violent offender group.

  9. Genomic Changes in Normal Breast Tissue in Women at Normal Risk or at High Risk for Breast Cancer

    PubMed Central

    Danforth, David N.

    2016-01-01

    Sporadic breast cancer develops through the accumulation of molecular abnormalities in normal breast tissue, resulting from exposure to estrogens and other carcinogens beginning at adolescence and continuing throughout life. These molecular changes may take a variety of forms, including numerical and structural chromosomal abnormalities, epigenetic changes, and gene expression alterations. To characterize these abnormalities, a review of the literature has been conducted to define the molecular changes in each of the above major genomic categories in normal breast tissue considered to be either at normal risk or at high risk for sporadic breast cancer. This review indicates that normal risk breast tissues (such as reduction mammoplasty) contain evidence of early breast carcinogenesis including loss of heterozygosity, DNA methylation of tumor suppressor and other genes, and telomere shortening. In normal tissues at high risk for breast cancer (such as normal breast tissue adjacent to breast cancer or the contralateral breast), these changes persist, and are increased and accompanied by aneuploidy, increased genomic instability, a wide range of gene expression differences, development of large cancerized fields, and increased proliferation. These changes are consistent with early and long-standing exposure to carcinogens, especially estrogens. A model for the breast carcinogenic pathway in normal risk and high-risk breast tissues is proposed. These findings should clarify our understanding of breast carcinogenesis in normal breast tissue and promote development of improved methods for risk assessment and breast cancer prevention in women. PMID:27559297

  10. Renal dysfunction and coronary disease: a high-risk combination.

    PubMed

    Schiele, Francois

    2009-01-01

    Chronic kidney dysfunction is recognized as a risk factor for atherosclerosis and complicates strategies and treatment. Therefore, it is important for cardiologists not only to detect and measure potential kidney dysfunction, but also to know the mechanisms by which the heart and kidney interact, and recognize that in cases of acute coronary syndrome, the presence of renal dysfunction increases the risk of death. The detection and classification of kidney dysfunction into 5 stages is based on the estimated glomerular filtration rate (GFR). The presence of hypertension, endothelial dysfunction, dyslipidemia, inflammation, activation of the renin-angiotensin system and specific calcifications are the main mechanisms by which renal dysfunction can induce or compound cardiovascular disease. The magnitude of renal dysfunction is related to the cardiovascular risk; a linear relation links the extent of GFR decrease and the risk of cardiovascular events. Renal dysfunction and acute coronary syndromes are a dangerous combination: more common comorbidities, more frequent contraindications for effective drugs and higher numbers of drug-related adverse events such as bleeding partially explain the higher mortality in patients with renal dysfunction. In addition, despite higher risk, patients with renal dysfunction often receive fewer guideline-recommended treatments even in the absence of contraindications. Renal dysfunction induces and promotes atherosclerosis by various pathophysiologic pathways and is associated with other cardiovascular risk factors and underuse of appropriate therapy. Therefore, the assessment of renal function is an important step in the risk evaluation of patients with coronary artery disease.

  11. Testosterone in men with hypogonadism and high cardiovascular risk, Pros.

    PubMed

    Rosano, Giuseppe M C; Vitale, Cristiana; Fini, Massimo

    2015-11-01

    Although numerous randomized studies have shown that testosterone replacement therapy (TRT) improves intermediate outcomes in patients at risk and in those with proven cardiovascular disease (CVD), results derived mainly from registries and observational studies have suggested an increased cardiovascular risk in elderly men receiving often supra-therapeutic doses of testosterone. Recent meta-analyses have shown that when testosterone has been used in patients with pre-existing cardiovascular conditions, the effect on the disease has been either beneficial or neutral. Similar results have been reported in hypo- and eugonadal men. Contrasting results have been reported by two trials of testosterone treatment in frail elderly men. Reports from poorly analyzed databases have reported an increased risk of cardiovascular events with testosterone use. More recently, a population-based study showed no increased cardiovascular risk of testosterone replacement in hypogonadal men. Available data from controlled clinical trials suggest that the use of testosterone in elderly men does not increase cardiovascular risk nor the risk of events. Studies in men with CVD, angina, or heart failure report a benefit from testosterone replacement in men with or without hypogonadism. Therefore, at present, the cardiovascular benefits of TRT in elderly men outweigh the risks. This is particularly evident in those men with pre-existing CVD.

  12. Risk factors that predict future onset of each DSM-5 eating disorder: Predictive specificity in high-risk adolescent females.

    PubMed

    Stice, Eric; Gau, Jeff M; Rohde, Paul; Shaw, Heather

    2017-01-01

    Because no single report has examined risk factors that predict future onset each type of eating disorder and core symptom dimensions that crosscut disorders, we addressed these aims to advance knowledge regarding risk factor specificity. Data from 3 prevention trials that targeted young women with body dissatisfaction (N = 1,272; Mage = 18.5, SD = 4.2) and collected annual diagnostic interview data over 3-year follow-up were combined to identify predictors of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Negative affect and functional impairment predicted onset of all eating disorders. Thin-ideal internalization, body dissatisfaction, dieting, overeating, and mental health care predicted onset of subthreshold/threshold BN, BED, and PD; positive thinness expectations, denial of cost of pursuing the thin ideal, and fasting predicted onset of 2 of these 3 disorders. Similar risk factors predicted core eating disorder symptom onset. Low BMI and dieting specifically predicted onset of subthreshold/threshold AN or low BMI. Only a subset of factors showed unique predictive effects in multivariate models, likely due to moderate correlations between the risk factors (M r = .14). Results provide support for the theory that pursuit of the thin ideal and the resulting body dissatisfaction, dieting, and unhealthy weight control behaviors increase risk for binge/purge spectrum eating disorders, but suggest that youth who are inherently lean, rather than purposely pursuing the thin ideal, are at risk for AN. Impaired interpersonal functioning and negative affect are transdiagnostic risk factors, suggesting these factors should be targeted in prevention programs. (PsycINFO Database Record

  13. A Risk Score to Predict Type 2 Diabetes Mellitus in an Elderly Spanish Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Guasch-Ferré, Marta; Bulló, Mònica; Costa, Bernardo; Martínez-Gonzalez, Miguel Ángel; Ibarrola-Jurado, Núria; Estruch, Ramon; Barrio, Francisco; Salas-Salvadó, Jordi

    2012-01-01

    Introduction To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. Materials and Methods A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample). Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample). The discrimination of Finnish Diabetes Risk Score (FINDRISC), German Diabetes Risk Score (GDRS) and our scores was assessed with the area under curve (AUC). Results The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%), and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. Discussion We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire. PMID:22442692

  14. Iatrogenic high-risk populations and foodborne disease.

    PubMed

    Acheson, David

    2013-09-01

    Certain subsets of the population are at a greater risk of acquiring foodborne infections and have a greater propensity to develop serious complications. Susceptibility to foodborne infection is dependent on numerous factors that largely relate to the status of an individual's defense systems in regard to both preventing and mitigating foodborne illness. Key examples include the increased susceptibility of pregnant women to listeriosis and increased severity of enteric bacterial infections in patients with AIDS. Clinicians must communicate with higher-risk patients about the risks of foodborne illness, and provide patients with information regarding safe food-handling practices.

  15. High metal reactivity and environmental risks at a site contaminated by glass waste.

    PubMed

    Augustsson, A; Åström, M; Bergbäck, B; Elert, M; Höglund, L O; Kleja, D B

    2016-07-01

    This study addresses the reactivity and risks of metals (Ba, Cd, Co, Cr, Cu, Ni, Pb, Zn, As and Sb) at a Swedish site with large glass waste deposits. Old glassworks sites typically have high total metal concentrations, but as the metals are mainly bound within the glass waste and considered relatively inert, environmental investigations at these kinds of sites are limited. In this study, soil and landfill samples were subjected to a sequential chemical extraction procedure. Data from batch leaching tests and groundwater upstream and downstream of the waste deposits were also interpreted. The sequential extraction revealed that metals in <2 mm soil/waste samples were largely associated with geochemically active fractions, indicating that metals are released from pristine glass and subsequently largely retained in the surrounding soil and/or on secondary mineral coatings on fine glass particles. From the approximately 12,000 m(3) of coarse glass waste at the site, almost 4000 kg of Pb is estimated to have been lost through corrosion, which, however, corresponds to only a small portion of the total amount of Pb in the waste. Metal sorption within the waste deposits or in underlying soil layers is supported by fairly low metal concentrations in groundwater. However, elevated concentrations in downstream groundwater and in leachates of batch leaching tests were observed for several metals, indicating on-going leaching. Taken together, the high metal concentrations in geochemically active forms and the high amounts of as yet uncorroded metal-rich glass, indicate considerable risks to human health and the environment.

  16. The Platte River - High Plains Aquifer (PR-HPA) Long Term Agroecosystem Research (LTAR) Network - Data and Technological Resources to Address Current and Emerging Issues in Agroecosystems.

    NASA Astrophysics Data System (ADS)

    Okalebo, J. A.; Wienhold, B.; Suyker, A.; Erickson, G.; Hayes, M. J.; Awada, T.

    2015-12-01

    The Platte River - High Plains Aquifer (PR-HPA) is one of 18 established Long Term Agroecosystem Research (LTAR) networks across the US. PR-HPA is a partnership between the Institute of Agriculture and Natural Resources at the University of Nebraska-Lincoln (UNL), the USDA-ARS Agroecosystem Management Research Unit (AMRU) in Lincoln, and the USDA-ARS Environmental Management Research Unit (EMRU) in Clay Center, NE. The PR-HPA network encompasses 27,750 ha of research sites with data going back to the early 1900s. A partial list of on-going research projects include those encompassing long-term manuring and continuous corn (Est. 1912), dryland tillage plots (Est. 1970), soil nutrients and tillage (Est. 1983), biofuel feedstock studies (Est. 2001), and carbon sequestration study (Est. 2000). Affiliated partners include the National Drought Mitigation Center (NDMC) that develops measures to improve preparedness and adaptation to climate variability and drought; the High Plains Regional Climate Center (HPRCC) that coordinates data acquisition from over 170 automated weather stations and around 50 automated soil moisture network across NE and beyond; the AMERIFLUX and NEBFLUX networks that coordinate the water vapor and carbon dioxide flux measurements across NE with emphasis on rainfed and irrigated crop lands; the ARS Greenhouse gas Reduction through Agricultural Carbon Enhancement network (GRACEnet) and the Resilient Economic Agricultural Practices (REAP) project; and the Center for Advanced Land Management Information Technologies (CALMIT) that assists with the use of geospatial technologies for agriculture and natural resource applications. Current emphases are on addressing present-day and emerging issues related to profitability and sustainability of agroecosystems. The poster will highlight some of the ongoing and planned efforts in research pertaining to climate variability and change, water sustainability, and ecological and agronomic challenges associated

  17. Examining the Relationship between Problem History and Violent Offending in High-Risk Youth

    ERIC Educational Resources Information Center

    Sullivan, Christopher J.; Veysey, Bonita M.; Dorangrichia, Linda

    2003-01-01

    Researchers, policy-makers, and practitioners continually attempt to develop and implement strategies that address the onset and continuance of violent behavior in young people. Researchers in multiple disciplines have identified risk factors that predispose young people to later violent offending (e.g., school performance, demographic…

  18. Addressing Ozone Layer Depletion

    EPA Pesticide Factsheets

    Access information on EPA's efforts to address ozone layer depletion through regulations, collaborations with stakeholders, international treaties, partnerships with the private sector, and enforcement actions under Title VI of the Clean Air Act.

  19. Facial emotion perception differs in young persons at genetic and clinical high-risk for psychosis.

    PubMed

    Kohler, Christian G; Richard, Jan A; Brensinger, Colleen M; Borgmann-Winter, Karin E; Conroy, Catherine G; Moberg, Paul J; Gur, Ruben C; Gur, Raquel E; Calkins, Monica E

    2014-05-15

    A large body of literature has documented facial emotion perception impairments in schizophrenia. More recently, emotion perception has been investigated in persons at genetic and clinical high-risk for psychosis. This study compared emotion perception abilities in groups of young persons with schizophrenia, clinical high-risk, genetic risk and healthy controls. Groups, ages 13-25, included 24 persons at clinical high-risk, 52 first-degree relatives at genetic risk, 91 persons with schizophrenia and 90 low risk persons who completed computerized testing of emotion recognition and differentiation. Groups differed by overall emotion recognition abilities and recognition of happy, sad, anger and fear expressions. Pairwise comparisons revealed comparable impairments in recognition of happy, angry, and fearful expressions for persons at clinical high-risk and schizophrenia, while genetic risk participants were less impaired, showing reduced recognition of fearful expressions. Groups also differed for differentiation of happy and sad expressions, but differences were mainly between schizophrenia and control groups. Emotion perception impairments are observable in young persons at-risk for psychosis. Preliminary results with clinical high-risk participants, when considered along findings in genetic risk relatives, suggest social cognition abilities to reflect pathophysiological processes involved in risk of schizophrenia.

  20. Teacher Effectiveness in Identifying High-Risk Kindergarten Children.

    ERIC Educational Resources Information Center

    Colarusso, Ronald P.; And Others

    1979-01-01

    Teacher effectiveness in identifying children "at risk" for learning problems was studied with five Head Start teachers. Results showed that, after training in classroom observation techniques, paraprofessional teachers are capable of identifying developmental delays in children. (PHR)

  1. Adaptive and maladaptive personality traits in high-risk gamblers.

    PubMed

    Carlotta, Davide; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Frera, Fernanda; Somma, Antonella; Maffei, Cesare; Fossati, Andrea

    2015-06-01

    Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs.

  2. Breast Cancer Screening for High-Risk Patients of Different Ages and Risk - Which Modality Is Most Effective?

    PubMed Central

    Vassiliades, Lauren; Abdalla, Reem

    2016-01-01

    While the guidelines for breast cancer screening in average-risk women are well established, screening in high-risk women is not as clear. For women with BRCA1 or BRCA2 mutations, current guidelines recommend screening by clinical breast examination and mammography starting at age 30. For certain high-risk women, additional screening with magnetic resonance imaging (MRI) is encouraged. This review focuses on differentiating imaging modalities used for screening women at high-risk for breast cancer over the age of 50 by discussing the different imaging techniques, cost versus benefit, detection rates, and impact on survival. While mammography is the only imaging modality proven to reduce mortality from breast cancer, MRI is more sensitive in identifying cancers. MRI can often identify smaller malignancies at a greater resolution at an earlier stage. The use of MRI would be more cost effective as there would be less need for invasive therapeutic procedures. Research thus far has not identified an age-specific preference in imaging modality. There are no guidelines for high-risk women that specify screening with respect to age (i.e., older than 50 years old). More research is needed before screening guidelines in different age groups with various risk factors can be established. PMID:28133583

  3. Leisure-Time Exercise Could Lower Your Risk of High Blood Pressure

    MedlinePlus

    ... exercise could lower your risk of high blood pressure American Heart Association Rapid Access Journal Report September ... Heart Association Download (1.4 MB) High Blood Pressure A high blood pressure reading. copyright American Heart ...

  4. Surveillance of Anaemia: Mapping and Grading the High Risk Territories and Populations

    PubMed Central

    Amirapu, Pallavi

    2016-01-01

    Introduction Surveillance of anaemia is an ongoing process for assessing iron status and anaemia prevalence among individuals and the communities they live in. Measuring blood haemoglobin levels is the commonest method espoused worldwide for screening individuals and populations for anaemia and iron deficiency. World Health Organization (WHO) proposed a classification of public health significance of anaemia in populations on the basis of prevalence estimated from blood levels of haemoglobin. India falls under “Severe public health problem” category. An attempt has been made to categorise “Severe public health problem” into grades of severity that will help in prioritising the states and districts for targeted action. Aim To adapt the “WHO Classification of anaemia as a problem of public health significance” and to use the same to identify and map high risk population groups in the southern states of India. Materials and Methods The category of ’Severe Public Health Problem’ has been graded based on prevalence of anaemia. Secondary data published in the District Level Household and Facility Survey - 4 is analysed for five states and 1 UT (Union Territory) of southern part of India. Choropleth Mapping was done to visually depict the intensity of anaemia problem across the geographic territories. Results Children from 6 months to 59 months were having highest prevalence of both, anaemia (68%) and severe anaemia (10%). This was followed by pregnant women aged 15 to 49 years and Girl Child 6 to 9 years. Four of the Southern states of India including Andhra Pradesh, Karnataka, Telangana and Tamil Nadu fall in the Grade 2 SPHP (Severe Public Health Problem) Conclusion The sixteen districts fall under Grade 3 Severe Public Health Problem in the states of Andhra Pradesh, Karnataka and Telangana, require special focus for identifying and addressing the determinants of such high prevalence of Anaemia. These populations and territories require priority in the

  5. High incidence and prevalence of HIV-1 infection in high risk population in Calcutta, India.

    PubMed

    Gupta, Phalguni; Kingsley, Lawrence; Sheppard, Haynes W; Harrison, Lee H; Chatterjee, Ramdas; Ghosh, Adhir; Roy, Pratima; Neogi, Dhruba K

    2003-07-01

    HIV-1 infection in India has been increasing steadily over the last decade. In the absence of potent antiviral therapy, estimates of HIV infection are needed to monitor the epidemic, institute prevention strategies in target populations and determine the suitable populations for vaccine studies. In this report we present the HIV-1 seroprevalence and annual estimates of seroincidence in a high risk population from Calcutta, the most populous city in the eastern part of India. In 1206 high risk subjects tested over two years between February of 1999 and December 2000, we have determined an overall seroprevalence of 40.1% using enzyme-linked immunosorbent assay followed by a confirmatory Western blot testing. Furthermore, using a newly described Standardized Testing Algorithm for Recent HIV-1 Seroconversion (STARHS), we have estimated an annual seroincidence rate of about 7% in this population during this two-year study. Such a high annual seroincidence rate makes this population well suited for studies of HIV-1 prevention, including vaccine trials.

  6. Is Clinical Stage T2C Prostate Cancer Intermediate or High-Risk Disease?

    PubMed Central

    Klaassen, Zachary; Singh, Abhay A.; Howard, Lauren E.; Feng, Zhaoyong; Trock, Bruce; Terris, Martha K.; Aronson, William J.; Cooperberg, Matthew R.; Amling, Christopher L.; Kane, Christopher J.; Partin, Alan; Han, Misop; Freedland, Stephen J.

    2014-01-01

    Background Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. In D’Amico grouping and AUA guidelines, cT2c is high-risk, whereas NCCN and EAU classify cT2c as intermediate-risk. We assessed whether cT2c tumors, without other high-risk factors (cT2c not otherwise specified (cT2c-nos)), behave as intermediate or high-risk by analyzing biochemical recurrence (BCR) after radical prostatectomy. Methods We analyzed 2,759 men from SEARCH and 12,900 men from Johns Hopkins Hospital (JHH) from 1988–2011 and 1982–2012, respectively. Patients were grouped into low (PSA<10ng/mL, Gleason sum≤6, and cT1-T2a), intermediate (PSA 10–20ng/mL, Gleason sum 7, or cT2b) and high-risk PC (PSA>20ng/mL, Gleason sum 8–10, or cT3). Men with cT2c who were not otherwise high-risk (i.e. PSA<20 ng/mL and Gleason sum<8) were placed into a separate category termed cT2c -nos. Associations between cT2c-nos and intermediate-risk, and high-risk patients and BCR were tested using log-rank test and Cox proportional analyses models. Results 99 men (4%) from SEARCH and 202 (2%) from JHH were cT2c-nos. cT2c-nos patients had similar BCR risk as intermediate-risk (SEARCH p=0.27; JHH p=0.23), but significantly lower BCR vs. high-risk (SEARCH p<0.001; JHH p<0.001). When specifically compared to intermediate and high-risk patients, and after adjusting for year and center, cT2c-nos patients had outcomes comparable to intermediate-risk (SEARCH p=0.53; JHH p=0.54), but significantly better than high-risk patients (SEARCH p=0.003; JHH p<0.001). Conclusions Patients with cT2c without other high-risk features had similar outcomes as intermediate-risk and significantly better than high-risk PC. These findings suggest men with cT2c should be considered intermediate-risk. PMID:25492369

  7. The Educational Value of High Risk Activities in the Physical Education Program: A Social Philosophical Perspective.

    ERIC Educational Resources Information Center

    Sparks, Robert E. C.

    A growing number of schools and institutions in North America have begun offering training in high risk activities such as high element rope courses, rock climbing, white water kayaking and canoeing, and scuba diving in conjunction with their regular physical education activity programs. High risk activities are those activities which occur in or…

  8. Attitudes, Knowledge, and Sexual Behavior of High-Risk Adolescents: Implications for Counseling and Sexuality Education.

    ERIC Educational Resources Information Center

    Melchert, Tim; Burnett, Kent F.

    1990-01-01

    Examined high-risk sexual behavior in adolescents (N=212) involved in juvenile justice system. Found that youth were at high risk for unintended pregnancy, Acquired Immunodeficiency Syndrome and other sexually transmitted disease. Compared to national norms, sample reported very early mean age at first intercourse and high rate of pregnancy. Most…

  9. A Comparison of Teacher and Student Functional Behavior Assessment Interview Information from Low-risk and High-risk Classrooms.

    ERIC Educational Resources Information Center

    Kinch, Carol; Lewis-Palmer, Teri; Hagan-Burke, Shanna; Sugai, George

    2001-01-01

    A study examined the usefulness of information secured from eight students displaying substantially more problem behaviors in one classroom (high-risk) than another, and 16 teachers. Students were able to provide reliable information in the functional assessment interview. Moderate to high agreement was obtained between students and teachers in…

  10. Drug Use Risk Behavior Co-Occurrence among United States High School Students

    ERIC Educational Resources Information Center

    Di Bona, Vito Lorenzo; Erausquin, Jennifer Toller

    2014-01-01

    Purpose: Prevalence estimates for drug use health risk behaviors among high school students are widely available, but relatively few studies describe how and to what extent these risk behaviors occur together. Furthermore, little research has examined whether the co-occurrence of health risk behaviors varies by key demographic characteristics such…

  11. Emotion Recognition in Fathers and Mothers at High-Risk for Child Physical Abuse

    ERIC Educational Resources Information Center

    Asla, Nagore; de Paul, Joaquin; Perez-Albeniz, Alicia

    2011-01-01

    Objective: The present study was designed to determine whether parents at high risk for physical child abuse, in comparison with parents at low risk, show deficits in emotion recognition, as well as to examine the moderator effect of gender and stress on the relationship between risk for physical child abuse and emotion recognition. Methods: Based…

  12. Risk Factors for Suicidality among a Nationally Representative Sample of High School Students

    ERIC Educational Resources Information Center

    Epstein, Jennifer A.; Spirito, Anthony

    2009-01-01

    Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk-related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually…

  13. Colonoscopy Reduces Risk of Death from Colorectal Cancer in High-Risk Patients

    Cancer.gov

    Long-term results from the National Polyp Study confirm that removing precancerous adenomas not only reduces the risk of colorectal cancer but also reduces the number of deaths from the disease by more than half.

  14. High-risk regions and outbreak modelling of tularemia in humans.

    PubMed

    Desvars-Larrive, A; Liu, X; Hjertqvist, M; Sjöstedt, A; Johansson, A; Rydén, P

    2017-02-01

    Sweden reports large and variable numbers of human tularemia cases, but the high-risk regions are anecdotally defined and factors explaining annual variations are poorly understood. Here, high-risk regions were identified by spatial cluster analysis on disease surveillance data for 1984-2012. Negative binomial regression with five previously validated predictors (including predicted mosquito abundance and predictors based on local weather data) was used to model the annual number of tularemia cases within the high-risk regions. Seven high-risk regions were identified with annual incidences of 3·8-44 cases/100 000 inhabitants, accounting for 56·4% of the tularemia cases but only 9·3% of Sweden's population. For all high-risk regions, most cases occurred between July and September. The regression models explained the annual variation of tularemia cases within most high-risk regions and discriminated between years with and without outbreaks. In conclusion, tularemia in Sweden is concentrated in a few high-risk regions and shows high annual and seasonal variations. We present reproducible methods for identifying tularemia high-risk regions and modelling tularemia cases within these regions. The results may help health authorities to target populations at risk and lay the foundation for developing an early warning system for outbreaks.

  15. State high-risk pools: an update on the Minnesota Comprehensive Health Association.

    PubMed

    Blewett, Lynn A; Spencer, Donna; Burke, Courtney E

    2011-02-01

    State health insurance high-risk pools are a key component of the US health care system's safety net, because they provide health insurance to the "uninsurable." In 2007, 34 states had individual high-risk pools, which covered more than 200 000 people at a total cost of $1.8 billion. We examine the experience of the largest and oldest pool in the nation, the Minnesota Comprehensive Health Association, to document key issues facing state high-risk pools in enrollment and financing. We also considered the role and future of high-risk pools in light of national health care finance reform.

  16. Childbirth Experience in Women at High Risk: Is It Improved by Use of a Birth Plan?

    PubMed Central

    Berg, Marie; Lundgren, Ingela; Lindmark, Gunilla

    2003-01-01

    Women at obstetric high risk more often experience negative feelings related to childbirth than women with normal outcomes. For these high-risk women, an individual birth plan does not appear to improve the overall experience of childbirth; rather, it seems to intensify the negative feelings in several aspects. The increased vulnerability in women at high risk warrants special attention to the possibility that types of care routinely offered to all women may negatively influence the experiences of high-risk women. PMID:17273335

  17. Efficacy of ACL injury risk screening methods in identifying high-risk landing patterns during a sport-specific task.

    PubMed

    Fox, A S; Bonacci, J; McLean, S G; Saunders, N

    2016-06-12

    Screening methods sensitive to movement strategies that increase anterior cruciate ligament (ACL) loads are likely to be effective in identifying athletes at-risk of ACL injury. Current ACL injury risk screening methods are yet to be evaluated for their ability to identify athletes' who exhibit high-risk lower limb mechanics during sport-specific maneuvers associated with ACL injury occurrences. The purpose of this study was to examine the efficacy of two ACL injury risk screening methods in identifying high-risk lower limb mechanics during a sport-specific landing task. Thirty-two female athletes were screened using the Landing Error Scoring System (LESS) and Tuck Jump Assessment. Participants' also completed a sport-specific landing task, during which three-dimensional kinematic and kinetic data were collected. One-dimensional statistical parametric mapping was used to examine the relationships between screening method scores, and the three-dimensional hip and knee joint rotation and moment data from the sport-specific landing. Higher LESS scores were associated with reduced knee flexion from 30 to 57 ms after initial contact (P = 0.003) during the sport-specific landing; however, no additional relationships were found. These findings suggest the LESS and Tuck Jump Assessment may have minimal applicability in identifying athletes' who exhibit high-risk landing postures in the sport-specific task examined.

  18. High hydrostatic pressure processing: a promising nonthermal technology to inactivate viruses in high-risk foods.

    PubMed

    Lou, Fangfei; Neetoo, Hudaa; Chen, Haiqiang; Li, Jianrong

    2015-01-01

    Foodborne outbreaks of viral origin have become increasingly a serious public health concern. High-pressure processing (HPP), a nonthermal technology, has come to the forefront for food processing given its minimal effects on food quality. Recent studies have revealed encouraging results for the inactivation of several human viruses by HPP. This review provides comprehensive information on the use of HPP to eliminate viruses in model systems and foods. We address the influences of various parameters, including pressure level, holding time, pH, temperature, and food matrix on the efficacy of pressure inactivation of viruses, as well as insight into the mechanisms for inactivation of enveloped and nonenveloped viruses. HPP is a promising technology for mitigating virus contamination of foods, thus it is essential to identify the optimal parameters for enhancing virus inactivation while ensuring sensory and nutritional quality retention of foods.

  19. Dimensions of adolescent rebellion: Risks for academic failure among high- and low-income youth

    PubMed Central

    Luthar, Suniya S.; Ansary, Nadia S.

    2015-01-01

    The central question addressed in this study was whether upper class, suburban teenagers can engage in various problem behaviors and still maintain adequate academic grades, because of environmental safety nets, unlike their low-income, inner-city counterparts. Three problem behavior dimensions were assessed among tenth graders, that is, substance use, delinquency, and low school engagement. Academic achievement was assessed in terms of grades across four major subjects. Variable-based analyses indicated unique links with grades for self-reported delinquency and school disengagement in high- and low-income samples, but for substance use only among the former. Person-based analyses showed that in both schools, grades were clearly compromised among youth with disturbances in all three problem domains. In addition, in the suburban school only, grades were low in the cluster characterized chiefly by high substance use. Results are discussed in terms of stereotypes regarding risks (or lack thereof) stemming from families' socioeconomic status; implications for theory and interventions are also considered. PMID:15971768

  20. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15–4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  1. Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

    PubMed Central

    Dlamini, Xolisile; Almonte, Maribel; Herrero, Rolando; Jolly, Pauline E.; Tsoka-Gwegweni, Joyce M.; Weiderpass, Elisabete; Broutet, Nathalie; Sartorius, Benn

    2017-01-01

    Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3–29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6–7.1, OR = 4.6, 95%CI: 2.8–7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3–13.4, p<0.021 respectively). Conclusion The prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention

  2. Cost-Effectiveness of Skin Surveillance Through a Specialized Clinic for Patients at High Risk of Melanoma.

    PubMed

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Mann, Graham J; Morton, Rachael L

    2017-01-01

    Purpose Clinical guidelines recommend that people at high risk of melanoma receive regular surveillance to improve survival through early detection. A specialized High Risk Clinic in Sydney, Australia was found to be effective for this purpose; however, wider implementation of this clinical service requires evidence of cost-effectiveness and data addressing potential overtreatment of suspicious skin lesions. Patients and Methods A decision-analytic model was built to compare the costs and benefits of specialized surveillance compared with standard care over a 10-year period, from a health system perspective. A high-risk standard care cohort was obtained using linked population data, comprising the Sax Institute's 45 and Up cohort study, linked to Medicare Benefits Schedule claims data, the cancer registry, and hospital admissions data. Benefits were measured in quality-adjusted life-years gained. Sensitivity analyses were undertaken for all model parameters. Results Specialized surveillance through the High Risk Clinic was both less expensive and more effective than standard care. The mean saving was A$6,828 (95% CI, $5,564 to $8,092) per patient, and the mean quality-adjusted life-year gain was 0.31 (95% CI, 0.27 to 0.35). The main drivers of the differences were detection of melanoma at an earlier stage resulting in less extensive treatment and a lower annual mean excision rate for suspicious lesions in specialized surveillance (0.81; 95% CI, 0.72 to 0.91) compared with standard care (2.55; 95% CI, 2.34 to 2.76). The results were robust when tested in sensitivity analyses. Conclusion Specialized surveillance was a cost-effective strategy for the management of individuals at high risk of melanoma. There were also fewer invasive procedures in specialized surveillance compared with standard care in the community.

  3. Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers.

    PubMed

    Muzik, Maria; Rosenblum, Katherine L; Alfafara, Emily A; Schuster, Melisa M; Miller, Nicole M; Waddell, Rachel M; Stanton Kohler, Emily

    2015-06-01

    Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child's early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers' mental health, parenting competence, and engagement in treatment. Mothers were referred from community health providers for a phase 1 trial to assess feasibility, acceptability, and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty, and single parenthood. Ninety-nine mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post-self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and post-traumatic stress disorder (PTSD)), parenting, and intervention satisfaction. Results indicate that MP participation was associated with reduction in depression, PTSD, and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70 % of the 10 groups (completers; N = 68) improved on parenting and mental health outcomes, in contrast to non-completers (N = 12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Results indicate that MP is feasible, acceptable, and holds promise for improving maternal mental health and parenting competence among

  4. Mom Power: Preliminary Outcomes of a Group Intervention to Improve Mental Health and Parenting Among High-Risk Mothers

    PubMed Central

    Muzik, Maria; Rosenblum, Katherine L.; Alfafara, Emily A.; Schuster, Melisa M.; Miller, Nicole M.; Waddell, Rachel M.; Kohler, Emily Stanton

    2015-01-01

    Purpose Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child’s early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers’ mental health, parenting competence and engagement in treatment. Methods Mothers were referred from community health providers for a Phase 1 trial to assess feasibility, acceptability and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty and single parenthood. 99 mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post- self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and PTSD), parenting and intervention satisfaction. Results Results indicate that MP participation was associated with reduction in depression, PTSD and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70% of the 10 groups (completers; N=68) improved on parenting and mental health outcomes, in contrast to non-completers (N=12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Conclusions Results indicate that MP is feasible, acceptable and holds promise for improving maternal mental health and parenting competence among high-risk dyads

  5. Genotype distribution characteristics of high-risk human papillomaviruses in women from Shanghai, China.

    PubMed

    Gu, Y; Yi, M; Xu, Y; Zhao, H; Fu, F; Zhang, Y

    2016-05-01

    High-risk human papillomaviruses (HPVs) are highly prevalent worldwide, and HPV genotype distribution varies regionally. Molecular surveys of HPVs are important for effective HPV control and prevention. Fifteen high-risk HPV strains (16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68) and six low-risk HPV strains (HPV6, 11, 42, 43, 44, CP8304) were detected by cervical cytology from 10 501 subjects. High-risk HPVs, low-risk HPVs, and both high- and low-risk HPVs were detected in 14·5%, 2·8%, and 2·4% of cases, respectively. Of 1782 subjects with high-risk HPV infection, 75·5%, 18·1%, and 6·4% were infected with one, two, and ⩾3 strains of high-risk HPVs, respectively. HPV52, HPV16, and HPV58 were the top three most dominant high-risk HPV genotypes in our population with positivity rates of 23·0%, 17·7% and 16·9%, respectively. Multiple infection was common, with significantly higher co-infection rates of HPV58/HPV33 (12·9%) and HPV58/HPV52 (11·3%). Further data comparisons showed that HPV genotype distribution varied markedly between domestic and international regions. In conclusion, a monolithic vaccination strategy is obviously impractical, and regional HPV surveillance is essential to optimize current HPV control and prevention.

  6. Perceptions of Community HIV/ STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates

    PubMed Central

    Blackstock, Oni J.; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L.; Justman, Jessica; Golin, Carol E.; Haley, Danielle F.; Kuo, Irene; Adimora, Adaora A.; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B.

    2015-01-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community’s HIV/STI risk. We explored perceptions of community HIV/ STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women’s HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/ STI risk driven by structural factors. PMID:26320916

  7. The Affordable Care Act and genetic testing for inheritable cancer syndromes: impact on high-risk underserved minorities.

    PubMed

    Walcott, Farzana L; Dunn, Barbara K; DeShields, Mary; Baquet, Claudia

    2014-02-01

    Genetic testing for inheritable cancer syndromes is becoming a critical part of preventive health services. The Patient Protection and Affordable Care Act (PPACA) Essential Health Benefits package addresses breast cancer susceptibility-gene testing for women who are unaffected by cancer. The absence of provisions for 1) men, 2) cancer patients, 3) other inheritable cancer syndromes, and 4) risk-reducing interventions are limitations of PPACA. We discuss provisions and limitations of PPACA pertaining to genetic testing and effects on high-risk populations, in particular minorities. The PPACA is the beginning of an ongoing process of incorporating genetic testing in the armamentarium of cancer prevention. Future efforts should focus on ensuring equitable access to genetic testing as a preventive service under PPACA to high-risk populations other than women. Consideration should also be given to provisions for risk-reducing interventions, especially in underserved minority populations, who are known to underutilize genetic testing and may have limited financial resources for medical intervention.

  8. Minimizing Accidents and Risks in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Meier, Joel

    The fundamental dilemma in adventure programming is eliminating unreasonable risks to participants without also reducing levels of excitement, challenge, and stress. Most accidents are caused by a combination of unsafe conditions, unsafe acts, and error judgments. The best and only way to minimize critical human error in adventure programs is…

  9. Low High-Density Lipoprotein and Risk of Myocardial Infarction.

    PubMed

    Ramirez, A; Hu, P P

    2015-01-01

    Low HDL is an independent risk factor for myocardial infarction. This paper reviews our current understanding of HDL, HDL structure and function, HDL subclasses, the relationship of low HDL with myocardial infarction, HDL targeted therapy, and clinical trials and studies. Furthermore potential new agents, such as alirocumab (praluent) and evolocumab (repatha) are discussed.

  10. Harden Security of High-Risk and Critical Supply Chains

    SciTech Connect

    Harrison, Glen

    2009-01-01

    This article focuses on the security risk in the container supply chain. It provides an overview of the technical and policy initiatives that are being implemented by international organizations, governments, and the private sector to enhance security in the container supply chain.

  11. Use of Demographics to Predict High Risk Individuals for Suicide

    DTIC Science & Technology

    2013-06-01

    24 Measures of Stress...Figure 2: Suicide and Suicide Related Behaviors (Berman, 2010) .................................. 12 Figure 3: Developing Comprehensive Suicide...2010). The emphasis placed on suicide prevention within the DoD has led to the development of numerous initiatives to reduce the risk of suicide

  12. Risk and Hazard Management in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Meier, Joel

    The dilemma in adventure education is to eliminate unreasonable risks to participants without reducing the levels of excitement, challenge, and stress that are inherent in adventure programming. Most accidents in outdoor pursuits are caused by a combination of unsafe conditions; unsafe acts (usually on the part of the student); and error judgments…

  13. Identifying Children at High Risk for a Child Maltreatment Report

    ERIC Educational Resources Information Center

    Dubowitz, Howard; Kim, Jeongeun; Black, Maureen M.; Weisbart, Cindy; Semiatin, Joshua; Magder, Laurence S.

    2011-01-01

    Objective: To help professionals identify factors that place families at risk for future child maltreatment, to facilitate necessary services and to potentially help prevent abuse and neglect. Method: The data are from a prospective, longitudinal study of 332 low-income families recruited from urban pediatric primary care clinics, followed for…

  14. Not all risk taking behavior is bad: Associative sensitivity predicts learning during risk taking among high sensation seekers

    PubMed Central

    Humphreys, Kathryn L.; Lee, Steve S.; Tottenham, Nim

    2013-01-01

    Risk taking behavior can be both adaptive and maladaptive depending on context. The majority of studies of risk taking, however, focus on clinical populations and dangerous or harmful risk taking. Individual differences in learning during risk taking are rarely examined in relation to task performance. The present study examined risk taking and associated outcomes in an exploration-based instrumental learning task (Balloon Emotional Learning Task; BELT), which presented a series of balloons in which participants pump up for points. Consistent with prior work, sensation seeking predicted increased risk taking behavior. Importantly, however, a significant interaction between sensation seeking and associative sensitivity, an attentional construct defined as the frequency and remoteness of automatic cognitive activity, was found. Specifically, among individuals high in sensation seeking, associative sensitivity predicted fewer balloon explosions and an increase in points earned on the balloon condition with the most potential feedback driven learning. Thus, these findings suggest that sensation seekers are a heterogeneous group, and secondary traits such as associative sensitivity moderate behavior such as risk taking and learning according to context. PMID:23935235

  15. Not all risk taking behavior is bad: Associative sensitivity predicts learning during risk taking among high sensation seekers.

    PubMed

    Humphreys, Kathryn L; Lee, Steve S; Tottenham, Nim

    2013-04-01

    Risk taking behavior can be both adaptive and maladaptive depending on context. The majority of studies of risk taking, however, focus on clinical populations and dangerous or harmful risk taking. Individual differences in learning during risk taking are rarely examined in relation to task performance. The present study examined risk taking and associated outcomes in an exploration-based instrumental learning task (Balloon Emotional Learning Task; BELT), which presented a series of balloons in which participants pump up for points. Consistent with prior work, sensation seeking predicted increased risk taking behavior. Importantly, however, a significant interaction between sensation seeking and associative sensitivity, an attentional construct defined as the frequency and remoteness of automatic cognitive activity, was found. Specifically, among individuals high in sensation seeking, associative sensitivity predicted fewer balloon explosions and an increase in points earned on the balloon condition with the most potential feedback driven learning. Thus, these findings suggest that sensation seekers are a heterogeneous group, and secondary traits such as associative sensitivity moderate behavior such as risk taking and learning according to context.

  16. Moving from viral suppression to comprehensive patient-centered care: the high prevalence of comorbid conditions and health risk factors in HIV-1-infected patients in Australia.

    PubMed

    Broom, Jennifer; Sowden, David; Williams, Merran; Taing, Kuong; Morwood, Karen; McGill, Karen

    2012-01-01

    HIV clinicians today need to move from focusing on viral suppression to a chronic disease model in which comorbid conditions and risk factors are comprehensively identified and addressed to reduce rates of serious non-AIDS-related morbidity and mortality. This study aimed to determine the prevalence of comorbid conditions in an Australian HIV-positive population. Of 180 patients included, there was a median CD4 count of 0.520 cells/mm(3). The majority (88%) of patients were currently receiving highly active antiretroviral therapy (HAART). There were high rates of failure to attend clinical appointments (30%), current smoking (42%), hypertension (16%), and dyslipidemia (17%). Significant rates of dipstick-positive proteinuria (16%) and elevated blood glucose (15%) were recorded. Risk factors were commonly not addressed by the treating clinician. There is an urgent need to systematize detection and management of high-prevalence comorbid conditions to prevent premature mortality associated with serious non-AIDS events.

  17. Addressing Social Issues.

    ERIC Educational Resources Information Center

    Schoebel, Susan

    1991-01-01

    Maintains that advertising can help people become more aware of social responsibilities. Describes a successful nationwide newspaper advertising competition for college students in which ads address social issues such as literacy, drugs, teen suicide, and teen pregnancy. Notes how the ads have helped grassroots programs throughout the United…

  18. Invitational Addresses, 1965.

    ERIC Educational Resources Information Center

    Gates, Arthur I.; And Others

    The full texts of invitational addresses given at the 1965 International Reading Association (IRA) Convention in Detroit, Michigan, by six recipients of IRA citation awards are presented. Gates suggests steps IRA should take to revive and redirect reading research. McCallister discusses the implications of the changing and expanding vocabulary of…

  19. States Address Achievement Gaps.

    ERIC Educational Resources Information Center

    Christie, Kathy

    2002-01-01

    Summarizes 2 state initiatives to address the achievement gap: North Carolina's report by the Advisory Commission on Raising Achievement and Closing Gaps, containing an 11-point strategy, and Kentucky's legislation putting in place 10 specific processes. The North Carolina report is available at www.dpi.state.nc.us.closingthegap; Kentucky's…

  20. Addressing Sexual Harassment

    ERIC Educational Resources Information Center

    Young, Ellie L.; Ashbaker, Betty Y.

    2008-01-01

    This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

  1. Renewable Energy and Efficiency Modeling Analysis Partnership: An Analysis of How Different Energy Models Addressed a Common High Renewable Energy Penetration Scenario in 2025

    SciTech Connect

    Blair, N.; Jenkin, T.; Milford, J.; Short, W.; Sullivan, P.; Evans, D.; Lieberman, E.; Goldstein, G.; Wright, E.; Jayaraman, K.; Venkatech, B.; Kleiman, G.; Namovicz, C.; Smith, B.; Palmer, K.; Wiser, R.; Wood, F.

    2009-09-30

    /or different answers in response to a set of focused energy-related questions. The focus was on understanding reasons for model differences, not on policy implications, even though a policy of high renewable penetration was used for the analysis. A group process was used to identify the potential question (or questions) to be addressed through the project. In late 2006, increasing renewable energy penetration in the electricity sector was chosen from among several options as the general policy to model. From this framework, the analysts chose a renewable portfolio standard (RPS) as the way to implement the required renewable energy market penetration in the models. An RPS was chosen because it was (i) of interest and represented the group's consensus choice, and (ii) tractable and not too burdensome for the modelers. Because the modelers and analysts were largely using their own resources, it was important to consider the degree of effort required. In fact, several of the modelers who started this process had to discontinue participation because of other demands on their time. Federal and state RPS policy is an area of active political interest and debate. Recognizing this, participants used this exercise to gain insight into energy model structure and performance. The results are not intended to provide any particular insight into policy design or be used for policy advocacy, and participants are not expected to form a policy stance based on the outcomes of the modeling. The goals of this REMAP project - in terms of the main topic of renewable penetration - were to: (1) Compare models and understand why they may give different results to the same question, (2) Improve the rigor and consistency of assumptions used across models, and (3) Evaluate the ability of models to measure the impacts of high renewable-penetration scenarios.

  2. On the use of fuzzy logic assessment for high consequence implementation risk analysis

    SciTech Connect

    Spray, S.; Cooper, A.; Bennett, R.

    1994-05-01

    ``High consequence`` operations are systems, structures, and/or strategies for which it is crucial to provide assured protection against some potential catastrophe or catastrophes. The word ``catastrophe`` implies a significant loss of a resource (e.g., money, lives, health, environment, national security, etc.). The implementation of operations that are to be as catastrophe-free as possible must incorporate a very high level of protection. Unfortunately, real world limitations on available resources, mainly money and time, preclude absolute protection. For this reason, conventional ``risk analysis`` focuses on ``cost-effective`` protection, demonstrating through analysis that the benefits of any protective measures chosen outweigh their cost. This is a ``crisp`` one-parameter (usually monetary) comparison. A major problem with this approach, especially for high consequence operations, is that it may not be possible to accurately determine quantitative ``costs,`` and furthermore, the costs may not be accurately quantifiable. Similarly, it may not be possible to accurately determine or to quantify the benefits of protection in high consequence operations. These weaknesses are addressed in this paper by introducing multiple parameters instead of a single monetary measure both for costs of implementing protective measures and their benefits. In addition, a fuzzy-algebra comparison based on fuzzy number theory is introduced as a tool in providing cost/benefit tradeoff depiction, with the incorporation of measures of the uncertainty that necessarily exists in the input information. The result allows a more informative comparison to be made through use of fuzzy results, especially at the extreme bounds of the uncertainty.

  3. High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

    PubMed

    Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

    2007-01-01

    Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

  4. Schizophrenia--A High-Risk Factor for Suicides: Clues to Risk Reduction.

    ERIC Educational Resources Information Center

    Caldwell, Constance B.; Gottesman, Irving I.

    1992-01-01

    Notes that suicide is chief cause of premature death among schizophrenic persons, with lifetime incidence of suicide for patients with schizophrenia at 10-13% compared to general population estimate of 1%. Discusses salient risk factors for suicide in schizophrenics and types of especially vulnerable patients identified by research. Notes that…

  5. Framework for Modeling High-Impact, Low-Frequency Power Grid Events to Support Risk-Informed Decisions

    SciTech Connect

    Veeramany, Arun; Unwin, Stephen D.; Coles, Garill A.; Dagle, Jeffery E.; Millard, W. David; Yao, Juan; Glantz, Clifford S.; Gourisetti, Sri Nikhil Gup

    2015-12-03

    Natural and man-made hazardous events resulting in loss of grid infrastructure assets challenge the electric power grid’s security and resilience. However, the planning and allocation of appropriate contingency resources for such events requires an understanding of their likelihood and the extent of their potential impact. Where these events are of low likelihood, a risk-informed perspective on planning can be problematic as there exists an insufficient statistical basis to directly estimate the probabilities and consequences of their occurrence. Since risk-informed decisions rely on such knowledge, a basis for modeling the risk associated with high-impact low frequency events (HILFs) is essential. Insights from such a model can inform where resources are most rationally and effectively expended. The present effort is focused on development of a HILF risk assessment framework. Such a framework is intended to provide the conceptual and overarching technical basis for the development of HILF risk models that can inform decision makers across numerous stakeholder sectors. The North American Electric Reliability Corporation (NERC) 2014 Standard TPL-001-4 considers severe events for transmission reliability planning, but does not address events of such severity that they have the potential to fail a substantial fraction of grid assets over a region, such as geomagnetic disturbances (GMD), extreme seismic events, and coordinated cyber-physical attacks. These are beyond current planning guidelines. As noted, the risks associated with such events cannot be statistically estimated based on historic experience; however, there does exist a stable of risk modeling techniques for rare events that have proven of value across a wide range of engineering application domains. There is an active and growing interest in evaluating the value of risk management techniques in the State transmission planning and emergency response communities, some of this interest in the context of

  6. Funding At-Risk Compensatory Programs: An Urban High School Case Study.

    ERIC Educational Resources Information Center

    Reyes, Augustina

    1995-01-01

    A micro-finance analysis of site-based at-risk per pupil costs conducted at a Texas urban high school with high minority student enrollment revealed that 68 percent of the students exhibited state-defined, at-risk variables and that the highest program cost produced the highest achievement. (SLD)

  7. The Effects of an Academic Alternative High School on Academically At-Risk Students

    ERIC Educational Resources Information Center

    Winningham, Mark L.

    2012-01-01

    In a causal-comparative research design, this study investigated the effectiveness of an academic alternative school in improving at-risk student outcomes in a selected county school system in the Upper Cumberland region of Tennessee. The academic alternative high school was compared to a traditional high school serving at-risk populations.…

  8. The Relationship between Self-Efficacy and Achievement in At-Risk High School Students

    ERIC Educational Resources Information Center

    Gold, Jarrett Graham

    2010-01-01

    The focus of this quantitative survey study was the examination of the relationship between self-efficacy and academic achievement in 164 at-risk high school students. The study used Bandura's self-efficacy as the theoretical framework. The research questions involved understanding the levels of self-efficacy in at-risk high school students and…

  9. Dispositional Empathy in Neglectful Mothers and Mothers at High Risk for Child Physical Abuse

    ERIC Educational Resources Information Center

    de Paul, Joaquin; Perez-Albeniz, Alicia; Guibert, Maria; Asla, Nagore; Ormaechea, Amaia

    2008-01-01

    This study investigates whether mothers who are neglectful and at high risk for child physical abuse present a deficit in empathy. Participants were neglectful mothers (n = 37), mothers at high risk for child physical abuse (n = 22), and nonmaltreating mothers (n = 37). The Interpersonal Reactivity Index, a self-report measure assessing specific…

  10. High-Risk Health and Credit Behavior among 18- to 25-Year-Old College Students

    ERIC Educational Resources Information Center

    Adams, Troy; Moore, Monique

    2007-01-01

    The number of students accumulating credit card debt--and the amount of debt itself--on college campuses is increasing. If high-risk credit and health behavior are associated, health behavior interventions might apply to high-risk credit behavior. Objective: The authors' purpose was to examine these possible associations. Participants and Methods:…

  11. Interrupting the Inter-Generational Cycle in High Risk Adolescent Pregnancy.

    ERIC Educational Resources Information Center

    Stirtzinger, Ruth; McDermid, Stephanie; Grusec, Joan; Bernardini, Silvia; Quinlan, Kathy; Marshall, Michelle

    2002-01-01

    Describes the creation of a parenting course for high-risk adolescent mothers. This study supports direction away from 'knowledge-only' prevention/interventions with high risk adolescents and advocates the integration of this type of mental health/education parenting course with secondary school health class curricula using selected, trained…

  12. Eye-Tracking Measurements of Language Processing: Developmental Differences in Children at High Risk for ASD

    ERIC Educational Resources Information Center

    Chita-Tegmark, Meia; Arunachalam, Sudha; Nelson, Charles A.; Tager-Flusberg, Helen

    2015-01-01

    To explore how being at high risk for autism spectrum disorder (ASD), based on having an older sibling diagnosed with ASD, affects word comprehension and language processing speed, 18-, 24- and 36-month-old children, at high and low risk for ASD were tested in a cross-sectional study, on an eye gaze measure of receptive language that measured how…

  13. Gender Differences in Predicting High-Risk Drinking among Undergraduate Students

    ERIC Educational Resources Information Center

    Wilke, Dina J.; Siebert, Darcy Clay; Delva, Jorge; Smith, Michael P.; Howell, Richard L.

    2005-01-01

    The purpose of this study was to examine gender differences in college students' high-risk drinking as measured by an estimated blood alcohol concentration (eBAC) based on gender, height, weight, self-reported number of drinks, and hours spent drinking. Using a developmental/contextual framework, high-risk drinking is conceptualized as a function…

  14. Psychosocial Functioning in Youths at High Risk to Develop Major Depressive Disorder.

    ERIC Educational Resources Information Center

    Birmaher, Boris; Bridge, Jeffrey A.; Williamson, Douglas E.; Brent, David A.; Dahl, Ronald E.; Axelson, David A.; Dorn, Lorah D.; Ryan, Neal D.

    2004-01-01

    Objective: To compare the psychosocial functioning of children and adolescents at high risk of major depressive disorder with youths with acute major depressive disorder and healthy controls. Method: High-risk (n = 57), major depressive disorder (n = 71), and healthy control (n = 48) youths and their families were recruited from 1987 to 1996 and…

  15. The School-Community Guidance Center: Alternative Education for High-Risk Students 1988-89.

    ERIC Educational Resources Information Center

    Swanson, Lesley Anne; Baenen, Nancy

    The School-Community Guidance Center (SCGC) is an Austin, Texas alternative education program for high-risk students. It employs three project specialists to work with high-risk and delinquent students at two locations, Rice secondary school and a juvenile detention center. Most of the students are referred for disciplinary reasons. Students in…

  16. Prominent Pulmonary Metastases Without Concurrent Osseous Involvement in Patients With High-Risk Neuroblastoma.

    PubMed

    Bai, Xia; Zhuang, Hongming

    2017-02-13

    Metastases from high-risk neuroblastomas generally are to the bone or bone marrow. Multiple lung metastases are rare, especially when there was no concurrent osseous metastasis. We report 2 cases of high-risk neuroblastomas having prominent lung metastases without concurrent osseous lesion observed.

  17. Middle School Predictors of High School Performance: A Case Study of Dropout Risk Indicators

    ERIC Educational Resources Information Center

    McKee, M. Todd; Caldarella, Paul

    2016-01-01

    Dropping out of high school has negative results and implications for individuals and society. The likelihood of dropping out is attributed to both social and academic risk factors. Poor high school attendance, low course completion, and low grade-point-average (GPA) have been identified as three leading indicators that students are at risk for…

  18. Breast Cancer Susceptibility Genes in High Risk Women

    DTIC Science & Technology

    2005-12-01

    232-7. 32. Deapen D, Escalante A, Weinrib L, et al. A revised estimate of twin concordance in systemic lupus erythematosus [see comments]. Arthritis...duplicates do not have identical genotype and the cause for the discordancy ( systematic or isolated) will be determined. A second level of QC is provided...AM, Healey CS, Pharoah PD, Teare MD, Ponder BA, Easton DF. A systematic review of genetic polymorphisms and breast cancer risk. Cancer Epidemiology

  19. Endometriosis: a high-risk population for major chronic diseases?

    PubMed Central

    Kvaskoff, Marina; Mu, Fan; Terry, Kathryn L.; Harris, Holly R.; Poole, Elizabeth M.; Farland, Leslie; Missmer, Stacey A.

    2015-01-01

    BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If

  20. When the Single Matters more than the Group (II): Addressing the Problem of High False Positive Rates in Single Case Voxel Based Morphometry Using Non-parametric Statistics.

    PubMed

    Scarpazza, Cristina; Nichols, Thomas E; Seramondi, Donato; Maumet, Camille; Sartori, Giuseppe; Mechelli, Andrea

    2016-01-01

    In recent years, an increasing number of studies have used Voxel Based Morphometry (VBM) to compare a single patient with a psychiatric or neurological condition of interest against a group of healthy controls. However, the validity of this approach critically relies on the assumption that the single patient is drawn from a hypothetical population with a normal distribution and variance equal to that of the control group. In a previous investigation, we demonstrated that family-wise false positive error rate (i.e., the proportion of statistical comparisons yielding at least one false positive) in single case VBM are much higher than expected (Scarpazza et al., 2013). Here, we examine whether the use of non-parametric statistics, which does not rely on the assumptions of normal distribution and equal variance, would enable the investigation of single subjects with good control of false positive risk. We empirically estimated false positive rates (FPRs) in single case non-parametric VBM, by performing 400 statistical comparisons between a single disease-free individual and a group of 100 disease-free controls. The impact of smoothing (4, 8, and 12 mm) and type of pre-processing (Modulated, Unmodulated) was also examined, as these factors have been found to influence FPRs in previous investigations using parametric statistics. The 400 statistical comparisons were repeated using two independent, freely available data sets in order to maximize the generalizability of the results. We found that the family-wise error rate was 5% for increases and 3.6% for decreases in one data set; and 5.6% for increases and 6.3% for decreases in the other data set (5% nominal). Further, these results were not dependent on the level of smoothing and modulation. Therefore, the present study provides empirical evidence that single case VBM studies with non-parametric statistics are not susceptible to high false positive rates. The critical implication of this finding is that VBM can be used