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Sample records for address high risk

  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. 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.

  3. Applying an Environmental Model to Address High-Risk Drinking: A Town/Gown Case Study

    ERIC Educational Resources Information Center

    Bishop, John B.; Downs, Tracy T.; Cohen, Deborah

    2008-01-01

    This article provides a case study of a project by the University of Delaware and the City of Newark to apply an environmental model to address the excessive use of alcohol by college students. Data about changes in the behavior and experiences of students over a 10-year period are compared. The authors discuss some of the practical implications…

  4. 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…

  5. 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

  6. 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…

  7. 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…

  8. THE ROLE OF RISK ASSESSMENT IN ADDRESSING HAZARDOUS WASTE ISSUES

    EPA Science Inventory

    Risk assessment plays many important roles in addressing hazardous waste issues. In addition to providing a scientific framework and common health metric to evaluate risks. Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or "Superfund") risk assessm...

  9. 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. PMID:25655822

  10. 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.

  11. 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.

  12. 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.

  13. 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?

    PubMed

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

    2015-09-01

    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. PMID:26451244

  14. 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.

  15. 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.

  16. 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.

  17. Obesity in pregnancy: addressing risks to improve outcomes.

    PubMed

    Kriebs, Jan M

    2014-01-01

    The rapidly increasing rates of obesity among women of childbearing age, not only in the United States but also across the globe, contribute to increased risks during pregnancy and childbirth. Overweight and obesity are quantified by body mass index (BMI) for clinical purposes. In 2010, 31.9% of U.S. women aged 20 to 39 years met the definition of obesity, a BMI of 30 kg/m or greater. Across the life span, obesity is associated with increased risks of hypertension, cardiovascular disease, diabetes, sleep apnea, and other diseases. During pregnancy, increasing levels of prepregnancy BMI are associated with increases in both maternal and fetal/neonatal risks. This article reviews current knowledge about obesity in pregnancy and health risks related to increased maternal BMI, addresses weight stigma as a barrier to care and interventions that have evidence of benefit, and discusses the development of policies and guidelines to improve care.

  18. Addressing Cardiometabolic Risk During Treatment With Antipsychotic Medications

    PubMed Central

    Amiel, Jonathan M.; Mangurian, Christina V.; Ganguli, Rohan; Newcomer, John W.

    2009-01-01

    Purpose of Review To raise awareness of and inform evidence-based practice regarding medical and behavioral interventions for antipsychotic medication-induced metabolic abnormalities. Recent Findings The current literature indicates that individuals with severe and persistent mental illness have significantly worse health outcomes and premature mortality compared to the general population, due to a combination of under-recognition and treatment of medical risk factors, reduced access to care, sedentary lifestyle and poor diet, and the potential contribution of adverse metabolic side effects of antipsychotic medications like weight gain, hyperglycemia and dyslipidemia. A combination of administrative, behavioral and medical approaches to addressing these medical risks may be more effective than any one of these approaches alone. Summary Treatment with antipsychotic medications can induce significant weight gain and abnormalities in lipid and glucose metabolism that increase risk for cardiovascular disease and diabetes in a population already at risk from multiple other sources. Managing the side effects of antipsychotics and lowering risk in general is an important aspect of the management of chronic mental illness. There are a variety of effective medical and behavioral interventions that can be employed to achieve primary and secondary prevention aims. PMID:18852570

  19. 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.

  20. Addressing Occupational Fatigue in Nurses: A Risk Management Model for Nurse Executives.

    PubMed

    Steege, Linsey M; Pinekenstein, Barbara

    2016-04-01

    Addressing occupational fatigue in nursing work systems and mitigating associated risks to nurses require strategic management and high-level decision making as well as daily management through operational and tactical actions. Nurse executives are well positioned to lead implementation of a proposed multilevel fatigue risk management system that includes monitoring and decision-support tools to support a culture of safety and nurse well-being. PMID:27011153

  1. Addressing Occupational Fatigue in Nurses: A Risk Management Model for Nurse Executives.

    PubMed

    Steege, Linsey M; Pinekenstein, Barbara

    2016-04-01

    Addressing occupational fatigue in nursing work systems and mitigating associated risks to nurses require strategic management and high-level decision making as well as daily management through operational and tactical actions. Nurse executives are well positioned to lead implementation of a proposed multilevel fatigue risk management system that includes monitoring and decision-support tools to support a culture of safety and nurse well-being.

  2. 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

  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. 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…

  5. The new hospice compliance plan: defining and addressing risk areas.

    PubMed

    Jones, D H; Woods, K

    2000-05-01

    The Department of Health and Human Services' (HHS) Office of the Inspector General (OIG), has advised hospices and other health care providers to formulate effective controls to ensure compliance with federal and state statutes, rules, and regulations, and private-payor health care program requirements. The recently released guidelines provide a blueprint for developing such programs. This is the first of four installments that focus specifically on the 28 risk areas identified in the guidance and offer strategies for incorporating them in a hospice compliance program. The authors have organized the 28 risk areas under 9 topic domains to simplify the task of tackling the guidance. This article covers the first two areas: Admission/Certification/Recertification and Billing.

  6. 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.

  7. Traffic, Air Pollution, Minority and Socio-Economic Status: Addressing Inequities in Exposure and Risk

    PubMed Central

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

    2015-01-01

    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. PMID:25996888

  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

    2016-01-01

    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. PMID:26990389

  9. 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.

  10. 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.

  11. Maximizing the benefits and minimizing the risks of intervention programs to address micronutrient malnutrition: symposium report.

    PubMed

    Bruins, Maaike J; Kupka, Roland; Zimmermann, Michael B; Lietz, Georg; Engle-Stone, Reina; Kraemer, Klaus

    2016-10-01

    Interventions to address micronutrient deficiencies have large potential to reduce the related disease and economic burden. However, the potential risks of excessive micronutrient intakes are often not well determined. During the Global Summit on Food Fortification, 9-11 September 2015, in Arusha, a symposium was organized on micronutrient risk-benefit assessments. Using case studies on folic acid, iodine and vitamin A, the presenters discussed how to maximize the benefits and minimize the risks of intervention programs to address micronutrient malnutrition. Pre-implementation assessment of dietary intake, and/or biomarkers of micronutrient exposure, status and morbidity/mortality is critical in identifying the population segments at risk of inadequate and excessive intake. Dietary intake models allow to predict the effect of micronutrient interventions and their combinations, e.g. fortified food and supplements, on the proportion of the population with intakes below adequate and above safe thresholds. Continuous monitoring of micronutrient intake and biomarkers is critical to identify whether the target population is actually reached, whether subgroups receive excessive amounts, and inform program adjustments. However, the relation between regular high intake and adverse health consequences is neither well understood for many micronutrients, nor do biomarkers exist that can detect them. More accurate and reliable biomarkers predictive of micronutrient exposure, status and function are needed to ensure effective and safe intake ranges for vulnerable population groups such as young children and pregnant women. Modelling tools that integrate information on program coverage, dietary intake distribution and biomarkers will further enable program makers to design effective, efficient and safe programs. PMID:27501994

  12. Addressing Risk Assessment for Patient Safety in Hospitals through Information Extraction in Medical Reports

    NASA Astrophysics Data System (ADS)

    Proux, Denys; Segond, Frédérique; Gerbier, Solweig; Metzger, Marie Hélène

    Hospital Acquired Infections (HAI) is a real burden for doctors and risk surveillance experts. The impact on patients' health and related healthcare cost is very significant and a major concern even for rich countries. Furthermore required data to evaluate the threat is generally not available to experts and that prevents from fast reaction. However, recent advances in Computational Intelligence Techniques such as Information Extraction, Risk Patterns Detection in documents and Decision Support Systems allow now to address this problem.

  13. Addressing arsenic bioaccessibility in ecological risk assessment: a novel approach to avoid overestimating risk.

    PubMed

    Ollson, Christopher A; Koch, Iris; Smith, Paula; Knopper, Loren D; Hough, Chris; Reimer, Ken J

    2009-03-01

    The risk of arsenic exposure to deer mice (Peromyscus maniculatus) living in areas of naturally and anthropogenically elevated arsenic levels was determined using three separate calculations of arsenic daily intake: Estimated daily intake (EDI), bioaccessible EDI (BEDI), and actual daily intake (ADI). The present work is of particular interest, because the risk assessments were determined for animals naturally exposed to arsenic. Gastric fluid extraction was used to obtain bioaccessibility data for soil and plant samples collected from three study sites (background, mine forest, and tailings) in Yellowknife (NT, Canada). Calculations using the EDI indicated that deer mice living in tailings habitat (average soil arsenic concentration, 1,740 +/- 2,240 microg/g) should have been experiencing serious health effects as a result of their exposure to arsenic. Using BEDI and ADI in the risk assessment calculation, however, resulted in an order-of-magnitude decrease in calculated risk. In addition, results calculated using the BEDI and ADI were not significantly different, suggesting that using bioaccessibility provides a more realistic estimate of potential risk. The present results provide evidence that the use of EDI in traditional risk assessments may seriously overestimate the actual risk, which in some instances may result in expensive and unnecessary clean-up measures.

  14. 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.

  15. 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. PMID:21624662

  16. Adopting Open Source Software to Address Software Risks during the Scientific Data Life Cycle

    NASA Astrophysics Data System (ADS)

    Vinay, S.; Downs, R. R.

    2012-12-01

    Software enables the creation, management, storage, distribution, discovery, and use of scientific data throughout the data lifecycle. However, the capabilities offered by software also present risks for the stewardship of scientific data, since future access to digital data is dependent on the use of software. From operating systems to applications for analyzing data, the dependence of data on software presents challenges for the stewardship of scientific data. Adopting open source software provides opportunities to address some of the proprietary risks of data dependence on software. For example, in some cases, open source software can be deployed to avoid licensing restrictions for using, modifying, and transferring proprietary software. The availability of the source code of open source software also enables the inclusion of modifications, which may be contributed by various community members who are addressing similar issues. Likewise, an active community that is maintaining open source software can be a valuable source of help, providing an opportunity to collaborate to address common issues facing adopters. As part of the effort to meet the challenges of software dependence for scientific data stewardship, risks from software dependence have been identified that exist during various times of the data lifecycle. The identification of these risks should enable the development of plans for mitigating software dependencies, where applicable, using open source software, and to improve understanding of software dependency risks for scientific data and how they can be reduced during the data life cycle.

  17. 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.

  18. 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).

  19. 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.

  20. Introductory address: lessons to be learned from high altitude.

    PubMed Central

    Houston, C. S.

    1979-01-01

    A historical account of the important landmarks in man's experience with the high altitude environment is followed by comments on the important stages in the understanding of its physiological effects. The work of The Mount Logan High Altitude Physiology Study on acute mountain sickness is reviewed from its inception in 1967 until the present. PMID:386292

  1. The power of special friends: addressing the risk of child abuse through mentoring.

    PubMed

    Vertermark, P; Russell, J; Mulvey, N

    1995-01-01

    Since 1989 two Saint Paul, Minnesota agencies have carried on a collaborative effort called the Befriender Volunteer Project. This project is designed to address the risk factors associated with child abuse which are often inherent in families headed by an adolescent. Between November of 1993 and October of 1994 a self-study of this project was conducted. An important objective of this study was to determine how the positive elements of a successful relationship affected the risk factors in these young families. Consistent with what we know about the effects of successful helping relationships, most significant improvements in young mothers were found in the areas of hopefulness, self-esteem, and parenting skills. Of significant note was the observation of the various ways the Befriender/young mother relationship enhanced the young mothers' potential for breaking the generational cycle of risk for child abuse and neglect.

  2. Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors.

    PubMed

    Hung, Dorothy Y; Rundall, Thomas G; Tallia, Alfred F; Cohen, Deborah J; Halpin, Helen Ann; Crabtree, Benjamin F

    2007-01-01

    This study examines the Chronic Care Model (CCM) as a framework for preventing health risk behaviors such as tobacco use, risky drinking, unhealthy dietary patterns, and physical inactivity. Data were obtained from primary care practices participating in a national health promotion initiative sponsored by the Robert Wood Johnson Foundation. Practices owned by a hospital health system and exhibiting a culture of quality improvement were more likely to offer recommended services such as health risk assessment, behavioral counseling, and referral to community-based programs. Practices that had a multispecialty physician staff and staff dieticians, decision support in the form of point-of-care reminders and clinical staff meetings, and clinical information systems such as electronic medical records were also more likely to offer recommended services. Adaptation of the CCM for preventive purposes may offer a useful framework for addressing important health risk behaviors.

  3. Addressing the Uncertainty in Prescribing High Flows for River Restoration

    NASA Astrophysics Data System (ADS)

    Downs, P. W.; Sklar, L.; Braudrick, C. A.

    2002-12-01

    Flow prescriptions for environmental benefit in regulated rivers are commonly focused on the provision of minimum flow depths to achieve fish passage and holding habitat objectives. Assessment of these flows can be achieved readily and with reasonable confidence by using low-flow hydrological records and channel morphology data in combination with one dimensional hydraulic modeling. More recently, as understanding has increased of the critical role played by high flows in maintaining a wide range of habitats for instream and riparian flora and fauna, attention has turned to prescribing high flows to invoke the geomorphic processes that maintain suitable habitat niches. Prediction of the effects of these flows may require high-flow discharge and sediment transport data, high resolution topographic data, hydraulic and sediment transport modeling (often in two or three spatial dimensions), knowledge of the watershed historical context, and an understanding of the thresholds for channel morphological change. Not surprisingly, the associated level of uncertainty in this analysis increases tremendously. High flows are defined by a combination of magnitude, frequency, timing and duration parameters and their impact varies according to antecedent events. High flow bedload sediment transport records are rare, sediment transport equations are reliable usually to only an order of magnitude, practical applications of two and three-dimensional sediment transport models are in their infancy, the watershed historical record may be patchy with the link between cause and effect difficult to ascertain, and thresholds of channel morphological change are poorly understood. As the first step in reducing uncertainty, it is essential to state precisely the ecological target objectives of prescribed high flows, and to link these objectives to the hydraulic and geomorphic thresholds to be achieved or exceeded. Such thresholds provide the basis for a systematic classification of high flows

  4. 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.

  5. 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.

  6. 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

  7. 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

    2016-01-01

    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

  8. 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

    2016-01-01

    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

  9. 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

  10. Polybrominated Diphenyl Ethers: A Case Study for Using Biomonitoring Data to Address Risk Assessment Questions

    PubMed Central

    Birnbaum, Linda S.; Cohen Hubal, Elaine A.

    2006-01-01

    The use of biomonitoring data holds promise for characterizing exposure and informing risk assessment. Biomonitoring data have been used successfully to track population trends, identify susceptible populations, and provide indications of emerging environmental health issues. However, there remain challenges associated with interpreting biomonitoring data for risk assessment. An international biomonitoring workshop was convened in September 2004 to explore the use of biomonitoring data in the context of risk assessment. Six compounds were examined as case studies for this workshop, including polybrominated diphenyl ethers (PBDEs). The PBDE case study was developed to provide an example of a persistent compound for which relatively few data are available for human exposure, biomonitoring, and health outcomes. PBDEs are used in hard plastics, electronics, textiles, and polyurethane foam products. The congener pattern downstream of production facilities often resembles the commercial mixture. However, because these compounds persist in the environment and in biota, the patterns of congeners evolve. PBDEs partition into body lipids, and direct measurement of bromodiphenyl ether congeners in biologic specimens provides a good marker of exposure. Data indicate significant variability (> 100-fold range) in lipid-adjusted levels for PBDEs in the general population. It is hypothesized that both exposure and pharmacokinetics may play a role in observed congener profiles. Significant gaps in our ability to interpret PBDE biomonitoring data to address public health and risk assessment questions include limited knowledge of environmental fate and transport of PBDE congeners, limited population-based data for adults, and lack of data for potentially vulnerable populations such as children. PMID:17107866

  11. 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.

  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

    2016-01-01

    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

  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. 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.

  16. 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)

  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 multiple breast cancer risk factors in African-American women.

    PubMed Central

    Stolley, Melinda R.; Fitzgibbon, Marian L.; Wells, Anita; Martinovich, Zoran

    2004-01-01

    This pilot study explored the acceptability and feasibility of and estimated the effectiveness of a weight loss/breast health intervention designed to reduce breast cancer risk in African-American women ages 35-65. The study had a one-group repeated-measures design and took place in a community setting. Forty-four African-American women were recruited, 35 completed the program, and 30 returned for the one-year follow-up. The pilot intervention was three weeks in duration and included twice-weekly exercise classes and weekly active learning seminars that addressed weight loss, breast health, healthy eating, and leading an active life. Measures included those of behavior related to diet, physical activity, and breast health. Satisfaction questionnaires and focus groups were also used to assess acceptability and cultural competency. Statistical analyses included Paired t-tests and Wilcoxon signed ranks tests. Significant results postintervention showed improved physical activity, dietary, and breast health behaviors. Results suggest the acceptability, feasibility, and effectiveness of this comprehensive weight/loss breast health program in reducing multiple breast cancer risk factors among African-American women. PMID:14746356

  2. Addressing risk factors of cognitive impairment in adults aging with HIV: a social work model.

    PubMed

    Vance, David E; Struzick, Thomas C

    2007-01-01

    With advances in life-extending medications and later- life infections, the number of older adults with HIV is increasing. Unfortunately, the synergistic effects of aging with HIV may place many people at risk of developing cognitive impairments which can disrupt everyday functioning. Fortunately, cognitive reserve may be maintained, or in some cases improved, by taking action to prevent or mitigate such loss. Preventative and treatment strategies that support biopsychosocial aspects of cognition include reducing alcohol and substance use; improving nutrition; diminishing the effects of comorbidities; increasing social contact; reducing depression and stress levels; engaging in cognitively stimulating activities; applying cognitive remediation therapies; and incorporating psychopharmacological interventions. Such strategies can improve the physiological integrity and health of the brain, thus supporting neuroplasticity and increasing cognitive reserve. Social workers are in a favorable position to recognize cognitive decline in clients and recommend or administer solutions to address such problems. A model for social workers advocating for older clients with HIV who have cognitive problems is provided. PMID:17953062

  3. 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. PMID:26630979

  4. 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

  5. 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).

  6. 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...

  7. 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

    ... INFORMATION: I. Background In the Federal Register of June 29, 2009 (74 FR 31038), FDA announced the... 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...

  8. Risk Factors for High Blood Pressure

    MedlinePlus

    ... the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... can increase your risk for developing high blood pressure. Age Blood pressure tends to rise with age. About 65 ...

  9. MULTIVARIATE STATISTICAL APPLICATIONS FOR ADDRESSING MULTIPLE STRESSORS IN ECOLOGICAL RISK ASSESSMENTS

    EPA Science Inventory

    Ecological risk managers more and more frequently are asking how specific risk factors act in the environment within the context of the large number of natural stressor amount of variability that always have occurred. They wish to manage for cologically relevant solutions that wi...

  10. 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…

  11. 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. PMID:25290130

  12. 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.

  13. 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.

  14. 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

  15. 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...

  16. 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…

  17. 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. PMID:24787707

  18. Guidance for exposure design of human studies addressing health risk evaluations of mobile phones.

    PubMed

    Kuster, Niels; Schuderer, Jürgen; Christ, Andreas; Futter, Peter; Ebert, Sven

    2004-10-01

    Conflicting results have recently emerged from human provocation studies that addressed the possible health hazards of radio frequency (RF) field exposure from mobile phones. Different findings may have resulted from exposures that are poorly defined and difficult to compare. The aim of this study was to develop guidelines to facilitate the development of exposure systems for human volunteer studies which lead to reproducible results and which provide maximum relevance with respect to the assessment of the safety of mobile technology. The most important exposure parameters are discussed such as the signal, field distribution, and field strength, as well as the minimum requirements for the setup and dosimetry. PMID:15376239

  19. Guidance for exposure design of human studies addressing health risk evaluations of mobile phones.

    PubMed

    Kuster, Niels; Schuderer, Jürgen; Christ, Andreas; Futter, Peter; Ebert, Sven

    2004-10-01

    Conflicting results have recently emerged from human provocation studies that addressed the possible health hazards of radio frequency (RF) field exposure from mobile phones. Different findings may have resulted from exposures that are poorly defined and difficult to compare. The aim of this study was to develop guidelines to facilitate the development of exposure systems for human volunteer studies which lead to reproducible results and which provide maximum relevance with respect to the assessment of the safety of mobile technology. The most important exposure parameters are discussed such as the signal, field distribution, and field strength, as well as the minimum requirements for the setup and dosimetry.

  20. 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.

  1. Committee Opinion No. 582: addressing health risks of noncoital sexual activity.

    PubMed

    2013-12-01

    Noncoital sexual behavior is a common expression of human sexuality, which commonly cooccurs with coital behavior. Sexually transmitted infections, including human immunodeficiency virus (HIV), herpes simplex virus, human papillomavirus, hepatitis virus (types A, B, and C), syphilis, gonorrhea, and chlamydial infection, can be transmitted through noncoital sexual activity. When engaging in oral and anal sex, most individuals, including adolescents, are unlikely to use barrier protection for a variety of reasons, including a greater perceived safety of noncoital sexual activity compared with vaginal sex. Clinicians should assess patient sexually transmitted infection risk and provide risk reduction counseling accordingly. Clinicians should encourage and counsel patients regarding the correct and consistent use of condoms, barrier protection during oral sex, and cleaning of sex toys. Patients who engage in noncoital sexual activity also commonly have vaginal sex and may require contraceptive counseling. PMID:24264716

  2. Reducing Cardiovascular and Cancer Risk: How to Address Global Primary Prevention in Clinical Practice.

    PubMed

    Battistoni, Allegra; Mastromarino, Vittoria; Volpe, Massimo

    2015-06-01

    Emerging evidence suggesting the possibility that interventions able to prevent cardiovascular disease (CVD) may also be effective in the prevention of cancer have recently stimulated great interest in the medical community. In particular, data from both experimental and observational studies have demonstrated that aspirin may play a role in preventing different types of cancer. Although the use of aspirin in the secondary prevention of CVD is well established, aspirin in primary prevention is not systematically recommended because the absolute cardiovascular event reduction is similar to the absolute excess in major bleedings. By adding to its cardiovascular prevention benefits, the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in primary prevention in favor of the latter and broaden the indication for treatment with aspirin in populations at average risk. Prospective and randomized studies are currently investigating the effect of aspirin in prevention of both cancer and CVD; however, clinical efforts at the individual level to promote the use of aspirin in global (or total) primary prevention already could be made on the basis of a balanced evaluation of the benefit/risk ratio. PMID:25873555

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

    PubMed Central

    Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Robles, Eden Hernandez; 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 cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. PMID:25527143

  4. Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol

    PubMed Central

    2013-01-01

    Background Previous studies have shown the importance of paying attention to lay peoples’ interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic patients with high cholesterol interpret risk of cardiovascular disease. Methods Fourteen patients with high cholesterol and risk of cardiovascular disease were interviewed, and patterns across patient accounts were identified and analysed from an ethnographic approach. Results Information from the general practitioner about high cholesterol and risk of cardiovascular disease was reinterpreted in everyday social life. The risk associated with fatty foods was weighed against the pleasures of social and cultural events in which this type of food was common and cherished. A positive mindset was applied as a strategy to lower the risk of having high cholesterol, but knowledge about risk was viewed as a cause of anxiety and self-absorption, and this anxiety made the body susceptible to disease, hampering the chances for healthy life. Conclusion Interpretations of high cholesterol and risk of cardiovascular disease are embedded in social relations and everyday life concerns. This should be addressed in general practice in preference-sensitive cases about risk-reducing medication. Trial registration ClinicalTrials.gov: NCT01187056 PMID:24040920

  5. 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.

  6. The new hospice compliance plan: defining and addressing risk areas. Part 2.

    PubMed

    Jones, D H; Woods, K

    2000-06-01

    The Department of Health and Human Services' (HHS) Office of the Inspector General (OIG), has advised hospices and other health care providers to formulate effective controls to ensure compliance with federal and state statutes, rules, and regulations, and private-payor health care program requirements. This is the second of three installments that focus specifically on the 28 risk areas identified in the guidance and offer strategies for incorporating them in a hospice compliance program. This article covers the areas of Expensive Care, Documentation, Interdisciplinary Group, and Kickbacks.

  7. Resilience among High Risk Youth.

    ERIC Educational Resources Information Center

    McIntyre, Kevin; And Others

    This report focuses on children who are at risk for abusing alcohol and other drugs. It notes that the concept of risk factors is only one component necessary to understanding the range of youth drug-related behaviors. A second component, protective factors, is identified and defined as those aspects of a person's biology, psychology, and…

  8. Earthquake Seismic Risk Reduction in Ohio: ODNR's Efforts to Address Issues with Natural and Induced Seismicity

    NASA Astrophysics Data System (ADS)

    Besana-Ostman, G. M.

    2013-05-01

    With the increasing concerns regarding both natural and induced seismicity in Ohio, ODNR (Ohio Department of Natural Resources) initial efforts on seismic risk reduction paved way to various changes and improvement to tackle several major issues. For natural earthquakes, regional seismicity indicates a NE-SW structure in the northern portion of the area associated with a number of moderate historical earthquakes but no active trace identified. On the other hand, earthquakes of 1986 and 2011 are most probably incidents of induced seismicity that trigger more public uproar against disposal of regulated waste waters through injections. ODNR, in efforts to adapt with increasing need to regulate all operations related to both the Utica and Marcellus shale play within the state, had recently strengthen itself both through additional human resources and improved infrastructure. Tougher regulations and additional field tests were required that took effect immediately when a M4 earthquake was associated with the operations of an injection well. Public meetings were undertaken focused on educating many local inhabitants related to oil and gas operations, hydraulic fracturing, injection wells, and seismicity. Trainings for new and existing staff were regularly done especially for field inspection, data management and technology advancements. Considering the existing seismic stations that are few and distant related to sites of the injection wells, additional seismic stations were installed to gather baseline data and monitor for earthquakes within the injection area(s). Furthermore, to assess if the sites of the injection wells are safe from active structures, initial geomorphic and structural analyses indicated possible active faults in the northern portion of state oriented NE-SW. With the above-mentioned recent changes, ODNR had made a significant leap not only in the improvement of its principal regulatory role in the state for oil and gas operations but also in its

  9. 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

  10. From default probabilities to credit spreads: credit risk models explain market prices (Keynote Address)

    NASA Astrophysics Data System (ADS)

    Denzler, Stefan M.; Dacorogna, Michel M.; Muller, Ulrich A.; McNeil, Alexander J.

    2005-05-01

    Credit risk models like Moody's KMV are now well established in the market and give bond managers reliable default probabilities for individual firms. Until now it has been hard to relate those probabilities to the actual credit spreads observed on the market for corporate bonds. Inspired by the existence of scaling laws in financial markets by Dacorogna et al. 2001 and DiMatteo et al. 2005 deviating from the Gaussian behavior, we develop a model that quantitatively links those default probabilities to credit spreads (market prices). The main input quantities to this study are merely industry yield data of different times to maturity and expected default frequencies (EDFs) of Moody's KMV. The empirical results of this paper clearly indicate that the model can be used to calculate approximate credit spreads (market prices) from EDFs, independent of the time to maturity and the industry sector under consideration. Moreover, the model is effective in an out-of-sample setting, it produces consistent results on the European bond market where data are scarce and can be adequately used to approximate credit spreads on the corporate level.

  11. 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.

  12. 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…

  13. Risk Factors and Levels of Risk for High School Dropouts

    ERIC Educational Resources Information Center

    Suh, Suhyun; Suh, Jingyo

    2007-01-01

    The study in this article identifies three major risk categories of high school dropouts and evaluates the impact of possible prevention strategies. As students accumulate these risks, they became more likely to drop out and prevention programs become less effective. Additionally, it was found that factors influencing the decision to drop out vary…

  14. Addressing Shewanella oneidensis cytochromome : a first step towards high-throughput expression of cytochromes c.

    SciTech Connect

    Londer, Y. Y.; Giuliani, S.; Peppler, T.; Collart, F.; Biosciences Division

    2008-11-01

    Integrated studies that address proteins structure and function in the new era of systems biology and genomics often require the application of high-throughput approaches for parallel production of many different purified proteins from the same organism. Cytochromes c-electron transfer proteins carrying one or more hemes covalently bound to the polypeptide chain--are essential in most organisms. However, they are one of the most recalcitrant classes of proteins with respect to heterologous expression because post-translational incorporation of hemes is required for proper folding and stability. We have addressed this challenge by designing two families of vectors (total of 6 vectors) suitable for ligation-independent cloning and developing a pipeline for expression and solubility analysis of cytochromes c. This system has been validated by expression analysis of thirty genes from Shewanella oneidensis coding for cytochromes c or cytochromes c-type domains predicted to have 1-4 hemes. Out of 30 targets, 26 (87%) were obtained in soluble form in one or more vectors. This work establishes a methodology for high-throughput expression of this class of proteins and provides a clone resource for the microbiological and functional genomics research communities.

  15. 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

  16. High Blood Pressure May Hike Dementia Risk

    MedlinePlus

    ... medlineplus.gov/news/fullstory_161398.html High Blood Pressure May Hike Dementia Risk New statement from American ... MONDAY, Oct. 10, 2016 (HealthDay News) -- High blood pressure, particularly in middle age, might open the door ...

  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. 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.

  19. 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

  20. SY 04-1 CVD RISK PREDICTION IN HIGH-RISK VERSUS LOW-RISK POPULATIONS.

    PubMed

    Kim, Hyeon Chang

    2016-09-01

    Disease risk prediction models have been developed to assess the impact of multiple risk factors and to estimate an individual's absolute disease risk. Accurate disease prediction is essential for personalized prevention, because the benefits, risks, and costs of alternative strategies must be weighed to choose the best preventive strategy for individual patients. Cardiovascular disease (CVD) prediction is the earliest example of individual risk predictions. Since the Framingham study reported a CVD risk prediction method in 1976, an increasing number of risk assessment tools have been developed to CVD risk in various settings. The Framingham study results are fundamental evidence for the prediction of CVD risk. However, the clinical utility of a disease prediction model can be population-specific because the baseline disease risk, subtype distribution of the disease, and level of exposure to risk factors differ by region and ethnicity.It has been proved that CVD prediction models which were developed in high-risk populations, such as the Framingham Risk Score, overestimate an individual's disease risk when applied to a low-risk population without re-calibration. Thus countries of relatively low CVD risk are trying to re-calibrate the existing CVD prediction models or to develop a new prediction model analyzing their own population data. However, even the re-calibrated or newly-developed CVD prediction models are often of little clinical value in a low-risk population. A good example is the CVD prediction in the Korean population. Compared to Western populations, the Korean population has much lower incidence of coronary heart disease. Therefore, the vast majority of individuals fall into the low-risk group when their disease risk is assessed with a prediction model. Even a well-validated prediction model may not identify high-risk individuals who merit aggressive preventive treatment.A few alternative approaches have been suggested for CVD risk prediction in a low-risk

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. When the risks are high: psychological adjustment among melanoma survivors at high risk of developing new primary disease.

    PubMed

    McLoone, Jordana; Watts, Kaaren; Menzies, Scott; Meiser, Bettina; Butow, Phyllis; Kasparian, Nadine

    2012-08-01

    In this study we explored the psychosocial experiences of melanoma survivors at high risk of developing new primary disease. A total of 20 survivors (9 men, 11 women, mean age 57.6 years) completed a semistructured telephone interview, exploring melanoma-related beliefs and experiences, psychological adjustment to melanoma risk, and supportive care needs. Participants perceived melanoma as potentially terminal and reported persistent worries about the possibility of developing new or metastatic disease. Fear of developing a new melanoma endured for years after treatment completion and, for some, created a pervasive sense of uncertainty. Still, not a single participant sought formal emotional support to address his or her melanoma-related concerns. Belief in the benefits of early intervention, including self- and clinical skin examination, provided a sense of control and a recommended course of action in an otherwise uncontrollable situation. The expertise of the High Risk Clinic physicians was perceived as instrumental in creating a sense of reassurance.

  6. Highly sensitive covalently functionalized light-addressable potentiometric sensor for determination of biomarker.

    PubMed

    Liang, Jintao; Guan, Mingyuan; Huang, Guoyin; Qiu, Hengming; Chen, Zhengcheng; Li, Guiyin; Huang, Yong

    2016-06-01

    A biomarker is related to the biological status of a living organism and shows great promise for the early prediction of a related disease. Herein we presented a novel structured light-addressable potentiometric sensor (LAPS) for the determination of a model biomarker, human immunoglobulin G (hIgG). In this system, the goat anti-human immunoglobulin G antibody was used as recognition element and covalently immobilized on the surface of light-addressable potentiometric sensor chip to capture human immunoglobulin G. Due to the light addressable capability of light-addressable potentiometric sensor, human immunoglobulin G dissolved in the supporting electrolyte solution can be detected by monitoring the potential shifts of the sensor. In order to produce a stable photocurrent, the laser diode controlled by field-programmable gate array was used as the light emitter to drive the light-addressable potentiometric sensor. A linear correlation between the potential shift response and the concentration of human immunoglobulin G was achieved and the corresponding regression equation was ΔV (V)=0.00714ChIgG (μg/mL)-0.0147 with a correlation coefficient of 0.9968 over a range 0-150 μg/mL. Moreover, the light-addressable potentiometric sensor system also showed acceptable stability and reproducibility. All the results demonstrated that the system was more applicable to detection of disease biomarkers with simple operation, multiple-sample format and might hold great promise in various environmental, food, and clinical applications.

  7. Predicting patients with high risk of becoming high-cost healthcare users in Ontario (Canada).

    PubMed

    Chechulin, Yuriy; Nazerian, Amir; Rais, Saad; Malikov, Kamil

    2014-02-01

    Literature and original analysis of healthcare costs have shown that a small proportion of patients consume the majority of healthcare resources. A proactive approach is to target interventions towards those patients who are at risk of becoming high-cost users (HCUs). This approach requires identifying high-risk patients accurately before substantial avoidable costs have been incurred and health status has deteriorated further. We developed a predictive model to identify patients at risk of becoming HCUs in Ontario. HCUs were defined as the top 5% of patients incurring the highest costs. Information was collected on various demographic and utilization characteristics. The modelling technique used was logistic regression. If the top 5% of patients at risk of becoming HCUs are followed, the sensitivity is 42.2% and specificity is 97%. Alternatives for implementation of the model include collaboration between different levels of healthcare services for personalized healthcare interventions and interventions addressing needs of patient cohorts with high-cost conditions. PMID:24726075

  8. 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

  9. Counseling the high-risk adolescent.

    PubMed

    Busen, N H

    1992-01-01

    Interviewing and counseling high-risk adolescents provides a challenge to nurse practitioners. The problems of poverty, substance abuse, mental illness, and low self-esteem overlay other characteristics of risk, making assessment and management of the adolescent's problems complex and difficult. Survey data, obtained in this study on adolescent risk-taking, suggest that violence, aggression, and thrill-seeking behaviors are increasingly common. The finding is supported by current national statistics on adolescents. A case study is used to show the process of gathering information on home and educational settings that can provide insight into family dysfunction and specific problem behaviors.

  10. 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.

  11. HCV epidemiology in high-risk groups and the risk of reinfection.

    PubMed

    Midgard, Håvard; Weir, Amanda; Palmateer, Norah; Lo Re, Vincent; Pineda, Juan A; Macías, Juan; Dalgard, Olav

    2016-10-01

    Injecting risk behaviours among people who inject drugs (PWID) and high-risk sexual practices among men who have sex with men (MSM) are important routes of hepatitis C virus (HCV) transmission. Current direct-acting antiviral treatment offers unique opportunities for reductions in HCV-related liver disease burden and epidemic control in high-risk groups, but these prospects could be counteracted by HCV reinfection due to on-going risk behaviours after successful treatment. Based on existing data from small and heterogeneous studies of interferon-based treatment, the incidence of reinfection after sustained virological response range from 2-6/100 person years among PWID to 10-15/100 person years among human immunodeficiency virus-infected MSM. These differences mainly reflect heterogeneity in study populations with regards to risk behaviours, but also reflect variations in study designs and applied virological methods. Increasing levels of reinfection are to be expected as we enter the interferon-free treatment era. Individual- and population-level efforts to address and prevent reinfection should therefore be undertaken when providing HCV care for people with on-going risk behaviour. Constructive strategies include acknowledgement, education and counselling, harm reduction optimization, scaled-up treatment including treatment of injecting networks, post-treatment screening, and rapid retreatment of reinfections. PMID:27641987

  12. HCV epidemiology in high-risk groups and the risk of reinfection.

    PubMed

    Midgard, Håvard; Weir, Amanda; Palmateer, Norah; Lo Re, Vincent; Pineda, Juan A; Macías, Juan; Dalgard, Olav

    2016-10-01

    Injecting risk behaviours among people who inject drugs (PWID) and high-risk sexual practices among men who have sex with men (MSM) are important routes of hepatitis C virus (HCV) transmission. Current direct-acting antiviral treatment offers unique opportunities for reductions in HCV-related liver disease burden and epidemic control in high-risk groups, but these prospects could be counteracted by HCV reinfection due to on-going risk behaviours after successful treatment. Based on existing data from small and heterogeneous studies of interferon-based treatment, the incidence of reinfection after sustained virological response range from 2-6/100 person years among PWID to 10-15/100 person years among human immunodeficiency virus-infected MSM. These differences mainly reflect heterogeneity in study populations with regards to risk behaviours, but also reflect variations in study designs and applied virological methods. Increasing levels of reinfection are to be expected as we enter the interferon-free treatment era. Individual- and population-level efforts to address and prevent reinfection should therefore be undertaken when providing HCV care for people with on-going risk behaviour. Constructive strategies include acknowledgement, education and counselling, harm reduction optimization, scaled-up treatment including treatment of injecting networks, post-treatment screening, and rapid retreatment of reinfections.

  13. 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)

  14. 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.

  15. Guaranteed Student Loans: GAO High Risk Series.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    As part of a larger program to identify and analyze federal programs at high risk for waste, fraud, abuse and mismanagement, this publication presents an evaluation of the Federal Family Education Loan Program (FFELP), formerly the Guaranteed Student Loan Program. The analysis argues that the program has not been successful in protecting the…

  16. 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,...

  17. Creating Profiles of High Risk Students.

    ERIC Educational Resources Information Center

    Higbee, Jeanne L.; Dwinell, Patricia L.

    Measures used at the Division of Developmental Studies at the University of Georgia in constructing a student profile (specifically, of high-risk college freshmen) are discussed. The areas measured concern: goals; learning styles; career exploration; stress and academic anxiety; developmental tasks; and locus of control. The goals checklist…

  18. High risk groups in oil shale workforce

    SciTech Connect

    Gratt, L.B.; Perry, B.W.; Marine, W.M.; Savitz, D.A.

    1984-04-01

    The workforce risks of a hypothetical one million barrels-per-day oil shale industry were estimated. The risks for the different workforce segments were compared and high risk groups were identified. Accidents and injuries were statistically described by rates for fatalities, for accidents with days lost from work, and for accidents with no days lost from work. Workforce diseases analyzed were cancers, silicosia, pneumoconiosis, chronic bronchitis, chronic airway obstruction, and high frequency hearing loss. A comparison of the workforce groups under different risk measures (occurrence, fatality, and life-loss expectancy) was performed. The miners represented the group with the largest fatality and the most serious accident rate, although the estimated rates were below the average industry-wide underground mining experience. Lung disease from inhalation exposure of about the nuisance dust threshold limit value presents a significant risk for future concerns. If future environmental dust exposure is at the 100 ..mu..g/m/sup 3/ alpha-quartz level, safety improvements in the mining sector are of prime importance to reduce the oil shale worker's life-loss expectancy. 11 references, 1 figure, 11 tables.

  19. 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.

  20. 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…

  1. 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

  2. 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

  3. 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.

  4. 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…

  5. The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women

    PubMed Central

    Katz, Kathy S; Blake, Susan M; Milligan, Renee A; Sharps, Phyllis W; White, Davene B; Rodan, Margaret F; Rossi, Maryann; Murray, Kennan B

    2008-01-01

    Background African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. Methods Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with < 4 sessions considered minimal adherence) for all enrolled women (n = 1,044), and perceptions of study participation from a sub-sample of those enrolled (n = 152) are reported. Results Forty-eight percent of women screened were eligible based on presence of targeted risks, 76% of those eligible were enrolled, and 79% of those enrolled were retained postpartum. Most women reported a single risk factor (61%); 39% had multiple risks. Eighty-four percent of intervention women attended at least one session (60% attended ≥ 4 sessions) without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were

  6. 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. PMID:25963556

  7. 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.

  8. The high-risk myocardial infarction database initiative.

    PubMed

    Dickstein, Kenneth; Bebchuk, Judith; Wittes, Janet

    2012-01-01

    Coronary artery disease and myocardial infarction represent a major cause of morbidity and mortality. Four randomized, controlled, double-blind clinical trials--VALIANT, EPHESUS, OPTIMAAL, and CAPRICORN evaluated pharmacologic intervention in a total of 28,771 high-risk patients following acute MI complicated with signs of heart failure or evidence of left ventricular dysfunction. The demographic profiles of the 4 study cohorts were similar. The High-Risk MI Database Initiative constructed a common database by merging the data captured by these 4 large trials. The merged data set did not contain the randomized study treatment, so no comparisons could be made between the agents investigated. A total of more than 17,600 subjects experienced a cardiovascular end point. Approximately 5100 deaths occurred, and more than 15,700 subjects experienced a hospitalization. The primary objectives of this initiative were to use this large database to define more precisely the prognostic profile of this high-risk population, to perform rigorous, adequately-sized, subset analyses, to provide epidemiologic information and event rate estimation based on baseline demographics. The methodological challenges and limitations of such an analyses are discussed. It is proposed that some thoughtful foresight and planning could enable us to use the large number of clinical events that accrue during randomized clinical trials to address questions of scientific and clinical interest. PMID:22226005

  9. Risk of Anal Cancer in People Living with HIV: Addressing Anal Health in the HIV Primary Care Setting.

    PubMed

    Walker, Crystal Martin; Likes, Wendy; Bernard, Marye; Kedia, Satish; Tolley, Elizabeth

    2016-01-01

    Anal health and anal cancer are rarely addressed in HIV primary care. We sought to understand factors that impeded or promoted addressing anal health in HIV primary care from providers' perspectives. In this exploratory study, HIV primary care providers from the Mid-South region of the United States participated in brief individual interviews. We analyzed transcribed data to identify barriers and facilitators to addressing anal health. Our study sample included five physicians and four nurse practitioners. The data revealed a number of barriers such as perception of patient embarrassment, provider embarrassment, external issues such as time constraints, demand of other priorities, lack of anal complaints, lack of resources, and gender discordance. Facilitators included awareness, advantageous circumstances, and the patient-provider relationship. Anal health education should be prioritized for HIV primary care providers. Preventive health visits should be considered to mitigate time constraints, demands for other priorities, and unequal gender opportunities. PMID:27080925

  10. 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

  11. Treatment of high-risk neuroblastoma.

    PubMed

    Sung, Ki Woong

    2012-04-01

    Although high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) have improved the prognosis for patients with high-risk neuroblastoma (NB), event-free survival rates remain in the range of 30 to 40%, which is unsatisfactory. To further improve outcomes, several clinical trials, including tandem HDCT/autoSCT, high-dose (131)I-metaiodobenzylguanidine treatment, and immunotherapy with NB specific antibody, have been undertaken and pilot studies have reported encouraging results. Nonetheless, about half of high-risk NB patients still experience treatment failure and have no realistic chance for cure with conventional treatment options alone after relapse. Therefore, a new modality of treatment is warranted for these patients. In recent years, several groups of investigators have examined the feasibility and effectiveness of reduced-intensity allogeneic stem cell transplantation (RI alloSCT) for the treatment of relapsed/progressed NB. Although a graft-versus-tumor effect has not yet been convincingly demonstrated in the setting of relapsed NB, the strategy of employing RI alloSCT has provided hope that treatment-related mortality will be reduced and a therapeutic benefit will emerge. However, alloSCT for NB is still investigational and there remain many issues to be elucidated in many areas. At present, alloSCT is reserved for specific clinical trials testing the immunomodulatory effect against NB.

  12. 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

    ... Trent Franks, U.S. House of Representatives. 10:35 a.m. Introductions; Commissioner Cheryl LaFleur... 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....

  13. 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.

  14. 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.

  15. 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. PMID:26590245

  16. 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…

  17. 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.

  18. 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. PMID:27376795

  19. Do Clinical Standards for Diabetes Care Address Excess Risk for Hypoglycemia in Vulnerable Patients? A Systematic Review

    PubMed Central

    Berkowitz, Seth A; Aragon, Katherine; Hines, Jonas; Seligman, Hilary; Lee, Sei; Sarkar, Urmimala

    2013-01-01

    Objective To determine whether diabetes clinical standards consider increased hypoglycemia risk in vulnerable patients. Data Sources MEDLINE, the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, and supplemental sources. Study Design Systematic review of clinical standards (guidelines, quality metrics, or pay-for-performance programs) for glycemic control in adult diabetes patients. The primary outcome was discussion of increased risk for hypoglycemia in vulnerable populations. Data Collection/Extraction Methods Manuscripts identified were abstracted by two independent reviewers using prespecified inclusion/exclusion criteria and a standardized abstraction form. Principal Findings We screened 1,166 titles, and reviewed 220 manuscripts in full text. Forty-four guidelines, 17 quality metrics, and 8 pay-for-performance programs were included. Five (11 percent) guidelines and no quality metrics or pay-for-performance programs met the primary outcome. Conclusions Clinical standards do not substantively incorporate evidence about increased risk for hypoglycemia in vulnerable populations. PMID:23445498

  20. 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…

  1. The role of risk perceptions in the risk mitigation process: the case of wildfire in high risk communities.

    PubMed

    Martin, Wade E; Martin, Ingrid M; Kent, Brian

    2009-01-01

    An important policy question receiving considerable attention concerns the risk perception-risk mitigation process that guides how individuals choose to address natural hazard risks. This question is considered in the context of wildfire. We analyze the factors that influence risk reduction behaviors by homeowners living in the wildland-urban interface. The factors considered are direct experience, knowledge of wildfire risk, locus of responsibility, fulltime/seasonal status, and self-efficacy. Survey data from three homeowner associations in the western U.S. are used to estimate the direct and indirect effects of this relationship. Our results indicate that the effects of knowledge and locus of responsibility are mediated by homeowners' risk perceptions. We also find that beliefs of self-efficacy and fulltime/seasonal status have a direct influence on risk reduction behaviors. Finally, we find, surprisingly, that direct experience with wildfire does not directly influence the risk perception-risk mitigation process.

  2. Language Deficits in Children at High Risk for Drug Abuse.

    ERIC Educational Resources Information Center

    Najam, Najma; Tarter, Ralph E.; Kirisci, Levent

    1997-01-01

    Compared the language capacities of children at high risk for substance abuse to low-risk children to uncover focal areas of deficit. Results indicate that high-risk subjects' performance was significantly poorer on several measures of language ability. Findings suggest that poor language mediation increases the risk for substance abuse. (RJM)

  3. 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…

  4. 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…

  5. Youth Risk Behavior Surveillance--National Alternative High School 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.

    1999-01-01

    The Alternative High School Youth Risk Behavior Survey (ALT-YRBS) is one component of the Youth Risk Behavior Surveillance System (YRBSS), which monitors six categories of health risk behaviors among youth and young adults. The 1998 ALT-YRBS measured priority health risk behaviors among students at alternative high schools. It used a three-stage…

  6. 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

  7. 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…

  8. 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. PMID:23767788

  9. High-Risk Childhood Acute Lymphoblastic Leukemia

    PubMed Central

    Bhojwani, Deepa; Howard, Scott C.; Pui, Ching-Hon

    2009-01-01

    Although most children with acute lymphoblastic leukemia (ALL) are cured, certain subsets have a high risk of relapse. Relapse risk can be predicted by early response to therapy, clinical and pharmacogenetic features of the host, and genetic characteristics of leukemic cells. Though early treatment response can be assessed by the peripheral blast cell count after 1 week of single-agent glucocorticoid treatment or percent of bone marrow blasts by morphology after 1 or 2 weeks of multiagent induction treatment, determination of minimal residual disease by polymerase chain reaction (PCR) or flow cytometry after 2 to 6 weeks of induction is the most precise and useful measure. Augmented therapy has improved outcome for the poor responders to initial treatment. Infants with mixed-lineage leukemia (MLL)–rearranged ALL comprise a very poor-risk group wherein further intensification of chemotherapy causes significant toxicity. Hybrid protocols incorporating drugs effective for acute myeloid leukemia could improve survival, a strategy being tested in international trials. Studies on the biology of MLL-induced leukemogenesis have prompted the development of novel targeted agents, currently under evaluation in clinical trials. Short-term outcomes of patients with Philadelphia chromosome (Ph)–positive ALL have improved significantly by adding tyrosine kinase inhibitors to standard chemotherapy regimens. New agents and methods to overcome resistance are under investigation, and allogeneic stem cell transplantation is recommended for certain subsets of patients, for example those with Ph+ and T-cell ALL with poor early response. Genome-wide interrogation of leukemic cell genetic abnormalities and germline genetic variations promise to identify new molecular targets for therapy. PMID:19778845

  10. High resolution fire risk mapping in Italy

    NASA Astrophysics Data System (ADS)

    Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

    2014-05-01

    The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

  11. 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.

  12. Faith-Based Institutions and High-Risk Youth. First Report to the Field. Field Report Series.

    ERIC Educational Resources Information Center

    Trulear, Harold Dean

    Building on a survey of the role of religious institutions in programs for high-risk youth and consultations with experts in the field, a field demonstration project was implemented to test strategies for using religious institutions to anchor local partnerships aimed at high-risk youth. The partnerships were designed to address the developmental…

  13. Biochemical recurrence risk factors in surgically treated high and very high-risk prostate tumors

    PubMed Central

    Bañuelos, Beatriz; Díez, Jesús; Alonso-Dorrego, Jose María; Cisneros, Jesus; Peña, Javier

    2015-01-01

    Introduction High and very high-risk prostate cancers are tumors that display great variation in their progression, making their behaviour and consequent prognosis difficult to predict. We analyse preoperative and postoperative risk factors that could influence biochemical recurrence of these tumors. Material and methods We carried out univariate and multivariate analyses in an attempt to establish statistically significant preoperative (age, rectal examination, PSA, biopsy Gleason score, uni/bilateral tumor, affected cylinder percentage) and postoperative (pT stage, pN lymph node affectation, Gleason score, positive surgical margins, percentage of tumor affectation, perineural infiltration) risk factors, as well as their relationship with biochemical recurrence (PSA >0.2 ng/mL). Results We analysed 276 patients with high and very high-risk prostate cancer that were treated with laparoscopic radical prostatectomy (LRP) between 2003-2007, with a mean follow-up of 84 months. Incidence of biochemical recurrence is 37.3%. Preoperative factors with the greatest impact on recurrence are suspicious rectal exam (OR 2.2) and the bilateralism of the tumor in the biopsy (OR 1.8). Among the postoperative factors, the presence of a LRP positive surgical margins (OR 3.4) showed the greatest impact, followed by the first grade of the Gleason score (OR 3.3). Conclusions The factor with the greatest influence on biochemical recurrence when it comes to surgery and high and very high-risk prostate cancer is the presence of a positive margin, followed by the Gleason score. Preoperative factors (PSA, biopsy Gleason score, rectal examination, number of affected cylinders) offered no guidance concerning the incidence of BCR. PMID:26568870

  14. 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

  15. Addressing missing covariates for the regression analysis of competing risks: Prognostic modelling for triaging patients diagnosed with prostate cancer.

    PubMed

    Escarela, Gabriel; Ruiz-de-Chavez, Juan; Castillo-Morales, Alberto

    2016-08-01

    Competing risks arise in medical research when subjects are exposed to various types or causes of death. Data from large cohort studies usually exhibit subsets of regressors that are missing for some study subjects. Furthermore, such studies often give rise to censored data. In this article, a carefully formulated likelihood-based technique for the regression analysis of right-censored competing risks data when two of the covariates are discrete and partially missing is developed. The approach envisaged here comprises two models: one describes the covariate effects on both long-term incidence and conditional latencies for each cause of death, whilst the other deals with the observation process by which the covariates are missing. The former is formulated with a well-established mixture model and the latter is characterised by copula-based bivariate probability functions for both the missing covariates and the missing data mechanism. The resulting formulation lends itself to the empirical assessment of non-ignorability by performing sensitivity analyses using models with and without a non-ignorable component. The methods are illustrated on a 20-year follow-up involving a prostate cancer cohort from the National Cancer Institutes Surveillance, Epidemiology, and End Results program.

  16. Scuba diving: how high the risk?

    PubMed

    Smith, N

    1995-01-01

    The host factors that represent the most risk for scuba-diving safety are poor fitness, overweight, chronic diseases, structural abnormalities of the heart and lungs, and multiple risk factors for CAD. Any of these factors, plus inexperience, a history of irresponsible behavior, or participation in technical diving should alert medical underwriting that a scuba diver has excess risk for fatal accidents.

  17. Modeling HIV Risk in Highly Vulnerable Youth

    ERIC Educational Resources Information Center

    Huba, G. J.; Panter, A. T.; Melchior, Lisa A.; Trevithick, Lee; Woods, Elizabeth R.; Wright, Eric; Feudo, Rudy; Tierney, Steven; Schneir, Arlene; Tenner, Adam; Remafedi, Gary; Greenberg, Brian; Sturdevant, Marsha; Goodman, Elizabeth; Hodgins, Antigone; Wallace, Michael; Brady, Russell E.; Singer, Barney; Marconi, Katherine

    2003-01-01

    This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a…

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

    PubMed Central

    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 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. PMID:26194205

  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. New dimensions in the care of high risk pregnancy.

    PubMed

    Sanchez, P

    1989-01-01

    In June 1989, the past president of the Philippine Nurses Association spoke at the annual convention of the Maternal Child Nurses Association at the Children's Medical Center in Quezon City. She addressed maternal health and high risk pregnancies in the Philippines. The maternal mortality rate was 90/100,000 live births each year. It was 4-5 times higher among remote tribes such as the Muslims of Sulu than the national rate. 54% of maternal deaths were attributed to pregnancy complications especially eclampsia (28%). About 2 million women experienced pregnancy annually and almost 1 million had anemia or were malnourished. 20% of these 1 million women gave birth to low birth weight infants who were at high risk of death from infections. About 574,000 out of 1.4 million infants born annually were unwanted. 63% of pregnant women each year did not want any children. Nurses can play an important role to reduce suffering and death among mothers and infants if they practice good health teaching. For example, they can inform mothers about child spacing and birth limiting. They can also identify high risk pregnancies and refer them to other health professionals to manage them. In September 1987, the Philippines Department of Health sponsored a conference on maternal health. Participants made 6 resolutions. The 1st resolution was to consider maternal mortality an indicator of Health for All by year 2000. They also resolved to declare 1988-97 the Decade of Safe Motherhood which included the creation of a multisectoral task force under the Department of Health. The speaker concluded by encouraging Philippine nurses to resist the temptation to work abroad to make more money and instead stay in the Philippines to care for their own people.

  1. 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

  2. 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. PMID:27249706

  3. 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.

  4. Addressing Concerns.

    ERIC Educational Resources Information Center

    Cronin, Greg; Helmig, Mary; Kaplan, Bill; Kosch, Sharon

    2002-01-01

    Four camp directors discuss how the September 11 tragedy and current world events will affect their camps. They describe how they are addressing safety concerns, working with parents, cooperating with outside agencies, hiring and screening international staff, and revising emergency plans. Camps must continue to offer community and support to…

  5. Step UP: Retaining High-Risk Students and Transforming the College Culture

    ERIC Educational Resources Information Center

    Frankel, Susan; Gale, Melodie; Walton, Peggy

    2009-01-01

    Step UP addresses retention of high-risk students through tapping into Howard Community College's finest qualities. The program encourages employees from all constituencies to engage and connect with students in a unique and personal way by implementing life coaching skills.

  6. Early Patterns of Parent and Child Behavior: Can We Identify High and Low Risk Combinations?

    ERIC Educational Resources Information Center

    This study addresses itself to the development of a valid method for identifying a high-risk group of preschool children. The design used is longitudinal and attempts to relate early child and parent behavior patterns to various outcome measures as the child grows older. This paper reports the behavior patterns of a group of two-year-olds and how…

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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. PMID:23487896

  12. [Anesthesiological management of the high-risk surgical patient].

    PubMed

    Bertoldi, G; Avalle, M

    1980-03-01

    Evaluation of the anaesthesiological risk in surgical patients is described and an account is given of results obtained with an association of ketamin and NLA II in 57 high-risk patients subjected to general surgical management.

  13. 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.

  14. 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),…

  15. [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.

  16. 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.

  17. A meta-analysis of asbestos-related cancer risk that addresses fiber size and mineral type.

    PubMed

    Berman, D Wayne; Crump, Kenny S

    2008-01-01

    Quantitative estimates of the risk of lung cancer or mesothelioma in humans from asbestos exposure made by the U.S. Environmental Protection Agency (EPA) make use of estimates of potency factors based on phase-contrast microscopy (PCM) and obtained from cohorts exposed to asbestos in different occupational environments. These potency factors exhibit substantial variability. The most likely reasons for this variability appear to be differences among environments in fiber size and mineralogy not accounted for by PCM. In this article, the U.S. Environmental Protection Agency (EPA) models for asbestos-related lung cancer and mesothelioma are expanded to allow the potency of fibers to depend upon their mineralogical types and sizes. This is accomplished by positing exposure metrics composed of nonoverlapping fiber categories and assigning each category its own unique potency. These category-specific potencies are estimated in a meta-analysis that fits the expanded models to potencies for lung cancer (KL's) or mesothelioma (KM's) based on PCM that were calculated for multiple epidemiological studies in our previous paper (Berman and Crump, 2008). Epidemiological study-specific estimates of exposures to fibers in the different fiber size categories of an exposure metric are estimated using distributions for fiber size based on transmission electron microscopy (TEM) obtained from the literature and matched to the individual epidemiological studies. The fraction of total asbestos exposure in a given environment respectively represented by chrysotile and amphibole asbestos is also estimated from information in the literature for that environment. Adequate information was found to allow KL's from 15 epidemiological studies and KM's from 11 studies to be included in the meta-analysis. Since the range of exposure metrics that could be considered was severely restricted by limitations in the published TEM fiber size distributions, it was decided to focus attention on four

  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. 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

  1. 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. PMID:20629244

  2. Thromboembolism Prophylaxis in Hip Arthroplasty: Routine and High Risk Patients.

    PubMed

    Nam, Denis; Nunley, Ryan M; Johnson, Staci R; Keeney, James A; Clohisy, John C; Barrack, Robert L

    2015-12-01

    This study's purpose was to present the use of a risk stratification protocol in which "routine" risk patients receive a mobile compression device with aspirin and "high" risk patients receive warfarin for thromboprophylaxis after hip arthroplasty. 1859 hip arthroplasty patients were prospectively enrolled (1402 routine risk--75.4%, 457 high risk--24.6%). The cumulative rate of venous thromboembolism events was 0.5% in the routine versus 0.5% in the high-risk cohort within 6weeks postoperatively (P=1.00). Patients in the routine risk cohort had a lower rate of major bleeding (0.5% versus 2.0%, P=0.006) and wound complications (0.2% versus 1.2%, P=0.01). Use of our risk stratification protocol allowed the avoidance of more aggressive anticoagulation in 75% of patients while achieving a low overall incidence of symptomatic VTE. PMID:26182980

  3. 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

  4. 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.

  5. 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.

  6. Common risk factor approach to address socioeconomic inequality in the oral health of preschool children – a prospective cohort study

    PubMed Central

    2014-01-01

    such as overweight. It will lead to the evaluation of the inter-relationship among main influences and their relative effect on child oral health. The study findings will provide high level evidence of pathways through which socio-environmental factors impact child oral health. It will also provide an opportunity to examine the relationship between oral health and childhood overweight. PMID:24885129

  7. 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.

  8. Fostering Resilience in At-Risk High School Students

    ERIC Educational Resources Information Center

    Tepovich, Ann

    2012-01-01

    There is a large volume of literature that discusses the at-risk high school student. This literature tends to focus on the factors that create the at-risk student whether those are environmental factors or perhaps the failure of schools in general that create the at-risk problem in the United States. Although the causes are important to…

  9. 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

  10. 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

  11. Women at High Risk for Diabetes

    MedlinePlus

    ... 173-199. 3 Dabelea D, Crume T. Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes Care , 2011;60:1849-1855. 4 Kitzmiller JL, Dang-Kilduff L, Taslimi MM. Gestational diabetes after delivery: short-term management and long-term risks. Diabetes Care. 2007;30: ...

  12. 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

  13. 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

  14. Convocation address.

    PubMed

    Ghatowar, P S

    1993-07-01

    The Union Deputy Minister of Health and Family Welfare in India addressed the 35th convocation of the International Institute for Population Sciences in Bombay in 1993. Officials in developing countries have been concerned about population growth for more than 30 years and have instituted policies to reduce population growth. In the 1960s, population growth in developing countries was around 2.5%, but today it is about 2%. Despite this decline, the world will have 1 billion more individuals by the year 2001. 95% of these new people will be born in developing countries. India's population size is so great that India does not have the time to wait for development to reduce population growth. Population needs to be viewed as an integrated part of overall development, since it is linked to poverty, illiteracy, environmental damage, gender issues, and reproductive health. Despite a large population size, India has made some important advancements in health and family planning. For example, India has reduced population growth (to 2.14% annually between 1981-1991), infant mortality, and its birth rate. It has increased the contraceptive use rate and life expectancy. Its southern states have been more successful at achieving demographic goals than have the northern states. India needs to implement efforts to improve living conditions, to change attitudes and perceptions about small families and contraception, and to promote family planning acceptance earlier among young couples. Improvement of living conditions is especially important in India, since almost 33% of the people live in poverty. India needs to invest in nutrition, health, and education. The mass media and nongovernmental organizations need to create population awareness and demand for family planning services. Improvement in women's status accelerates fertility decline, as has happened in Kerala State. The government needs to facilitate generation of jobs. Community participation is needed for India to achieve

  15. 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

  16. Guidelines for management of high-risk African Americans with multiple cardiovascular risk factors: recommendations of an expert consensus panel.

    PubMed

    Williams, Richard Allen; Flack, John M; Gavin, James R; Schneider, Wendy R; Hennekens, Charles H

    2007-01-01

    African Americans have higher rates of cardiovascular disease (CVD) than do Caucasians, which contributes significantly to their reduced life expectancy. Most African American adults have at least one major risk factor for CVD. Nonetheless, African Americans are often underdiagnosed and undertreated, despite presenting to the healthcare system late in their course, often after a CVD event. Patients with multiple risk factors have a CVD risk far greater than the sum of their individual risks. Metabolic syndrome tends to be clustered to a greater degree in African American women. Aggressive management of African Americans is necessary. In this report, we provide guidelines for the management of high-risk African Americans. For each individual risk factor, we address existing data and guidelines in the general population, existing data in African Americans, and proposed guidelines for African Americans based on evidence or extrapolation. In particular, for elevated cholesterol and blood pressure, evidence is emerging that lower is better, so aggressive management strategies are necessary. For dyslipidemia, statins alone will generally reach the goal, but for hypertension, multiple drugs are usually necessary. We conclude that further research in African Americans is necessary to complete the totality of evidence.

  17. Identification of High Risk Students from Matriculation Information.

    ERIC Educational Resources Information Center

    Sandusky, Sam T.

    A study was conducted at Sacramento City College (California) to determine the possibility of identifying high-risk students from information available from applications, assessment results, transcripts, and college enrollment data. Fall 1985 grade point averages (GPA) and progress percentages were used for high or low risk determination. Study…

  18. Identify and Assist the Development of High Risk Preschool Children.

    ERIC Educational Resources Information Center

    Mann, Marlis

    This speech offers a guide to identifying and teaching high-risk children, those who exhibit a lag in development severe enough to be a handicap in learning. The high-risk children focused on are those whose developmental lag is frequently not recognized until they fail in school. The two major areas of neurodevelopmental learning disorders are in…

  19. 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...

  20. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  1. Evaluation of association methods for analysing modifiers of disease risk in carriers of high-risk mutations.

    PubMed

    Barnes, Daniel R; Lee, Andrew; Easton, Douglas F; Antoniou, Antonis C

    2012-04-01

    There is considerable evidence indicating that disease risk in carriers of high-risk mutations (e.g. BRCA1 and BRCA2) varies by other genetic factors. Such mutations tend to be rare in the population and studies of genetic modifiers of risk have focused on sampling mutation carriers through clinical genetics centres. Genetic testing targets affected individuals from high-risk families, making ascertainment of mutation carriers non-random with respect to disease phenotype. Standard analytical methods can lead to biased estimates of associations. Methods proposed to address this problem include a weighted-cohort (WC) and retrospective likelihood (RL) approach. Their performance has not been evaluated systematically. We evaluate these methods by simulation and extend the RL to analysing associations of two diseases simultaneously (competing risks RL-CRRL). The standard cohort approach (Cox regression) yielded the most biased risk ratio (RR) estimates (relative bias-RB: -25% to -17%) and had the lowest power. The WC and RL approaches provided similar RR estimates, were least biased (RB: -2.6% to 2.5%), and had the lowest mean-squared errors. The RL method generally had more power than WC. When analysing associations with two diseases, ignoring a potential association with one disease leads to inflated type I errors for inferences with respect to the second disease and biased RR estimates. The CRRL generally gave unbiased RR estimates for both disease risks and had correct nominal type I errors. These methods are illustrated by analyses of genetic modifiers of breast and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers. PMID:22714938

  2. Can high-risk fungicides be used in mixtures without selecting for fungicide resistance?

    PubMed

    Mikaberidze, Alexey; McDonald, Bruce A; Bonhoeffer, Sebastian

    2014-04-01

    Fungicide mixtures produced by the agrochemical industry often contain low-risk fungicides, to which fungal pathogens are fully sensitive, together with high-risk fungicides known to be prone to fungicide resistance. Can these mixtures provide adequate disease control while minimizing the risk for the development of resistance? We present a population dynamics model to address this question. We found that the fitness cost of resistance is a crucial parameter to determine the outcome of competition between the sensitive and resistant pathogen strains and to assess the usefulness of a mixture. If fitness costs are absent, then the use of the high-risk fungicide in a mixture selects for resistance and the fungicide eventually becomes nonfunctional. If there is a cost of resistance, then an optimal ratio of fungicides in the mixture can be found, at which selection for resistance is expected to vanish and the level of disease control can be optimized.

  3. 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

  4. 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.

  5. Contraceptive use and distribution of high-risk births in Nigeria: a sub-national analysis

    PubMed Central

    Akinyemi, Akanni; Adedini, Sunday; Hounton, Sennen; Akinlo, Ambrose; Adedeji, Olanike; Adonri, Osarenti; Friedman, Howard; Shiferaw, Solomon; Maïga, Abdoulaye; Amouzou, Agbessi; Barros, Aluisio J. D.

    2015-01-01

    Background Family planning expansion has been identified as an impetus to harnessing Nigeria's demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design The study utilised women's data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results Findings showed that respondents in avoidable high-risk birth categories were less likely to use contraceptives compared to those at no risk [rate ratio 0.82, confidence interval: 0.76–0.89, p<0.001]. Education and wealth index consistently predicted significant differences in contraceptive use across the models. Conclusions The results of this study suggest that women in the high-risk birth categories were significantly less likely to use a modern method of contraception relative to those categorised as having no risk. However, there are huge sub-national variations at regional and state levels in contraceptive prevalence and subsequent high-risk births. These results further strengthen evidence-based justification for increased investments in family planning programmes at the state and regional levels, particularly regions and states with high unmet needs for family planning. PMID:26562145

  6. 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.

  7. 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. PMID:25894839

  8. 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. PMID:27235336

  9. 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.

  10. '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. PMID:27044155

  11. Presidential address.

    PubMed

    Shunglu, V K

    1994-07-01

    Rapid and substantial population growth in India is hampering development. Family welfare programs in the country during the last four years have not met population reduction goals. The decentralization of political and administrative power in relevant programs, however, will help the country attain its goal of replacement fertility. To that end, the 73rd and 74th amendments to the constitution have recently been enacted to help decentralize power to people at the village, intermediate, and district levels. The participation of the people is essential for success. State ministers of health must begin assigning management of the rural health care systems to the Panchayats. Population policy has changed so that family planning is now provided within the broader context of maternal and child health care, emphasizing voluntarism and informed choice among contraceptive methods and popular participation. The speaker laments the decline of male participation in family planning and calls for high priority to be given to developing fertility regulation methods for men as well as identifying factors which prohibit male participation. The country's unbalanced female to male sex ratio and interstate and inter-district variations in social parameters which have a bearing upon population growth rates also merit attention. Investing in human resources is crucial to the success of population programs. Financing has therefore increased for poverty alleviation programs and other social sector programs.

  12. Coordinating perioperative care for the 'high risk' general surgical patient using risk prediction scoring.

    PubMed

    Hafiz, Shaziz; Lees, Nicholas Peter

    2016-01-01

    Identifying 'high risk' (> 5% mortality score) emergency general surgical patients early, allows appropriate perioperative care to be allocated by securing critical care beds and ensuring the presence of senior surgeons and senior anesthetists intraoperatively. Scoring systems can be used to predict perioperative risk and coordinate resources perioperatively. Currently it is unclear which estimate of risk correlates with current resource deployment. A retrospective study was undertaken assessing the relationship between deployment of perioperative resources: senior surgeon, senior anesthetist and critical care bed. The study concluded that almost all high risk patients with high POSSUM mortality and morbidity scores had a consultant senior surgeon present intraoperatively. Critically unwell patients with higher operative severity and perioperative morbidity scores received higher care (HDU/ICU) beds postoperatively, ensuring that they received appropriate care if their condition deteriorated. Therefore POSSUM scoring should be used perioperatively in emergency cases to coordinate appropriate perioperative care for high risk general surgical patients. PMID:26901929

  13. Understand Your Risk for High Cholesterol

    MedlinePlus

    ... or trans fats also increases the amount of LDL cholesterol in your blood. If high blood cholesterol runs ... may not be enough to help lower your LDL blood cholesterol. View an animation of cholesterol . More information: Women ...

  14. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    PubMed

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

  15. [USA approval of high-risk medical device].

    PubMed

    Chang, Yongheng

    2013-03-01

    During the practice of supervision and management of medical device in different countries, the strict regulatory and needs of the program by the regulations is to be determined by the risk level of the medical equipment. This paper briefly describes the regulatory requirements of the United States to enter the market for high-risk medical device. PMID:23777072

  16. An Association of Human Papillomaviruses Low Risk and High Risk Subtypes with Skin Tag

    PubMed Central

    Pezeshkpoor, Fakhrozaman; Jafarian, Amir Hossein; Ghazvini, Kiarash; Yazdanpanah, Mohammad Javad; Sadeghian, Ali; Esmaili, Habiballah; Karrabi, Maryam; Rohani, Fatemeh; Joushan, Bahareh

    2012-01-01

    Objective(s) Human papillomavirus (HPV) infections are related to the genesis of various benign lesions and some malignant tumors, but no clear relationship has been identified so far between the subtypes of HPV and skin tag. Materials and Methods The present case-control study was designed to detect the existence of low risk and high risk HPV types in lesions of 50 patients with skin tag (case group) and normal skin around the melanocytic nevus of 30 patients (control group), using PCR. Results All of the samples were negative for HPV subtypes, except two samples in control group which were positive for high risk HPV. There was no significant relationship between the HPV subtypes and skin tag. Conclusion There is no association between skin tag and low risk and high risk human papillomaviruses. PMID:23493098

  17. 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.

  18. 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…

  19. 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"…

  20. High risk groups in an oil shale workforce

    SciTech Connect

    Gratt, L.B.; Marine, W.M.; Perry, B.W.; Savitz, D.A.

    1984-04-01

    The workforce risks of a hypothetical one million barrels-per-day oil shale industry were estimated. The risks for the different workforce segments were compared and high risk groups were identified. Accidents and injuries were statistically described by rates for fatalities, for accidents with days lost from work, and for accidents with no days lost from work. Workforce diseases analyzed were cancers, silicosis, pneumoconiosis, chronic bronchitis, chronic airway obstruction, and high frequency hearing loss. A comparison of the workforce groups under different risk measures (occurrence, fatality, and life-loss expectancy) was performed. The miners represented the group with the largest fatality and the most serious accident rate, although the estimated rates were below the average industry-wide underground mining experience. Lung disease from inhalation exposure of about the nuisance dust threshold limit value presents a significant risk for future concerns.

  1. Female seafarers adopt the high risk lifestyle of male seafarers

    PubMed Central

    Hansen, H. L.; Jensen, J.

    1998-01-01

    OBJECTIVE: To study the mortality of women in an occupation known to have a high mortality among men. METHODS: A total of 6788 female seafarers of all job categories who had been employed on Danish merchant ships, passenger ships, and privately owned ferries between 1986 and 1993, were followed up until the end of 1993. RESULTS: Standardised mortality ratio (SMR) was 1.20 (95% confidence interval (95% CI) 0.89 to 1.58) for all causes of death and job categories together. For women in traditionally male jobs, SMR was 2.82 (1.41- 5.05), whereas galley and catering staff had SMRs close to the general female population. The high mortality among women in traditional male jobs could be explained by a high risk of fatal accidents including occupational accidents. In the whole cohort, there were fewer deaths from natural causes than expected but an excess risk of death due to lung cancer, heart diseases, and non-natural deaths. CONCLUSION: The increased mortality could primarily be explained by an excess risk of fatal accidents and suicide. Especially, female seafarers entering traditional male jobs had a high risk of fatal accidents, not only at sea but also ashore. An excess risk of dying of lung cancer and heart diseases probably reflects a high tobacco consumption. Female seafarers are probably influenced by their occupation towards hazardous behaviour and a high risk lifestyle but people with a high risk lifestyle may also be attracted by or forced into high risk jobs such as traditional male jobs at sea.   PMID:9536163

  2. Contemporary therapeutic options for children with high risk neuroblastoma.

    PubMed

    Sterba, J

    2002-01-01

    Despite the use of aggressive chemotherapy, stage 4 high risk neuroblastoma still has a very poor prognosis, which is estimated at 25%. Therefore, novel treatment approaches are needed. Increasing number of reports has been concerned with the use of novel treatment modalities. Literature regarding intensive induction, local therapy, myeloablative therapy and immunotherapy and biotherapy was reviewed in order to draw conclusions and recommendations for the management of children with high risk neuroblastic tumors.

  3. Survey on Addressing the Information and Support Needs of Jewish Women at Increased Risk for or Diagnosed with Breast Cancer: The Sharsheret Experience

    PubMed Central

    Tercyak, Kenneth P.; Silber, Elana; Johnson, Andrea C.; Fleischmann, Adina; Murphy, Sarah E.; Mays, Darren; O’Neill, Suzanne C.; Sharkey, Christina M.; Shoretz, Rochelle

    2015-01-01

    Approximately 12% of women living in the United States will be diagnosed with breast cancer during their lifetimes. While all women face formidable challenges posed by the threat of living with or at increased risk for breast cancer, those of Ashkenazi Jewish descent face additional challenges owing to higher BRCA1/2 mutation prevalence in this population. Amidst calls for population-based screening for hereditary breast cancer risk, much can be learned from the experiences of Jewish women about their needs. The present study is a secondary analysis of psychoeducational program satisfaction and evaluation data previously collected by a community organization dedicated to serving women of all Jewish backgrounds facing, or at risk for, breast cancer. Among respondents (n = 347), over one-third were referred to the organization by family or friends, most often after a cancer crisis. Of the information and support resources offered, the greatest level of engagement occurred with the one-on-one peer support and health care symposia resources. Respondents endorsed high levels of satisfaction with the programs and services, and a strong desire to give back to the community. These data suggest that culturally-relevant information and support services for Jewish women could be scaled-up for larger dissemination to meet the anticipated needs in this special population. PMID:27417765

  4. Comparison of risk assessment strategies for not-high-risk pulmonary embolism.

    PubMed

    Hobohm, Lukas; Hellenkamp, Kristian; Hasenfuß, Gerd; Münzel, Thomas; Konstantinides, Stavros; Lankeit, Mareike

    2016-04-01

    We compared the prognostic performance of the 2014 European Society of Cardiology (ESC) risk stratification algorithm with the previous 2008 ESC algorithm, the Bova score and the modified FAST score (based on a positive heart-type fatty acid-binding protein (H-FABP) test, syncope and tachycardia, modified using high-sensitivity troponin T instead of H-FABP) in 388 normotensive pulmonary embolism patients included in a single-centre cohort study.Overall, 25 patients (6.4%) had an adverse 30-day outcome. Regardless of the score or algorithm used, the rate of an adverse outcome was highest in the intermediate-high-risk classes, while all patients classified as low-risk had a favourable outcome (no pulmonary embolism-related deaths, 0-1.4% adverse outcome). The area under the curve for predicting an adverse outcome was higher for the 2014 ESC algorithm (0.76, 95% CI 0.68-0.84) compared with the 2008 ESC algorithm (0.65, 95% CI 0.56-0.73) and highest for the modified FAST score (0.82, 95% CI 0.75-0.89). Patients classified as intermediate-high-risk by the 2014 ESC algorithm had a 8.9-fold increased risk for an adverse outcome (3.2-24.2, p<0.001 compared with intermediate-low- and low-risk patients), while the highest OR was observed for a modified FAST score ≥3 points (OR 15.9, 95% CI 5.3-47.6, p<0.001).The 2014 ESC algorithm improves risk stratification of not-high-risk pulmonary embolism compared with the 2008 ESC algorithm. All scores and algorithms accurately identified low-risk patients, while the modified FAST score appears more suitable to identify intermediate-high-risk patients. PMID:26743479

  5. Activity Involvement among Suicidal and Nonsuicidal High-Risk and Typical Adolescents.

    ERIC Educational Resources Information Center

    Mazza, James J.; Eggert, Leona L.

    2001-01-01

    Compared weekly activities among four groups of high risk and typical high school students: potential dropouts at suicide risk; typical youth at suicide risk; potential dropouts not at suicide risk; and typical youth not at suicide risk. Of the 1,286 participants, 39.4% of high risk and 30.1% of typical high school students screened in at suicide…

  6. Diagnosis and Management of High Risk Group for Gastric Cancer

    PubMed Central

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

  7. Diagnosis and management of high risk group for gastric cancer.

    PubMed

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval.

  8. HIV risk behavior, street outreach, and condom use in eight high-risk populations.

    PubMed

    Anderson, J E; Cheney, R; Clatts, M; Faruque, S; Kipke, M; Long, A; Mills, S; Toomey, K; Wiebel, W

    1996-06-01

    In this paper we examine risk behavior, exposure to street outreach, and condom use in samples of injecting drug users (IDUs) and high-risk youth. We used systematic sampling methods to produce representative samples of injecting drug users IDUs (five sites) and high-risk youth (three sites). The populations surveyed engaged in high levels of sexual risk behavior: 20% to 46% reported two or more sex partners in the last month. The majority (62% to 97%) knew someone infected with HIV. Condom use rates approached national health promotion goals for nonsteady partners but not for steady or main partners. Having a condom at time of interview was the most consistent predictor of condom use at last intercourse. Many of the respondents have been in contact with street outreach programs and many acknowledged some personal risk for HIV infection. However, most of the injecting drug users and high-risk youth interviewed (and their sex partners) were still at risk through unprotected sex.

  9. North Carolina high-risk insurance pools.

    PubMed

    Moore, David R

    2006-01-01

    Imagine this: You are a 58-year-old man. You have worked all your life, paid taxes, and helped support your family. Two years ago you had a mild heart attack. Your wife has diabetes and high blood pressure. Luckily, you had health insurance through your job that helped you pay for the hospitalization, doctor's visits, and necessary medications for you and your wife. With a new diet, exercise, and the medications, you both are doing well managing your health problems. A little over a year ago, you lost your insurance when your company downsized. You found another job, but your current employer doesn't offer insurance. Your wife also works, but she works for a small employer that does not offer coverage. So, you pay approximately dollar 600/month for continuation coverage (COBRA) for your wife and yourself through your former employer. Last month, you found out your COBRA coverage is about to end. You want to continue to buy insurance coverage, but you were told that purchasing a comprehensive policy with a dollar 1,000 deductible (70% coinsurance) that covers your needed medications would cost more than dollar 4,000/month for your wife and yourself. PMID:16846164

  10. Delivering asthma education to special high risk groups.

    PubMed

    FitzGerald, J M; Turner, M O

    1997-12-01

    Patients at high risk from their asthma and therefore worthy of more focused asthma education are those at risk of fatal and near fatal asthma(NFA). In recent years the characteristics of these patients have been better defined. The most important risk factor appears to be a prior history of NFA. Other important features include prior emergency room visits or hospitalization for asthma. Excess use of beta-agonists, especially in the absence of inhaled corticosteroids, also confers increased risk. High risk groups also share similar psychosocial barriers as well as economic deprivation. The benefits of asthma education in these groups have been assessed in a number of studies. In general, asthma education has been shown to have an impact on these patients. Greater effects have been achieved where there has been consistent follow-up by the same physician. Patients require frequent reinforcement of their asthma management, especially regarding their response to acute exacerbations. A sub-group of patients with more severe asthma appear to have a problem perceiving dyspnoea and may therefore benefit from peak flow monitoring but the problem of compliance with this intervention is significant. Behaviour modification plays an important role as does ensuring the patient has adequate resources to purchase medications especially the more expensive anti-inflammatory therapy. Future studies should focus on optimizing the potential benefits of educating high risk patients as they are not only those at greatest risk of death but also consume a disproportionate amount of health care resources.

  11. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed Central

    Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

    2002-01-01

    Medical practice today, more than ever before, places greater demands on physicians to see more patients, provide more complex medical services and adhere to stricter regulatory rules, leaving little time for coding and billing. Yet, the need to adequately document medical records, appropriately apply billing codes and accurately charge insurers for medical services is essential to the medical practice's financial condition. Many physicians rely on office staff and billing companies to process their medical bills without ever reviewing the bills before they are submitted for payment. Some physicians may not be receiving the payment they deserve when they do not sufficiently oversee the medical practice's coding and billing patterns. This article emphasizes the importance of monitoring and auditing medical record documentation and coding application as a strategy for achieving compliance and reducing billing errors. When medical bills are submitted with missing and incorrect information, they may result in unpaid claims and loss of revenue to physicians. Addressing Medical Audits, Part I--A Strategy for Achieving Compliance--CMS, JCAHO, NCQA, published January 2002 in the Journal of the National Medical Association, stressed the importance of preparing the medical practice for audits. The article highlighted steps the medical practice can take to prepare for audits and presented examples of guidelines used by regulatory agencies to conduct both medical and financial audits. The Medicare Integrity Program was cited as an example of guidelines used by regulators to identify coding errors during an audit and deny payment to providers when improper billing occurs. For each denied claim, payments owed to the medical practice are are also denied. Health care is, no doubt, a costly endeavor for health care providers, consumers and insurers. The potential risk to physicians for improper billing may include loss of revenue, fraud investigations, financial sanction

  12. Candidate Risks Indicators for Bipolar Disorder: Early Intervention Opportunities in High-Risk Youth

    PubMed Central

    Jones, Steven; Goodday, Sarah; Bentall, Richard

    2016-01-01

    Background: Psychiatric illnesses like bipolar disorder are increasingly understood to be neurodevelopmental disorders with clinical, psychological, and biological indicators recognizable long before the emergence of the full-blown syndromes. Methods: This paper is a selective review of findings from studies of high-risk children of affected parents that inform the knowledge of illness risk and development markers of bipolar disorder. We specifically focus on candidate clinical, biological, and psychological risk indicators that could serve as targets for future early intervention and prevention studies. Results: There is convergent evidence from prospective studies that bipolar disorder typically debuts as depressive episodes after puberty. In some high-risk children, sleep and anxiety disorders precede mood disorders by several years and reflect an increased vulnerability. An association between early exposure to adversity (eg, exposure to parental illness, neglect from mother) and increased risk of psychopathology may be mediated through increased stress reactivity evident at both behavioral and biological levels. Inter-related psychological processes including reward sensitivity, unstable self-esteem, rumination, and positive self-appraisal are risk factors for mood disorders. Disturbances in circadian rhythm and immune dysfunction are associated with mood disorders and may be vulnerability markers influenced by these other risk factors. Conclusions: There is accruing evidence of a number of measurable and potentially modifiable markers of vulnerability and developing illness in youth at familial risk for bipolar disorder. Longitudinal studies of multiple biological and psychological risk processes in high-risk offspring, both individually and together, will improve our understanding of illness onset and lead to the development of specific early interventions. PMID:26116493

  13. On the Alleged Right to Participate in High-Risk Research.

    PubMed

    Różyńska, Joanna

    2015-09-01

    Reigning regulatory frameworks for biomedical research impose on researchers and research ethics committees an obligation to protect research participants from risks that are unnecessary, disproportionate to potential research benefits, and non-minimized. Where the research has no potential to produce results of direct benefit to the subjects and the subjects are unable to give consent, these requirements are strengthened by an additional condition, that risks should not exceed a certain minimal threshold. In this article, I address the question of whether there should be limits of permissible risks in non-therapeutic research involving competent and healthy subjects. Some commentators argue that competent and informed individuals should have a right to participate even in extremely risky research and that research ethics committees should never reject studies because they are too dangerous. To use David Shaw's expression, competent volunteers should have 'a right to participate in high-risk research'. I argue that this idea is ill-founded, as it does not take into account the social mission and complex collaborative nature of research practice as well as the inequity of power between researchers and subjects. Imposition of limits on permissible risks for healthy volunteers is justified by the need to protect research enterprise and the need to protect the weaker party, namely the subjects. Also, I suggest that the best way to set boundaries on research risks is to leave the judgment of risk acceptability to research ethics committees.

  14. On the Alleged Right to Participate in High-Risk Research.

    PubMed

    Różyńska, Joanna

    2015-09-01

    Reigning regulatory frameworks for biomedical research impose on researchers and research ethics committees an obligation to protect research participants from risks that are unnecessary, disproportionate to potential research benefits, and non-minimized. Where the research has no potential to produce results of direct benefit to the subjects and the subjects are unable to give consent, these requirements are strengthened by an additional condition, that risks should not exceed a certain minimal threshold. In this article, I address the question of whether there should be limits of permissible risks in non-therapeutic research involving competent and healthy subjects. Some commentators argue that competent and informed individuals should have a right to participate even in extremely risky research and that research ethics committees should never reject studies because they are too dangerous. To use David Shaw's expression, competent volunteers should have 'a right to participate in high-risk research'. I argue that this idea is ill-founded, as it does not take into account the social mission and complex collaborative nature of research practice as well as the inequity of power between researchers and subjects. Imposition of limits on permissible risks for healthy volunteers is justified by the need to protect research enterprise and the need to protect the weaker party, namely the subjects. Also, I suggest that the best way to set boundaries on research risks is to leave the judgment of risk acceptability to research ethics committees. PMID:25644532

  15. Prediction of risk for drug use in high school students.

    PubMed

    Climent, C E; de Aragon, L V; Plutchik, R

    1990-05-01

    On the basis of questionnaires administered to almost 2,000 high school students in Cali, Colombia, a subset of items was selected that deal primarily with parent--child relationships. This 53-item set, referred to as the Drug Risk Scale (DRS), was administered to two new cross-validation samples, one consisting of high school students and the other consisting of drug addicts attending drug rehabilitation centers. Significant differences in parent--child relations were found between these new groups. The DRS was also found to have reasonably high sensitivity and specificity. Its potential value as a risk-prediction instrument is discussed. PMID:2258260

  16. Prediction of risk for drug use in high school students.

    PubMed

    Climent, C E; de Aragón, L V; Plutchik, R

    1989-11-01

    On the basis of questionnaires administered to almost 2,000 high school students in Cali, Colombia, a subset of items was selected that deal primarily with parent-child relationships. This 53 item set, referred to as the Drug Risk Scale (DRS), was administered to two new cross-validation samples, one consisting of high school students and the other consisting of drug addicts attending drug rehabilitation centers. Significant differences in parent-child relations were found between these new groups. The DRS was also found to have reasonably high sensitivity and specificity. Its potential value as a risk-prediction instrument is discussed. PMID:2628355

  17. Psychological characteristics in high-risk MSM in China

    PubMed Central

    2012-01-01

    Background Men who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26%) had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P < 0.05). In contrast, the two groups did not differ significantly the sexual orientation, level of education, types of profession, drug use, condom use and experience of social stigma and discrimination (P > 0.05). A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to

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

    PubMed Central

    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; Glöckner, 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

    2016-01-01

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system1. 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 elusive2–4. 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 type1,2,5. 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. PMID:26466568

  19. 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…

  20. Risk analysis for truck transportation of high consequence cargo.

    SciTech Connect

    Waters, Robert David

    2010-09-01

    The fixed facilities control everything they can to drive down risk. They control the environment, work processes, work pace and workers. The transportation sector drive the State and US highways with high kinetic energy and less-controllable risks such as: (1) other drivers (beginners, impaired, distracted, etc.); (2) other vehicles (tankers, hazmat, super-heavies); (3) road environments (bridges/tunnels/abutments/construction); and (4) degraded weather.

  1. Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

    PubMed Central

    Yeoh, Ping Ling; Hornetz, Klaus; Dahlui, Maznah

    2016-01-01

    Background The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. Methods A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. Results Intensive or “adequate-plus” antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation

  2. Risk adjustment for high utilizers of public mental health care.

    PubMed

    Kapur, Kanika; Young, Alexander S.; Murata, Dennis

    2000-09-01

    BACKGROUND: Publicly funded mental health systems are increasingly implementing managed care systems, such as capitation, to control costs. Capitated contracts may increase the risk for disenrollment or adverse outcomes among high cost clients with severe mental illness. Risk-adjusted payments to providers are likely to reduce providers' incentives to avoid or under-treat these people. However, most research has focused on Medicare and private populations, and risk adjustment for individuals who are publicly funded and severely mentally ill has received far less attention. AIMS OF THE STUDY: Risk adjustment models for this population can be used to improve contracting for mental health care. Our objective is to develop risk adjustment models for individuals with severe mental illness and assess their performance in predicting future costs. We apply the risk adjustment model to predict costs for the first year of a pilot capitation program for the severely mentally ill that was not risk adjusted. We assess whether risk adjustment could have reduced disenrollment from this program. METHODS: This analysis uses longitudinal administrative data from the County of Los Angeles Department of Mental Health for the fiscal years 1991 to 1994. The sample consists of 1956 clients who have high costs and are severely mentally ill. We estimate several modified two part models of 1993 cost that use 1992 client-based variables such as demographics, living conditions, diagnoses and mental health costs (for 1992 and 1991) to explain the variation in mental health and substance abuse costs. RESULTS: We find that the model that incorporates demographic characteristics, diagnostic information and cost data from two previous years explains about 16 percent of the in-sample variation and 10 percent of the out-of-sample variation in costs. A model that excludes prior cost covariates explains only 5 percent of the variation in costs. Despite the relatively low predictive power, we find some

  3. Addressivity in cogenerative dialogues

    NASA Astrophysics Data System (ADS)

    Hsu, Pei-Ling

    2014-03-01

    Ashraf Shady's paper provides a first-hand reflection on how a foreign teacher used cogens as culturally adaptive pedagogy to address cultural misalignments with students. In this paper, Shady drew on several cogen sessions to showcase his journey of using different forms of cogens with his students. To improve the quality of cogens, one strategy he used was to adjust the number of participants in cogens. As a result, some cogens worked and others did not. During the course of reading his paper, I was impressed by his creative and flexible use of cogens and at the same time was intrigued by the question of why some cogens work and not others. In searching for an answer, I found that Mikhail Bakhtin's dialogism, especially the concept of addressivity, provides a comprehensive framework to address this question. In this commentary, I reanalyze the cogen episodes described in Shady's paper in the light of dialogism. My analysis suggests that addressivity plays an important role in mediating the success of cogens. Cogens with high addressivity function as internally persuasive discourse that allows diverse consciousnesses to coexist and so likely affords productive dialogues. The implications of addressivity in teaching and learning are further discussed.

  4. 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

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

    PubMed

    Hudson, P

    2003-12-01

    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

  6. 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

  7. 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

  8. 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,…

  9. High-risk neuroblastoma: a therapy in evolution.

    PubMed

    Fong, Abraham; Park, Julie R

    2009-11-01

    High-risk neuroblastoma remains a therapeutic challenge for pediatric oncologists. It is becoming increasingly evident that conventional chemotherapeutics are approaching or perhaps have already attained their maximum therapeutic potential. The focus of this review is to summarize current therapies and bring to light some of the novel strategies for treating high-risk neuroblastoma. These rationally designed therapies include molecular- and immune-targeted agents in an attempt to exploit the biology of the neuroblastoma cell. These novel therapies are likely to pose a whole new set of challenges and questions and emphasize the need for continued enrollment of patients in therapeutic studies.

  10. High cost pool or high cost groups-How to handle high(est) cost cases in a risk adjustment mechanism?

    PubMed

    Schillo, Sonja; Lux, Gerald; Wasem, Juergen; Buchner, Florian

    2016-02-01

    Competitive social health insurance systems (at least) in Western Europe have implemented systems of morbidity based risk adjustment to set a level playing field for insurers. However, many high cost insured still are heavily underfunded despite risk adjustment, leaving incentives for risk selection. In most of these health care systems, there is an ongoing debate about how to deal with such underpaid high cost cases. This study develops four distinct concepts by adding variables to risk adjustment or by setting up a high cost pool for underpaid insured besides the risk adjustment system. Their features, incentives and distributional effects are discussed. With a data set of 6 million insured, performance is demonstrated for Germany. All models achieve a substantial improvement in model fit, measured in terms of R(2) as well as CPM. As the results of the various models are different in different dimensions, the trade-offs that have to be dealt with and should be addressed, when implementing a model to reduce underfunding of high cost cases. PMID:26806676

  11. High cost pool or high cost groups-How to handle high(est) cost cases in a risk adjustment mechanism?

    PubMed

    Schillo, Sonja; Lux, Gerald; Wasem, Juergen; Buchner, Florian

    2016-02-01

    Competitive social health insurance systems (at least) in Western Europe have implemented systems of morbidity based risk adjustment to set a level playing field for insurers. However, many high cost insured still are heavily underfunded despite risk adjustment, leaving incentives for risk selection. In most of these health care systems, there is an ongoing debate about how to deal with such underpaid high cost cases. This study develops four distinct concepts by adding variables to risk adjustment or by setting up a high cost pool for underpaid insured besides the risk adjustment system. Their features, incentives and distributional effects are discussed. With a data set of 6 million insured, performance is demonstrated for Germany. All models achieve a substantial improvement in model fit, measured in terms of R(2) as well as CPM. As the results of the various models are different in different dimensions, the trade-offs that have to be dealt with and should be addressed, when implementing a model to reduce underfunding of high cost cases.

  12. 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…

  13. 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

  14. 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

  15. 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…

  16. Addressing the challenges of the HIV continuum of care in high-prevalence cities in the United States.

    PubMed

    Greenberg, Alan E; Purcell, David W; Gordon, Christopher M; Barasky, Rebecca J; del Rio, Carlos

    2015-05-01

    In summary, addressing the challenges of the HIV care continuum is critical so that the goals of the NHAS can be achieved. CDC is working closely with federal partners, public health departments, and communities throughout the United States on multiple surveillance, programmatic, and research initiatives to inform and improve outcomes along the HIV care continuum. Currently, a large number of research projects are being conducted to describe the care continuum in various populations, assess and model the impact of interventions, and monitor the quality of care. To contribute to this knowledge base, NIH is working with its academic partners to support research that will inform the optimization of HIV treatment and prevention programs. As part of this focus, the CFAR/APC HIV Continuum of Care Working Group was formed to encourage communication between academic investigators and their local DOHs and to support joint research initiatives that are both timely and relevant to their own cities and environments. Finally, the results presented in this supplement may have implications for jurisdictions beyond those in which the studies were conducted.

  17. 2D and 3D spatially addressed arrays for high-throughput automated synthesis of combinatorial libraries.

    PubMed

    Patek, Marcel; Safar, Pavel; Smrcina, Martin; Wegrzyniak, Eric; Bjergarde, Kirsten; Weichsel, Aleksandra; Strop, Peter

    2004-01-01

    One of the key elements in the drug discovery process is the use of automation to synthesize libraries of compounds for biological screening. The "split-and-mix" approaches in combinatorial chemistry have been recognized as extremely powerful techniques to access large numbers of compounds, while requiring only few reaction steps. However, the need for effective encoding/deconvolution strategies and demands for larger amounts of compounds have somewhat limited the use of these techniques in the pharmaceutical industry. In this paper, we describe a concept of directed sort and combine synthesis with spatially arranged arrays of macroscopic supports. Such a concept attempts to balance the number of reaction steps, the confidence in compound identity, and the quantity of synthesized compounds. Using three-dimensional arrays of frames each containing a two-dimensional array of macroscopic solid supports, we have conceptualized and developed a modular semiautomated system with a capacity of up to 100 000 compounds per batch. Modularity of this system enables flexibility either to produce large diverse combinatorial libraries or to synthesize more focused smaller libraries, both as single compounds in 12-15 micromol quantities. This method using sortable and spatially addressed arrays is exemplified by the synthesis of a 15 360 compound library.

  18. Addressing the challenges of the HIV continuum of care in high-prevalence cities in the United States.

    PubMed

    Greenberg, Alan E; Purcell, David W; Gordon, Christopher M; Barasky, Rebecca J; del Rio, Carlos

    2015-05-01

    In summary, addressing the challenges of the HIV care continuum is critical so that the goals of the NHAS can be achieved. CDC is working closely with federal partners, public health departments, and communities throughout the United States on multiple surveillance, programmatic, and research initiatives to inform and improve outcomes along the HIV care continuum. Currently, a large number of research projects are being conducted to describe the care continuum in various populations, assess and model the impact of interventions, and monitor the quality of care. To contribute to this knowledge base, NIH is working with its academic partners to support research that will inform the optimization of HIV treatment and prevention programs. As part of this focus, the CFAR/APC HIV Continuum of Care Working Group was formed to encourage communication between academic investigators and their local DOHs and to support joint research initiatives that are both timely and relevant to their own cities and environments. Finally, the results presented in this supplement may have implications for jurisdictions beyond those in which the studies were conducted. PMID:25867773

  19. Addressing key issues in the consanguinity-related risk of autosomal recessive disorders in consanguineous communities: lessons from a qualitative study of British Pakistanis.

    PubMed

    Darr, A; Small, N; Ahmad, W I U; Atkin, K; Corry, P; Modell, B

    2016-01-01

    Currently, there is no consensus regarding services required to help families with consanguineous marriages manage their increased genetic reproductive risk. Genetic services for communities with a preference for consanguineous marriage in the UK remain patchy, often poor. Receiving two disparate explanations of the cause of recessive disorders (cousin marriage and recessive inheritance) leads to confusion among families. Further, the realisation that couples in non-consanguineous relationships have affected children leads to mistrust of professional advice. British Pakistani families at-risk for recessive disorders lack an understanding of recessive disorders and their inheritance. Such an understanding is empowering and can be shared within the extended family to enable informed choice. In a three-site qualitative study of British Pakistanis, we explored family and health professional perspectives on recessively inherited conditions. Our findings suggest, firstly, that family networks hold strong potential for cascading genetic information, making the adoption of a family-centred approach an efficient strategy for this community. However, this is dependent on provision of high-quality and timely information from health care providers. Secondly, families' experience was of ill-coordinated and time-starved services, with few having access to specialist provision from Regional Genetics Services; these perspectives were consistent with health professionals' views of services. Thirdly, we confirm previous findings that genetic information is difficult to communicate and comprehend, further complicated by the need to communicate the relationship between cousin marriage and recessive disorders. A communication tool we developed and piloted is described and offered as a useful resource for communicating complex genetic information. PMID:26363620

  20. Addressing key issues in the consanguinity-related risk of autosomal recessive disorders in consanguineous communities: lessons from a qualitative study of British Pakistanis.

    PubMed

    Darr, A; Small, N; Ahmad, W I U; Atkin, K; Corry, P; Modell, B

    2016-01-01

    Currently, there is no consensus regarding services required to help families with consanguineous marriages manage their increased genetic reproductive risk. Genetic services for communities with a preference for consanguineous marriage in the UK remain patchy, often poor. Receiving two disparate explanations of the cause of recessive disorders (cousin marriage and recessive inheritance) leads to confusion among families. Further, the realisation that couples in non-consanguineous relationships have affected children leads to mistrust of professional advice. British Pakistani families at-risk for recessive disorders lack an understanding of recessive disorders and their inheritance. Such an understanding is empowering and can be shared within the extended family to enable informed choice. In a three-site qualitative study of British Pakistanis, we explored family and health professional perspectives on recessively inherited conditions. Our findings suggest, firstly, that family networks hold strong potential for cascading genetic information, making the adoption of a family-centred approach an efficient strategy for this community. However, this is dependent on provision of high-quality and timely information from health care providers. Secondly, families' experience was of ill-coordinated and time-starved services, with few having access to specialist provision from Regional Genetics Services; these perspectives were consistent with health professionals' views of services. Thirdly, we confirm previous findings that genetic information is difficult to communicate and comprehend, further complicated by the need to communicate the relationship between cousin marriage and recessive disorders. A communication tool we developed and piloted is described and offered as a useful resource for communicating complex genetic information.

  1. 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.

  2. 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. PMID:25820865

  3. 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

  4. Academically at-risk students' perceptions of a constructivist high school biology pedagogy

    NASA Astrophysics Data System (ADS)

    Sweeney, Heidi

    Successful completion of the Living Environment, one state's high school biology course, is a state graduation requirement. The academically at-risk students enrolled in one suburban public high school had been disproportionately unsuccessful at achieving a passing grade in this course. In response, a constructivist biology curriculum was created to address the needs of at-risk students in a heterogeneous ability classroom. There is a gap in current research on students' perceptions of their learning experiences; consequently, the purpose of this phenomenological study was to obtain at-risk students' perceptions of a constructivist-based curriculum and to clarify what aspects of the Living Environment course assisted in their success. Eight academically at-risk students who successfully passed the Living Environment course were surveyed to seek their perceptions of the curricular and pedagogical change. These data were analyzed using the typological method with the inclusion of both inductive and predetermined categories. The students stated a preference for group work and active engagement. They also found that the binder system introduced in the course kept them better organized and helped them increase academic performance. Students perceived that effort was required but was rewarding. Findings derived from this study may contribute to social change by assisting teachers in tailoring curriculum and pedagogical decisions. This study provided a voice for the academically at-risk student and, in doing so, may contribute to social change by providing insight to teachers and administrators that can help students succeed academically, increase graduation rates, and enhance employment opportunities.

  5. High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

    PubMed Central

    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. PMID:23908794

  6. 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.

  7. 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…

  8. Prediction of Violence Perpetration Among High-Risk Youth

    ERIC Educational Resources Information Center

    Sussman, Steve; Skara, Silvana; Weiner, Michelle D.; Dent, Clyde W.

    2004-01-01

    Objectives: To prospectively examine demographic background, personality, perceived environment, and behavior as violence perpetration predictors in emerging adulthood among high-risk adolescents using problem-behavior theory as a conceptual perspective. Methods: Self-report questionnaires were administered 5 years apart to 676 participants.…

  9. 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.…

  10. 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…

  11. Distribution of influenza vaccine to high-risk groups.

    PubMed

    Ompad, Danielle C; Galea, Sandro; Vlahov, David

    2006-01-01

    Vaccine distribution programs have historically targeted individuals at high risk of complications due to influenza. Despite recommendations from the Advisory Committee on Immunization Practices, vaccination coverage among high-risk populations has been generally low. This review systematically summarizes the recent literature evaluating programs in different settings, from within medical settings to venue-based and community-based approaches, in an effort to identify successful program components. The published literature was identified by using the MEDLINE database from 1990 to 2006 covering studies that reported on interventions or programs aimed at vaccinating high-risk populations. The authors reviewed 56 studies. In the United States, the Healthy People 2010 goals included 90% vaccination coverage for adults aged > or = 65 years and 60% for high-risk adults aged 18-64 years. Only a handful of the studies reviewed managed to meet those goals. Interventions that increased vaccination coverage to Healthy People 2010 goals included advertising, provider and patient mailings, registry-based telephone calls, patient and staff education, standing orders coupled with standardized forms, targeting of syringe exchange customers, and visiting nurses. Few studies evaluated the impact of vaccination programs by race/ethnicity and socioeconomic status. Few studies targeted individuals outside of the health-care and social services sectors. Given the growing disparities in health and health-care access, understanding the way in which interventions can remedy disparities is crucial.

  12. 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…

  13. 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…

  14. 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…

  15. 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...

  16. 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.

  17. 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…

  18. Prospective screening for deep vein thrombosis in high risk patients.

    PubMed

    Barnes, R W

    1977-08-01

    In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.

  19. Biochemical profile and outcome in normal and high risk subjects.

    PubMed

    Vijayalaxmi, K G; Urooj, Asna

    2009-07-01

    The present study was carried out to assess the biochemical profile and outcome of pregnancy and study the adverse consequences if any, among normal and high risk pregnant women. The study group included 182 normal and 168 high risk cases attending to private and Government Hospitals in Bangalore. The high risk groups were: Pregnancy induced hypertension (PIH), gestational diabetes mellitus (GDM), Adolescents and anemic cases. Lipid peroxidation was enhanced in PIH and GDM groups (5.56 nmol/ml and 3.98 nmol/ml) MDA values as compared to other groups. Vitamin E levels were significantly (p< 0.05) lower in PIH group (0.38 mg/dl) as compared to other groups. Caesarean as a mode of delivery indicating more number of complications were higher among GDM (61.9%) followed by PIH group. Incidences of low birth weight were observed more in PIH group. The study revealed occurrence of oxidative stress and adverse outcome among high risk pregnancy groups. PMID:23105848

  20. Behavioral Risks during the Transition from High School to College

    PubMed Central

    Fromme, Kim; Corbin, William R.; Kruse, Marc I.

    2008-01-01

    The transition from high school to college is an important developmental milestone that holds the potential for personal growth and behavioral change. A cohort of 2,025 students was recruited during the summer before they matriculated into college and completed Internet-based surveys about their participation in a variety of behavioral risks during the last three months of high school and throughout the first year of college. Alcohol use, marijuana use, and sex with multiple partners increased during the transition from high school to college, whereas driving after drinking, aggression, and property crimes decreased. Those from rural high schools and those who elected to live in private dormitories in college were at highest risk for heavy drinking and driving after drinking. PMID:18793080

  1. Influenza vaccination status of healthcare workers and the extent of their domestic contact with individuals at high risk for influenza-related complications.

    PubMed

    Ong, A K; Srimanunthiphol, J; Frankel, R I

    2000-11-01

    Many healthcare workers have frequent household contact with persons at high risk for influenza-related complications. Educating healthcare workers about the risk of domestic transmission of influenza may improve their acceptance of influenza vaccination. Concerns regarding vaccine efficacy and safety also need to be addressed.

  2. High-risk energy plans yield low rewards

    NASA Astrophysics Data System (ADS)

    Gwynne, Peter

    2009-10-01

    Scientists have complained that a new research body run by the US Department of Energy (DOE) is suffering from management problems and is rejecting funding proposals without stating why. The DOE's Advanced Research Projects Agency-Energy (ARPA-E) - created in 2007 - is designed to fund high-risk, high-payoff research and development projects in energy. However, the agency, which received its first budget in April, has so far turned down almost 95% of proposals after the first round.

  3. 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,…

  4. 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…

  5. 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. PMID:26559511

  6. 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.

  7. 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.

  8. Patterns of alcohol use and the risk of drinking and driving among US high school students.

    PubMed Central

    Escobedo, L G; Chorba, T L; Waxweiler, R

    1995-01-01

    Approximately one third of deaths among persons aged 15 to 24 years are the result of motor vehicle-related crashes. Data from a national sample of US high school students were used to assess patterns of alcohol use among adolescents in relation to the risk of drinking and driving. Prevalence and odds ratios were calculated for drinking and driving associated with patterns of alcohol use. Drinking and driving increased with increasing frequency of alcohol use and binge drinking and when alcohol was used in addition to other drugs. Efforts to reduce drinking and driving among adolescents should address underage drinking that is frequent or heavy. PMID:7604923

  9. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude.

    PubMed

    Miele, Catherine H; Schwartz, Alan R; Gilman, Robert H; Pham, Luu; Wise, Robert A; Davila-Roman, Victor G; Jun, Jonathan C; Polotsky, Vsevolod Y; Miranda, J Jaime; Leon-Velarde, Fabiola; Checkley, William

    2016-06-01

    Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93-100, 2016.-Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated with cardiovascular complications, it is unclear how worsening hypoxemia of any degree affects cardiometabolic risk factors in high-altitude populations. We studied the relationship between daytime resting oxyhemoglobin saturation and cardiometabolic risk factors in adult participants living in Puno, Peru (3825 m above sea level). We used multivariable logistic regression models to study the relationship between having a lower oxyhemoglobin saturation and markers of cardiometabolic risk. Nine hundred and fifty-four participants (mean age 55 years, 52% male) had information available on pulse oximetry and markers of cardiometabolic risk. Average oxyhemoglobin saturation was 90% (interquartile range 88%-92%) and 43 (4.5%) had excessive erythrocytosis. Older age, decreased height-adjusted lung function, and higher body mass index (BMI) were associated with having an oxyhemoglobin saturation ≤85%. When adjusting for age, sex, socioeconomic status, having excessive erythrocytosis, and site, we found that each 5% decrease in oxyhemoglobin saturation was associated with a higher adjusted odds of metabolic syndrome (OR = 1.35, 95% CI: 1.07-1.72, p < 0.04), insulin resistance as defined by homeostasis model assessment-insulin resistance (HOMA-IR) >2 mass units (OR = 1.29, 95% CI: 1.00-1.67, p < 0.05), hemoglobin A1c ≥6.5% (OR = 1.66, 95% CI: 1.09-2.51, p < 0.04), and high sensitivity C-reactive protein (hs-CRP) ≥3 mg/L (OR = 1.46, 95% CI: 1.09-1.96, p

  10. 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.

  11. 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.

  12. 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. PMID:24509326

  13. 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.

  14. 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

  15. Identifying and addressing mental health risks and problems in primary care pediatric settings: a model to promote developmental and cultural competence.

    PubMed

    Godoy, Leandra; Carter, Alice S

    2013-01-01

    Young children, particularly uninsured children of color, suffer from mental health disturbances at rates similar to older children and adults, yet they have higher rates of unmet needs. To address unmet needs, efforts to identify mental health problems in primary care pediatric settings have grown in recent years, thanks in large part to expanded screening efforts. Yet, health disparities in early detection remain. Enhancing understanding of how early childhood mental health problems can be identified and addressed within pediatric settings is an important and growing area of research. The authors draw on theoretical models from public health policy, health psychology, and child development, including health beliefs, help seeking, transtheoretical, motivation to change, and dynamic systems, to better understand and address challenges to and disparities in identifying and addressing mental health problems in pediatric settings. These theories have not previously been applied to early mental health screening and identification efforts. Developmental and sociocultural considerations are highlighted in an effort to address and reduce higher rates of unmet needs among young, uninsured children of color.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. Pediatric Bipolar Disorder: Combination Pharmacotherapy, Adverse Effects, and Treatment of High-Risk Youth.

    PubMed

    Chang, Kiki D

    2016-01-01

    Treating bipolar disorder in pediatric patients is challenging because data from rigorous trials of pharmacotherapy in this population are still not plentiful enough. Furthermore, the treatment of children and adolescents is complicated by the frequent need to combine pharmacotherapies to address all bipolar symptoms as well as this population's elevated risk for experiencing side effects. Additionally, young patients with depressive episodes who are at high risk for developing bipolar disorder need careful treatment to prevent or delay the emergence of mania. Despite these challenges, clinicians should evaluate the existing pediatric literature, extrapolate evidence obtained from adult patients, and draw from clinical experience to guide treatment decisions for children and adolescents with bipolar disorder. PMID:27570929

  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. Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

    PubMed

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2016-07-01

    Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group.

  3. Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study.

    PubMed

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2016-07-01

    Objective To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group. PMID:27040523

  4. Risk factors for HIV acquisition in high risk women in a generalised epidemic setting

    PubMed Central

    Naicker, Nivashnee; Kharsany, Ayesha BM; Werner, Lise; van Loggerenberg, Francois; Mlisana, Koleka; Garrett, Nigel; Karim, Salim S. Abdool

    2015-01-01

    In South Africa young women bear a disproportionate burden of HIV infection however, risk factors for HIV acquisition are not fully understood in this setting. In a cohort of 245 women, we used proportional hazard regression analysis to examine the association of demographic, clinical and behavioural characteristics with HIV acquisition. The overall HIV incidence rate (IR) was 7.20 per 100 women years (wy), 95% Confidence Interval (CI) 4.50–9.80]. Women 18–24 years had the highest HIV incidence [IR 13.20 per 100 wy, 95% CI 6.59–23.62] and were almost three times more likely to acquire HIV compared to women 25 years and older [adjusted Hazard Ratio (aHR) 2.61, 95% CI 1.05–6.47]. Similarly, women in relationships with multiple sex partners had more than twice the risk of acquiring HIV when compared to women who had no partner or who had a husband or stable partner (aHR 2.47, 95% CI 0.98–6.26). HIV prevention programmes must address young women's vulnerability and sex partner reduction in this setting. PMID:25662962

  5. [Artificial circulation in high-risk percutaneous coronary interventions].

    PubMed

    Bazylev, V V; Evdokimov, M E; Pantiukhina, M A; Morozov, Z A

    2016-01-01

    In their everyday practical clinical work cardiovascular surgeons sometimes have to deal with patients at extremely high risk of both percutaneous coronary interventions (PCIs) and direct myocardial revascularization. A method of choice in such situations may become a PCI supported by artificial circulation (AC), for which foreign and Russian authors propose using systems of prolonged extracorporeal membrane oxygenation (ECMO). The present work was aimed at sharing our experience with using standard systems of AC and their modifications (mini-circuit systems) for performing high-risk PCIs. Between October 2011 and November 2014, PCIs supported by artificial circulation were performed in a total of ten patients. All had extremely high risk of PCI due to coronary artery lesions [subocclusion of the trunk of the left coronary artery (LCA) combined with occlusion or significant stenosis of the right coronary artery (RCA)], concomitant pathology (obesity, diabetes mellitus, age, etc.) or critical state (circulatory arrest, resuscitating measures). Three patients during PCI developed ventricular fibrillation and one patient suffered an episode of asystole. All cardiac arrhythmias after restoration of the coronary blood flow disappeared spontaneously on the background of extracorporeal support. The only lethal outcome was registered during emergency PCI in a female patient admitted to the roentgen-operating room in the state of clinical death, on the background of continuing resuscitation measures. The presented methods of assisted circulation based on the standard AC systems and modification thereof (mini-circuit system) proved efficient. They make it possible to perform high-risk PCIs, including in clinics having neither appropriate equipment nor experience in ECMO. PMID:27626258

  6. 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.

  7. 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.

  8. High-risk acute myelogenous leukemia: treatment today ... and tomorrow.

    PubMed

    Schiller, Gary J

    2013-01-01

    High-risk acute myelogenous leukemia (AML) constitutes a distinct subset of disease based on clinical and biological characteristics and comprises a significant percentage of all cases of adult AML. Biologic features such as distinct clonal cytogenetic and molecular abnormalities identify a subgroup of AML patients characterized by poor response to induction chemotherapy and poor long-term survival after treatment with consolidation chemotherapy. Clinical variables that predict for poor response include AML relapsed after less than 1 year of remission and AML characterized by resistance to conventional agents. We review here our understanding of the defining biologic subtypes of AML and discuss how adequate initial evaluation can be used to inform the choice of treatment. By defining high-risk biologic and clinical variables, a strong case can be made for treating patients with investigational agents, with treatment directed at distinct cytogenetic or molecular abnormalities. Allogeneic transplantation is the only form of therapy available outside of the setting of a clinical trial that may offer a chance for long-term survival for patients with high-risk AML.

  9. 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

  10. 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

  11. Addressing Environmental Health Inequalities.

    PubMed

    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

  12. Management of high-risk gestational trophoblastic disease.

    PubMed

    Lurain, J R

    1998-01-01

    Multimodality therapy with combination chemotherapy employing etoposide, high-dose methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO), and adjuvant radiotherapy and surgery, when indicated, has resulted in cure rates of 80-90% in patients with high-risk metastatic gestational trophoblastic tumors. However, approximately 25-30% of high-risk patients will have an incomplete response to first-time chemotherapy or will relapse from remission. Most of these patients will have a clinicopathologic diagnosis of choriocarcinoma, metastases to sites other than the lung and vagina, more than eight metastases and/or failed inappropriate previous chemotherapy, resulting in very high World Health Organization scores. Salvage chemotherapy with cisplatin/etoposide, usually in conjunction with bleomycin or ifosfamide, as well as surgical resection of sites of resistant disease in selected patients, will result in a cure in most patients. New technology, such as the use of colony-stimulating factors to prevent treatment delays and dose reductions or high-dose chemotherapy with or without autologous bone marrow transplantation or peripheral blood stem cell support, may play an important role in the future management of patients who develop drug resistance. PMID:9475149

  13. 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.

  14. Ithubalethu-Intervention to Address Drug Use and Sexual HIV Risk Patterns among Female Commercial Sex Workers in Durban, South Africa.

    PubMed

    Carney, Tara; Petersen Williams, Petal M; Parry, Charles D H

    2016-01-01

    Previous research shows that interventions aimed at female sex workers (FSWs) can be successful in reducing HIV risk behavior. The current study evaluated a specific HIV prevention intervention for substance-using FSWs in Durban, South Africa by comparing such behaviors before and after the intervention. The intervention was provided by trained outreach workers by an organization that worked with FSWs, and consisted of community-based outreach, HIV and substance use education and information. Safer sex practices were also taught. The sample consisted of 457 substance-using FSWs, with findings indicating a significant decrease in the number of sexual partners (z = -16.05, p < 0.001), number of times they engaged in vaginal sex (z = -8.07, p < 0.001), and a significant decrease in all substances used with the exception of over-the-counter or prescription substances. The intervention therefore seemed to reduce certain risk behaviors among this group of FSWs. Future research should focus on the aspects of the substance use-sex risk intervention that were associated with decreased risk behavior, and include a randomized controlled trial to assess effectiveness of the intervention. PMID:27437563

  15. The integrated approach—Regulating private human spaceflight as space activity, aircraft operation, and high-risk adventure tourism

    NASA Astrophysics Data System (ADS)

    von der Dunk, Frans G.

    2013-12-01

    One of the overriding issues concerning private human spaceflight concerns how to properly regulate this specific new type of activity. Noting that in the discussion regarding regulation thereof usually the three distinct regimes of space law, air law and high-risk adventure tourism law are drawn upon to look for solutions, the present paper addresses the key elements of each of these approaches as they are to some extent already currently being applied and where, as a consequence, gaps and overlaps arise, as well as presents an effort to address the latter in a sensible, coherent, efficient and feasible manner.

  16. 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.

  17. Antibody-based immunotherapy in high-risk neuroblastoma.

    PubMed

    Johnson, Erik; Dean, Shannon M; Sondel, Paul M

    2007-01-01

    Although great advances have been made in the treatment of low- and intermediate-risk neuroblastoma in recent years, the prognosis for advanced disease remains poor. Therapies based on monoclonal antibodies that specifically target tumour cells have shown promise for treatment of high-risk neuroblastoma. This article reviews the use of monoclonal antibodies either as monotherapy or as part of a multifaceted treatment approach for advanced neuroblastoma, and explains how toxins, cytokines, radioactive isotopes or chemotherapeutic drugs can be conjugated to antibodies to enhance their effects. Tumour resistance, the development of blocking antibodies, and other problems hindering the effectiveness of monoclonal antibodies are also discussed. Future therapies under investigation in the area of immunotherapy for neuroblastoma are considered.

  18. Influenza vaccination in children at high risk of respiratory disease.

    PubMed

    Patria, Maria Francesca; Tagliabue, Claudia; Longhi, Benedetta; Esposito, Susanna

    2013-05-01

    Chronic respiratory diseases (CRDs) are a heterogeneous group of diseases that can affect the pediatric population and health authorities throughout the world recommend influenza vaccination because of the significant risk of influenza-related complications. However, despite this recommendation, vaccine coverage is generally unsatisfactory. The aim of this review is to analyze the impact of influenza on children at high risk of respiratory disease, and the immunogenicity, safety and efficacy of influenza vaccination in such children. The results show that there is a significant risk of influenza-related complications in preterm neonates and infants, in whom influenza vaccines are immunogenic and safe (although their efficacy has not been specifically studied). There are conflicting data concerning the effect of influenza infection on asthma morbidity in children, and whether or not influenza vaccination helps to prevent asthma exacerbations. Recent data provide no evidence that influenza is more frequent in patients with cystic fibrosis than in healthy subjects, or that it is responsible for increased lower respiratory tract morbidity. The lack of any clear correlate of protection suggests that future studies should also consider the efficacy of the different influenza vaccines and not only evaluate them in terms of immunogenicity. Furthermore, there is a need for clinical studies to assess the effectiveness of the available vaccines in patients with other rare CRDs and other chronic underlying diseases with possibly severe respiratory involvement. It is also important to determine whether children with recurrent respiratory tract infections should be included in the list of those for whom influenza vaccination is recommended. In the meantime, given the increasing evidence of the burden of influenza on the population as a whole and the benefits associated with vaccination, annual influenza vaccinations should be recommended for all children at high risk of

  19. 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.

  20. 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…

  1. HIV Risk Factors among Pregnant and Non-Pregnant High-Risk Women in New York City.

    ERIC Educational Resources Information Center

    Deren, Sherry; And Others

    1993-01-01

    Compared high-risk pregnant (n=55) and nonpregnant (n=598) women from Harlem on human immunodeficiency virus-related drug and sexual risk behaviors. Found higher percentage of intravenous drug users (IVDUs) among nonpregnant women and no significant differences between pregnant and nonpregnant IVDUs in terms of needle risk behaviors. Pregnant…

  2. Breast cancer risk in women who fulfill high-risk criteria: at what age should surveillance start?

    PubMed

    Brandt, Andreas; Lorenzo Bermejo, Justo; Sundquist, Jan; Hemminki, Kari

    2010-05-01

    Family history is a strong predictor of hereditary breast cancer, particularly when it includes cases of early onset or bilateral breast cancers and multiple cases of breast or ovarian cancers. This article provides relative risks and cumulative risks of breast cancer in women whose family history indicates high risk. Specifically, the aim was to determine how many years earlier the high-risk women reach the cumulative risk of women without family history at the age at which screening in average-risk women is initiated. The women of the nation-wide Swedish Family-Cancer Database were classified according to clinical criteria based on family history suggesting high risk for hereditary breast ovarian cancer syndrome. The relative risks of breast cancer were calculated as hazard ratio using Cox regression. Cumulative risks of breast cancer were estimated with a stratified Cox model based on Tsiatis' method. The hazard ratios of breast cancer for the considered criteria ranged from 1.50 to 5.99. The cumulative risks ranged from 1 to 10% by age 50 years. The age to reach the same cumulative risk as women lacking a family history at the age of 50 years ranged between 32.0 and 40.8 years. Relative and cumulative risks of women at high risk of breast cancer associated with different clinical criteria were diverse, which may be helpful in considering when current clinical criteria are revised. According to the present results, current recommendations of starting clinical interventions 10 years earlier in high-risk women, based on expert opinions, appear justified at least for the largest high-risk groups. PMID:19641988

  3. Identification of high risk DISC1 structural variants with a 2% attributable risk for schizophrenia.

    PubMed

    Song, Wenjia; Li, Wenyan; Feng, Jinong; Heston, Leonard L; Scaringe, William A; Sommer, Steve S

    2008-03-14

    The causes of schizophrenia remain elusive. In a large Scottish pedigree, a balanced translocation t(1;11) (q42.1;q14.3) disrupting the DISC1 and DISC2 genes segregates with major mental illness, including schizophrenia and unipolar depression. A frame-shift carboxyl-terminal deletion was reported in DISC1 in an American family, but subsequently found in two controls. A few common structural variants have been associated with less than a 2-fold increased risk for schizophrenia, but replication has not been uniform. No large scale case-control mutation study has been performed. We have analyzed the regions of likely functional significance in the DISC1 gene in 288 patients with schizophrenia and 288 controls (5 megabases of genomic sequence analyzed). Six patients with schizophrenia were heterozygous for ultra-rare missense variants not found in the 288 controls (p=0.015) and shown to be ultra-rare by their absence in a pool of 10,000 control alleles. We conclude that ultra-rare structural variants in DISC1 are associated with an attributable risk of about 2% for schizophrenia. In addition, we confirm that two common structural variants (Q264R and S704C) elevate the risk for schizophrenia slightly (odds ratio 1.3, 95% CI: 1.0-1.7). DISC1 illustrates how common/moderate risk alleles suggested by the HapMap project might be followed up by resequencing to identify genes with high risk, low frequency alleles of clinical relevance. PMID:18164685

  4. ESA’s process for the identification and assessment of high-risk conjunction events

    NASA Astrophysics Data System (ADS)

    Flohrer, T.; Krag, H.; Klinkrad, H.

    2009-08-01

    ESA's Space Debris Office provides an operational service for the assessment of collision risks of ESA satellites. Currently, the ENVISAT and ERS-2 missions in low Earth orbits are covered by this service. If an upcoming high-risk conjunction event is predicted based on analysis of Two-Line Element (TLE) data from the US Space Surveillance Network, then independent tracking data of the potential high-risk conjunction object are acquired to improve the knowledge of its orbit. This improved knowledge and the associated small error covariances derived from the orbit determination process scale down the position error ellipsoid at the conjunction epoch. Hence, for the same miss-distance, in most cases an avoidance manoeuvre can be suppressed with an acceptable residual risk. During the past years sophisticated stand-alone tools have been developed and maintained at ESA's Space Debris Office. The central tools for analysing conjunction events are the collision risk assessment software CRASS and the orbit determination software ODIN. ODIN is used to process tracking data and to determine orbits by least-squares fits of tracking data, or of pseudo-data in terms of osculating orbit states, which can for instance be derived from TLEs. On this basis, estimates of TLE error covariances also can be established as input for initial collision risk assessments. For ESA's automated routine conjunction event assessments which are embedded in a daily process with 7-day predictions, the handling of high-risk events is work-intensive. This shortcoming has been addressed by the implementation of a job scheduler, and automated procedures to facilitate the processing of tracking data, the update of ephemerides and covariances, and the update of conjunction geometries and collision risk estimates. The application of the upgraded software environment is illustrated through two exemplary, recent conjunction events of ENVISAT (02009A) with Russian Cosmos satellites: the conjunction event on

  5. Hangover frequency and risk for alcohol use disorders: evidence from a longitudinal high-risk study.

    PubMed

    Piasecki, Thomas M; Sher, Kenneth J; Slutske, Wendy S; Jackson, Kristina M

    2005-05-01

    Data from a prospective high-risk study (N=489; 51% with a family history of alcoholism) were used to test whether family history is associated with greater hangover proneness and whether hangover is a risk factor for alcohol use disorders. Hangover was more frequent in family-history-positive participants during the college years. Persons with an alcohol diagnosis showed excess hangover before earning a diagnosis. Year 1 hangover predicted alcohol use disorders at Years 7 and 11, even when family history, sex, Year 1 diagnoses, and Year 1 drinking were statistically controlled. Several nonhangover drinking symptoms failed to predict later diagnoses. Taken together, the findings suggest a need for further research and theory on the role of hangover in the etiology of drinking problems.

  6. Indoor tanning and risk of melanoma: a case-control study in a highly exposed population

    PubMed Central

    Lazovich, DeAnn; Vogel, Rachel Isaksson; Berwick, Marianne; Weinstock, Martin A.; Anderson, Kristin E.; Warshaw, Erin M.

    2010-01-01

    Background Indoor tanning has been only weakly associated with melanoma risk; most reports were unable to adjust for sun exposure, confirm a dose-response, or examine specific tanning devices. A population-based case-control study was conducted to address these limitations. Methods Cases of invasive cutaneous melanoma, diagnosed in Minnesota between 2004-2007 at ages 25-59, were ascertained from a statewide cancer registry; age-, gender-matched controls were randomly selected from state driver's license lists. Self-administered questionnaires and telephone interviews included information on ever use of indoor tanning, device types used, initiation age, period of use, dose, duration, and indoor-tanning related burns. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for known melanoma risk factors. Results Among 1167 cases and 1101 controls, 62.9% of cases and 51.1% of controls had tanned indoors (adjusted OR 1.74, 95% CI 1.42-2.14). Melanoma risk was pronounced among users of UVB-enhanced (adjusted OR 2.86, 95% CI 2.03-4.03) and primarily UVA-emitting devices (adjusted OR 4.44, 95% CI 2.45, 8.02). Risk increased with use: years (p<0.006), hours (p<0.0001), or sessions (p=0.0002). Odds ratios were elevated within each initiation age category; among indoor tanners, years used was more relevant for melanoma development. Conclusions In a highly exposed population, frequent indoor tanning increased melanoma risk, regardless of age when indoor tanning began. Elevated risks were observed across devices. Impact This study overcomes some of the limitations of earlier reports and provides strong support for the recent declaration by International Agency for Research on Cancer that tanning devices are carcinogenic in humans. PMID:20507845

  7. Autonomic dysfunction in subjects at high risk for Parkinson's disease.

    PubMed

    Liepelt-Scarfone, Inga; Pilotto, Andrea; Müller, Katharina; Bormann, Christian; Gauss, Katharina; Wurster, Isabel; Streffer, Johannes; Berg, Daniela

    2015-12-01

    Aim of this project was to evaluate autonomic dysfunction in subjects proposed to be at high risk to develop Parkinson's disease (PD) compared to control subjects and PD patients at different disease stages. Combinations of substantia nigra hyperechogenicity (SN+) assessed by transcranial ultrasound (TCS), hyposmia, lifetime prevalence of depression and mild PD-specific motor signs were used to identify subjects at high risk for motor Parkinson's disease (HR-PD). Supine and standing blood pressure (BP), hearth rate (HR), orthostatic, urinary, sexual and bowel symptoms were evaluated in HR-PD, healthy control subjects and PD patients, divided into mild and advanced stages. The study group consisted of 113 PD patients (mild PD n = 71, advanced PD, n = 42), 40 HR-PD individuals and 50 controls. Compared to controls, HR-PD subjects complained more often about urinary (p = 0.002) and bowel dysfunction (p = 0.001) and had a higher diastolic BP drop after standing (p = 0.01). The cumulative number of autonomic symptoms differentiated PD as well as HR-PD significantly from controls (p < 0.001). Advanced PD patients presented often and severe orthostatic symptoms, not significantly different from mild PD after concomitant medication correction. Our results support the presence of urinary and bowel dysfunction in subjects at high risk for motor PD. Presence and severity of orthostatic symptoms was higher during stages and increase in advanced stages, at least partly due to increase in dopaminergic and conflicting medication. Understanding the progression of non-motor aspects in PD might offer the possibility to use them as targets for disease-modifying therapies.

  8. 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

  9. 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 PMID:26472157

  10. 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

  11. 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

  12. Firearm Violence Among High-Risk Emergency Department Youth After an Assault Injury

    PubMed Central

    Walton, Maureen A.; Roehler, Douglas R.; Goldstick, Jason; Zimmerman, Marc A.; Blow, Frederic C.; Cunningham, Rebecca M.

    2015-01-01

    BACKGROUND: The risk for firearm violence among high-risk youth after treatment for an assault is unknown. METHODS: In this 2-year prospective cohort study, data were analyzed from a consecutive sample of 14- to 24-year-olds with drug use in the past 6 months seeking assault-injury care (AIG) at an urban level 1 emergency department (ED) compared with a proportionally sampled comparison group (CG) of drug-using nonassaulted youth. Validated measures were administered at baseline and follow-up (6, 12, 18, 24 months). RESULTS: A total of 349 AIG and 250 CG youth were followed for 24 months. During the follow-up period, 59% of the AIG reported firearm violence, a 40% higher risk than was observed among the CG (59.0% vs. 42.5%; relative risk [RR] = 1.39). Among those reporting firearm violence, 31.7% reported aggression, and 96.4% reported victimization, including 19 firearm injuries requiring medical care and 2 homicides. The majority with firearm violence (63.5%) reported at least 1 event within the first 6 months. Poisson regression identified baseline predictors of firearm violence, including male gender (RR = 1.51), African American race (RR = 1.26), assault-injury (RR = 1.35), firearm possession (RR = 1.23), attitudes favoring retaliation (RR = 1.03), posttraumatic stress disorder (RR = 1.39), and a drug use disorder (RR = 1.22). CONCLUSIONS: High-risk youth presenting to urban EDs for assault have elevated rates of subsequent firearm violence. Interventions at an index visit addressing substance use, mental health needs, retaliatory attitudes, and firearm possession may help decrease firearm violence among urban youth. PMID:25847808

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. High salt intake: independent risk factor for obesity?

    PubMed

    Ma, Yuan; He, Feng J; MacGregor, Graham A

    2015-10-01

    High salt intake is the major cause of raised blood pressure and accordingly leads to cardiovascular diseases. Recently, it has been shown that high salt intake is associated with an increased risk of obesity through sugar-sweetened beverage consumption. Increasing evidence also suggests a direct link. Our study aimed to determine whether there was a direct association between salt intake and obesity independent of energy intake. We analyzed the data from the rolling cross-sectional study-the UK National Diet and Nutrition Survey 2008/2009 to 2011/2012. We included 458 children (52% boys; age, 10±4 years) and 785 adults (47% men; age, 49±17 years) who had complete 24-hour urine collections. Energy intake was calculated from 4-day diary and misreporting was assessed by Goldberg method. The results showed that salt intake as measured by 24-hour urinary sodium was higher in overweight and obese individuals. A 1-g/d increase in salt intake was associated with an increase in the risk of obesity by 28% (odds ratio, 1.28; 95% confidence interval, 1.12-1.45; P=0.0002) in children and 26% (odds ratio, 1.26; 95% confidence interval, 1.16-1.37; P<0.0001) in adults, after adjusting for age, sex, ethnic group, household income, physical activity, energy intake, and diet misreporting, and in adults with additional adjustment for education, smoking, and alcohol consumption. Higher salt intake was also significantly related to higher body fat mass in both children (P=0.001) and adults (P=0.001) after adjusting for age, sex, ethnic group, and energy intake. These results suggest that salt intake is a potential risk factor for obesity independent of energy intake.

  19. High salt intake: independent risk factor for obesity?

    PubMed

    Ma, Yuan; He, Feng J; MacGregor, Graham A

    2015-10-01

    High salt intake is the major cause of raised blood pressure and accordingly leads to cardiovascular diseases. Recently, it has been shown that high salt intake is associated with an increased risk of obesity through sugar-sweetened beverage consumption. Increasing evidence also suggests a direct link. Our study aimed to determine whether there was a direct association between salt intake and obesity independent of energy intake. We analyzed the data from the rolling cross-sectional study-the UK National Diet and Nutrition Survey 2008/2009 to 2011/2012. We included 458 children (52% boys; age, 10±4 years) and 785 adults (47% men; age, 49±17 years) who had complete 24-hour urine collections. Energy intake was calculated from 4-day diary and misreporting was assessed by Goldberg method. The results showed that salt intake as measured by 24-hour urinary sodium was higher in overweight and obese individuals. A 1-g/d increase in salt intake was associated with an increase in the risk of obesity by 28% (odds ratio, 1.28; 95% confidence interval, 1.12-1.45; P=0.0002) in children and 26% (odds ratio, 1.26; 95% confidence interval, 1.16-1.37; P<0.0001) in adults, after adjusting for age, sex, ethnic group, household income, physical activity, energy intake, and diet misreporting, and in adults with additional adjustment for education, smoking, and alcohol consumption. Higher salt intake was also significantly related to higher body fat mass in both children (P=0.001) and adults (P=0.001) after adjusting for age, sex, ethnic group, and energy intake. These results suggest that salt intake is a potential risk factor for obesity independent of energy intake. PMID:26238447

  20. Contraception: Efficacy, Risks, Continuation Rates, and Use in High-Risk Women.

    PubMed

    Batur, Pelin; Bowersox, Natalie; McNamara, Megan

    2016-08-01

    The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to the use of contraceptive methods. We highlight articles on continuation rates of long-acting reversible contraception versus nonlong-acting methods, updated risks of intrauterine devices, use of estrogen-containing contraceptives during anticoagulation for venous thromboembolic events, and the efficacy of oral and emergency contraception in women with elevated body mass index. PMID:27438879

  1. Noninvasive Cerebral Perfusion Imaging in High-Risk Neonates

    PubMed Central

    Goff, Donna A.; Buckley, Erin M.; Durduran, Turgut; Wang, Jiongjong; Licht, Daniel J.

    2010-01-01

    Advances in medical and surgical care of the high-risk neonate have led to increased survival. A significant number of these neonates suffer from neurodevelopmental delays and failure in school. The focus of clinical research has shifted to understanding events contributing to neurological morbidity in these patients. Assessing changes in cerebral oxygenation and regulation of cerebral blood flow (CBF) is important in evaluating the status of the central nervous system. Traditional CBF imaging methods fail for both ethical and logistical reasons. Optical near infrared spectroscopy (NIRS) is increasingly being used for bedside monitoring of cerebral oxygenation and blood volume in both very low birth weight infants and neonates with congenital heart disease. Although trends in CBF may be inferred from changes in cerebral oxygenation and/or blood volume, NIRS does not allow a direct measure of CBF in these populations. Two relatively new modalities, arterial spin-labeled perfusion magnetic resonance imaging and optical diffuse correlation spectroscopy, provide direct, noninvasive measures of cerebral perfusion suitable for the high-risk neonates. Herein we discuss the instrumentation, applications, and limitations of these noninvasive imaging techniques for measuring and/or monitoring CBF. PMID:20109972

  2. 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

  3. 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.

  4. 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. PMID:27579180

  5. 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.

  6. Prevalence of Hearing Impairment in High Risk Infants.

    PubMed

    Vashistha, Ishika; Aseri, Yogesh; Singh, B K; Verma, P C

    2016-06-01

    Hearing impairment is prevalent in the general population, early intervention facilitates proper development. The aim of this study was to establish the prevalence of hearing impairment in high-risk infants born between 2013 and 2014. 100 newborns were evaluated using evoked otoacoustic emissions and distortion produce and auditory behavior. Tests were reported if the results were altered. If altered results persisted, the child was referred for impedance testing and when necessary for medical evaluation. Infants referred for BOA and OAE undergone Brainstem auditory evoked potential testing. Of 100 children, 85 children have hearing within normal limits. Hearing impairment was found in 15 out of which 7 had unilateral hearing loss and 8 had bilateral hearing loss. The high prevalence of hearing impairment in this population underlines the importance of early audiological testing.

  7. Prevalence of Hearing Impairment in High Risk Infants.

    PubMed

    Vashistha, Ishika; Aseri, Yogesh; Singh, B K; Verma, P C

    2016-06-01

    Hearing impairment is prevalent in the general population, early intervention facilitates proper development. The aim of this study was to establish the prevalence of hearing impairment in high-risk infants born between 2013 and 2014. 100 newborns were evaluated using evoked otoacoustic emissions and distortion produce and auditory behavior. Tests were reported if the results were altered. If altered results persisted, the child was referred for impedance testing and when necessary for medical evaluation. Infants referred for BOA and OAE undergone Brainstem auditory evoked potential testing. Of 100 children, 85 children have hearing within normal limits. Hearing impairment was found in 15 out of which 7 had unilateral hearing loss and 8 had bilateral hearing loss. The high prevalence of hearing impairment in this population underlines the importance of early audiological testing. PMID:27340640

  8. 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.

  9. 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

  10. 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. PMID:26603310

  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. 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.

  13. 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.

  14. Culture Change and Democracy at an Alternative High School for High-Risk Students.

    ERIC Educational Resources Information Center

    Neumann, Richard A.

    1998-01-01

    Examined the nature of culture change that occurred at an alternative continuation high school for at-risk students (n=116) and changes in student attitudes over 2 years. Quantitative and qualitative data show the effectiveness of the school's Team Learning Projects model and the school's restructuring program. (SLD)

  15. Childhood mortality after a high dose of vitamin A in a high risk population.

    PubMed Central

    Daulaire, N. M.; Starbuck, E. S.; Houston, R. M.; Church, M. S.; Stukel, T. A.; Pandey, M. R.

    1992-01-01

    OBJECTIVES--To determine whether a single high dose of vitamin A given to all children in communities with high mortality and malnutrition could affect mortality and to assess whether periodic community wide supplementation could be readily incorporated into an ongoing primary health programme. DESIGN--Opportunistic controlled trial. SETTING--Jumla district, Nepal. SUBJECTS--All children aged under 5 years; 3786 in eight subdistricts given single dose of vitamin A and 3411 in remaining eight subdistricts given no supplementation. MAIN OUTCOME MEASURES--Mortality and cause of death in the five months after supplementation. RESULTS--Risk of death for children aged 1-59 months in supplemented communities was 26% lower (relative risk 0.74, 95% confidence interval 0.55 to 0.99) than in unsupplemented communities. The reduction in mortality was greatest among children aged 6-11 months: death rate (deaths/1000 child years at risk) was 133.8 in supplemented children and 260.8 in unsupplemented children (relative risk 0.51, 0.30 to 0.89). The death rate from diarrhoea was also reduced (63.5 supplemented v 97.5 unsupplemented; relative risk 0.65, 0.44 to 0.95). The extra cost per death averted was about $11. CONCLUSION--The results support a role for Vitamin A in increasing child survival. The supplementation programme was readily integrated with the ongoing community health programme at little extra cost. PMID:1739794

  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. PMID:26705655

  17. Optically Addressable Silicon Vacancy-Related Spin Centers in Rhombic Silicon Carbide with High Breakdown Characteristics and ENDOR Evidence of Their Structure

    NASA Astrophysics Data System (ADS)

    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.

    2015-12-01

    We discovered a family of uniaxially oriented silicon vacancy-related centers with S =3 /2 in a rhombic 15 R -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 VSi- in the paramagnetic state with S =3 /2 that is noncovalently bonded to the neutral carbon vacancy VC0 in the nonparamagnetic state, located on the adjacent site along the SiC symmetry c axis.

  18. Seismic, high wind, tornado, and probabilistic risk assessments of the High Flux Isotope Reactor

    SciTech Connect

    Harris, S.P.; Stover, R.L.; Hashimoto, P.S.; Dizon, J.O.; Oak Ridge National Lab., TN; EQE, Inc., San Francisco, CA )

    1989-01-01

    Natural phenomena analyses were performed on the High Flux Isotope Reactor (HFIR) Deterministic and probabilistic evaluations were made to determine the risks resulting from earthquakes, high winds, and tornadoes. Analytic methods in conjunction with field evaluations and an earthquake experience data base evaluation methods were used to provide more realistic results in a shorter amount of time. Plant modifications completed in preparation for HFIR restart and potential future enhancements are discussed. 5 figs.

  19. 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.

  20. High risk of tick bites in Dutch gardens.

    PubMed

    Mulder, Sara; van Vliet, Arnold J H; Bron, Wichertje A; Gassner, Fedor; Takken, Willem

    2013-12-01

    Lyme borreliosis is the most prevalent tick-borne disease throughout the Northern Hemisphere. Because the disease has large socioeconomic consequences, there is an urgent need to further educate the public to stimulate preventive behavior. Unfortunately, risk factors for tick bites are poorly known. In this study, we determined the habitats and activities at risk for tick bites for people of different age categories using reports of Dutch citizens. Most people, 43%, were bitten in the forest, and an unexpected large number of people reported tick bites from their gardens (31%). Hiking, hobby gardening, and playing were the most-mentioned activities during which tick bites were received; people aged from 50 to 69 and children below 10 were bitten most. Different age categories were bitten in different habitats and during different activities. People aged from 0 to 60 reported most tick bites related to visiting a forest and hiking, whereas people older than 60 were mainly bitten in gardens. The percentage of garden and hobby gardening tick bites increased with age, but was also high for children less than 10 years of age. We suggest that these findings should be taken into account for the development of prevention strategies aiming to decrease the number of Lyme borreliosis cases.

  1. 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

  2. Competing Risks Data Analysis with High-dimensional Covariates: An Application in Bladder Cancer

    PubMed Central

    Tapak, Leili; Saidijam, Massoud; Sadeghifar, Majid; Poorolajal, Jalal; Mahjub, Hossein

    2015-01-01

    Analysis of microarray data is associated with the methodological problems of high dimension and small sample size. Various methods have been used for variable selection in high-dimension and small sample size cases with a single survival endpoint. However, little effort has been directed toward addressing competing risks where there is more than one failure risks. This study compared three typical variable selection techniques including Lasso, elastic net, and likelihood-based boosting for high-dimensional time-to-event data with competing risks. The performance of these methods was evaluated via a simulation study by analyzing a real dataset related to bladder cancer patients using time-dependent receiver operator characteristic (ROC) curve and bootstrap .632+ prediction error curves. The elastic net penalization method was shown to outperform Lasso and boosting. Based on the elastic net, 33 genes out of 1381 genes related to bladder cancer were selected. By fitting to the Fine and Gray model, eight genes were highly significant (P < 0.001). Among them, expression of RTN4, SON, IGF1R, SNRPE, PTGR1, PLEK, and ETFDH was associated with a decrease in survival time, whereas SMARCAD1 expression was associated with an increase in survival time. This study indicates that the elastic net has a higher capacity than the Lasso and boosting for the prediction of survival time in bladder cancer patients. Moreover, genes selected by all methods improved the predictive power of the model based on only clinical variables, indicating the value of information contained in the microarray features. PMID:25907251

  3. 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

  4. Risk of Window Period HIV 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.

    2010-01-01

    The OPTN defines high risk donors (HRDs), colloquially known as “CDC high risk donors,” as those thought to carry an increased risk of HIV window period (WP) infection prior to serologic detectability. However, the true risk of such infection remains unknown. To quantify the risk of WP infection in each HRD behavior category, we performed a systematic review and meta-analysis of studies of HIV prevalence and incidence. Of 3,476 abstracts reviewed, 27 eligible studies of HIV infection in HRD populations were identified. Pooled HIV incidence estimates were calculated for each category of HRD behavior and used to calculate the risk of WP HIV infection. Risks ranged from 0.09–12.1 per 10,000 donors based on WP for ELISA and 0.04–4.9 based on nucleic acid testing (NAT), with NAT reducing WP risk by over 50% in each category. Injection drug users had the greatest risk of WP infection (4.9 per 10,000 donors by NAT WP), followed by men who have sex with men (4.2:10,000), commercial sex workers (2.7:10,000), incarcerated donors (0.9:10,000), donors exposed to HIV through blood (0.6:10,000), donors engaging in high risk sex (0.3:10,000), and hemophiliacs (0.035:10,000). These estimates can help inform patient and provider decision-making regarding HRDs. PMID:21366859

  5. Marital status and cardiovascular risk factors among middle-aged Japanese male workers: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study.

    PubMed

    Kamon, Yuko; Okamura, Tomonori; Tanaka, Taichiro; Hozawa, Atsushi; Yamagata, Zentaro; Takebayashi, Toru; Kusaka, Yukinori; Urano, Sumio; Nakagawa, Hideaki; Kadowaki, Takashi; Miyoshi, Yuji; Yamato, Hiroshi; Okayama, Akira; Ueshima, Hirotsugu

    2008-01-01

    Marital status is related to cardiovascular disease (CVD) risk factors in Western countries. However, few studies have addressed the relationship between marital status and CVD risk factors in other populations. We investigated lifestyle and CVD risk factors relative to marital status among middle-aged Japanese men. We analyzed baseline data of 40-59-yr-old male workers who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study. We compared lifestyle and CVD risk factors between men who were married (Group M; n=1,419, mean age 47.9 +/- 5.1 yr) and those who had never married (Group N; n=163, mean age 46.7 +/- 4.3 yr). Men in Group N were more likely to skip breakfast, work more shifts and exercise less. Current smoking rates, as well as average values of diastolic blood pressure (DBP), serum total cholesterol and fasting plasma glucose were also higher in Group N than in Group M. The proportion of participants with three or more CVD risk factors, namely smoking, hypertension, hypercholesterolemia and hyperglycemia was higher in Group N, than in Group M (12.9% vs. 5.0%, p<0.01). The difference between Groups M and N was more evident in the subgroup of living with others, than in the subgroup of living alone. Since men who have never married might be at higher risk for CVD, effort should be made to educate this population about decreasing lifestyle-related risk factors. PMID:18540118

  6. Comparison of Pap test among high and non-high risk female.

    PubMed

    Vaidya, A

    2003-01-01

    A prospective study of pap smear in 100 high risk and equal number of non high risk female among total 1022 female Gynecological patients within a period of two and half months {Beginning of Sept. to middle of Nov. 1995} in Maternity Hospital, Thapathali is presented. There were 9 cases positive for dyskaryosis among high risk and 3 cases among the comparison group. All positive cases were at the age of 35 years and above. In 9 positive cases, 5 cases were in CIN I (55.55%) while 4 were in CIN II (44.44%). Similarly out of 3 positive cases in comparison group 1 was in CIN I category (33.33%) and 2 cases were in CIN II (66.66%). Relation of positive cases with low social class revealed 80% CIN I and 50% CIN II among high risk group where as 66.6% CIN II in comparison group. Analysis of risk factor in development of various grades Dyskaryosis revealed 60% of CIN I had high parity while 50% had CIN II. There are about 40% of CIN I and 75% CIN II among child birth less than 19yrs, 60% smoker had CIN I where as 100%. Smoker had CIN II. 80% of CIN I gave history of excessive vaginal discharge where as 50% of CIN II had excessive vaginal discharge. 40% of CIN I was having injection Depo provera. Cases were also analyzed according to risk factor. Out of 9 positive cases among high-risk females 5 positive had parity more than 4 and 4 cases had less than 4. 5 positive cases were among less than 19 years of first childbirth, 4 among more than 19 years. 7 positive cases were smoker and 2 positive cases were non-smoker. 6 positive cases gave history of abnormal vaginal discharge and 3 positive cases had no abnormal vaginal discharge. Out of 9 positive cases 2 had history of injection Depo provera continuously for more than 5 years where as 7 were non users.

  7. 45 CFR 153.250 - Coordination with high-risk pools.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coordination with high-risk pools. 153.250 Section... ACT State Standards Related to the Reinsurance Program § 153.250 Coordination with high-risk pools. (a) General requirement. The State must eliminate or modify any State high-risk pool to the extent...

  8. Reentry Programming for High-Risk Offenders: Insights From Participants.

    PubMed

    Bender, Kimberly A; Cobbina, Jennifer E; McGarrell, Edmund F

    2016-10-01

    The mass increase in imprisonment of the last two decades has led to an increasing number of adults released from prison. Scholarly accounts of prisoner reentry have demonstrated that incarcerated individuals face barriers on release from prison and that intervention programs are necessary to assist their transition to the community. Here, we build from the insights of previous research by examining how high-risk offenders perceive a reentry program. Using a qualitative approach, our findings suggest that procedural and substantive justice affect their satisfaction and involvement with the program. This study highlights the importance of providing employment opportunities, social support, and fair and respectful delivery of services to assist incarcerated individuals transitioning to the community.

  9. Prenatal diagnosis of osteochondrodysplasias in high risk pregnancy.

    PubMed

    Gordienko IYu; Grechanina EYa; Sopko, N I; Tarapurova, E N; Mikchailets, L P

    1996-05-01

    We collected data on 39 prenatally diagnosed osteochondrodysplasias. We detected 30 (76.9%) cases in the first and second trimesters, including 18 (46.2%) with two twins before the 24th week of gestation. Of 39 cases 11 (28.2%) had osteogenesis imperfecta (OI) type II. Verification of the prenatal diagnosis was attempted in 26 cases on the basis of the data obtained from ultrasonographs, radiographs, external examination, and autopsy protocols. The prenatal diagnosis was confirmed in 19 (73%) fetuses. In 13 cases verification was not possible because one or several investigations could not be performed. Counselling followed all identified cases with osteochondrodysplasia. We present the pedigree of two families indicating the possibility of early prenatal diagnosis of achondrogenesis type I and metatropic dysplasia. We propose indications for ultrasonographic anatomical screening with subsequent phenotype analysis in high risk pregnancy to provide for the prenatal detection of malformations and hereditary diseases. PMID:8723093

  10. Alcohol Use, Depression, and High-Risk Occupations Among Young Adults in the Ukraine.

    PubMed

    Polshkova, Svitlana; Chaban, Oleg; Walton, Maureen A

    2016-06-01

    This study examined alcohol consumption in relation to anxiety, depression, and involvement with high risk occupations (HRO; e.g., coal miners), among young adults in the Ukraine (aged 18-25) (N = 192; 60.9% male; 100% Caucasian). Participants were grouped on the basis of drinking status: (1) current drinkers (CDs; n = 132) or (2) nondrinkers (NDs; n = 60). Questionnaires assessed frequency of alcohol use, motives for drinking, problem identification, as well as anxiety and depression (i.e., Hamilton scales). Bivariate analyses showed that CDs were more likely than NDs to be single, have a HRO, and have greater anxiety and depression; for example, 91.7% of CDs had a HRO as compared to 56.7% of NDs. Drinking status was not significantly related to age or gender. Among CDs, common motives for use included: to reduce anxiety and fears (60.6%), because my friends use alcohol (75.0%), to fight stress (78.8%), and to increase self-esteem (64.4%). Among CDs, past month drinking days were: 25% 1-2 days, 37.9% 3-7 days, 25% 8-21 days, and 12.1% 22-30 days. Regarding problem identification, 29.5% reported not having a problem, 34.8% reported possibly having a problem, 21.9% reported having a problem but not needing help, and 13.6% reported having a problem/needing help. Young adults involved in HRO may be a particularly high risk population given increased likelihood of alcohol use, anxiety, and depression. Early intervention strategies that incorporate motivational interviewing approaches to address coping and social motives for use may be beneficial to address substance use and mental health problems. PMID:27144438

  11. 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.

  12. High prevalence of cardiometabolic risk factors in Hispanic adolescents: correlations with adipocytokines and markers of inflammation.

    PubMed

    Pérez, Cynthia M; Ortiz, Ana P; Fuentes-Mattei, Enrique; Velázquez-Torres, Guermarie; Santiago, Damarys; Giovannetti, Katya; Bernabe, Raúl; Lee, Mong-Hong; Yeung, Sai-Ching J

    2014-10-01

    This study assessed the association of cardiometabolic risk factors with systemic inflammation, insulin resistance, and adypocytokines in a Hispanic adolescent subgroup. A clinic-based sample of 101 Puerto Rican adolescents, 48 of whom were overweight or obese based on body mass index percentiles for age and sex, was recruited during 2010. Data were collected through interviews, blood pressure and anthropometric measurements, and blood drawing. Overall prevalence of the metabolic syndrome was 16.8 % and increased to 37.5 % among overweight/obese youth. The overweight/obese group exhibited significantly (p < 0.05) higher values for abdominal obesity measures, systolic blood pressure, triglycerides, insulin resistance, C peptide, high-sensitivity C reactive protein, fibrinogen, leptin, and IL-6 and lower levels of high density lipoprotein cholesterol, adiponectin, and IGF-1. Total adiponectin significantly correlated with most cardiovascular risk factors independent of sex, Tanner stage, and adiposity. Altered cardiometabolic and adipocytokine profiles were present in this Hispanic subgroup, reinforcing the need to strengthen strategies addressing childhood obesity. PMID:23828626

  13. 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

  14. 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

  15. 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

  16. Patterns of Health-Risk Behavior among Japanese High School Students.

    ERIC Educational Resources Information Center

    Takakura, Minoru; Nagayama, Tomoko; Sakihara, Seizo; Willcox, Craig

    2001-01-01

    Surveyed Japanese high school students' health risk behavior patterns, examining clustering and accumulation of health risk behaviors. Physical inactivity and alcohol use were the most common risk behaviors. Prevalence rates for most risk behaviors varied by demographic variables. Smoking, drinking, and sexual intercourse clustered among both…

  17. 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…

  18. Targeted screening for colorectal cancer in high-risk individuals.

    PubMed

    Wong, Martin C S; Wong, Sunny H; Ng, Siew C; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y

    2015-12-01

    The idea of targeted screening for colorectal cancer based on risk profiles originates from its benefits to improve detection yield and optimize screening efficiency. Clinically, it allows individuals to be more aware of their own risk and make informed decisions on screening choice. From a public health perspective, the implementation of risk stratification strategies may better justify utilization of colonoscopic resources, and facilitate resource-planning in the formulation of population-based screening programmes. There are several at-risk groups who should receive earlier screening, and colonoscopy is more preferred. This review summarizes the currently recommended CRC screening strategies among subjects with different risk factors, and introduces existing risk scoring systems. Additional genetic, epidemiological, and clinical parameters may be needed to enhance their performance to risk-stratify screening participants. Future research studies should refine these scoring systems, and explore the adaptability, feasibility, acceptability, and user-friendliness of their use in clinical practice among different population groups. PMID:26651255

  19. 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…

  20. 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.

  1. Screening for eating disorders in pregnancy: how uniform screening during a high-risk period could minimize under-recognition.

    PubMed

    Hawkins, Leah K; Gottlieb, Barbara R

    2013-04-01

    Eating disorders in the United States are on the rise, disproportionally afflict reproductive-age women, and can affect mortality rates as high as those in major depression. (1-3) Though studies have characterized associations of eating disorders with numerous adverse maternal and fetal outcomes, a paucity of studies have addressed diagnosis and management of eating disorders in pregnancy. (4-6) The present work synthesizes current literature to demonstrate how providers can improve identification by capitalizing on this high-risk period.

  2. Upper tract urothelial carcinoma: epidemiology, high risk populations and detection.

    PubMed

    Redrow, Grant P; Matin, Surena F

    2016-08-01

    Upper tract urothelial carcinoma (UTUC) is a rare but highly morbid genitourinary malignancy. In 2014 approximately 15,000 new cases were diagnosed in the United States. It accounts for approximately 5-10% of all urothelial cell carcinomas, and 10% of renal tumors. Recent research has increased understanding of the epidemiology of this disease, including several high-risk populations. Environmental exposure to tobacco as well as aristolochic acid, and other carcinogens significantly increase the development of UTUC. Additionally, the genetic condition of hereditary nonpolyposis colorectal carcinoma (HNPCC), also known as Lynch Syndrome (LS) is linked to development of UTUC. Advances in imaging, ureteroscopy, cytological techniques and pathological recognition have allowed for improved detection of primary tumors and recurrent disease. Non-invasive imaging with computed tomography (CT) and magnetic resonance imaging (MRI) now represent the gold standard in imaging detection and surveillance, while technological advances in ureteroscopy allow for minimally invasive approaches to obtain pathologic diagnosis anywhere within the upper tracts. This review will highlight these recent improvements to allow better understanding of who is affected by this rare and morbid disease, as well as the latest developments in detection and surveillance. PMID:27008468

  3. Decontamination of High-risk Animal and Zoonotic Pathogens

    PubMed Central

    Menrath, Andrea; Tomuzia, Katharina; Braeunig, Juliane; Appel, Bernd

    2013-01-01

    Preparedness for the decontamination of affected environments, premises, facilities, and products is one prerequisite for an immediate response to an animal disease outbreak. Various information sources provide recommendations on how to proceed in an outbreak situation to eliminate biological contaminants and to stop the spread of the disease. In order to facilitate the identification of the right decontamination strategy, we present an overview of relevant references for a collection of pathogenic agents. The choice of pathogens is based on a survey of lists containing highly pathogenic agents and/or biological agents considered to be potential vehicles for deliberate contamination of food, feed, or farm animals. European legislation and guidelines from national and international institutions were screened to find decontamination protocols for each of the agents. Identified recommendations were evaluated with regard to their area of application, which could be facilities and equipment, wastes, food, and other animal products. The requirements of a disinfectant for large-scale incidents were gathered, and important characteristics (eg, inactivating spectrum, temperature range, toxicity to environment) of the main recommended disinfectants were summarized to assist in the choice of a suitable and efficient approach in a crisis situation induced by a specific high-risk animal or zoonotic pathogen. The literature search revealed numerous relevant recommendations but also legal gaps for certain diseases, such as Q fever or brucellosis, and legal difficulties for the use of recommended disinfectants. A lack of information about effective disinfectants was identified for some agents. PMID:23971795

  4. 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 in settings…

  5. Academic achievement trajectories of homeless and highly mobile students: resilience in the context of chronic and acute risk.

    PubMed

    Cutuli, J J; Desjardins, Christopher David; Herbers, Janette E; Long, Jeffrey D; Heistad, David; Chan, Chi-Keung; Hinz, Elizabeth; Masten, Ann S

    2013-01-01

    Analyses examined academic achievement data across third through eighth grades (N = 26,474), comparing students identified as homeless or highly mobile (HHM) with 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.

  6. 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

  7. HIV vaccine acceptability among high-risk drug users in Appalachia: a cross-sectional study

    PubMed Central

    2014-01-01

    provide evidence for feasibility of HIV vaccination in a rural, high-risk population in the United States. This study provides preliminary evidence that gender-specific targeting in vaccine promotion may be necessary to promoting vaccine uptake in this setting, particularly among men. The data also underscore the importance of addressing perceived risks and benefits, social norms, and logistical constraints in efforts to achieve widespread vaccine coverage in this high-risk population. PMID:24885970

  8. Dispositional Empathy in High- and Low-Risk Parents for Child Physical Abuse.

    ERIC Educational Resources Information Center

    Perez-Albeniz, A.; de Paul, Joaquin

    2003-01-01

    Parents identified as either at high risk (n=36) or low-risk (n=38) for child physical abuse were assessed for dispositional empathy. High-risk parents showed lower total scores on the Hogan Empathy Scale and the Questionnaire Measure of Emotional Empathy. They also scored higher on the Interpersonal Reactivity Index "personal distress" dimension.…

  9. Cooking methods and esophageal squamous cell carcinoma in high-risk areas of Iran.

    PubMed

    Hakami, Roya; Etemadi, Arash; Kamangar, Farin; Pourshams, Akram; Mohtadinia, Javad; Firoozi, Mehdi Saberi; Birkett, Nicholas; Boffetta, Paolo; Dawsey, Sanford M; Malekzadeh, Reza

    2014-01-01

    Cooking methods have been implicated in the etiology of gastrointestinal cancers, reflecting exposure to potential carcinogens as results of cooking. We used a validated food frequency questionnaire and a pretested cooking method questionnaire in 3 groups: 40 esophageal squamous cell carcinoma (ESCC) cases from a high-risk area in northeast of Iran, 40 healthy subjects from the same high-risk area, and 40 healthy subjects from a low-risk area in Southern Iran. We compared the frequency of boiling, grilling, and frying, and the frying score among these 3 groups. We also calculated "frying index" by multiplying the frequency of each fried food item by its frying score. Mean frying to boiling ratios were 18.2:1, 12.8:1, and 2.6:1 for cases, high-risk controls, and low-risk controls, respectively (P < 0.01). Reuse of cooking oil for frying was reported in 37.5% of the ESCC cases, 25% of high-risk controls, and 7.5% of low-risk controls (P < 0.001). Frying index was higher in the high-risk than in the low-risk controls (P < 0.001) and in cases than in the high-risk controls (P < 0.05) after adjusting for smoking, opium use, rural residence, education, and ethnicity. High-temperature cooking and frying may be associated with increased risk of ESCC in high-risk areas.

  10. Gender Differences in Empathy in Parents at High- and Low-Risk of Child Physical Abuse

    ERIC Educational Resources Information Center

    Perez-Albeniz, A.; de Paul, Joaquin

    2004-01-01

    Objectives: The present research was designed to study empathy in high-risk parents for child physical abuse. The main objective was to study if high-risk mothers and fathers, compared to low-risk mothers and fathers, presented more Personal distress, less Perspective-taking, less Empathic concern and a deficit in dispositional empathy toward…

  11. 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

  12. 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. PMID:23884091

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. Eye-tracking measurements of language processing: developmental differences in children at high risk for ASD.

    PubMed

    Chita-Tegmark, Meia; Arunachalam, Sudha; Nelson, Charles A; Tager-Flusberg, Helen

    2015-10-01

    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

  18. Eye-tracking measurements of language processing: developmental differences in children at high risk for ASD.

    PubMed

    Chita-Tegmark, Meia; Arunachalam, Sudha; Nelson, Charles A; Tager-Flusberg, Helen

    2015-10-01

    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.

  19. Breast Cancer Patients with High Density Mammograms Do Not Have Increased Risk of Death

    MedlinePlus

    ... News Releases News Release Thursday, September 6, 2012 Breast cancer patients with high density mammograms do not have ... is a marker of increased risk of developing breast cancer, does not seem to increase the risk of ...

  20. 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.

  1. 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.

  2. 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.

  3. Influenza and pneumococcal pneumonia immunization. Protecting our high risk population.

    PubMed

    Siegel, B R; Mahan, C S; Witte, J J; Janowski, H T

    1990-06-01

    Pneumonia and influenza (P & I) constitute Florida's sixth leading cause of death. The P & I death rate in 1987, 10.5 per 100,000, was the highest since 1978. Major target groups for one or both vaccines used in prevention, as recommended by the Immunization Practices Advisory Committee (ACIP), include persons with chronic diseases of the heart or lungs, residents of nursing homes and other chronic care facilities, and persons aged 65 and older. Despite well-defined recommendations, vaccine coverage rates in Florida are as low as 30% in persons greater than or equal to 65 years of age. Knowledge and attitude surveys demonstrate that low coverage among various population groups may be due largely to insufficient awareness and/or negative attitudes regarding pneumococcal and influenza vaccines. Conversely, recommendations by physicians and other health care providers are strongly associated with receiving either vaccine. If the incidence of P & I is to decrease substantively in Florida, much wider use of the vaccines must occur. Because so many high-risk patients depend on private physicians for health care, their role is critical to the success of Florida public health strategies to reverse P & I trends.

  4. 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. PMID:23535471

  5. Rodent and germplasm trafficking: risks of microbial contamination in a high-tech biomedical world.

    PubMed

    Mahabir, Esther; Bauer, Beth; Schmidt, Jörg

    2008-01-01

    High-tech biomedical advances have led to increases both in the number of mice used for research and in exchanges of mice and/or their tissues between institutions. The latter are associated with the risk of dissemination of infectious agents. Because of the lack of international standardization of health surveillance programs, health certificates for imported rodents may be informative but may not address the needs of the importing facility. Preservation of mouse germplasm is achieved by cryopreservation of spermatozoa, embryos, or ovaries, and embryonic stem cells are used for the production of genetically engineered mice. After embryo transfer, recipients and rederived pups that test negative in microbiological screening for relevant microorganisms are released into full barrier holding areas. However, current research shows that embryos may also transmit microorganisms, especially viruses, to the recipient mice. In this article, we discuss regulations and practical issues in the shipping of live mice and mouse tissues, including spermatozoa, embryos, ovaries, and embryonic stem cells, and review work on microbial contamination of these biological materials. In addition, we present ways to reduce the risk of transmission of pathogens to mice under routine conditions. PMID:18506068

  6. Molecular Mechanisms Linking High Dose Medroxyprogesterone with HIV-1 Risk

    PubMed Central

    Irvin, Susan C.; Herold, Betsy C.

    2015-01-01

    Background Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms. Methods Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated. Results Treatment of VK2/E6E7 cells with high doses (>15μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively. Conclusion We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo. PMID:25798593

  7. 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

  8. Drug Prevention with High Risk Families and Young Children.

    ERIC Educational Resources Information Center

    Hahn, Ellen J.; Hall, Lynne A.; Simpson, Mary Rado

    1998-01-01

    Examines the effects of a school and home-based drug-abuse prevention program on risk factors for subsequent alcohol, tobacco, and other drug (ATOD) use among children. The parent-child intervention had no effect on parent or child risk factors, but the program was favorably received by parents and children. (Author/MKA)

  9. College Student Smokers' Cognitive Appraisal of High-Risk Activities

    ERIC Educational Resources Information Center

    Copeland, Amy L.; Kulesza, Magdalena; Patterson, Scott M.; Terlecki, Meredith A.

    2009-01-01

    Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, "Environ Behav." 1999; 23:575-591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions.…

  10. Risk and Resilience in Student Transitions to High School.

    ERIC Educational Resources Information Center

    Catterall, James S.

    1998-01-01

    Explores the concepts of risk and resilience applied to eighth graders and suggests advantages in considering a definition of risk grounded in actual school performance and behavior rather than to various group-level probabilities of failure. Evidence shows the importance of family supports, school responsiveness to students, and student…

  11. 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

  12. 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

  13. Variable addressability imaging systems

    NASA Astrophysics Data System (ADS)

    Kubala, Kenneth Scott

    The use of variable addressability for creating an optimum human-machine interface is investigated. Current wide field optical systems present more information to the human visual system than it has the capacity to perceive. The axial resolution, and/or the field of view can be increased by minimizing the difference between what the eye can perceive and what the system presents. The variable addressability function was developed through the use of a human factors experiment that characterized the position of the eye during the simulated use of a binocular system. Applying the variable addressability function to a conventional optical design required the development of a new metric for evaluating the expected performance of the variable addressability system. The new metric couples psycho-visual data and traditional optical data in order to specify the required performance of the variable addressability system. A non-linear mapping of the pixels is required in order to have the system work most efficiently with the human visual system, while also compensating for eye motion. The non-linear mapping function, which is the backbone of the variable addressability technique, can be created using optical distortion. The lens and system design is demonstrated in two different spectral bands. One of the designs was fabricated, tested, and assembled into a prototype. Through a second human factors study aimed at measuring performance, the variable addressability prototype was directly compared to a uniform addressability prototype, quantifying the difference in performance for the two prototypes. The human factors results showed that the variable addressability prototype provided better resolution 13% of the time throughout the experiment, but was 15% slower in use than the uniform addressability prototype.

  14. Injuries in high-risk persons and high-risk sports. A longitudinal study of 1818 school children.

    PubMed

    Backx, F J; Beijer, H J; Bol, E; Erich, W B

    1991-01-01

    In this Dutch population-based study we attempted to determine the incidence and severity of sports injuries occurring during different kind of sports in a longitudinal way. The study included 1818 school children aged 8 to 17 years. Over a period of 7 months, 399 sports injuries were reported in 324 youngsters. The most common types of injuries were contusions (43%) and sprains (21%). Medical attention was needed in 25% of all cases. Young basketball, handball and korfball players had a nearly 100% chance of suffering one sports injury per year. Volleyball especially had a high incidence rate in practice (6.7 in 1000 hours). Although physical education classes had a low incidence rate, there were significantly more fractures on the upper limb. Etiologically, sports-related factors were much more important than personal-bound factors. The injured youths spent more time in practice than the noninjured ones, both in organized and nonorganized sports (P less than 0.001). High-risk sports were characterized by contact, a high jump rate, and indoor activities. These three factors explained 78% of the total variance. The contact versus noncontact factor accounted for 48% of the medically treated injuries. An additional goal of this study was to explore the seasonal influence as an extrinsic environmental factor. We found that the duration of injury was increased in the spring (P less than 0.05). Specific preventive measures were formulated in order to reduce the number of new and recurring injuries and a proposal was made to implement injury prevention in school curriculums.

  15. [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.

  16. 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.

  17. 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

  18. Genomic Changes in Normal Breast Tissue in Women at Normal Risk or at High Risk for Breast Cancer.

    PubMed

    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

  19. Latent Model Analysis of Substance Use and HIV Risk Behaviors among High-Risk Minority Adults

    ERIC Educational Resources Information Center

    Wang, Min Qi; Matthew, Resa F.; Chiu, Yu-Wen; Yan, Fang; Bellamy, Nikki D.

    2007-01-01

    Objectives: This study evaluated substance use and HIV risk profile using a latent model analysis based on ecological theory, inclusive of a risk and protective factor framework, in sexually active minority adults (N=1,056) who participated in a federally funded substance abuse and HIV prevention health initiative from 2002 to 2006. Methods: Data…

  20. 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. PMID:27077538

  1. 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.

  2. 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

  3. Weighted Road Density and Allergic Disease in Children at High Risk of Developing Asthma

    PubMed Central

    Hansell, Anna L.; Rose, Nectarios; Cowie, Christine T.; Belousova, Elena G.; Bakolis, Ioannis; Ng, Kitty; Toelle, Brett G.; Marks, Guy B.; Almqvist, plus Catarina; Ampon, Rosario D; Ayer, Julian; Bird, Tessa; Brew, Bronwyn K; Britton, Warwick J; Celermajer, David; Cowell, Christopher T; Crisafulli, Daniele; Criss, Sally; Davis, Stella; Nabil Ezz, Wafaa; Forbes, Samantha; Garden, Frances L; Kemp, Andrew S; Knezevic, Natalia; Krause, William; Leeder, Stephen R; Mellis, Craig M; Mihrshahi, Seema; Neumann, Mark; Peat, Jennifer K; Quinones-Lucio, Andres; Skilton, Michael; Tattam, Anne; Tovey, Euan R; Vanlaar, Carl H.; Vukasin, Nicola; Wainwright, Craig; Webb, Karen L; Weber-Chrysochoou, Christina; Woolcock, Ann J; Zhou, Jie

    2014-01-01

    Background Evidence for an association between traffic-related air pollution and allergic disease is inconsistent, possibly because the adverse effects may be limited to susceptible subgroups and these have not been identified. This study examined children in the Childhood Asthma Prevention Study (CAPS), potentially susceptible to air pollution effects because of a family history of asthma. Methods We examined cross-sectional associations at age eight years between road density within 75 m and 50 m of home address weighted by road type (traffic density), as a proxy for traffic-related air pollution, on the following allergic and respiratory outcomes: skin prick tests (SPTs), total and specific serum IgE, pre- and post-bronchodilator lung function, airway hyperresponsiveness, exhaled NO, and reported asthma and rhinitis. Results Weighted road density was positively associated with allergic sensitisation and allergic rhinitis. Adjusted relative risk (RR) for house dust mite (HDM) positive SPT was 1.25 (95% CI: 1.06–1.48), for detectable house dust mite-specific IgE was 1.19 (95% CI: 1.01–1.41) and for allergic rhinitis was 1.30 (95% CI: 1.03–1.63) per 100 m local road or 33.3 m motorway within 50 m of home. Associations were also seen with small decrements of peak and mid-expiratory flows and increased risk of asthma, current wheeze and rhinitis in atopic children. Conclusion Associations between road density and allergic disease were found in a potentially susceptible subgroup of children at high risk of developing atopy and asthma. PMID:24949625

  4. Comparison of methods trial for high-risk HPV.

    PubMed

    Kurtycz, Daniel F I; Smith, Michele; He, Rong; Miyazaki, Kayo; Shalkham, John

    2010-02-01

    In efforts to improve service, we compared the performance of four methods of HPV detection: Invader HPV (Hologic), Hybrid Capture 2 (Qiagen), Inform HPV detection (Ventana), and standard PCR.Using blinded/de-identified cervical samples in Preservcyt (Hologic), we compared Ventana's Inform HPV Test, against Hologic's HPV Invader and PCR. In a separate evaluation, we compared Inform versus Invader versus hc2. Ventana employs in situ hybridization; Hologic's technology uses three specifically designed oligonucleotides and a fluorescent signal for detection. Qiagen's hc2 method incorporates enzyme-linked antibody detection of RNA-DNA hybrids. PCR testing was provided by Access Genetics (Minneapolis, MN). The United States Food and Drug Administration recently approved the Third Wave/Hologic Invader HPV high-risk test (rebranded as Cervista HPV HR Test).In this small study, involving a few hundred tests, Third Wave, Qiagen, and PCR tests were comparable. Kappa statistics comparing Third Wave to PCR and Third Wave to Qiagen were 0.88 and 0.74, respectively. Ventana's method did not correlate well with any of the other methods with Kappa's ranging from a low of 0.25 versus Qiagen to 0.31 versus PCR. Kappa statistics measure correlation and not accuracy of measurement.Although we felt that the specificity of our original HPV method, Ventana Inform was satisfactory and lowered our subsequent colposcopy rate, worries about its lower sensitivity caused us to look at other techniques. Other methods, PCR, hc2, and Invader, appeared comparable with one another in our series. We chose to implement the Third Wave test in our laboratory.

  5. 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. PMID:24582775

  6. 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…

  7. 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.

  8. Reforming America's Schools: The High Risks of Failure.

    ERIC Educational Resources Information Center

    Best, John Hardin

    1984-01-01

    The decline of America's schools risks the country's leadership in technology and production, economic well-being, military security, and social and civil order. The role that the educational system plays in this society is explored. (DF)

  9. Early Signs of Organic Symptomatology in High-Risk Infants.

    ERIC Educational Resources Information Center

    Denhoff, Eric

    The author discusses the question of whether problems during infancy associated with organic impairment are substantially different from those related to social-emotional deprivation. Five factors which have a significant impact for both organically impaired and environmentally deprivated infants are addressed: prenatal intensive care, very early…

  10. Intentions for risk-reducing surgery among high-risk women referred for BRCA1/BRCA2 genetic counseling

    PubMed Central

    Tong, Angie; Kelly, Scott; Nusbaum, Rachel; Graves, Kristi; Peshkin, Beth N.; Valdimarsdottir, Heiddis B.; Wood, Marie; McKinnon, Wendy; Garber, Judy; McCormick, Shelley R.; Jandorf, Lina; Schwartz, Marc D.

    2014-01-01

    Objective Genetic testing for breast and ovarian cancer susceptibility is now part of routine clinical practice. Although rates of risk-reducing surgery following genetic testing have been increasing, little is known about attitudes toward risk-reducing surgery in women prior to genetic counseling and testing. This study examines correlates of patient intentions to undergo risk-reducing mastectomy (RRM) and risk-reducing oophorectomy (RRO). Methods Participants were 696 women, ages 21–85, who sought breast cancer gene 1 and 2 (BRCA1/2) genetic counseling and had at least a 10% risk of carrying a mutation. The sample included women who were affected with breast or ovarian cancer and unaffected women with a known familial BRCA1/2 mutation. Participants completed a precounseling telephone questionnaire. Results Prior to receiving genetic counseling, 23.3% of participants were considering RRM and 42.5% were considering RRO. Variables that were independently associated with RRM intentions were cancer-specific distress (OR = 1.14, 95% CI = 1.03–1.26), perceived risk of breast cancer (OR = 1.16, 95% CI = 1.05–1.28), education (OR = 1.76, 95% CI = 1.03–2.99), and age (OR = 0.96, 95% CI = 0.95–0.98). Predictors of RRO intentions were perceived risk for ovarian cancer (OR = 1.25, 95% CI = 1.14–1.37), perceived risk of carrying a BRCA1/2 mutation (OR = 1.74, 95% CI = 1.15–2.62), marital status (OR = 1.92, 95% CI = 1.34–2.76), and age (OR = 1.02, 95% CI = 1.00–1.03). Conclusions Because precounseling intentions predict subsequent risk-reducing surgery decisions, this study identified patient factors associated with surgical intentions. These factors reinforce the critical role for pretest genetic counseling in communicating accurate risk estimates and management options, and addressing psychosocial concerns, to facilitate informed decision making regarding RRM and RRO. PMID:24839250

  11. 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

  12. 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…

  13. 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…

  14. 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…

  15. 45 CFR 153.250 - Coordination with high-risk pools.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 153.250 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT State Standards Related to the Reinsurance Program § 153.250 Coordination with high-risk pools....

  16. 45 CFR 153.250 - Coordination with high-risk pools.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 153.250 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT State Standards Related to the Reinsurance Program § 153.250 Coordination with high-risk pools....

  17. 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…

  18. 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.

  19. State High-Risk Pools: An Update on the Minnesota Comprehensive Health Association

    PubMed Central

    Spencer, Donna; Burke, Courtney E.

    2011-01-01

    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. PMID:21228286

  20. 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. PMID:21228286

  1. Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?

    PubMed Central

    2014-01-01

    Background Colorectal cancer (CRC) may be reduced by healthy lifestyle behaviours. We determined the extent of self-reported lifestyle changes in people at increased risk of CRC, and the association of these reports with anxiety, risk and knowledge-based variables. Methods We randomly selected 250 participants who had undergone surveillance colonoscopy for family history of CRC. A telephone interview was conducted, recording demographics and family history. Self-reported lifestyle change due to thoughts about CRC across a range of dietary and lifestyle variables was assessed on a four-point scale. Participants’ perceptions of the following were recorded: risk factor knowledge, personal risk, and worry due to family history. General anxiety was assessed using the GAD-7 scale. Ordinal logistic regression was used to calculate adjusted results. Results There were 148 participants (69% response). 79.7% reported at least one healthy change. Change in diet and physical activity were most frequently reported (fiber, 63%; fruit and vegetables, 54%; red meat, 47%; physical activity, 45%), with consumption of tobacco, alcohol, and body weight less likely (tobacco, 25%; alcohol, 26%; weight 31%). People were more likely to report healthy change with lower levels of generalized anxiety, higher worry due to family history, or greater perceived knowledge of CRC risk factors. Risk perception and risk due to family history were not associated with healthy changes. Conclusions Self-reported lifestyle changes due to thoughts about CRC were common. Lower general anxiety levels, worries due to family history, and perceived knowledge of risk factors may stimulate healthy changes. PMID:24507382

  2. An Examination of Prepartying and Drinking Game Playing During High School and Their Impact on Alcohol-Related Risk Upon Entrance into College

    PubMed Central

    Kenney, Shannon R.; Hummer, Justin F.

    2015-01-01

    Prepartying and drinking game playing are associated with excessive alcohol consumption and alcohol-related negative consequences in college populations; however, research exploring the prevalence of these high risk drinking contexts among high school students, and how such engagement may impact both high school and subsequent college drinking risk, is lacking. The current study, which is the first study to assess prepartying during high school, examined how engaging in either prepartying or drinking game playing during high school was associated with risky high school drinking as well asalcohol use and consequences during the transitional first month of college. The study involved 477 first-year college students, the majority of whom were 18 years old (94%), female (66%), and Caucasian (59%). Prepartying was found to be highly prevalent in high school (45%). Further, students who prepartied or played drinking games during high school drank significantly more in high school than students who did not engage in these high risk activities. Finally, prepartying and game playing during high school were associated with greater collegiate alcohol consumption (controlling for high school drinking) and consequences (controlling for both high school and college drinking). This study establishes prepartying and drinking games as common high risk activities among both high school and incoming first-year college students, and addresses implications for prevention and targeted interventions. PMID:19904593

  3. 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.

  4. 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

  5. Dimensions of adolescent rebellion: risks for academic failure among high- and low-income youth.

    PubMed

    Luthar, Suniya S; Ansary, Nadia S

    2005-01-01

    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.

  6. Predicting Prostate Cancer Mortality Among Men With Intermediate to High-Risk Disease and Multiple Unfavorable Risk Factors

    SciTech Connect

    Nguyen, Paul L. Chen Minghui; Catalona, William J.; Moul, Judd W.; Sun, Leon; D'Amico, Anthony V.

    2009-03-01

    Purpose: To determine whether the number of unfavorable risk factors could be used to predict the risk of prostate cancer-specific mortality (PCSM) among men with intermediate- to high-risk prostate cancer. Methods and Materials: We studied 1,063 men who underwent radical prostatectomy (n = 559), external beam radiotherapy (n = 288), or radiotherapy plus androgen suppression therapy (n = 116) for prostate cancer between 1965 and 2002. Fine and Gray's regression analysis was used to determine whether an increasing number of unfavorable risk factors (prostate-specific antigen level >10 ng/mL, Gleason score of {>=}7, clinical Stage T2b or greater, or pretreatment prostate-specific antigen velocity >2.0 ng/mL/y) was associated with the interval to PCSM and all-cause mortality. Results: Median follow-up was 5.6 years. Compared with those with one risk factor, the adjusted hazard ratio for PCSM was 2.3 (95% confidence interval 1.1-4.8; p = 0.03) for two risk factors, 5.4 (95% confidence interval 2.7-10.7; p < 0.0001) for three risk factors, and 13.6 (95% confidence interval 6.3-29.2; p < 0.0001) for all four risk factors. The 5-year cumulative incidence of PCSM was 2.4% for one factor, 2.4% for two factors, 7.0% for three factors, and 14.7% for all four factors. Prostate cancer deaths as a proportion of all deaths was 19% for one factor, 33% for two factors, 53% for three factors, and 80% for four factors. Conclusion: The number of unfavorable risk factors was significantly associated with PCSM. Prostate cancer was the major cause of death in men with at least three risk factors. Therefore, these men should be considered for clinical trials designed to assess whether survival is prolonged with the addition of novel agents to current standards of practice.

  7. Breast Density and Benign Breast Disease: Risk Assessment to Identify Women at High Risk of Breast Cancer

    PubMed Central

    Tice, Jeffrey A.; Miglioretti, Diana L.; Li, Chin-Shang; Vachon, Celine M.; Gard, Charlotte C.; Kerlikowske, Karla

    2015-01-01

    Purpose Women with proliferative breast lesions are candidates for primary prevention, but few risk models incorporate benign findings to assess breast cancer risk. We incorporated benign breast disease (BBD) diagnoses into the Breast Cancer Surveillance Consortium (BCSC) risk model, the only breast cancer risk assessment tool that uses breast density. Methods We developed and validated a competing-risk model using 2000 to 2010 SEER data for breast cancer incidence and 2010 vital statistics to adjust for the competing risk of death. We used Cox proportional hazards regression to estimate the relative hazards for age, race/ethnicity, family history of breast cancer, history of breast biopsy, BBD diagnoses, and breast density in the BCSC. Results We included 1,135,977 women age 35 to 74 years undergoing mammography with no history of breast cancer; 17% of the women had a prior breast biopsy. During a mean follow-up of 6.9 years, 17,908 women were diagnosed with invasive breast cancer. The BCSC BBD model slightly overpredicted risk (expected-to-observed ratio, 1.04; 95% CI, 1.03 to 1.06) and had modest discriminatory accuracy (area under the receiver operator characteristic curve, 0.665). Among women with proliferative findings, adding BBD to the model increased the proportion of women with an estimated 5-year risk of 3% or higher from 9.3% to 27.8% (P < .001). Conclusion The BCSC BBD model accurately estimates women's risk for breast cancer using breast density and BBD diagnoses. Greater numbers of high-risk women eligible for primary prevention after BBD diagnosis are identified using the BCSC BBD model. PMID:26282663

  8. [Vegetarians are at high risk of vitamin B12 deficiency].

    PubMed

    Javid, Parva; Christensen, Erik

    2016-01-01

    Since vegetarians have a lower intake of vitamin B12 (B12) than non-vegetarians, they are at increased risk of developing B12 deficiency. The less animal products the food contains the worse the B12 status. However, even lacto-ovo-vegetarians run the risk of becoming deficient in B12. Vegetarians are recommended regularly to take supplements of B12, and they should be informed of the lacking content of B12 of plant products and the hazards of B12 deficiency. Furthermore, vegetarians should routinely be checked for possible B12 deficiency.

  9. 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.

  10. Prognostic Utility of Anti-EBV Antibody Testing for Defining NPC Risk among Individuals from High-Risk NPC Families

    PubMed Central

    Yu, Kelly J.; Hsu, Wan-Lun; Pfeiffer, Ruth M.; Chiang, Chun-Ju; Wang, Cheng-Ping; Lou, Pei-Jen; Cheng, Yu-Juen; Gravitt, Patti; Diehl, Scott R.; Goldstein, Alisa M.; Chen, Chien-Jen; Hildesheim, Allan

    2012-01-01

    Purpose Epstein–Barr virus (EBV) infection and a family history of nasopharyngeal carcinoma (NPC) are associated with NPC risk. We examined the risk associated with EBV markers and their clinical utility to identify NPC susceptibles within high-risk NPC families. Experimental Design We evaluated antibody titers against viral capsid antigen (VCA) IgA, EBV nuclear antigen-1 (EBNA1) IgA, and DNase among unaffected relatives of NPC cases from 358 multiplex families in Taiwan. Incident NPC cases were identified via linkage to the National Cancer Registry. Clinical examinations of 924 individuals were also done to identify occult, asymptomatic NPC. Baseline EBV serology was used to estimate NPC risk using rate ratios with 95% CI. Associated sensitivity/specificity and receiver operating characteristic (ROC) curves were calculated. Results A total of 2,444 unaffected individuals with 15,519 person-years (6.5 years median follow-up) yielded 14 incident NPC cases (nearly 11 times the general population rate). The absolute rate of NPC among anti-EBV EBNA1 IgA seropositives using a standard positivity cutoff versus an optimized cutoff point defined by ROC analyses was 265/100,000 person-years with a 4.7-fold increased risk of NPC (95% CI: 1.4–16) and 166/100,000 person-years with a 6.6-fold increase (95% CI: 1.5–61), respectively. Sensitivity and specificity using the optimized positivity cutoff points were 85.7% and 51.2%, respectively. It is estimated that active evaluation of 49% of individuals from high-risk NPC families seropositive for this marker could lead to earlier detection of up to 86% of NPC cases. Risks associated with the other three EBV markers were weaker. Conclusions Future efforts are needed to identify susceptibility markers among high-risk NPC families that maximize both sensitivity and specificity. PMID:21447725

  11. 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

  12. 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

  13. 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

  14. 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

  15. Maternal Attitudes and Child Development in High Risk Families.

    ERIC Educational Resources Information Center

    Newman, Lawrence S.; Ramey, Craig T.

    The purpose of this study is to understand how parental attitudes affect the development of children at risk for psychosocial retardation. The investigation employs measures of maternal attitudes toward self, toward parenting, toward the child, a measure of the quality of the home environment, and measures of children's self-concept, school…

  16. Overcoming the Odds: High Risk Children from Birth to Adulthood.

    ERIC Educational Resources Information Center

    Werner, Emmy E.; Smith, Ruth S.

    The lives of 505 individuals born in 1955 on the island of Kauai (Hawaii) were followed from the prenatal period to adulthood to elucidate their resilience in the face of childhood adversity or their recovery in later years. The Kauai Longitudinal Study monitored the impact of a variety of biological and psychosocial risk factors, stressful life…

  17. Low High-Density Lipoprotein and Risk of Myocardial Infarction

    PubMed Central

    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. PMID:26692765

  18. 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. PMID:26692765

  19. 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.

  20. 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…

  1. 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…

  2. Targeting Oral Language Development in High-Risk Preschoolers

    ERIC Educational Resources Information Center

    Collins, Molly F.; Dennis, Sarah E.

    2009-01-01

    Among risk factors associated with reading difficulties, poverty and underdeveloped oral language skills can be particularly detrimental to reading success. The City Early Reading First (CERF) project implemented a comprehensive curriculum, professional development, intensive mentoring, and home supports to enhance children's language, literacy,…

  3. 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…

  4. High Blood Pressure, Afib and Your Risk of Stroke

    MedlinePlus

    ... is generally considered the most common controllable risk factor for stroke, but atrial fibrillation is the most powerful, said Ralph L. Sacco, M.D., professor and chairman of neurology at the Miller School of Medicine at the University of Miami and past president of the American ...

  5. An examination of the Clinical Impairment Assessment among women at high risk for eating disorder onset

    PubMed Central

    Vannucci, Anna; Kass, Andrea E.; Sinton, Meghan M.; Aspen, Vandana; Weisman, Hannah; Bailey, Jakki O.; Wilfley, Denise E.; Taylor, C. Barr

    2013-01-01

    Identifying measures that reliably and validly assess clinical impairment has important implications for eating disorder (ED) diagnosis and treatment. The current study examined the psychometric properties of the Clinical Impairment Assessment (CIA) in women at high risk for ED onset. Participants were 543 women (20.6 ± 2.0 years) who were classified into one of three ED categories: clinical ED, high risk for ED onset, and low risk control. Among high risk women, the CIA demonstrated high internal consistency (α = 0.93) and good convergent validity with disordered eating attitudes (rs = 0.27–0.68, ps < 0.001). Examination of the CIA’s discriminant validity revealed that CIA global scores were highest among women with a clinical ED (17.7 ± 10.7) followed by high risk women (10.6 ± 8.5) and low risk controls (3.0 ± 3.3), respectively (p < 0.001). High risk women reporting behavioral indices of ED psychopathology (objective and/or subjective binge episodes, purging behaviors, driven exercise, and ED treatment history) had higher CIA global scores than those without such indices (ps < 0.05), suggesting good criterion validity. These data establish the first norms for the CIA in a United States sample. The CIA is psychometrically sound among high risk women, and heightened levels of impairment among these individuals as compared to low risk women verify the relevance of early intervention efforts. PMID:22516320

  6. Evolving treatment strategies in patients with high-risk acute myeloid leukemia.

    PubMed

    Schiller, Gary J

    2014-11-01

    Acute myeloid leukemia (AML) is defined by a set of biologically distinct diseases characterized by maturation arrest and clonal proliferation of myeloid cells. Recommendations for post-remission therapy depend on assessing the leukemia risk characteristics, such as cytogenetics and molecular features present at diagnosis. Patients with high-risk disease include those whose leukemia is characterized by monosomal karyotype or poor-risk cytogenetic or molecular abnormalities, patients with antecedent hematologic disorders or therapy-related AML, and presence of adverse host factors, such as comorbidities, impaired performance status or older age. Older patients are more likely to have these adverse features. High-risk AML responds poorly to available induction treatment and is likely to relapse despite consolidation therapy. Current data support an increasing understanding of prognosis but have not yet resulted in effective therapies for patients with high-risk disease. This review discusses current therapies and evolving treatment strategies for high-risk AML.

  7. 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.

  8. Refining Neurobehavioral Assessment of the High-Risk Infant Using the NICU Network Neurobehavioral Scale.

    PubMed

    Sullivan, Mary C; Miller, Robin J; Fontaine, Lynne Andreozzi; Lester, Barry

    2012-01-01

    Nurses caring for high-risk infants use advanced assessment skills to identify the nature of infant instability and to assure timely intervention. The NICU Network Neurobehavioral Scale (NNNS) is a comprehensive assessment of neurological integrity and behavioral function of infants at risk. Research evidence supports its validity and reliability for clinical and research use. The NNNS offers nurses a neurobehavioral assessment especially suited to high-risk and premature infants.

  9. Post-Transplant Outcomes in High-Risk Compared with Non-High-Risk Multiple Myeloma: A CIBMTR Analysis.

    PubMed

    Scott, Emma C; Hari, Parameswaran; Sharma, Manish; Le-Rademacher, Jennifer; Huang, Jiaxing; Vogl, Dan; Abidi, Muneer; Beitinjaneh, Amer; Fung, Henry; Ganguly, Siddhartha; Hildebrandt, Gerhard; Holmberg, Leona; Kalaycio, Matt; Kumar, Shaji; Kyle, Robert; Lazarus, Hillard; Lee, Cindy; Maziarz, Richard T; Meehan, Kenneth; Mikhael, Joseph; Nishihori, Taiga; Ramanathan, Muthalagu; Usmani, Saad; Tay, Jason; Vesole, David; Wirk, Baldeep; Yared, Jean; Savani, Bipin N; Gasparetto, Cristina; Krishnan, Amrita; Mark, Tomer; Nieto, Yago; D'Souza, Anita

    2016-10-01

    Conventional cytogenetics and interphase fluorescence in situ hybridization (FISH) identify high-risk multiple myeloma (HRM) populations characterized by poor outcomes. We analyzed these differences among HRM versus non-HRM populations after upfront autologous hematopoietic cell transplantation (autoHCT). Between 2008 and 2012, 715 patients with multiple myeloma identified by FISH and/or cytogenetic data with upfront autoHCT were identified in the Center for International Blood and Marrow Transplant Research database. HRM was defined as del17p, t(4;14), t(14;16), hypodiploidy (<45 chromosomes excluding -Y) or chromosome 1 p and 1q abnormalities; all others were non-HRM. Among 125 HRM patients (17.5%), induction with bortezomib and immunomodulatory agents (imids) was higher compared with non-HRM (56% versus 43%, P < .001) with similar pretransplant complete response (CR) rates (14% versus 16%, P .1). At day 100 post-transplant, at least a very good partial response was 59% in HRM and 61% in non-HRM (P = .6). More HRM patients received post-transplant therapy with bortezomib and imids (26% versus 12%, P = .004). Three-year post-transplant progression-free (PFS) and overall survival (OS) rates in HRM versus non-HRM were 37% versus 49% (P < .001) and 72% versus 85% (P < .001), respectively. At 3 years, PFS for HRM patients with and without post-transplant therapy was 46% (95% confidence interval [CI], 33 to 59) versus 14% (95% CI, 4 to 29) and in non-HRM patients with and without post-transplant therapy 55% (95% CI, 49 to 62) versus 39% (95% CI, 32 to 47); rates of OS for HRM patients with and without post-transplant therapy were 81% (95% CI, 70 to 90) versus 48% (95% CI, 30 to 65) compared with 88% (95% CI, 84 to 92) and 79% (95% CI, 73 to 85) in non-HRM patients with and without post-transplant therapy, respectively. Among patients receiving post-transplant therapy, there was no difference in OS between HRM and non-HRM (P = .08). In addition to

  10. Post-Transplant Outcomes in High-Risk Compared with Non-High-Risk Multiple Myeloma: A CIBMTR Analysis.

    PubMed

    Scott, Emma C; Hari, Parameswaran; Sharma, Manish; Le-Rademacher, Jennifer; Huang, Jiaxing; Vogl, Dan; Abidi, Muneer; Beitinjaneh, Amer; Fung, Henry; Ganguly, Siddhartha; Hildebrandt, Gerhard; Holmberg, Leona; Kalaycio, Matt; Kumar, Shaji; Kyle, Robert; Lazarus, Hillard; Lee, Cindy; Maziarz, Richard T; Meehan, Kenneth; Mikhael, Joseph; Nishihori, Taiga; Ramanathan, Muthalagu; Usmani, Saad; Tay, Jason; Vesole, David; Wirk, Baldeep; Yared, Jean; Savani, Bipin N; Gasparetto, Cristina; Krishnan, Amrita; Mark, Tomer; Nieto, Yago; D'Souza, Anita

    2016-10-01

    Conventional cytogenetics and interphase fluorescence in situ hybridization (FISH) identify high-risk multiple myeloma (HRM) populations characterized by poor outcomes. We analyzed these differences among HRM versus non-HRM populations after upfront autologous hematopoietic cell transplantation (autoHCT). Between 2008 and 2012, 715 patients with multiple myeloma identified by FISH and/or cytogenetic data with upfront autoHCT were identified in the Center for International Blood and Marrow Transplant Research database. HRM was defined as del17p, t(4;14), t(14;16), hypodiploidy (<45 chromosomes excluding -Y) or chromosome 1 p and 1q abnormalities; all others were non-HRM. Among 125 HRM patients (17.5%), induction with bortezomib and immunomodulatory agents (imids) was higher compared with non-HRM (56% versus 43%, P < .001) with similar pretransplant complete response (CR) rates (14% versus 16%, P .1). At day 100 post-transplant, at least a very good partial response was 59% in HRM and 61% in non-HRM (P = .6). More HRM patients received post-transplant therapy with bortezomib and imids (26% versus 12%, P = .004). Three-year post-transplant progression-free (PFS) and overall survival (OS) rates in HRM versus non-HRM were 37% versus 49% (P < .001) and 72% versus 85% (P < .001), respectively. At 3 years, PFS for HRM patients with and without post-transplant therapy was 46% (95% confidence interval [CI], 33 to 59) versus 14% (95% CI, 4 to 29) and in non-HRM patients with and without post-transplant therapy 55% (95% CI, 49 to 62) versus 39% (95% CI, 32 to 47); rates of OS for HRM patients with and without post-transplant therapy were 81% (95% CI, 70 to 90) versus 48% (95% CI, 30 to 65) compared with 88% (95% CI, 84 to 92) and 79% (95% CI, 73 to 85) in non-HRM patients with and without post-transplant therapy, respectively. Among patients receiving post-transplant therapy, there was no difference in OS between HRM and non-HRM (P = .08). In addition to

  11. 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…

  12. 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…

  13. 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.

  14. 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…

  15. 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.…

  16. 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:…

  17. 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…

  18. Schizophrenia in High-Risk Children: Sex Differences in Predisposing Factors.

    ERIC Educational Resources Information Center

    Mednick, Sarnoff A.; And Others

    Reported is a research program to observe children at high risk for schizophrenia and explore possibilities of prevention. Characteristics of the high risk group (n=207) observed during 1962 are discussed, and a theory which suggests that schizophrenia is an evasion of life is explained. Among results of a diagnostic assessment conducted 10 years…

  19. 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…

  20. Academic and Social Outcomes for High-Risk Youths in Manitoba

    ERIC Educational Resources Information Center

    Brownell, Marni D.; Roos, Noralou P.; MacWilliam, Leonard; Leclair, Leanne; Ekuma, Okechukwu; Fransoo, Randy

    2010-01-01

    This study examined academic and social outcomes for high-risk youths in Manitoba, using longitudinal, population-based data. All children born in Manitoba in 1984-1985 who resided in Winnipeg the year they turned 18 were included in analyses (N = 11,703). High risk youths were defined as those involved with child welfare services, living in…

  1. Managing caries in the high-risk child.

    PubMed

    Duffin, Steven

    2009-03-01

    Dentists often report that treating children in their practices is either the most rewarding or the most challenging of all their professional experiences. Special considerations must be made for the biology of the caries process, the psychological development of the child, parental involvement, the complex environmental factors that contribute to caries, and the wide variety of clinical treatment options available. Caries management by risk assessment (CAMBRA) is becoming the standard of care for dental professionals. Although significant progress has been made against caries in the past 30 years, very resistant pockets of disease remain in certain demographics. This article presents a number of different clinical scenarios, which will explore diagnostic and restorative protocols that apply to children who are at risk for caries.

  2. The risk of retina damage from high intensity light sources.

    PubMed

    Pollak, V A; Romanchuk, K G

    1980-05-01

    The risk of thermal damage to the retina of the eye by exposure to excessive light intensities from continuous and pulsed man-made sources is discussed. The probability of injury increases, the larger the radiant power absorbed by the retina and the smaller the size of the retinal image of the source. A mehtod of estimating the temperature increase of the immediately affected area of the retina is presented. The time constants involved are also briefly considered. Using numerical values from literature for the relevant parameters of the eye, threshold values for a variety of conditions can be established. Below these values little risk of retina damage should exist. The degree of hazard when these values are exceeded depends upon the circumstances. A case study of a welding accident showed good agreement between the conclusions of the theoretical analysis and clinical findings.

  3. 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

  4. 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

  5. Parental bonds in children at high and low familial risk for panic disorder.

    PubMed

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H; Flament, Martine F; Bradwejn, Jacques

    2013-04-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n = 71) and children of parents with no psychiatric history (n = 80) participated in the study. Results indicate that high risk children do not perceive their parents as being more protective and less caring than low risk controls. The optimal bonding type (high care, low protection) was the most frequently reported parenting style across groups. The constraining type of maternal bonding (high care, high protection) was less frequently reported by high risk children (p < 0.05). Overall, these data suggest that parental PD does not compromise the parent-child bonds in never-ill offspring. PMID:22837072

  6. Switching patients at high risk of PML from natalizumab to another disease-modifying therapy.

    PubMed

    Giovannoni, Gavin; Marta, Monica; Davis, Angharad; Turner, Benjamin; Gnanapavan, Sharmilee; Schmierer, Klaus

    2016-10-01

    There are several options for switching people with multiple sclerosis (MS) who are at high risk of developing progressive multifocal leukoencephalopathy (PML) from natalizumab to alemtuzumab. However, some of these have risks that need to be managed, for example, the risks of carrying over asymptomatic PML from natalizumab on to the new therapy, and the risk of rebound disease activity associated with a prolonged washout after starting natalizumab. We propose a pragmatic bridging strategy, using another disease-modifying therapy (DMT), to reduce the risk of switching from natalizumab to alemtuzumab. We also discuss the caveats and subtleties associated with sequencing DMTs in MS and the complex decision making involved. PMID:27114560

  7. Preventing Violence Among High-Risk Youth and Communities with Economic, Policy, and Structural Strategies.

    PubMed

    Massetti, Greta M; David-Ferdon, Corinne

    2016-02-12

    Youth violence is preventable, and the reduction of health disparities is possible with evidence-based approaches. Achieving community-wide reductions in youth violence and health disparities has been limited in part because of the lack of prevention strategies to address community risk factors. CDC-supported research has resulted in three promising community-level approaches: Business Improvement Districts (BIDs) in Los Angeles, California; alcohol policy to reduce youth access in Richmond, Virginia; and the Safe Streets program in Baltimore, Maryland. Evaluation findings indicated that BIDs in Los Angeles were associated with a 12% reduction in robberies (one type of violent crime) and an 8% reduction in violent crime overall. In Richmond's alcohol policy program, investigators found that the monthly average of ambulance pickups for violent injuries among youth aged 15-24 years had a significantly greater decrease in the intervention (19.6 to 0 per 1,000) than comparison communities (7.4 to 3.3 per 1,000). Investigators of Safe Streets found that some intervention communities experienced reductions in homicide and/or nonfatal shootings, but results were not consistent across communities. Communitywide rates of violence can be changed in communities with disproportionately high rates of youth violence associated with entrenched health disparities and socioeconomic disadvantage. Community-level strategies are a critical part of comprehensive approaches necessary to achieve broad reductions in violence and health disparities.

  8. Monitoring high-risk patients: minimally invasive and non-invasive possibilities.

    PubMed

    Renner, Jochen; Grünewald, Matthias; Bein, Berthold

    2016-06-01

    Over the past decades, there has been considerable progress in the field of less invasive haemodynamic monitoring technologies. Substantial evidence has accumulated, which supports the continuous measurement and optimization of flow-based variables such as stroke volume, that is, cardiac output, in order to prevent occult hypoperfusion and consequently to improve patients' outcome in the perioperative setting. However, there is a striking gap between the developments in haemodynamic monitoring and the increasing evidence to implement defined treatment protocols based on the measured variables, and daily clinical routine. Recent trials have shown that perioperative morbidity and mortality is higher than anticipated. This emphasizes the need for the anaesthesia community to address this issue and promotes the implementation of proven concepts into clinical practice in order to improve patients' outcome, especially in high-risk patients. The advances in minimally invasive and non-invasive monitoring techniques can be seen as a driving force in this respect, as the degree of invasiveness of any monitoring tool determines the frequency of its application, especially in the operating room (OR). From this point of view, we are very confident that some of these minimally invasive and non-invasive haemodynamic monitoring technologies will become an inherent part of our monitoring armamentarium in the OR and in the intensive care unit (ICU). PMID:27396807

  9. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance.

    PubMed

    Huh, Warner K; Ault, Kevin A; Chelmow, David; Davey, Diane D; Goulart, Robert A; Garcia, Francisco A; Kinney, Walter K; Massad, L Stewart; Mayeaux, Edward J; Saslow, Debbie; Schiffman, Mark; Wentzensen, Nicolas; Lawson, Herschel W; Einstein, Mark H

    2015-04-01

    In 2011, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology updated screening guidelines for the early detection of cervical cancer and its precursors. Recommended screening strategies were cytology or cotesting (cytology in combination with high-risk HPV (hrHPV) testing). These guidelines also addressed the use of hrHPV testing alone as a primary screening approach, which was not recommended for use at that time. There is now a growing body of evidence for screening with primary hrHPV testing, including a prospective US-based registration study. Thirteen experts including representatives from the Society of Gynecologic Oncology, American Society for Colposcopy and Cervical Pathology, American College of Obstetricians and Gynecologists, American Cancer Society, American Society of Cytopathology, College of American Pathologists, and the American Society for Clinical Pathology, convened to provide interim guidance for primary hrHPV screening. This guidance panel was specifically triggered by an application to the FDA for a currently marketed HPV test to be labeled for the additional indication of primary cervical cancer screening. Guidance was based on literature review and review of data from the FDA registration study, supplemented by expert opinion. This document aims to provide information for health care providers who are interested in primary hrHPV testing and an overview of the potential advantages and disadvantages of this strategy for screening as well as to highlight areas in need of further investigation.

  10. Cortical thickness reduction in individuals at ultra-high-risk for psychosis.

    PubMed

    Jung, Wi Hoon; Kim, June Sic; Jang, Joon Hwan; Choi, Jung-Seok; Jung, Myung Hun; Park, Ji-Young; Han, Ji Yeon; Choi, Chi-Hoon; Kang, Do-Hyung; Chung, Chun Kee; Kwon, Jun Soo

    2011-07-01

    Although schizophrenia is characterized by gray matter (GM) abnormalities, particularly in the prefrontal and temporal cortices, it is unclear whether cerebral cortical GM is abnormal in individuals at ultra-high-risk (UHR) for psychosis. We addressed this issue by studying cortical thickness in this group with magnetic resonance imaging (MRI). We measured cortical thickness of 29 individuals with no family history of psychosis at UHR, 31 patients with schizophrenia, and 29 healthy matched control subjects using automated surface-based analysis of structural MRI data. Hemispheric mean and regional cortical thickness were significantly different according to the stage of the disease. Significant cortical differences across these 3 groups were found in the distributed area of cerebral cortices. UHR group showed significant cortical thinning in the prefrontal cortex, anterior cingulate cortex, inferior parietal cortex, parahippocampal cortex, and superior temporal gyrus compared with healthy control subjects. Significant cortical thinning in schizophrenia group relative to UHR group was found in all the regions described above in addition with posterior cingulate cortex, insular cortex, and precentral cortex. These changes were more pronounced in the schizophrenia group compared with the control subjects. These findings suggest that UHR is associated with cortical thinning in regions that correspond to the structural abnormalities found in schizophrenia. These structural abnormalities might reflect functional decline at the prodromal stage of schizophrenia, and there may be progressive thinning of GM cortex over time. PMID:20026559

  11. Work and High-Risk Alcohol Consumption in the Canadian Workforce

    PubMed Central

    Marchand, Alain; Parent-Lamarche, Annick; Blanc, Marie-Ève

    2011-01-01

    This study examined the associations between occupational groups; work-organization conditions based on task design; demands, social relations, and gratifications; and weekly high-risk alcohol consumption among Canadian workers. A secondary data analysis was performed on Cycle 2.1 of the Canadian Community Health Survey conducted by Statistics Canada in 2003. The sample consisted of 76,136 employees 15 years of age and older nested in 2,451 neighbourhoods. High-risk alcohol consumption is defined in accordance with Canadian guidelines for weekly low-risk alcohol consumption. The prevalence of weekly high-risk alcohol consumption is estimated to be 8.1% among workers. The results obtained using multilevel logistic regression analysis suggest that increased work hours and job insecurity are associated with elevated odds of high-risk alcohol consumption. Gender female, older age, being in couple and living with children associated with lower odds of high-risk drinking, while increased education, smoking, physical activities, and, and economic status were associated with higher odds. High-risk drinking varied between neighbourhoods, and gender moderates the contribution of physical demands. The results suggest that work made a limited contribution and non-work factors a greater contribution to weekly high-risk alcohol consumption. Limits and implications of these results are discussed. PMID:21845153

  12. The relationship between discrimination and high-risk social ties by race/ethnicity: examining social pathways of HIV risk.

    PubMed

    Crawford, Natalie D; Galea, Sandro; Ford, Chandra L; Latkin, Carl; Link, Bruce G; Fuller, Crystal

    2014-02-01

    High-risk social ties portend differences in opportunity for HIV exposures and may contribute to racial/ethnic disparities in HIV transmission. Discrimination may affect the formation of high-risk social ties and has not been explored as a possible explanation for these persistent disparities. Using data from injection and non-injection drug users, we examined the association between the number of high-risk sex and drug ties with discrimination due to race, drug use, and incarceration stratified by race/ethnicity. Negative binomial regression models were used. While blacks had significantly fewer injecting ties than Latinos and whites, blacks who reported racial discrimination compared to blacks who did not, had more sex and injecting ties. Latinos who reported drug use discrimination compared to Latinos who did not also had more sex ties. Latinos and whites who reported drug use discrimination had more injecting ties than Latinos and whites who did not. Discrimination is associated with high-risk social ties among all racial/ethnic groups. But, these data highlight different forms of discrimination within racial/ethnic group are associated with risky social ties. More research is needed to confirm these findings and further explore the association between various forms of discrimination and social ties that may help explain racial/ethnic disparities in HIV.

  13. Parachuting: High Risk in Free-Flying Sport.

    PubMed

    Evenson, L

    1983-10-01

    Highly maneuverable parachutes and lighter equipment have increased the popularity of parachuting. Most injuries are to the lower extremity and are caused by high-speed landings, poor technique, and incorrect foot position on impact.

  14. High Throughput Screening For Hazard and Risk of Environmental Contaminants

    EPA Science Inventory

    High throughput toxicity testing provides detailed mechanistic information on the concentration response of environmental contaminants in numerous potential toxicity pathways. High throughput screening (HTS) has several key advantages: (1) expense orders of magnitude less than an...

  15. Parachuting: High Risk in Free-Flying Sport.

    PubMed

    Evenson, L

    1983-10-01

    Highly maneuverable parachutes and lighter equipment have increased the popularity of parachuting. Most injuries are to the lower extremity and are caused by high-speed landings, poor technique, and incorrect foot position on impact. PMID:27442481

  16. Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma

    PubMed Central

    Fonseca, Rafael; Siegel, David; Dimopoulos, Meletios A.; Špička, Ivan; Masszi, Tamás; Hájek, Roman; Rosiñol, Laura; Goranova-Marinova, Vesselina; Mihaylov, Georgi; Maisnar, Vladimír; Mateos, Maria-Victoria; Wang, Michael; Niesvizky, Ruben; Oriol, Albert; Jakubowiak, Andrzej; Minarik, Jiri; Palumbo, Antonio; Bensinger, William; Kukreti, Vishal; Ben-Yehuda, Dina; Stewart, A. Keith; Obreja, Mihaela; Moreau, Philippe

    2016-01-01

    The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24%) were categorized with high-risk cytogenetics (KRd, n = 48; Rd, n = 52) and 317 (76%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2% vs 59.6% (high-risk cytogenetics) and 91.2% vs 73.5% (standard-risk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2% vs 5.8% and 38.1% vs 6.5%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01080391. PMID:27439911

  17. Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma.

    PubMed

    Avet-Loiseau, Hervé; Fonseca, Rafael; Siegel, David; Dimopoulos, Meletios A; Špička, Ivan; Masszi, Tamás; Hájek, Roman; Rosiñol, Laura; Goranova-Marinova, Vesselina; Mihaylov, Georgi; Maisnar, Vladimír; Mateos, Maria-Victoria; Wang, Michael; Niesvizky, Ruben; Oriol, Albert; Jakubowiak, Andrzej; Minarik, Jiri; Palumbo, Antonio; Bensinger, William; Kukreti, Vishal; Ben-Yehuda, Dina; Stewart, A Keith; Obreja, Mihaela; Moreau, Philippe

    2016-09-01

    The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24%) were categorized with high-risk cytogenetics (KRd, n = 48; Rd, n = 52) and 317 (76%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2% vs 59.6% (high-risk cytogenetics) and 91.2% vs 73.5% (standard-risk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2% vs 5.8% and 38.1% vs 6.5%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01080391. PMID:27439911

  18. Easy and fast detection and genotyping of high-risk human papillomavirus by dedicated DNA microarrays.

    PubMed

    Albrecht, Valérie; Chevallier, Anne; Magnone, Virginie; Barbry, Pascal; Vandenbos, Fanny; Bongain, André; Lefebvre, Jean-Claude; Giordanengo, Valérie

    2006-11-01

    Persistent cervical high-risk human papillomavirus (HPV) infection is correlated with an increased risk of developing a high-grade cervical intraepithelial lesion. A two-step method was developed for detection and genotyping of high-risk HPV. DNA was firstly amplified by asymmetrical PCR in the presence of Cy3-labelled primers and dUTP. Labelled DNA was then genotyped using DNA microarray hybridization. The current study evaluated the technical efficacy of laboratory-designed HPV DNA microarrays for high-risk HPV genotyping on 57 malignant and non-malignant cervical smears. The approach was evaluated for a broad range of cytological samples: high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and atypical squamous cells of high-grade (ASC-H). High-risk HPV was also detected in six atypical squamous cells of undetermined significance (ASC-US) samples; among them only one cervical specimen was found uninfected, associated with no histological lesion. The HPV oligonucleotide DNA microarray genotyping detected 36 infections with a single high-risk HPV type and 5 multiple infections with several high-risk types. Taken together, these results demonstrate the sensitivity and specificity of the HPV DNA microarray approach. This approach could improve clinical management of patients with cervical cytological abnormalities. PMID:16879879

  19. Engineered nanoconstructs for the multiplexed and sensitive detection of high-risk pathogens

    NASA Astrophysics Data System (ADS)

    Seo, Youngmin; Kim, Ji-Eun; Jeong, Yoon; Lee, Kwan Hong; Hwang, Jangsun; Hong, Jongwook; Park, Hansoo; Choi, Jonghoon

    2016-01-01

    Many countries categorize the causative agents of severe infectious diseases as high-risk pathogens. Given their extreme infectivity and potential to be used as biological weapons, a rapid and sensitive method for detection of high-risk pathogens (e.g., Bacillus anthracis, Francisella tularensis, Yersinia pestis, and Vaccinia virus) is highly desirable. Here, we report the construction of a novel detection platform comprising two units: (1) magnetic beads separately conjugated with multiple capturing antibodies against four different high-risk pathogens for simple and rapid isolation, and (2) genetically engineered apoferritin nanoparticles conjugated with multiple quantum dots and detection antibodies against four different high-risk pathogens for signal amplification. For each high-risk pathogen, we demonstrated at least 10-fold increase in sensitivity compared to traditional lateral flow devices that utilize enzyme-based detection methods. Multiplexed detection of high-risk pathogens in a sample was also successful by using the nanoconstructs harboring the dye molecules with fluorescence at different wavelengths. We ultimately envision the use of this novel nanoprobe detection platform in future applications that require highly sensitive on-site detection of high-risk pathogens.

  20. Holographic content addressable storage

    NASA Astrophysics Data System (ADS)

    Chao, Tien-Hsin; Lu, Thomas; Reyes, George

    2015-03-01

    We have developed a Holographic Content Addressable Storage (HCAS) architecture. The HCAS systems consists of a DMD (Digital Micromirror Array) as the input Spatial Light Modulator (SLM), a CMOS (Complementary Metal-oxide Semiconductor) sensor as the output photodetector and a photorefractive crystal as the recording media. The HCAS system is capable of performing optical correlation of an input image/feature against massive reference data set stored in the holographic memory. Detailed system analysis will be reported in this paper.